Scratch Test for Histamine-Positive Skin

/by William Rassman, M.D./0 /,

What is the scratch test you mentioned in a previous post?

I refer to the test as one used to discover a histamine positive skin type. The simple test is done by scratching the skin with a finger nail (for example) with moderate pressure, but not enough to cut into the skin. The skin will develop a red-streak within a minute surrounding the finger nail scratch. This, I believe, is local release of vasodilators at the skin edge. I have noted in my practice that people who react to the scratch with a red streak are the ones who tend to remain more pink after a hair transplant. When I transplant these patients, I will often use copper peptide dressing, which I have found gets the pink out sooner in these patients. I have had patients who were positive to the scratch test who were not treated after their first surgery and then when I did their surgery a second or third time, the addition of (1) copper peptide dressings after surgery and (2) the use of high dose steroids at surgery has helped minimize the pink discoloration over time. My view of copper peptide is not shared by many doctors, suggesting that what I observed have not been their observations and their experience.

Tags: histamine, hairtransplant, hair transplant, copper peptide, healing

Removed My Hairline with Laser Removal, Now I Want to Cover the Scars

/by William Rassman, M.D./0 /,

Hi Dr. Rassman…..I have a bit of a problem and I’d like your advice. I recieved two hair transplants in the 90’s and wound up with a low hairline. I’m 32 years old and a natural norwood 3/4. I just recently removed my hairline via laser hair removal. I’m now dealing with the underlying skin which is scarred. It’s not terrible but I’m very self conscious. I’ve decided on another hair transplant. I’d like to bring the hairline down to where it was to cover any scars. I’m thinking low density with good coverage. My doc estimates that I have about 4000 donor grafts left. Any feedback would be greatly appreciated.

It is difficult without pictures or seeing you in person to render an opinion that has real value to you. You can excise the frontal scarred hairline (done frequently) and then have those grafts transplanted with a normal soft transition zone of 1, 2, and 3 hair units. As you are on the east coast, Dr. Robert Bernstein in NY might be worth visiting for a second opinion. If you make it out to California, I’d be happy to see you.

Tags: hairline, laser, bernstein, new york, newyork, hairtransplant, hair transplant

Traction Alopecia in Teenager

/by William Rassman, M.D./0 /

Hi,
I am 15 and I have traction alopecia. I got it because I am of Sikh decent and I recently cut off my tightly tyed hair. I have bald spots in the back of my head, on my forhead, and the front of my sides by my forehead. I am desperate for help as Im just 15 and I want to do things with my hair. Right now I just have long hair to cover things up. Please tell me any medicines like rogaine or something that will help. Thanks

Traction alopecia in many young Sikhs may be permanent, even at your age. If you have not worn the turban for more than a year and no hair has grown back, chances are that only a hair transplant will solve the problem. Many Sikhs have this problem. You may consider seeing a hair restoration doctor (with your mother/father) to consider surgical options.

Tags: hairloss, hair loss, sikh, turban, alopecia, teen

Grafting Skin from Elsewhere to the Transplant Scar

/by William Rassman, M.D./0 /,

Dr. Rassman- I have no background in medicine, so I apologize if this might be a stupid question. I have a thin transplant scar on the back of my head and would like to shave my head. Would it be possible to do a scar revision that would involve taking skin and tissue from say my upper back and grafting it to the HT donor scar? Would that then leave minimal scarring? I know they do similiar type of work for burn patients.

You are semi-correct in stating that burn patients get skin grafting. However the burn patients still end up with a scar that is quite visible. To clarify, ALL scars and ALL cuts will be visible and unavoidable. Once you have scar on your scalp (as you have a linear strip surgery scar) it is impossible to hide if you shave your head. The best approach is to minimize the scar as much as possible with a scar revision (if indicated). Also you can consider FUE/FOX into the scar. FUE/FOX scars are scattered dots which are less than 1mm and are in random distribution, thus it does not stand out as a linear scar. Keep in mind if you SHAVE your head you will still have a scar.

Tags: fue, fox, follicular unit extraction, hairloss, hair loss, hairtransplant, hair transplant, scar

Hair Loss On One Side of Head

/by William Rassman, M.D./0 /,

i’m 25. i started noticing thinning hair in the temple area at the age of 21-22 so i shaved my hair. i kept it like that for 2 years. i started taking propecia for 12 months while my hair was shaved and added rogaine in to that. After the 2 year period i let my hair grow out and to my surprise the front temple hair line looked good. i kept it long for a couple of months, but after a while i started losing hair again on my right hand side. keep in mind i’m still using propecia and rogaine. i want to know if its a faze that my hair has to go through, or if this hair loss is gonna be permanent. its only happening on one side of my head.

The frontal hairline is often not symmetrical You need to evaluate your scalp with miniaturization studies to see just where your hair loss is going. The focused question is — Where are you going with your hair loss? You need a few measurements over time to find out if the Propecia is failing to work. If the hairline has gone up quite a bit, you might be a candidate for a hair transplant, but first you need to be evaluated. Dr. Pak and I are based in Southern California (as you’ve indicated that you were), so please consider paying us a visit.

Tags: hairloss, hair loss, symmetrical, hairline, propecia, finasteride

Safe to Color My Hair After Hair Loss from Hyperthyroidism?

/by William Rassman, M.D./0 /,

(female) I have hyperthyroidism my hair was falling out something terrible. I’ve been on medication for almost a year. It has improved alot, would it be safe to color my hair?

A thyroid condition is one of the more common causes of hair loss in women. You may color your hair, provided that you use safe dyes.

Tags: thyroid, hairloss, hair loss, color, dye, women, woman, female

Nizoral Safety?

/by William Rassman, M.D./0 /,

Recently, I have noticed white spots all over my back and my chest. I personally believe that I caught a fungus from the tanning bed.

The dermatologist gave me a prescription for Nizoral tablets. His recommendation is to take two tablets, then exercise to sweat a couple hours after ingestion. Then, repeat the process with two more tablets one week later.

My questions is—are Nizoral tablets safe? I have heard that they are very taxing on the liver and may cause side-effects, one of which could be hairloss??? Will it most likely be safe for me to take this round of 4 tablets? Thank you

If a medical doctor prescribed you the medication for a condition he has diagnosed, then you should ask these questions and concerns to that doctor. I cannot stress enough the importance of a good patient to doctor relationship. BaldingBlog is not intended to give second medical opinions or diagnose medical problems. This site is here to educate the public from our professional experiences. That being said, anti-fungal medications are used to treat fungal infections. They may be toxic to the liver if taken in large doses and/or if you are particularly sensitive to that medication or have underlying liver problems. You should also know that other medications, such as Tylenol, are also toxic to the liver if taken in large doses.

Tags: nizoral, hairloss, hair loss, liver, safety

Does Sex Cause the Body To Produce More DHT?

/by William Rassman, M.D./3 /

Hello, i know that finasteride avoids the productions of dht by methods i cant explain with my bad english. The fact is that the DHT is needed for the erectile functions of the penis. How can i think that sex/masturbation dont make the body to produce more DHT to have reserves?

If that logic holds true, then all the bald men of the world must be sex addicts or rampant masturbators. Please excuse my humor, but your assumptions are erroneous. Increased DHT does not lead to erectile dysfunction. And increased sex or masturbation does not cause hair loss. Have fun!

Tags: masturbation, dht, sex, hairloss, hair loss

My Neck is Balding

/by William Rassman, M.D./0 /

I am 30 years old and since I was around 20 I’ve been able to grow a very thick, full beard. Within the past month or so I’ve begun to notice areas on my neck that are balding. Now more bald spots are appearing more regularly and are occurring very quickly (within 3 to 5 days). I have a clean bill of health as far as I know. Would there be any medical reason for the random hair loss? I am considering going to a dermatologist, but any other opinions would be appreciated. Thank you.

You can start with the dermatologist, as you suggested. The differential diagnosis is quite varied and it is possible that with the proper experience, a good dermatologist may make the diagnosis. Random patches of hair loss or hair loss in non-patterned areas may be a sign of other medical problems and/or conditions such as alopecia areata, ring worm, etc.

The progressive loss of neck hair may be a genetic process that starts in the middle of the neck (just below the notch at the base of the skull) and then moves outward. There will be miniaturization of the hairs in some pattern extending outward from the center. Eventually, the miniaturized hairs will fall out. This is a slower process than you are talking about, so it may not apply.

Tags: hairloss, hair loss, balding, neck, unpatterned, alopecia

Blood Tests to Determine if Propecia is Working?

/by William Rassman, M.D./1 /

I’m 19 and have been experiencing hair loss for about 4 months now and been on Propecia for about 2 and a half months. Since going on Propecia I feel like I’ve been shedding more (which I’ve read may be an indicator that its working, and may not). I’ve yet to get my scalp mapped for miniaturization and my hairline is not receding, just overall very noticable thinning. I’ve been told, the effects of Propecia won’t become noticable for 3 to 6 months, but its a pretty helpless feeling not knowing if its actually working. Are there any blood tests to measure your body’s DHT level to see if the Propecia is infact blocking it well enough to stop hair loss?

There are no blood tests that will tell you that it is working. At 19, I am sure that you expect everything to happen on command, but patience is a virtue and you have no choice but to wait. If you want to know for sure if it is working, you should have your hair mapped out for miniaturization and then take readings 8 months apart. If you do not establish the metrics, then just wait patiently for the 8th month and you should see the shedding slow down or the hair loss stopped (other than the normal 100 hairs or so everyone loses each and every day).

Tags: propecia, finasteride, hairloss, hair loss

Lowering Teen Hairline?

/by William Rassman, M.D./1 /,

(female) I am 15, gonna be 16 in march 2007, and i have an extremely high forehead. i would like to get that lowered. about how much can u lower the forehead? i would like 4 inches or so

To lower the hairline 4 inches can be done, but it would take a balloon expander to do this. That would make your head look like a basketball in front while the expanding balloon is stretching the forehead and scalp. Four inches is a great deal and probably unrealistic. The average female hairlines are lowered by about 1 inch. You need to be evaluated with your parents present, of course. This type of surgery (less aggressive) is done on teenagers.

Tags: hairline, lowering, female, women, woman, hairloss, hair loss

Thin Pubic Hair from Thyroid Disease

/by William Rassman, M.D./0 /

Dr:

I was diagnosed 10 years ago with thyroid disease. At that time, my hair came out terribly. I have remained on a maintenance dosage of Armour because my THS levels are always within lower limits of the normal range of functioning. Most of my hair, over the years has grown back, but it does not have the same thickness. Also, the top is thinner than the rest.

Additionally, my pubic hair thinned out years ago. However, it never grew back, and it began to gray. Is there something that can be done to thicken my pubic hair, stop the graying, and thicken the hair in the top of my head?

Thanks

The use of hair dyes is the only treatment for graying. What you are reporting with the hair in other parts of your body is a consequence of thyroid disease over the long term in some patients.

Tags: pubic, hairloss, hair loss, dye, thyroid

Happy Holidays from BaldingBlog!

/by William Rassman, M.D./0 /

It’s the holiday season, so we’re off today to be with family and friends. We’ll still post a few times a day for the rest of the week, and things will pick back up to the normal amount of posts on January 2nd.

Here’s hoping everyone a happy and safe Christmas, Hanukkah, Kwanzaa, or whatever it may be that you’re celebrating.

Happy Holidays!

I Based My Hair Transplant Doctor Decision on Promotional Materials

/by William Rassman, M.D./0 /,

i understand that you are under no obligation to answer my question, but i am a 27 year old male and just yesterday i had my first hair transplant of 1200 grafts. i went with [name removed], and made the huge mistake of basing my decision soley on their promotional material. now, everywhere i look says that theyre crooks and im going to wind up looking like a monster. could you provide any answers?

Today’s transplant by that particular medical group is much better than their internet reputation indicates. Even the groups which do large scale promotion are now performing much better work. Wait it out and have hope and faith. Next time, follow through with the type of investigation I outline in The Truth About Cheap Hair Transplants. You generally get what you will see when you meet the doctor’s patients and you should see enough of their patients (face to face) to get the type of quality work you need.

Tags: hairtransplant, hair transplant, hairloss, hair loss, doctor, promotion

Seborrheic Dermatitis and Hair Loss

/by William Rassman, M.D./2 /,

Hi Dr.I wanted to follow up with you. I wanted to let you know what I’ve found out after three trips to my primary care doctor. I gave blood twice and had it checked for thyroid, full panel scan, cancer and HIV to name a few. Plus chest x-rays.I have all normal levels and no HIV. I’ve been diagnosed with seborrheic dermatitis on my face and scalp. When I started using the brow conditioner is about the time my eyebrow hair started falling out. The areas it was applied, started flaking bad. I am still having hair loss in my eyebrow and some on my temple areas with itching. I hear hair loss is normal with seborrheic dermatitis? I notice the eyebrow hairs falling often have a piece of dry skin attached to the base. How long can I expect to have hair loss now that I’m being treated with desonide cream? Will the hair grow back once the seborrheic dermatitis clears? If not when can I consider scalp and eyebrow transplants. Will they be successful? Thanks.

The role of seborrheic dermatitis in hair loss is debated. Patients with seborrheic dermatitis may lose hair indirectly due to the inflammation of the skin that can accelerate telogen effluvium, which is reversible in most cases. The other mechanism of hair loss in these patients is through traction alopecia by scratching and rubbing hair. Traction alopecia is reversible in many cases. A small group of patients with baldness due to chronic traction alopecia may never grow hair back and a hair transplant may become necessary and could be done successfully after the skin inflammation is over. Before embarking on a transplant for the eyebrows, be sure that you have controlled the seborrheic dermatitis. This should be easy for a good dermatologist.

Tags: seborrheic, dermatitis, hairloss, hair loss