Transplanting Hair Between Fraternal Twins?

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

I’m worried that the combination of continued balding and my very fine hair will make it difficult to naturally and densely cover my scalp via transplant. In the case of having a fraternal twin, female family members, or maybe even friends with hair to spare, is it ever possible to retrieve grafts from a donor that is not the patient? Would grafts from a female donor be viable on a male MPB scalp? Thanks!

Unfortunately, transplanting hair from any person other than an identical twin will fail and get rejected. Hair is like any other organ transplant, which would require anti-rejection medication that could lead to further health complications. I’ve written about this process and the medication required before.

Tags: twins, organ transplant, hair transplant, hair loss, hairloss, medication, drugs

Travel for Hair Transplant Surgery?

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

Hello Dr. Rassman,

As you seem to be the leader in your industry (in my opinion, at least), I assume many patients travel from afar to see you. Do you treat Canadian residents? I am in the eastern part of Canada, and while there seem to be some good surgeons in my area, I feel a visit to you is my best option. Any thoughts about this? Thank you.

PlaneYes, I can treat any patient that sees me from any part of the world. We also offer a travel discount for surgical patients. Before we arrange that we should have a telephone consultation and that works best if you send me photos so I can see what your problem areas are. If you’d like to setup a phone consult, you can fill out this form so that someone on my staff can get back to you to schedule it and get those photos.

Here’s the info about the travel discount from our website:

    “If you live more than 150 miles from the office where your surgery is performed, you are eligible to participate in our travel program. NHI will reimburse you for up to 5% of your net procedure cost for reasonable transportation expenses incurred while traveling to one of our facilities for a seminar, consultation or procedure. If you drive to one of our facilities, you can choose to be reimbursed for either mileage or gasoline expenses. If you fly to one of our offices, please note that frequent flyer miles are not reimbursable. NHI can only reimburse you for your flight-related out-of-pocket expenses. In all cases, please remember to provide receipts. In addition, you will receive one night’s stay at a pre-selected area hotel at our expense. This program is based on a minimum procedure fee of $3,000.00.“
Tags: travel, hair transplant, surgery, hairloss, hair loss, hair restoration

My Teen Daughter is Losing Hair — What Should She Do?

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

Is their a Dr.in the Sacramento area who specializes in hair loss. My 18 year old daughter has been experiencing hair loss for about a year. I took her to the Dr. last year and was told it was probably due to stress. Her blood work showed no abnormalities. She has another appointment soon. I am thinking it could be heredity. My father stated losing his hair at 18. I have Kaiser Insurance and I don’t think they are going to do a whole lot to figure out what is going on with her hair loss. What would be the next step? Should she be referred to a Dermatologist? If you could give some assistance, that would be appreciated, thanks.

Women’s hair loss is very different from men’s hair loss. Finding the source of the female thinning isn’t as simple as looking to the history of hair loss from the male side of the family. You should take a look at the female hair loss category of this site and read the many posts on the subject. A doctor who specializes in hair transplantation and has the intellectual capacity to analyze it may be able to help. Usually this is an elimination process for known causes.

I would be happy to give you an opinion, but you would have to fly to Los Angeles to see me. Or Dr. Pak goes to our San Jose office and may be a first start to the process of analysis. It’s not quite Sacramento, but it’s closer than Los Angeles. If not, you can try the physician search at ISHRS.org.

Tags: teen, teenage, daughter, hairloss, hair loss, female hair loss

Does the Hardy-Weinberg Principle Apply to Balding?

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

I’ve heard the Hardy-Weinberg principal can help determine your probability of going bald. Is this true?

If you know what the Hardy-Weinberg principle is all about, you should know it is a GENERAL principle… and at the risk of seeming like I’m just brushing this off, I doubt most readers have heard of it or would be interested in it. Moreover, genetic male balding only applies to men, but the trait is not sex linked (meaning women can carry the gene), and the gene in question may be more than just one gene, as nobody has found the specific gene(s) for balding.

In the end, if you have it, you have it! It is not that difficult to see the balding. And even if the principle works, how useful would it be?

Tags: hardy-weinberg, principle, hairloss, hair loss, balding

In the News – Ever Wonder What a Bear Looks Like Without Hair?

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

Snippet from the article:

Bald bearYou’d have thought a fur coat would have been the ultimate bear necessity.

But not for the unfortunate Dolores who has lost all her body hair and has just been left with a few tufts around her head.

Vets have been left baffled by the condition of the bespectacled bear, who lives at a zoo in Leipzig.

Read the full article (with beautiful, large photos) at: DailyMail UK

This is very peculiar. I don’t know much at all about alopecia in animals to even begin to speculate what the cause is, but the article hints to genetic causes and I’m sure the veterinarians there are going to continue to study it.

Tags: bear, alopecia, animal, zoo, germany, hairloss, hair loss

Tanning Lotion and Hair Loss?

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

Hi there,

I have an unusual question! I have noticed mild temple recession over the past 6 months. I am not aware of my hair “falling out” in the shower or anything like that, but rather when I look at photos of myself of late, it is noticable that my temples are more receded. I still have hair in the temple point region, but it is not as thick or prominent as it used to be.

However, something occurred to me today. I have for the past 6-8 months been using a “self-tan” moisturizer, of which the active ingredient is DHA… The areas where I have noticed hairloss (frontal hairline & temples) are the exact areas where my hairline comes into contact with the tanning lotion. The instructions for the self tan state that you should avoid the hairline, as it may cause mild discoloration of the hair, which I have noticed in this area.

After googling DHA and DHT, my initial understanding is that it seems that there may be some correlation between the two? My question therefore is could the DHA in self tan be having an impact on my hair and causing slow but gradual hair loss? And if so, if I stop the self-tan, will the hair likely return in these areas? I look forward to hearing from you. Thanks

I do not know the connection to the tanning solutions and hair loss. If you think that it may be the cause, then stop using the self-tanner and see if your loss subsides. Most tanning lotions like that will advise to not let it touch the hairline, but that is because it could dye your hair.

Tags: tanning, self-tanner, lotion, cream, hair loss, hairloss, dye

Will Finasteride Work for 30 or More Years?

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

Doc, I really appreciate this blog which I consider, by the way, the funniest blog on the Internet about hairloss. My question is about maintainance. You have written many times that baldness will catch up all of us sooner or later but, on the other hand, some people, mostly in their early twenties are still maintaining after ten years, their benefits of Finasteride. According to these: you think that those who are taking Finasteride will lose most of their retained hair, maybe at their late thirties or fourties? Or perhaps these people could get to keep their hair until they reach their fifties or sixties?

I know very well that you don’t like the guessing game but I am sure your professional experience gives you a better perspective about these topic.

You’re right in that I don’t like to guess, so I’m not going to do so here. The data is just not there. Finasteride hasn’t been around long enough to say whether it’ll maintain hair loss treatment benefits 30 or 40 years after you start taking it. What I do know is that it does still provide benefits after the 10 year mark for some men, because the medication has been available for about that long. Finasteride was around in a larger dosage (5mg) since 1992 to treat the prostate, but I don’t have data about hair loss treatment benefits in those that took the drug back then for prostate health.

The drug company Merck shows a slow loss of effectiveness over the first 5 years, but there is no published data beyond 5 years. I have had many patients starting this drug in their early to mid-twenties and over the 10 or so years the drug has been on the market, many of the men who reversed the balding in the crown have maintained all of the benefits. Unfortunately, I can not project this out for the length of time you are asking about.

Tags: finasteride, propecia, hairloss, hair loss

When I Cut My Hair Short, It Looks Thinner

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

(male) Hi, i was wondering something and had a question. When i cut my hair real short and stand under direct light you can see my scalp, but if i am in just regular light like out in the car i can not see it. The strange thing is when i let it grow out i cant see through it at all. I dont understand whats goin on. People say my hair looks thin at the top but the lady that does my hair says i have good fine thin curly hair. Could you please give me some insight? thanks.

Bird's eye viewImagine looking out your window when you’re in an airplane on a sunny day and seeing some thin, short trees. You’d probably be able to see the ground in between them. Now imagine looking out that same window on a gloomy day and seeing thick, tall redwoods. You probably won’t be able to see the ground between the trees. Now apply that logic to the hair on your head.

If that doesn’t make sense, how about this: Fine hair has less hair bulk than coarser hair, so the longer the fine hair is, the more significant will be the bulk. People with fine hair have difficulty looking full-headed, because the bulk of the hair shaft is small.

Tags: haircut, hair, thinning, light

Are There Any PRP Studies Underway?

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

You recently stated that you would need to see a well-controlled scientific study to be convinced that PRP would be worth the cost. I was wondering if you were aware of any such study. I’m sure doctors and patients alike would be eager to see the results if in fact a study is currently underway.

The popularity of PRP treatment seems to be increasing and I get the impression (just from what I read online) that more and more doctors are adopting the practice.

Platelet-rich plasma (PRP) is a great marketing gimmick, but there is no good scientific evidence that it has any value. Most of the studies that I do know of don’t provide the quality of data I demand before I’d consider using it. Also, we have not heard from the FDA, which may be interested in the claims made by those who promote it.

I am not aware of a well designed scientific study going on with good double blind controls, but maybe there is such a study being conducted. If so, when it is published, I will certainly know about it. As a surgeon quoted in this recent article about PRP says, “there currently is minimal evidence of this clinically and more research must be performed“.

Tags: prp, platelet rich plasma, surgery, hair transplant, study, fda

Any Hair Thickening Recommendation?

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

What product will you recommend for hair thickening and to stop hair-loss. When do you think Follica will be ready with the miracle drug?

For hair thickening, there are a variety of products like volumizing shampoos and protein fibers that you can apply to your hair. I don’t have any specific recommendation for these, as they’re over the counter and you can try them as you like. Some work better than others to give the illusion of thicker hair, but none of them will stop hair loss.

As for information on Follica, please contact the company (here is their Consumer Inquiries form). I have no insider information.

Tags: hair thickening, volumizing, hairloss, hair loss, follica

Random Jet Black Hairs, Follow-Up

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

Hey doc I wrote you here and after you mentioned the chimeric process I did a little research because frankly I had no idea what that was, and I’m convinced I am chimeric.

It’s literally like I have two different kinds of hair everywhere on my body. On my head I have brown normal hairs much like my father and Black thick really curly ones, I have noticed there are a few patches where the curly hair is more concentrated, it makes me look incredibly silly when my hair gets longer. The same goes to my body, except the black body hairs aren’t curly. Assuming I am chimeric (I understand no one really knows how frequent it really is, and I’m not going to get tested because i don’t care that much and don’t have the money), does this mean my different hair will inherit different balding genes? Have you dealt with anything like that before?

Sorry, but I just don’t have the answer to your question. In the real world things are not so theoretical and your guess is as good as mine. You should try to send me some photographs of what you’re seeing with the different hairs (you can blank our your face, as that is not important for us).

Tags: chimeric, chimera, hair growth, hair character

Doctors in Trouble — It Would Be Funny If It Wasn’t So Tragic

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

Medical Board of CaliforniaIt’s not hair loss related, but I wanted to share something…

The Medical Board of California sends each licensed physician notification of doctors who are being investigated by them for a variety of problems as well as doctors who have been disciplined by the Medical Board. With the Michael Jackson fiasco in mind, I read about a doctor who is under investigation for overprescribing Endocet (a controlled narcotic). One patient who found the doctor through the Yellow Pages, received 7,912 tablets of Endocet over a 77 day period (1-2 pills per day for short periods of time should be normal). One of the excuses given as to why such a large amount of pills were needed included: the family dog ate them. I wonder what happened to the dog?

The Medical Board is given the responsibility to watch over the practices of doctors. They have told me privately that they do not have the resources to chase down every complaint, but they will open an investigation on doctors who practice outside what is considered the Standard of Care. I have been an expert witness for the state in the past and the actions of that one particular doctor just amazed me.

Tags: california, law, legal, medical board, endocet, physician, doctor

Any Significance if I Lose Hair at the Vertex First?

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

Thank you again for maintaining this blog. It’s very informative. I have two questions:

  1. What does it generally mean when a man loses hair at the vertex first? I understand that every one is different, but do people who lose hair in the vertex and have little to no hair loss at the hair line tend to maintain their hair line? The Norwood scale suggests that hair loss usually begins with a receding hairline, with hair loss in the crown coming later. Also, I have noticed that men with receding hair lines generally state that they started to lose hair (in the front) in their early 20’s. Do men that make it to their late 20s with little to no recession tend to maintain strong hair lines, or have less recession?
  2. I use minoxodil. However, I still have quite a bit of hair and don’t think it absorbs into my scalp very well. Even after 4 hours or so I can touch my head and my hands will be wet from the liquid sitting on my scalp. Should I use a scalp roller? I have read before that it may increase absorption. It seems relatively easy to use and inexpensive. So long as it does not cause any harm (or further hair loss) I would give it a shot. Thoughts?

Thanks again

  1. Depending upon your genes, the balding may or may not start with thinning in the crown. If you keep your hairline into your 30s or so, you have a better chance that you will keep it — but some men do lose their hair later in life. I really can’t give you odds, as each case is unique. From your question, I am guessing that you’re losing hair in the crown and are worried about the hairline going, but I can’t provide you any clear comfort.
  2. If you do not believe that regular minoxidil works well for you, try Rogaine Foam, which is reportedly easier to use and better on the absorption. I wouldn’t bother with the scalp roller until there have been some established trials that show it is worth using. Contributing author Dr. Bessam Farjo wrote about that recently.
Tags: scalp roller, scalproller, minoxidil, rogaine, foam, hairloss, hair loss, crown, vertex, hairline

Spectral.DNC-L

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

Dr. Thank you for this informative site.D o you have any thoughts on using minoxidil other than Rogaine. DS Labs has there own formula DNC and a brand new formula DNC-L for advanced stages of balding. I don’t know if this company can be trusted due to it’s claims the their shampoo Revita will stop hair loss. It’s website is impressive and I do like the shampoo.

Spectral DNC-LIf you like the shampoo and it seems to be working for you, I’d keep using it. Claims on preventing hair loss may be in violation of permitted language from an FDA perspective if the formulation impacts the effectiveness of the minoxidil in their product. I believe if you want minoxidil, get it the generic way. If you want the minoxidil foam, you’ll have to get the name brand stuff. As for this lotion… well, it’s up to you. The combo products, without proper studies, just don’t do it for me. That kind of sums up my opinion.

I think it is easier to build a great website than it is to create a product that actually slows, stops, or reverses hair loss.

Tags: spectral dnc-l, spectral, dnc, ds labs, minoxidil, lotion, hiarloss, hair loss

In the News – Andre Agassi Wore a Wig

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

Snippet from the article:

Former tennis star Andre Agassi has admitted the lion mane-style hairstyle he sported during the 1990s was actually a wig, in extracts from his autobiography published in British newspapers Saturday.

Agassi said he wore a hairpiece held together with pins in his first Grand Slam final, the 1990 French Open final, and blamed his concerns that it would fall apart for losing the match to Andres Gomez.

Before the match he prayed “not for victory, but that my hairpiece would not fall off”, he writes in “Open”.

Read the rest — Agassi admits mane was a wig

Well, coming clean about his wig-wearing days is certainly one way to sell books. Here are some before and after photos for those that might not remember him with his mullet wig in the 90s:

Andre Agassi
Tags: wig, hairpiece, tennis, celebrity, andre agassi, hairloss, hair loss