I Met with a Doctor That Immediately Told Me I Needed Three FUE Procedures for $45,000

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

Hi Doctor,

I am 26 and have been losing my hair at the centre, back and recently at the front.

I consulted this week with a doctor in Dubai and he classified my hair loss as pattern 4 class 5 (Hair characteristics are color:black, quality: wavy,thickness is average and density is average). He told me i would have to undergo the FUE procedure. His treatment recommendations were 2 sessions of 3000 hair follicular units at the center and back, another 3000 at the front. The total cost of it being 45,000 usd with a 3 month gap in between these surgeries.

What puzzled me the most is that he just had a look and told me that i would have to undergo this surgery. My concerns are that the price quoted is too expensive for me and i want to know if there are any good doctors out here in Dubai who could do this for a lesser cost. I would greatly appreciate your opinion on this. Thank you.

Nuts
More examples of nuts

This is nuts! By just looking at you, he knows your hair density? My opinion is that no doctor can do 9000 grafts total in 3 sessions over a period of 6 months without really examining you, knowing your density, scalp laxity (for strip surgery), etc. And to add insult to potential injury, recommending it blindly every three months on the schedule outlined above is either the work of God, or possibly a doctor who has a streak of larceny (small or large) in him. Maybe I am just overreacting, knowing that I have a human type of limitations.

In other words, I’d seriously think about what this doctor is trying to sell you, and whether it is even possible for him to do what he is suggesting with any consistent quality. You wouldn’t want to pay for something and only get a small percentage of hairs actually taking and growing, leaving the other grafts too damaged to be of any good. Maybe Dubai does not have laws that protect consumers (nevermind, they do), but I would be suspicious, at the very least.

Tags: fue, hairtransplant, hair transplant, dubai, hairloss, hair loss

Should I Increase My Saw Palmetto Intake?

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

I am taking saw palmetto to slow my hair loss, but it seems to not stop the hairs from falling, rather when they do fall, they have a bulb on the end with the saw palmetto, but without, they are bulbless. Does this mean I should increase my saw palmetto intake?

Saw palmettoSaw palmetto is not proven to work for treating male pattern baldness, so increasing saw palmetto will likely have no effect. Traditionally, food supplement companies jumped on the bandwagon to promote saw palmetto for hair loss, as they made a connection that the herb helps with prostate issues. In fact, there is no clear evidence that even that is true. Now for years people have been taking saw palmetto for prostate problems, but no study I’ve seen has been able to prove that it really works, even though it has been embedded in our popular culture to be true. Somewhere along the road someone made the connection that since finasteride and saw palmetto are for prostate problems, saw palmetto may also work for hair. This is not true!

To put it into perspective, finasteride 5mg pills (marketed as a brand name Proscar) is a drug that helps with prostate conditions. A side effect of finasteride 5mg (Proscar) was that it grew hair on balding men who were taking the medication for their prostate conditions. The drug company saw the marketing potential for such side effect (of growing hair on balding men) and marketed finasteride 1mg (as Propecia) for genetic male pattern baldness. Propecia and Proscar are the same medication in different doses. You don’t need the higher (5mg) dose to grow hair. As such, some patients take Proscar and break up the pill in 1/4 pieces (ideally it would be 1/5, but that is difficult) to take for hair loss. If your hair is important to you, consider the use of Propecia rather than saw palmetto.

Tags: saw palmetto, propecia, proscar, finasteride, hairloss, hair loss, prostate

Nitric Oxide to Increase Hair Growth?

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

Hi Doctor, I’m a Finasteride User and have been using the same from past 2 months but not have seen visible results as its Just a starting. I have been using BSN Products like Nitrix, Cell Mass and NO-Xplode for performance enhancement in the Gym. One of web pages which triggered my interest is this: HairLossTalk.com, which says NO levels can increase hair growth and it stimulates the hair growth. I don’t know how far it is true. Also i cannot relate my hair loss with usage of these products as I have Just started using it. Could please go through the link and tell us Does Nitrix Oxide and L-Arginine and other amino acids can increase hair growth ? I was always in a Dilemma whether to use or not to use these nutrient supplements. Kindly clarify my doubts.

The Internet is filled with good information and a whole lot of misinformation. I don’t believe there is a link with hair growth from nitric oxide (NO) or L-arginine. L-arginine is an amino acid you get by just having a normal diet. No one has yet to find the cure for hair loss and everyone is trying to make a fast buck. Of course, since you’re trying it for yourself, if it grows hair where you were once thinning, let me know.

I wrote about this a few months back — Nitric Oxide and Hair Loss.

Tags: nitric oxide, no, hairloss, hair loss, hair growth, l-arginine, nitrix, no-xplode

I’ve Seen 2 Doctors About My Hair and Think Both Are Wrong

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

I’m a 25 year old male and my frontal hairline began receding rapidly about 9 months ago. From reading your blog and my own observations I assumed it was male pattern baldness kicking in earlier than I would have liked.

I have now seen two doctors (One family doctor and one dermatologist) who have both told me that It would grow back by itself as they both said it was due to stress (About a year ago my dad passed away right after I moved to a new city and I had to start a new job the day after the service). The family doctor briefly looked over my hair and the dermatologist asked me my family history (No balding on my mom’s side, and my dad started balding in his early 40s) and did a pull test (No miniturization test)

The problem I’m having is that from reading your blog it seems like they’re both incorrect. There is obviously miniturization at my hairlines which to my understanding means there its is MPB which could have been triggered by the event.

Does my hair growing back by itself like they both said sound at all realistic? Should I try yet another doctor?

Thanks for your time.

I agree with you that a mapping of your scalp for miniaturization will make the diagnosis for you. The pull test that your dermatologist did will check out conditions like telogen effluvium (see article at eMedicine), which if positive might indicate that the process will reverse, but people with genetic hair loss will not have a positive hair pull test. See another doctor who can make the correct diagnosis for you.

Tags: hairloss, hair loss, dermatologist, miniaturization, pull test

Pimples a Couple of Days After Hair Transplant?

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

Good day,

When I had hair transplant, a couple days later I noticed there developed small (about size of pinhead) yellow “pimples” at base of transplanted hair. is this common ? could it be a dermatophyte infection or tinea and is it problematic ? Thank you !

At two days after your hair transplant, these pinhead pimples you are talking about may be the tops of the hair transplants. The skin shows in some surgeons hands if they do not trim the grafts closely. At just two days, I would doubt an infection, but certainly go back and ask your doctor to take a look at what you’ve described to me.

Tags: hairtransplant, hair transplant, pimple, infection

If I Don’t Use Conditioner After Shampooing, My Scalp Gets Red and Itchy

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

ConditionerMy hair is thinning and falling out. I’ve had a problem with acasional redness and serious flaking and itching. Only happens on my scalp. If I don’t condition after shampooing, it shows up that day. Otherwise, its alright.Could there be a fungus that is causing my hairloss? My family doesn’t have hairloss problem.

If hair conditioner works to prevent the problem, why don’t you just use conditioner? I would doubt it is a fungus if simply using a good conditioner corrects the problem, but you could go see your primary care physician if this is a concern. A dermatologist would be a good person to meet with, as well.

Tags: conditioner, shampoo, hairloss, hair loss, skin, scalp, itch

Woman Balding All Over Scalp

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

(female) hi doctor, after reading lots of hair loss forums and websites i have found this to be the most reliable and informative for hair loss.

my question today is about my weird pattered hair loss which is identical to my mothers but less advanced, basically my entire scalp is thinning evenly effecting even the hair near my ears and back where you would call the permanent zone in a male. i had had this condition since ive been 18 and now at 23 its more or less the same i think. about one year ago i did something stupid and bought generic propecia from a website, which did nothing for my hairloss after 10 months so i quit, i am now reading into rogaine which sounds promising as it can even stimulate hair growth even in other parts of the body where DHT is not even an issue, since my hair loss I’m guessing is not caused by DHT could rogaine work for me?

Rogaine (minoxidil) is worth a try, but you should get a diagnosis first to rule out any medical causes of hair loss. It is probable that you are following your mother’s pattern. If you can, bring her into a good doctors office with you when you see your physician to get a diagnosis and a treatment protocol.

Tags: hairloss, hair loss, rogaine, minoxidil, women, woman, female

Is Propecia Shrinking My Penis?

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

Dear Doctors:

Thanks for all your help and responding all the posts in this site that has been so useful to me in the last 2 years.

I am 33 years and since 25 I started to lose my hair and 2 years ago I decided to get a hair transplant in Miami with Dr. Bernard Cohen and it really changed my life for good I had amazing results and at at the same time I started to take Propecia so my results are really amazing and I am very happy. But I am concerned because after 2 years of taking propecia just in the last 3 or 4 months I have noticed my penis to shrink in the flacid state. And the morning erections dispaear since i started but that really was not a problem at all. I read in your archive that some other persons are experiening the same: Is DHT Essential for Genital Function?

I dont have problems getting an erection and I have a very active sexual life no complaints, but it worries me that I have the same simpthoms of this guy in the post and really I did not have any troubles in almost year and a half. I dont want to leave Propecia, but would you recommend to stop for a week and see how it goes?? would that make any damage to my good results over 2 years??

Please advice.

The symptom of a decreased penis size is not a reported side effect of Propecia and I have no experience with it. I’ve certainly never had any patients tell me about this, and frankly, I’ve been taking the medication for years and don’t have that issue. Are you in a colder climate? Feeling a lot of anxiety? See Genital retraction syndrome at Wikipedia for some other possible causes for your thinking.

The lack of morning erections is a known problem with Propecia, but if you are not having erectile dysfunction (ED) problems, then I do not believe that you need to consider stopping the medication, especially if the results from it are good and your goals at stopping the hair loss is working for you.

Tags: penis, propecia, finasteride, hairloss, hair loss, genital, genitalia

Taking Finasteride for a Year With Good Results — Is It Time for a Hair Transplant?

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

Hello Dr. Bill,

First, thank you again for your continued dedication to providing the most up to date information on the issues regarding MPB.

My question is this: I’m a 25 y.o male experiencing early stages of a balding pattern in the form of NW 3-4. I have been on finasteride for almost a year and am satisfied with the results thus far (no further loss, and from an initial glance, some reversal). However, I want to achieve a more aesthetic look. I’m wondering if its advisable to undergo a HT to fill in the thin areas even though theres no bald spot. Would i probably have some shock loss? Is it too early to begin the rearrangement process that is to come with HT?

Thank you for your advice!

If you have a good response to Propecia and are still wanting more hair, considering a hair transplant is appropriate, but you want to make sure that your selection of a doctor is an informed one. You may consider reviewing the links on this page — Hair Transplant Doctor Credentials — to get a better idea of what to look for in a hair transplant surgeon.

I couldn’t say if you’ll probably have shock loss. If you’re sticking with the Propecia, I’d say your chances are quite slim that you’d experience shock loss of any great significance. I also couldn’t tell you if you’re even a candidate for transplantation without seeing you, but based on what you’ve described (mid 20s, Norwood 3-4, finasteride for a year), you’re not automatically disqualified. In other words, if you were 19 years old with a Norwood 2 and have never taken finasteride, it’d be pretty easy for me to tell you to not consider a transplant for at least a few years.

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

In the News – Goodbye to Bad Hair Days?

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

Snippet from the article in Telegraph UK:

A way to banish split ends, lifeless locks and “bad hair days” could come from an analysis that reveals the secret of silky hair.

The first detailed analysis of what happens to individual hair fibres as they rub past each other when tresses are tossed has been conducted down to a billionth of a metre, showing how to make hair smooth to the touch.

Bad Hair DayFull article: Bad hair days may soon be over, say scientists

The findings were presented at the American Chemical Society’s national meeting in Philadelphia and appear to be a way to replicate conditions that occur which make hair difficult to manage. There is big money in this, because if these conditions can be obviated with a shampoo or conditioner, the market could shift to such a new product.

Tags: bad hair day, american chemical society, hair, split ends, shampoo, conditioner

Not Sure If I’m Losing Hair from MPB or From Significant Weight Loss

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

I am a 24 year old male who has lost a lot of weight in the last 8 months. I feel like my hair is thinning but am not sure. I haven’t noticed any excessive shedding, my hairline is the same, but my hair does feel a little thinner. I’m not sure if it’s due to weight loss or the beginnings male pattern hair loss (my family does have a history of it).

My question is would it be bad to get on Propecia now even if I am unsure as to whether or not i have male pattern baldness? and if i’m not balding would it be bad to start taking propecia for preventative measures? i.e. If I start propecia can it jump start male pattern balding?

and do you know of any places in Sacramento that do the miniaturization test?

Weight loss produces dietary problems which can cause hair loss, particularly if you are genetically prone to it. Genetic male pattern baldness (MPB) is the most common cause of hair loss or hair thinning in men. It occurs special “patterns” — as the term implies. If you have MPB, any good dermatologist can diagnose this problem and prescribe you Propecia (finasteride 1mg) as an option. Only a doctor can prescribe you Propecia. Propecia does NOT jump start hair growth from male pattern baldness. It slows it down as a rule.

Tags: propecia, finasteride, weight loss, mpb, genetic, diet, hairloss, hair loss

Triangle of Hair Missing in Middle of the Hairline

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

hi,what is it called when the hairline is kind of an inverse widow’s peak – when there’s a little spot (maybe triangle-ish) of hair missing right at the top?

i’ve been googling to no avail and it is rather worrying me as i am only 16 years of age ,male. i have very thin hair aswell but only because i have straightened it for the past 2 years so i am not sure as if that has somthing to do with it

Assuming that you have not damaged the hair from straightening it, some people have irregularities in the frontal hairline that is normal and genetic. These irregularities can be fixed with a transplant into them to reshape the hairline. At 16 years old, I am not sure that you are a candidate, but you should be examined by an expert if this is something that you want to do.

Tags: hairline, hair transplant, hairtransplant, hairloss, hair loss, teen

Will Buzzing My Miniaturized Hairs Pull Them Out?

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

I have been diagnosed with miniaturization through-out the scalp.(30%) Was told it wasn’t dupa though. It is advised that those with this type of hair loss pattern keep their hair very short. Buzz cut! My hair looks horrible grown out but am afraid buzzing it every few weeks will speed up the loss. In a past question you mentioned friction on weak miniaturized hair can pull it out. What should I do?

Thanks

Buzzing hair that has miniaturization will not impact that hair unless it is poorly cut with non sharp instruments that pull. In other words, I do not believe that buzzing your hair will help it or hurt it. My advice is to style your hair any way you like it.

Tags: haircut, hair style, hairloss, hair loss

Are Bald Spots in My Beard Related to Minoxidil Use on My Scalp?

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

I used to be able to grow a full beard. Now there are patches over my face where absoultely no hair grows. Is this related to monoxidil use on my head? Or could this be from something
else?

No, it is likely from something unrelated. Minoxidil on the scalp does not cause you to lose hair elsewhere on your body.

Tags: minoxidil, rogaine, hairloss, hair loss

Joe Biden’s Hair Transplant

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


Doctor Rassman,

What is your opinion on Joe Biden’s HT? This was the most read article in Politico during the weekend!

Biden’s helmet

Joe Biden - After
Joseph Biden’s hairline, 2008
[larger version]

 

Joe Biden - Before
Joseph Biden’s plugs, 1987

It was only a matter of time until US Senator and Vice Presidential nominee Joe Biden‘s hair transplant became part of the discussion of the man. I am old enough to remember when he first had it done. It was done in the old style of transplants (the “pluggy” look) and he clearly has had more transplants since then to soften the hairline presentation to be more consistent with the newer technologies being done today. Having white hair solves most of the refinement problems as well.

I remember a very prominent litigating lawyer who came in for a hair transplant when the BBC asked to interview a patient. Under the provision that it not be shown in the United States, the lawyer agreed. A caustic British lady interviewer asked him (while on camera) why he felt so “inadequate” that he had to have a hair transplant to face the world. He responded that he had no problem with who he was. He was happily married with two children and he had a very successful law practice, but the man in the mirror no longer reflected what he felt he should look like. If he had a broken nose, he said, he would of course fix it. So with good technology available, he decided to have a hair transplant and bring back the man in the mirror that he thought he was. Why not? He combed his hair in the morning, put on a tie and a nice suit, wore nice shoes, and created an image of who he was to the world about him. He did it because it made him feel good, not particularly to impress anyone. Hair was just part of his image.

Having vanity surgery (hair transplants, eyes done, face lift, liposuction) or just working out does not mean that people who do this have feelings of inadequacy. People who take charge of their lives should be admired — certainly, I admire them. For the readers of this site, they might like to know that I have had transplants, my eyes done, and a face lift some years ago. I also work out regularly to create who I want to be and to be healthier, but I am no Joe Biden. His hair transplant is just a tiny, tiny footnote in his 35+ year career in the public eye, but I won’t wish him luck in the Presidential election, because men of his stature make their destiny happen.

Tags: hair transplant, hairtransplant, election, politics, obama, biden, joe biden, mccain, hair loss, hairloss