In the News – Bald Women Are a Fashion Statement?

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

Snippet from the article:


Women who want to go bald as a fashion statement may find the process smoother than ever.

Some fashion experts believe female baldness is getting its most positive fashion exposure since singer Sinead O’Connor hit it big in 1990. Although Britney Spears went bald a few years back, it was viewed as a cry for help, not a fashion statement.

Part of the reason why baldness is in is because of the positive press given to Miss America finalist Kayla Martell, who suffers from “alopecia areata” — an autoimmune disease that led to complete hair loss when she was a child.

Read the full story at AOL News — More Women Taking a Shine to Going Bald

I agree that Miss Delaware Kayla Martell is a good role model for young women dealing with alopecia (we wrote briefly about her here), but I also found a rebuttal to the idea of hair loss as a fashion statement at Salon.com.

Tags: bald, hairloss, hair loss, female hair loss, miss delaware, kayla martell, alopecia

Why Do You Keep Saying Propecia Doesn’t Work in the Hairline?

/by William Rassman, M.D./2 /,

Propecia does work in the front!! Why you keep saying it doesn’t or is of little help that confuses everyone! If you mean that for example you are a NW3 and want to become a NW2 then its true Propecia won’t magically grow those hairs but in very rare cases im sure it has. But if your front is thinning it CAN STOP those hairs from continuing to thin and even thicken up some if its early.

I started mildly thinning in the front 2 years ago at age 21 1/2 and as soon as I started taking Propecia it stopped it completely! Today I look exactly like 2 years ago. I was hoping for some thickening up as well but that didnt happen though.

Also from my understanding dht causes hair loss in MPB so in that case why won’t Propecia help the front to stop hairline recession!?

PropeciaI’ve been consistent with my message about Propecia and the frontal hairline. Here’s a post from over four years ago, where I say the same thing — the medication doesn’t regrow at the hairline in most cases. Please understand that there is no cure for MPB. If you have the gene and it expresses itself, you will go through some degree of hair loss… and Propecia can drastically slow this process down.

Propecia works great on the top crown area as research shows, but it doesn’t work as well in the frontal hairline for most men. I don’t have a reason as to why this is the case, but I’ve speculated in the past.

On rare occasions we have seen reversal of frontal hair loss from Propecia, and I’ve even written about it before on this site. If you are one of the lucky patients that saw benefits in the frontal hairline, that’s great, but even as you noticed, it did not thicken the front. It’s obviously not impossible for the medication to work in the front, but the likelihood of seeing major regrowth in that area is slim.

Tags: propecia, finasteride, hairline, hair loss, hairloss

The Price of a FUE Megasession?

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

hi Dr. Rassman,
i just had a quick question for you and i would really appreciated if you could answer it. well dr. rassman i just wanted to know, i’m thinking of having a hair transplant and the only way would be with the FUE procedure. i’ve been saving money for that the past 4 years just for this, so was just wondering let say i get a mega session done with about 2,500 to 3,000 hairs how much would that cost??

and doesn’t matter when i get it even if its on a stand by procedure could you give me a rough estimate?? so i can keep on saving so what i have is not enough. once again thanks for your answer and keep up the great work!!

First, we generally use the term “grafts” which will contain 1, 2, 3, or 4 hairs. I have heard of some doctors doing 2500 to 3000 graft FUE procedures, but in my experience as the one who first published the FUE techniques in 2002 (which all doctors use), megasession FUE of that high a number may be dangerous in terms of the graft survivability and donor area scarring.

At New Hair Institute, we usually limit the FUE to 1500 maximum, but may flow over into a second day surgery in special cases where the donor density is good. The cost of FUE at NHI is now $8/graft with my associate Dr. Pak. We do not offer the FUE procedure in our standby program.

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

I Was Born with a Bald Spot

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

I was born with a bald spot on the side of my head. About the age of 14 I noticed that some hair in the middle of the bald spot grew and is long. Now at age 23 it’s still there and some strands of hair if you look closely here and there. What caused this and why did some hair grew back.

I don’t have a clue without seeing just what you are talking about. I’ve gotten similar questions in the past, and the only thing I could think might’ve been the cause is a birthmark or some kind of trauma. As to why some hair grew in… again, I’d have no clue. Not everything can be explained (and I’m even more limited because this is the Internet and I’ve never seen you).

There are some areas where there are typical inherited patterns and others that are not typical. For those that are typical, we might be able to tell you more about the cause.

Tags: hairloss, hair loss, bald spot, baby

No Growth Months After My Hair Transplant — Am I a Slow Responder?

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

I had a transplant on 3.16.10. The crown and the left and right sides frontal. Went in for a 4 month check up and nothing has started to come in. I had no post operative issues. I was very careful for the 2 weeks post op with the grafts. Doctor said I am a slow responder and to come back at 7 months. I been on the internet and I see all these patients with growth at 4 months and I wondering If my procedure failed. I am getting panicky.

Don’t panic! Results from a hair transplant will usually be seen from 3 months all the way up to 7 months on average. The speed at which it grows has nothing to do with success of the surgery. The waiting is the hardest part… but you’re going to have to find the patience. If at month 7 you still see nothing, have a chat with your surgeon about that. Right now though, you have no reason to be worried about your transplant’s success or failure.

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

Do Celebrities Have Access to Hair Loss Cures?

/by William Rassman, M.D./2 /

Dear Doc.

Once again a question about Matthew Mcconaughey’s hair. I know people have different views on his regrowth. If he’s using a hair piece or have had a transplant. He’s claiming to use Regenix. He must be paid by them. Because if Regenix can cure hair loss like that, the company would be one of the richest companies in the world. Must be fake. I’ve seen the pictures and there’s no doubt he have done something with his hair! He said it himself at Letterman; I was balding. So something has happened.

Do the rich and famous have a secret club of doctors who can make them grow hair again??!! I have never seen such regrowth at a “normal” person. Or do they just have the money to have endless hair transplants. What is your opinion on all the famous people getting regrowth as never seen before? Transplants? Hair piece or what?

I would easy pay 50.000$ to see such a regrowth!

Best regards

HollywoodNo matter how much money you have, you cannot have endless hair transplant surgeries, because your hair will run out and eventually develop scarring one way or the other. Take a look at Donald Trump, for example, as it is widely believed that he had the old hair plug type surgeries from many years past. If that’s the case, he’s likely run out of donor hair and is now stuck with his trademark comb-forward/swirl/whatever hair style.

I’ve performed surgery on many celebrities and some of the richest people in the world, but I cannot give them endless amount of hair. The secret club sounds like it could be great fun, but alas, it isn’t the case.

With respect to celebrities (particularly those in movies or on TV), they are probably rich enough to afford top-of-the-line wigs and makeup artists to look good in public… but up close and personal, right out of the shower in the privacy of their own home, we will never know. A wig can look fantastic, but they can also be high maintenance and expensive. Some do opt to go the surgical route, of course. For celebrities that rely on looking good in front of the camera though, money is no object.

As for actor Matthew McConaughey’s mysterious hair growth years ago, he claimed it was Regenix, but I find it hard to believe. If I had to guess, I’d say hair transplant or wig. It’s been a few years since we’ve written about him, but here are some past posts:

  1. Matthew McConaughey’s Hairline… Revealed?
  2. Matthew McConaughey’s Hair
  3. Matthew McConaughey and Hair Transplants
Tags: actor, celebrity, hollywood, mcconaughey, hairloss, hair loss, hair growth

Am I Looking at Hair Genetics the Wrong Way?

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

Hello doctors, thank you so much for taking the time to do this, I really appreciate it.

Let me start off saying that I am a male and 19 years old. My question is about family hair types and the balding gene. My father is bald (looks like NW6 or NW5V). When he was younger, he told me he had hair that was like mine in that it was wavy/not naturally straight. Now this is my question, does this mean I inherited his hair gene since my hair is like his? Does this also mean I will go bald because of this, or is this the wrong way to think about the genetics?

I read your other posts about a gene being inherited but not expressed, but I would really like to know in your professional opinion that if my hair is like my dad’s(in terms of style only, his colour was black but mine is brownish)did I get his gene for hair and hair loss?

Thank you so much.

I really have no clue as to how you will bald or when or if you will even bald at all. It’s just not an easy thing to predict based on what you’ve told me. Male pattern baldness is genetically inherited, but just because you and your father have similar hair characteristics, does not necessarily mean you will have the same hair loss pattern. The only real way to tell is by time. In time, you’ll know if you’re destined to follow your father’s balding pattern.

The next best thing is an examination by a qualified physician with a miniaturization study. With that, you should be able to get an idea of early thinning (if any) and slow it down with medication. Then with follow-up studies of your scalp, you’ll be able to see how the hair loss is progressing and the doctor should be able to make an educated guess as to where you’ll end up.

Tags: genetic, hair loss, hairloss, balding, father

Would My Regrowth Be Even Better If I Didn’t Take 2 Weeks Off Propecia Last Year?

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

Dr. Rassman,

Thank you for taking the time with this blog and the questions you have answered for me over the past year. I’m 30, I take Propecia and have been on it a year for crown thinning. I’ve gotten very good results but have a question that has been bugging me.

Last year, after a month on propecia, I read a lot of scare-stuff on the internet about it causing permanent impotence, premature aging, etc. I freaked out and started to think it was happening to me and stopped taking it for a week. It was generally a painful summer,there were days where I got very depressed and thought the baldness was getting worse and the propecia wasn’t working; altogether I skipped about two weeks worth of days before I started reading your blog and got a grip. I haven’t missed a dose for a year now (mid July ’09 to now).

What I want to know is: do you think the approximately two weeks of days I skipped last year have any impact on the results I have gotten now, that is, would my regrowth be even better if I had never missed those days? I am quite happy, the drug has reversed most of the apparent baldness in my crown area.

Thanks always for your time, have a great day

I don’t believe two weeks away from Propecia will have a deleterious or negative effect on your hair. Generally, I advise patients not to take a vacation from this drug, but in your case, what’s done is done. I don’t see the point in beating yourself up about whether your results are 95% of what they could’ve been. If you’re happy with the results thus far, that should be what counts.

Remember, you will still lose hair even if you take Propecia, but it should slow that process down. Stick with the medication as you’ve been doing and try not to let yourself get worked up about everything you read online.

Tags: propecia, finasteride, hairloss, hair loss

Scalp Massage After a Hair Transplant

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

Greetings Dr. Rassman! I just had a hair transplant about a month and a half ago. I had a full body massage today and I made the mistake of dozing off during the session. While I was asleep, the masseuse did massage my head, which probably involved some hair pulling and moderately heavy pressure on the scalp. When I woke up, there were 5 red spots on some of the areas where the transplant took place. There was minimal bleeding on each spot and I’m afraid that the grafts on those areas may have been damaged.

I was under the assumption that the grafts are permanent and would not get damaged after the first ten days following the procedure unless a really traumatic event occurs on the scalp. I’m worried that the grafts on those areas may have been damaged. Is there a chance that the grafts may have been possibly damaged on those areas where the red spots/minimal bleeding occured?

You really cannot kill the transplanted grafts from a massage after a month, and I would think it’s quite strange to have any kind of bleeding in the transplant area. Please follow up with your hair transplant doctor and have your scalp examined to see what’s going on.

Tags: scalp massage, massage, hair transplant, hairloss, hair loss

Biopsy Indicates MPB or Mature Hairline?

/by William Rassman, M.D./4 /, ,

I just got the results from a scalp biopsy. My doctor had some interesting conclusions. I was wondering if I could run them by you.

  1. She said that the results from the biopsy were able to differentiate between MPB and a maturing hairline. Is that possible? She said that the biopsy did indicate MPB. I find this confusing considering I have only lost hair at the corners of my hairline. I just assumed it was a mature hairline.
  2. She prescribed Propecia. She said that if you have very slow hair loss that Propecia will in fact completely arrest its development. From what I’ve read on this blog Propecia can only slow it down.
  3. She also said that Rogaine works on the hairline as well as the crown.

Your thoughts would be greatly appreciated.

In all my years, I really never relied on a biopsy to differentiate between male pattern baldness (MPB) and a maturing hairline. Actually, I do not know how one would see that on a biopsy and I would want to know exactly where the biopsy was placed. Plus, it would leave a scar if you were to biopsy the frontal hairline. Getting a biopsy to determine the cause of hair loss is generally performed to see if there is an inflammatory or a scarring type of balding from an autoimmune disease, for example. In my opinion, a maturing hairline or genetic male pattern baldness diagnosis does not require a biopsy.

There is nothing that completely stops hair loss. Propecia is a great medication, but it is not a cure for hair loss. It could slow the hair loss down to make it appear that its completely stopped, but there’s still minor loss going on.

Rogaine and Propecia have been tested and proven to work best on the crown area. Many patients use both Rogaine and Propecia for the frontal hairline and it does work for some men… but not as well as it does for the crown.

If you’re concerned that your doctor made the wrong diagnosis, feel free to get a second opinion. You don’t want to take medication if it is unnecessary… so if it turns out you only have a mature hairline, there would be no reason for you to take Propecia or use Rogaine.

Tags: biopsy, hair loss, hairloss, mpb, rogaine, propecia

My Doctor Recommends One Proscar Tablet a Week

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

I’m an 18-year old male showing the first stages of male pattern baldness. My doctor has prescribed me 1-tablet of Proscar 5mg, per week. Is this a common dosage? All the literature indicates that 1mg/day of Propecia is the correct dose. If I persist with one tablet of Proscar 5mg/week, is it enough to do the job, considering the short half-life of finasteride?

It seems you already know the answer. The dosage your doctor recommended is incorrect (or in all fairness maybe he forgot to give you or write out specific instructions).

For genetic male pattern balding (androgenic alopecia), the recommended standard dose for finasteride is 1mg a day (not 5mg a week). In the interest of saving money, many patients buy the generic finasteride in 5mg strength and cut the pill into four pieces, taking one piece each day. I realize this is taking finasteride 1.25mg a day, but it isn’t practical to cut a round pill into five equal pieces. Generic finasteride in 1mg strength is not yet legally available in the United States, but the 5mg is (patent laws). Taking 5mg finasteride once a week will not provide the same benefits as taking the proper daily dosage would, as you said, because of the half-life of the drug.

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

Wearing Lace Wigs with Female Hair Loss

/by William Rassman, M.D./2 /,

What do you think of wearing hair systems or lace wigs..for people that are losing their hair?

I saw two companies that I am interested in www.kaisdreamhair.com and www.divalacewigs.com. Do you think this is a good route to go..or should I purchase products and try to let my hair grow naturally. I have did my research for a year and these are supposed to be best sites or should I save my money and grow my own hair? I am just not happy with my hair and most hairloss products dont seem to work. Any help would be appreciated.

I really cannot comment on those websites, because I am not an expert at wigs or hair systems. I do know some are great and some patients love them. You must factor in the cost, maintenance, replacement, and possible further hair loss as a direct result of using the hair systems/wigs (from the pulling, called traction alopecia).

I am certainly not against the idea of wigs, but if you’ve researched for a year already you’re probably in a better position than I am to make a recommendation between the two sites.

Tags: lace wig, hairloss, hair loss, female hair loss, traction alopecia, wigs

How Much Are Sideburn Transplants?

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

The problem that I have is the inability to grow sideburns due to sparcity of hair in that region. I have seen the results on your website and I am interested in obtaining information on procedures, costs, etc. If you could provide me with any details on how to initiate the process, I would greatly appreciate it. Thank You.

You’ll need to start with a consultation. You can send us photos by email along with your contact info and we can arrange for a one-on-one phone consultation with a physician. Or you can call the office at 800-NEW-HAIR (or 310-553-9113) to setup the phone consult. Photos are always helpful.

As for costs, that would depend on the number of grafts (hairs) you receive or require. Our minimum fee is $3000, and that usually ends up to be the cost of the sideburn transplants since it often comes under our minimum charge.

Tags: sideburn, hair transplant, sideburns, hairloss, hair loss

Rogaine Worked Great but I Stopped Due to Loss of Libido

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

Hey thanks for your time. I had been using rogaine 5% solution for about 2 years. I only used it once a day.. but I used a lot more than the recommended dosage(all over my head). I have had a lot of regrowth even on the hair line. I quit using rogaine about a month ago due to face bloating and loss of libido.

I started taking procerin about a week after I quit using rogaine and I started using nioxin about 2 weeks ago. I am still experience a lot of regrowth. I even buzzed my hair the other day and I still see slow improvement like always. Do you think it is my new regimen? or is it still the rogaine that is causing my hair to still improve?

People attribute all sorts of problems to specific medications, but I doubt the Rogaine (minoxidil) caused the libido effects. You used the medication for 2 years before you saw any issues, so it is strange that you’d suddenly develop a loss of libido.

I would’ve tried using less of the Rogaine (or in your case, just using the recommended dosage) before stopping it completely, but that was your call to make. I don’t know what to attribute your continued hair improvement to, but if you only stopped Rogaine a month ago you’ll likely see the benefits disappear over the next few months. Those new products you’re using won’t maintain what Rogaine regrew, since they don’t contain minoxidil.

Procerin’s main ingredient is saw palmetto which is a popular yet unproven hair loss treatment, but Nioxin is definitely not something I’d recommend if you’re serious about treating your hair loss.

Tags: rogaine, minoxidil, procerin, saw palmetto, hairloss, hair loss, nioxin, shampoo

Shampoo for Thinning Hair?

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

What is the best shampoo for thinning hair ?

I saw this shampoo called Nano on the internet which is made by a doctor ,what do you think about it ? Thank you for your time !

Just because its made or promoted by a doctor doesn’t mean it’s going to work.

There are no shampoos that are proven to regrow hair, but some suggest Nizoral (ketoconazole) works for some men. I’m not recommending everyone run out and by Nizoral to treat hair loss, and to be honest, I’m skeptical that it even works. There aren’t proper studies that show ketoconazole is good for hair regrowth, though it is a good anti-fungal shampoo. With that said, I suppose it’s worth a shot if you’re only considering using shampoo to treat your hair loss (which is a bad idea).

The best way to go about this is to talk to a doctor about Propecia, which is a proven treatment for hair loss and is just one pill daily.

Tags: shampoo, hairloss, hair loss, nizoral, ketoconazole