This is a comment left by a reader in response to Propecia being under patent protection…

And that is exactly why we need to see the end of Patent laws as we know them today, companies are given way too much time to bleed us. Its evil. Especially when medication has been Government funded or approved.

The real issue is that patents stop other companies from innovating. In fact while I’m thinking about, we should all be lobbying against the company that tried to sue Histogen. Because that company only cares about your money not your hair. There is nothing more criminal then these companies slowing down the discovery process – its anti human and we want our hair back

USPTOMaybe you are right, but we live in a capitalist society. I’m not going to make excuses for it. These are for-profit companies and they spend millions (if not billions) of dollars on research and tests to develop new products and new drugs. Some drugs fail, some succeed. When one succeeds, it makes up for all the R&D and failures that still had to be paid for.

Do you think they should just give that away for essentially nothing? Patents form the backbone of what built our country into an industrial giant. In time though, the patents on these drugs will expire and generic versions will be legally available in the US… so there’s no stranglehold forever.

We all have the right to our own opinions, but hair loss is seen as a cosmetic issue. I have a hard time believing that the government would fund hair loss issues when its hard enough to have HIV or diabetes or heart medicines funded. But hey, maybe you can lobby the government and try!

Tags: patent, medication, drug, hairloss, hair loss, cosmetic, uspto

I have used the “cover-up” product, Toppik, for a couple of years with pretty good results. I have recently read — albeit online, so of course I am quite guarded in my reaction — that there is aluminum in this keratin fiber product which may actually clog pores and cause or speed up hair loss/miniaturization. While I have continued to thin in the front and temples where I use the product, I atrributed that to the progress of MPB, not this product. Do you have thoughts on this? Do you ever suggest these types of products, of course, in conjunction with other treatments (HT, finasteride, etc)?

Also, can one use a product like Toppik in the recipient and donor areas after an HT to camouflage the scabbing/markings until healing — particularly in FUE procedures?

Dr, thanks for providing this service. You are setting yourself far apart with this type of service to those with hair loss issues.

I also welcome other readers to post their thoughts if they have used Toppik or other similar products. Thank you.

ToppikTopical “cover-up” products like Toppik or DermMatch do not cause hair loss, nor would it cause an increase in loss. Male pattern hair loss is from genes. You’re using these products so it’s likely you’ve got genetic hair loss… and that loss is progressing.

Some patients use Toppik or DermMatch after a hair transplant surgery to cover the scabs during the healing process. When removing it, you must not scrub the scalp harshly or you can pull out your existing hair. You can use either of them in conjunction with finasteride.

If any reader would like to contribute information about personal experiences with these camoflauging agents, please feel free to post a comment…

Tags: dermmatch, toppik, hair loss, hairloss

Snippet from the article:

Dr. George Q. Daley sits at his keyboard and types “stem cell treatments.” In less than a second he gets 13.4 million Google hits.

“Here’s a website where they claim over 1,500 patients treated,” says Daley, one of the world’s foremost stem cell researchers. “That doesn’t mean they’ve been treated successfully. It’s ‘buyer beware!'”

But consumers have a hard time sorting out all the stem cell claims out there. Websites often look professional and convincing. Typically they feature distinguished-looking white-coated doctors posed in front of bookcases, technicians holding up flasks with mysterious colored liquids, and happy, healthy-looking clients cavorting on beaches.

NPRRead the full story at NPR — Offshore Stem Cell Clinics Sell Hope, Not Science

This is a good article about scams and selling false promises online. Although it targets the people looking for stem cell treatments that don’t exist, much of this can be applied to the same people seeking out a hair loss “cure”.

Bottom line, there are unscrupulous people that are more than willing to take money from desperate folks looking for miraculous medical treatment via the web.

Tags: stem cell, npr, treatments, scams

Hi there it has been 1 year since my aunt has burnt my scalp with a relaxer it was red then healed but now there is a bald spot will my hair grow back and i am 14. what can i do to help it grow back? how fast will it grow? please help!

Honestly, I do not know. Your aunt’s hair may never grow back if the damage is significant and the burn went down to the root of the hair. If it was to grow back, I’d expect it might have grown back by now (since it’s been a year) or at least some regrowth should’ve occurred.

She should have the burned area examined by a dermatologist.

Tags: chemical burn, chemical relaxer, hairloss, hair loss, damage


I started noticing hair loss around the age of 26. I tried the laser for a year and did not believe it worked and took propecia, but felt that did not provide help either. In 2009 I decided to have a hair transplant surgery 2,000 hairs. 1,000 in the front and 1,000 in the back.

After the transplant I began finasteride and rogaine to maintain the amount. I was so happy after the first 6 months, until I started noticed thinning in the front again. Everytime I go to the doctor who will remain nameless they say things are fine. I went for the second procedure a year later to thicken up the front. It has been 5 months and the front looks worse and the back is starting to thin out on the sides and a little in the middle. I have a few questions.

  1. Can the initial surgery cause this shedding to occur and then stop?
  2. Could the rogaine cause an adverse affect? Every time I use the rogaine and start combing my hair at least 10-20 hairs come out. I read somewhere that if shedding does not stop after 5 months then stop.
  3. Does the finasteride not work as well as the propecia? These 2 drugs should keep the back fine, but that is not the case.
  4. Also could transplanted hair fall out?

I cannot comment too much on your particular issues, because I’ve never examined you… but I suspect there was no Master Plan associated with your hair loss issue and you were chasing after a goal that wasn’t clearly laid out. It’s possible you were never given realistic expectations. Perhaps you should see another surgeon for his/her opinion.

1. I do not know what your initial surgery was, what it was suppose to do, or even if it was successful. In general, you can have shock hair loss from the surgery itself. That’s one possibility. The shedding from shock hair loss is permanent.

2. Rogaine is a topical medication to grow hair, not lose hair. If you have an adverse reaction, then ask your doctor for an examination. Losing 10-20 hairs is normal with or without Rogaine. Finally, some patients report slightly more hair loss when starting Rogaine treatment, but as you continue to use it there should not be a problem. The initial hair loss from Rogaine is thought of as a “cycling” of the old hair falling out in preparation of new hairs to grow.

3. Propecia is finasteride in 1mg strength. There is no difference as it is the same medication. Propecia is the marketing name, like Tylenol is the marketing name for acetaminophen… or Rogaine is the name for minoxidil. I’m not sure what you mean by the “back” … is it the back of the head (donor area) or the top/crown?

4. Transplanted hairs are considered permanent as your donor hair. They do fall out as the hairs cycle, but it regrows.

Tags: hairloss, hair loss, master plan, hair transplant, rogaine, minoxidil, propecia, finasteride

Dr. Rassman, you have said before that minoxidil works for about half of men. The box says that minoxidil has only been proven to work for men experiencing hair loss at the apex/top of head and not for men that are balding from the front. Are these clinical studies made up of men that are already “good candidates”, meaning they have the right kind of balding for the drug to work? Or are all types of balding patterns included in the trials?

I am 34 years old, been on finasteride for a year and noticed that it slowed things down, but didn’t stop it completely. I have since added minoxidil. I would appear to be a perfect candidate from what I have read. I caught it early, I don’t think most people would even realize I am losing my hair, it is still pretty thick. I am losing my hair at the apex/top of head area, my hairline looks good. Is someone like me almost guaranteed to get a good result? Or am I still just a 50/50?

Thanks so much, your site is a huge help!

There is no guarantees in life (other than death and taxes). If it works for you it’s 100%. If it doesn’t work for you it’s 0%. Statistics do not apply when it’s you… and you won’t know until you try. That being said, I’ve found that these medications tend to work best in the early stages of hair loss. So while I’m hesitant to “guarantee” anything from the medications, I’d suspect you’d have a better chance at seeing benefits than someone that started the medication after losing hair for 20 years.

Selective patients for these studies would discredit the studies. Minoxidil is very effective in about 15% of patients and mild benefits can be seen in half of those who are thinning in the crown (more stats here). With regard to the frontal area, the reports indicate it is less effective than when used on the crown.

Tags: finasteride, propecia, rogaine, minoxidil, hairloss, hair loss, statistics, stats

Hi, I received a hair transplant FUE type, nearly two months ago. I am a male and aged 46 years. After the first month i developed bumps of dry scalp on the transplanted area only. The Doctor stated that this was a fungal infection, so i started using Nizoral shampoo after using this shampoo for 15 day’s the condition has cleared. My question is, will this effect the hair transplant and the growth of the graphs, to become a successful hair transplant.

Thanking you for you professional advice.

I’ve never seen a fungal infection following a hair transplant, so I have no experience with this type of situation as a point of reference. I would think that if the infection is gone it should not impact your hair growth, particularly since the infection occurred a month after the transplant. That being said, I would ask these questions to your surgeon and hope for the best!

If one of my patients had a fungal infection, I would get the opinion of an expert who works with fungal infections (perhaps a dermatologist). Good luck.

Tags: fungus, fungal infection, hair transplant, hairloss, hair loss

Hello Dr. In How many month I can see the final results for an eyebrow transplant?

As with hair transplant surgery on the scalp, you should see some results from an eyebrow transplant anywhere between 3 months up to 12 months after the procedure. Some grow faster, some grow slower. Everybody is different.

Tags: hair transplant, eyebrow transplant, hair growth

Thirty years ago I had 4 or 5 sessions hair transplant sessions done using the old punch graph method. For most of those years I was fairly satisfied. Lately that has not been the case. The appearance of corn rows is starting to show in the front and it is getting harder to cover up the donor area in the back. Twenty years ago I spoke to a specialist in Philadelphia who disappointed in the methods used in my procedures and he implied that I was not a good candidate for future transplants. If this is the case I would prefer to shave my head instead of continuing trying to cover up, which can only become more problematic in future years.

The scarring at the donor site is a concern. Are there any procedures to reduce this scarring? Thank you in advance for any information and/or advice you can give me based on this limited description.

We have routinely performed surgeries for men who are in your situation. You can read about one patient’s journey here and see some of my repair patients here.

As you undoubtedly know, everyone is different and unique so I really cannot comment on your particular case without examining you. Many patients who had 4-5 sessions of the old hair plugs have heavily depleted donor areas, and a skilled surgeon with experience in this field can often soften the plugs by harvesting the recipient plugs as well as redistribute some of the remaining donor area. If you want to explore options, please send me photos and set up at the least a phone consultation with me.

There is no simple answer to your problems, and each person must be evaluated one on one before recommendations can be made. This goes for both repairing/removing the “corn rows” and seeing what can be done about fixing the donor scars.

Tags: repair, hair plug, hairloss, hair loss, hair transplant, donor, scarring

Hi, doc. I’ve been researching hair-transplantation, and I have a question concerning F.U.T. (strip-harvesting): I understand, in this method, a strip is excised from the back of the scalp, the wound then closed. I wonder, then, is not the overall surface of the scalp reduced in this procedure? After two or three procedures, especially, (or even after one large session) — when, totally, a reasonably wide portion of the scalp has been removed, will not a patient’s hairline, in accordance, also be shifted?

That is, the front hairline would move back by the amount of scalp excised, or, more likely, the “rear hairline” (which ends at the back of the neck) must certainly be “moved upward.” At least, this is how I imagine it would be. Is my logic flawed? I’ve been trying to understand this in researching the procedure, but the point still evades me.

I understand a physician will take into consideration laxity of the scalp, so what I’m talking about might not be immediately noticed — I also hear doctors will try to cut out strips that are longer rather than wider, to reduce tension — but, ultimately (again, especially when a large number of grafts must be harvested), will not the hairlines (front and certainly rear) be affected? If not, why not? If so, is this effect permanent? The piece of scalp taken out can’t “regenerate,” can it (and, if it could, would it regenerate hair follicles, too)?

Sorry for this long question, but certainly I’d appreciate your taking the time to answer. Thank you very much.

P.S. Just one other question (a brief one): Can hair that’s already been transplanted to a new location be removed and successfully retransplanted in another area (e.g., back to front, then, later, if need be, north of that region)?

The hairline never shifts, but the scalp itself does stretch a little with each procedure so that the donor density reduces a bit. I’ve answered a similar question before.

Neither the front hairline nor the neck hair moves as a result of these excised areas. The only part of the scalp that is impacted is either the posterior scalp (which would be stretched) or in a small group of these patients, the redundancy of the scalp (scalp laxity) reduces. The scalp is attached to the galea and then to the skull. This keeps the movement from one area to another minimal, if at all. Scalp and follicles can’t regenerate.

As for your P.S. — Yes, we often move previously transplanted hair when the work is not good, but there are limitations to moving a great deal of transplanted hair. This is commonly done in repair procedures.

Tags: hair transplant, scalp laxity, hairline, hair loss, hairloss, repair, surgery

Snippet from the article:

PrincePrince believes playing the electric guitar has stopped him from going bald.

The 52-year-old pop legend – who can play 27 different instruments – is convinced the electricity that flows through a guitar when he strums it is the reason he still has luscious locks.

He said: “Playing electric guitar your whole life does something to you. I’m convinced all that electricity racing through your body made me keep my hair.”

Read the full story — Prince: Playing the electric guitar prevented hair loss

So there you go, folks. The secret to keeping your hair — learn the guitar. Be sure to get a nice electric guitar with a huge, loud amp (bonus points if you live with people that are not musicians, since they will love to hear you learn).

I’m kidding, of course. Hair loss is from genetics… not electricity racing through your body.

Tags: singer, celebrity, prince, guitar, hair loss, hairloss, ridiculous

I recently moved to US (bay area) and have been noticing a lot of hair fall. Slightly pulling my hair causes them to come out. I have no serious illness etc. What could be causing the increased hair loss?


It could be a variety of things. Perhaps it is your genetics and the timing was coincidental to the move… or it could be stress-induced (moving can do that)… or it could be allergy… etc, etc. I really have no way to know based on your email with limited information. You should see a doctor if you’re concerned.

Tags: hairloss, hair loss, stress

Hi, Dr. Rassman. Thanks for answering all of our questions.

My question is, How likely is it for someone to “settle in” to a level of hair loss (Norwood 3A, for example) and not see any more rapid loss for a period of time (years, for example)? Do some people get to a certain level of hair loss beyond a mature hairline and stay that way without medication? Or is your fate essentially sealed after you reach a certain level?

Let me clarify what I see as your misunderstanding. The Norwood chart is not to be seen as a progression of hair loss chart, but rather the final patterns seen in a large male population.

Some people do seem to go from a Norwood class 3 to a 4 and then to a 5 pattern, but you may just “settle in” to your Norwood 3A state, as an example. There is really no 100% certainty, but a good doctor with a good miniaturization study and examination can give you a better assessment of what hair may go with time. Here’s the Norwood chart so we’re all on the same page:


Your “fate” was sealed in your genetic code when you were conceived many, many years ago. Very few patients become a Norwood class 7 pattern, and even the balding patients who start as a class 5 may not go much further, even at the age of 100 or so. So for example, there’s no “point of no return” that says if you reach class 4 by this certain age, you’re guaranteed to be a class 7 later in life.

Tags: hairloss, hair loss, pattern, norwood

Snippet from the press release:

The United States Food and Drug Administration (FDA) has just cleared a new laser proven to regrow hair in women. The FDA ruling was based on a study performed by Dr. Grant Koher which showed that low level laser light, specifically with a precise wavelength, provides a medically significant treatment for women’s hair loss. Dr. Koher is the first physician to conduct a study resulting in 510k FDA clearance for a medical device for the treatment of female pattern baldness.

Dr. Koher conducted a three phased medical study to confirm that females with androgenetic alopecia, when exposed to scheduled applications of low level laser light, would have a reduction in hair loss and promotion in hair growth. This study was conducted over 18 months with 82 qualified participants. Each participant was scheduled to receive 52 treatments of 20 minute duration, over a period of 26 weeks. All study procedures included clinical protocol, clinical tracking, and clinical analysis approved by the Western Institutional Review Board (WIRB).

LaserRead the full PR — New Laser Cleared by Food and Drug Administration for the Treatment of Female Pattern Hair Loss

The study that is referenced was done by Dr. Koher in North Carolina, but I can’t find any information about it outside of this press release (not even on the doctor’s website). He apparently presented the study, “Effect of Laser Biostimulation In The Treatment of Female Pattern Hair Loss“, at last year’s ISHRS (International Society of Hair Restoration Surgery) meeting, but I can’t find any evidence that it was published anywhere.

Note that it is not FDA approved, but it is “cleared”. When the FDA clears something like this technology, it means that it is safe… not necessarily effective. For more information on 510(k) clearance, see here.

Tags: fda, female hair loss, hair loss, hairloss, lllt, laser, hair laser

Hi Doc. Right know I’m on Propecia for 3 years, but I’m noticing some thinning in the frontal area. Would it be effective to start to take 2 mg a day? Thank you.

Increasing the medication dosage will not necessarily slow down or help stop the hair loss process. Propecia is a good medication, but it is not the magic bullet. It does not completely stop hair loss and different people have different results with the medication.

As Propecia is a prescription medication, talk to your prescribing physician about changes in dosing. If he/she decides you should, that’s between you and your physician.

Tags: propecia, finasteride, hairloss, hair loss