How Long After a Hair Transplant Can I Fully Appreciate the Results?

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

Dear Dr. Rassman,
Well we have emailed one another before and I thank you for the answers.It has now been almost 5 months since my transplant and I am pleased with the development of the hairline-still a little sparse, however I was assured the hair will get thicker and make a bigger impact than I think it will. I have seen other’s and see the same thing happening the hair gets thicker at the 9th month and since i am5 months I still have a ways to go. Some people claim that it takes a full 14 months to fully appreciate the entire effect. Is that true?

My main question is, do the hairs grow in stages or by the time 6 months rolls around, is that all the hairs that will actually grow in? My hairstylist who had it done told me he had hairs growing from a full year-sprouting at different times.

I will tell you this, my confidence with the result so far and the reaction of people I tell who never met me, tell me if I had not told them they never would have known. I will keep you posted via photography privately. Please let me know what to reasonably expect as far as a time frame.Just a reminder, I had 2500 grafts totaling about 3500 hairs- that is 1450 grafts in hair line the balance on the top. Looking forward to your answers to my questions

Yes, it will take somewhere between 7-14 months after your hair transplant to see the end result. Hair does grow in stages, not all equal. The sleep cycle for hair varies between 3-8 months easily and that is why I tell patients to wait at least 7 months to see 80-90% of the growth.

I just saw a man I performed surgery on 4 months ago and all of his hair never went into telogen, presenting to me with a full head of hair in just 3 months! I wish I could command this speed of growth for the rest of my patients, but I do see it in maybe 5% of patients.

Tags: hairloss, hair loss, hair transplant, hairtransplant, months, aftercare

How Closely Does a Hair Loss Timeline Follow That of Family Members?

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

My father and my brother both showed significant hair loss in the crown area by the time they were my age (25). I do not currently have any hair loss in the crown. I guess my question is how closely does one follow their relatives hair loss timeline? In other words, if I’m not showing the same hair loss results he had at my age is it safe to assume that I have another family members hair loss pattern?

If I were a gambling man, I might bet that you would not follow the family pattern, but if you let me map out your hair for miniaturization, I would consider that “stacking the deck” on my gamble. With no crown miniaturization today at 25 years old with that family history, I would think that there is a high probability that you will not follow the family pattern and the timeline.

Tags: hairloss, hair loss, family, genetics, timeline

Why Is Hair Loss Not Listed as an Official Accutane Side Effect?

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

You said on one response that if accutane had caused the person’s hair loss then drugs would not help to fix it, could you please explain why this is? And why does hair loss not appear on
the side-effects section of the medications packaging?

I do not have the drug insert on accutane, so I don’t know what is listed on the packaging. Many dermatologists tell me that there is no effective treatment for accutane-induced hair loss. I would write to the drug manufacturer or ask your pharmacist about the warnings in the insert.

Tags: accutane, hairloss, hair loss, acne, roaccutane

Growth Hormones in Milk

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

I emailed a professor at Colorado State who knew about growth hormone and IGF-1. He said there is a difference between GH that is injected and turns into IGF-1 and IGF-1 that is consumed orally. GH that is consumed orally is orally inactive and is a protein hormone that is digested completely by the stomach, while GH that is injected into the bloodstream is the only way for GH to take effect on one’s body. And theoretically even if GH was not digested by the stomach, he said there is not enough GH in milk for example to cause any difference. He did not know about anything related to GH and balding though.

Good point and your diligence is appreciated. The stomach does inactivate many things that we eat because of the high acid content. I don’t know what else I can add to this. For those curious about the growth hormone / milk saga, see DHT and Milk.

Tags: growth hormone, hgh, hairloss, hair loss, hormone, dht, dairy, milk

Age That Hair Stops Growing

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

At what age does your hair stop growing? I am 52 and people say i look 38……..and i would love my hair to grow but it never seems to pass the middle of my back. Just curious. Does Biotin help? I take that often.

As we age, our anagen cycle (the growth cycle of the hair) shortens. Hair grows out at about 1/2 inch per month, but the number of months of growth before it cycles is what I am talking about. If your hair cycle was 6 years, then you could expect a hair length of 3 feet; 3 years would be 18 inches (or shoulder length), 2 years is 12 inches, 1 year is 6 inches, and so on.

Men generally have shorter hair cycles than women (it is rare for a man to be able to grow 3 feet long hair). As we get into our senior years, the hair cycle may only last months, so the hair is shorter. The hair stops growing in balding or thinning areas, or at death.

Tags: hairloss, hair loss, anagen, hair growth, age

Any Hair Multiplication Updates?

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

Hi Dr. Rassman,

I know you’ve been skeptical in the past when discussing hair multiplication, at least its viability in the near future (next 2-3 years). I’m wondering if you’d be willing to update your views on the timeframe for one of these “cure” solutions, and/or what you think the most promising treatments, drug or surgical, are on the horizon and what kind of timeframe we’re looking at. Obviously this requires a good deal of speculation but you are much better informed on the state of the hair loss treatment industry than most of us who just read your blog and don’t have time to get into the hardcore research.

Thanks for your blog!

Hair multiplication is most likely more than 2-3 years away. There was some talk about it at the International Society of Hair Restoration Surgery (ISHRS) conference years ago, but nothing was said this past year (not the upcoming one in September, obviously), which I take to mean that there was no advancements worthy to take through FDA type of clinical trials. It is still an elusive “cure” far away on the horizon, but hopefully in our lifetime.

To put it in perspective, the cure for HIV/AIDS, diabetes, herpes, and even the common cold with billions of dollars invested in research is still a far distance away and may be easier to cure than balding is. I realize that the 10 year prediction seems to be a rolling number, but there is nothing out there to suggest that any breakthrough is imminent. I’m sure that statement will cause me to receive an email flood from angry fans of press releases, but show me some reproducible proof and I’ll be glad to post an update here.

Tags: hair multiplication, hair cloning, hairloss, hair loss, cure

Propecia — The Happy Medium for Effectiveness and Minimal Side Effects?

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

Is Propecia a “happy medium” between the effectiveness of finasteride and the minimisation of side effects? I heard they tested up to 20mg of finasteride during clinical studies. Assuming the side effects were much greater, did those help reduce hair loss more?

Higher doses of finasteride does not seem to treat hair loss any better than the recommended 1mg. This study was done by Merck already after working with real experts in the field who had nothing to prove other than find the safest and most effective dose. The connection between dose, effectiveness, and side effects are not one-to-one.

Side effect possibilities do go up with higher doses and studies on humans have shown that. Stick to what is known and safe. The reports suggesting ideal impact on hair loss at the 1mg level are based upon observations on hair loss, not logic on what a higher or a lower dose should do. People who have the sexual side effect seem to get it on very low doses as well as those who get breast lumps. That suggests to me that we really do not understand the process clearly enough.

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

My Natural Hairline Is Too Low!

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

hi
i have a very low hairline and that makes impossible for me to have some great hair styles. is there any solution to my problem?? i want a higher hairline..

thanks

There is a surgical procedure called a brow lift (or forehead lift) which will elevate the hairline along with your eyebrows. If you are not too young (ideally you should be over 40) it may work for you, but you should seek out the services and opinions from plastic surgeons for this. Generally for the young man (in their 20s) this is something you will have to live with until you’re a candidate, but do talk to plastic surgeons about this.

Tags: browlift, brow lift, forehead, forehead lift, hairline, plastic surgeon, plastic surgery

Hair Transplant on Jon and Kate Plus 8

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

I just want to send you a quick Thank You for the recent overview of the hair transplant procedure on Jon and Kate Plus Eight. It was very very enlightening, and although I won’t be getting hair transplant surgery in the near future, I’ve always been curious for my future in general. The show really explained the procedure in further depth than what I have seen or heard of before on TV or on the internet.

Thanks again for both the blog and taking part in the show for all of us balding folk!

TLCThe show was indeed very educational. Jon is pretty funny and as he goes through the day with a great attitude, Kate (the Chief Operating Officer of the family) makes sure it works out each and every day. They are really nice people. Thank you for watching!

I’m trying to find a video clip online to post here, but I’m not having any luck. If I can find something from the episode, I’ll update this post.

Tags: jon kate, gosselin, hair transplant, hairtransplant, tlc, reality tv

Is This a Sign of Alopecia Areata?

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

I have a patch of hair missing on the back my head, size of a quarter. The spot is not shiny or totally missing hair, there is some hair growing but not alot. Is this still a sign of Alopecia Areata. OTC methods?

Thank you

This is often the way alopecia areata presents, but you could have other causes such a ringworm, as well. Get to see a dermatologist and have it evaluated. There are no over the counter medications to treat what you do not know you really have.

Tags: alopecia areata, alopecia, hairloss, hair loss

Will Skipping Some Minoxidil Applications Still Be Effective?

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

I am a 22 year old male and use 5% minoxidil either once or twice a day. My new schedule makes it hard for me to use minoxidil everyday and am wondering if using it every other day will
still be effective.

Every other day is not the recommended dose and you probably will not get much, if any benefit from it. Twice a day is the only way to use it. At the age of 22, if this is male pattern baldness (MPB), then Propecia (finasteride 1mg) is the preferred way to go, not minoxidil. I’ve seen much better results in the younger men taking Propecia than those using minoxidil.

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

An All-Too-Common Problem — Restarting Propecia After Realizing that Stopping It Was a Mistake

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

I was taking propecia last year. I have read on your blogs that stopping the medication is not good if one has to achieve effective results.

However, now that i have restarted taking it, I was wondering can propecia + 5% minoxidil bring back lost hair? Or it just treats existing miniaturization? How many years of lost hair can one gain back, That is if the medication is effective?

Basically, i’m looking for hope, considering i did the mistake of discontinuing….Thx.

PropeciaUnfortunately, there is no way to answer your question other than provide these points:

  1. You need to see a doctor who can follow your hair loss and establish a good plan for your specific situation (this may involve starting Propecia or minoxidil or even nothing at all).
  2. I doubt you will regain what you have lost and the stopping of the drug did you no service. Undoing it is something we may or may not observe, but it is worth a try.
  3. There is always hope as long as there are reasonable expectations.

I hope that our readers really take note to what has happened here, because it seems that so many people start the drug, do not give it a chance, stop the drug for a variety of illogical reasons (not observed side effects), and then they want to undo the decision. This hair loss problem is progressive and you never make up what you lost in terms of the opportunity to stop the hair loss early.

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

After Switching to Avodart, I’m Losing More Hair

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

I have recently begun taking avodart (.5mg) after taking propecia for ten years. I began the avodart due to research suggesting it to be more effective. I have been using avodart 7 mos. I feel I have lost more hair in my temple areas. Should I have expected more positive results by now or could I be experiencing some shedding due to the change in meds as is sometimes the case when patients usually start a new hair loss therapy.

AvodartAlthough it does sound unusual, I can not explain what you experienced with the switch to Avodart (dutasteride). I have no real experience with Avodart and only know what I read. There were clinical trials conducted in Korea for dutasteride to treat hair loss, but I’ve yet to see them published. At this time, Propecia (finasteride) is the best FDA-approved oral drug for slowing or stopping the hair loss process, but if you have the genes for male pattern baldness, you will still eventually bald, although at a slower rate with the medication. If/when Avodart is approved to treat hair loss, I’ll look into revising that statement.

Propecia has a poor record of slowing frontal / temporal recession, but it (in my hands and I suspect the hands of many other doctors) does slow or stop even frontal loss in many, but not all, patients — and therefore we can expect Avodart to do at least the same.

Tags: propecia, avodart, dutasteride, finasteride, hair loss, hairloss

I Want to Sue My Hair Transplant Doctor!

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

Dr. Rassman,

Hi doctor. I wish I could be writing to you under different circumstances, but I’ve got a major problem that I need some advice on. I had a hair transplant with a doctor here in Canada about 10 months ago and I really, really hate the results. This doctor completely ruined my appearance. I’m considering legal action due to what I feel are unethical practices. A couple thousand dense-packed grafts were placed in the hairline (some of them were placed at the wrong angles), and many 2-hair grafts were also placed there. My hair is dark and coarse, so it just does not look right! I’m considering electrolysis to try to undo this and maybe start over elsewhere. I need help!


Electrolysis

It is quite hard to remove hair by electrolysis and lasers without creating hypopigmentation (loss of skin color) in the area where the grafts are taken out. Surgically removing the hairline could work, but it would require real expertise in doing this. Hairs transplanted in the wrong direction / angle should be a real concern and some of the solutions can be as difficult to achieve as the actual problem you are trying to solve.

I always tell the patients I see to talk with their doctor. Most doctors care about the results you got and the doctor should be able to address your problem in detail. I always tell patients that the good news and the bad news about a hair transplant is that it is permanent. It is very hard to undo them if they are not done properly. I couldn’t tell you if legal action is the way to go — what I can do is try to help get you back to normal looking. You do have a very real problem, but I would have to see you in-person to determine what can be done to help your particular case. Whatever happens, you must know and set realistic expectations on what can be achieved with any ‘repair’ that you undergo.

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

Age-Related Thinning

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

Hi Doc,

I’ve been working at the same office for 17 years. Many of the same guys I started with are still there. As I looked at pictures of the group over the years I noticed every guy has less hair. Not bald, but you can see a decreasing hairline or slight thinning in the crown over time. Do drugs such as Rogaine and propecia prevent or regrow age related thinning which appears to happen to most men over time?

About half of the male population will have genetic hair loss so what you may be observing is just that. Not everyone with genetic balding gets very bald.

I’m unclear about what you mean by “age related thinning”. If you’re talking about the natural maturing of the hairline or the thinning that occurs as men age, then no, it is not likely that medication will regrow this hair. If you happen to work at a place where the men all coincidentally have some degree of genetic male pattern hair loss, then yes, those medications will likely help in some degree.

Tags: hairloss, hair loss, age, thinning