Reader Says He Discovered the Hair Transplant Miracle-Gro!

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

Miracle-GroHello! I’m a 55-yr-old guy who’s had several HT procedures over the past 20 years. My last two were performed by different surgeons (both well-respected in this field), and both times I was surprised and delighted to note astounding growth of newly-grafted hair which I believe resulted from my coincidental use of a unique nutritional supplement. At six weeks following surgeries, I already had a solid half-inch crop of thick, colored new hairs which continued to grow like crazy. My current HT doc is starting a small trial with this supplement next week. Would you be interested in hearing about this? I think I accidentally discovered HT Miracle-Grow!

Sure, please keep me in the loop. I try to keep an open mind.

Update:
The person that sent me this email has told me that he’ll send me updates when he can, so I’ll post more information as it becomes available. In the meantime, take the above for what you will. Anyone want to wager a guess as to what this supplement could be?

Tags: hairtransplant, hair transplant, miracle gro

Using Lasers to Remove Hair Transplants from 14 Years Ago

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

Hello,

I am 33 years old and had a transplant surgery done in 1994. My hairline had receded slightly and I thought I was going bald, so made a rash decision and had the procedure done. Since that time I have lost very little hair and currently have a full head of hair.

I have never been happy with the results, as it looks unnatural and obviously not my own hairline. Now, at 33, I would like to have it fixed. I have been in contact with a local doctor who operates a medical spa and he has recommended laser hair removal. He said it should take about 4-6 months to complete.

I have 3 questions: First, is laser hair removal effective for removing transplants. Second, is scaring likely. Third, if successful at killing the hair, will laser hair removal address the issue of the bumps I feel at the base of the transplants? And if not, what are options for smoothing out these bumps?

Thanks.

Cases like yours are unfortunate, but it is an important reminder that hair transplants are permanent. As such, you need to make sure you are getting the treatment done by a physician and a medical group that you trust and that you have checked out for competence in this area. Do not search for the best deals, but rather do the research and make an informed decision. Most importantly see prior patients up close (not just photos) to gauge your realistic expectations.

Laser removal does work on transplanted hair, but you would need many treatments and there may be some discoloration of the skin. More importantly your “bumps” will still remain. In the end you may be left with no hair, but with bumps that are discolored. If this is still something you are interested in, you need to ask the doctor if he/she has had experience with cases like yours and if so, ask to see former patients and results.

You may also consider a consultation with a hair transplant doctor to see if there are repair surgeries possible to soften your unnatural hairline. As an example, you can see some before/after photos of repair work at NHI. Also, there’s a story I posted a while ago from a man that wanted to “undo” his hair transplant, complete with photos — Horror Story with a… Happy Ending?. What is important in that “Horror Story” is that the patient was happy with the results of his laser treatments, although I would imagine that many of the viewers here may not find it acceptable. Compare where he ended up with where he began, as everything is relative.

Tags: repair, laser, hair removal, hairtransplant, hair transplant, hairloss, hair loss

Biotinidase Deficiency from Accutane Causing Hair Loss?

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

Hi Dr Rassman,

firstly I would like to thank you for your website, I’ve been a keen reader for many months. Well about me, i’m 23 years old and ever since I stopped a nine month course of Accutane at the age of 19 I suddenly began to lose my hair rapidly in a diffuse pattern on the whole scalp area. This is very depressing as I used to have long thick hair. My hairline is relatively intact but I would say i’ve lost 60% volume at least, so you can see my scalp through it. There is some balding on my mothers side but they didn’t start balding till age 40+ and not in a agressive diffuse pattern like me. I strongly believe this is from the Accutane, maybe it has accelerated my mapped out MPB that I would get later in life. But also I’ve heard of people suffering Biotinidase Deficiency after a strong course of Accutane that can last for years and cause severe hair loss. Do you think biotin or any other vitamins could benefit post accutane treatment? I’ve been on 1mg propecia for 1 year with no regrowth or noticable benefits and Rogaine also with very slight regrowth, so these seem to not be helping my hair loss at my tender”ish” age.

Also i’ve was diagnosed with arthritis a few months ago and i’m on 4x 500mg paracetamol/30mg codeine tablets a day to help with the pain, but i’ve read that paracetamol reduces the effectiveness of rogaine do you know anything about this?

thanks for your time.

Marc P DiFazio, MD authored a good source for botinidase deficiency information, available at eMedicine.

I don’t know enough about the connections other than what I have learned via the web (researched briefly after your question was received). I am sure that you know the information on Accutane (isotretinoin) and hair loss seems to be a real problem for many people, but the solution to this problem is not evident. I did write to an email group of experts on the subject and there was no real insight into the connections you are looking at. I do not know if there is reaction between minoxidil and paracetamol, so I’d discuss this further with your prescribing physician.

Tags: botinidase, hairloss, hair loss, accutane, isotretinoin, biotin

Neck Hair and DHT, Follow-Up

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

This is a follow-up to Neck Hair and DHT

To further elaborate about my earlier question about neck hair being prone to DHT. When I say neck hair I mean the normal hair that grows from the base of the scalp toward the neck. Not body hair. You know where the hair ends on a guy when he gets his hair trimmed. I have a very thick density from which the surgeon says would be a great alternative donor supply for FUE.

Will that be a good choice to gleen hair from and not worry about DHT? I hope the question is clearer. thanks

Sorry, but that still doesn’t help me. Neck hair starts at the notch at the base of the skull. The hair at and above the notch is scalp hair. Where exactly is the hair you are talking about? When you touch your chin to your chest, does the hair in the area of your focus tighten? If so, it is probably neck hair.

If you’re in California, why not visit me and I can tell you in less than a minute? If you can’t visit me, send me a good set of digital photos (reference this post) and mark where the notch on the midline of your skull is in the back of your head.

Tags: dht, neck hair, neck, hairloss, hair loss, hairtransplant, hair transplant

Traction Alopecia or Trichotillomania?

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

Dear Dr. Rassman,

I have been rubbing my scalp and playing with my hair at the roots since I was about 12. I’m noticing that my hair seems to be thinning now. I’m 30, female and have beautiful hair, but I’m concerned that my OCD behavior towards my scalp and hair roots is causing this hair loss. My hairdressers insist I don’t have thinning, but I can clearly see that I do when I look at old pictures.

In addition, my aunt on my mother’s side has experienced major hair-thinning. She now wears a “fall.” I think you should also know that a couple of years ago I noticed my hair to be thinning, so I abstained from “playing” with my hair. I saw regrowth (or, at least I perceived it) soon after. I realize I should never have restarted the behavior, but I guess I’m an anxious person…

My questions:

What is my chronic scalp-rubbing considered? Is it Trichotillomania or traction alopecia?
And, if I stop this behavior (which I’ve done as of yesterday), am I likely to experience regrowth like in the past?

Thanks!

Trichotillomania is a psychological disorder that makes oneself pull on the hair, causing traction alopecia. It seems you have this type of behavior. This problem is very difficult to control on your own. You may benefit from seeing a doctor or joining a support group.

If you have seen return of the hair from stopping your rubbing/pulling, then maybe it is not too late for some of your hair in the impacted area. Best try to stop… and stay stopped.

Tags: ocd, obsessive compulsive, trich, trichotillomania, traction alopecia, hairloss, hair loss

Would Switching Away From HCTZ Help My Hair Regrow?

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

I am a 60 year old female taking HCTZ and Norvasc for blood pressure control. My doctor increased my HCTZ from 12.5 to 25 last year. For the past year my blond hair has been thinning DRASTICALLY. Neither my family doctor nor the dermatologist I recently consulted connected it with the HCTZ. After reading that hair loss IS a possible side effect, I want to take a different medication that will not have this side effect. My question: Will I be able to regrow the hair I lost when I change to a different medication? Also, my dermatologist is planning to remove several broken blood vessels on my face with a light therapy next week. In one web- article, I read that artificial light shouldn’t be used with HCTZ and that it could cause photosensitivity. Your comments please.

Thank you

You should focus on your medical needs with your doctors and ask your questions to them. I do not know what photosensitivity you are focusing upon that would prevent what you doctor is planning do with the the ‘light’ therapy. Your question about hydrochlorothiazide (HCTZ) and hair loss is addressed at eMedTV – Hydrochlorothiazide and Hair Loss.

Tags: hctz, hydrochlorothiazide, laser, hairloss, hair loss, dermatology

Nitric Oxide and Minoxidil Are Both Vasodilators

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

If Nitric Oxide the supplement is a vasodilator, and so is Minoxidil, does that mean that taking the NO supplement would have the same effects? You answered a question and said NO would not haev any effect on hair loss. How is this contradiction explained?

If there is a vasodilator effect of nitric oxide, it has nothing to do with the impact on the hair growth cycle that I know of. Minoxidil works such that it probably impacts the growth cycle of the hair follicle, prolonging the anagen phase. Nitric oxide has not been studied for hair loss and we do not know what it does to the hair cycle.

Tags: nitric oxide, no, minoxidil, hairloss, hair loss

How Long Do I Need to Wait After Surgery to Repair Strip Scar with FUE?

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

Dr. Rassman

Congratulations once again on a great blog that is truly informative and of great help to the hairloss community. My question revolves around FUE into scar.

On past blogs I know you mentioned that you like to wait at least 5-6 months to do a scar repair… but if I understood your reply correctly I think you were referring to a tryclosure revision.

I recently got a HT (2400 grafts) and part of my scar got a bit infected. One side came out perfect with no problems and the other one not so much. Luckly the infection wasn’t necrosis or anything too serious but I have experience shockloss around it and was wondering how long do you recommend before I or anybody can do a small FUE session into the scar. I seriously refuse to go the strip route ever again even for a repair. BTW, I’m only about a 1.5 months out of the surgery (which was closed using tryclosure technique) and this was my 2nd HT. I know it’s too early to panic on the healing of the scar but wanted to know a timeframe as to when is the earliest I can act to correct this if need be.

Thanks to you and your staff once again for taking he time to answer our questions.

It takes about 6 months for any scar to heal relatively fully, thus I recommend waiting out that 6 month time frame.

Tags: surgery, hairtransplant, hair transplant, fue, scar, scarring, repair, strip

Acid Reflux Medication and Hair Loss

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

I’m a 23 year old male with something like a Norwood II or III hairline. My family history is likely to blame, but I’ve also been on various medications for acid reflux, including omeperazole, protonix, nexium and prevacid for some time. My family Dr. noted that some of these drugs could cause hair loss before prescribing propecia. Do you think this is true, and is any one best?

ElephantPractically every day over the years, I’ve received questions asking whether a specific drug or drugs cause hair loss. Again and again, I must remind everyone that there are many drugs that MAY cause hair loss as one of MANY potential side effects. Protonix (pantoprazole), Prilosec (omeprazole) and Nexium (esomeprazole) have very rare instances of hair loss reported, but the most important thing to remember is that male pattern baldness (MPB) is the number one cause of hair loss in men. Drugs are the very very last on the list of cause for hair loss in men.

If you believe you are balding or losing hair you should have your doctor evaluate your hair (with a miniaturization study if possible) to see if you indeed have genetic male pattern baldness. Starting on Propecia (finasteride 1mg) just because you believe you are losing hair without a clear diagnosis is not a smart thing to do either — this is why Propecia is a prescription medication. If I may bastardize an old metaphor — when you are being charged by a herd of dancing elephants, don’t look at the ants that may get trampled.

Tags: acid reflux, nexium, hairloss, hair loss, mpb, protonix, pantoprazole, nexium, prevacid, prilosec, omeprazole, esomeprazole

Took Finasteride for Years And It Didn’t Stop My Hair Loss

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

I took finasteride 1mg for two years, and it did not stop my hair loss. Five weeks ago, I switched to dutasteride .5mg, and I am still seeing the same level of hair loss. What are some of the possible factors resulting in my continued hair loss? Might it have something to do with the DHT still residing in my scalp?

Also, how much of a decrease in DHT is generally required in the blood and/or scalp in order to stop hair loss?

Male, Age 31

Thank you

Neither dutasteride or finasteride are guaranteed to stop the hair loss. There is a race between your genetics and your attempt to stop the loss and from what you are saying, your genes are winning. If you were to become a Norwood Class 5 balding pattern by the time you are 23 years old, for example, I would doubt that finasteride or dutasteride will stop the progression completely, but it may slow down the process a bit. Do you get what I am saying?

There is no magic DHT level that you must hit as your genes do not seem to care (metaphorically speaking). You are under the illusion that DHT can be controlled, but the issue is with your genes, not DHT levels. Certainly what you are reporting appears that way.

Tags: finasteride, dutasteride, avodart, propecia, proscar, hairloss, hair loss, dht, genetic, gene

Should I Take Propecia at 16 Years Old?

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

Hi doctor, I have a question. I am sixteen years old and I feel my hair is falling because I have like a balding twirl in the vertex. It seems like if the hair in my vertex is starting to fall. Also, the hair on the top of my head is thinning. I don’t have a receding hairline, but I am scared to loose all my hair before I am twenty. I don’t know if this could be the cause of genetic hairloss (my dad is bald, but he is 52) or if it is another thing. Also, my pubic hair seems less dense. Do you recommend any drug like finasteride or propecia????

Any good doctor can do this and it is critical (particularly at 16 years old) that you get excellent metrics from a miniaturization study to determine what is happening to your hair before starting on a life long course of Propecia (finasteride 1mg).

You need a Master Plan for your overall management of your hair loss and you should have your scalp hair mapped out for miniaturization prior to starting any treatment. There is no reason not to take it if you are really balding, but you may not be balding, so find out first! That being said, safety of finasteride was studied at age 18 and above. Your prescribing doctor will have to be the one to make the call on whether the benefits outweigh the risks. Get a good doctor to help you with this.

Tags: propecia, finasteride, teen, hairloss, hair loss

Girls In Haiti Orphanage Are Losing Hair

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

There is a wonderful ministry called “Love a Child” which has an orphange in the country of Haiti. The owner/manager of the orphanage is struggling to help several of her African American orphan girls who are suddenly suffering from hair loss. She has pictures of the girls on her site at loveachild.com

From reading various information on your website and others it seems the only options are:
1. Stop tight hair braids (but it’s too late now)
2. Costly hair implants

Any suggestions or advice you might have to help these precious children would be greatly appreciated.

From the photos in the link you provided, it seems the girls on the site have traction alopecia from wearing tight hair braids for long periods of time. Unfortunately, traction alopecia is permanent and there are no good treatment options. Hair transplantation surgery may help, but it cannot replace all the hair that was lost as even with a hair transplant, the supply of hair may exceed the demand for hair in the balding area.

Tags: girl, female, women, woman, traction alopecia, alopecia, braids

Accutane Now Lists Hair Loss As a Side Effect?

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

My 17 year old brother has had rapid hair loss for over a year now. Mainly on the top of his head & now the hairline is receding as well. There is no male pattern baldness on either sides of the family. We have taken him to several specialist & have had all possible bloodwork & even a scalp biopsy done. He has finally been diagnosed w/ Chronic Telogen Effluvium. He has C3 & Igg deposits in his follicular bulbs. There are an increased number of catagen & telogen follicles accompanied by shriveled, wrinkled, glassy membranes & fibrous tracts. The lower follicular epithelium is visibly in necrosis in some slide levels. There are few inflammatory cells. It is believed that the cause of the TE is medicine induced from Accutane. He has been off the medicine for one year & has continued to have hair loss & no re-growth. Accutane is now listing hair loss that may be permanent as one of it’s side effects due to the overwhelming amount of cases of this. Some people have had regrowth well others have not. Since it has been over a year & based on the diagnosis, is regrowth still possible? Will he go completely bald? Would he still be a candidate for a hair transplant down the road? What are the possible treatments for him? He has already tried Rogaine, Tagament, & the laser comb. He is devastated & is becoming more & more depressed. Any advice would be greatly appreciated. Thank you.

I can not fully answer this question, but I’ll do my best. For people with chronic telogen effluvium (TE), long term use of minoxidil may help. The good news is the chronic TE implies that the hair is still there, unlike in the case of genetic hair loss. As I am not a dermatologist and have limited understanding of chronic TE, your brother will be best served by someone with expertise in this field and a track record for it. Good luck to your brother and thanks for sharing this with us.

Tags: accutane, chronic telogen effluvium, hairloss, hair loss, acne, isotretinoin

Teenager’s Eyebrow Never Grew Back After Shaving It 3 Years Ago

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

(male) I shaved a good bit of my eyebrow when I was twelve – I’m, fifteen now. In short, they never quite grew back right. Will rogaine work? If not, what can I do?

I don’t think that giving a 15 year old advice on medication should come from me. Assuming that you were of legal age to make such decisions on your own, minoxidil might grow back eyebrows… and then again it may not. See a doctor and have your problem managed. You should also get a parent/guardian involved in your situation.

Tags: hairloss, hair loss, teen, eyebrow

White Bulb vs Darker Bulb on Fallen Hair

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

Hey Doc,

What exactly are those white ‘bulb’ sort of things that are at the tip of hairs that fall out? Most of my hair that fall out have that white bulb sort of thing. What are those?

Also, somewhere I read by a noted hair doctor that a white bulb means that the hair fell out in it’s growing phase, whereas a darker bulb meant that the hair was already grown or such. Is that true?

The white bulbs are likely sebum, a remnant of your oil gland that happened to come out with your hair. The darker bulb just came out without the sebum.

Tags: sebum, hairloss, hair loss, follicle