Hundreds of Hairs Down the Drain with Each Shower!

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

(male) I am currently experiencing significant hair loss. Whenever I VERY lightly pull on a small section of hair (1/2 inch area) on the top, back and sides of my head, 1-5 hairs come out without fail! Is this normal for someone who is balding, because I am not washing my hair regularly due to the excess amount of hairs that will come out on my hands. Normally, if I lightly wash my hair, being as gentle as possible, literally 40-75 hairs will come out on my hands! By the end of the shower, there will be hundreds of hairs lining the bathtub. Please let me know if this is normal, and if not, any causes for this terrible situation.

ShowerI will sympathize that you are noticing hair loss, but a normal amount of hair you should lose is around 100-150 a day. Do you have product in your hair that is trapping the loose hairs, which are then released during a shower? I really do not know what to tell you based on your description, but it’s possible that you may be balding and this may be an early sign of genetic hair loss. I don’t want to get you too worried about it yet, as I’m just making guesses based on a few sentences you wrote. I’d need to examine your scalp to see what’s what.

Is there a pattern as to where the hairs are falling from? In other words, do you lose hair on top of the head but not on the sides or back? This would point more to genetic balding. If you are worried I would consider seeing a doctor for a better diagnosis and a miniaturization study. I believe you indicated you’re nearby my office in Los Angeles, and if so, you can call my office 310-553-9113 to setup a free consultation.

Tags: hairloss, hair loss, shower

It’s Been a Year Since I Stopped Pulling My Hair Out and It’s Not Regrowing

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

Hello,

A year ago, I had a bad habit of pluck my hair off. I stopped after realize how bad it was. I have lost alot of hair, and after cut my hair short for a year to wait for it to grow back. It did, but it only 1/4 or 1/3 of how much hair that I had before. What can I do? Please help!

What you are describing is a disorder called trichotillomania. We’ve written about this in the past. There’s been a small study about an over-the-counter pill that may stop you from getting the urge to pull out your hair, but that’s somewhere down the line and hopefully you won’t need it anyway as you’ve stopped the plucking. Unfortunately if your hair has not grown back in over a year, it will likely never grow back. There’s not much you can do.

Depending on the severity, one option may be hair transplants. Doctors generally do not perform hair transplant surgeries on patients who pull/pluck their hair, for obvious reasons as the old habits usually return and any gain from the hair transplant is impacted by the same process as before.

Tags: hair pulling, trich, trichotillomania, ttm, hairloss, hair loss

In the News – FDA Fails to Follow-Up

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

Snippet from the article:


The Food and Drug Administration has allowed drugs for cancer and other diseases to stay on the market even when follow-up studies showed they didn’t extend patients’ lives, say congressional investigators.

A report due out Monday from the Government Accountability Office also shows that the FDA has never pulled a drug off the market due to a lack of required follow-up about its actual benefits — even when such information is more than a decade overdue.

When pressed about that policy, agency officials said they have no plans to get more aggressive.

Read the full story at USA Today.

The policing arm of the federal government seems to fail because of lack of funding for that activity. The results are shown in the above linked article. It seems that the Hurricane Katrina debacle is the same government style they use in managing its agencies. For those of you who saw 60 Minutes this weekend (watch the video), you can marvel on how the US government is failing in the management of Medicare expenditures and now we are trying to take that expertise into the development of national healthcare policy.

Tags: fda, government, accountability, drugs, disease

Restoring Mixed Race Asian-Caucasian Hairline

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

Jon GosselinHi Dr Rassman,

I am mixed race chinese-caucasian 25 year old and have noticed some frontal recession behind the hairline and while it is very minor at this point unnoticible unless under bright light (which I am combating with propecia)… if my hairline were to recede… which hairline do you recommend when getting a transplant, the flatter asian one or the more pointed caucasian one? Which one will allow me to use less hair for the hairline in order to save my donor hair for other parts in case I need it? Did you give Jon Gosselin (great job on him by the way) a caucasian hairline? Which do most people choose who are in this situation? I have brown caucasian hair fairly thick hair shafts, but a flat asian hairline in my case.

The basic difference between the Asian and Caucasian hairline shape is, as you point out, that Asians have a flatter hairline. This is not always the case, though. The convex Caucasian hairline works well in most men and that is what we did for Jon Gosselin. Sometimes, we lower the corners slightly in the Asian hairline reconstruction.

Tags: asian, caucasian, hairloss, hair loss, hair transplant, gosselin

Could the Video Microscope (for Miniaturization Mapping) Cause Hair Loss?

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

Do you think it’s possible the Celestron 44300 handheld digital microscope, that you recommend for mapping miniaturization can harm newly placed grafts on someone who just had a hair transplant? (Im mainly concerned with the LED illuminator, could that possible cause damage?)

I would doubt that the light from the hand held microscope will have any impact on the health of your hair.

Tags: microscope, led, light, hairloss, hair loss

Regenium XY Shampoo

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

Is there anything to thickening shampoos that contain “regenium xy” and the like? Or is that just marketing? If they’re for real, how do they work?

Elvive ShampooRegenium XY is an ingredient in some thickening shampoos by L’Oreal. I haven’t seen anything about L’Oreal Elvive shampoo (also known as L’Oreal Vive) that states it regrows hair, so I’ll have to assume you’re talking strictly about hair thickening itself.

Hair thickeners just give the illusion of fuller hair and are pretty commonplace. Different thickeners exist in the form of shampoos like the one you asked about, and camouflaging agents like Toppik that are applied when the hair is dry. I have a feeling that the “Regenium XY” name itself is likely just branding to make it sound more amazing than other products for sale, but perhaps there’s more science to it that I don’t understand (I’m not a shampoo expert). This site might have some more useful info about it.

In general, some thickeners might work better than others and some people might not see any real benefit whatsoever, so you’ll have to try them out to see what your personal preference is. To learn how they work, I found a sites that explain it — understanding-hair-loss.net.

Tags: regenium, elvive, vive, regenium xy, loreal, hair thickening, shampoo

Staples vs Sutures

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

Is there a difference between “internal sutures” and staples? Does one result in a less detectable scar?

Anything going through the skin produces a highway for bacteria to grow. Staples and sutures do just that, so bacteria can invade the body through the holes created by the needles, sutures, or threads, and through the use of stainless steel staples.

The final answers to your question relate to the opinions of doctors. I have waffled both ways in the many years of being a surgeon, and now I prefer staples over absorbable sutures. I don’t like leaving a foreign body like a suture in for very long and the absorbable suture is a foreign body. At least with staples or non-absorbable sutures, they can be removed by the surgeon when healing has occurred and wound strength builds enough to hold the wound edges together. At between 2-4 weeks, collagen production forms a lattice of ‘cable-like’ material that progressively gets laid down so that the wound will hold together. See Wikipedia for a better understanding of the various phases of wound healing. Some excellent videos covering wound healing can be found at Google Video.

Tags: wound healing, healing, hair transplant, staples, sutures, scarring, hairloss, hair loss

No Growth 6 Months After My Hair Transplant!

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

I had a transplant done exactly 6 months ago. I was under the impression that between months 5 and 6 post-operation I would start to see the new grafts growing in. I have seen nothing, or very little. Does this mean it won’t grow in or something is wrong? I’m getting a little worried about it.

Why don’t you call your doctor who performed the surgery and ask for a follow up appointment? If I paid for something that didn’t turn out the way I thought it would, I’d contact the seller. Although you could apply that logic to buying a used car, this same principle goes for cosmetic surgery. If you were told one thing and it hasn’t happened, take charge and find out from the doctor!

Generally speaking, it takes on the average 4 months to see some growth, but it can take as long as 12 months. Everybody is different and not all surgeries are the same. You may be a late bloomer!

Tags: hair transplant, hairloss, hair loss, hair growth

In the News – Aging to End in 20 Years?

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

Snippet from the article:

Call it an anti-death panel. We just received a press release saying that the world’s top aging scientists will converge on Manhattan Beach from November 13 through 15 to figure out how to put off that whole getting-old-and-dying thing.

The scientists, supposedly, will “predict the end of aging by 2029.”

Read the full text at OC Weekly

I am curious to understand how they came up with 20 years from now being the end of aging. Or are they giving themselves 20 years to form a prediction of when aging will stop? I guess that’s why the OC Weekly article was written with a sarcastic overtone.

Tags: aging, age, conference

Will Hairline Lowering Look Better than Hair Transplants?

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

Hi Dr Rassman, i have spoken to you before and cannot decide between scalp advancement or hair transplants. I spoke to beverly hills institute and they told me dr mayer and dr fleming are the ones who started scalp advancement and having hair transplants will not look as good and that i will only be disappointed…i am now confused because i thought dr kabaker initiated this procedure. Also the doctor i went and saw suggested 2000 grafts however he seems to think a scalp advancement may be a better option….why is this so it seems so extreme as i have a young family i am scared …thanks for listening

You have every right to question the things that are unknown to you. It is a surgery on YOUR body that you will carry for the rest of your life. Different doctors will have their own opinions, as doctors are human and they tend to ‘sell’ what they do best. My point is that there is no clear and definite answer to your question. You need to do your due diligence and research and speak with former patients. You need to try to see the before and after results (not just pictures) of the doctors and procedures you’re researching. This may be easier said than done, but not for our hair transplant practice, as we do this all of the time. We do this in our monthly Open House events where my prospective patients have an opportunity to meet my past patients who have had the surgery, so they can see the results for themselves.

To clarify some facts: Dr. Kabaker is well known to perform hairline lowering procedures. He is not the only one that does this, as many plastic surgeons who do browlifts can easily do hairline lowering procedures. Dr Fleming is well known for his scalp reductions and flap procedures, not for hair transplants and therefore they will sell what they do best. Scalp reduction is different than hairline lowering.

If you have a hairline lowering procedure you may need a small hair transplant procedure to hide the inevitable scar at the frontal edge, but the procedure is literally instantaneous while you must wait for 6+ months for the hair transplants to grow out. If you have a hair transplant procedure you many need a second hair transplant procedure to meet the density goal that you desire no matter what anyone tells you. Just remember that if it sounds too good to be true… well, you know the rest.

Tags: hairloss, hair loss, hair transplant, hairline lowering

Minoxidil in the Refrigerator?

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

Dear Doctor,

I’ve bought a bottle of liquid Regaine and read the booklet, which said that the max. temp at which I can keep it is 25 C degrees. I figured that I should put it in the fridge then…so it spent about 14 hours in the fridge, when I googled for a booklet in English and they said that it has to be kept at 20-25 C (some say 15-25). I have no idea how cold the inside of a fridge is, but i guess its below 15 C…so, have I totaled 50 dollars?

FridgeI doubt you harmed the medication effectiveness, but I would follow the instructions on the bottle and not different language instructions you’ve found on the web (there might be slightly different formulations or packaging). My gut tells me you’re worrying about this too much.

The temperature warnings might just be safety notices so you’re not shocked if the medication’s container explodes under pressure created by fluctuating temperatures, though it also will likely contain some wiggle room on the exact temperature (which is why you’ve seen the range move so drastically). If you don’t know how cold it is in the refrigerator, get a thermometer so you don’t have to worry about this anymore.

Tags: minoxidil, rogaine, regaine, fridge, refrigerator, hairloss, hair loss

I Stopped Using Minoxidil Twice Daily and Saw Hair Loss in a Week

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

(male) i use minoxodil & have for the past 5 yrs. for the past 2 weeks i got into the habit of using it once a day rather than twice. & for about a week i have noticed increased shedding. did i do anything that could potentially accelerate any hair loss? & will the shed hair grow back?

thank you

Based solely on the limited information you’ve given, the only thing that changed was applying minoxidil once a day from twice a day. Maybe there is a correlation, but perhaps there are other things you forgot to mention or do not know of. I wouldn’t expect your hair to be so dependent on the twice a day minoxidil application that you’d notice significant loss in just 2 weeks, but if you think that is the cause I would just start using it twice a day again. A simple solution! Twice a day is the recommended dose anyway. Unfortunately, I have no way of knowing if the shed hairs will grow back.

Tags: rogaine, regaine, minoxidil, hairloss, hair loss, shedding

I Had 2 CT Scans in 2 Weeks, Now I’m Losing Hair

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

4 months ago I had two ct scans within 2 weeks. For about a month I had been losing hair Could the two be related.

I highly doubt it. The radiation from CT scans can be high, but it does not generally cause hair loss… even if you have 2 CT scans. Yes, there was the recent news item about patients experiencing hair loss after a poorly configured machine, but this is a rare case. You must have had a medical issue that prompted two CT scans. Severe physical and mental stress from medical conditions can cause hair loss as well (rare). I really cannot say what is causing your hair loss.

Tags: ct scan, cat scan, hairloss, hair loss, radiation

Can Norwood 5A Get Full Coverage from Transplantation?

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

Greeting Dr Rassman,
my question is the following : How often do you see people with Norwood “A”-pattern hair loss that reach Norwood 7 (or 6) AND how difficult is a 5a pattern to treat with transplants (can they get full coverage). My grandfather has a Norwood 7 (in “one go”, so no separate vertex balding), my father is maybe thinning into a 5a, that’s why I’m curious.

Norwood 5AI generally like the results on the ‘A’ pattern balding patient, provided that they have a good density and scalp laxity. Even a Norwood 7 can get full coverage (see here). Hair transplants are about hair supply and the demand for hair as determined by the balding pattern (size of the bald area).

Tags: hair loss, hairloss, hair transplant, norwood

Are Hair Products Purposely Trying to Give False Hopes?

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

Dear doctor. I think you are correct about Segals. Its now seven weeks since I have started using Segals solutions, no visible changes, so far no new hair growth. Now I want to know whether these people like Segals, Foltene, etc are trying to make money by giving false hopes. But some people blogged that these are working for them. Are they mere illusions? and compared to minoxidil why these products are very expensive? I would like your views on that.

Recently I have studied so many articles on Internet that “EMU oil” is a DHT blocker and it grows new hair. I would like your comments on emu oil and whether applying oils like coconut oil, olive oil or almond oil promote hair growth?

Fake fertilizerI really think the driving force behind many of these products is the ability to make easy money. If I posted a study on the internet consisting of 2 people and said fertilizer applied to the upper lip caused a moustache to grow in thicker 50% of the time, I’d imagine there would be a dozen products like “Magic Fertilizer Moustache Cream” for sale by the end of the month. I wouldn’t have to provide any photos or scientific proof whatsoever for people to believe it. Of course, I would never do that and fertilizer will not grow hair, so don’t bother trying. What I’m getting as it that there’s no proof that emu, coconut, olive, almond, peanut, caramel, nougat, dung, or any other substance will regrow hair. I don’t know where this stuff comes from, but I’ve yet to see proof that it does what it claims.

People are so willing to believe almost anything when it comes to hair loss. Look at the ridiculous “Trust Timmy” and “Honest Jimmy” type of sites out there. Anyone that has searched for “hair loss” on Google has undoubtedly seen those advertisements. Those are simply marketing campaigns created to give you confidence in the product to get you to place an order. They might give false hopes, but their real intention is to make money. Perhaps I should make a “Believe Bill” site to warn people not to fall into these traps.

The sellers of these hair loss products can charge an inflated price, because people tend to equate this higher price with a higher level of efficacy. That reminds me of a story I’d read about consumer electronics (unrelated to hair). In the mid-1990s, high-end electronics began appearing on the market with blue LED lights (rather than the red lights that were common). When cheaper products with blue LEDs began hitting the shelves, it instantly gave some higher perceived value to those products. Now you see those blue lights in everything (instead of red, like it used to be). It was a novelty that has now become commonplace. Granted, blue and green LEDs weren’t developed until the mid-1990s, but the demand for blue in particular was spurred by the higher-end products including these tiny lights. But I digress…

Tags: hairloss, hair loss, false hope, scam, oik, shampoo, hair products