Why Is Hair Transplantation Not More Common?

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

thanx for the informative blog. i have a question, despite of such enormity of hair loss problem , why the hair transplantation is not so common.

It takes time for people to accept a new breakthrough in surgery. If you look at female breast augmentation, it took more than a decade for women to feel comfortable enough with it to step up and undergo the surgery. Most people think that hair transplants can always be seen and when they run into a person with plugs coming our of the scalp, they get the idea that this is a hair transplant and say to themselves, “This will never be me!” Today’s hair transplant can not be detected, so the good work done regularly is not something that the average person can detect unless you can remember what someone looked like before they got the hair transplant. A woman with an “A” breast size can be detected when she gets breast augmentation and one day comes out with a “C” or “D” size showing good cleavage. Only a bald man who now has hair, can be detected much like the woman with the newly larger breasts.

Tags: hairtransplant, hair transplant, surgery, cosmetic

Doctor Says After 10 Years on Propecia It Looks Like How You Were Before Starting

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

I read an article written by a Hair Specialist from Saratoga Hair Transplant Center that Propecia works great for the first 4-5 years for most men, and then slightly each year the hair gets worse again and by the time you been on the drug for 10 years you are back to where you were 10 years ago, this sounds really good to me! But is it really true?

I always believed that after 2-3 years you will start going downhill.

Tug of warI don’t agree that after 10 years on Propecia, you end up right back where you started. Some men fully maintain the benefits from Propecia in the long term, and others just do not. Everyone is different and will react differently to medication. I have patients that have been taking the drug each day for over a decade and are still seeing the benefits from it.

Think of this as a war between balding and the drug holding onto your hair. May the better side win!

Tags: propecia, finasteride, hairloss, hair loss, long term, years

My Doctor Told Me I Have Keloids On My Scalp

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

my derm told me that i had keloids in the back of my scalp. is it normal for a women to get them in there scalp? i have 7 of them in the lower back of the scalp and the and maybe 3 in the middle. they injected them with steroids 1 and they didnt get any better. just got a lil smaller, not to much though. i thought in the back of the scalp was more for men to have.

I would assume that your doctor is right if he diagnosed you with keloids. If you want a second opinion, you can try seeing another dermatologist. Keloids don’t discriminate.

Here is an excerpt from eMedicine: “The prevalence [of Keloids] has been reported to be higher in young females than in young males, probably reflecting the greater frequency of earlobe piercing among females. Keloids and hypertrophic scars affect both sexes equally in other age groups.”

Tags: keloids, keloid, scalp

Drinking Fruit Juices with Propecia?

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

Hi Dr. Rassman,

This news story recently came up and I was wondering if it at all pertains to Propecia? Do fruit juices hamper the effect of the pills or does Propecia work no matter what it’s ingested with? Thanks for your time and consideration.

Taking pills? Lose the juice and take with water to ensure absorption: study

GrapefruitIt has been known for some time that grapefruit juice can decrease the effectiveness of certain drugs. I do not believe Propecia is one of them, but if you are concerned, then simply do not take Propecia (finasteride 1mg) with grapefruit juice. The article does do a good job telling you when grapefruit juice is a problem.

Tags: grapefruit, juice, hairloss, hair loss, finasteride, propecia, medication

Propecia Is Working in the Hairline, But Not on the Top of the Scalp

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

Thank you for listening. I have been taking Propecia for a little over 10 months now, and it seems as if it is having a strange effect. It seems that it has started to rebuild my hairline, which was receding somewhat with moderate miniaturization. Alas, it has not shown any results in the vertex/top of scalp. Have you heard of this before? I’m merely curious as to whether this is common. Thanks for your time.

What you are experiencing is not common, but it does happen. Hair loss varies in individuals and by location in the scalp. Experience has shown that the drug works best in areas where the hair loss is most recent. Is that what you are seeing?

Tags: propecia, finasteride, hairloss, hair loss, crown, hairline

Any Way for Women to Prevent Further Hair Loss?

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

(female) I am 27 years old and have been steadily losing my hair for 4 years. My mom is almost completly bald on the crown of her head and I really don’t want to end up like that. Is there anything I can do now to prevent any more loss. I can already see my scalp and it’s getting harder to do combovers. I’ve done several blood tests and all have come back normal. Any suggestions?

You might see an expert on hair loss (some dermatologists or hair transplant doctors might be helpful). The only FDA approved treatment available for women is topical minoxidil (Rogaine).

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

My Doctor Said Finasteride Makes Prostate Cancer Untreatable!

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

After much consideration, I finally made an appointment with my physician to discuss going on Propecia to halt further hair loss. I figured that I really couldn’t lose – a drug to stop my hair loss and help reduce my chance of getting prostate cancer. A double threat – sounded like a good idea! My doctor who is very knowledgeable informed me of something I had never heard before. He said that even though Propecia (finasteride) helps to prevent prostate cancer in most men – some men do develop prostate cancer anyway, even while on the drug. He said the prognosis for treatment of prostate cancer is very good, but if you are one of the men who develop prostate cancer WHILE ON FINASTERIDE the cancer is extremely aggressive and you will undoubtably die from the disease. He said since I do not have any of the risk factors for developing prostate cancer, he did not think it was worth chancing developing an untreatable form of prostate cancer to save my hair. Have you ever heard this…that even though Propecia helps to reduce the risk of prostate cancer that if you get the disease anyway, that it is untreatable due to it being so aggressive?

The report on the study of over 15,000 men showed that although the cancer risk on 5mg of finasteride for 7 years decreased the incidence of cancer by 25%, of those who did get cancer, the classification of aggressiveness (judged by the Gleason score) is higher in some of the prostate cancers found. This is a pathologist’s description of the tumor based on appearance under a microscope.

There is some controversy on this issue, because some doctors believe that the Gleason score may not be indicative of the reality seen in long term follow-ups of these cancers, which I believe did not show more clinical aggressiveness. One medical paper discussed the overall risk to life when one compared the decreased incidence of 25% for cancers in patients on long term finasteride, with the risks to life with a possible more aggressive tumor. The claim that one risk may offset the other was in consideration. Where ever the truth lies, this finding is what it is without any final conclusions drawn at this time.

Tags: prostate, gleason score, gleason, cancer, finasteride, propecia, proscar

The 5mg Finasteride Sold Here Is Too Small to Be Cut!

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

I am 24 years old male. in my country there is no finasteride 1mg product of the pharmaceuticals companies. It’s also impossible for me to order online or import propecia. there is some finasteride 5mg product named “Prosfin” and it’s a famous pharma company. The main problem is the size of the tablet Prosfin is very small and it can not be cut with knife or pill cutter. i have to take finasteride because it works for me. Now what is the best solution for me, i mean how can i take finasteride 5mg tablet? it will be very helpful if u advice. should i take 1 tablet/3 days or 1 tablet/2 days? what will be the best? of course there is no way rather taking 5mg finasteride and it also impossible to cut it. Please advise. At last your blog is very helpful and i have not seen such a fantastic blog before.

Beximco Pharma

You don’t want to take too much of the finasteride unnecessarily, as you do run a greater risk of side effect potential. Also, there’s no reason to have more medication in your system than needed for treatment.

I did some research and found that Prosfin (5mg finasteride for treating BPH) is made by Beximco Pharmaceuticals, one of the leading pharmaceutical companies in Bangladesh. The same company does make a pill called Recur (1mg finasteride for treating MPB), so it should be available in your country. This should be the same as Propecia.

Tags: beximco, recur, prosfin, finasteride, hairloss, hair loss, bangladesh, propecia, proscar

I Remember an Advertisement for Artificial Hair Implants

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

Years back I could swear, unless I’m imagining this, that I saw an ad in a magazine about hair replacement that consisted of attaching artificial hair into the scalp. This was not a “piece” either. It was actually inserting hairs directly into the scalp. The reason I think I could be imagining this is because it was so long ago and I have never heard anything about it since. The thing is…I really do remember reading it. Have you ever heard of this? If yes, can you tell me (and your readers) what you know about it? Does it work? Do you do it? Please share whatever you know.

Thank you very much for your time.

There are many problems associated with inserting artificial hair into the scalp, including:

  1. Infection
  2. Horrible scarring
  3. Scalp irritation
  4. Accelerated hair loss
  5. Infection, infection, infection!!!

As such, this type of procedure has been banned in the United States, yet this has been done for many years in the past, particularly in some Asian countries. For more info, check out the post I wrote about this a few years back — Artificial Hair.

Tags: artificial, implant, hairloss, hair loss, biofibre, artificial hair

Hair Loss After Battling Multi-Year Illness

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

(female) I was ill with fever of unknown origin (temp about 100.7 – 102) from Jan. 2004- Jul. 2007. It eventually went away by itself (after I was checked for everything under the sun numerous times) but left me with much, much thinner hair. It completely changed my hair texture from thick and very curly to thin and barely wavy. Most of the loss is on top of my head, but there is also some at the nape of the neck. Will it grow back? I’m even considering the transplant procedure. I just don’t know how long I should wait for this to resolve itself on its own. I have been using Minoxil and taking vitamins (biotin and vit B.)

The hair loss you describe sounds like it is diffuse, and as such, you would most likely NOT be a candidate for a hair transplant procedure. To have such a procedure, you need good hair from some plentiful source to move into the bald areas. It doesn’t sound like you have such a source.

Sadly, I really cannot say if your hair will grow back to its original state. You may try topical minoxidil (Rogaine), and it generally takes over a year to notice some growth with this medication.

Tags: hair loss, hairloss, sick, illness, rogaine, minoxidil

ACell to Heal Donor Scar?

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

Hi Dr.Rassman,

Firstly i would like to thank you for the time and effort you take in providing this valuable blog – it is a great source of information! I am writing to you to ask about recent discussions on the web with respect to Acell and its (potential) ability to (completly) heal the donor scar. Have you had a chance to look at this ? What are your thoughts? If Acell can revise our donor scars it would be a great step for many of us who just want to buzz our heads!!

ACellThe technology sounds good, but I have no experience on how it would be used after a scar has formed. The question would be, “Would there be value for a person to include this therapy in the actual surgery?” Frankly, I do not know the answer to that question and can not render an opinion at this time.

Although they appear to have more invested in veterinary services at this point (there’s a lot more info on treating animals than on treating humans), you can check out the ACell site here.

Tags: acell, wound healing, wound, hair transplant, hairtransplant

Thin Skin Patients

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

Hi Doc,
During hair transplant, are thin skin patients more prone to damage to dermis when incisions are made or is the thickness of epidermis layer same in everyone.

The epidermis is about the same size in everyone. Some people have large amounts of dermal and subdermal fat making their scalp appear thicker. With good surgical techniques, damage should not be a problem for those with “thinner” skin.

Tags: thin, thinner, skin, surgery, dermis

Low Carb Diet and Hair Loss?

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

Will low carb diets (or no carb diets for that matter) cause hairloss in males with MPB?

Unless you are not meeting your daily nutritional needs, a low carb diet will likely cause weight loss, not hair loss.

Tags: low carb, no carb, carbs, hairloss, hair loss, weight

If Propecia Only Slows MPB, What Eventually Happens?

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

I was curious, if drugs like propecia only slow mpb and genes usually overcome them after time and you get hair transplants, what do you do later on when the drugs looses it’s effect and you loose hair in the non transplanted areas, and by chance you don’t have the donor hair to compensate. Thank you for your time.

Norwood Class 7Great question! The treatment of male pattern baldness with drugs and possible transplants requires a good Master Plan with your doctor. The Master Plan will balance the eventual worst case scenario for your balding pattern (only 7% of men go all the way to a Norwood Class 7 pattern — see illustration at right), the donor supply, and the reconstruction. For example, a person who has a Class 3A balding pattern at 35 years old, has a worst case scenario of a Class 5A pattern, but probably wont get there if he is treated with Propecia (finasteride 1mg) and is a good responder. I find that I can restore almost all Class 5A patterns with reasonable hair density, good laxity and average or better than average hair weight. When you discuss your balding problem with your doctor, this should become the central focus on your consultation.

Like you suggest, going into transplants blindly could not work in your favor if your hair loss pattern eventually works to a Class 7 pattern. With that said, people who may evolve into a Class 7 pattern could accept coverage in the front and top, leaving the crown out of the reconstruction if their pattern goes too far. A frontal reconstruction with a Class 7 pattern looks great in the mirror and is a reasonable option for the worst of the balding patients.

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

Propecia Raised My Testosterone, So I Switched to Avodart

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

since taking propecia for 6 months my testosterone had been raised quite high, so i decided to switch over to avodart as i heard it is better. my testosterone is still high. my question is, is it worth me taking these medications for my hair loss as its raising my testosterone in turn producing higher amounts of DHT and higher amounts of DHT will cause more hair loss. in a sense im taking a drug to stop DHT but at the same time the drugs making higher amounts of DHT so im in a confusing paradox. should i continue with either one of these medications if all there doing is creating more DHT, even though there getting rid of it. please help Dr. Rassman and NHI team. thanks

It sounds like you are buying these drugs on your own without being followed by a doctor. There is a reason why these medications require a prescription from a doctor. In general, Propecia should not raise your testosterone levels to a significant amount over the long term, but testosterone levels have been found to be higher in those men on Propecia. There may be other issues special to your particular case. If Propecia raises your testosterone levels, Avodart will also increase the levels (certainly not decrease). If you’re indeed under the care of a physician, you need to ask these questions to him/her.

Without going into the biochemical aspects, there is no paradox that you are referring to. The real paradox is taking Avodart (dutasteride), because Propecia (finasteride) raised your testosterone level.

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