When Will Hair Cloning Be Perfected?

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

Dr. Rassman,

I know that you have replied to a few posts in relation to hair cloning about timeline etc. My question isn’t about when the procedure will be available, but when you think the procedure will be perfected.

In other words, when do you think that a man suffering from extensive baldness (with hair available for cloning at the back and sides) will be able to walk into a clinic and have his hair cloned so that he can have a full head of hair that looks completely natural?

I really have no way to tell how long something like this actually will take to be perfected (nor would anyone know precisely how long it would take to perfect hair cloning), but my guess is ten to twenty years.

Tags: hair cloning, haircloning, hairloss, hair loss

Will Switching to Dutasteride in a Few Years Keep What Finasteride Has Already Kept?

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

Hi Dr..
I took my first pill yesterday, but now am not so sure if i should continue. Im 18, and I dont want to become tolerant to finasteride at 22-23.

But let’s ASSUME that dutasteride is approved by the FDA in the future, and I’m 23 with a tolerance to finasteride. Will switching to dutasteride restart the process, like will it act separately from the finasteride, and thus give me another 5-7 years of low DHT?

Please reply. I need to make up my mind, soon. Thank You

There is not such thing as tolerance to finasteride (Propecia). See Propecia and Hair Count for more information on that.

I don’t think taking finasteride has to do anything with your possible use of dutasteride in future.

Tags: dutasteride, propecia, finasteride, avodart, hairloss, hair loss

How Do Doctors Know That Finasteride Only Affects the Hairs that Were Destined to Fall Out?

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

Recently I have noticed thinning at the front of my hairline. I would like to start using propecia but I have heard horror stories from my friends. I was told by one that it actually increased his balding. Apparently he started shedding more with propecia, and what started as a receding hairline also started affecting him in the crown. Is this possible? Can propecia actually speed up balding, or were those just hairs that were falling out anyways? I also heard that once off propecia, the rate of balding increases. I understand “catch up” time, but how do doctors actually know that propecia just affects hair that was destined to fall out? Thank you for your time! Hope to hear from you soon!

When a person who is not balding takes Propecia, nothing happens to the hair. That clearly shows that Propecia does not impact normal hair.

Tags: finasteride, propecia, hairloss, hair loss

The Pros and Cons for FUE / Strip Harvesting

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

I’ve put together a nice list of things to consider if you’re interested in having a hair transplant, particularly when comparing the Follicular Unit Extraction (FUE) technique and the Follicular Unit Transplant (FUT / strip) technique.

FUE pros

  • There will not be a detectable scar in donor area. Of course the scar will be present after every skin incision, but since scars are very small and scattered in a larger area, they are not detectable even on a head with a close crew cut.
  • There are no sutures or staples to be removed. The small pointy wounds on the back of the head will be left to be closed on their own with no sutures or bandages.
  • There is minimal or no pain in donor area after the removing the grafts.

FUE cons

  • Not everyone is a good candidate for this procedure. We always test our patients before doing the actual procedure with several biopsies with different methods and view the grafts under microscope to see whether we can harvest them without damaging the hair follicles. If we see a lot of transected (damaged) follicles, we can not proceed with this procedure.
  • It is more expensive (almost double the cost compared to the strip procedure). Follicular Unit Extraction is very tedious and every graft should be individually extracted by the surgeon as opposed to the strip method where skin is removed first and grafts are harvested under a microscope.
  • It takes more time, sometimes up to twice the time when compared to a strip procedure for the same number of grafts. A procedure to harvest one thousand grafts may take six to eight hours.
  • A large area of the scalp needs to be shaved or clipped very short. This is not acceptable for many patients.

There are a few issues that are important to look at and understand. Hairs within a graft can be killed by improper harvesting (e.g. drying, cutting it at a critical point in the anatomy of the hair follicle within a follicular unit). This can happen if there is poor cutting techniques in strip harvesting, or in actual transection of hairs within a follicular unit during an FUE procedure. I personally do not believe most of the doctors who claim 95+% successful hair counts from FUE and I would love to pay a visit to some of these doctors and actually do the hair count from their FUE extracted grafts.

Thick grafts (those that are transplanted with fat around the follicular unit) can tolerate air exposure longer than a skinny graft (which can dry in seconds when exposed to the air). But tolerating air exposure for longer than 10-20 seconds suggests to me that hair follicle death may occur and the staff do not have strict quality control process implemented. What is important is not how many hairs are extracted successfully and anatomically intact. The important question to ask is, “Will they grow?”

The best part about strip harvesting is that there is a very high yield with the experienced team. The risks of scar formation that is detectable (greater than 3mm wide) is about 5% with the first procedure, 10% with a second procedure, and higher with a third procedure. Other than the scar possibilities and a slightly more painful recover period of a day or two, the strip procedure is more cost effective and more efficient from a time and yield point of view.

Tags: fue, follicular unit extraction, strip procedure, strip, hairtransplant, hair transplant, hairloss, hair loss, hairrestoration, hair restoration

Does DHT Cause Miniaturization or Shedding?

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

Does an increase in DHT cause hair shedding or does it just cause miniaturization for those who are prone? I understand its normal to loose about 100 hairs a day, but does the DHT increase the shedding to abnormally high levels including hairs that are not miniaturized already?

The process of genetic balding is produced by DHT (Dihydrotestosterone). If there was no DHT, balding would not occur. The way to prove this is to remove the testicles. If genetic balding had not already started, it would certainly not start after removing the testicles. This has been shown classically when one of two identical twins had his testicles removed. The balding occurred only in the twin with testicles.

There are two ways in which balding occurs. You could go from normal thickness hair to miniaturized hair with progressive miniaturization as the hair shaft loses more and more of its thickness over time. Alternatively, the hair can go into its normal sleep cycle and never come out of it. You might look at this second way as normal thickness hair falling out.

Tags: dihydrotestosterone, dht, hairloss, hair loss, miniaturization

Finasteride Is Making Me Aggressive and Horny!

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

Dr Rassman, I have a very serious question and I trust you will treat it as such. Over the past two years of taking Proscar split into quarters, I have noticed a ridiculous, almost insatiable increase in sexual desire. I mean its always been there before but I believe its increased dramatically. I’m also finding women attractive I never before felt attracted too. Every second woman I see these days seems incredibly attractive to me and I usually lust after them which is just ridiculous! Also occasionally I have noticed that I can be filled with intense rage and aggression for no reason at all which usually lasts about 30 mins to an hour its almost like i’m full of insane amounts of testosterone temporarily. At these times I feel like I want to run through a brick wall for fun, or break walls with my fists (scary i know) Its almost like a form of roid rage! Not that ive ever taken steroids. But its my understanding that Finastraside lowers DHT and increases free testosterone floating in the body. Could this be a possible reason for what i’ve mentioned?

I guess in a nut shell im asking…

Does Propecia make you more horny?

Has Propecia ever been known to increase anger or irritability?

Finasteride has been reported to increase testosterone by 18% on average. I have had reports from many patients that their sex drive has increased and some wives reported that to me in their older husbands. I have not heard about the degree to which you report the drug impacts you. You might measure your testosterone before you stop taking finasteride, and then measure it again a month after you are off the drug. That would give you an answer. Be warned though, if you saw benefits from treating your hair loss with finasteride, your hair loss might start up again when you stop the drug.

Tags: finasteride, hairloss, hair loss, aggressive, aggression, horny, libido, sex

If Propecia’s Half-Life Is Short, How Can It Be Effective?

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

Hi, Dr Rassman.

I’m a caucasian male, 30 years old.

Can thyroid problems hasten or kick start the balding process? I’ve been diagnosed with hypothyroidism and have experienced early signs of MPB around the same time. No member of my immediate family has severe hair loss and certainly hadn’t lost any by age 30.

If propecia’s half life is so short, and only reduces DHT in the body modestly, for only part of the day, why then can it be so effective at treating hair loss? Are there other, hidden attributes to Propecia that we do not yet understand that is helping millions of men stave off the shiny dome?

Thanks, Doc. You have a great site, and I’m a daily reader!!

Thyroid problems can precipitate hair loss and hair texture.

You are correct in stating that Propecia’s half life is short (about 4-5 hours). That is why you need to take it everyday. There is also tissue fixation of the drug that probably reflects a longer tissue hair life (not easy to measure) that may hold the effects on the hair follicles. The testing on hair regrowth and hair counts were done with various doses from 20mgs per day down to less than 1 mg per day. The results were published showing that the 1mg dose was as good as a higher dose in treating hair loss. As many of you know, finasteride is packaged in a 5mg dose as Proscar (or generics), which is used for treating prostate disease. Seeing as how Propecia is the same medication, it may also help your prostate health.

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

I Want to Remove My Transplanted Hairline Altogether

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

I had single hair and multi-hair transplants on my hairline but I am not pleased with the results. I’ve had multiple procedures over the years expecting frontal hairline to one day be as thick as before. I suppose I held wrong assumptions. I’d rather remove the 1/4 to 1/2 inch length hairline of transplants than “fill in” the area with more hair. I followed that advice over and over but it never fully filled so it does not look natural. Is there a method to remove them without obvious scaring? I shave and even pluck them out of frustration but I end up regreting because it looks awful. I wish I never had gotten the transplants. Can I be helped? Thank you.

I have removed hairlines, but that requires surgery in most instances either by excising individual grafts or the entire line with a brow lift type of incision. Scars are generally barely detectable. Alternatively, you can do laser hair removal, which may take up to 6 treatment sessions. There could be depigmentation present, where the skin will become very light as its pigment cells are killed off.

Tags: hairtransplant, hair transplant, repair, pigment, removal

Hair Plugs Are the Latest in Hair Transplantation?!

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

Doc,
I just saw this in my local news and didn’t know if it was a weird April Fools prank or if this is actually legit? It says “Dr. Quatela uses the latest hair transplantation procedure: hair plugs that use 15 or more hairs. ”

See for yourself. I’d love your commentary. News 10 Now: Reverse the effects of aging with hair plugs

It looks deforming to me. This technique has been abandoned for over a decade. We actually perform many repairs on these old plug procedures to make them look more natural.

If anyone considers plugs to be the “latest” in hair restoration, they are apparently living in a cave.

Tags: plug, plugs, hairtransplant, hair transplant, hair restoration, hairrestoration, hairloss, hair loss

Percocet, Gabapentin, and Female Hair Loss

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

I fractured my C4 vertebra 3 months ago and underwent 2 spinal fusion surgeries within one week. Subsequently I was on multiple medications for pain and muscle spasms (percocet, gabapentin). I have weaned myself off the meds; however, in the past week I have noticed significant hair loss. When I brush or even just run my hand through my hair, it’s coming out in small bunches. I have a good diet and am taking a lot of vitamins and flaxseed oil. What do you think is causing the hair loss and what can I do to stop it? I do not take birth control pills, btw. Thank you.

People who have had surgery and stress, can lose their hair. Add to that birth control pills in combination with the surgery, and there are two contributing factors. I would have a complete medical work-up to determine if there are other contributing factors. Female hair loss is often associated with a variety of medical conditions.

Tags: percocet, hairloss, hair loss, female, women, woman, stress, surgery

Young Daughter is Losing Eyelashes

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

My 11 year old daughter recently began losing big clumps of her upper eyelashes. I have heard that hypothyroidism can cause this, but she is very small for her age and has none of the other symptoms. What else could cause this sudden loss of lashes?

Get her evaluated for medical problems such as thyroid disease, anemia …..

Tags: hairloss, hair loss, child, thyroid

Why Did You Get Into Hair Restoration?

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

I, as a first year medical student, am curious as to the reasons you went into hair reconstructive surgery. Too personal??

LionAs a surgical specialty, hair restoration has got to have the greatest patient satisfaction of any (at least in my opinion). It is supreme for helping people solve a problem that bothers them. Some people are quick to say that “it’s just hair” or look at hair transplants as strictly a vanity issue — and while those people are certainly entitled to their opinions, I would disagree with this notion. Hair loss can be a nightmare for many, and the injury to one’s confidence can be substantial. As I’ve said before, hair can be as important to men as the lion’s mane is to the lion. It is what creates his majestic look.

I also recognized that there was a need for a better technology. I entered the business when plugs and scalp reductions were the ‘standard of care’ and immediately determined that this was not an acceptable standard of care for my patients. So I analyzed what had to be done and on the very first day, the very first surgery, I created a new standard. My practice’s personal standard of care (large session surgeries of small follicular unit grafts) has now become the industry’s standard of care. So satisfaction came not only from patients I directly treated, but also from thousands of other patients who I know benefited from what was then a revolutionary change in the art of hair transplant surgery. I take great personal satisfaction in knowing that I have made a difference and this industry has been good to me. It was uniquely backward and unrefined when I entered the field and I contributed to its modern day evolution. You can see my professional history on my CV for a full look at what I’ve done. I apologize in advance if this answer seems like a big pat on the back to myself, but hey, you asked. There’s no magic or myth about it — nothing too personal to share.

Tags: hairloss, hair loss, hair restoration, hairrestoration, hairtransplant, hair transplant, rassman

Growing a Heart from Stem Cells

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

British scientists have just grown a heart valve from stem cells. Sir Magdi Yacoub, who led the team involved with the project, guesses that an entire heart may be grown using this technology in 10 years. Do you think that this advance will speed the process of hair cloning/multiplication any?

HeartI am aware that stem cells can grow organs. Hair is an organ so if you can grow a heart, then one should be able to grow hair from stem cells. There are clinical trials presently underway that show stem cell placed in the heart, will grow heart cells.

Please see:

Tags: stem cell, stemcell, heart, hair, hairloss, hair loss, organ

I Want to Look Into Hair Restoration In 4 Years

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

Hello
I’m only 16 and i have a terrible baldness. Rogaine and propecia didn’t have any effect on me after a year of use so i think that the only solution is an operation later(after 3 years).so i’d like to know if the method of hair restoration can be used in 2010 and if i can do operate at the age of 20 years old.

Severe balding at age 16 is not common. You should be evaluated by a hair specialist to confirm your diagnosis and rule out other causes that may result in premature hair loss. If you are diagnosed with androgenetic alopecia or male pattern baldness with no other causes involved, the best thing is to prevent further loss by taking the medication finasteride. Only after examination of your hair loss and the changes in its pattern, can we tell you what is the best timing for a hair transplant procedure. Hair transplants a rarely performed in men under the age of 24 years old. Please get good metrics on your hair situation by getting your hair mapped out for miniaturization so you can follow scientifically what is happening to you.

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

Propecia and Ejaculation

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

For the first time ever when I ejaculated I noticed it has a strange yellow discoloration. Can this be a side effect of propecia? If so, should I quit taking it or lower my dosage?

Some people report that the quantity of the ejaculate is less when taking Propecia. Maybe the reduced volume is responsible for the change in color. The reports on the quality (potency)of the sperm indicate that is just as effective at lower quantities. Taking a lower dose pf Propecia makes no sense if you want the full benefit of the drug, but unofficial reports indicate that half the dose (1/2 mg) will be 80% as effective. Since you are concerned, I’d suggest paying a visit to the prescribing doctor to find out what he/she recommends.

Tags: finasteride, propecia, proscar, sperm, ejaculate