I Have DUPA — Can I Transplant My Beard Hair to the Scalp?

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

i was wondering if a person like myself with DUPA had a strong beard would if be possible to transplant it to the scalp and if so how much coverage would i get?

Such a transplant (beard to scalp) would technically work, but to what master design is the question! The character of beard hair is different than scalp hair.

You’d need to come in for a consultation and let me look at the many variables. With your goals clearly defined, we can discuss not only using beard hair, but perhaps even leg, chest, arm, and pubic hair as well. I generally do not recommend body hair transplants, but in a case of DUPA (diffuse unpatterned alopecia), things are different. Generally though, the hair of DUPA patients is so thin that you may not get what you need from other body parts.

Tags: dupa, diffuse unpatterned alopecia, hairloss, hair loss, bht

Expired Rogaine Foam

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

Hi Doc,

I’ve seen expired Rogaine foam on ebay selling for rather cheap. I could understand that overtime, a drug might lose its effectiveness, but I can’t imagine that Minoxodil spoils like milk.

From a business standpoint, it would make a lot of sense for Pfizer to put an expiration date on their product in order to minimize competition with 2nd hand merchants. I acknowledge my ignorance in the subject, so I am appealing to you. Do you think using Minoxodil that’s a month or a year past its expiration date is any less potent?

Thanks for all of your hard work.

My official response is to follow the general advice on all expired medications and trash it.

Off the record, I think that expiration dates are often accelerated for the very reasons you are probing and would expect that if I was taking minoxidil that is properly stored 1 year past its expiration date, I would be comfortable using it. But don’t quote me on that, of course. Oh, this blog is public?!

Tags: rogaine, rogaine foam, minoxidil, hairloss, hair loss, expired, expiration

Shock Loss in Donor Area

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

I was wondering if schock loss on the donor scar is common and will it grow back, I have two quarter size bald spots above each ear wher the surgeon had to take more donor hair. the rest of the scar also shows loss above and below the scar. it has me freaked out. should I be??

A reactive telogen effluvium is what you are describing. It usually, but not always, reflects a tight closure of the donor wound. It may be permanent, but you won’t know for about 4-7 months. Wait it out and keep your hair long while you are being patient. This complication needs discussion between you and your doctor.

Tags: hair transplant, hairtransplant, shock loss, hairloss, hair loss, donor area, donor

Does Sleeping On Your Side Make a Difference to Your Hair Loss?

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

SleepDr. Rassman,

Does running your hand through your hair have any effect on the rate of hair loss? I have a habit of running my hand through my hair frequently (possibly 50 times) each day, and being a 20 year old male with my genetics against me, I am beginning to wonder if this may be encouraging hair loss to occur (although no loss, other than slight recessions, is visible yet).

Also, when sleeping, does it matter whether I sleep on the crown of my head verses the side of my head? Specifically, does sleeping on the crown help to encourage hair loss in the crown area (eg. the bald spot), and should I attempt to sleep on my side more often, or does it not matter whatsoever? Once again, no hair loss is visible in my crown as of yet, other than the small spot I was born with.

Thank you!

There is no real risk to running your fingers through your hair, unless you are pulling on your hair. Running your fingers through your hair is not causing your hairline to recede, I can tell you that much. Sleeping positions do not impact hair loss.

Tags: hairloss, hair loss, sleep, position

If Every Male in My Family Lost Hair in Their 50s, Will I Follow Their Rate of Loss?

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

first i would like to say that i greatly appreciate your website and the time you put into it.

does the rate and age at which a male starts to bald corespond to the rate and age at which other men in their family start to bald? in other words, my dad and every guy on his side of the family and on my moms side of the family started going bald in their early 50s. does this mean that i will also start balding in my early 50s. also is it possible for me to start balding at the crown eventhough everyone in my family has never shown signs of baldness in that area?

i have been reading that scientists in britain have said that weightlifting can increase the rate of the male pattern baldness? is there any truth to this? do aerobic exercise reduce testosterone levels in your body?

thanks for your time

There is no way to be definitive in answering the question. Many people do follow their family patterns of hair loss. You may or may not. I do not believe that exercise increases hair loss unless you are taking exogenous steroids.

Tags: hairloss, hair loss, genetic, gene, exercise

Mapping Your Own Scalp for Miniaturization, Part 2

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

This is part 2 of a series. For the first part, see Mapping Your Own Scalp for Miniaturization.

—

Interpreting the Results:

Is miniaturization present? Hair shaft thickness should be relatively comparable from one part of the head to another. There are exceptions to this rule in the first 1/4 inch of hairline, the temple prominences, and the hair of the neck where the shaft thickness may be less than that found throughout the scalp. In any one area of the scalp, the hair shaft thickness may be reduced significantly in 20% of the viewed hairs. These reflect vellus hairs, not mature normal ‘terminal’ hairs — so any measurement below 20% can be thought of as normal without miniaturization.

The area of the head may have different findings. For example, frontal hair in the balding Norwood Class 3A will show varying degrees of miniaturization eventually leading to complete balding, while crown views of the hair may show no miniaturization whatsoever. The balding patterns shown in the Norwood classification chart will parallel the distribution of miniaturization as the balding process develops.

All miniaturization is not equal. Some hairs in any one part of the scalp may show different degrees of thinning. That is because the impacted hairs are self-destructive and different times. Eventually, those miniaturized hairs at the beginning of the destructive process will progress with more and more miniaturization until they just fade away. In the various stages of miniaturization, the hair’s growth slows (no longer growing at 1/2 inch per month) and they will lose their pigment (become gray or transparent). These changes will be appreciated by those of you who become experts on your own miniaturization process.

Now What?

This week, I’ll be posting a tutorial video on BaldingForum.com to show how the process works using the sub-$100 Celestron handheld microscope I mentioned in part 1 of this series. First though, you’ll need to get the microscope. I provided the links in part 1, but to keep things convenient here they are again:

Assuming you have the microscope, the tutorial video (Below!) will be a big help. It’ll not only show you where to map on your scalp, but it’ll also show you how to create files of your historical record on your computer and compare the pictures you obtain over time may give you insights into your balding problems.

 

 

Tags: miniaturization, hairloss, hair loss, mapping, celestron, microscope

I’m 23 Years Old and Losing Hair Slowly

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

Hi Doctor,

Well at 23, I’ve finally come to terms with it: I’m slowly going bald. I’ve probably been thinning since I was 18-19, and right now I stand as a 2 on the Norwood scale. And honestly, for the first time, I feel like I can’t let this get out of hand any more. Now, I’ve read your blog and figure it’s time to jump on the Propecia bandwagon. So I was hoping, since you have so much experience, could you tell me what my prospects are- How many years of damage can I repair? What are the chances I’ll fully recover my hairline? or rather, how often does a person of my age and degree of balding recover any bit of their hairline? Yes I am looking for hope :)

Thanks so much for your answer ahead of time!

I’m sure it’s not what you want to hear, but it’s difficult to give percentages or even estimations for this kind of thing, especially considering I haven’t seen you. The medication works differently for each person, so some might see greater benefits than others. For a 23 year old with early balding, I’ve seen Propecia work very well in halting hair loss. Regrowth in the hairline isn’t as common, but certainly keeping the hairline from receding further is something I’ve seen many, many times. You’ll want to meet with a physician for the prescription, and you’ll definitely want to find out if what you’re seeing is even male pattern baldness at all (Norwood 2 may not even be balding, but a mature hairline). If there’s genetic hair loss going on, there’s no need for the medication.

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

Local Pharmacy Claimed They Cut Up Generic Proscar to Make 1mg Generic Propecia Tablets

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

Hey Doctor! Huge fan of your site, your clearly the top in the hairloss industry. Here is my question I was on propecia for over a year and decided to switch the generic. Well the generic must have been fake because I would clearly see my hair thinning more and my hairline pull back. I am 21 years old, and thank god switched immediately back to the real version of propecia. I was off propecia for maybe 3-4 weeks max. I was doing great on propecia until the switch.

Do you think my hair is likely to continue to fall-out even though I am back on the drug? Should I consider starting rogaine to bring back those hairs lost in the frontal region?

On a side note, I would continue to recommend informing people of the dangers of the generic, I got the generic from a real pharmacy in the state of NY. There was no way this was the same strength as propecia. I could tell it was so obvious. It was said to be 1mg by the Pharmacy. They claimed they cut up proscar and turned it into 1MG tablets. There was no way this was real though.

If the pharmacy is making 1mg dose tablets, they are breaking the law (violating Merck’s patents). There are many counterfeit pills on the market and the best way to guarantee what you are buying is to get it from reliable sources. If your pharmacist is willing to break the law, I wouldn’t put a lot of faith in the pharmacy selling you reliable medication. Now that you’ve restarted the real medication, the hair loss should subside again. Give it some time. You can add Rogaine if you’d like.

Tags: pharmacy, hairloss, hair loss, generic, finasteride, propecia, proscar, rogaine, minoxidil

Tingling Sensation from Liquid Rogaine

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

My question involves Rogaine Liquid 5% and Rogaine 5% foam. I switched to the foam (after about 3 months on the liquid) about two weeks ago and have noticed that the tingling sensation has ceased. I used to feel the tingling on and off throughout the day. I began using the liquid with a shaved head (it is now grown out to about 1 inch) and it is difficult to gauge any increase in shedding but from 3 weeks ago to now, it seems like there is an increase.

My questions are :

  1. Is there an increase in shedding when starting the Foam after having used the liquid?
  2. Is there evidence that the “tingling” sensation is correlated to absorption into the scalp?
  3. If application/time is not a big issue, which of the 2 do you recommend?

There’s no difference that I’m aware of between any initial shedding from the foam or liquid. Tingling may have a correlation to absorption, but the foam does provide better absorption than the liquid. The tingling might just be from the amount you’re applying, or perhaps you have a sensitivity to a secondary ingredient in the liquid that isn’t in the foam.

Tags: rogaine, foam, liquid, regaine, minoxidil, hairloss, hair loss, tingling

Is Propecia Illegal in Parts of the World?

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

Hi there,

Appreciate that customs of countries would probably be the most effective people to ask, but in terms of small and remote countries that are not so advanced technologically, is it possible that someting like propecia is illegal?

Cheers

I doubt that finasteride would be illegal to possess, as it has been available worldwide for the treatment of prostate problems prior to becoming available as a hair loss treatment. It is illegal in many countries to import drugs from other countries, and of course in many countries it is illegal to purchase prescription drugs without a prescription.

Tags: propecia, finasteride, proscar, legal, illegal, drug, medication, hairloss, hair loss

Can Propecia Change Hair Color?

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

Would taking Propecia, if I am diagnosed with balding, alter my hair color? I have heard, for instance, that Rogaine has changed some individuals hair colors dramatically, so that’s why I ask. My hair color’s dirty blond.

I do not believe that Propecia will change hair color (I haven’t seen it in my practice), but as hair miniaturizes more and more, the hair may become whiter or blonder if your hair is light brown / dirty blonde.

Tags: propecia, finasteride, hair color, hairloss, hair loss, side effect

Could I Ruin My Hair By Sleeping On It?

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

I had a hair transplant about 14 months ago now and the transplant was successful. I would of liked more density, however i am happy with it. My question is, when i sleep and wake up the transplanted sections-which is both temple areas are always messy and ruffled up because i lean on them on my pillow. Its hard to explain however i feel i am putting pressure on the hairs and pulling them because the hairs are getting trapped between the pillow and my head if you can understand. not terribly but my temple areas which were transplanted are always messed up as though i was lying on it and putting a certain amount of pressure as my head was lying on the hair and the pillow-its really hard to explain. Do you think this will cause damage. And if so how long will it take before i see? will it go gradually?

thank you

There’s no problem sleeping on your transplanted hair. On occasion, transplanted hair will become more curly and even wiry, so look carefully at the transplants and see if the character is the same as the non-transplanted hair.

Tags: sleep, hair transplant, hairtransplant, hairloss, hair loss

Mapping Your Own Scalp for Miniaturization, Part 1

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

What’s the Point?

For some years now, I have been advocating the use of video magnification for the purpose of:

  1. Detecting the presence of miniaturization to establish the presence of genetic balding in men.
  2. Examining the extent of the miniaturization as a predictor of just how far the balding pattern might go if left untreated.
  3. Using the estimate of measurements for the degree of miniaturization to establish reversal or progression of the balding process.

The medical community has been less than enthusiastic about accepting this approach for reasons that I never have and still do not understand.

 

Do It Yourself!

CelestronPeople interested in getting this study have been unable to find cooperative doctors willing to make this service available and many doctors just laugh when they have been approached by blog readers asking to get the study done. Many doctors don’t even understand what it means to analyze the presence and degree of miniaturization. I have realized for some time that performing these determinations is not rocket science, so I have made the decision to enable those interested readers to perform their own miniaturization study. It requires an adequate video imaging system (a computerized version of my original U.S. Patent issued in 1994) which I’ve found available over the internet for under $100. For the informed patient who is interested in getting this analysis and can not find a doctor to do it, they can purchase the handheld unit from one of the sources referenced below and perform the testing themselves. The cost of the video imaging system is often less than the cost of the physician’s visit and it will allow the interested person to repeat the study yearly, accumulate a set of photographs of their balding area and compare the results over time. For those on medications like Propecia, it will enable the user to see if he is getting control of his hair loss over the course of 8-12 months.

Take a good look at the defined Norwood balding pattern classifications and you can clearly see that quantifying miniaturization in the areas of balding will give you a tool to determine just how far your balding might progress.

 

What Do I Buy?

The hardware required is a Celestron 44300 handheld digital microscope, and what I particularly like about this (aside from the sub-$100 cost) is that you can plug it into your computer’s USB slot to save the images in JPG format. That will make it easy for you to upload the saved images so that physicians can analyze the results. But I don’t want to get ahead of myself just yet (wait until Monday)! This microscope works for both Windows and Mac computers. I’ll be providing a tutorial video next week on our new sister site, BaldingForum.com, that will show you how to use this microscope and how to map your scalp.

Here are some sites that sell the microscope; I have no preference of which site you purchase from:

 

Click here to read part 2!

 

Tags: miniaturization, hairloss, hair loss, mapping, celestron, microscope

Do Birth Control Pills Treat or Cause Hair Loss?

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

Bottom Line with hair loss and birth control pills?

I read conflicting information about the birth control pills and hair loss. It can trigger hair loss yet is also a treatment for androgenic alopecia.

I experienced heavy shedding after discontinuing Ovcon 35 several years ago. I became pregnant shortly after stopping the pill, and the hair loss ceased. I had moderate TE after all three of my subsequent pregnancies. I am now finished childbearing (at 32)and looking for contraception. My mother has severe androgenic alopecia and I’m quite sure I’m destined for the same fate.

So, for my case (there are no other known health problems in myself or my family) should I take BCP’s to prevent the alopecia? I was thinking of trying Yaz or Yasmin because of the drospironone that is derived from spironolactone and has anti-androgenic properties. But is it the estrogen or the progesterone in the pills that cause the hair loss? Should I stay away from BCP’s completely due to my history?

You should have this conversation with your OB/GYN doctor. I do not prescribe or recommend birth control pills (BCP) in my practice, but more importantly you should not be taking BCP for hair loss. All medications have risks and benefits and potential side effects. As such, these matters are highly specific to each and every individual.

I wish I can give you a blanket answer saying one birth control pill is better than the other at hair loss or hair growth, but I do not know of any firm proof of what is good/bad for what. From a theoretical perspective (as you seem to have done your research), spironolactone does have anti-androgenic properties. From a practical and real world perspective, spironolactone does not stop or help with androgenic alopecia, which is why I do not prescribe spironolactone for hair loss either.

Tags: spironolactone, birth control, bcp, hairloss, hair loss

How Can I Tell If I Damaged My Transplanted Grafts?

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

Hi there.

14 days after hair transplant surgery i got sunburned…i saw a similar question here on the site.

my question is – is there a way to know if i damaged my hair transplant? Does in any case of sunburn the newly grafts are “killed” what are the signs ( if any ) to know whether you killed your grafts or are they alive and slowly growing….? I would appreciate if you could explain why and under what conditions the sunburn can prevent growth.

i’m quite worried and appreciate your answer. thank you

Ultraviolet light is bad for skin and worse for new wounds, which are your healing grafts at 2 weeks. If the burn was deep enough to be a second degree burn, then you could have damaged the grafts, but superficial first degree burns should not have gone deep enough to damage the grafts from a growth perspective. Healing tissues, on the other hand, may be a problem.

Did you get the instructions to keep your head covered? My patients are indoctrinated on the things that they can and can not do. Ask your surgeon for a list of do’s and don’ts, and as long as you avoid the don’ts I’d expect that you shouldn’t experience any problems with your transplant.

Tags: hair transplant, hairtransplant, damage, hairloss, hair loss, grafts