Filling in FUE Scars with Body Hair?

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

Hello Doctors!

I have a question about FUE and scarring. It seems that you use the same instruments to make both the donor excision as well as the recipient sites. Yet the recipient sites show no scarring. Where the small donor area punch marks are simply left open (and a scar forms from the skin healing over the small hole) I am guessing the fatty tissue keeps any perceptable marks from forming on the transplanted ares.

So, if you wanted to take it a step further, couldn’t you perform a body hair transplant on someone to fill in the FUE scars? Even if the body hair is not as cosmetically effective wouldn’t the “fatty tissue” from the BHT leave the donor area with no small white holes? Is my logic twisted?

A crazy hair question for the only people capable of answering it. Thanks for your time!

The recipient sites are not made with punches like those used for follicular unit extraction (FUE). They’re two different tools. We generally create slits for recipient sites with needles or tiny scalpel blades.

The white dot scar is the result of skin being removed along with the graft in the FUE technique, and it really would not be reasonable to fill these tiny holes with body hair to eliminate all scalp scarring. The ‘bulk’ of a body hair may be finer than the ‘bulk’ of your head hair. Body hair usually grows in single-hair follicular units while scalp hair usually has more than one hair in a follicular unit, making for even less ‘total bulk’ of the transplanted grafts. That is why it is important to be assessed for these many variables and their meaning to you.

Tags: follicular unit extraction, fue, scarring, hair transplant

Zinc Shampoo for Treating Hair Loss?

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

What I believe to be a reputable private practice hair transplant specialist here in San Francisco advised that I exclusively use a 2% zinc shampoo, a recommendation he apparently makes routinely for hair loss.

I however have read conflicting information about the value of topical zinc for men experiencing hair loss, and even that it may accelerate the process. Do you have any thoughts on this issue?

BTW I have not yet undergone any transplant procedure.

Thanks, and with regards

Zinc will not help with treating genetic hair loss. There may be such things as zinc deficiency that can cause hair loss, but that is diet related (which has nothing to do with zinc shampoo). Your reputable private practitioner seems like a good entrepreneur, as well. Sometimes I think about going into the shampoo business…

There was a small study published 7 years ago that said there was a modest improvement in hair growth in those that used a 1% pyrithione zinc shampoo, but it also said that the benefits were only apparent to the investigator and not the patients using the product. Some marketers will use that weak study as a sales point for zinc shampoo.

Tags: zinc, shampoo, hairloss, hair loss

Can Rogaine Retain My Current Hair?

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

Hi Dr. Rassman,

I understand that Minoxidil is generally ineffective at regrowing hair in the frontal and temple regions of the scalp. However, since I am in the early stages of male pattern baldness, I would like to know how effective Rogaine is for maintaining my current hair count.

Is it true that rogaine stops working after a certain number of years?

Thank you for your time.

Rogaine is not a cure. It is not that it stops working, but it is more of the fact it is not a cure. Everyone is different and responds differently to Rogaine, so there is no way to tell how long it will retain your hair or even if it will retain your hair. Excellent response to Rogaine generally is seen in about 15% of the population.

Tags: rogaine, minoxidil, hairloss, hair loss

Web of Deception

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

The following post is by UK-based physician Dr. Bessam Farjo:


Written by:
Dr Bessam Farjo, United Kingdom
Dr Bessam Farjo
United Kingdom

The internet is a wealth of knowledge where literally anyone can have their say. Whether it’s a blog, tweet, or status update, men and women have the ability to get their views across to a global audience. This is a fantastic way to find out important information on a wide variety of subjects; however a lack of regulation means that often the information is widely inaccurate.

The other day, for example, I followed a tweet titled “Justifying the Cost of Modern Hair Implant Techniques“. The link led me to a blog discussing hair loss in women which naturally, bearing in mind the subject matter, I was interested to read.

Sadly, my interest soon changed to infuriation – the author was either severely uneducated on the subject or blatantly and significantly economical with the truth; either way I was unsettled by that fact that this misinformation was visible to potentially millions of people.

The author referring to the strip method of donor harvesting stated that: “A number of hair clinics will promote older, less good hair implant methods in order to keep costs down“. Nothing about the aforementioned sentence is correct; not even the grammar, nevermind the scientific information written especially since implying that FUE is the donor harvest method of choice in women.

This reiterated to me how important it is for potential patients to seek advice from trusted authorities on the subject, as it is all too easy for advertisers and novices to pose as educators on the net.

Another promotion from a relatively new provider of one technique only, claimed they are THE LEADING clinic in Europe, that they produce no scars, actually pioneered the procedure and pretty much saved the British public from the dire services of the existing providers (including ourselves!)

For the above reasons, especially when considering surgery, it is crucial that men and women acquire knowledge from reputable sources, such as the Institute of Trichologists, International Society of Hair Restoration Surgery, British Association of Hair Restoration Surgeons, Hair Transplant Network and International Alliance of Hair Restoration Surgery. I would also suggest looking for scientific research with proven reproducible clinical data, as well as case studies when considering any kind of medical or surgical treatment.

So, even with cutting edge technology, the old age saying is true; be it on paper or online, don’t believe everything you read!

—

Learn more about the author of this article, Dr. Bessam Farjo, on his BaldingBlog profile or at his website.

Tags: scams, hair loss, hairloss, hair transplant, surgery, farjo

Does Cut Proscar Have a Shorter Half-Life than Propecia?

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

Is it possible that cut pills (generic Proscar in fourths) have a shorter half life than Propecia with its protective coating still intact?

ProscarPropecia and Proscar aren’t time released medications, so the protective coating wouldn’t change the half-life of the medication. A big reason for the coating is to protect pregnant women, as women that handle a cut finasteride pill run the risk of absorbing the active ingredient through the skin. The coating also helps make the pill easier to swallow and helps to extend the shelf-life by protecting it from the environment to some degree.

I know you realize the following information, but just in case some readers out there aren’t aware — some people choose to cut a Proscar (5mg finasteride) pill to make it equal to Propecia (1mg finasteride). Different generic pharmaceutical makers may make different shapes and sizes of the pill, but generally it’s easier to cut the Proscar into 4 equal pieces (making the dose 1.25mg). Why do people cut the Proscar? Well, Proscar (and the generic variant) is much cheaper than Propecia, which has no generic legally available in the US due to patent laws.

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

I Burned My Daughter’s Scalp and Years Later the Hair Grows Slowly

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

I burned a very small area of my daughter’s scalp while straigtening her hair with a hot comb around 2 years ago. Ever since then this area of her hair grows very very slowly in comparison to the rest of her hair. Its only grown to around 1 to 4 inches while the rest of her hair is flourishing. Also, I use chamical straightners in her hair and this patch tends not to straighten at all. If there is a re-growth in this area when its being straightened, within days the regrowth breaks off and the hair is back down to 1 – 2 inches long.

Could you tell me please whether it is likely that this area is permanently damaged or what we can do to solve the problem.

Many thanks

It sounds like you accidentally created permanent damage to your daughter’s hair. Without an examination I couldn’t get into detail about regrowth possibilities… but generally speaking, if after multiple years the hair is still barely growing in the burned area, I would have to assume the damage is permanent.

If you haven’t taken your daughter to a dermatologist for an examination of her scalp, you should consider doing so.

Tags: scalp burn, chemical burn, hot comb, hairloss, hair loss, chemical straightener, chemical damage

Small Hairs are Now Growing in My Facial Hair Bald Spot!

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

So for about 4 months I’ve had to bald spot on lower right cheek. the bald spots were very smooth but now I fill little and blond hairs sprouting up. What caused this? Is it stress or alopecia or cancer? What can I do ?

Doubtful that it is cancer. It could be stress induced or it could be alopecia areata, but it’s impossible to say without an exam. I’d really doubt it is life-threatening or anything to be concerned about in regards to your overall health. See a dermatologist if you’re looking for a more direct reason as to why spots appeared in your beard.

Tags: hairloss, hair loss, alopecia areata, cancer, facial hair

Dutasteride 0.5mg (Avodart) Phase III Study Results

/by William Rassman, M.D./5 /

AvodartA recently published study in the Journal of the American Academy of Dermatology shows that in a 6 month limited span, 0.5mg dutasteride (commonly known as Avodart) was shown to be effective at treating hair loss in men aged 18-49 years. Now we have known for some time that this drug is effective, but I’m still unclear about side effect risks. This is a stronger medication than finasteride and there is no real statement by the FDA on the issue of fertility with dutasteride that has been reported by some medical authorities. I have prescribed dutasteride at this point on a very limited basis with the caveat that the sterility factor is unknown.

It is worth pointing out that dutasteride’s half life is measured in weeks, while finasteride’s half life is measured in hours (finasteride currently being the only FDA approved DHT blocker for treating hair loss). In other words, if you do experience side effects from dutasteride they’ll take much, much longer to clear.

I must caution that dutasteride isn’t FDA approved to treat hair loss at this time, but these results appear to be a positive step in the right direction. Also, this study does not compare dutasteride to finasteride, but rather dutasteride to placebo… so that’s still a big question mark.

Read the study abstract — Efficacy, safety, and tolerability of dutasteride 0.5 mg once daily in male patients with male pattern hair loss: a randomized, double-blind, placebo-controlled, phase III study.

Photos from the study can be found at Regrowth.com

Tags: avodart, dutasteride, hairloss, hair loss, propecia, finasteride, glaxosmithkline

After 10 Years, Finasteride Seems to Have Stopped Working!

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

I have been using propecia, now generic finesteride, for at least 10 years. Recently, I noticed that I have a noticeable bald spot extending from my front to my back of the head. I am 58 years old. Is it true that in a lot of cases the treatment simply stops working as we get older?

It’s not that finasteride stops working altogether, but rather, your body is likely starting to win the war against the drug. I’ve seen this happen in some patients that have taken the medication for many years, though I also have patients that haven taken it for a decade without any problems.

I’d imagine that if you quit the medication completely you’d see further loss. Besides, at 58 years old the finasteride is good for prostate health. You should be under a doctor’s care and discuss your problem with him/her. Perhaps you should talk to your prescribing doctor about increasing the dose to 2mg to see if that might help.

I’ve written about this before here and here, so you’re not alone.

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

Reader’s Theory About Gynecomastia and Finasteride

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

Doc, my hair is getting a little thin and I want to start on propecia and rogaine. Unfortunately, I have heard some bad things about propecia…In the sense that if used for long periods of time it can cause ED problems and the possibly of not being able to have children? I was just wondering in your experience what would be my chances of not being able to have kids or having ED problems?

Also, it seems that all of the problems that stem from propecia is do to estrogen. Testosterone converts to DHT, and if propecia stops this then there is more testosterone in the body which than converts to estrogen…

This would be the side effects I am assuming of thinning body hair(women are not as hairy), gynocomastia, and ed problems. Estrogen is what makes women more feminine, so in turn it starts giving our male body feminine characteristics.

I have talked to a few Derms and they seem to not even know what gynocomastia is, or if they do they don’t seem to understand that it is due to the estrogen increase. Do most doctors really prescribe this stuff not even knowing about the drug? Which brings me to the question, wouldn’t an anti-estrogen cause a stop to all these estrogen related side effects?

I think that you are perhaps overreacting. Lots of things are said about Propecia (finasteride 1mg), and if someone took the time to read the actual scientific studies done they’d have a clearer picture of what is and what isn’t likely. Erectile dysfunction is a possibility in 1-2% of men that take the medication. Fertility issues are also rare, and I’ve written about this before here.

We really do not know why some men get gynecomastia and others don’t. Its appearance is in 1 in 300-500 men. As for taking anti-estrogens to counteract possible gynecomastia, I honestly don’t know if that would work, but I do know that most of those medications list hair loss as a possible side effect.

Tags: anti-estrogen, testosterone, hairloss, hair loss, finasteride, propecia, gynecomastia

Normal Moustache Hair Loss?

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

How many hairs are lost each day from an average moustache? Is moustache hair more or less likely to fall out than hair on the head?

I have been working in the food industry for more than 20 years. Many manufacturers are beginning to require covering moustaches while working with food.

Best regards

The best I can tell you is that the overall moustache hair cycle runs between 2-6 months. The telogen (resting) phase follows the fall out of the moustache hair lasts up to 2 months. All hair is likely to fall out as it cycles.

Tags: moustache, mustache, hairloss, hair loss, facial hair

Styling a Partially Transplanted Hairline as Hair Loss Progresses

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

I have a styling question for you dr. rassman.

I’m thinking of transplanting some hair in the side on the front of my scalp as it is quite thin on the sides. I’m worried if my center forelock hair becomes thin one day and the sides appear thicker, it will look awkward. If such a case were to happen do you think it is plausible to individually cut some of the transplanted side hairs very short to thin it out in such a way it blends with the center? I know its a strange styling question, but let me know your thoughts if this has been done before?

thanks

Hair styleI’m just trying to figure out if I understand what you want to do and what you’re asking me. Perhaps your terminology is off. I have to assume that when you say you want hair transplanted to your “sides” you actually mean the corners of the hairline… not the sides of your head.

As for styling, I’m sure something can be done… but you could also have a second transplant procedure to strengthen the forelock area again and complete the hairline. I think most patients would opt to having another transplant to the bald area at the hairline center (assuming that is how the loss progresses), rather than just giving up after transplanting the corners. If you want to find out the options for how you can cut your hair, you should talk to a barber or hairdresser.

I’d hope that any doctor that performed such a surgery on the corners of your hairline would inform you of the possibility that your hair loss could progress, and put you on Propecia to halt that.

Tags: hair transplant, hairloss, hair loss, styling

Could I Have Hair Loss from Two Different Factors at the Same Time?

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

I am a male in my late 20’s, I’ve had hair loss for about 3 years. Went to a DR in the city in March and he prescribed Finasteride and Minoxidil. After about a month, I started seeing GREAT results, hair became stronger and stopped falling out and began growing again! Then 2 or 3 weeks ago, I started shedding again like crazy and it has not stopped and I beleive my hair is getting worse again. I was on Iron supplements since before I started with the other treatments and I ran out right around the same time that my hair started falling out again and I did’nt bother buying anymore. I did not put 2+2 together until 2 days ago when I started racking my brain trying to figure out what had changed.

My question is If it is possible that my hair loss is caused by two different factors (DHT, as well as iron deficiency) and they need to be treated together in order to be effective? The treatments seemed to be working fine while I was taking the Iron and as soon as I stopped, the hair loss started again. Any advice would be a great help. Thank You!

Iron supplementsIt is possible to have more than one type of hair loss — for example, a balding person with genetic hair loss can also have alopecia areata.

Some people report that finasteride and minoxidil have associated temporary hair loss seen in the first few months after starting them, likely reflecting changes in hair cycling brought on by these medications. This shedding problem usually disappears after a few months.

If you were iron deficient and corrected it by taking supplements, it would not necessarily produce hair loss when you stopped taking those supplements.

Tags: hairloss, hair loss, iron deficiency, dht, finasteride, minoxidil, sideropenia, hypoferremia, anemia

Could Putting On / Taking Off Hat Over and Over Cause Hair Loss?

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

Hello doctor. Thank you so much for taking the time to loo at and answer this question.

I know a question like this has been answered many times before, but I have a slight variation in the question concerning baseball caps and hair loss. My job (part-time) requires me to wear a hat and I have to wear it for about 5-8 hours straight each shift. I keep it a little bit loose so it doesn’t cause a cut off in circulation, but my question is, sometimes I adjust my hat, for example take it off and put it back on or shift it around a little bit.

I’ve read on other sites that putting your hat on/taking it off if you do it often/a few times can cause hairs to pull out/fall out. I do not know if there is any truth to these sources, so I am asking a professional. Is there ANY risk of thinning by wearing a baseball cap for long periods of time 3-4 times a week?

Also, how about hair nets, do they cause any damage/thinning to your hair?

Thank you so much and I hope this question doesn’t cause any irritation as it is a common one.

CapIf the hat is not pulling on your hair, taking it off and putting it on over and over again should not cause any impact. Same goes for hair nets.

Basically, if something is tugging on your hair for extended periods of time, that is when you run the risk of developing traction alopecia, which is commonly seen in women with tight braids.

Tags: hair net, hairloss, hair loss, hat, cap

My Hair on Top is Thick, But My Sides Are Thinning Quickly!

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

First of all i would like to take this time to say that this is the most helpful internet site about regarding hairloss.

My question is that i have began receding and thinning badly on the sides of my hair. From the side burn to just above my ear. My hair on top is thick and i am slightly receding at the corners, but at the side of my hair it is getting extremely worse quickly. why is this? what options do i have?

This is a good situation for mapping out your miniaturization. This will put numbers to what you are observing. A good doctor will know how to do this for you.

If you are thinning only on the sides, something that I have rarely seen, it’s often associated with diffuse unpatterned alopecia (DUPA).

Tags: dupa, hairloss, hair loss, thinning