Woman Losing Hair with Hormones, DHEA, and Antibiotics

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

I started to lose your hair this July. About that time you also went on hormones, DHEA, and antibiotics. Could these medications have caused my hair loss. I recently stopped taking these medications and think that the loss may have slowed and some reversal may be going on. Is this possible

I believe that considering the short period of use and the known relationships between DHEA and hair loss, it is reasonable to expect that the hair loss you had might be related to the medication. You think that the hair loss is reversing upon stopping the medication so it is reasonable to expect that your progress will continue. You need to determine the status of your hair in and around your head, get the hair and scalp mapped out for miniaturization and if this is normal, that would make the process most probably reverse.

Tags: hairloss, hair loss, female, woman, women, miniaturization

I Have Hair Regrowing in the Temples

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

Got recently linked to your site, looks like lots of good reading for the next couple of weeks for me.

I just wanted to say that I am 39 and am a five year user of Propecia. My main point is that I have added Rogaine Foam, MSM and Niz shampoo since Xmas 2006 and have seen great results first behind my hairline, a bit in the crown, and now a bit at the temples. My crown is to the point where I can style my hair and hide the diffuse thinning. I’m hopeful in 4-6 months to have filled in the crown even more. I’m surprised to see hair regrowing at my temples. Only spot not showing much improvement in the exact middle of my hair line.

If you are getting good response from Propecia and the routine you are using, stay on that track. Temple regrowth (temple prominences) is unusual, but I have seen corner and frontal hairline regrowth in a few people.

Also, I realize you included a link to a site full of photos, but to protect your privacy I removed the link before posting this. If you’d like to make this link available to the public, you can either post it as a comment here or send me a note and I’ll update the post. Thanks for sharing.

Tags: hair growth, regrowth, temple, temples, hairloss, hair loss

Anything I Can Do for Alopecia Universalis?

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

hello, I have Alopecia universalis & pitting nails. The treatment of last year: cortisone (painful), prednisone, minoxidil (2%), revalid, zinc, vitamins. Now I do… nothing. What`s your advice for me?

Sorry, do not have any solutions for your condition. I would recommend visiting the National Alopecia Areata Foundation site for more information on research and support.

Tags: alopecia, universalis, naaf, hairloss, hair loss

Trying to Keep Looking Full

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

I am working harder and harder to keep my hair looking fuller and it is progressively getting more difficult. Been on Propecia since it first came out and in the past year or so, I spend more and more time in the morning trying to maintain my look. God forbid, the styling gel does not hold it! Should I switch to Avodart? If it is safe enough for prostate disease, why Avodart be safe for me, age 31?

Avodart is safe and approved for prostate problems which only occur in men over 50, most often over 60. If there were a Vioxx type of problem to come about after taking this medication for 20 years in a 70 year old man, I doubt that we would ever see it. In someone your age, I can’t say that. There are trials underway for treating hair loss, however.

Thank you for coming into the office after sending your email. Examining you (see pictures below) showed the following:

  1. You still have your childhood hairline.
  2. You do not look bald or thin from any angle.
  3. When we separate your hair, is is clear that you work hard to keep this full look.
  4. There is 50% miniaturization.
  5. With styling in a dark hair, light skin person, 50% is almost as good as 100% density with any reasonable styling. Your hair is medium-fine thickness and has a slight wave to it. Many men would be happy to be where you are now and with 50% miniaturization I would not consider you a transplant candidate. Drugs (DHT blockers) like finasteride (Propecia) or dutasteride (Avodart) are the best way to maintain where you are.

The photo on the left is this man’s hairline from the front. The photo on the right shows the miniaturization in his parted hair. Click the photos to enlarge.

Tags: hairloss, hair loss, hairtransplant, hair transplant, avodart, propecia, dutasteride, finasteride, photos

What is the FUG in Hair Transplantation?

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

Is the FUG different from the other hair transplant method. Does FUG uses strips from the back also? I may wish to have a camera sent for a view and consulatation. I will discuss that with you after learning the answer to these questions. Thanks,

I’m under the impression that the FUG transplants you’re talking about are identical to Follicular Unit Transplants. The harvesting method for Follicular Unit Transplants are either through strip harvesting or Follicular Unit Extraction (FUE). It is a good idea to send me photographs and I can give you a consultation either over the phone or through the internet. Please reference this blog posting when sending photos.

Tags: fug, follicular unit graft, follicular unit, hairloss, hair loss, hairtransplant, hair transplant

Transgender Hair Restoration Surgery

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

Hello, I am a M-F Transgendered and would like to change my hairline to produce the best possible female results. I have tried monoxidil but always develop a rash that itches and causes flaking of the scalp. I have tried to continue but the itching gets worse and stop. My hair is very fine and straight. I would like to cover the MPB patch in the back and move the hairline forward. I plan to have FFS and have a scalp advance procedure however, I’m sure I’ll need transplants as well. I’m interested to know how you would approach my condition. I live in CA. Thank you kindly

Everyone is different. I have transplanted quite a few transgendered people. The main issue is whether or not you have male patterned hair loss. If you do not have male genetic patterned hair loss and your testicles are surgically removed, then you will not bald and the hairline lowering procedure might work well if all you are treating is the mature male hairline. Take a look at Maturation of a Hairline — Moving From Juvenile to Mature and tell me which is your hairline. If you have a mature hairline, then bringing it back down can be done with a hairline lowering procedure (with transplants for the corners if needed). If. however, you have balding as shown in this reference, only a hair transplant will get you what you need because moving more than 1 inch of hairline is impractical at a single surgical session. If you are more bald than what is shown in this reference, the question may be, Do you have enough hair to treat the frontal recession and the balding in the crown?

As you are in California, I have an office in Los Angeles and San Jose, so a visit with us would allow you to create a good plan for you.

Tags: transgender, lgbt, hairloss, hair loss, hairtransplant, hair transplant

Hairs in Middle of My Hairline Are Thinner Than Elsewhere

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

Hi I am 20 year old Caucasian male and I have, I think, a normal hairline. Certainly my hair above my temples is not receding nor is there any recession at the back. My hair seems to be growing normally and healthily.

However, a number of odd things have been happening. I’ve noticed mostly in the middle of my hairline at the very very front there are some hairs which are a lot shorter than the rest of the hair behind them – maybe 3/4 of the length of the normal hair which is about 3 or 4 inches – though they do not look weak. Equally the hair (in the same areas), maybe a centimeter in or so is thinner than all the rest of the hair though this is only at the front and does does not seem to be true above the temples. Finally in the the middle of the front, I seem to have developed a small lock of hair that is independent from all the rest of the hair in so far as it won’t be tamed at all – this was never the case – though it may simply have grown oddly as I have not cut my hair since the summer when I shaved off my dreadlocks. Can you explain any of this to me?

What you are looking at is not easy for me to understand without seeing what you’re talking about. At the age of 20, you might be developing elements of the maturing hairline. You should get your hair mapped out for miniaturization and see if there is early genetic balding occurring, which might explain some of your problems.

Tags: hairloss, hair loss, miniaturization

Dense Packing of Grafts

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

Hi Dr…. is it really possible to pack 70 to 120 cm2 in a hair transplant???? Please let me know because a doc told me he can do this….

Some people can do the impossible. Putting that density together is crazy. The normal density is 100 follicular units per square cm, so why put in a number that is greater than normal? The real issue here is not if it can be done, but whether or not they will actually grow. What you are hearing/reading are stupid comments by an ignorant doctor.

Tags: hairtransplant, hair transplant, dense packing, density, hairloss, hair loss

Does Other Body Hair Grow in the Scalp?

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

I was wondering if hair from other than your head can be used for hair transplant for example from you face?

Yes, I have actually used beard hair from a face lift and from a brow lift to transplant into the crown. I have also used pubic hair to create beard hair. It works nicely.

Tags: body hair, bht, hairtransplant, hair transplant, beard

Medication for the Hairline and Corners?

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

Hello Dr. Rassman, You are doing a great job by answering people’s questions about hair loss. Propecia and Rogaine both say they only work if the hair loss is on the vertex (top of the head). Is it useless to use these if we lose hair on the side corners of front? Is there any medicine available for the front side corners?

I believe that Propecia (finasteride) will slow or stop hair loss in the front and corners. This is probably less common than the impact on the crown. On a few patients, I have seen hair loss reversal in the front, but only a couple that I can think of. There are no other medications that I would suggest at this point.

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

Stitches in the Donor Area

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

Hi Doc, Does the stiches which takes place at donor area hurt after HT? any headaches does it has to be protected from Sun etc for a long time

Thanks

Stitches are something you feel, but I would not say that they hurt. I am talking from my experience with stitches after my two hair transplants. The back hair covers the stitched area so you do not have to worry about the sun.

Tags: stitches, hairtransplant, hair transplant

Surgical Camouflage of Pluggy Hair Transplants (with Photos)

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

This patient had 1414 grafts almost 12 years ago to camouflage the obvious grafts in his frontal hairline and in the process, bring down his hairline into its normal position. His old transplants were placed too high and looked too pluggy. This is a nice result and a good demonstration of the value of camouflage when used properly. The photo on the left is before I performed any transplants on him (note the plugs there on the close-up), and the photo on the right is over a decade later. The key to the camouflage was to create a feathering zone of one hair grafts irregularly placed and spaced apart in front of the plugs, then with two hair grafts placed closer together, the transition to the old plugs was so gentle that the plugs were hidden from view. The patient was thrilled with the results.

When we wrote the original articles on repairs for the medical journals, it was taken from experiences like this man had. Today, we can harvest hair from the big plugs (not shown in these photos) as well as use camouflage as we did here. When this repair was done in 1995, the unfortunate standard of care at the time was still the ‘plugs’ that produced the corn row deformities. Surgeons were trying to repair the rough work by putting even more large grafts in between the larger grafts, which only compounded the problem. Fortunately today, few of these pluggy procedures are done and much of what we published has become today’s standard of care for repairs. To see the original work we did on the subject and the publications, look at: NewHair.com – Repair (search).

Click the photos to enlarge.

Tags: hairloss, hair loss, hairtransplant, hair transplant, photos, repair, plugs

Female Hair Transplant and Shock Loss

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

I am a female planning to get a hair tranpslant and have heard that the trauma of the surgery can cause other hair to fall out. I was wondering if being on Propecia would help keep the hairs from shedding. And if so, do you need to be on Propecia for a certain number of months before it works (i.e. keeps hair from falling out)? Thanks!

Propecia (finasteride) is contraindicated in women who may become pregnant and inefficient in post-menopausal women. It probably will have no impact on pre-menopausal women. Although studies have shown significant reduction in the rate of shock loss in men who are on Propecia, it has not been studied for in women for that purpose and in theory should not work. Hair loss shock is not common in women after transplantation.

Tags: shockloss, shock loss, hairloss, hair loss, women, woman, female, hairtransplant, hair transplant

Worried About Hair Getting Worse Before Propecia Effects Kick In

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

Dear Dr. Rassman, I know you’ve been asked a billion times about Propecia but I just have one question about it.

I understand we need to wait at least 8-12 months to see whether it is ‘working’ and I also realize that by taking Propecia we’re at least slowing down the rate of balding. With this said I have a hypothetical question.

It’s been 3 months since I’ve been taking Propecia (much too early to tell) but let’s say hypothetically, Propecia will actually stop my hair loss. Before my 8-12 months trial period is up, can my hair still become miniaturized before Propecia “locks in” the hair I have? I’ve been on Propecia for 3 months and I’m starting to see significantly more thinning in the front and I’m curious whether or not I’m going to lose a big chunk of my frontal hair before propecia stops the recession.

Any help would be appreciated. Thanks.

When Propecia works, it works very fast. You may not see the full impact for 8 or so months, but you do not have to wait to get the benefits. Be patient, as it sounds like you are doing the right thing.

Tags: propecia, finasteride, hairloss, hair loss

Taking 5mg Finasteride Once Every 3 Days

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

Hi, I have been told by my doctor that taking 5mg Finasteride tablet(Proscar)once every three days is also effective for treatment for balding. I’m 21 years old and was told that I’m having genetic alopecia. Can I have your opinion or recommendation?

I don’t have a problem with this suggestion if it works. The reason we recommend daily dosing is because that is the way the data was collected and the official recommendation of the drug company (1mg/day). It is logical as a daily dose, because the half life of the drug in the body is about 5 hours. Maybe your doctor has a great deal of experience with this every 3 day dosing routine. It may work OK!

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