Vitamin Supplements — Problem for My Hair?

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

Hello – I recently added some new supplements to my daily routine and wanted to know if any them or the amounts could be potentially damaging to hair?

  1. vitamin b6 – 200mg – is this excessive? I have read that a lot of b6 could potentially stimulate hair growth in men. Have you heard of this?
  2. vitamin d – 2400IU – again, I feel that this is a necessary vitamin that is often overlooked. But how much is too much?
  3. magnesium – 900mg

Vitamin B6 — Recommended dosage is between 1.3mg-2mg daily, depending on age and sex; Maximum dosage is 100mg… so you’re taking double the maximum. (source)

Vitamin D — Recommended dosage is around 200 UI, though it varies depending on age. The upper limit is 2000 IU. Again, you’re taking more than the maximum recommended. (source)

Magnesium — Recommended dosage is between 300-400mg, depending on age, weight, and sex. (source)

Now I do realize that when taking supplements the Recommended Daily Allowances (RDA, also known as DRI) are many times thrown out the window, but you should talk to a doctor about the potential side effects of taking too much of any particular vitamin. I’ve read that excessive about of vitamin B6 or vitamin D can help with hair loss, but that’s not been proven (and keep in mind it’s just what I’ve read online, not in a medical journal). Magnesium can help with healthy hair growth, but generally it is deficiencies in these vitamins that can cause problems. I’ve never told a patient to take excessive amounts to help their hair, though. I can’t find any information that shows potential damage to hair, but again, you should consult with your physician about taking so much of these supplements on a daily basis.

Tags: vitamins, supplements, magnesium, vitamin b6, vitamin d, hairloss, hair loss, dri, rda

I Don’t Want Multiple Linear Scars from Multiple Hair Transplants

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

Hello Dr.Rassman,

Is it true that during the second transplant, the physician can cover the first scar that was caused by the first transplant? I would like to do a second procedure but do not want to have multiple scars as well as one BIG scar. Also, is it true that a scar from the transplant will be visible as the person ages and the hair in the back of the head gets thinner? One last question, can shock loss (loss of hair due to transplant) occur for already transplanted hair when a person undergoes a second transplant.

Thank You for your time

The state of the art today is to limit transplanted scars to just one, even with multiple surgeries. If, for any reason, the scar gets wider (5-10% of people) then a single scar can often be corrected in a special surgery that addresses the need for a scar revision. Some surgeons go into untouched areas of scalp and intentionally produce a ‘step ladder’ set of scars which accomplishes two things: (1) a higher yield of hair, and (2) more dollars for the doctor’s pocket. I generally believe that step ladder scars produce a more unsightly look and can not be fixed easily while a single scar is easier to manage in the long term.

I personally had two hair transplant surgeries 16 years ago and you can barely see my scar and it has not changed (as typical) since the last surgery that had been done.

Your last question addressed shock loss in previously transplanted hair. It is very, very rare and if it should occur (less than .01% of cases) it always returns.

Tags: scars, scarring, hair transplant, hairtransplant, hair loss, hairloss, shock loss

Kankho Product in New Zealand

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

Hi There,

I have just been to Clive hair clinics in New Zealand and can’t find much information about their product “Kankho” which they are trying to sell me. Have you heard of this and would you recomend? Propcecia worries me as we are thinking about having children soon and I am concerned about the side effects in relation to this.

Any information would be greatly appreciated.

Kind Regards

I just quickly looked up the Kankho product line and while information is pretty sparse, I found this site.

There’s nothing in the listed ingredients of Kankho products that is proven to regrow hair. Their site says, Kankho contains “effective levels of Azeleic Acid, Zinc, Sulphate and Vitamin B6”. Sounds real effective to me (note sarcasm). I’m not sure what they’re trying to sell or for what reason (regrowth, halting loss), but the proven treatments are minoxidil and finasteride. Side effects are not that common with the proven medications, so your concerns may be over nothing.

Tags: finasteride, minoxidil, kankho, hair loss, hairloss, clive

Eating a Marijuana Brownie After a Hair Transplant?

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

Doctor,

I asked you this question in a very log winded fashion the other day without a response, pls let me be more brief….as I am sure you are quite busy and I do realize you have answered somewhat similar but certianly not the same questions. If you are uncompfortable answering these questions I understand so pls let me know and I will not bother you, but i LOVE the blog!!!!

Would you think I would impact my hair transplant yield or donor scar if I eat marijuana(this is all legal) in a brownie or take it in a “marinol” pill via prescription a few times a week? Or have 1 TINY 5 second inhale of smoke daily? Pls let me know, I would love to have my hair and enjoy my life as well.

FYI I am 31 and in pretty good shape.

Thanks

I have no experience with this situation, but I would guess that there will be no impact from the marijuana (legal or otherwise *cough*) on a hair transplant growth rate.

For the record, brief emails do help (as long as the pertinent facts are there), but I wasn’t avoiding your email because it was lengthy. I just get a lot of messages and can’t get to all of them.

Tags: marijuana, pot, hair transplant, hairloss, hair loss, brownie

Bald Spot from Bleaching My Hair?

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

(female)
I usually color my hair and a few weeks ago i did a triple process where i had 3 different colors put in but the process of bleaching. My new roots started growing back so i decided to lighten them. While applying the bleach we noticed a bald spot at the back of my head. It was smooth soft and the same color of my scalp. It has feeling and it does not pain at all. Could the chemical have caused it!? Would it grow back? I am very worried

You should be worried. Bleach can burn the hair root and cause permanent balding. Wait it out for 3-6 months and you will know if it will reverse. Be careful in using too much or too strong bleaches. You can read more about this in my book, Hair Loss and Replacement for Dummies, where this is discussed in considerable detail.

Tags: bleach, chemical burn, hairloss, hair loss, female hair loss

Hair Loss and Hair Spray

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

Are you sure that hair spray does not contribute to hair loss? I would think the alcohol in it somehow is absorbed into the scalp and negatively affects or dries up the hair follicles.

Yes I am fairly sure, but that assumes that you comb in gently and do not pull on the hair when you brush or comb it.

Tags: hair spray, hairloss, hair loss

Total Crown Renewal

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

Hi Dr. Rassman, thanks for your great contribution to hair loss sufferers, and the art of hair transplantation.

I have a question concerning a practice said to completely eliminate balding in the crown area called “total crown renewal” done by a doctor in the U.S., or it’s original counterpart, the triple flap with tissue gain/scalp extension done by it’s inventor in Europe. This practice is not promoted as a “repair” procedure, but is promoted to completely eliminate crown area baldness for “normal HT candidates”. I saw pictures on their site and the result “seems” great, but I am wondering if it causes a new “head shape” by stretching and pulling the sides of the scalp to such extent.

  • Would the face and profile look different by such a procedure?
  • Would the crown hair, while completely full, look peculiar to some extent? (Most pictures I saw were from the back, not face or side…)
  • My last question: I already had 2 strip procedures for a total of 5000 grafts (one scar). Would this procedure be a risk to my existent scar? (stretching)

I am puzzled because I was about to go for a last strip for the crown, while maybe I could save all these grafts for other areas “if” needed in the future (I’m a 38 y.o. and good responder to propecia and minoxidil), and solve the crown problem with this total crown renewal procedure. What would you recommend?

Thanks very much in advance for your help!

The procedure you referenced is an old procedure called scalp reduction using a Frechet Extender (named for the doctor that created it). For a reasonable Norwood Class 6 patient it would take between 3-5 scalp reduction procedures, ending up with what is called a Triple Flap procedure. The scalp reduction procedure has been discredited as a deforming procedure thanks in part to me being so outspoken about it. I am a personal victim having had three of them in 1992. I was furious at the deformities that it created on my scalp and let the world know about it though publications in the Hair Transplant Forum (industry newsletter) and debates before medical physician audiences. Now, people doing this procedure could be open to malpractice actions if things went wrong and I have personally testified as an expert on such cases in the past.

Call it anything you want but as Shakespeare wrote, “A rose by any other name would smell as sweet” — in other words, however you change the name, it is what it is and in my opinion the scalp reductions should not be back on the market because they are deforming procedures.

Tags: flap, scalp reduction, hair transplant, surgery, hairloss, hair loss, frechet

Hair Transplants for Really Short Hair Style?

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

Hello Dr.

I have a short but interesting question for you.

Is there a way to get a hair transplant which caters to a shaved head? what I mean is, since it’s less important to have such a packed in and natural look when you shave your head; is it easier or cheaper to get some sort of thinner coverage on your head which still looks natural when you shave it really short?

I really don’t know what your expectations are, but I think that the answer is a hair transplant will not add value to your bald areas in the front, top, or crown in very low densities and wide distributions. If you want the easiest and cheapest way to have a shaved head look, use a razor and just take off whatever hair you have left.

Otherwise, the follicular unit extraction (FUE) technique doesn’t leave any linear scar in the back of the head, but there are tiny pinhole size scars that could be visible upon close examination. I’m not sure how short “really short” is for hairstyles.

Tags: hair transplant, fue, hairloss, hair loss

How Long Should I Wait Between Hair Transplants?

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

Hi Dr. Rassman,
I recently had a hair transplant in February and have a few questions:

  1. How long do you recommened waiting before having another procedure? I’m thinking a year (to see results), but would any sooner hurt the transplanted hair?
  2. If you have additional procedures, can the newly transplanted hair be affected by shock loss?
  3. How often do your patients stop using Finasteride after having hair transplants?

  1. I generally recommend waiting between 8-12 months between hair transplants as 80% of the hair will be at styling length by the 8th month.
  2. Shock loss is rare in a second hair transplant within 2 years of the first.
  3. I generally think of Propecia/finasteride as a lifetime decision, because stopping it would allow the progressive nature of hair loss to show and evolve. So I don’t recommend stopping Propecia once it is started. I don’t have statistics on how many patients stop using the medication after a transplant, though.
Tags: shock loss, hair transplant, hairloss, hair loss, propecia, finasteride

Physical Activities That Can Cause Hair Loss?

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

Hi doctor Is it normal for the left side of your hair line to be higher and thinner than the right? Also besides genes what are some physical activities than can cause hair loss?

Hair loss, when it occurs, is often not symmetrical. If you’re seeing the left side of the hairline creep higher than the right, there’s nothing unusual about it.

There are no activities that should cause hair loss. Unless you count pulling on your hair as an activity, but I think you mean something like sports or hobbies. You need a good examination to determine if your hair loss is genetic and then map out the status of your hair loss (see Mapping Your Own Scalp for Miniaturization).

Tags: activity, hairloss, hair loss

My Doctor Told Me To Wait Up to 2 Years to See Results from Propecia

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

8 months ago I was at Dr. Bernstein and under miniaturization he said I have MPB. Right now I’m a NW2 but with early frontal hair loss. And I’m 22 1/2 years old. I been on Propecia daily for 8 months and everything is about the same. I keep reading that you should see all of your results by 8 months! I called Dr. Bernstein today and asked him if what I see are my final results and he said I gotta wait a full year and it may even take up to 2 years to see the full benefits. This is exciting to know but why do you always says 8 months is the optimal time for full results!?

I tell patients not to expect results from Propecia for 8 months, but suggest a 1-2 year waiting time for maximum results. Merck (Propecia’s maker) has a chart that shows when to expect results, though they show that by month 3 you could get some slowing of the hair loss. See Propeca.com for more.

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

Shedding vs Hair Loss

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

Doc,

Could you discuss shedding vs hairloss. From reading blogs all over the web I think it’s one of the most confusing aspects of hairloss for people. Especially when medication is used. One doc told me to forget about shedding and counting hairs in the sink and shower. Says we shed for many reasons, the usual 100 a day, plus some seasonal, stress, medication.. but shedding isn’t loss, miniaturization is loss.

I would guess you have patients who complain of increased shedding but after a few follow up min examinations your would see some actual reversal. What’s your take on shedding and actual hair permanent hairloss?

Thanks

I agree with the comments made by the doctor you visited. We all shed and it varies by day and season. Good miniaturization studies will tell you if you are balding and that should be your focus.

Tags: hairloss, hair loss, shedding

Remarkable Result from 2 Years on Propecia (with Photos)

/by William Rassman, M.D./7 /,

This patient has been taking Propecia for 2 years and not only did the hair growth fill in the crown, but even the miniaturization study showed significant microscopic benefit. This is what I keep talking about in this blog, there is the measurements of science behind what the eye sees.

Miniaturization mapping (captured with video microscope):

Propecia - Before / After

 

Before photo on the left / After photo on the right (2 years on Propecia — no surgery). Click to enlarge:

 

Tags: hairloss, hair loss, finasteride, propecia, medication, crown, photos

How Do You Determine a Successful Hair Transplant Procedure?

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

Dear Dr.,

If you can’t accurately measure the growth rate of your hair transplants (as posted in a previous blog post), how do you determine if a transplant was successful considering that no quantitative data is available (i.e. 95% growth)…?…

Also, since you’ve been doing this so long, what is your opinion on whether people are too vain? You must see lots of interesting information regarding this since you are in a unique position as a hair transplant surgeon.

Success is determined by your ability to achieve your goals provided that you have had realistic expectations of it. A good doctor will tell you if it meets his/her expectations. I have had patients who felt that they had their expectations met and I did not, so in those very, very few patients I usually just do another hair transplant at my cost.

We are all vain, but we do not like to admit it. I can fill hundreds of pages of stories on vanity, but I’ll save them for another time. I don’t believe people are too vain, but some people see vanity as a problem, and that is where I disagree. There is nothing wrong with wanting to look as good as you feel (or hope to feel).

Tags: vanity, vain, hairloss, hair loss, hair transplant, success

Hair Transplant at Early Stage of Hair Loss?

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

hi doctor,
in your earlier blog you said that best time to do a hair transplant is when the hair loss becomes unbearable and you(doctor) has something to work upon.however in your recent blog you said that it is better to have hair transplant in early stage. what exactly in your view is the better option?

For starters, you need a Master Plan to understand what is going to happen to you.

Hair transplants work well early in some men if there is obvious balding, but just having miniaturized hair and some thinning may be better treated with medications like Propecia (finasteride) before considering a surgical approach. Frontal areas, as they bald, work well with hair transplants, while crown areas may take huge amounts of hair that will not meet your needs in the supply/demand ratios of your hair density and scalp laxity.

Tags: hair transplant, hairtransplant, hairloss, hair loss, age, early hair loss