I’m getting a little tired of doctors saying there are no studies that demonstrate the effectiveness of LLLT on hair regrowth. They need simply do a medline search. A recent study of alopecia areata using intra-subject controls found regrowth on over 90% of the treatment bald spots and 0% regrowth on the control spots. Granted, they don’t understand why and the positive results come from studies using 308nm xenon-chloride excimer lasers to 904nm pulsed diode lasers. The doctors thaat don’t understand the significance of these results simply don’t understand experimental design.

Remember the birth defects from thalidimide that doctors endorsed and prescribed? Recall 20 years ago doctors said megadoses of vitamin C did nothing. Sometimes doctors are wrong and sometimes they are right, but opinions from individuals who have not read the research are of no value.

As I’ve said, the medical field is often referred to as the “practice” of medicine and not “science” of medicine. Thus, sometimes doctors do not know why certain treatments work and sometimes they are wrong in prescribing a treatment.

With respect to lasers, you can approach it from either a scientific perspective or a capitalistic perspective. From a scientific perspective, you mention a very important bullet point: the “experimental design”. Look behind the research method and the sponsors of said research and you may find conflicting sources of interest. With respect to the capitalistic perspective, it boils down to making money. It sounds harmless and it may be worth a try to many individuals, especially with these research papers, but you also forget how many research papers have gone scrutinized (as your thalidomide example). Research papers endorsed medications such as Celebrex (COX2 inhibitors), but in recent years controversy arose from risks associated with heart attacks.

You are correct in stating that sometimes doctors are wrong, but sometimes research papers are wrong. You can see this as a stalemate. You can see it as buyer beware. We all have choices and opinions.

Tags: laser, hairloss, hair loss, research, doctor, physician, thalidomide, alopecia, lllt, medline


It seems like every HT Doctor recommends someting differenet for post-op care of the new grafts…..such as…..Biotin Spray…..Saline Spray…..Graftcyte….Vitamin E Oil…..to nothing….etc.

What do you recommend for post-op care of the grafts?


Ritual danceYou are correct. Nearly every hair transplant doctor seems to recommend something different. There are no scientific studies that indicate that one post operative care is better than the other.

It is important to note the most critical part of a hair transplant surgery is during the procedure itself (the peri-operative care). Making sure that the surgical staff kept the grafts moist, wet, and cool at all times so they have the maximum chance at survival. Once the grafts have been transplanted in to the recipient area, it should be fine. All of the post-operative care is not as important as the peri-operative care. Even if you do nothing to at all, the transplanted hair should grow just as well. In my practice, I make sure the recipient sites are kept clean with daily washings with a mild soap. For over 15 years, we’ve consistently had great results! Perhaps it was the ritualistic hair growth dance and chanting I teach to all my patients. Ha!

Tags: hairloss, hair loss, hairtransplant, hair transplant, aftercare, graft

I just realized recently that after wearing a beanie (all types…polyester, cotton etc.) for a long period, my head becomes all sensitive. My brother experienced this too…and hypothesized that because the hair follicle is ‘pushed’ into one direction for so long, it becomes sensitive. It made me think…perhaps they (hair follicles) are really fragile? But then I think…this never happens when I wear a regular hat…do you have any idea why this happens?

BeanieMany of the Jewish faith wear yarmulkes, and the Pope wears a zucchetto (both are skullcaps), and they keep it on most of the time. These are loose fitting and non-constricting. If your beanie is tight, then maybe it is putting pressure on the peripheral nerves and causing your problem. I do not believe that there is any connection to the fabric, because you have used caps with different fabrics and still experience the same reaction. I don’t really have an answer for you, unfortunately, except for the too tight explanation, but you know how tight it is on your head. Covering part or all of the head is essentially the same, whether with a skullcap, beanie, or even a baseball cap.

Tags: beanie, skullcap, hat, cap, hairloss, hair loss, pain, irritation, sensitive

I have shedding/thining all over my top of head with no family history of MPB. I have an intense burning sensation in my scalp that is very painful. I have gone to three different dermatologists who have perscribed topical steroids and still no relief of pain or from thinning. Nerologists perscribed amitriptyline for the pain but is has worked very little. Is there any rational explaination for this hairloss and pain?

Head painYou need to be evaluated by a hair specialist to determine the pattern and type of your hair loss. You may be experiencing a typical pattern baldness that is aggravated by other medical disorders. Some medical conditions such as iron deficiency or skin inflammatory conditions can accelerate the hair loss in pattern baldness. If this is the case for you, treatment of the underlying cause may stop or slow down your hair loss. The next step is to get to the root of your underlying problem. I think your primary care doctor and dermatologist are the best people to start with.

Tags: hairloss, hair loss, scalp, pain, steroids

Hi Doctors,

I am a 23 year old male. I started taking Dr. Reddy’s 5mg Finasteride about a month ago in 1.5 mg doses. I have noticed that it has made my penis decrease in size in it’s flacid state (it’s like right after coming out of cold water), as well as a tightening of the scrotum.

I stopped for about a week and the problem went away. I tried to start taking it again today and the same problems occur.

I have heard of people feeling this tightness in the scrotum, but not the sympton of decrease in penis size. Have you heard of this before? Should I discontinue my use of the finasteride.

I highly doubt a small penis size is a reaction from finasteride or any drug for that matter. If stopping the drug solves the problem, then you made a decision between your penis and your hair. Trade-offs in life are always made. I’d say the penis is more important than the hair, but I really suggest you see a physician in person for an exam if you are concerned.

Tags: hairloss, hair loss, penis, finasteride, propecia, proscar

I am a 16 year old male and I’ve been noticing since about a week or two ago I’ve started losing much more hair than usual. When I take a shower, a lot more hair collects on the drain than ever used to before and when I comb my hair at least 10 hairs fall out. I’ve always had very thick and strong hair and it’s worrying me. I also notice that each hair that’s falling out is very thin and weak-looking. I have been using Head and Shoulders Intensive Care for a couple months now. Do you think it could be the cause?

ShampooI doubt that the shampoo causes your hair loss, but the underlying factors that make people use the shampoo may do that. Head and Shoulders shampoo is used for seborrheic dermatitis, which is an inflammatory disorder of the skin. This condition can possibly initiate hair loss or accelerate the loss due to the other causes.

Tags: shampoo, dermatitis, hairloss, hair loss

I am a 40 year old African-American male with a receeding hairline. I have been thinking about hair transplants, but am worried that they will not take or fall out as I relax (straighten) my hair. Will the chemicals in these relaxing products damage the hair grafts? Thanks … this site is incredibly helpful.

As long as you wait on using the relaxers for a few weeks it should not affect the hair grafts. People can color their hair 2+ weeks after hair transplants. Using relaxers is not much different.

Tags: hairtransplant, hair transplant, relaxer, dye, color

Boiling water

Does showering using hot water cause hairloss?

Not if you don’t burn your skin. Boiling water, perhaps — just a hot shower, no.

Tags: shower, hot, water, hairloss, hair loss

Dr Rassman on The Great American Dream VoteI received quite a few emails today from readers of Balding Blog that saw me on the new Great American Dream Vote television show last night on ABC. Thanks for writing in to let me know you saw the program. I was only on there for a few moments as part of the prize package for the dream winner named Russ, but it was a fun experience. Russ is a very nice 22 year old college student with significant hair loss — Norwood Class 6/7 balding pattern (Class 7 is the worst with only a 3 inch rim of normal hair around the side and back of the head and Russ is already close to that pattern).

The basic idea of the show is that a number of everyday folks are selected to go up on stage to tell the audience what their dream is (from opening a flower shop to opening a dog rescue shelter to having a full head of hair) — and eventually the contestants are narrowed down to only 2. Those 2 contestants are then voted for by the home audience by a toll-free phone number, and the person with the highest amounts of votes gets their wish. Young Russ was chosen! He will receive hair transplant surgery at the New Hair Institute, as well as a bevy of other prizes (of which I have nothing to do with)! He’s been quite overwhelmed by all the attention he’s received and has headed back home to get back to his schooling. He’ll be back out to my Los Angeles office very soon to have his procedure performed, and I’ll be sure to post photos of his results as the updates are sent to my office. In the meantime, here are some photos I took at his consultation that really show off how much work he needs. Click the photos to enlarge.

Tags: great american dream vote, abc, tv, hairloss, hair loss, hairtransplant, hair transplant, rassman

Late Puberty and Propecia! is it safe to take if possibly still going through puberty??!!

Generally you should not be taking Propecia if you are going through puberty. Not because puberty is an absolute contraindication, but because DHT does impact many of the changes in your ‘adult male characteristics’. You need to discuss using this drug with your doctor and you need a good diagnosis of actual male pattern (androgenic) hair loss, which would be unlikely in a male prior to puberty. Some men may start to experience hair loss after they go through puberty and on rare occasions some doctors may prescribe Propecia after a proper physical exam and medical history.

Tags: puberty, propecia, finasteride, hairloss, hair loss

Dr. Rassman,

I have come across an article on the web which quoted a recent medical study finding that intake of 5mg Finasteride (proscar strength) overtime (up to 1 yr) did result in loss of sperm count and volume. Would appreciate your thoughts on it if you have come across this rather troubling piece of news. Thanks.

Here’s the link: https://news.hairlosshelp.com/hair-loss-news/dht-inhibitors-can-lower-your-sperm-count-says-study/

SpermOne of the possible side effects of finasteride (Propecia is 1mg of finasteride) is a decrease in ejaculatory volume. However it does not occur in all men. Finasteride should not affect your sperm count (number of sperm seen in 1ml of volume) to be of any significance. All of these studies will indicate that after stopping the use of finasteride, you would return to your original base line volumes.

Tags: propecia, finasteride, volume, sperm

I have been on Propecia for 6 months and have seen no benefit at all, not even a slowdown in the amount that I lose daily.

Can we really expect to see positive results on Propecia if we’ve seen nothing after 6 months?

Any changes in the process of hair loss or gain are subtle because of the gradual nature of hair growth. The medication Propecia (finasteride) affects patients differently. For instance, patients in their 20s may have a better response to Propecia than a person in their 50s. The drug seems to work better in recent balding, so young men who are earlier in the hair loss cycle get better benefits (as a rule). I always check the miniaturization of the entire scalp before starting my patients on Propecia and follow my patients over 12 months after starting the medication for assessment of their gain or loss. In your case, if you had a prior examination, it is a good time to get checked again for comparison. If not, map your miniaturization now to at least get a point of reference for future follow-ups.

I would generally not give up on Propecia until after 12 months of treatment. The effects in some people are very subtle.

Tags: hairloss, hair loss, propecia, finasteride

Do you think the combination of both Propecia and Rogaine is the best one two punch to combat MPB. Do you have any other recommendations as I sometimes get a bad reaction to Rogaine.

I wish it was as simple as that. Some doctors believe that Rogaine (minoxidil) and Propecia (finasteride) together is a good idea and may even provide a synergistic effect. Practicality, however, plays a part and if you consider the finances and twice a day application, it is difficult to use both drugs. My recommendation is to use something that you can be consistent with and stick to it. If you have a bad reaction to Rogaine, ask yourself if it is worth taking it at all.

Tags: finasteride, propecia, minoxidil, rogaine, hairloss, hair loss

I am a 22 year old male who has started receding. I have a lot of unwanted ‘neck hair’ that grows on the back of my neck below the hair line. Could it be used in a hair transplant as ‘filler’? The hair doesn’t grow and long or think as normal hair though.

I often get this question asked to me during office consultations. Unfortunately, neck hair is not considered permanent, as the hair on the back of your scalp is. Neck hair is different. Many men lose neck hair as they age. Thus, while you can have a neck hair transplantation, you risk losing it as you get older. Then there is the issue of the punctate scars left behind, whihc would look like white dots (from the FUE) on a shaved neck. It would not be a wise investment on your part.

Tags: neck hair, hairloss, hair loss, hairtransplant, hair transplant

i’m a 15 yr old girl and i have traction alopaecia-i have really long hair and i’m not allowed to cut it so i braid it really tightly every day- if i change my hairstyle, will it grow back?

Traction alopecia may not reverse if it has been a chronic problem. Some hair may grow back, but there is no guarantee. If you are worried about hair loss from traction alopecia the best advice is to stop the offending cause (stop braiding your hair). Your circumstance may not be as easy as words of advice, but at the least do not braid your hair so tightly.

Tags: alopecia, traction alopecia, hairloss, hair loss