Can I Have a Hair Transplant If I Have My Head Already Shaved?

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

Hi, is it easier to operate on a person with a shaved head (#2)? I want a transplant but i have a shaved head. Someone told me you can’t get a donor strip with the hair to short? Is this right? I thought it would be easier if I have a shaved head?

A shaved head can be transplanted. I generally like a couple of weeks growth so that the hair length will be about 1/4 inch, which is enough to cover the scar from the excision of the donor strip. Although it is easier to transplant a head where the hair is very short, with good skills and a great staff, it is not necessary to shave the head.

Tags: hairtransplant, hair transplant, shave, hairloss, hair loss, buzzed

Granzyme B Enzyme Linked with Aging and Hair Loss?

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

This press release speaks to some interesting research. Granted, this is the only place I can find this info on the web, so I can’t vouch for its validity.

Providence Health Care researcher Dr. David Granville has made a series of discoveries that could have a major impact not only on the treatment of cardiovascular disease, but also on other conditions associated with aging, including hair loss.

Full press release — Discovery links enzyme with atherosclerosis and aging

Tags: granzyme b, enzyme, aging, hair loss, hairloss, granville, providence

Punch Biopsy to Help Determine Cause of Female Hair Loss?

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

23 y/o female
All over hair loss for about 1 year.

I saw a dermatologist about a year ago, who did nothing but refer me to Rogaine. I am seeing a new doctor who suggested some hormone tests (all blood results came back normal last year) for FSH and a male hormone (she did not specify which). She then said “there is likely nothing we can do, but at least we’ll know the cause”. I am quite nervous about this, as I don’t wish to go through all the testing if there is nothing that can be done, and also because I have heard that with a punch biopsy hair must be shaved and hair will not regrow. She wants to do 2. Is it worth having this done? I am already losing enough hair and certainly do not want to voluntarily get rid of more…

Punch biopsyHair loss in women is a difficult problem, because most of the time there is no medical cure. Even if you correct the “curable” causes of hair loss, such as low iron levels or thyroid problems, it does NOT necessarily mean your hair will grow back. I suspect this is due to genetic causes, but women’s hair loss is different from men’s hair loss. Medications such as Propecia are not approved by the FDA (even if it were approved it may not work). Hair transplantation for women is also limited, because women’s’ hair loss is generally diffuse and there is no good “donor” hair area as there is in men.

Thus, often times doctors are left when a desperate female patient coming to them with hair loss and it is often times our reflex to order blood tests and biopsies to find the “problem”. Some conditions do show up on a biopsy, some of them are expressions of genetic female balding, and sometimes autoimmune type diseases like diffuse alopecia areata. Unless your hair loss is due to major medical problems, there are very few medical options available to you and Rogaine (minoxidil) is generally the main modality of treatment. When used as directed, the Rogaine works well in a small majority of women, and mildly in a larger proportion of women. Some doctors may offer a variety of steroid shots or other hormone altering regimen, but none of these methods have been universally accepted to work. The use of spironolactone injections have been discussed on this site before.

If you are losing hair and you need to know why, you can consider a punch biopsy. This is a question you need to address with your doctor, of course, as you weigh the risks versus the benefits. Your doctor should be able to tell you why there is a need for the biopsy and what he/she is expecting to see.

Tags: female, women, woman, hairloss, hair loss, biopsy, punch, diffuse, rogaine, minoxidil

Small FUE Procedures Every Couple Weeks — A New Marketing Gimmick or a Reality?

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

A patient came to see me last week asking about multiple, short Follicular Unit Extraction (FUE) procedures for his frontal hairline, eventually totaling 1400 grafts. He is a busy attorney and wants to have his hairline restored, but did not have the time to get it done. He went to a doctor who told him that he could come in after court every 2-3 weeks, and get 200 FUE grafts placed into the frontal hairline. As an attorney who does not trust anyone at first glance, he came to me for a second opinion. Money was not an issue, but the charge would be $2,000 for each procedure.

I told him that this did not seem like a good idea to me. If he had 1400 grafts total over 7 sessions just two-three weeks apart, the hair would fall out between the surgeries and the surgeon could not see where the previous transplants were placed, therefore possibly causing damage. I also believe that 7 surgeries are not as good as one, but if he insisted on multiple surgeries, he must wait 7-8 months between the surgeries so that the previous grafts would not be damaged. It is possible that two surgeries spaced 2-3 weeks apart (one on the right side and one on the left side) might be able to harvest 500-700 grafts through an FUE surgery, but he would have to keep his hair long.

For more on FUE / FOX Procedure, please see:

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

Blocking 100% of DHT?

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

Hi Doc,

I have asked you several questions in the past, all of which you have given me very good responses, I am very grateful for that.

This is just a speculative question; If 100% of DHT was to be blocked do you believe the number of patients growing hair would drastically improved.

Blocking 100% of DHT is seen in those individuals who are born with 5 alpha-reductase deficiency and there is no balding in these men. Androgenic alopecia (AGA), otherwise known as male pattern baldness (MPB), is genetic… and genetic predisposition will always win with any DHT production.

Castration is a radical way to block DHT formation by removing the major testosterone influence and we know that there is some androgen hormone production from other than the testicles (we do see women with androgenic influences on their genetic hair loss in some situations). I suspect, however, that a 100% block of DHT would stop the hair loss at whatever stage it is in, but not reverse what had already happened.

Tags: castration, dht, balding, hairloss, hair loss, testosterone

Traction Alopecia… From Masturbating?

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

I seem to look at pornography a lot and masturbate. As a result I’ve experienced hair loss around my thighs. What are some ways to regrow that hair and how long does it take to regrow?

I am sure that there are may ways to masturbate, but I have no idea what in the world you would be doing to cause traction alopecia on your thighs. Am I asking the right question here?

If you are particularly bothered by hair loss on your thighs you can try Rogaine (minoxidil), which may help. Transplants should be your last step and assuming that you have traction alopecia, you should stop (or alter) the action that is rubbing on your thighs.

Tags: rogaine, minoxidil, alopecia, traction, masturbation, hairloss, hair loss, thigh

Would You Recommend a Flap Surgery?

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

Hey doc, would you recommend or consider performing a flap surgery on those who would prefer having an amazingly dense hairline over one that’s more natural looking?

Most people who have had this procedure and have any continued balding, most certainly regret the decision of having it done. A natural appearance is far better than a dense one. In other words, no, I would not recommend a flap surgery.

Some people get competitive fullness with a hair transplant in just one session. An example of this is seen in sports broadcaster Steve Hartman, whose single procedure was performed by me about 3 years ago.

Tags: hartman, sports, flap, hairtransplant, hair transplant, hairloss, hair loss

Any Antidepressant Drugs Without Hair Loss Side Effects?

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

Hi Doc,

I was wondering if you know of any antidepressant drugs that do not have hair loss as a side effect. I have severe OCD and depression but I know if I was to take a medication and loose my hair I would be devastated. I was thinking about wellbutrin and did pick up a prescription for it but I am nervous about what it will do to the thickness of my hair sense I have always had thin hair to begin with. Your website has been very helpful and admire your work so any feedback you might have for me on this issue will be greatly appreciated.

Antidepressant medications do not necessarily cause hair loss, but it is a known side effect in a small number of patients. The most common cause of hair loss in men is genetic. Any changes in medications and its potential side effects should be discussed with your doctor.

Tags: antidepressant, depression, drug, hairloss, hair loss, side effect

Doctor Froze Bumps on My Scalp — Now I Have Even More Bumps!

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

Hello,

I am 54 years old and recently found bumps all over my scalp. I went to my dermatologist and before I could say a word she “froze” the bumps! I was in such shock and pain that I couldn’t move and when I got home, the bumps were much bigger, swollen and scabby. I started to use the shampoo she prescribed as well and it got a little better, but now I have twice the amount of bumps I had then before! Please help! I don’t want these bumps on my head and I’m afraid of going to another dermatologist. Just for some past reference, I do dye my hair and have been doing so for the past 25 years. Can this be something that is causing the bumps now? I really appreciate your help with this.

I honestly don’t know how to help you. I take the view that the doctor works for you, so if the doctor does not satisfy your medical needs, you “fire” the doctor and “hire” another. I don’t know what the bumps are or what could be causing them. You need to see a doctor who takes the time to bond with you. Unfortunately, I can’t provide more help without examining you.

Tags: bump, scalp, shampoo, dermatology

Chest Pain, Indigestion, and Outpatient Surgery

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

HeartYesterday, I received some sad news when I learned about the passing of one of our hair transplant patients just 5 months after his procedure. He had complained to his local doctor about chest pain and was told that it just was indigestion. This patient complained a number of times about the chest pain to his physician and each time he was tagged with the diagnosis of reflux. He recently had a heart attack and died.

Although the outcome was different, this reminded me of a similar case that I wanted to share. A female hair transplant patient had complained of periodic chest pain when I took her medical history. It sounded like cardiac pain (angina), so I had her see her doctor. He took an electrocardiogram (ECG — also known as an EKG) and told her that the pain was reflux (stomach type pain), not heart pain. She came back to me for a hair transplant, but I did not like her doctor’s diagnosis since it sounded like classic angina (pain coming on with exertion, climbing stairs, and fast paced walking), so I sent her back to her doctor. Again, he reassured her that the pain was not cardiac in nature, as her ECG was normal. I then got into her medical care and called her doctor, suggesting that he perform a stress ECG. He told me that it was unnecessary and again insisted that the pain was not cardiac. This lady wanted a hair transplant and was unable to persuade her doctor to get further testing, so because her doctor had cleared her and she wanted to proceed, I transplanted her.

During the surgery, she began experiencing chest pain, which I then treated with nitroglycerin, fortunately relieving her discomfort. This happened twice during the procedure. After surgery, I called her doctor and told him of the events at surgery. He saw her again after the transplant procedure and told her that she did not have cardiac pain and was upset with me for interfering with his medical care of her. I suggested to her that she see another doctor for a second opinion, but she liked her doctor and wanted to stay with his opinion. Three weeks after the surgery, she had a heart attack, and fortunately for her, she survived.

Being right is not a consolation from my point of view. We know from the anesthesia literature, that for people with heart disease and outpatient surgery, the risk of a heart attack in the 30 days after the surgery is higher than in the average person without surgery. Undergoing any surgery is no small matter and although I have never experienced any cardiac problems with my patients that I could not manage in surgery, risk clearance for anyone over the age of 45 years old, a good and thorough physical examination should be a medically necessity. We must all be on guard for detecting heart disease early and there are many good ways to do this today. The sad reality, however, is that in nearly 50% of cases, the first sign of heart disease is death.

Tags: hairloss, hair loss, chest, pain, indigestion, outpatient, surgery, heart attack, heart disease, disease, procedure, transplant

Salome Shampoo for Hair Loss?

/by William Rassman, M.D./8 /

Hi, Doctor Rassman, I’m a 22 year old male, i’m going bald and I found a colombian product: salome shampoo for hair loss it is intended for cancer patients I would like to know any expert information on this product. the website where it is been sold is: www.emarket-pro.com/tratamiento-m-salome.html

thank you.

SalomeMy Spanish is a little rusty, so I ran it through Google’s online translation here.

I do not know of this product other than the information you gave. I have looked at the site and I do not see any ingredients listed. Even if there were ingredients listed somewhere, I do not know of any natural herbal ingredients that actually grow hair.

It it apparently from Colombia and is on sale for the “low” price of $89 — wow, only around 40x the price of normal shampoo! And with free shipping in the United States! I don’t think I need to write the following, but for those readers that may actually think I am endorsing this product — I am being sarcastic. I understand hair loss can be devastating to some people, but sometimes common sense can get in the way of balding.

Tags: solme, shampoo, hairloss, hair loss

Deca-Durabolin and Hair Loss

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

I have used Deca Durabolin (Nandrolone) for two weeks (100mg/week) and I have started to lose hair. I have been told that tropical use of Spiromide and Minoxidil should stop the hair loss.

After doing some research I read in some forums that Deca Durabolin counter acts Minoxidil or Propecia. I would like your expertise on how to stop my hair loss and/or possibly reverse it. I am a 30 year old male.

Thanks

SyringeNandrolone is an anabolic steroid (such as Deca-Durabolin) and can accelerate androgenic alopecia (AGA), otherwise known as male pattern baldness (MPB). First, I would suggest that you stop taking it. See whatever doctor who is treating you and ask him/her about this. Unless you are under the supervision of a medical doctor, using anabolic steroids is illegal in the U.S. and also dangerous to your health. If you are under the care of a physician, I would address these issues with him/her. There is no role for me here.

For more info on nandrolone, see Wikipedia.

Tags: anabolic, anabolic steroids, steroids, deca, durabolin, deca-durabolin, hairloss, hair loss, minoxidil, propecia

Finpecia is the Same as Propecia

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

dear doctor,hi i use finpecia tablets for 4 day,my doctor suggested to me i use this tablet for always because my hair lose,i want to know that this tablet is the same as propecia and if it causes decrease sexual tendency and maybe porstate cancer, please explain to me,best regards.

FinpeciaFinpecia is the brand name that Cipla has given to 1mg generic finasteride. This drug is not legally available in the United States, as Merck still holds the patent for 1mg finasteride.

The phenomenon you mentioned has been documented in less than 1% of patients to decrease libido (sex drive) and the higher dose has been shown to reduce the risks of prostate cancer in men over 55. I suspect that the same anti-cancer effects will be at the 1mg level.

Tags: finasteride, propecia, finpecia, hairloss, hair loss, sexual, prostate, sex

Had Good Results from Propecia, Switched to Avodart and Now See Hair Loss

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

Hello. I have taken Propecia since 2004, with great results. I was sick of paying for it, and got my hands on avodart. I switched to avodart in March 2007, and it has been about 6 months now. My concern is that my hairline in the front has definately thinned, and there is no question that it began shortly after I started Avodart. My question is could Avodart have worsened my condition and will it continue to get worse? Will it grow back? Should I go back on propecia or wait this out? Thanks!!

You should address these concerns with the doctor who prescribed you Propecia (finasteride) or Avodart (dutasteride). If you switched to Avodart specifically due to cost issues, you should know there are other less costly alternatives, such as generic finasteride in 5mg strength, that you can cut in 4 pieces to approximate the 1mg finasteride (Propecia). I have very little experience with Avodart, but the limited studies which are published show some (more than Propecia) value at much higher doses.

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

Could Female Hair Loss Occur From Stopping Birth Control Pills?

/by William Rassman, M.D./5 /,

I am 29 years old. I have no herditary hair thinning or baldness in my family on either my mother’s or father’s side. But in the past few months my hair has been abruptly thinning. My pony tail is srinking and a lot more full length hair strands are coming out in my hair brush and comb. I am very freaked out at this point. I have always had a full head of hair. I did stop taking my birth control pills in the past few months. Is this the cause of the thinning?

Maybe… maybe not…

There is really no way to tell without a good medical history and a physical examination. If you are losing hair, first I would look to other causes and get a full medical work up which will define your hormone balances, hemoglobin, iron levels, and more (see list here).

Tags: birth control, bcp, hairloss, hair loss, female, women, woman