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    My Lack of Facial Hair Makes Me a Social Outcast!

    Jun 30, 2010/by William Rassman, M.D./0 /Hair Loss Causes

    Sir,
    I am aged 24 and I dont have facial hair except a few hair on my chin. I have a mustache but even that is not thick. I dont have even a single hair on my chest. Hair have grown normally in head, hands, legs, arm pits and pubic hair also are normally grown. My father has thick and complete facial hair. I have a brother and he too has good facial hair. I dont find anyone among my relatives also who lack facial hair. I am the only one. Apart from this problem I am a healthy person.

    Please suggest me some remedy. Due to this problem I am unable to involve in social gatherings. My height is 5 feet 9 inches but I look like a child among my other same aged friends. Thank you.

    BeardYou know, some people would be very happy to not have facial or chest hair. I would guess that when you are 50 years old, you would enjoy your youthful appearance. This must be a cultural or religious thing that I’m not all that familiar with, and I don’t mean to make light of your situation.

    Unfortunately, there’s really no simple solution to what you’re asking. If we could easily get hair to grow in areas that we wanted, the population of bald men would likely be much smaller.

    If you want to look older with facial hair, you can possibly have a hair transplant to your face, but I don’t know that I’d recommend trying to transplant a full beard for someone. You’d also need to find a skilled surgeon with experience transplanting facial hair.

    Tags: facial hair, beard, hair growth

    In the News – Naomi Campbell’s Bald Patch

    Jun 30, 2010/by William Rassman, M.D./0 /Female Hair Loss, Hair Loss Causes, Hair Pieces / Systems

    Snippet from the article:

    Naomi CampbellHer wild behaviour is often shocking, but Naomi Campbell caused jaws to drop for entirely different reasons today.

    The supermodel left onlookers stunned as she revealed a huge bald patch beneath her long luscious wig while on a fashion shoot for designer Dennis Basso in New York.

    The 40-year-old has revealed signs of a vanishing hairline before, but the true extent of the problem was put on show as she held her hair back as a stylist adjusted her clothing.

    Read the rest at DailyMail UK — Just WHERE has Naomi Campbell’s hair gone?

    This appears to be a bad case of traction alopecia, but perhaps she has alopecia areata? I couldn’t say without an exam. Traction alopecia is likely based on the wigs/weaves she has worn over the years in her modeling photo shoots, which produces a tight pulling on her hair and leading to the loss you see.

    The above photo is from the article, where you can also find plenty of others. If this story sounds familiar, we previously wrote about Naomi Campbell’s hair loss when an article was published a couple years ago.

    Tags: model, supermodel, naomi campbell, traction alopecia, hair loss, hairloss, celebrity

    Major Shedding 7 Months After My Hair Transplant

    Jun 30, 2010/by William Rassman, M.D./0 /Hair Transplantation, Post-Operative

    Hello,

    I had a transplant of over 3,000 follicles about 9 months ago. I have seen growth but it is still thin and not what I have expected. I have noticed major shedding about 7 months in with the hairs having white bulbs attached to the end. I am concerned that some may be transplanted hairs. What could be the cause of this? Should I be worried?

    I do not know what is going on in your case, so I could just guess. Maybe you have increasing native (non-transplanted) hair loss. Maybe you have other medical problems. Maybe your hair transplant was not a success. Maybe you have diffuse unpatterned alopecia (DUPA), which would produce failures to hair transplant surgery. Maybe you are not on Propecia. Maybe you stopped Propecia. ANYTHING is possible. And I would be worried too.

    You should be asking your surgeon about the problem and he should be really worried for you. Please, contact your surgeon and discuss these issues with him!

    Tags: hair transplant, hair loss, hairloss, shedding

    New Genetic Hair Loss Test in India

    Jun 30, 2010/by William Rassman, M.D./0 /Hair Products

    I just read this press release about a company in India that developed a baldness prediction test that sounds similar to Hair DX.

    Do you know anything about it? It sounds like it is just limited to India right now, but I was curious if its like a generic Hair DX (I dont know if that’s even possible) or if they are testing in an entirely different way. Thanks

    Link: Metropolis develops screening test to predict genetic predisposition to baldness

    MetropolisThe press release you sent is the first I’ve heard of it (thanks for bringing it to my attention), but I’d assume this newly announced test identifies the same genes as HairDX. It doesn’t appear that the HairDX test is available in India, so Metropolis appears to have the market cornered there.

    Tags: hairloss, hair loss, metropolis, india, genetic, prediction test

    Nurse Told Me to Stop Propecia for 8 Days After Chest Discomfort

    Jun 29, 2010/by William Rassman, M.D./0 /Drugs

    Hi, I have been taking Propecia 1mg for a little over 4 months now. About 3 months in, I thought I noticed some slight discomfort in my chest (although it may have just been in my head). Now, a month later, it seems much more evident that I am experiencing breast discomfort/tenderness. It is not constant, although I do feel it many different times throughout the day. I am worried that this will lead to breast enlargement. Are breast tenderness and breast enlargement related? Or are the completely independent of each other?

    I am 22 years old and have had puffy nipples (I don’t think it is actual gyno) since I was about 16. I don’t want this to get any worse. I spoke to the nurse at my dermatologist’s office and she told me that even though the discomfort could be something completely unrelated to the Propecia, that I should stop taking it for 8 days (until I go in for my appointment). Will these 8 days off Propecia undo the progress that I’ve made or is it safe to go without it for a week? Thanks a lot for all the help!

    Chest discomfortYou’ve had puffy nipples long before taking Propecia, but if you are experiencing discomfort and tenderness in your chest after taking Propecia, I would highly advise you to discuss these symptoms with your doctor. In our experience, Propecia rarely impacts men’s breasts, but the appearance of new symptoms while on the drug such as gynecomastia or painful breasts/nipples should be addressed in a thorough examination.

    The symptoms you report are a valid and known side effect that occur in less than 1% of men, but they are reversible after stopping the medication. It just might be that you are not be a candidate for Propecia with these side effects.

    Breast enlargement and tenderness could be related. Stopping Propecia for 8 days should have no major impact on your treatment course, and is probably the safest way to go about this until you can meet with your doctor for the exam.

    Tags: propecia, finasteride, hairloss, hair loss, breast, chest, gynecomastia

    Using Minoxidil Once Every Other Day

    Jun 29, 2010/by William Rassman, M.D./1 /Drugs

    Hi,
    I am a 24 year old male and have begun the early stages of MPB. My doctor has prescribed Minoxidil 5% and I know your suppose to apply it twice a day but that doesn’t really fit into my schedule, so I have only been applying it about once every other day. My question is, is there any harm that can be done applying 5% Minoxidil once every other day or is it simpy not as effective as using it twice everyday? Thanks.

    RogaineYou shouldn’t need a prescription for minoxidil 5% topical for use in treating hair loss, as it is available over the counter (at least in the U.S., though I can’t say for sure in other countries).

    The recommended dose as you know is applying it twice a day. There is no harm is using it once every other day, but you will not be using it the way it is recommended and you may not get any benefit from infrequent use. I suspect poor compliance and/or not following the recommended directions are the main reasons why patients give up using minoxidil, because they don’t see a benefit.

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

    In the News – Miss Delaware 2010 is Bald

    Jun 29, 2010/by William Rassman, M.D./1 /Diseases

    Snippet from the article:

    Kayla MartellLike many beauty queens, Kayla Martell is beautiful, blue-eyed and out to support a good cause.

    Martell, the newly crowned Miss Delaware 2010, also is completely bald. The 21-year-old pageant winner suffers from alopecia areata, a condition that causes hair loss and afflicts 4.7 million Americans, according to the National Alopecia Areata Foundation.

    Sporting a blond wig, Martell beat out 15 other women — all with full heads of hair — to take home the Miss Delaware crown this month.

    Read the full story at AOL News — New Miss Delaware Says Bald Is Beautiful

    This is quite the inspirational story and should help bring awareness to alopecia areata patients. She competed four previous times in the pageant before taking home the crown on June 12. Congratulations to Ms. Martell!

    There’s also a video available within the article from the CBS Early Show that is worth a view, and you can learn more about the new Miss Delaware at her blog.

    Tags: miss delaware, kayla martell, alopecia areata, hairloss, hair loss

    I Had Trichotillomania as a Teen, Now My Hair Is Thinning More

    Jun 29, 2010/by William Rassman, M.D./0 /Diseases

    Hello Doc,

    I am 24 years old and rapidly thinning out. I noticed this a little over two years ago as I was graduating college and it really hit me hard. I have had a tough time accepting it and it has crippled my confidence and social life.

    In addition I had a severe case of Trichotillomania when I was in my teens years (13-15 or so). I would repeatedly rip my hair out with a brush in front of my bathroom mirror. I outgrew my bad habit eventually, but there is no doubt that this disease is the main reason for my permanent hair loss.

    Is someone with my case treatable? And what steps should I take to start. I sincerely appreciate any feedback or comments.

    Wow, this is a difficult if not impossible request without a good examination of your hair and scalp. Many people with trichotillomania just continue the pulling and compounding the problem, so you need to be completely sure you’re not still doing this (perhaps without realizing it). With an examination, I’d be able to tell if you stopped pulling out your hair, a critical first step to solving your problem.

    Tags: trichotillomania, hairloss, hair loss, pulling

    I’ve Seen Improvement from Propecia, But Can I Cut the Dose in Half?

    Jun 28, 2010/by William Rassman, M.D./0 /Drugs

    Hi Docs,

    My question is about propecia. I’ve been taking the med for about a year and a half and have seen some nice improvement in the crown and im sure it’s doing the rest of my hair some good.

    I’ve been off of the pill for a week. I’m planning to go back on asap but i was wondering if i would maintain these great results if i were to only take half of the dose each day?

    Thank you!

    The recommended dose for treating hair loss is 1mg finasteride per day, which is what you were taking. If 1mg (Propecia) is working for you, why would you want to change the dose? I would expect that if you cut the dose in half to 0.5mg you may see some continued benefit, but you will run the risk of losing the crown improvement you currently enjoy.

    If cost is the reason you’re considering a lesser dose, then you can ask your physician for a prescription of the 5mg finasteride (available in generic form, which works out to about $70 for a year supply) and cut it up into 4 pieces, taking one piece each day. Ideally you should cut it is in 5 pieces, but cutting a small round pill into 5 equal pieces is very difficult. Cut only one pill at a time and store it where moisture won’t get to it (and out of the reach of children, pregnant women, and women that could become pregnant).

    There is no generic 1mg finasteride legally sold in the US due to U.S. Patent protection until 2013. There should be no difference in the 5mg generic and 1mg brand name medication other than the cost and having to cut the pill.

    Tags: propecia, finasteride, proscar, hairloss, hair loss, generic, medication

    Costs to Remove Hairline Cowlick?

    Jun 28, 2010/by William Rassman, M.D./1 /Hair Transplantation, Other Surgical Procedures

    Hello. I have read in many places about how expensive it it to fix a cowlick (in the front hairline, in my case) by surgery. However, I have not yet found an estimated price range. Could you ball park what it would be to align the folicles into a more regular hairline pattern? I am a 25 year old male, and the pivot is quite pronounced about half way between the middle and the side.

    I am not sure where you have tried to find the information, but here at New Hair Institute (NHI) the minimum cost of a hair transplant surgery is $3000. Otherwise, the cost of each graft ranges anywhere from $5 to $6 a graft (see fees). I don’t know that any clinic would have a flat “cowlick removal” fee.

    You are more than welcome to send in some photos to me of your problem area and schedule a phone / photo consult. From those photos, I may or may not be able to quote you without seeing you.

    Or…. electrolysis might be a reasonable way to accomplish what you want without surgery.

    Tags: cowlick, hairloss, hair loss, hairline, hair removal

    Would Getting a Hair Transplant Give Me Cloning Priority at NHI?

    Jun 28, 2010/by William Rassman, M.D./0 /Hair Cloning, Hair Transplantation

    Dr. Rassman I have an odd question for you. I plan to have a hair transplant with you in the near future. Playing devils advocate here, let’s say that hair cloning is a viable option in five years and the demand would be great.

    Would having a prior surgery with you give me an advantage of getting this procedure done sooner? (i.e. cutting in line)

    Thank you for your time.

    First and foremost, having posted over 8000 questions on this site and answering some real doozies, I don’t think yours is all that odd.

    Hair cloning just means there will be more hairs available for transplantation and you will not be limited to the donor hair. With respect to priority, our surgeries are scheduled on a first-come, first-served basis… but when it comes to procedures done with hair cloning, it’s all hypothetical at this point. I’d like to hope that in 5 years from now we’ll be transplanting with cloned hair, but that remains to be seen.

    We look forward to seeing you!

    Tags: hair cloning, hair transplant, hairloss, hair loss

    Why Doesn’t MPB Occur on the Sides?

    Jun 28, 2010/by William Rassman, M.D./1 /Hair Loss Causes

    Greetings Dr. Rassman. I just would like to know why most MPB only occurs on the top of the head(meaning frontal, top and crown area) and not on the sides?? What is the difference of the scalp on top of a male’s head and the scalp in the sides?

    Norwood 7There is no clear answer as to why the hair only falls out at the front, top, and crown. The reality is that the fringe seen in the Norwood Class 7 pattern is permanent hair that is never lost in 99+% of men with male pattern baldness.

    Tags: hairloss, hair loss, genetics

    Family History Shows Men Losing Hair Later, So Why Am I Losing Hair at 19?

    Jun 25, 2010/by William Rassman, M.D./0 /Age, Drugs, Hair Products

    My father start to lose his hair at 45 and my uncle at 35-40, and no grandfather have hairloss problem. I have 21 now and for 2 years i’m fighting to keep my hair with avodart, kirkland and some vitamins named forcapil, but this seems that not work very well for me. Why i begin to lose my hair at 19 if my father start to lose at 45. I can make something else for my hair?

    ForcapilFamily patterns do not necessarily follow either by the degree of balding or the onset of balding. Sometimes they can be used as a guideline, but it’s not a guarantee. So why did you start losing hair at 19 years old? I guess you can attribute it to bad luck.

    You’re young with early hair loss and you’re using multiple treatments. Let’s break down your regimen:

    Avodart (dutasteride) — I assume you don’t have a prescription, as I’d expect most doctors would not prescribe this strong prostate medication to a 19 year old with early hair loss. Avodart is not approved to treat hair loss at this time. Although there is evidence it works to treat genetic hair loss, most doctors would not be comfortable prescribing this until at least dosing and safety data is available. If you do have a prescription, you should be talking to your doctor about this.

    Minoxidil (I believe this is what you meant by Kirkland) — This is fine, but I don’t know if you’re following the dosing instructions. Apply it twice a day to the area that you’re losing hair. If you’re losing hair in the frontal hairline, it probably won’t be much help there.

    Forcapil (vitamin supplement) — Their site describes it as a “special formula combining vitamin B complex, sulfurated amino acids, zinc and vitamin D3“… which means if you’re taking it with hopes of regrowing your hair this is probably a waste of time and money. I hadn’t heard of Forcapil before, but it appears to be made by a French pharmaceutical company and not sold in the US. I found the dosing instructions are to take 6 pills a day for the first 2 weeks, then 2 pills a day for the next 6 weeks… so I hope you enjoy taking pills.

    Tags: hairloss, hair loss, dutasteride, avodart, forcapil, vitamins, supplement, minoxidil, age

    Anastrozole and Propecia

    Jun 25, 2010/by William Rassman, M.D./0 /Drugs

    Hi doc! Thank you for your excellent and informative blog! I’ve been hearing things recently about using the very potent aromatase inhibitor anastrozole to prevent the ‘estrogenic’ side effects of finasteride. Anastrozole drastically reduces estrogen levels in men and, unsurprisingly, raises free testosterone as well. Would you be comfortable with one of your patients adding anastrozole (‘Arimidex’) to his propecia regimen, or would you see this is opening up a whole other ‘can of worms’, and potentially serious side effects?

    ArimidexArimidex (anastrozole) is a anti-breast cancer medication for post menopausal women. There are no clinical trials in men. You would basically be experimenting with your body without any knowledge of the consequences. I would recommend against this. Especially since I’ve seen the complaints/worries people have about side effects from Propecia, you would be just adding fuel to the fire.

    According to the Arimidex website, some of the most common side effects seen with the drug include, “hot flashes, joint symptoms (including arthritis and arthralgia), weakness, mood changes, pain, back pain, sore throat, nausea and vomiting, rash, depression, high blood pressure, osteoporosis, fractures, swelling of arms/legs, insomnia, and headache”. Also, a less common side effect of Arimidex is hair loss.

    Tags: anastrozole, arimidex, propecia, finasteride, hairloss, hair loss

    Transplanting from My Hairy Neck

    Jun 25, 2010/by William Rassman, M.D./0 /FUE, Hair Transplantation

    I have quite a lot of hair in my neckline. The hair is thick and straight, which makes me wonder whether it could be transplanted to my head. I have already had 1000 grafts via FUE, and I see the diffuse pattern from the FUE transplant whenever I trim my hair very close to the scalp. Using neck hair seems like a way to augment the donor pool, but I don’t know how receptive the scalp is to that type of hair and whether FUE performed on the neck would leave visible scarring. What do you think?

    Neck hairNeck hair is not considered “permanent” like the hair on the back of your scalp. There is a chance that as you get older your neck hair will fall out, so if neck hairs were used for a hair transplant it would also fall out. This is what makes neck hair not ideal for transplantation.

    In addition, as you clearly have found out, follicular unit extraction (FUE) still produces small round punctate scars. So if you have a FUE procedure to the hairs on your neck you will definitely see the same type of scarring, which would be more difficult to hide.

    Tags: fue, follicular unit extraction, hairloss, hair loss, hair transplant, neck hair
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