I Had a Transplant a Month Ago and Feel New Hairs Sprouting Up

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

Dear Dr. I had hair transplant back in November 3, 2008. When I gently place my hand on the transplanted area I can feel the “bed of thorns” or “sprouting new hairs”. My concern is are they really new hairs or is it the grafted hair waiting to fall out. I have been taking finasteride religiously for more than two years and still continue to be on it. Does this suggest that grafted hair may not fall out and continue to grow right away, since it is over 45 days from surgery and grafted hairs should have fallen out by now. Is it compulsory for grafted hairs to fall out, if so, generally how many days from surgery they should fall out.

Thanks

In about 5% of people who have hair transplants, they will notice immediate growth without a ‘sleep period’ of 2-5 months, which is normally seen. If the hair falls out (95%) of patients, it will occur in the first 3-4 weeks. Propecia should be continued through the entire process without stopping it.

Tags: hair transplant, hair growth, hairloss, hair loss, propecia, finasteride

Can Transplanted Hair Grow Long?

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

Most men who have had hair transplants show shorter hairstyles. Can transplanted hair even grown long (12 inches)? If so, what would it look like?

Many of my patients with comb-backs, allow their transplanted hair to grow to lengths of 9+ inches routinely. From there it is up to you and the barber to decide what you want for the length of the hair. It is purely a styling decision.

Tags: hair transplant, hairloss, hair loss, long hair

Happy Holidays!!

/by William Rassman, M.D./0 /
Happy Holidays from BaldingBlog

 

It’s the holiday season, so we’re taking some days off. Check back Monday for more new content here. In the meantime, please sign up at our new BaldingForum and be sure to participate!

Happy Holidays from Dr Rassman, Dr Pak, and the entire New Hair Institute staff!

 

Is Revivogen Safe?

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

I have been experiencing male pattern baldness for some years now. Initially used Rogaine, it worked at first but now no longer respond to it. Next used Propecia, but had to stop due to side effects.Lasercomb failed too. I am currently saving up and considering getting a hair transplant maybe in 4 years time.I’ll have enough money by then.

There’s one thing I’m really curious about. Would you happen to know anything about Revivogen from www.revivogen.com. It’s a topical lotion combined with shampoo/conditioner that was invented by Doctor Alex Khadavi, MD, a US Board-certified dermatologist. I have a question below which I hope you can answer and shed light on.

All I just want to know before trying the product and applying the lotion to my scalp is for my “safety” concerns.If this product was developed by a dermatologist (i.e.Dr Alex Khadavi,MD) is it okay to allow myself to test it out even if it may not grow/and or stop hair loss but at least I can be rest assured it won’t cause allergic reactions on the localized surface of my scalp. Although I don’t have sensitive scalp skin, some of the things I’m scared of are like more hair loss(worse than pre-treatment) or cause unknown severe harm like scalp dermatitis/acne/burn/swolleness, stain my scalp permanently orange etc.(I’ve probably just exaggerated every side effect.May or may not true!). This is what I mean by safety. What’s the worse a topical solution like Revivogen could do to my scalp anyway? Any potential risks? Are the ingredients mentioned on the website even safe on humans?

Finally, do you believe it is safe enough and whether its worth a try for me to test out what appears to be a very safe and sound consumer product and hopefully not a scam? There’s nothing else on the market and I’m really desperate too to give it a go(whether it works or not its a small price to pay).

Please do feel free to take your time and answer me whenever you can.Your comments and recommendations would be very appreciated. Thanks.

RevivogenYou can experiment with almost anything that is not prescription, including Revivogen. It is not true that medications that are developed by a doctor will not cause allergic reactions as they happen, but if someone is telling you this, then I would run from the recommendation. You can still get an allergic reaction if you’re allergic to an ingredient in the product. Being made by a dermatologist doesn’t make any difference in that regard. The ingredients are safe for humans, but I am not an expert on this product so I can not offer you advice on its efficacy. It contains saw palmetto extract, and that appears to be the active ingredient… but I’ve written about saw palmetto before (see here).

What you should be doing is what I’ve discussed over and over again on this blog: the use of one or both of the proven drug approaches to genetic balding, finasteride and minoxidil. If you had side effects from the Propecia, you should consider cutting the dosage in half (some finasteride is better than none). If you stopped responding to Rogaine, perhaps you could try a greater strength. As you have seen, the LaserComb does not really add any value, so I can not put more advice that you already do not know yourself.

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

I Shed Hair Twice from Propecia

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

Hi,

I’m currently on propecia which I started 6 months ago. I experienced a shed in the 2nd month lasting for 2 months which stopped and my hair started growing in the temple region. Its good for a month or so and I’m experiencing a shed again, this time mainly on the top of my head. Is this normal – to have shedding twice? or have my body gotten immune to the pills? Pls advice if I should carry on the medication. I’m 26 by the way.

You must have had a doctor prescribe you the Propecia and you should be going to that doctor for this type of advice. I would need to see you, map out your hair for miniaturization and it would have been best to do this before you started the Propecia so we could understand what is happening to you. Better late than never, so get back to your doctor for the advice you seek. I can’t tell you whether to stop or start a prescription drug that I didn’t prescribe to you. I don’t think you’re immune to the medication, though.

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

Can Sunscreen Clog Pores on My Scalp?

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

I have shaved my head due to hairloss…in the meantime, I am still using rogaine foam, and I can see where hairs are starting to grow in…

I am trying to protect my scalp, and keep it as healthy as possible…. I understand sun can cause hairloss, or could damage the scalp, so I am going to use sunscreen when in the sun. However, my question is, won’t the sunscreen clog the hair/pores?

Not a problem. Be sure to wash your scalp daily if you are concerned. Contrary to popular belief promoted by trichologists, the pores in the scalp do not clog easily. Rogaine will continue to work, but it is best that the Rogaine be applied well before the sunscreen, as the sunscreen can block the Rogaine.

Tags: rogaine, minoxidil, sunscreen, sun screen, lotion, hairloss, hair loss

Suddenly Thinning Hair in Mid-30s

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

Two years ago I was getting my hair thinned out by my stylist because it was to thick. Two years later at age 37 my hair is considerably thinner. The thinning is more prevalent on the left top side of my head. The initial thinning was drastic and took place within a couple of months. Should I expect for this to continue at such a fast pace or will it slow down. My mother’s side of the family has little issues with hair loss while my father’s side does. Beside genetics what possible causes would be responsible for this to happen in the timeline it has?

First, I would want to map out your hair to see if this is symmetrical balding. At times, genetic hair loss is asymmetrical and will show miniaturization in the areas most impacted. Get to see a good doctor for an assessment. I can not help you over the Internet and would need to see you myself.

Tags: hairloss, hair loss

Myth Busted – Most Body Heat is Not Lost Through Your Head

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

Snippet from the article:

When it comes to wrapping up on a cold winter’s day, a cosy hat is obligatory. After all, most of our body heat is lost through our heads – or so we are led to believe.

Closer inspection of heat loss in the hatless, however, reveals the claim to be nonsense, say scientists who have dispelled this and five other modern myths.

They traced the origins of the hat-wearing advice back to a US army survival manual from 1970 which strongly recommended covering the head when it is cold, since “40 to 45 percent of body heat” is lost from the head.

Full article here — Scientists debunk the myth that you lose most heat through your head

Tags: body heat, head, heat, hat

Rogaine Foam Allergy Due to Fragrance in the Formula?

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

Dr. Rassman,

Have you received reports from any of your patients claiming that they are allergic to Rogaine Foam? The Rogaine Foam apparently has a fragrance in the formula, which I suspect is responsible for the irritation it causes in some individuals.

On various message boards, there are reports of this allergy or irritation from Foam. I have tried contacting McNEIL-PPC, Inc. about the “non-scented version” that they have apparently received label approval for from the FDA, but this “non-scented version” of the Foam has yet to hit the market. It makes no sense to me that the Company would only offer the “scented version” of the Foam while the Regular Rogaine (liquid formula) comes in both “non-scented” and “scented” versions. Additionally, most dermatologists claim that fragrance-free is the way to go!

Can you contact the makers of the Foam and see when they plan to market the “non-scented version”? Perhaps you will have better luck getting a response back from them! Thanks in advance for your time and attention to this matter.

I would doubt that I would have any influence on the makers of Rogaine Foam. They will release it when they are ready and that may include FDA testing, manufacturing problems that are worked out, and many other such parts of the process. Many times, the filler ingredients are responsible for the allergies we see, so your claim is not unreasonable.

Tags: rogaine foam, rogaine, minoxidil, foam, allergy, hairloss, hair loss, fragrance

A Bargain Hair Transplant? Not Quite! (with Photos)

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

The following comes from Dr Paul Cotterill in Toronto, Ontario, Canada:

Here is an example of why proper training and regional workshops are a pretty good idea:

I saw this patient in my office yesterday that was referred to me for assessment. This 38 year old fellow ( Class IV-V ), had a transplant 4 weeks ago in Ludhiana, India. He felt that the procedure didn’t go very well.

On examination the crown had been transplanted with 60 – 65 punch grafts that were 2-3 mm in diameter and the distance between grafts was 1 – 1.75 cm, very irregularly, across the crown. Peri-folliculitis was evident and residual crusting on some of the grafts. There was up to 7 hairs in some of the grafts. The grafts were removed via FUE from the occipital area. The procedure took 1 hour and he was told to return next month for a second session of the same. The cost – $500.00 for both sessions.

I have swabbed for C&S what I could, cleansed the scalp, started an antibiotic and suggested Propecia, with follow up in 1 week. He would like further sessions to the crown. He needed a proper consultation as to planning and the consequences of starting the crown in a 38 year old with certainly further thinning in the future. Further sessions at this point are unwise. I will be following up with him closely.

Dr. Cotterill has given me permission to repost these photos. It is unfortunate that people treat a hair transplant procedure as if they’re just getting a haircut. This is surgery! You want to do your research and know what you’re getting into. How could anyone recently get the old, ugly plugs of decades past? It’s disturbing on many levels. So he only spent $500 on 2 sessions to get this look. Now how much time and money will he have to spend to try to undo this foolish mistake? A bargain indeed.

Click the photos below to enlarge.

 

Tags: plugs, repair, photos hair transplant, hairtransplant, hairloss, hair loss, cotterill

When Is it Right to Start Propecia?

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

When is the right time to start using Propecia? I’m 29 and have visited three doctors to get different opinions about my slowly thinning hair that I’ve started to notice in the past year. Two doctors told me my thinning is not significant enough for Propecia and instead suggested I try Rogain. The third doctor told me to start Propecia, Rogain and laser comb therapy as soon as possible.

If you are balding, then you should start it ASAP. Mapping the scalp for miniaturization will give you a metric for a starting point so that in a year you can compare not only the value of returned hair, but the change in the degree of miniaturization. You can even map your own scalp, as outlined in part 1 and part 2 of Mapping Your Own Scalp for Miniaturization.

Propecia is available by prescription only, so your doctor has to be involved with that — Rogaine is available over the counter, and I seriously doubt the laser therapy will provide any help. The right time to start treatment is when you start seeing early hair loss, and you don’t have to wait until you’re significantly balding.

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

Propecia Alters PSA Results in Prostate Cancer Screenings?

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

Dear Doctor:

I saw this online about the cancer risk and PSA results of people on propecia. What do you think about this article?

Propecia and Prostate Cancer: Balancing Vanity With Health

Thanks for sending that link. It has been known for some time that finasteride will reduce the PSA levels so a pre-PSA level is critical to get, particularly if you are over 50 years old when you start the drug. Prostate cancer is highly unusual in men under the age of 50, so I routinely get a PSA test on all men over 50 who I start on Propecia/finasteride. The interesting studies indicate that this drug will reduce the risk of prostate cancer, and that is great news.

Tags: hairloss, hair loss, propecia, prostate, cancer, psa, finasteride

My Surgeon Said to Put Rogaine on My Newly Transplanted Grafts for 3 Months

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

I am 57 and had a hair transplant three weeks ago. I had a full head of hair until I was 40, and then very gradual thinning. The transplant was done to provide more thickness in the front and in the crown. The surgeon who performed the transplant said that in addition to taking finasteride (which I have done for several years), he advised using Rogaine (Regaine outside of the US) for three months on the new grafts.

However, the Rogaine website specifically says that the product should be used on the top of the head only. When I checked with their help line, they said that research had not been completed about success using rogaine at the front of the head. My guess is that this is because the success rate (both to promote new growth or even to arrest hair loss ) in the front of the head has not been good. I am looking for a second opinion and want to know whether it is best to ignore the front and just put it on the crown. If so, I wonder why one would apply six pumps to the area rather than one or two, the recommended dose, regardless of the area being covered.

The Rogaine representatives are clearly pleased that the product is being recommended by tricologists for hair transplant patients in the post operative stage but they will not endorse the use of the product on the front although they believe one should follow the advice of one s doctor. With your knowledge of transplanted follicles, what would you say about it? Many thanks

I did a study some years ago where I used minoxidil on 1/3d of the transplants and on the other 2/3rds I did not. I maintained the treatment for the entire growth period for the hair transplants (6-8 months) and noted:

  1. That both sides grew in at the exact same rate
  2. That both sides started growing at the exact same time

I never published the study because the doctor who was doing this with me was a bit sloppy in his record keeping and I was not surprised at the outcome. I was able to conclude, however, that minoxidil has no effect on transplanted hair.

Tags: minoxidil, rogaine, hairtransplant, hair transplant

Should I Avoid Dandruff Treatments if I’m Losing Hair Already?

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

I am balding and have dandruff that is consequentially becoming more obvious. I know that dandruff is not supposed to cause hairloss, however, while looking at potential treatments for dandruff I have noticed that some appear to be harsh on the hair, and was wondering if there were any that should be avoided for some one succumbing to MPB.

You are correct that dandruff does not cause hair loss. If you use any good dandruff shampoo, that should be adequate. Head and Shoulders is generally a good shampoo worth using, though there have been unverified reports of hair loss here. I don’t have any recommendations in particular, nor do I have a list of those to avoid. You can find a list of popular shampoos here.

Tags: hairloss, hair loss, dandruff, shampoo