How Much Would a Hair Transplant Cost Me?

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

Dear Doctor,
Im 23 and im a about 2 – 2A on the norwood scale (male pattern baldness on moms side, no balding on fathers). dark brown straight hair and my brother and cousins on my moms side all show signs of balding. I realize you are unable to make a proper evaluation of my hair characteristics with out photo’s and testing. But my question is this:

approximately what is the best, and all time worse case scenario on how much a hair transplant would cost me?

And I truly do realize it is hard for you to answer considering the circumstances so I will keep a very open mind on the subject. But there must be some rough numbers along with a brief description you could possibly throw at me to help get some idea on what a person like me should be expecting for the future. Thanks so much

Costs could range anywhere from $3000 to $10,000 on average depending on how much hair you need, but at this point you’re likely not to be a candidate. I couldn’t even begin to guess what an all time worst case scenario would be for you. If you’re worried about retaining your hair, I suppose the worst case would be that you develop alopecia universalis and lose all hair on your body, making hair transplantation impossible.

What you want to do is examine your scalp for miniaturization (here’s a handy guide to doing it yourself) and if it is present, you should try to prevent further loss by using medications. Surgery shouldn’t be the first solution you rush to, particularly as you are still young with very early hair loss. Finasteride (Propecia) is the drug of choice and requires a prescription by a doctor.

Tags: hair transplant, age, miniaturization, finasteride, propecia, medication

In the News – 80 Year Old Man Looks Much Younger Thanks to His Hair

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

Snippet from the article:

Ron WilliamsonWhen strangers mistake him for a man 30 years younger, Ron Williamson doesn’t turn a hair.

He explains that he is in fact 80 – but his luxuriant dark-brown mane refuses to show any sign of age. The secret of his follicular success, he claims, is two fold – good genes and a healthy blob of his favourite hair cream.

Read the full article at DailyMail UK

No, the man in the photo above is not a patient of mine… but according to the article, he is 80 years old. Remarkable! What more can I say? For those people who have not found the elusive cure for hair loss, I have performed hair transplants on men in their 80s and they are generally very satisfied patients. Safety for such a surgery is not a problem as the procedures are performed under local anesthesia.

Tags: hair, age

Hair Growing to the Edge of the Scar Where a Mole Was Removed

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

I had a mole removed about a month ago, and the actual scar is healing very thin and good. The hair is growing right up to the edge of the scar from the top, and even at some points looks like it is growing through it. My concern is that underneath the scar, there is patches where the hair is scarcely coming in, and even patches where no stubble is visible. Can you shed some light as to how hair grows around scars, could the surgery have put the hairs beneath the incision into the resting phase. I have been worried about their growth and realize it’s way too soon to start thinking about FUE to fix the scar, although I realize it may be a solution if the hair doesn’t return to its normal growth. Any light you can shed would be greatly appreciated.

Yes, damage can be done when surgery is performed in the scalp. Sometimes, the hair follicles are amputated while the stubble remains and this may be a cause of hair loss from a local excision. The stitches that are placed can produce damage to the hair along the leading edge of the excised mole (as in your case). Wait it out a full 6 months and hopefully the hair will grow. If it is a problem, transplants work very well here.

Tags: hairloss, hair loss, scar, mole, hair transplant

What Percentage of Men Get to Norwood Class 6?

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

I’ve seen that you say only 7% of balding men will hit stage seven on the Norwood Scale. What about stage six? Theoretical if there were no treatments would most men (93%) be destined for stage six on the Norwood Scale? And is whether or not you reach seven on the Norwood scale genetic?
Thanks

This is not an easy question to answer because of judgment problems in those that wrote the original charts. The best statistics I could find indicate that the Class 6 and 7 patterns in men over 50 years old are present between 23-30%. Assuming that the Class 7 pattern is 7%, then the Class 6 pattern is twice as common.

Tags: norwood, class, hairloss, hair loss

Testosterone Therapy is Causing Hair Loss — Should I Stick it Out?

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

I recently did a 3rd procedure with you and it turned out great. You did a scar revision which has reduced my scar width by at least 50%. In some places more.

Now the problem: My doctor has prescribed testosterone replacement therapy for me because of permanently low testosterone induced by the use of anabolics at a younger age. I have read in your posts where propecia or dutasteride might help negate the effects of hormone replacement therapy. Furthermore, the goal of the therapy is to reach ‘normal’ testosterone levels, not outrageous levels. I have been taking propecia for years, but when I started the testosterone gel (testim 1%) I started shedding like crazy. I understand that this can be one of the side effects.

My question is: In the past, every time I have used something like testosterone, after I stop much of the hair that I lose grows back. Furthermore, I have read that any kind of abrupt change to the body’s hormone level (such as starting Propecia for the first time) can cause hair loss. So, is it possible that I should just stick with the therapy and that I will shed, but that these hairs will grow back? Were they just induced to go into a dormant phase early, but will return? In other words, after my levels normalize and are not abnormally high, with propecia in the mix, can I expect to return to normal? Or is it that I basically have a choice – low testosterone for ever or bald?

I will talk to my doctor and I will see an endocrinologist about this, but I was wondering if you had any anecdotes about this particular kind of treatment.

Thanks

I agree that you should discuss this issue with an endocrinologist, as the problem is a bit complex. Unfortunately, I do not have any anecdote to share with you. At the least your transplanted hair will not be affected with testosterone. In theory Propecia should counter the DHT effects.

Tags: testosterone, endocrinologist, hairloss, hair loss, hair transplant

I Took 2 Finasteride Tablets in One Day By Mistake

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

What if i forget and take 2 tables in one day of appecia finasteride some times i forget if i took it in the morning…just once in while not all the time. what is the side affects if any?

Skipping a day or doubling up the dose should not be a problem, just don’t make it a routine.

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

Is Finasteride Evenly Distributed in a Proscar Tablet?

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

I would like to thank you for this very useful resource, and your consideration of submmited questions. I have a question about Proscar- since Proscar tablets are not scored four ways- is the finasteride distributed equally throughout the pill, in other words could their be more potent peices of the pill. This was a concern I had about switching to proscar. Are you aware if the pills have an equall distribution of finasteride? It seems like they may not since they are designed to be halved not quartered.

ProscarI can not imagine why Merck would weight the active ingredients in a tablet of Proscar (finasteride 5mg). I can’t say with 100% certainty, but I’d believe the distribution is fairly even throughout, particularly since the pill is likely homogenized. If it’s not perfect, it would probably be within a very small fraction of a percent difference. The Proscar isn’t scored, so you will likely get a little more of less each day anyway unless you somehow manage to get a perfect cut on an odd-shaped pill (see image at right). It’s a good question and although I did a little bit of research on it, I couldn’t find the absolute answer for you.

There’s an interesting thread at Drugs-Forum.com about splitting pills and ingredient distribution that you might find useful.

Tags: proscar, finasteride, propecia, hairloss, hair loss, merck

Indian Finasteride

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

I am taking Propecia for the past 4 months.However being a student, I find it very costly and would like to take the generic Popecia.On talking with my family doctor in INDIA ,I got to know that the generic Propecia made by Dr Reddys Pharmaceuticals is FDA approved and also much cheaper. FDA.gov

The Doctor who gave me a prescription for Propecia in Boston says that the medicines from India do not contain Finasteride at all and should not be taken.Also I read in an earlier question about the same issue u had answered that the Propecia from India is not FDA approved and is of Poor quality.But Dr Reddys Pharma Claim that their Product has been FDA approved. Should I ask my Parents to send me the Generic Dose from INDIA or continue using the Brand Propecia as cost is a major issue.Also wanna know if using the Generic Propecia will give the same results. (Dr Reddys Pharma is considered amongst the best Pharmaceuticals in INDIA.)

Dr. Reddy’s Pharmaceutical Company is well-known and I believe that their generic Propecia is FDA approved. I wrote about it before. To get approved by the FDA, the company must show that it contains what it stated on the packaging.

The distribution of finasteride should be equal throughout the tablet (1mg or 5mg tablet), but I conclude that by using my common sense. I can not tell you what to do, but many people who use the Dr. Reddy’s finasteride products say that it is the same as what is sold as Propecia or Proscar. You should know that getting the generic 1mg pill into the US violates Merck’s patent, which is why it is illegal to sell the medication in the United States.

Tags: dr reddys, finasteride, generic, propecia, proscar, hairloss, hair loss, india

Aderans ARI and Hair Multiplication

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

Dear Dr. Rassman, Just heard an ad on the radio and checked out the website. h-ari.com

I haven’t seen this technique before nor saw it on your blog. I was just curious if you knew about this or heard any promise in this field. Thank You.

This is all promise at this time. The company hopes that their treatment methodologies will eventually lead the area of hair multiplication, but as of this time, it is not available (except as an experimental subject). The text of the site requires considerable reading for the consumer to determine that this is an experimental technique, not something available on the market today.

In around the year 2000, they made claims that this technology would be available in 3-5 years. Now it is another 3+ years, which seems to be a moving target further from our reach.

Tags: aderans, ari, hair multiplication, cloning, hairloss, hair loss

Shock Loss for Previously Transplanted Hairs?

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

Are previously transplanted hairs at a big risk to shock loss following a second or third transplant?

Generally, transplanted hair is “permanent” and are not at risk of shock loss. Some hair loss may occur immediately after a hair transplant, but it should not be permanent if it is transplanted hair that has fallen out. I have seen shock loss in previously transplanted hair in less than a half dozen men and the hair came back as full as it was in all of them.

Tags: shock loss, hairloss, hair loss, hair transplant

In Case of Emergency, Ration Propecia

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

I recently went hiking/camping on the Appalachian trail for 9 days, and only managed to bring 3 days of propecia medication. My poor packing skills brought up the question: What is the best way to ration/use propecia medication in this situation? – Once a day for the first 3 days? Once every 2 days? Cut the pills in half?

thanks for your time

I would have taken the Propecia every other day and cut the pills to spread it out. 6 days may not matter in the grand scheme of things, though. There is no right answer in a situation like that where you made a mistake. Do your best to spread the medication out so there’s not too much time in between dosings.

Tags: propecia, finasteride, ration, hairloss, hair loss, vacation

Oily Scalp and DHT?

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

Does oily scalp causes DHT to bind with the follicle?

Does thyroid problems has anything to do with hair loss?

An oily scalp has nothing to do with DHT. DHT is associated with the presence of testosterone and if you are balding, the DHT is probably responsible for it.

Thyroid problems can cause hair thinning and hair loss, but it is generally not a problem for most men.

Tags: oily scalp, oil, dht, hairloss, hair loss, thyroid

Gastrointestinal Problems and Propecia

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

Hello Doctor,

I’m thinking of taking Propecia to combat my hair loss dilemma, but I have gastrointestinal issues that prevent me from taking certain medications. Even just taking a garlic supplement results in some intestinal pains. Would taking propecia be an option for me? Does Propecia have any recommendations for patients with other health issues to refrain from taking the drug?

The best way to find out is to try it yourself for a few weeks. Most doctors have professional samples in their offices which will allow you to try it. I would doubt significant GI problems would appear, but try it and find out.

Tags: propecia, finasteride, gastrointestinal, stomach, health, hairloss, hair loss

I Know There’s No Guarantee About Propecia, But Hypothetically…

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

I wrote once asking you if in 8-9 months you don’t see any thickening/regrowth on Propecia that later results are unlikely. You said there is no guarantee the medication will work for me. I understand that nothing is a guarantee but my question really was that “if” thickening/regrowth will happen for a man on Propecia does it “must” happen on the 8-9th month mark or can it happen later?

PropeciaYou will likely know by the 8 or 9th month mark, but keep in mind that if you also notice less hair loss (but no thickening or regrowth) it may still be working… even if it’s just slowing the process down. I don’t recall saying that if you didn’t see regrowth that results are unlikely. Just seeing the hair loss halt is also a benefit of finasteride.

To answer the question you’re asking directly though, if you’re expecting regrowth of your hair and you don’t see it by month 9, I don’t think that continuously taking the drug will result in regrowth by month 15. If you do take Propecia for 15 months (as an example) and decide to stop, you’ll see your hair loss continue and possibly speed up. This is what I call catch-up hair loss, in that any halting benefits the Propecia gave you would be gone after stopping the drug, and your hair loss catches up to the point that you’d be at had you never taken it at all.

Tags: propecia, finasteride, hairloss, hair loss

Propecia Allergy and a Swollen Throat?

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

I have been looking at your website for quite sometime and have sent pics of my receding hairline. After much thought, i decided to start on propecia and after taking it for 2 or 3 days i felt no side effects. on the 3rd or 4th day i felt my throat swelling ant tightening. I figured it was a virus due to the cold whether we have been having in Chicago and at night i would hear strange sounds in the middle of the night. I started on zithromax and after a couple of days i began to feel much better.(during this time i stopped using propecia.) after finishing the zithromax i started taking propecia again and within minutes i felt my throat swell up and started to itch. I went to the pharmacy and they gave me benedril which helped. Therefore, it seems i am allergic to propecia and am trying to prevent my hair line from receding any more, any suggestions???

I have never heard of such complaints from my own patients, but allergies do happen. This is something you should discuss with your doctor (who can run various allergy tests on you, for example), not someone like me over the Internet. The question you should pose to your doctor is, “Is this an allergic reaction?” and then work out a plan with him/her on what to do.

Aside from the 1mg of finasteride, Propecia pills have the following inactive filler ingredients: lactose monohydrate, microcrystalline cellulose, pregelatinized starch, sodium starch glycolate, hydroxypropyl methylcellulose, hydroxypropyl cellulose LF, titanium dioxide, magnesium stearate, talc, docusate sodium, yellow ferric oxide, and red ferric oxide. Perhaps there is something in there that you have an allergy to?

Tags: finasteride, propecia, allergy, allergic, hairloss, hair loss