Possible to Change the Angle of Hair Grafts?

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

Hey Dr. Rassman,

Appreciate all you do on the blog as well as answering my questions in the past. I had a less than desirable result from a HT procedure to say the least. Make a long story short, if I ever need to get one again, which I will since I have small gaps on my head still, I will be visiting your office before.

The grafts that did grow, which was on the low side, are coming in at all different angles and growing in different directions than both the other grafts and of my current hair. When I mentioned this to my doctor and the dissatisfaction of my results, he mentioned that it might be possible to change the angle of the grafts with a new tool? Is this possible to your knowledge? If not, is there anything I can do or this is just the way my grafts will grow forever? Also, do you ever have any open houses in the New York area?

Thanks so much.

It is unfortunate that your grafts were placed at poor angles and your results are questionable. Your story of a bad procedure result illustrates the fact that hair transplant is for LIFE and you should do your research of the doctors and see their work first hand before going ahead with the surgery.

There is no tool or technique that will change the direction of your hair. I suppose you can individually excise them one by one and try to re-implant them, but that could potentially cause more damage, trauma, scarring, and failure to grow. Plus why would you place more trust and risk a poor outcome from the same doctor who already put the hairs in the wrong angle? You are a brave man!

I don’t have offices on the east coast any more, but Dr. Bernstein does have open houses in his NY office.

Tags: hairloss, hair loss, hair transplant, trust, surgeon, doctor

When I Comb My Hair, I See Thinner Hairs Falling Out

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

Dear Dr Rassman,

You often recommend that people get their hair mapped with a densitometer. I am still trying to find someone in my area to perform this. But here’s the question. I can see very clearly when I comb my hair that some of the hairs that fall out are shorter, thinner, and lighter in color than others. I can also see that many hairs along my front hair line and at my temples also look this way. Aren’t these hairs “miniaturized”? Is there anything other than common pattern hair loss that causes such miniaturization?

Male, age 28

The thinner, lighter hairs you likely see at the frontal hairline and temples are called vellus hairs in normal non-balding men and they could be miniaturized hairs as well in the balding male. Vellus hairs are normal and help to create the visual transition from hair to no hair (from scalp to face). The hairs that you see coming out when you comb could be miniaturized hairs which are weaker hairs being pulled out by the brushing or they could be coming out as part of the natural hair cycling process. I’m not sure that what you’re seeing indicates genetic hair loss. That being said, I’m just going off of what you wrote and haven’t seen you to be able to form any kind of opinion on your state of balding.

If you can’t find someone in your area, you can map it yourself with the right tools (and by watching a video tutorial).

Tags: hairloss, hair loss, vellus hair, miniaturization, hairline, densitometer

Could Cutting the 5mg Finasteride Pill Result in Poor Absorption?

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

Hello Doctor Rassman!

Huge Balding Blog fan here! Have you considered selling official ‘Balding Blog’ T-shirts? Regardless, my wife thinks it’s nuts I have this site bookmarked, but it’s an invaluable resource!

My question is this:

I’ve switched from Merck Propecia (1mg) to generic Teva Finasteride (5mg). When I cut the pill into 1/4 (1.25mg), I get a fair amount of powder that comes out of the pill. Undoubtedly, when I put the pill into my mouth, my saliva would break down some finasteride. I guess my worry is that by splitting the pill, exposing the white powder, and swallowing is resulting in poor absorption.

A picture of the pill is here: photo

What are your thoughts?

Thanks!

Thank you for following the site. We played with the idea of selling BaldingBlog shirts, but the idea never took off simply because we really didn’t think anyone would buy them.

Splitting the 5mg finasteride pill in quarters should not have any clinical significance on absorption or effectiveness. My Propecia drug representative from Merck has raised this question before, but there are conflict of interests there as you may guess.

Tags: propecia, finasteride, merck, absorption, hairloss, hair loss, merchandise, t-shirt, shirt

In the News – Hair Loss Increases As Women Age

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

Snippet from the article:

You’ve heard of male pattern baldness, but did you know that 50% of all women experience significant hair loss by the time they reach 50? According to one study, major hair loss increased to 75% for women over age 65.

While harsh chemical treatments like bleaching and perms can contribute to hair loss in women, factors such as stress, poor nutrition, heredity, medical conditions, and chemotherapy are more common factors that cause the hair to fall out, and in some cases, permanently.

Read the full article: Hair loss in women increases with age

Interesting reading and some good information throughout!

Tags: hairloss, hair loss, female hair loss

Female Hair Loss After Scalp Infection

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

Hello, 2 weeks ago a little cyst i had on my scalp got infected. My Doctor gave me antibiotics and 2 days later i had a lot of pus coming out for a few days. now the infection is gone and the little cyst is there, back to its original dime size, but i lost a lot of hair (about a quarter size in diameter if not larger) on top and around the cyst. Will it grow back? How long, if ever, should i start noticing hair growth? If not, before considering a hair transplant are there any natural remedies product that could activate the hair growth? thanks

It may grow back. I generally tell people to wait up to a year for growth the return. There are no special remedies or products that would grow back that hair. If you still have a cyst I would make sure there isn’t an infection brewing underneath. Follow up with your doctor.

Tags: hair loss, hairloss, infection, cyst, scalp infection, female hair loss

Fluocinonide Stopped My Female Hair Loss for a Couple Months

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

Hi. I am a 32 year old female who has been experiencing hair loss every six months for the last two years. Every time my dermatologist or GP would prescribe Fluocinonide Topical Solution (.05%). The shedding would stop about 2 months later. However, 5 months later the shedding would start up again. I had some blood work done, but they came back normal. Can you tell me what is going on?

Also, can you recommend a hair loss expert/dermatologist in Orange County? I would like some answers.

Thank you so much for taking the time out of your busy day to answer my questions.

This may be a jaded perspective and opinion, so be forewarned…

Hair loss for women can be a very frustrating condition to treat and diagnose for physicians. Miniaturization studies will show the status of the hair, thinning possibly in some areas. The doctors are under pressure to be proactive and to provide some form of treatment to the distraught patient even if they are not losing hair. If a doctor prescribes a harmless treatment that does not really have any clinical basis or proven results, is the doctor being honest? Treating hair loss with a corticosteroid (anti-inflammatory drug) such as fluocinonide would mean that there may be some inflammatory process going on behind the hair loss, but even without the use of such drug it is more likely the shedding would have stopped in a few months time. Hair loss can be cyclical in women. Oh… and don’t discount the power of the placebo effect.

I would think that if you have some sort of an inflammatory cause of hair loss (that is responding to fluocinonide) you would need a scalp biopsy to make the diagnosis. Any GP or dermatologist would be able to do that. Be forewarned that a biopsy would leave you with a small bald spot.

Tags: biopsy, inflammation, hairloss, hair loss, female hair loss, fluocinonide, corticosteroid

Propecia Peaks at 2 Years?

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

hi dr,
just had a few questions about propecia and why its peek results are reached at 2 years. is it possible that it could continue the de-miniaturization process beyond that point for a young man such as myself at 21? i began taking it at an early 20. thank you for this informative blog and your response in advance.

We don’t know why results from Propecia (finasteride 1mg) peaks at the first 1 to 2 years, but it is an observation many doctors and patients have made. With that said, it does not mean the medication stops working or is less effective after that time frame.

For the few who see more balding after years on Propecia, I have been advising that they consider increasing the dose to 2mg daily provided that there are no sexual side effects. Of those whom I’ve given this recommendation, none have reported sexual side effects. Please remember, I’m not your doctor and I’m not recommending this to anyone here.

Tags: finasteride, propecia, hairloss, hair loss

Hair Above Where I Use My Cell Phone is Thinning

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

Doc,
I have an area above my right ear where the hair is about 75% thinner — the hair itself, not the coverage, though that’s thinner too. There is also a substantial amount of grey hair here, but not the thick scraggly kind, these are also finer than the rest of my hair. Of note — I don’t have any grey hairs anywhere else but this area. No one in my family appears to have a similar condition. The only thing I can attribute it to is cell phone usage. I only hold the phone to my right ear, and while I don’t spend all day on the phone, I do take 20-30 calls/day. I’m interested in your comments.
Thanks

Cell phoneIf (keyword is: “IF”) cell phone use is causing your hair loss, maybe you are pressing it too tight to your ear and rubbing up on the side of your head where you have hair loss. This would be considered traction alopecia.

I highly doubt it has to do with radiation from cell phone use. It may not be cell phone related at all and what you’re seeing is coincidental. Without an examination and a more careful history your guess is as good as mine.

Tags: cellular, cell phone, mobile phone, hairloss, hair loss, traction alopecia, radiation

I Started Losing Hair at 46 Years Old, But My Twin Has No Loss!

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

I am a 50 year old male… There’s no history of baldness in family. At around 46 years of age I started noticing thinning hair around the right front side of my hair. There was no noticeable thinning elsewhere on my head. Then at around 48 years of age I noticed the left front side and top front of my hair thinning. And around the upper back of my head I noticed thinning hair. It stayed about the same – no extra thinning until 2 weeks ago and now I’ve experienced more thinning than ever on both front sides and on upper back of my head.

TwinsI have a twin brother who has not experienced any hair loss at all. Could the hair products (waxes, putty’s, pastes, and pomades) be causing this? I wash my hair once to twice a week. Sometimes with just water. My hair is very dry. I’m not experiencing any scalp itching or pain.

You may have genetic balding. If you have an identical twin brother it should affect him as well. If your twin brother is a fraternal twin, you are like any other person in the family with regard to balding risks. It’s unclear what you have with just a description. I would follow up with your doctor to get a good diagnosis. I doubt hair products caused such hair loss.

Tags: hairloss, hair loss, genetic, genes, twin, brothers, family

If Castration Stops MPB, How is Female Hair Loss Possible?

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

I’ve read many times that castration will stop male pattern baldness, in that case how are there forms of female hairloss?

Male pattern baldness occurs in MEN (as the term implies). Female hair loss has nothing to do with men or for that matter androgens (males type hormones made by women, including low doses of testosterone). It is considered genetic, but it is not cause by the male hormones women produce.

Tags: testosterone, hormones, men, dht, hairloss, hair loss, female hair loss, castration

Do You Think Hair Cloning Will Ever Be Readily Available?

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

Dear Dr,

From one of the last posts I saw about hair cloning it appears that there is a real possibility that it will never emmerge. You mentioned that the trials have been underwhelming and are not working how they were expected. Do you think that the compnaies invoved with developing hair cloning will wash their hands of it. Do you think we will ever see it working. Obviously, everyone is waiting for a genuine ‘cure’ for baldness and if it is not going to be hair cloning is there anything else on the horizon that might be it? Surely, we must be getting closer to that day and if so when do you think that day will be? Many thanks for your blog.

DNAI think that hair cloning will be available at some point in the future, but certainly not in the immediate future. I feel like I’m the lone person willing to say that it is not ready for primetime yet (not even close), and I wonder why some people are just willing to believe every press release with a tiny nugget of information.

There are more promising options than just hair cloning alone such as stimulating the stem cells in the skin and epidermis, finding of compounds that are the missing link to hair growth (for example, some medication that might just grow back the follicular units that may be present throughout the bald head). While I think that any one solution is not at hand, the availability of multiple approaches just increases the odds that some solution will someday be at hand.

There are breakthroughs occurring at a rapid rate now on using stem cells to generate entire organs like the kidney, heart, and lungs. Hair is another such organ system that could benefit from such breakthroughs. I am optimistic that one of these breakthroughs will be evident in the next decade or so, but which one? Your guess is as good as mine.

Tags: hair cloning, hairloss, hair loss, stem cells

Do Men Have More Shock Loss Than Women?

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

I notice most females get transplanted hairs into diffusely thin areas and seem to get better results than men in those areas. In your experience, do men tend to get more shock loss than females? And if so why? Would a male who has female pattern balding (mostly diffuse thinning down the middle front area) have a higher chance for shock loss even if they are on Propecia versus a women with the same balding pattern?

Women are not always good hair transplant candidates because they usually have diffuse thinning, including in the “donor area” (rim of hair around the back and sides). Contrary to what you may have seen, women do not necessarily have better results than men. What you may be noticing is that women tend to keep their hair longer, curl their hair, layer their hair, or style their hair that is more conducive to disguising their hair loss.

There is no difference in shock loss for men (who are on Propecia) or women. Young men that are not on Propecia are the ones that get the worst shock loss, but both sexes can get it.

Tags: hairloss, hair loss, hair transplant, female hair loss, diffuse thinning

My Hair Thinning a Few Years Ago but Stopped — Should I Take Propecia Now?

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

Hello. I noticed that I started thinning at the top of my head when I was about 23-24 years old. I lost quite a bit of hair but still had a reasonably decent amount of hair left. I am now almost 28 and have not really lost any more hair but haven’t really regrown it either. I have started Propecia to prevent any further loss but I was wondering if I have waited too long for any regrowth to happen. If my hair stays like this it’s ok but I do feel a little bitter at myself for not starting propecia earlier.

I would follow up with the doctor you are receiving Propecia from and get a good documentation of your current state of hair. This may be in the form of a photograph… or better yet, a miniaturization study to get an estimate of the percentage of miniaturization on certain areas of your scalp. Then you can judge if Propecia is worthwhile or at the least keep track of the hair loss progression. Lets try to take a scientific approach! Regrowth isn’t guaranteed for anyone taking the medication (some will just see the hair loss halt), so I wouldn’t beat yourself up about it.

Tags: propecia, finasteride, hairloss, hair loss

Tongkat Ali and Finasteride

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

Hi Doc,
Thank you for this site, it is a source of valuable info for a lot of people including me. Keep up the good work.

My question is, can tongkat ali affect the effectiveness of finasteride (Proscar) in stopping hair loss? I read that tongkat ali is a natural testosterone enhancer and can benefit the person using it with stronger libido, sexual performance enhancer, and can promote good physical well being. Will it make the finasteride less effective? According to some research it has not found any baldness side effect for people using tongkat ali. Thank you and more power to your work.

I’ve got no experience with this herbal, also known as eurycoma longifolia, so I turned to the internet for some info. According to this page, tongkat ali requires DHT to boost the libido, and finasteride blocks DHT. Therefore, you should not take both at the same time if you want the tongkat ali to work and if what I read on that site is actually true.

I don’t know if it’ll make finasteride less effective, but it seems that the finasteride would make the tongkat ali ineffective.

Tags: tongkat ali, dht, finasteride, proscar, propecia, libido, herbal

In the News – Women May Have Lead in their Lipstick?

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

Not exactly hair loss related, but interesting nonetheless —

Snippet from the article:

Fact is, FDA has found lead in all 20 lipsticks tested, in significantly higher amounts than those that caused a minor media uproar when the Campaign for Safe Cosmetics (CSC) tested lipstick in 2007. The FDA detected lipstick lead concentrations up to 3.06 parts per million (ppm), more than 4 times the maximum (0.65 ppm) measured by CSC.

LipstickRead the full article — I’ll take my lipstick unleaded, please

Oh boy. Should we think twice about kissing a woman with lipstick on? I wouldn’t jump to conclusions that leaded lipstick is causing hair loss, but it is a little odd to me that the FDA is fine with traces of lead in lipstick, yet the EPA wants it out of our environment.

Tags: lead, lipstick, fda, epa