Many women lose hair or see thinning in their frontal corner hairline. This female patient had such a problem on one side, which was transplanted with 600 grafts. She had a wonderful result by her assessment and mine.
Before photo on the left / After photo on the right. Click to enlarge.
I have 2 VP Shunts one on either side of the back of my head. Would this be prohibitive to having a hair restoration procedure? Also, does Dr. Rassman have any experience working on patients that have shunts? Any information you could provide would be greatly appreciated.
For those that aren’t familiar with the term, a ventriculoperitoneal (VP) shunt is a tube that takes brain fluid and connects it to the abdomen where it drains for the treatment of hydrocephalus (or water on the brain). And yes, I have done hair transplants on patients who have had VP shunts (see here).
As you indicated that you are from out-of-town, I would have requirements for you if you wanted me to do your hair transplant. First, send me detailed pictures of your hair loss and then I would want to get specific X-rays to locate the shunts. I must know the course of the shunt and how far under the skin it is. With the shunt located, the hair transplant can be done safely. You can call my office at 310-553-9113 and arrange to have a phone consultation with me.
Yo doc,
Alot of guys that are my age (20s) are taking this supplement called Spawn right now. It’s supossed to help you pack on the pounds quickly. I’m a pretty skinny guy and was wondering if you think this supplement would be bad for my hair. A side effect is protection from gynomatastia. What you think? Should I give it a try for 30 days (that’s the max amount of time they recommend taking it). Here are some relevant links… myogenix.com
The second post on this one has side effects info… bodybuildingdungeon.com
One website I found states there’s a risk of hair loss and even suggests steroid type effects on body mass… and that is a big turn-off for me. Then again, nearly every site I’ve found that sells this product states it will not cause acne or hair loss. Who to believe?
You’re an adult and this is an over the counter supplement. This is not something I would recommend, but I’m not your physician, nor do I have any experience with patients taking this stuff.
Dr. Rassman,
Why do some say that Finasteride does not work in the frontal area/hairline? If the drug simply prohibits DHT conversion, why would it discriminate against frontal hairs?
I believe your stance on the issue is that Finasteride does halt hair loss in the frontal area in some cases, but I’d like some clarification on the issue, as I’m sure most of the younger users of Finasteride are mostly concerned with halting early temple/hairline recession. Thank you.
No one knows. This is an observation that we have seen clinically. Its just the way things are! It may point to the fact that DHT is not the only culprit in male pattern baldness. Generally, frontal hair loss in men occurs faster than crown hair loss, so it might be that DHT blocking works earlier in the miniaturization process and many times when the patient gets to the doctor, the frontal balding is further into its progressive path. It also points out that blocking DHT may not be a cure for hair loss. There is no cure for hair loss yet.
I developed nerve pain and my doctor thought it might be related to Propecia. So with the advice of my doctor, I stopped the Propecia. Naturally, my thinning has progressed though after I stopped it, so now I am considering starting it again if my doctor approves. I am going to speak with him first of course, but, after stopping taking the medication for the past 5 months after taking the medication for 1 year before that, what I want to know is will it still be effective if i restart it? Your response would be extremely appreciated. Thank you for your time.
I am unaware of peripheral neuropathy being a known side effect of Propecia. Your response on restarting it will not be as good as when you originally started it, but it should still have value. Only time will tell.
Dear Sir:
i had FUT 23 days ago and my doctor told me that the transplanted hair will fall out in two weeks, then start to grow again. The transplanted hair didn’t fall out up until now and the hair covers the bald area and i feel that it is slightly longer. is this is a good sign and means complete success of surgery? or does it mean nothing? thanks for your time and patience and hoping to answer me back.
If it continues to grow, you will be like 5% of people who never lose the hair after a transplant. You won’t know for another few weeks and it is not unusual that the hair appears to be growing as it is being pushed out of the skin. The hair length below the skin varies with race, but for a Caucasian, the length is between 5-6 mm, for an Asian it is often longer by a mm or so. I hope that you join the ranks of the 5% who keep on growing. Drop me a line and let me know and I will post your comment here on the blog linked to this post.
In the local pharmacies in the UAE a hair-loss treatment product by the name of Foltene is readily available. What are your thoughts on it’s components and do they hold any merit on it’s effectiveness? foltene.eu
I haven’t heard of Foltene before, but I checked out the site. The ingredients are a bunch of vitamins and something they are calling “Tricosaccaride”, which according to information I can only find on their company site, is something that they discovered in the 60s. Common sense time — If this really worked as claimed, don’t you think in the past 40+ years it would’ve been a little more well known? The vitamins in the ingredients will nourish the hair, but I have no idea how they can assume that means it’ll regrow hair. Looking a little further into what Tricosaccaride is, it seems like it is an acid that helps with blood circulation to the scalp. The idea of poor circulation leading to hair loss is false. See here for more on that.
The product claims to change the number of hairs in the anagen (growth) and telogen (sleep) phases. In other words, it claims to be able to tweak the cycling of your hair growth. Hair cycle is something that is controlled below the skin (genetics) and not above the skin… so a topical treatment that can do as they claim just doesn’t make sense.
How do they know that Sebhoraic Dermititus and Psoriosis do not cause hair loss? You wrote on your blog once that it can cause reversible hair loss indirectly by the inflammation accelerating telogen effluvium. Can the inflammation in someone that does not have telogen effluvium do this? Many (not all) of my outer brows fall out by just touching them gently. I have sebhoraic dermititus, is this accelerated a normal symptom of the condition or does this mean I also might have telogen effluvium?
I suppose any inflammation or trauma or stress can cause hair loss, but these types of hair loss are generally reversible and do not occur in everyone… just some susceptible people. I suppose extreme seborrheic dermatitis can trigger telogen effluvium, but it would be rare. It may cause some hair loss from scratching producing traction alopecia (not as drastic as telogen effluvium).
(female)
Dr. Rassman, thank you for time. I have read your answer as well as several other sites that state ‘A’ CT scan is not sufficient to cause hair loss. I have been having repeated intensive CT scans. My research has shown that the amount per CT scan (chest, abdomen and pelvis) is relative to approximately 1/4 the radiation exposure of a survivor of the atomic bombs that were set off in Japan. I have now had 8 such scans in a year and a half period. There are more issues than hair loss that drove me to my doctors seeking answers, but they have none for me. The only other significant health or living circumstance change for me in this time period has been weight loss. I ask you again because my question is so specific to the amount of radiation I am receiving… Is it possible repeated CT scans (versus ‘a’) could cause hair loss?
Certainly it is possible that radiation from multiple computed tomography (CT) scans of the scalp could produce hair loss. Various CT scanners produce varying amounts of radiation but even your 6 CT scans to the head may not be enough radiation to produce hair loss like victims of the atomic bomb experienced. There is not much information available to produce a more certain answer to your question.
Hi doctor.
I recently asked you a question regarding if testosterone rise from propecia can cause hair loss, you said that testosterone doesn’t cause hair loss but DHT does. Someone else asked you if receiving testosterone shots can cause hair loss you replied:
“First of all I do not know why you are receiving testosterone shots. I would discuss all its negative side effects (including hair loss, liver damage, etc) with your doctor.
If you have the gene for androgenic balding, testosterone will increase the balding rate and possibly even continue on if you stop the testosterone therapy. If you do not have the balding gene, your hair should be safe with increasing amounts of testosterone, but your body may decay.”
Now here you clearly state testosterone does cause hairloss: “testosterone will increase the balding rate “
if someone takes propecia it means they have the balding gene, so then propecia will decrease DHT and in return increase testosterone that will lead to more hairloss. Please clarify this if you can because it is really confusing. I would really appreciate it. Thank you! you have an awesome blog! keep up the good work
Testosterone is metabolized by the body into DHT. If you increase your testosterone, your body will metabolize the testosterone and make more DHT as a byproduct of the metabolic process. It is the DHT that causes hair loss (if you have the genes for it).
Thanks for all you great help and advice Dr. Rassman & Dr. Pak…Its obvious how much your site is appreciated by all the balding males and females…
Anyways, my question revolves around the application of rogaine to the scalp. I have a decent amount of hair on my head and find it hard to get rogaine directly to the scalp – especially the foam…..I part my hair but still find that it seems my scalp becomes more saturated with the medication rather then my scalp…Does rogaine get absorbed to the scalp systemic circulation and cause hair growth across the scalp or rather just in the area applied? Do you have any advice for the application of minoxidil or rogaine foam? I have read the information that comes with the actual foam but its not that informative…just tells you to part your hair and apply to the crown (from what I understand though is that Rogaine has shown growth all over the scalp except the temporal region). I apply to the frontal region and crown myself…
Any advice would be greatly appreciated.
Thanks again
I suppose having trouble applying Rogaine because you have too much hair is a good thing. You can try parting your hair and applying around the part. Or applying it when your hair is damp and shows more scalp area. I would apply the foam anywhere you want hair to grow. It may not work as well on the temporal or frontal region, but it does not hurt to try.
Dear Sir/Madam
I have been using minoxidil for more than year and i am happy with it, since the results are great so far!I have been pretty concerned lately though, given that i seem to be developing some kind of gynecomastia. Perhaps it is due to high levels of prolactine (just a guess)… Could minoxidil increase the level of prolactine and thus lead to gynecomastia?
Thanks a lot in advance
There are many possible causes of gynecomastia and you should certainly see a doctor to rule them out. I have answered the question of minoxidil and gynecomastia before, and there is no connection between the two that I’m aware of.
I am 25 (almost 26) and I am starting to notice some hair loss. I have been using generic finasteride…5 mg…and I cut it into 4 pieces to take once a day. I’ve been using it for a couple years now. I also use Rogaine (the foam), though sometimes I forget to put the rogaine on.
I have noticed on this board that you mention finasteride will “eventually stop working” and there is really nothing I can do about it. Is there any way to further slow the growth down? I was thinking of upping my dosage to 2-3 mg a day of finasteride. Will this work? Am I doing myself a disservice by using the generic brand instead of Proscar?
Also, is there any way to predict exactly how much hair I will lose, and how fast?
Thanks!
Finasteride does not stop working, but your hair loss can continue while you are taking it. Some people report a noticeable decline in the benefits they saw from Propecia after the 5 year mark or so, but that just means your body is winning the tug of war over genetic balding. If you stop the medication at that point, you will see even further, faster loss (which is what I refer to as “catch-up” hair loss). Finasteride slows hair loss in men, but does not necessarily stop it. I wouldn’t up the dosage without first consulting your prescribing physician. The higher the dose, the greater the side effect risk.
To my knowledge, there should be no difference between the generic finasteride 5mg pills cut into quarters from the 1mg Propecia pill. It’s the same drug, afterall… just different dosages.
There is no way to predict exactly what your hair loss pattern will be or when you’ll get to it. You can get a good idea by mapping your scalp for miniaturization, and then mapping it again in 6-12 months to see the progression (if any). An educated guess could give you some clues at that point, but it’s not an exact science.
How would Hair Multiplication work? Not technology wise, but market placement wise. How much would it cost? I’m pretty sure they could charge whatever they want and it wouldn’t change the mind of too many potential customers you would think. So really it’s a question of of their ethical and moral standpoint I guess, but if you could give some sort of estimate I would really appreciate it. Also what would happen to the drugs market, I know drugs like Finasteride, Dutasteride and Minoxidil are used for other reasons but I have reason to believe that most of their money is made in the Hair loss market, I’m aware that most people who are in the early stages of MPB would continue to use these as you can still get a good 5+ years out of it, but people worried about side-effects and people who are on high income will just forgo the drugs and go straight into the HM procedure. Finally I wonder about hair transplant doctors such as yourselves, I know that they will be useful in performing the HM procedures but from the procedures described by Intercytex these would be of much less precision and skill, would this mean that HT doctors would have to take a huge wage fall? I think most of the money would be paid to the company which take the hair follicles and multiply them, so what is your opinion on this.
On another note, I asked a question recently about why hair follicles can’t be preserved and I now understand that they can not be preserved, so how is this going to work? they plan to take your hair and multiply and this process would take a few weeks, but surely all the hair would just die in that time?
I do not know the answers to your questions. I would assume that there will be training in whatever the technology evolves into, but as it is not final yet, there is no way to tell. Usually drug companies come out with the product and the process and doctors become qualified to use it.
Take Botox, for example… the doctor buys it from the manufacturer and then charges the patient for the medicine used and the service he provides with its use. I would imagine the same would occur with hair multiplication.
I was looking online for numerous hair loss products and after researching about the products I found, it turned out that most of them are scams. However, I found a product called Yuda Pilatory Platinum Edition. (chinahairloss.com)
I couldn’t find any information on this product. Does anyone know if this product actually works or is it just another scam?
Thank you
I don’t have a clue if these herbals work, but I love the cartoon they use at the top of their site of the fellow spraying this stuff in his mouth and got a hairy tongue. Ridiculous! In fact, at the top of the site it says that it is an herbal formula “without color and taste”, and then at the bottom lists a caution as “can not be eaten”. Uh…
The ingredients listed on that site certainly don’t lead me to believe this Yuda “platinum edition” will provide the benefits the seller is promising (the box art says hair growth in 10 days — ha!).