I’m Wondering If My Strip Scar Is Bigger Than Most

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

Hi Doc,
Have a question on my strip scar. I can shave the sides with a #8 guard and can still see my scar, do you think its a little bigger than most. I also have light hair. Had my procedure done at [name removed].

Everyone has a linear scar after a strip hair transplant, but some tend to have wider scars than others. Normal scarring in 95% of first time hair transplant patients is under 2-3 mm. Scars are produced by a combination of:

  1. surgical technique
  2. healing properties of the patient
  3. tension on the wound

Don’t be too hard on the doctor, for as you can see from the above list, you are more likely the cause of the scar from healing properties. The medical group you used does good work. I am sure their surgeons are all well qualified and fully capable of performing the strip excision.

Tags: scar, strip, hairtransplant, hair transplant, scarring, healing, tension, wound, donor area, hairloss, hair loss

The Study That Was Submitted to the FDA Before Approving the LaserComb

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

I was looking at a site called hairlossadvances.com and on it they show a study that they claim is the actual study that Lexington submitted to the FDA for the lasercomb’s 510k SE clearance.

What I found odd was that the study was completed some 9 months before it was submitted, one of the exclusion criteria for participants was having a buzz cut, (you’d think that having shorter hair would allow more ” nourishing laser light” to penetrate the scalp and provide better results) and the person producing the study claimed that the study wasn’t required by the FDA. Have you seen this study, and if so, what are your thoughts.

I have seen the original study and I have published my opinions on the matter:

I tend to agree with your astute observations and criticism. This is a subject that I can not fight over. There seems like there is some evidence in the study that it works, but I frankly don’t believe it. It is hard for me to believe that there is almost 100% more growth after a few months. The FDA study is what it is.

Tags: lasercomb, laser comb, hairmax, lexington, fda, hairloss, hair loss, hair growth

13 Year Old Girl Found a Bald Spot After a Haircut

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

Hi, I am a 13-year old female girl. A few months ago in December 2007, I got a haircut and noticed a bald spot about the size of a dime on top of my head a few days later. I was really worried, and told my parents about it. They said me that it was due to stress in school etc., but I wasn’t completely sure.

It is now February. I’ve noticed a few days ago that there was a small part above my forehead that had very little hair (I have bangs). I have a feeling that I’ve been losing more hair, but I could be overreacting. I think that the previous bald spot had expanded.

My parents have made an appointment with the doctor, I will probably be going to see her in a week or so. Since I was a baby, I’ve had eczema, a skin condition, and I don’t know if it has any links to it. I don’t really remember, but my dad told me that around 5 years ago I’ve had this hair problem. The doctor gave me some medicine to put on my hair, and it seemed to work.

After looking on the internet for information, I’m really worried about any conditions I might have. I’m scared I’ll lose all my hair in the next few months or so. Any info will be greatly appreciated, thank you so much.

The right thing to do would be to see a doctor. There are many causes of bald spots appearing, some of which have been discussed on this site before (ringworm, alopecia areata, etc.). A doctor should give you a diagnosis after an in-person exam. Via the internet and based on just an email, I would just be blindly guessing.

Tags: hairloss, hair loss, haircut, bald spot, girl, teen, female, women, woman

How Do You Measure Scalp Laxity?

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

Hello dr Rassman

How exactly do you figure out the laxity of the scalp and the residual donor area capacities if somebody went through strip procedures in the past? Is there a “measurement” possible or is it only by touching and feeling?

Thanks

There are two tools that I use on occasion, one in the office and the other in the operating room. We call it a Laxometer which we invented and just submitted for publication in the Hair Transplant Forum. Experienced surgeons know how to test and quantify scalp laxity at examination and good surgeons develop a ‘feel’ for it. You can see the video on scalp exercises and estimate the up and down movement. One half inch is average, more is better, less is tight.

Tags: scalp, laxity, exercise, hairloss, hair loss, hairtransplant, hair transplant

Female Hair Loss After Stopping Topamax

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

I did not have hair loss while taking Topamas, but after weaning off of the Topamax, it was 3 months later when I started losing a ton of hair as described by others in this blog. I have been losing hair for a month now (I’m 4 months off of Topamax). I’m not taking birth control pills or DHEA. I too had all of my bloodwork done. I do have new hair growth, but I’m wondering when the hair loss will cease. Any estimates? Thanks very much.

Topamax is an antiseizure medication known to produce hair loss. It sounds like you are going through a telogen effluvium and that you are cycling your hair, with some returning and others falling out. Wait this out for 8 months. Sometimes minoxidil helps move the process along.

Tags: hairloss, hair loss, topamax, topiramate, migraine, epilepsy

Benzoyl Peroxide and Hair Loss

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

Is it possible that a particular acne treatment (benzoyl peroxide) can cause hair loss at the temples and receding of the hair line if applied too close or on to the hair? This has occured over the last 6-8 months and i’m not sure whether the cause is male pattern baldness or the acne medication.

Benzoyl peroxide is a weak acid sometimes used for acne. It can irritate the skin, but it should not cause hair loss since the effects are probably superficial. The most common cause of hair loss in men is genetic balding and a good doctor should be able to point to the diagnosis.

Tags: benzoyl, peroxide, acne, hairloss, hair loss

Hair Loss from Cyst?

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

Can I have lots of hair fall due to a Cyst in my scalp?

A cyst should not cause hair loss unless it becomes infected. Unfortunately, you just did not supply me with enough information to be helpful. A picture would be useful, or even your age, sex, and hair loss history. I would see a dermatologist.

Tags: hairloss, hair loss, cyst

The Damage Produced by Sun Exposure (with Photos)

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

This is a 70+ year old man who had blonde hair in is youth. He was a lifeguard for 15 years and constantly got sun burned. The price he paid for this sun exposure is monthly visits to his dermatologist with many, many skin cancers. Notice that his hair loss could not be worse, with hair not only in the front and top, but also the sides to just behind the ears. I suggested that he was not a candidate for hair transplants. You can see the many scars resulting for removal of his skin cancer. The message to take from this is to stay out of the sun and certainly be careful that you don’t get sun burned!

Click the photos to enlarge.

 

Tags: hairloss, hair loss, sun damage, sun, cancer, skin, dermatologist, photo

Propecia and Reflex Hyperandrogenicity

/by William Rassman, M.D./4 /

Dr. Rassman, if you could, please answer this question. It’s very important, I’ve seen a ton of people online that really need this clarified for them by an expert in this field. Can Propecia cause Reflex Hyperandrogenicity, thus actually accelerating your MPB and, if so, what are the symptoms? I can’t tell if this is happening to me or not. Also, if I have lost hair due to Reflex Hyperandrogenicity is that hair gone forever or is there a chance I can get it back?

HairLossHelp.com has a good explanation of reflex hyperandrogenicity —

“When the effects of androgens in the body are lessened, e.g. through lowering DHT or by systemic hormone receptor blockade, the body seeks equilibrium through a process called upregulation. This can take the form of increased hormone production and/or increased tissue sensitivity to the remaining hormones. The reason side effects usually gradually disappear with finasteride is probably due to such upregulation. In a small percentage of individuals, it may be that this process overshoots the mark, resulting in significant hyperandrogenicity. This is marked by such signs as greatly increased facial oil, increased pimples, and greatly elevated libido. It’s possible that in certain cases such hyperandrogenicity overcomes the hair-protective effect of, say, finasteride, though this does not appear to be the case for the vast majority of people.”

The term “reflex hyperandrogenicity” is a new one to me, and while I unfortunately do not have the answers to your questions directly, hair loss from genetic causes in men is usually not reversible.

More about reflex hyperandrogenicity at PropeciaHelp.com and Google Answers.

Tags: reflex hyperandrogenicity, propecia, finasteride, hairloss, hair loss

In the News – Hair Loss Gene Identified?

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


Hey doc, how’s it going? I’ve stumbled across this article on MSNBC.

I don’t want to get my hopes up too high, but the identification of a gene linked to hair loss sounds like an important discovery. What’s your take on it?

I had many people send me that MSNBC article yesterday, and my take on this is the following —

I think it is great that a possible hair loss gene may have been identified, but that does not necessarily solve the problem of genetic balding in the short term. It will help focus the research on the mechanism that have heretofore not been well understood. It is a step in the right direction, for sure. I’m looking forward to seeing where this discovery will take us.

Other articles about this can be found here:

Tags: gene, genetic, hairloss, hair loss, baldness, balding, mpb, medication, P2RY5, saudi

Moderate Crown Thinning — Should I Use Rogaine?

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

If I only have moderate thinning at the crown, is it worth the risk using rogaine if I may lose hair and make a somewhat bad situation worse? In other words, if it only works 50% of the time, why should I take a chance that the Rogaine causes intial hair loss and then hope I get it back with it working for me? Is this initial hair loss rare or common? If it only happens 5% of the time I will risk it but if it happens 20% of the time, it isn’t worth the risk to me. Can you help me out? Thanks.

It seems you have already made up your mind, but you may consider seeing a doctor to have your hair in the crown area measured for the degree of miniaturization (for an objective documentation) and explore other medical options, such as Propecia (finasteride 1mg). To blindly start a journey (medical treatment) without a map (miniaturization study) would not be very smart.

Minoxidil does not cause hair loss that lasts if shedding does occur, and whatever is lost from the initial shed should regrow back. I don’t have statistics to show what percentage of users the shedding occurs with.

Tags: crown, rogaine, minoxidil, propecia, finasteride, hairloss, hair loss

If Facial Hair Loss is Not MPB, What Is It?

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

You said in en earlier archive, “You can have very high levels of DHT, but as long as your hair is not sensitive to DHT, Propecia will have little effect on the normal hairs.” My question is what causes hairs to thin where its not male pattern like a mustache, sideburns or a beard. Both my doctor and dermatologist, prescribed for me to take propecia or Rogaine but I haven’t any signs of male pattern baldness. The hairs on my mustache have become very thin, brown and a little white. 4 years ago the hairs were denser and black. I am a 26 year old male with African/Caucasian decent.

You are correct that MPB and DHT do not impact the facial hair. We see changes with age in many people, although you are young for thinning of facial hair. At this point, I do not have the answer to your problem. I would love to examine your beard and measure the thickness of different hairs from different parts of the face. That would give me more insights into your problem.

Tags: beard, moustache, mustache, hairloss, hair loss, dht, facial hair

Is There a Drug for Facial Hair Growth?

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

is there a medicine,vitamins or any way to make facial hair grow?

Minoxidil is known to produce facial hair in some when applied to the face, but I can not tell you what will happen if you are trying to push beard growth by using it if you’re very young. I am not aware nor do I think that minoxidil will bring on a bristly beard.

If you want to accelerate your beard growth, I do not know any drug or vitamin that will help.

Tags: beard, moustache, mustache, facial hair, hairloss, hair loss, minoxidil, rogaine

Surgical Hairline Lowering Is Not Permanent?

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

I have read in a couple of blogs on the web that the surgical hairline lowering procedure is not permanant -ie. in 10 years after the procedure, the skin can stretch back and pull the hairline back to its original position. Is this true?

It may be true. Many brow lifts (just the reverse of hairline lowering) will stretch back. As we get older, the skin loosens and stretch-back may occur to some degree.

Tags: hairline, lowering, brow lift, browlift, plastic surgery, hairline lowering

European Research Concludes MPB is from Maternal Side?

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

Hey guys thanks for answering this question,
Recently European research has come to the conclusion that the maternal inheritance is a main factor for MPB, which is great news for me since my mother’s father and her brother have great heads of hair at a late age. My dad and his brother have great hair as well though their father (my paternal grand father) was completely bald. What are the chances that I have inherited his hair? Impossible since MPB is not a single gene thus his baldness has not been passed to my father and his brother?
Thanks so much for evaluating this

DNAWhile male pattern baldness may be passed from either the maternal side or paternal side, there are still other factors, such as expression of the balding gene (or genes), that determine if a man is going to bald. Men get their balding gene from the mother’s side in about 52% of cases (if you got it from your mother’s side, then it is 100% for you and no longer 52%). In either case, it may be impossible to plan real statistical probability based upon either your mother’s or father’s balding pattern. You may have the gene, but simply do not express it.

If you are balding due to genetics, you will have the gene from your mother or your father and unless you want to use the research as an excuse to blame your parent a bit more, it does not really matter in the end. There is a new test for balding genetics called HairDX. Maybe this will give you some insights into your question which I can not address.

Tags: hairloss, hair loss, maternal, paternal, mother, father, europe, european, research