Possible Nerve Damage in Recipient Area from FUE?

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

Hi

I have recently undergone an FUE procedure. I had about 2500 hairs placed in total. One week after the procedure, The grafts have taken really well and the scabs have fallen off. All swelling on my forehead has subsided. There is only slight swelling on the vertex. I still have numbness in the recipient area on the top of my scalp, behind the hairline.

When I run my hand over the new implanted hairs, I feel slight twitching on the skin on the scalp. I am concerned about nerve damage in the recipient area. Is it possible that a nerve was pinched, poked or disturbed in the recipient area ? What is the corrective action to take if this was the case ?

regards

Whenever there is a cut on the skin it may cause numbness or tingling or pain. This should subside after several weeks (sometimes months). This should have been thoroughly explained to you before the surgery in your Pre-Operative Consent form and by your doctor. The follicular unit extraction (FUE) technique still involves a cut on your skin. Cut nerves in the donor area is more of a problem, because there are major nerve trunks there, but your question was about the recipient area.

Tags: fue, nerve, damage, hairloss, hair loss, hair transplant, hairtransplant, scar

DHT and Progesterone?

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

I know that DHT is a derivative of testosterone. I read on some hair site that DHT is also a derivative of progesterone. Is this true or not?

I don’t know if DHT is a derivative of progesterone. I get conflicting information from various sources. According to HairSite, progesterone inhibits the enzyme 5-alpha reductase, thereby reducing the DHT that is normally made from testosterone.

In this reference, the derivatives of the various steroids are discussed which may answer your question better.

Tags: dht, hairloss, hair loss, progesterone, testosterone

Suffering from Propecia

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

I felt compelled to add a bit to the writers concern over propecia. I personally tried propecia for 2 months, the sexual side effects were terrible and forced me to go see a specialist in the field. He told me he was amazed at how many of the people he sees are suffereing from propecia. A year removed from the drug, the sexual side effects have yet to correct themselves. At the very least this says something about Propecia’s claim that all side effects should reverse themselves with the discontinuation of the drug.

I know the drug can be beneficial, and I see why it is s popular. I just believe that the company doesn’t accurately advertise the potential adverse effects.

Thank you for sharing. Did you see a specialist for your erectile dysfunction to see if there are other causes?

Tags: propecia, finasteride, hairloss, hair loss

Does Gray Hair Fall Out More than Normal Hair?

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

Does gray hair fall out more than normal hair? Sometimes I find loose hair on my pillow after waking up – only grays though.

Gray hair doesn’t fall out any faster than normal hair, at least as far as I know. Maybe you discovered something new (I am being serious) as I have never heard of, nor have I considered that observation before.

Tags: gray hair, grey, gray, hairloss, hair loss

FUE, Hair Cloning, and Propecia

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

Hello, and thank you for this wonderful blog!

Now, down to the point. I’m an 18 year old experiencing slight SLIGHT recession. I went to my Dermatologist and was put on Propecia and Regaine to control and halt hairloss. I understand that with time, these medications will eventually stop working. Now, the question is, in your professional opinion, do you think that I will be one of those lucky ones who can benefit from future hairloss treatments such as Hair cloning, or will FUE still be my future hairloss friend? I have no problem with FUE, as I live so close to your office to have the procedures done. My only quarrel with it is the success rate and donor patch areas. Can you see any advancements in 5-10 years, such as Hair Cloning and Gene Therapy?

It’s not that the medications will stop working — it’s that your body tries to fight the meds. So usually around 5+ years of taking finasteride, some people will report that they’re seeing a little more hair loss than they’d been used to, but its not that case for everyone. I’ve got patients that have been taking finasteride for a decade and their hair still looks great.

As for FUE, with our latest FUE advancement (FUE2), we’ve eliminated the problems that most doctors will experience with the technique.. which is what lead to poor success rates. Check out www.newhair.com/fue2 for more on that.

Hair cloning is still in its infancy. There are some people that were saying 5 years ago that we’d be seeing cloning available by now, and that is obviously not the case. I couldn’t really speculate on the availability of cloning a decade from now. I hope it does work, but hoping for things and seeing the reality are two very different things. Personally, I think it will take more than 10 years because of FDA issues in releasing any advancement that may come up.

Tags: cloning, hair cloning, propecia, finasteride, fue, fue2, hairloss, hair loss

I Scratched Away Some Grafts During My Hair Transplant Procedure

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

I just did a small fue procedure into my scar, I asked to be sedated but during the procedure I scratched away some of my grafts unconsciously. The operating team choose to put some of the grafts back in the scar, can you please tell me something about the grafts survival chances?

For starters, I do not know what, where, and how your surgery was performed. Generally, an FUE procedure may have lower yield and is HIGHLY variable with different medical groups and doctors; the procedure is almost never the same from one doctor to another. Moreover, hair transplantation to a scar may not have a high growth yield when compared to hair transplanted to normal skin.

Graft survival depends on how long it was out of your body with the real issue of graft drying. Grafts that are left in the open hair for 20 seconds will generally die and that is why we are compulsive in keeping the grafts moist as we move them. As you can start to see there are numerous variables at work here and it is not a question I can answer, but most of the time if the grafts come out, they dry and die. Your surgeon is the best person to address your concern (as it always should be).

Tags: hair transplant, hairtransplant, fue, scar, surgery, hairloss, hair loss, grafts

Hair Loss and Herpes Remedies in One Handy Book

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

Hair Loss and Herpes bookAs you may know, I co-authored the newly released Hair Loss and Replacement for Dummies book (which you can purchase at HairOutletStore.com, powered by Amazon.com). While looking at the other books Amazon offers in the hair loss category, I found a book that got me thinking: If You Can Cook, You Can Make Powerful Topical Remedies for Hair Loss, Pain and Herpes Infections

Unfortunately, I’m not much of a cook!

According to the reviews, it’s a 38 page book, so you’re paying around a buck per page for basically a pamphlet full of hilarity (judging by the title). I do not recommend buying this. I just thought it was funny enough to mention. If you’re looking to buy a great hair loss guide book, check out my new Hair Loss and Replacement for Dummies!

Tags: dummies, hairloss, hair loss, herpes, amazon, book

Seeing Hair Growth After Finishing Chemotherapy

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

(female) i have finished chemo four weeks and i can see signs of hair growth. is it true that my hair may change colour and texture?

Many women with chemotherapy will have hair loss during the treatment, and the hair is pushed into its telogen cycle which usually lasts 3-8 months after the chemotherapy insult. When the hair comes back, it may not return to its full density, but the type of chemotherapy and the full recovery is poorly documented.

Tags: cancer, chemo, chemotherapy, hairloss, hair loss

My Testosterone Is Up Since Starting Propecia

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

This is in response to: But, You Said Testosterone Can Cause Hair Loss…

Above was a reply you gave to a question. My question is, in reference to your reply, is it worth taking propecia if all its doing is raising my testosterone, inturn causing higher DHT, in turn making more trouble for propecia causing more hairloss. My testosterone increased when i started taking propecia and hasnt decreased and ive been taking a full year now, longer. So what do you suggest

Higher amounts of testosterone will not stop finasteride from working. The higher testosterone levels have been reported usually get back to normal in 2-3 months. If you have a high, abnormal testosterone level, you need to see a doctor.

Tags: finasteride, propecia, testosterone

How to Fix a Pluggy Hairline (with Photos)

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

From time to time, I get emails from men that are incredibly embarrassed about the results they got from an old, pluggy hair transplant. They’re so embarrassed that they request I don’t even publish their emails (even if there’s nothing identifiable in there)… and that’s fair enough. So I just wanted to write a post to quickly explain the best way to fix a pluggy hairline: you need to cut out the plugs and then put transplants in the place the plugs originally were. This is generally done in two sessions (8-10 weeks apart) and we have been doing this for years. It turned out that this man’s scar (from excising the grafts) healed very well, so well that it could not be detected. I put hair wide enough in front of where the scar was so that his hairline was lowered quite a bit. We built a wide transition zone in the leading frontal edge. Here is such a case on a man with black hair.

Before on the left, after on the right. Click the photos below to enlarge.

 

There’s another plug repair case at the NHI site — Dean’s Story. Be warned, some of the photos there contain surgical content, so if you have a weak stomach, you may want to avoid that link.

Tags: hairtransplant, hair transplant, hairline, repair, photos, hairloss, hair loss

Hair Loss and Teeth Problems After Cortisone Injections

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

Hello, Dr.,
The strangest thing happened to me. I got 2 shots in my shoulder and 1 in my back (cortizone) for trigger point pain of fibromyalgia, then 3 months later I had another one in my back. Very soon afterward my hair started falling out by the handful. Then I began getting lesions on my arms, chest, and face. Both things cleared up after many months. Now the latest thing that has happened is my teeth are dissolving quickly. My teeth were fine a year ago and now I have not one top or bottom front tooth that is intact, they are just melting away. Nobody can figure out what is going on with me. It’s pretty scarey. Any thoughts? Thank you (I am 55 years old)

ToothbrushBased on what you are describing, I really would not know where to start. The problem sounds alarming, and you should get yourself to a good doctor ASAP for an examination. I’ll try to give some general information, hoping that it relates to what you’re experiencing…

Teeth problems are commonly associated with fibromyalgia, particularly from grinding of the teeth due to Temporomandibular Joint Disorder, also known as TMJD or TMJ. See this article at PsychologyToday.com for more information. As for the hair loss, cortisone shots can sometimes cause it — see Cortisone Shots and Hair Loss.

Tags: teeth, hairloss, hair loss, cortisone, cortizone, fibromyalgia, tmj, tmjd

Hair Transplant and the Flu

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

I had a hair transplant a few weeks back and got symptoms of the flu on the 10th day. Is it possible that this will hurt the growth yield of the hair transplant?

TissueThere is no connection between the flu and a hair transplant, either before or after the flu. Many times people will ask if they can go forward with a hair transplant while they have or are recovering from the flu. As a hair transplant is performed under local anesthesia, there is no danger to your health to have a hair transplant with a fresh case of the flu, nor is there any impact on growth from a hair transplant days or weeks after you recover from the flu.

Tags: sick, flu, hair transplant, hairtransplant, hairloss, hair loss

Hairs Come Out from Top, But Not from the Sides When I Pull On It

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

When I do a gentle pull test for my hair, I always seem to get about 10 or so hairs from the top front of my head,whereas I usually don’t get any (maybe one or so) from the sides and back. I’m wondering if this has anything to do with MPB or perhaps the hairs on the side and back come out at other times i.e. combing, hands through hair, etc.

Why are you pulling your hair? As the name implies, there is a pattern to male pattern baldness (MPB) — most of the hair is lost from the top and if it is impacted with miniaturization I would expect that you can easily pull out the hairs that are miniaturized. Hair impacted from genetic hair loss that is very early in the process should not pull out with the pull test. So if you have MPB, pulling your hair is not the way to go about diagnosing it. Mapping our your hair for miniaturization will tell you what you need to know for balding purposes.

Tags: hairloss, hair loss, pull test, mpb

Comb or Brush?

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

I was taking a shower the other day and the back of the shampoo bottle said to use a wide tooth comb and not a brush when combing wet hair. What is better to use for combing wet hair, a brush or a comb? I use a small brush that I believe is from an airplane kit, but that I really like.

Well, if the directions say to use a wide tooth comb and not a brush, I would use a wide tooth comb and not a brush. I am sure if you go to a respectable supermarket, pharmacy, or hair salon, you will be able to find a wide tooth comb. I wrote about this previously.

Tags: comb, brush, hairloss, hair loss