Today Show Tells How Women Can Stop Hair Loss

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

Every bit of information educates the public. Interesting reading.

From the article —

We normally have, on average, 100,000 hairs on our scalp. And as evinced by our changing hair lengths, roots and visits to our hairdressers, those hairs grow; in fact, 90 percent of our hair is actively growing at any given time. Hair is the second fastest growing tissue in our body after (I’d love for you to guess) … bone marrow.

Read the full article by Dr. Judith Reichman: Today – What women can do to stop hair loss

Cutis Verticis Gyrata and Hair Loss

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

I have a condition that is called ‘cutis verticis gyrata’ where the scalp grows ridges or abnormal lines on the surface. I have had this condition for some time, but have never been concerned before because I have hair that covers the ridges in my head. I’m in the beginning stages of MPB, and have been taking propecia for about a month. I don’t know if my hair loss will ever be extensive enough to show the condition of my scalp, but it causes great concern because I do not want this to happen. I am 32 years old. Have you ever dealt with this issue before? I have read a little on the internet to try to see what people have done with this, but there is not much out there about it. I have read that it has been treated with scalp reduction, which sounds reasonable, but then what? Any ideas?

Cutis Verticis GyrataAfter receiving your email, I wrote to a group of well-respected doctors to inquire about experience in this area, and the general consensus was that this should not be treated surgically. Most of the doctors I wrote to were dermatologists who may have an aversion to scalp reductions in this situation. You need to be evaluated by a surgeon, perhaps a very specialized plastic surgeon who has experience doing this surgery in a patient with your diagnosis. Logically, scalp reductions should work, but I wouldn’t recommend that you be the first patient to attempt surgery to correct this condition.

If you are concerned about balding (which might make the appearance more detectable) then I strongly suggest a miniaturization study to see what degree of hair is at risk of falling out, followed up by a Master Plan. If I was your doctor, I would explore your options after you became my patient, but I simply cannot give you an in-depth answer as I have not examined your scalp or your hair.

Image from DermAtlas

Tags: cutis verticis gyrata, scalp, ridges, hairloss, hair loss, dermatlas

Do You Think My FUE Procedure Was Traumatic?

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

Hi Dr. Rassman. This blog you got here is wonderful. Thank you.

I recently had an FUE procedure of about 4000 grafts. It took the whole day for the procedure. The first 5 hours weren’t too bad but the last few were terrible because of the constant need for freezing the donor area for the use of extraction.

Some of the later extractions from the donor area hurt me and no matter what I did I still felt the pain and I couldn’t bear it. But being the man that I am I didn’t complain. Rather, I silently cried and couldn’t stop crying for about 15 minutes. I really couldnt control myself. I am not a man who cries over things like that but my body couldnt control the pain and crying was a form of relief to me at that point.

That’s when they stopped everything and gave me about a 30 minute break. Everything went ok after that.

My question is regarding shock loss. Do you consider what I went through trauma? What are the chances that I would get shock loss? And how would you know whether your natural hairs or the grafted hairs have fallen off due to shock loss?

During these 5 days of post op cleaning, I havent really seen anything fall out. Oh and I am taking proscar daily for 6 months now.

Thank you very much for taking the time to answer my questions. I really appreciate it.

Regards

YES!!! I absolutely think your FUE procedure was traumatic!

There is no reason why you had to bear the pain and cry. That is absurd! The surgery is done under local anesthesia and you should not have felt any pain and should have had medications on board to help you deal with the length of the procedure and your emotions. It should be a painless surgery. I am shocked at your story and I am sorry that you were so traumatized.

Shock loss, if it occurs, usually starts weeks after the hair transplant procedure and runs its course over a few months. Previously transplanted hair rarely is effected (I have only seen it less than a dozen times), but your surgeon should be aware of what miniaturized hairs you had and did not have. Shock loss usually occurs in the miniaturized hairs and a good hair transplant surgeon should be able to tell you that. As you are only a few days/weeks following a transplant, I would doubt enough time has gone by to evaluate your concerns. This is something you should speak with your doctor about, as it is his/her job.

With respect to 4000 FUE grafts, I also find that very difficult to believe in sheer numbers, since 2000 grafts would be a very high number for any surgeon. Your wound would also have been massive since a 1mm diameter FUE instrument on 4000 FUEs would leave about 19.5 square inches of punched skin. It would be equivalent to the area of a 4 x 5 inch note card. You must’ve either had a very large wound or a very large head. Privately, I would like to know the name of the doctor who claims to be able to do 4000 FUE grafts in one day and I would love to know what the percentage of grafts that were successfully harvested and not damaged.

Tags: hairtransplant, hair transplant, fue, trauma, pain, hairloss, hair loss, grafts

I Have Thin Hair Around All Around the Sides

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

I started loosing lots of hair right after i turned 21, i’m a male 26 now, some hair has to be growing back because in all these 5 years after all the hair i saw i lost i still have hair, my hairline is intact but i have thin hair ALL AROUND including the sides. What i noticed the most is that i wash my hair daily, but in the morning my scalp is very oily and greasy same as my hair, very itchy too. I can take with my nails the build up thats on my scalp, its oily and kind of yellow colored. I can see when i look at the hair shaft that falls out that there is always this kind of flake or build up attached to the end of it (coming from the scalp). When i pull out hair from my head a lot of hair falls out with the same description. For the itching and burning sensation and the very oily scalp i’m pretty sure it has something to do directly with all the hair lost. I used and try all shampos like t-gel. nizoral , ect, making it worst, more flakes and more irrtitation. What tipe of hair loss do you think i’m suffering or what kind of scalp problem do you think it is???

Unfortunately, I can’t really give you a great answer to your question without examining you. Many people write to me with partial descriptions of things that they recognize, but they often do not understand what they are seeing. A trained eye from a good dermatologist will tell you what you are experiencing. There is no simple way to go on the internet and solve even many of the simple problems.

Tags: hairline, hairloss, hair loss, thinning, problem

My Hair Regrew with Propecia and the LaserComb

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

Hello.

This is MY video: YouTube – Hair Grew Back with Propecia, Laser Comb, and Rogaine foam

My hair DID regrow using Propecia and the laser comb MAY have helped thicken the existing hairs. I don’t even care if anybody buys the laser comb, in fact, I often tell them not to buy one. My video is 100% real and I would never mislead anyone into thinking something that wasn’t true.

Both Dr. Bernstein and Dr. Bauman believe the laser comb works to some degree. It’s fine to disagree with them, but please understand that my video is 100% real and true. I’m an advocate for hair loss sufferers, I would never send them to buy a product that doesn’t work to some degree.

I have been on the radio show “The Bald Truth” debating with the Hairmax company against their claims! I say it doesn’t work anywhere near what they claim. I told them the product was disappointing, but may have thickened my existing high quality hairs. I’m even open to the suggestion that it was a placebo effect.

Bottom line…my video is real.

Thanks, I think you’re honest and have the same goal as me…….educate patients!

Good for you! Thanks for sharing this. You do agree that the results are sometimes disappointing compared to the advertisement, but I have seen many patients achieving similar results with Propecia alone, particularly in men under 27 years old.

I can’t display the video on this page since he’s disabled the ability to embed the video, but it can be seen by going to YouTube.

Tags: hairloss, hair loss, lasercomb, finasteride, propecia, laser, comb, hair growth, hairmax

Better Diagnosis for Prostate Cancer

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

The diagnosis for prostate cancer is a hit or miss process based upon elevated blood tests for PSA and blind needle biopsies, which are done over and over again until a diagnosis is in hand. This announcement is an alternative way of making the diagnosis with a new diagnostic tool that men need to know about.

So while this isn’t hair related, it is important for men to know about. From the article —

Presently, a new case of Prostate cancer is diagnosed every 3 minutes while 90 men die from prostate cancer every day. Prostate Biopsy, the “gold standard” for finding cancer of the prostate is associated with trauma, infection, bleeding and sampling bias. National statistics show that 10 men must undergo an ultrasound and biopsy to find 2-3 cancers. Translated another way, 7-8 men must undergo a procedure that is unnecessary as documented by a negative biopsy.

Read the full pres release: New Prostate Cancer Technology Saving Lives

Tags: prostate, cancer, biopsy

When I Wash My Hair, More Comes Out From the Top than The Sides

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

I am 33 and have receeded to what I hope is just a mature hairline. I have noticed that when I wash my hair, I get at least twice as much hair coming out from the top of my head than the sides and back. Is the hair on top of the head more prone to coming out, or is this a sign of hair thinning on top?

If you are prone to male pattern baldness, you should expect significant miniaturization before see any baldness. You should get your scalp mapped to help determine just what is going on. It may help you to predict your future hair loss.

Tags: hairloss, hair loss, baldness

In the News — Young Girl Went Bald After Getting Braids

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

Braids can cause hair loss from the traction that is produced by the tight pulling. Unfortunately, this 8 year old girl experienced a horrible scenario from her new hairstyle.

From the article —

Jodie, eight, pestered her mum for the £30 style after seeing a stall offering the service. But days after arriving home her locks started to fall out because the braids had been wound too tight, killing her hair follicles.

Traction alopecia

Read the full article: Hols hair braids made me bald

Image from The Sun

Tags: traction, alopecia, braid, braids, hairloss, hair loss, pull, tight, young, girl, hairstyle

Scalp Pimples Weeks After Hair Transplants

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

I had 2200 grafts in the front. About 6 weeks later, I noticed pimples breaking out on my head. I went back to my doctor and he put me on an antibiotic which helped for a week and then when I went off the antibiotic, the pimples came back. What is happening to me? Will this kill off the transplants?

After a hair transplant, spicules of hair are left behind after the grafts have shed. These spicules of hair can be like a foreign body and cause cystic reactions. This process is usually self-limiting and with warm soaks, will disappear over the next month or so. I believe that every person has these spicules in the recipient area, but only a limited number of patients have these type of reactions. The differential diagnosis is important here, namely distinguishing it from folliculitis, which can endanger the growth of the grafts.

You may have heard about MRSA (Methicillin-resistant Staphylococcus aureus), and if this should occur, a culture of these pimples are important to determine the correct treatment modality. There can be iatrogenic (doctor induced) causes where during the placing process the staff ‘piggyback’ one graft on top of another. This is often due to poor quality control processes and if the doctor sees this often, then the doctor may have a problem with his office staff. In less experienced hands, this is an iatrogenic problem so a good solid surgical team with good quality control systems in place will guarantee that this will not happen to you.

If properly treated, these sores will not cause hair loss. Sometimes local drainage with a needle is needed, but usually they will spontaneously drain on their own with frequent warm compresses.

Taking Half a Propecia (0.5mg Finasteride) Twice Daily?

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

If the half-life of finasteride is 4 to 5 hours, wouldn’t it be better to split the 1mg propecia pill in two, and take one in the morning, and one in the evening?

The half life of finasteride is 4.5 hours. This means that in 4.5 hours, serum levels of finasteride drop to the half of its original level, but the tissue levels will last longer than the serum levels. Finasteride blocks the effect of the enzyme 5-alpha-reductase, and the effects of the medication due to the blocking of this enzyme is actually much longer and can last up to a few days. On the other hands, the body can eliminate the finasteride, but the pharmacological effects of the medication persist long after.

Considering long lasting pharmacological effects of finasteride, taking it on a more frequent basis probably does not make any difference in its final results.

Tags: finasteride, propecia, proscar, hairloss, hair loss, half-life

Another Hair Transplant Clinic Called NHI

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

Hello NHI team,
I was wondering if you have heard of another NHI hair transplant clinic in greece and how they can use the same name. They use the choi implanter. Their representative is a man called Malcolm Mendelsohn. Heres their web site www.nhihairclinics.co.uk

I try to refrain from commenting on other clinics unless specifically asked. One can only assume that the NHI name was taken by this man for his clinic, because he wanted to claim some affiliation with us (or give the illusion of such). There is no connection between this clinic and the New Hair Institute. The name has also been copied by others in various parts of the world for hair transplant clinics (from Australia to the UK to even here in the US) with the same nefarious reasons, I suspect.

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

In the News — Rogaine Foam Has Advantages?

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

From the article —

Unlike Rogaine solution, “the foam formulation does not have propylene glycol, an agent that commonly causes irritation and occasionally causes an allergic contact dermatitis,” said Dr. Elise A. Olsen, professor of medicine in the divisions of dermatology and oncology at Duke University Medical Center, Durham, North Carolina.

“Many patients prefer a foam versus a solution that may drip on application to the scalp. The foam is not greasy or drying,” she added.

Read the full article at Reuters Health: Foaming Rogaine has advantages, expert says

Tags: rogaine, minoxidil, foam, health, propylene glycol, duke, hairloss, hair loss

Age and Hair Transplants

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

At what age will a transplant not work?

I have done hair transplants on children with bad scars and men as young as 89 years old. They really work regardless of age. I perform it with the same basic anesthesia routine, but in children, I often use less systemic drugs if one of the parents comes into the operating room and holds the child’s hand. There is nothing more soothing to a child than the touch of a parent’s warm hand.

Tags: hairtransplant, hair transplant, age, parent, young

In the News — Every Man Fears Going Bald

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

History, from the earliest recorded times’ bares out the impact of balding on men, their manliness, and their sexuality.

From the article —

It’s a terror so great that a musical superstar such as Sir Elton John, whose hair has been as thin as a Chernobyl technician’s since the mid 1970s, convinced himself he could fool the world into thinking that he has a mane as lustrous as a teenage beauty queen. It is this kind of susceptibility to mass delusion….

Read the full article by Christian O’Connell: TimesOnline UK – The thing every man fears

Tags: bald, bruce willis, elton john, Hair Loss, hairloss, tony blair