How Do So Many Older Rock Stars Still Have Such Great Hair?

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

I always find it amazing how rock and roll stars in their 50’s and 60’s still have hair like 20 year olds. Could there be something they are doing or is it just the lack of stress of being a rock star has enabled them to keep their youthful look. Just some examples would be Sammy Hagar,Mick Jagger, Robert Plant and Steven Tyler.

Thanks

Rock and rollI can not comment specifically on any of these men, but I am personally aware of a few musicians that use either hair extensions or hair systems to give the appearance of a full head of hair. Long hair seems to be for musicians like hair was to Samson and I have been told over and over again, that without the appearance of hair, they can not perform well. Perhaps it is a confidence issue, perhaps it is something else entirely.

Tags: musician, rock star, rock and roll, celebrity, hairloss, hair loss

Lexapro and Female Hair Loss

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

Dear Doctor,

I’m a 35 yr old female who was put on Lexapro to combat mild depression last Thanksgiving. After two weeks of taking the drug, my hair began to fall out in large clumps leaving me with bald spots. I contacted my doctor and she told me to stop taking the Lexapro as it this is a known side effect. I am not taking a replacement drug as my depression was only mild and the hair loss has scared me enough for now. The hair stopped falling out 7 to 10 days after I stopped taking the Lexapro. Luckily, I had long thick hair and even though I lost about 15% to 20% of my hair it was not extremely obvious. However, I have been waiting patiently for my hair to start growing back, but the bald spots are still bald. How long should it take before the hair starts growing back as it has been over ten weeks? I would think that by now I’d see at least some stubbles of new hair growing back. Also, I have a friend who told me that after she had chemotherapy treatment (breast cancer) her doctor told her to take Biotin vitamins and use Nioxin shampoo. Should I use these products to try and speed things up?

Thanks in advance for any help and suggestions!

Telogen effluvium may take from 2-6 months to reverse. Assuming that this is a drug induced TE, you should wait out the process for at least 6 months and then if you still have bald spots, you need to see a specialist. The medications used by your friend may have value. Also, the use of minoxidil 5% may help.

Tags: lexapro, hairloss, hair loss, female, women, woman, depression, escitalopram oxalate, biotin, nioxin, telogen effluvium

Is It Ever Too Late to Start Propecia and Minoxidil?

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

I am 36, have been balding since 21 and now seem to have a pretty full head full of hairs in the advanced miniaturization, with some hairs in the moderate miniaturization phase. Not a lot of normal hairs at all.

Area of balding pretty much covers the entire area; T1, T2 = Temples
F1, F2 = Frontal
M = Middle
V = Vertex

When is it considered too late to start a regimine of Propecia/ Minoxidil? Can these miniaturized hairs be saved, or is it already too late? In the past, have used minoxidil with some results, with the middle and vertex becoming much less visible. More pigment, thicker hairs, but threw in the towel after a year.

It is never too late. I like the fact that you now have a baseline measurement to know what these medications will do if you start them again. Go for it!

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

Applying Rogaine Foam Directly After Showering

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

Does applying Rogaine Foam directly after showering with the hair somewhat wet, but not soaked, bring down the effectiveness of the foam? I read through the directions, but it does not specify unlike the old Rogaine solution.

Thanks!

I believe that it should be applied after a shower and after you mostly dry your hair. Circulation in the scalp is high at that time.

Tags: foam, rogaine, minoxidil, hairloss, hair loss, shower

I Had Poor Results After a Transplant 11 Months Ago — What Can I Suggest to My Doctor?

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

Hello Dr Rassman,
i had a hair transplant surgery,(strip method of 2400grafts approx)from a well reputable doctor about 11 months ago with relatively poor results in the crown area. what can i do in my case, what can i suggest to my doctor? my doctor would make the final assets at the 12th-14th month he told me. (what usaualy happens in cases like mine?)
Thank you

Failure to grow can happen, even if everything is done right. Assuming that your doctor and his/her team did it all right and you did not grow the hair, you should sit down with your doctor for a frank discussion of the problem. His/her experience should produce a good interchange with the risks of failure amongst the possible outcomes. In the hands of an inexperienced team, failure rates might be much higher. On the rare occasions that I have seen failures of the transplants to grow, I have offered to repeat them at my cost. Sometimes it grows just fine the second time, yet sometimes it does not grow even on the second round. I generally wait a year to determine what the results will probably be.

The profession has called the failure of a hair transplant to grow, the “X” (unknown) factor. This distinguishes the cause from the “H” (human) factor, which reflects defects in either the surgeon’s control or the transplant surgeon’s team. Some of the causes of “H” factor include trauma to the grafts caused by drying (leaving the grafts exposed to air for more than 30 seconds at a time), or rough handling, or a switch of the solutions used in error from saline or Ringer’s solution to distilled water (slop in protocols and process of the team).

Failures in follicular unit extraction (FUE), in particular, reflect many elements of damage caused by the extraction process which have been defined by me and some other experts at various medical meetings. Lack of required skills in FUE is the most common cause of graft growth failures. Some of the causes of failure to grow may reflect autoimmune diseases such as diffuse alopecia areata, which has no real physical presentation for an easy diagnosis other than a series of biopsies to look at the scalp under the microscope.

Tags: hairtransplant, hair transplant, failure, fail, hairloss, hair loss, problem, fue

Removing vs Camouflaging Old Plugs

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

In correcting an old pluggy hair transplant,is it feasible or possible to transplant behind the old plugs first, let this mature, then remove the old plugs so the initial transplants (from the donor area) can camoflage the surgical sites of the excised plugs(this is assuming the old plugs cannot be camoflaged via a transitional zones of fue transplants). I have seen the reverse procedure on your website often when corrective procedures such as this are done. Also, if old plugs need to be excised can you use a flesh colored suture material to minimize post surgical incision lines of the excised plugs? And final question, in determining whether to excise old plugs or place a zone of camoflaging units in front, if the existing hairline is on the borderline (low or high) what is your criteria in your choice.Thanks.

The decision to remove the hairline is a joint arrangement between patient and doctor. Sometimes the social limitations of removing the frontal hairline is just not a good choice for the patient. One should outline the number of surgeries with the various approaches. The decision for FUE, or excision of single plugs and building a hairline in front of the old plugs at the time of the FUE, or individual plug excision, seems to be the choice most patients are making despite a hairline excision which may, in the long term, be a better decision. The location of the old pugs is important. If the old plugs are at least 1 1/4 inches above where the natural juvenile hairline was located originally, then just camouflage may work fine. The lower the hairline, the better is the excision of the hairline, but still many people today are opting for the FUE/selective plug excision and frontal camouflage, because it does not limit their ability to go out in public within days of this surgery.

Tags: plugs, hairloss, hair loss, hair transplant, hairtransplant, repair

If My Libido is Better than Ever with Dutasteride, Will It Cause More Hair Loss?

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

I have heard on almost every website that Propecia/Avodart decreases your libido and they find it hard to get an erection, however my libido is working better than it ever did. Since taking Avodart, i feel as though it has raised my testosterone and increased my sexual desire. My question is, if Avodart increased my testosterone which it can, will it increase my hairloss. If it has increased my testosterone, does that mean it will continually stay at the same level, what i mean is that will my testosterone always be higher because im taking Avodart or will it slowy decrease over the months. If it will not should i stop taking it as it will increase my hair loss.

I know that men who take Propecia (finasteride) sometimes get an increased sex drive because testosterone levels rise by about 15% on this drug. I don’t have direct experience, but I would expect that Avodart (dutasteride) should have similar effects, because there is a feedback loop which tells your body just how much male hormone it needs. That feedback loop is what causes the rise in testosterone on finasteride.

The value for treating hair loss has nothing to do with your libido, and you should get benefits for hair growth.

Tags: dustasteride, avodart, finasteride, propecia, libido, sex drive, increase, hairloss, hair loss

Why Bother With Taking Medication? Shouldn’t I Just Go Bald Enough for a Hair Transplant?

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

i am 25 and i was just starting to loose hair(have a small bald spot in ‘U’ shape at the crown and can be covered easily) . My doc confirmed it as pattern baldness and asked me to use finasteride and minoxidil 5%. i dont want to get bald at any age. So,instead of loosing hair after 10 years or whenever hair loss beats propecia and getting hair transplant,why not let the hair loose now and get a HT,so that i can save the money on drugs for years. My doc said thats stupid.whats your opinion?

I think it is a bad idea to wait for all your hair to fall out and then have hair transplant. First, it may not all fall out. Second, you will become balder when you are younger and the medication may delay this for years. You have a limited amount of permanent hair that can be used for hair transplantation. The cost of the drug is much, much less than a hair transplant.

You don’t have to take my word for it — if anyone wants to give their 2 cents, please leave a comment below to let this writer know what you would do in his shoes.

Tags: hair transplant, hairtransplant, medication, propecia, finasteride, minoxidil, rogaine, hairloss, hair loss

Body Hair or Scalp Hair — Which Grows Faster?

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

which grows faster body hair or scalp hair?

The cycle of hair growth is shorter with body hair than scalp hair.

If what you are actually wondering is whether or not body hair or scalp hair will grow faster after a hair transplant, that would require some experience with body hair for an answer. I frankly do not have the answer for that, other than to say that hair growth after a hair transplant ranges from immediate to about 5 months on average.

Tags: hairtransplant, hair transplant, growth, hairloss, hair loss, scalp, body

Will My Urologist Tell Me to Stop Finasteride?

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

Going to see a Urologist next week, will he tell me to stop finasteride?

Hi Doctor. I have been on 1/4 proscar for over a year now with great success, no side effects, and great reqrowth and maintenance. I’m a 26 year old male and went to my hair loss doctor for my yearly check up a few weeks back and he and I were very happy with the way things are going. In the last 3 months however i have had 3 cases of hematospermia, passing blood in the semen accompanied with some minor pelvic pain. I however, have no other problems urinating so it’s clearly something to do with the prostate. My family GP gave me some antibiotics, which seemed to clear one episode and he referred me a urologist to get it checked out further. He mentioned that the fact i was on finasteride would have to be seriously looked at when I visit the urologist. I mentioned all of this to my hair loss doctor during my yearly consultation, now this guy is very ethical and has over 20 years in micro surgery and over 2000 patients my age on the drug. He told me that the finasteride had nothing to do with it.

In fairness to finasteride, I was on it for 10 months without a hitch before I started getting episodes of hematospermia. I’m just worried that the urologist may ask me to stop it as he clearly will not be concerned about male pattern baldness…and effectively lose the wonderful gains the drug has provided me.

In your experience have you ever encountered cases of hematospermia any more in patients on finasteride in my age group? Do you think it may have anything to do with it, what about prostate shrinkage?

Thank you so much and i hope you can help me on this, i really hold your opinion i this area in high regard.

Regards

People who are not on finasteride do develop hematospermia, so I would expect that people on the drug will be at the same risks. I doubt that the drug is contributing to the problem and would agree that finasteride should be continued. I would doubt that a urologist would ask you to stop this, considering the benefit you have achieved.

Tags: hematospermia, finasteride, proscar, propecia, prostate, urologist, urology, hair loss, hairloss

Months After My Transplant, There’s Dead Hairs In My Scalp

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

I received a 3100 graft procedure a little over 5 months ago in the 1/3 frontal area. I see a lot of growth, but also noticed that there are areas that still have the short, blunt hairs that were originally in the follicle when it was transplanted. They never grew, nor ever fell out. If I take a tweezer to them, the hair just slips right out, and has a bent area where it’s in the scalp. Also there are black bumps at the scalp that if pulled with a tweezer, keeps getting longer and longer until it comes out of the scalp. No pain, just seems like dead hairs. Can you “shed” some light on any of this?

I am sure that when you pluck these short hairs, you will not see any bulb with them. These reflect remnants of the old hairs and they are not growth from new hair follicles. I see this in a few patients and they usually fall out with good washing.

Tags: scalp, hairtransplant, hair transplant, follicle, bulb, hairloss, hair loss

How Good Are The Chances that Transplanted Hair Will Grow?

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

Hello Dr.

What are the chances that transplanted hair will grow?
What is cost/per graft?
How much area 2500 cover ?

Best Regards

WalletIf everything goes as planned, you should expect 95+% of the transplanted follicular units (grafts) to grow. I am not sure if you are asking me what the cost per graft is for us at NHI or what the average rate is. Prices do vary per doctor or clinic. There are many variables to consider when evaluating a facility to perform your surgery, and cost should not be the most important factor. There are many places that will charge you per hair, and not per graft. Some clinics cut up follicular units to milk the patient for more money, yet no more hair. The quality of work will also suffer if you choose a disreputable hair transplant surgeon, just because you are attracted to their price for the procedure.

The number of grafts you require is relative and depends on the color of your hair contrasting with your skin tone, the character of hair you have (curly vs straight), and your hair density. In general you should get about 4 sq. inches of coverage with 2500 follicular units. Shear numbers are not the answer — all the other aspects are just as important.

For more, please see:

Tags: hairloss, hair loss, hairtransplant, hair transplant, doctor, doctors, physician, surgeon, grafts, price

Who Cares About Meeting Patients — You Will Just Show the Best Anyway

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

In this video you say that people can come in to Your office and see former patients. But does it really matter? If You have 10-12 patients with great result, that doesn´t say anything about the rest. I guess You show Your best results, not the worst.

Many people just assume that you can always tell a hair transplant from normal hair, and based on the work that was done many years ago I can see where this belief stems from. That is simply not the case today. The major point of making patients available to meet people like you is to allow you to examine the work and see if you can tell there was a hair transplant. Many times our former patients come into the open house events spontaneously, so we never know 100% of who is going to be there. A few of the people who are our regulars, have themselves seen hundreds and hundreds of our patients as well as patients of other doctors and are worth talking to because of that experience.

We stand by all of our results. When we invite people to come to our monthly open house events, we invite all of our patients. You are welcome to come by and meet some of our patients during one of these events — the list of upcoming dates can be found here.

Tags: event, open house, hairtransplant, hair transplant, patient, doctor, exam, hairloss, hair loss

Can NHI Help Balding African American Men?

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

Hey, I came in last summer for a consultation and I had a miniaturization test. The doctor confirmed that I was probably a class 2-3 on the Norwood scale. At the time he prescribed finasteride, which I have taken daily ever since. It’s been about a year now, and although my hair loss may have slowed down, it certainly hasn’t stopped. My hairline is a little suspect at this point, and I’m nervous that if I wait much longer people will really start to notice I’m “losing it.” I am biracial, with relatively coarse hair, and I’ve been able to get away with styling it so that no one can tell, however I think I’d like to solve the problem while I still have a relatively large amount of hair on my head. I’ve heard that there are doctors who specialize in treating African American hair loss patients. I’m wondering if this is true, or is NHI capable of generating the same results? Also, I’ve heard that micro-grafting is the least noticeable transplant procedure, do you perform this procedure at NHI?

Thanks for your help.

We are as experienced with African hair types as any medical group anywhere. We also stand by all of our results. You should be seen yearly, so I would hope to see you again.

The most natural way to transplant hair is with individual follicular units, as these are the natural groupings of hair in your scalp. A micrograft is not the same as a follicular unit and you need to be aware that the gold standard for hair transplantation in any race is follicular unit transplantation (FUT). Propecia (finasteride) is probably working for you, as it is slowing down what would probably be more dramatic hair loss. You are welcome to come back and have one of us take a look and further answer any questions you have.

Tags: finasteride, propecia, african, african american, hairloss, hair loss, micrograft, micro-graft

I Have Red Hair — My Dad’s Family Has Red Hair, My Mom’s Family Line Is Balding

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

Hi

I have red hair and it comes from my father’s side of the family only. The men on this side of the family have their hair but the men on my mom’s side (who do not have the red hair gene)all suffer from MPB.

My hair is starting to form into Norwood Scale 2: is it possible I could go bald too even though the red hair gene comes from my dad’s side?

Thank you for your help.

The color of you hair, along with other physical characteristics you inherited, are carried in different genes than the ones associated with MPB. The genetic predisposition for balding is inherited from either your father’s and mother’s sides, with more weight on your maternal lineage (48% for father’s side vs 52% for mom). There is a possibility that you may develop MPB. You need to be examined by an expert, someone who will map out your scalp hair for miniaturization to determine if you will be losing your hair. If you are in the early stages of hair loss, then you need a Master Plan to determine how to proceed with your hair loss treatments.

Tags: mpb, genetic, hairloss, hair loss, genes