Is There a Recommended Hairstyle After a Hair Transplant? (with Photos)

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

Hi Dr. Rassman,
I am 33 years old former patient. I was wondering what kind of hair style you recommend for patients who have had a procedure done? I have great coverage in the front but it gets a little thinner towards the back which however, is a huge improvement from my balder self. I would love another procedure, but I have had two so far and I think I will have to wait financially to afford the third one. Until then…is longer on top better or is shorter better? I sometimes feel a little more “exposed” on top when I cut my hair short revealing thinner hair. I was also wondering about highlighting my hair for a thicker look? I have dark blonde hair currently.

Thanks and happy holidays

If what you’re asking is for hair style decisions after the new hair growth is starting, look to the photo galleries on NewHair.com to see all types of hair styles used by transplant patients. There isn’t one best way to style your hair. Some opt to keep the hair a little longer to cover thinner areas, but that is really a patient decision, not a doctor decision. In other words, I don’t really have any styling advice.

Since you have had previous procedures, you’re intimately familiar with how the recipient area looks immediately post-op, but I’ll use this opportunity to answer one of the most frequent requests I get from people — to see what a hair transplant looks like just days after it is done. Many are concerned that they will be a walking billboard for surgery, and understandably so. I tell these patients that if they had any hair in front, they could cover the hair transplants. Of course, each person is different and your redness level may differ from the patient below, but here are photos taken just 12 days after a procedure of 1,959 grafts, showing a patient who used his existing hair to cover the transplanted area (only one side is shown in these photos which reflect half of the total number of transplanted grafts he received). Note that when you zoom in on the photo, most of the hair has already fallen out (and will return sometime between 2-5 months).

Click photos to enlarge.

 

Tags: hairloss, hair loss, hairtransplant, hair transplant, photo, styling

Persistent Juvenile Hairline in Advanced Balding Man (with Photos)

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

The pictures below are of a man of Indian decent who lost most of the hair on his head, but kept his juvenile hairline intact. We see this rarely in European Caucasians and more frequently amongst people from South Asia. This particular man is in his mid-thirties and may get a good response from Propecia, as his hair loss has just appeared in the past 2-3 years. If he does not benefit from the medication, a hair transplant will be on his agenda.

Note that there was no hair transplant performed on this patient as of the time these photos were taken. This is his natural balding pattern. Click the photos to enlarge.

 

What is particularly important to note is that this juvenile hairline is just the exact same part that is generally lost in the Caucasian maturing hairline. Please compare the hairline shown here with the one from a previous blog, Maturation of a Hairline — Moving From Juvenile to Mature and imagine that one is just the reverse of the other.

Tags: hairloss, hair loss, hairline, miniaturization, juvenile, mature

Female Hair Loss and Postmenopausal Hormone Changes

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

I have been asked many times about the drop in estrogen levels with menopause and its effect on hair loss as a protective hormone. The following comes from Dr. Bernard Nusbaum of the Hair Transplant Institute Miami:

“We generally attribute the increased incidence in female pattern hair loss in postmenopausal women to decreased estrogen levels but, the role of estrogens in pattern hair loss is not well understood. Androgens, because of their conversion to estrogen by the enzyme aromatase, indirectly influence estrogen effects. How estrogen affects hair growth is uncertain. There are studies on mice which show that topical estrogen application inhibits hair growth and treatment with an estrogen blocker caused hairs to grow. Laboratory studies on human follicles have shown that estrogen inhibited growth of cultured human follicles.

In contrast, hair dermal papilla cells have been shown to grow in response to estrogen in the laboratory. Also, estrogens are known to increase the production of the protein, sex hormone binding globulin, which leads to a lowering of the active form of testosterone in the blood. Reports of using topical estrogens in patients with pattern alopecia are mostly anecdotal but one double-blind six-month trial of topical estradiol showed stabilization of hair loss in male and female patients.”

Tags: postmenopausal, post menopausal, menopause, hairloss, hair loss, hormone, women, woman, female

Is My Hockey Helmet Causing Hair Loss?

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

I am a seventeen year old. I visited my doctor he said I have male pattern baldness. My hairline is starting to recede quite badly. But I did some research and I learned that people with certain hair styles, get hair loss, such as braids because it applies stress to the scalp. I was wondering if my hockey helmet can be the cause of this, because it pulls on my scalp. Also I am wondering if my hair will grow back once I sort the problem out with my helmet.

Hockey helmetIt is possible that constant rubbing can cause traction alopecia (hair loss from pulling), but a good examination by a good doctor in the hair field should answer that question for you. If you started with early male pattern baldness (MPB), then you should get your hair mapped out for miniaturization and this will tell you if MPB is a reasonable diagnosis.

Could you just be developing a mature hairline? That is a question I simply can’t answer without seeing what you’re talking about.

Tags: hairloss, hair loss, sports, hockey, helmet, traction, alopecia

20 Year Old with Early Hair Loss

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

Hi, a dermatologist told me that I am definitely losing my hair. I come by it naturally as my father is bald. I am only 20 and wonder if I started now with the transplants it would be less noticable to people. I am already getting comments from people concerning my hair loss. It is really beginning to affect my life. Can you help? Thanks,

In a young man just starting to lose his hair, the best treatment is not hair transplants, but rather medications. Propecia (finasteride 1mg) is the best way to approach the problem. Transplanting you at this age would be not only unethical, but wrong. I tell young men that see me to treat their hair loss that they need to get their hair mapped out for miniaturization prior to starting the drug so that you can understand the impact of the drug on hair measurements. The drug can stop and possibly reverse the hair loss if it is early.

Tags: propecia, hairloss, hair loss

I See Growth from Laser Treatment, But Still Experience Hair Loss

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

HI,
Im a women of 25 years old, ive always had probles with my loss of hair, some months ago i heard about the laser hair therapy so i started a treatment. Ive been doing that treatment for about 3 months (Twice a week) and even i have noticed i have some newborn hairs i still loosing a lot of hair (about 100 per day), is that normal? what else can i do? Also i wanted to know if the laser hair therapy has any side effect…
Thank you!

It is normal to lose about 100-150 hairs a day, as new hair should grow (with or without laser) in place of those hairs that were lost. Sometimes we tend to lose more at certain times than at others and we quickly jump into panic mode. I cannot say if the laser treatment has regrown your hair, but if you think that the laser has given you a positive overall effect, then go for it. I don’t know of any side effects, other than an empty wallet. As for what else you can do — minoxidil (Rogaine) is a FDA approved treatment for female hair loss, if you want to give that a try.

Tags: laser, hairloss, hair loss, treatment, regrowth

Will Hair Dye Cause Cancer?

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

Hi doc,
I have a question regarding hair dye. I have found articles on the internet linking hair dye to cancer. Is there any medical truth to this or is a basic dye product, such as Just for Men, safe to use? Thanks

Certain chemical colorings may have potential cancer risks, but that does not necessarily mean you will get cancer. Read the product label for any warnings. Any real risks must be appropriately labeled by law in the United States and most countries.

Tags: cancer, hair dye, dye, risk, chemical

Late Onset of MPB? (with Photos)

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

Hi Dr. Rassman,

Consider this permission to use the photos if you use my question.

51 years old, full, thick head of hair until recently. I have been thinning for about 2 years I guess, it has been a few hairs here and a few there. Didn’t think too much of it until this last 6-8 months when it really seemed to accelerate. My brother is 59 and has no balding in the crown/vertex. I started on Propecia in December of this year and have been tolerating it well. So far no side effects. Have a very stressful life ( I’m in Healthcare ! ) and this Year has been the worse.

My question is ? I would like to try the propecia for a full year to see if it can help. Given my age and late onset of what I think is MPB do you think this is a good course of action ? At what point would I be a candidate for a hair transplant ?

Thanking you in advance, maybe one day we will meet !

 

It is unusual for a man of your age to start genetic hair loss, but I have seen it before. You want to make sure that you do not have a medical illness that is causing it. Propecia is most effective with recent hair loss of 2-3 years duration. Thank you for giving me permission to post your photos (click them to enlarge).

You have some options. You can try taking Propecia for 8-12 months. As a general rule, the older you are, the less likely will be the response, but with your gray hair, any response will add value and with the 2-3 year history of hair loss, you may break the ‘rules’. If you still have no response after that period of time and wish something done about it, then a hair transplant may have value. Alternatively, you can have a transplant and take Propecia. There is no doubt that the hair restoration will be good with the transplants alone, and any gain you have from the Propecia is a bonus. The more the grafts, the better the fullness if you go forward to transplants. I’d estimate between 1000-1500 grafts might give you reasonable coverage.

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

Silicium 44 Shampoo

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

I have been using Silicium and there was nothing wrong previously with my hair but after seeing the product in a shop i thought i would try it to make my hair thicker.(they say do not try and fix something that is not broke) After a month my hair started falling out with the root end quite visible at the ends.I stopped using it but now 2yrs on and my hair is still falling out excessively. Please could you tell me what is in the product that could do this to me. If my roots are damaged by this product is there any cure for me now. Please help me?? (i am 28 now and started using it when i was 26)

Silicium 44It is impossible to answer that question, as I’m not even completely sure what the product you’re talking about is. Some quick Google searches showed me a product called Silicium 44 that calls itself a “hair loss shampoo”, although I can’t find more info than a sale listing on a UK pharmacy website. I assume this is the product you mean, but even if this is the one you’re talking about, I unfortunately don’t have more info than the description provides — “It contains uniquely concentrated organic silicon which helps the self repair of damaged roots“. Silicium is the latin word for silicon, so the name isn’t a mystery.

A good examination of your hair and scalp needs to be done by a competent doctor who is skilled in this field. Sounds like you may have screwed up 2 years ago by not doing the right thing and getting yourself examined. Your hair is too important to treat in such a casual way!

Tags: silicon, silicium 44, silicium, hairloss, hair loss, shampoo, product

Vacuum Pump Regrows Hair — from Popular Science Magazine in 1936

/by William Rassman, M.D./0 /
Hair Growth Vacuum - 1936

From the November 1936 issue of Popular Science Magazine comes this gem, thanks to the great Modern Mechanix site. It should go without saying, but the article is over 70 years old now, and if the technology was successful as it claimed, it would probably be the recommended treatment today. My favorite part of this has got to be the caption under the full image, which says “A patient receiving the vacuum treatment for baldness while he reads and smokes in comfort“.

Here’s an excerpt from the article:

USE VACUUM TO AID HAIR GROWTH

CAN SCIENCE restore hair to the bald? Startling results in the affirmative are reported in 500 cases treated with a new machine, developed by Dr. Andre A. Cueto, of Cincinnati, Ohio. Fourteen to twenty half-hour treatments are said in many cases, to produce the appearance of “fuzz,” and from this point on the patient is declared to progress toward a normal growth of hair.

Read the full text at Modern Mechanix

Tags: hairloss, hair loss, vacuum, 1936, popular science, modernmechanix, gadgets, technology

I’m Worried That When Cleaning My Transplant Scabs a Week After Surgery, I Injured Grafts

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

I had my first transplant recently and the washing of my scabs did not go as smoothly as planned. In other words on day 6 or 7 my scabs were such that they felt soft enough to gently scrap, which I did. The stress for me was that many, many hairs accompanied those scabs for which made me think, did I lose the entire transplanted graft? Some scabs had a fatty white tissue attached. Am I okay? A tech stated not to worry as the hairs are their permanently after the first couple of days, is that true? I was very gentle during the washing process but am concerned that I may have lost the entire graft?

Generally, when the scabs are off, there is no risk of graft loss. When there are scabs present, you can pull out the grafts if you are rough with it, but at a week, it would be unlikely. Most people see scabs and hair and something that looks like a graft to the untrained eye, but it is generally not grafts at a week. For more info, please see:

Tags: hairtransplant, hair transplant, healing, heal, scab, scabbing, hairloss, hair loss, graft

Hair Loss from Exercise?

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

Hello Doctor. I’m a 31 year old male with a receding hairline. I’ve been using Propecia for 2 years now and I believe it has stopped the recession. I would like to start exercising again to get back in shape, but I’m afraid the increased Testosterone levels from exercising will put me at risk for further balding. Now, I don’t want to lose any more hair, but I don’t want to remain out of shape either. Are my fears well founded or is hair loss and exercise not related. If my fears are well founded, what can I do to exercise yet not cause any further baldness. Also, since Propecia effectively cuts the levels of DHT in the body, will that inhibit any gains from exercising? Thank you.

Exercise will not cause you to lose hair, so I think you’re safe to start working out again (unless you have some injury or underlying condition that you haven’t mentioned). What I mean to say is — don’t let fears of hair loss stop you from keeping in shape. To my knowledge, there will be no impact on your muscle mass caused by Propecia (finasteride 1mg).

Tags: exercise, workout, hairloss, hair loss, finasteride, propecia

Testosterone Therapy and Hair Loss

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

Hi Doctor:
Since being on Testosterone therapy for about a year now, I am suffering from serious male pattern baldness. I am 49 and realize it is natural to lose some of my hair but I know it is coming from the testosterone. If I discontinue the treatment (against my Doctor’s wishes) will the hair loss stop and perhaps even grow back as the testosterone level drops or is the damage already done?
Thanks

Once the testosterone has precipitated the hair loss, the loss is not reversible. Maybe your final hair loss pattern has not occurred, and if that is the case and you stop the testosterone and go on Propecia, maybe you can still save some of the hair that will eventually fall out. Please discuss this with your doctor more or see another doctor for a second opinion.

Tags: testosterone, hairloss, hair loss

Advice for a 16 Year Old with Bald Spot?

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

Okay, Well I’m not quite sure how this works but I’ll try it out anyway. I’m a 16 year old male living in the state of Washington. I constantly get crude remarks on how I have a bald spot. Self confidence and the inability to function without a hat is very depressing. I the thing that gets me is how young I am. If you could provide any advice it’d be very much appreciated.

Thank You.

Without seeing you, I do not know what you mean by a bald spot. Are you balding? Did you suffer from some trauma on your head, which produced a bald spot? You need to be examined by an expert doctor. If you are balding, then you will show miniaturization of your hair in the balding area. Even at your age, when balding occurs, the drug Propecia usually works very, very well to reverse it.

Tags: age, teen, hairloss, hair loss, trauma, balding

Woman with Tingling Scalp Pain; Doctors Can’t Find Anything (with Photos)

/by William Rassman, M.D./3 /, ,

I am a 22 year old female, active, healthy diet. For a year I have slowly been experiencing some form of hairloss. It seems that with every hair that falls out there is nothing to take its place. I have been to the dermatologist 3 times, and had a skin biopsy that came back perfect. The Derm gave me tetracyclen to try but after 4months I found it wasn’t working. She then sent me to a rheumotologist who see’s no signs of lupus etc. But saw in my blood work that there could be something wrong with antibodies?, she has given me APO-Hydroxyquine 200mg to try for 4 months. With my hairloss I feel a lot of tingly, burning and pain which makes me feel that this would be a skin situation, apparently it isnt though because of my clear scalp biopsy! When i get these tingling sensations in my head I will also sometimes feel the same pain on my nose, back and shoulder. I have sent you a photo to help! I have been reading your blog and trust your word more than anyone else.

 

Thank you for the compliment and the trust, but I really am not your doctor and I do not have the luxury of examining you in person. I do not take your trust for granted and I do appreciate you sending me photos with permission to publish them here.

Moreover, it seems you have been evaluated by many doctors for your condition. I realize that you are frustrated and confused about your condition and lack of improvement despite various treatments. The best advice I can offer you is this — what doctors do is often referred to the “practice of medicine” and not a complete “science of medicine”. I realize this isn’t what you want to hear (or read, as the case may go), but this points to the fact that sometimes we (physicians) are just as confused as you (patients) and sometimes there are no good treatments to offer. If you want a medical opinion, you must establish a doctor/patient relationship and that is something that just can not be done over the internet.

Tags: patient, doctor, tingle, pain, hairloss, hair loss, female, women, woman