Hair Transplants in a Class 7 Blonde Patient (with Photos)

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

This is a patient who was transplanted in two sessions totaling 4500 grafts over a decade ago. He stopped by my office to say hello and show off his great results so many years later. His before pictures (I apologize for the quality, as they were before we used digital cameras) are shown as well as the pictures taken today. Essentially, all of the original hair is now gone (Propecia was not available at the time he had his original surgery) and 100% of the coverage you are seeing in the recent photos are the results of his hair transplant. The only hair that exists now apart from the transplants is the 3 inch high ridge of hair around the side and back of his head. In many ways, this is a worst case scenario because his donor supply was limited but even with that, he has coverage for the front (going back about 4-5 inches) and his hair naturally parts down the middle. He is active in life, surfing regularly.

He is 57 years old and he now has the look of a 35 year old from the front. He told me that this was the best thing he ever did, that is, before he got married to his beautiful wife 18 months ago. Note that the crown bald area is wider than it was 10 years ago, but because of his comb-back, the view from the front (the fellow he sees in the mirror every day) is a hairy fellow.

Click the photos to enlarge.

Before:

 

After (a decade later):

 

Tags: hairtransplant, hair transplant, blonde, blond, hairloss, hair loss, photo

My Father Was Bald By My Age — So Perhaps I Don’t Take After Him?

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

Firstly i’d like to say this site is a great resource! and has been extremely useful reading over the last few months.

Some background…I’m a 21 year old male, with extremely thick hair (both in hair diameter and in density). Around a year ago i began to develop my mature adult hairline and since then there doesnt appear to have been much if any miniaturization past the future hairline.

I had two questions, firstly i know most mpb loss starts at the temples before balding at the crown is evident, but i was wondering if it was possible (or has happened in your experience) for a person to begin balding at the vertex before there is any significant recession from the temples? as hair loss in this area would be much more distressing to me than progressing to a norwood 3 for example.

My second question is to do with predicting my future pattern, my father is a norwood 7 who says he had significant thinning at the temples and crown by my age and from looking at wedding photos was a norwood 4 or 5 by 23. His father also followed a similar pattern.

The other side of my family i.e. my maternal grandfather had a norwood 3/ 3vertex pattern until into his 70’s. So my question is seeing as my hair loss is at least slower than my father could i be expected to have avoided a norwood 7 future or can this advanced pattern start at say 22-25? (basically, at what age would you say i was ‘safe’ from suffering my dads fate!)

You can certainly have balding at the vertex without any frontal recession.

There is no definitive way to predict your hair loss by just looking at your father or uncles or grandfathers. It may offer a clue, but there is no good way to predict balding at this point. I tell men to find someone that they think that the look like (hair loss pattern) in their family and find out what age each step took in the development of the hair loss. That will give you just an idea, because there are probably many genes involved and varying expressions of those genes that may skip generations, so it may be impossible to determine who you might take after or what you pattern might be. If you are asking for some sort of assurance that you will not go bald, the best way to to this is to have a miniaturization study and following the progress of the miniaturization over time.

Tags: hairloss, hair loss, genetic, father, grandfather, generation, miniaturization

Computers Causing Hair Loss?

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

Hi doctor I have three major concerns:

  1. I have been using Tricovivax (“Minoxidil 5%”) for about two months and I have noticed a massive rate of hair fall, shedding, and thinning. Even my family members are telling you are starting to have bald spots in your head.
  2. I am very concerned with thinning at the back of my head (donor) are and when my doctor mapped my hair for “Miniaturization” noticed that my donor area is thinning too; and he applied the “pull test” and noticed a large amount of hair being pull.
  3. Is setting long time at the computer screen during work will accelerate my hair loss since the computer screen emits radiation?

Thanks a lot doctor

MonitorI am pleased to hear that you have had a miniaturization study done. By your brief description, you may have a condition known as DUPA (diffuse unpatterned alopecia) or chronic telogen effluvium. Using drugs such as minoxidil or finasteride may not help in these cases. You need to follow-up with your doctor for options, diagnosis, and treatment. Sounds like he started off by taking the first correct steps.

Sitting at a computer screen will not cause hair loss.

Tags: computer, screen, monitor, hairloss, hair loss, technology, dupa

I Had a Hair Transplant 4 Months Ago and See Nothing

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

i had my hair transplant done 4 months ago and I do not see any results.

how long before i see my new hair. do you think i’ll see a big diffrents by next month?

thanks doc

It can takes 4-7 months for the hair to grow after a hair transplant. You have to be patient. Most people will see results by the 6th month or so.

I wonder why you thought I would be a better source for this information than your doctor? It is important that you take full advantage of your doctor/patient relationship to answer these questions. If you don’t have a good relationship, then get another doctor, one who is free to talk and answer your questions.

Tags: hairtransplant, hair transplant, hairloss, hair loss

My Diet Has Become More Healthy Over the Past 2 Years, But My Hair Improves So Slow

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

I’m a 27 year old male. About 3 year ago, at the age of 24, I went to work abroad for a year. At the time of leaving home I had a full head of hair.

When I was abroad my diet deteriorated. During this time my hair became very unhealthy. It became brittle and it stared to fall out. I returned home 2 years ago and my diet has returned to normal. My hair’s condition has improved and it has stopped falling out.

Though it has improved, progress is very slow and it has not returned to its former condition.

Could you help me, please?

A normal diet should not have any significant impact on hair loss. If you were malnourished during your travels abroad, it may have had some impact. However, once you start the hair loss process, I have found that it is difficult to stop the hair loss process. Some have explained this phenomenon by analogizing to a light switch that is turned on, but can’t be turned off. You should have your scalp hair mapped for miniaturization to see it there is a pattern to this hair loss. You have a component of genetic hair loss which may not be related to the diet issue.

Tags: hairloss, hair loss, diet

Thinning In Sideburns

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

Hello,

My hair has been thinning and while I understand this is natural I have a few questions. First off, my hair is very thin in my sideburn area. I is distinctive because hair the same length a little farther back is much fuller. When I say sideburns i mean the whole thing and in both sides. My doctor said this is genetics but I cant find much online on people loosing hair in this area. I am also thin in the front but it isnt very noticeable. Interestingly it is much more apparant on one side where it seems to be like a line of no hair. I just went on propecia a week ago. What do you think??

If you are thinning on your sideburns, it may be related to genetics or just a normal part of the aging process. There are many other considerations in the differential diagnosis, but it is impossible for me to guess what you may be going though without a examination including a miniaturization study.

Tags: hairloss, hair loss, sideburns

Counting Hairs in the Shower

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

I am not sure if you have been asked this, but could you explain the hair counting thing? Does counting the hairs that come out in the shower really tell you anything? Thats not really a good indicator of anything is it?

Counting the hair in the shower (hair by hair) would mean that you are likely obsessive about hair loss. It would be logical that if you are losing hair, the hairs lost in a single shower would vary by time of day, the vigor of your washing and massaging, the number of times you actually apply shampoo in a single shower, etc.. Generally all non-balding people lose about 100 hairs a day. If you see a change in number of hairs (a gross change) over a long time frame and keep all of the things you do constant, you may be losing hair.

Tags: shower, hair loss, hairloss

Oozing Bumps on My Son’s Head for Years

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

My son has had big bumps on his for two years. these bumps are sore, oozing white-yellowish thick puss. they never heal. The sores have spread to the cressses behind his ears. lately he’s complain about chills and fevers the only medicine been prescribe is antifungus. What’s left to do?

What you describe seems horrible and in need of a medical attention. Please see a doctor or get a second opinion from another doctor. There is no way for me to tell you what he has from your descriptions, but it must be identified by a competent doctor.

Tags: ooze, bump, fungus, wound

Donor Area Looks Like a Golf Ball a Week After My FUE Procedure

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

Hi,
I had FUE procedure done one week ago. It was for 2000 grafts, from a reputable Doctor with many years of experience. He came recommend. I’ve seen a few of his works in person, along with numerous photos from his website.

Anyways, my concern is that the donor site has many dimpled scabs; some have fallen out but most remain. The area resembles that of a golf ball. Is this natural and will my skin go back or remain like this?

Thank you.

The healing process of a wound goes into different phases. The length of the time it takes to heal reflects the size of the instruments used. Doctors use instruments that range in size from 1.5mm to 0.8mm. The best and fastest healing is in those with smaller wounds and the final appearance will reflect the size of the instrument used. See 1 Year Post-Op Photo of FUE Donor Area for an example.

The initial scabs should have come off in a week from the donor area. Full healing usually takes months and within 4-6 months the wound is probably close to its final stage. Healing of the FUE wounds is not an exception to this rule. Give it more time and the scabbing will go away in a week or two. The area may continue to be red for a while, but eventually will get back to its normal color.

If you are telling me that you have a golf ball size swelling in the donor area, you probably have an infected ingrown hair, which happens in FUEs when a graft is buried in the wound and did not come out after an attempt to extract it. Buried grafts can reflect your tissue type, your surgeons skills, the instrument used, etc… In this case, you may need your surgeon’s attention.

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

My Old Plugs Are Going to Be Visible Soon!

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

I’m 47 years old and had several “plug” transplant sessions and a few single hair sessions. My first session was in 1990. I was on Lexapro for 4 months (Feb 06 – May 06) and I lost a lot of hair. That hair has not grown back and I’m losing additional hair (sides and back)! Soon my “plugs” will be very noticeable and I’m very upset! I’m currently using Nizoral, Avodart, laser comb and 2% Rogaine for the last 6 months.

Will the hair I lost from the Lexapro grow back?

There is no way to tell if the hair will grow back. I suspect you have a component of genetic male pattern hair loss and at your age, you will lose more hair despite all your preventative measures. You many need further hair transplant surgery to disguise the plugs (granted that you enough donor supply left), or you can have an FUE procedure to core out and thin the plugs. You need a real expert to give you an opinion. For more information on repairing old hair plugs, please see:

Tags: hairtransplant, hair transplant, fue, plugs, hair plugs, avodart, rogaine, lexapro

Forza-T and Hair Loss

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

I’m 23, male… Normally I have healthy hair as does everyone in my family, but about 6 months ago I took Forza-T that I think caused my hair to thin out. Forza-T boosts testosterone, so I figured my DHT level got too high. So I took DHT blockers just recently and that made it worse! My hair is noticeably thinner/weaker, and overall I just feel unhealthy compared to how I was before. I’m positive the DHT blockers caused it because I noticed a significant difference in my hair and skin within minutes of taking them. Anyway, is this permanent or is there something I can do to fix the problem… in a natural way. i’m scared to take anything now that’s not completely natural. Thank you!

Forza-T claims an increase in free testosterone from the use of this product. There is, of course, no proof, but if you take that claim at face value, it will almost certainly increase hair loss.

You sound like you are playing with fire. DHT blockers (I am assuming that you are talking about finasteride as that is the only FDA-approved medication for treating hair loss that blocks DHT on the market today) will NEVER give you an instant change. Please note that hair above the skin is dead, not alive, so it could not possibly change in minutes. Are you possibly body dysmorphic?

Tags: forza-t, testosterone, hairloss, hair loss, dht

Size of Incisions Contribute to Hair Transplant Failure?

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

Dr. Rassman,

For people with very fine native hair, is it important that the incisions for the recipient site be made very small to minimize shock fallout. I had a procedure about 1 year ago and lost much native hair due to shock fallout even though I was on Propecia for several years beforehand. Obviously I am very disappointed with my results (less hair now than prior to surgery) and am wondering if the size of the incisions caused this unfortunate outcome. Thanks for any insight you can provide.

I cannot tell you why your hair transplant failed, but the size of the incisions should not have a significant impact on hair growth. The size of the incision is related to the size of the grafts (not the size of the hair). Just because your hair is fine does not necessarily mean that the size the graft will be small (needing a smaller incision). Get a second opinion. Hair transplantation works.

Tags: hairtransplant, hair transplant, incision, surgery, procedure

19 Year Old Stressing Over School, Thinning at Hairline

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

I’m 19 and a freshman in college. I’ve been stressed these last two semesters over grades and other things and I noticed in January that my hair was thinning at the hairline on both sides. There are people in my family who are losing hair, but their hair loss didn’t even begin until they were in their 40’s, 50’s and 60’s and it’s still not bad. I just wanted to know if this is likely from the stress or if it’s genetic since it’s forming in the male pattern baldness form. The hair loss is giving me even more stress and I don’t know what to do. I’m thinking about using propecia.

While emotional or physical stress may be a factor in hair loss, you may also have a component of genetic hair loss. There is no way for me to tell you or diagnose your condition via the internet. You need to see a doctor for a good diagnosis and a miniaturization study to see if there is a pattern (such as male pattern hair loss) to your hair loss problem. The good news is that if you have genetic balding, the drug Propecia (finasteride) can slow or stop it in a reasonable percentage of young men. At your age, clearly you need a Master Plan for your hair loss process.

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

Woman Growing Facial Hair from Rogaine

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

I am (female) developing face hair ever since I started Rogaine. I believe that the Rogaine is helping. What can I do?

I have seen many women who report this. Usually, the hair is a fine, baby hair. You can bleach it or shave it off. Shaving will not make the facial hair thick, so I would not worry about that.

Tags: women, woman, female, hairloss, hair loss, rogaine, minoxidil

Decreased Ejaculate After Taking Propecia for a Week?

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

I only took propecia for a week until i encountered sexual side effects. Ive been off the drug for close to a month now and the issues seem to be resolving themselves all except for decreased ejaculate volume. There is quite a noticable difference in amounts, possibly less than half the volume than before. I have an upcoming appointment with my doctor to discuss this and I was just wondering what treatments you might recommend, so i could bring it up with my doctor and see what he thinks. Thanks.

I’d give it a few more weeks, as time should solve the problem that is left. Of course, you should speak with your doctor about this if you are concerned.

Tags: propecia, finasteride, ejaculate, sex, hairloss, hair loss