I Am Losing a Lot of Hair After My Transplant — The Doctor Didn’t Tell Me About This

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

Hello Dr.

I recently(two weeks ago) had a hair transplant and am experiencing a lot of hairfall right now. My Dr. told me that i would lose the transplanted hair after the procedure, but i am also losing a lot of my own hair. Is it normal after the procedure? Would be greatful to you if you could please answer my question.

It sounds like you are experience a phenomenon called “shock loss”. It occurs more in younger patients and patients with pre-existing miniaturized hairs. Thus, you often see me reiterate on here about the importance of a miniaturization study. It is a risk associated with a hair transplant procedure and it should have been outlined for you in your informed consent paper work before the surgery. You should have been put on Propecia prior to the surgery to minimize the risks, particularly if you are under the age of 35 or if you have had recent hair loss.

Tags: shock loss, shockloss, hairloss, hair loss, hair transplant, hairtransplant, propecia, finasteride

DHT and High Cholesterol

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

I am a 36-year-old male noticing some hair loss. I thought it was related to having taken prohormones, but the slow hair loss has continued after more than a year off the prohormones. I am considering taking Avodart/dutasteride, but not just for the cosmetic hair loss. A concern I have is the relation between MPB to increased risk of heart disease. Thus, my two questions:

  1. Do you know of any connection between DHT and high cholesterol/heart disease? And if there is a connection, would DHT suppression also contribute a health benefit above and beyond the cosmetic issue of MPB?
  2. Do you have any suggestions for any OTC or prescription drugs/remedies that would work to help curb the aromatization of the increased testosterone from taking a DHT inhibitor?

  1. I do not believe that using DHT blockers like Propecia will have any effect on your cholesterol. We know that Propecia will reduce the risk of prostate cancer.
  2. With regard to your second question, I am not an expert on OTC medications that curb aromatization from increased testosterone.
Tags: cholesterol, hairloss, hair loss, dht, propecia, finasteride

Subcapsular Orchiectomy (Removing the Testicles) to Prevent Hair Loss

/by William Rassman, M.D./6 /

Hello Doctor,
I am soon to be 25 yrs old. My hair line is beginning to recede at my temples. I am extremely concerned with this. For many years I have considered having a subcapsular orchidectomy procedure to prevent any further hair loss. I have researched the side effects of this procedure and am willing to accept them. Can you recommend a doctor who will perform this outpatient operation? Thank you for your time.

Any urologist should be able to help you, but I doubt they would do so. There is likely more to your story than you are telling me here. Taking out your testicles is an extremely radical way to prevent further hair loss… though it will work.

Tags: testicles, hairloss, hair loss, subcapsular orchiectomy

Hair Loss After Breast Implants?

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

In Jan. 03 I had saline breast implants and 4 months later my started falling out and to this day it still is. The dermatologist said it was AGA but my thinning is all over and my part is not get wider. Could it be chronic TE or something else? Please Help!

Unfortunately, I can not address your problem without seeing you. Surgeries produce stress and people with AGA can lose hair with stress. You can try to do the hair pull test on yourself. For information on telogen effluvium (TE), please see Wikipedia.

Tags: te, telogen effluvium, breast implants, hairloss, hair loss, stress

Does the Follicle Eventually Just Stop Producing Hair?

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

Hi doc,
is it true (..or partly true under certain conditions) that the follicle will go through the growth, release and snooze phases a specific amount of times and then stop to produce hair?

If so, MSM and it’s claimed increase in hairgrowth speed would actually do more harm then good in the long turn.

It is normal to lose 100 to even 200 hairs a day (though the average would be closer to 100, I’d say). As hair falls out, there are hairs that are also starting to grow. Hair may also grow in cycles and you may notice more hair falling out at different phases and seasons of the month. Hair follicle cells have three phases of growth:

  1. Growth phase (Anagen phase) which lasts anywhere from 2 to 6 years. This is the phase where your hair is actively growing at approximately 10cm per year. 85% of hair is at this phase at any given time.
  2. Transitional phase (Catagen phase) which lasts about 2 weeks. This is the phase where the hair follicle shrinks and prepares to enter the resting phase.
  3. Resting phase (Telogen phase) which lasts about 1- 6 months. This is the phase where hair does not grow but stays attached to the follicle. Some hairs are shed at this phase, but at the end the hair follicle re-enters the growth phase to start the cycle over again. 10-15% of hairs are at this phase at any given time.

Eventually, as we age, some of the hair follicles will die and stop producing hair. But keep in mind the life expectancy for a hair follicle can be over 100 years (provided that you live that long). My great grandmother had a full head of hair at 114 years of age, so clearly the hair can live longer than we do. I’ve written about this before — At What Age Does Hair Stop Growing Naturally?

Finally, there are no products or medications proven to speed up or increase hair growth. Drugs like minoxidil are thought to prolong the hair cycles and that might mean, in the long term, that hair treated with minoxidil might last more years. I would be interested to see product results on half a scalp to see if that half has faster hair growth, longer cycles, or whatever.

Tags: follicle, hairloss, hair loss, anagen, catagen, telogen, age

Abnormally High Yeast and Female Hair Loss

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

Dear Doctor,

I am a 38 year old female. I recenly had developed a severe burning stinging head. Saw a very well known derm locate what they said highly abnormal yeast. Put on diflucan. Yeast are not changing pain not improving. But here is one of my main concerns. I have had elevated blood cortisol in the AM at 56 which is rather high. My urine cortisol normal. Male androgens coming back upper limits of norm.

What role does cortisol play in hair loss (if any) And are there any adrenal or hormonal issues that can contribute to the overgrowth of yeast? To date i have lost 50% of my hair all over my head with no clear cut answer. I do not have cushings. Any thoughts would be greatly appreciated. Pain like this is not normal – its ice pack material!

You describe a medical condition that I rarely see in my practice. As such, I believe you are doing the right thing by being under the care of a dermatologist and possibly an endocrinologist if you can’t get all of your answers from your dermatologist. With respect to your hair loss, there is not much I can offer if you are actively under treatment and have undergone the appropriate tests for other medical conditions that can produce hair loss in women.

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

Developed Facial Swelling from Propecia?

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

hiya i was taking propecia last year for about 6 months and it was great. i started again very recently and i’ve deleloped swelling in the face of my skin, i have stopped now. i’m just wondering if there is anything i can take that can counteract that and be able to still take propecia because it worked so perfect a such a long time before?
thankyou

I have never heard of Propecia causing facial swelling, but drug allergies sometimes present that way. It can happen with any medication. Facial swelling can sometimes be related to tongue and throat swelling, which may be life threatening if the allergy presents in its worse form. While life threatening issues from the use of Propecia (to my knowledge) have never been reported, it is still a remote possibility. And with only the information you provided without a physical exam and complete medical history, it is impossible to give you any advice other than to see your doctor and share these concerns with him/her.

Tags: propecia, finasteride, swelling, allergy, reaction, hairloss, hair loss

Low Ferritin and Female Hair Loss

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

Im female age 44. Last year I lost hair due to low ferritin stores. My level is now 100, when can I expect to see regrowth and should I continue to take supplements until I do? Thanks

It is impossible to give you a time frame, but I suspect you should see some hair growth in about one year. That being said, you may not notice any significant hair growth even after your low iron levels have been corrected. This is due to a phenomenon that is not well understood. At best it can be analogous to a genetic “switch” for hair loss that has been turned on when your iron stores were low. Even after the iron levels are corrected it is sometimes difficult to turn that “switch” completely off.

Tags: ferritin, iron, hairloss, hair loss, female, women, woman

Taking Propecia at 50

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

I just turned 50 and have been noticing more thinning on the crown and front areas of my head. When my hair is wet after a shower you can see the thinning sections, but when it is dry I have very good coverage. I do notice more hair than normal in the shower floor than before.

My question is about Propecia and Proscar as a possible treatment. Do they still have a positive affect at my age, or is there an age range that makes these less affective. Also, is this the same with Minoxidil 5% solution. I am trying to determine if I can realistically maintain my current hair thickness and possibly regrow some of my recent hair loss, or is this a problem that needs a medical evaluation.

Thank you.

Propecia is good at practically any age, provided that your have some hair or are in an active form of miniaturization (thinning) or hair loss. For example, Propecia would not help much if you are already totally bald.

My patent attorney, who is almost 80 years old, started Proscar a few years back, and the thinning hair on his crown area has grown back.

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

FUE Procedure to Fill In Scar from FUT?

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

Doc: For those of us who prefer to wear our hair very short and are concerned about a visible scar left behind by FUT, is it possible to receive a FUT procedure followed by a FUE procedure to fill in the FUT scar? If so, how much time must pass before performing the FUE? Have there been positive results? Thanks.

Yes, that is one way to treat the widened donor scars and the results are usually good. You should allow at least 8-12 months so the donor scar can complete its maturation before any intervention. Some patients may need more than one session for this type of procedure and it has to do with the location of the scar and the quality of patient’s hair.

Tags: fue, hairtransplant, hair transplant, scar, hairloss, hair loss, donor

Comment from a Skeptical Reader About Procede

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

if procede works why not sell it in stores? i’m very skeptical of having to go online or calling an 800 number. i’m vain enough to have considered buying it but my good judgement says NO. i believe in miracles but not this one yet. if the product is as good as claimed free samples would get more results as the word is faster than a bullet. besides i’ve gone to using nothing except shampoo and hair conditioner. besides i have a nice tan on the places the hair doesn’t cover and with those thin hairs i can cover all the bare places without it looking prearranged and funny. good luck to all attempting to grow hair!

Thank you for the comment.

Tags: procede, hairloss, hair loss

Result from Trichophytic Incision (with Photo)

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

In the photo below, you will see one of the best wounds I have seen after a strip surgery. In fact, I could not find it when I initially looked for it and only recognized it from some mild pinkish color that still remained in the scar area. Clearly, this is an atypically good healing situation with a good trichophytic closure where both technique and the patient’s healing characteristics work favorably for the patient. Photo taken just over 6 months after surgery.

Click the photo to enlarge.

 

Tags: hairtransplant, hair transplant, hairloss, hair loss, trichophytic closure, trichophytic, donor, scar

Tuberculosis Medication and Hair Loss

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

i have been taking TB medicine AKT-4 for 2 months and now i am on AKT-2 for six months. my hair is falling rapidly. is this because of my medicine? please advice

First and foremost, you should not start or stop taking any medication on your own without consulting your doctor that prescribed the medication to you. Tuberculosis is a serious matter and you should not do anything to jeopardize your treatment regimen. With respect to hair loss, it is virtually impossible to tell if it is the medication that is causing it. You may have a component of genetic hair loss and may be noticing a coincidental correlation or the existence of TB as a debilitating disease — this alone can cause hair loss. You may consider seeing a physician for further medical work-ups to rule out any other potential causes for hair loss and particularly determine if your overall ‘nitrogen balance’ is positive (nutritional balance). For genetic balding, finasteride should not be contraindicated.

Tags: tuberculosis, tb, akt-4, akt-2, hairloss, hair loss, finasteride

Scalp is Itching from Finasteride

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

Hi Doctor,

I am a 36 year old male and have been on Proscar (quartered) for 7 months now. I have been getting alot of itching in the front 3rd of my scalp and it seems I am loosing an abnormal amount of hairs, just up front. Could this be a shed?? And do you think they will come back?

It is difficult to answer your question without a complete medical history and exam, including a miniaturization study. Your hair loss may be a normal progress with or without Propecia/Proscar (finasteride). It may actually be less than it would have been if you were not on finasteride. Unfortunately, we will never truly know unless you had your hair loss and miniaturization status documented before starting the drug. If you think that the itching is related to the medication (possible allergy), try stopping it for a week and see if the itching stops. One week off the medication should not be a problem.

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

Fibrosis

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

I keep reading a lot about “fibrosis” and how it develops with male pattern baldness. Does this fibrosis mean that no new hair will ever grow in “fibrotic” areas except by transplant?

Thank You!!

Fibrosis refers to subtle microscopic changes that can be seen in the balding process, but if it exists secondary to balding, it is a controversial issue amongst doctors. Histologic assessment of the skin during balding may show some inflammation around the follicles followed by fibrosis (molecular deposition of collagen) of the hair follicle and its appendages.

Tags: fibrosis, hairloss, hair loss