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We’re off for a few days for the Thanksgiving holiday. We’ll be back with new posts on Monday!
In the meantime, you can:
Doc, I appreciate this site so very much and all you’ve done to help us guys going bald.
Even though my results from a hair transplant 2 years ago look fine to me, I’m still suspicious that I got all 2300 grafts so I can totally understand why people are skeptical about their doctors. I wish I found out about you before I had my surgery.
Anyways I just wanted to drop you a line to say thanks
Thank you for your encouraging words. I also wish you had found out about us first. The purpose of this site isn’t to direct people to NHI for surgery (though if that happens, I won’t complain), but rather, to inform and assist the millions of people out there that are losing hair.
Some of the more common complaints I’ve received via email lately from folks regarding their surgery have been:
I get comments from people questioning their doctors and looking to me for help, but I wasn’t in the room when your surgery took place and there’s only so much I can do via email without seeing you. Remember, don’t be afraid to question your doctor if you have any concerns. Some of these patients ultimately come in to see me, but they somehow never got our message on how to choose a good doctor. I realize any surgery can be a nerve-wracking experience, particularly an elective cosmetic procedure, but you should always do plenty of research and meet with the doctor before the surgery to feel some level of comfort and establish trust.
So for those of you thinking about hair transplantation, please check out this featured 3-part article about selecting a hair transplant doctor. It includes a checklist of sorts, along with a bunch of links for further reading. We’ve written nearly 9000 posts at this point, and that article is one of my favorites.
Hi again, Dr. Rassman. The blog keeps getting more interesting, congratulations! My question is: in theory if the ACell procedure works, would patients on Propecia need to keep taking it or there would be no need for the drug anymore? Thanks!
You will likely need Propecia (finasteride) to maintain any benefits, whether that includes regrowth or just slowing the loss down. I have a feeling I’m going to be writing this quite a bit over the next few months, but ACell is not a hair loss cure.
We are all optimistic, but even in the best case scenario it is not a complete answer to hair loss and you will always likely need a medication (Propecia) adjunct.
Last week I asked readers to share their stories about body hair growth (increased or decreased) while taking Propecia…
Hi Dr. Rassman,
About the body hair thing..
Background on me….I am a 25 year old male, started finasteride about a year ago. Thanks to YOU and YOUR blog I decided to walk into Dr Bernstein’s office one day and do something about my early hair loss. Without your blog I would have gone into further denial, waiting until I was a NW3 or NW4 to finally accept the fact I had MPB. Thanks to the information you provide, I started early. Dr. Bernstein classified me as a NW2.5 and prescribed 1/3 of a 5mg pill daily (normally he said he gives 1/4 but I am a pretty big guy). Now, a year later, I have not missed a dose my hair definitely has not gotten any worse. I think it has gotten slightly better actually. Either way, I am content with what I have. Would I like to have hair like Reagan or Clinton? Of course. However, I am pretty darn happy that I have what I have and started early. I have hair like a Bush or Carter and thats good enough for me! So thank YOU Dr Rassman for being so informative and helpful.
About the body hair. I have always had a lot of body hair – arms, legs, thighs, chest, back and shoulders. This is hair I keep groomed. The finasteride has DEFINITELY slowed the body hair growth. It is definitely not in my imagination, I am positive. I have always been conscious of my back hair and kept it shaven. I also trim my chest, armpit, and pubic hair. However, I now do it every 2 months instead of every 2 weeks. So it has been a good thing for me.
If you are still reading this you should also note that Dr Bernstein suggested Rogaine along with the finasteride. I decided to do a year of finasteride BY ITSELF first. Now a year later, things are looking fine with finasteride alone. I made this decision based on information you have provided about the two drugs in the past. So thank you again for the knowledge you provide. If I had used the Rogaine, I’d now be wondering which drug was doing the work. I might try it some day, but for now finasteride is doing the trick.
I should also note that other side effects are not present :)
Thank you again
This is not an atypical story. Most men who do their research and keep a level head about the hair loss problem will tackle it with logic. The logical steps are clearly defined in this and other good websites. I’m glad it has worked out for you thus far and thanks for sharing your story.
CNN asked Dr. Rawnsley, a hair transplant surgeon and clinical associate professor of facial and plastic surgery at UCLA, about hair loss from heavy workouts.
Snippet from the article:
So it is very unlikely that your weight lifting program is contributing to hair loss. More likely, your hair has been thinning over time and you are beginning to notice as a critical level has been reached, usually about 50 percent, according to Rawnsley.
Read the full blog at CNN.com — Can heavy weight exercise cause hair loss?
So while I’ve said the same thing before (that I doubt the two are linked), it’s always nice to have confirmation from another source to show those readers that tend to question my opinions about stuff like this.
Hey Doctor,
I’d like to start off by thanking you for such a wonderful blog you have set up. I am 18 years old and have been on propecia for about 6 months or so and I am still able to pluck hairs from the top of my head. This worries me. Does this mean I am not responding to propecia well or further time is needed for propecia to to take effect? Do new hairs grown or maintained by propecia remain weakly intact to the scalp? As of now, I have not noticed any significant changes to my thinning hair except the hair in the crown appears just a little bit thicket (I believe I have a diffuse thinning pattern on top of my head), then again I do not have the proper equipment to verify it’s working.
Is there a place in Vancouver, BC that you know of that can help me develop a “Master Plan” and contains a densometer to confirm any results?
Thanks
Propecia isn’t going to cement every hair into your scalp, and by that I mean if you pull on your hair, you will still see some come out. That is normal. I don’t know if you are responding to Propecia, but if you do have regrowth I’d expect they wouldn’t be weak after some time. Pulling or plucking your hair isn’t going to help with your hair loss situation. If you keep on pulling it, you can develop traction alopecia which will clearly add to your problem.
Your prescribing doctor should be able to help you figure out if you’re seeing any benefits from Propecia. If you really want to know if you are gaining or losing the hair loss battle, read up on a device called Haircheck. If you grow your hair out to 1.5 inches in length, a doctor with this device can measure the bulk of the hair in the crown, compare it to the donor area, and then repeat it in a year to see the impact of the drug. I’ve advocated the microscopic miniaturization mapping for years, and this tool takes it one step further by providing actual numbers.
I don’t have any personal recommendations in BC for you. Check the physician search at ISHRS.org to see if there’s a doctor in your area. Call the doctor and find out if they offer Haircheck or at the very least, video microscopic miniaturization mapping.
Does drinking diet coke cause more thinning? one glass a day? I am a 41yr old woman, with thinning scalp/crown especially, and thinning on sides of head.
My diet is very nutritious, but I am wondering exactly HOW diligent I have to be with food…..or will my hair progressively thin by itself….. if you know what I mean….
should I be worrying about a coke, or some chocolate at night etc etc.thank you
Many diet or light sodas (like Diet Coke) contain aspartame, which is an artificial sweetener used as a sugar substitute. As far as I know, it does not cause hair loss. There are natural health “experts” that will claim that aspartame and even chocolate are toxic to hair, but I’ve not seen any actual proof of such.
Enjoy life — eat your chocolate and drink your Diet Coke (in moderation of course), as I see no reason why either would cause hair loss. Female hair loss can be caused by a variety of issues, some of which are listed here.
Hey dr, let me start by saying that this site has given me a lot of information about hairloss. I give it an A+.
My question is – I have been on finasteride for about 5 months and a half and I am thickening on the very top of my head, even slightly at the hairline. I have been checking the crown, but it seems to be taking longer to show results. Is this normal? Will my crown fill in eventually as treatment goes on?
Thank you for the favorable grade!
Everyone responds differently to drug treatments. Finasteride (Propecia) works best for the top/crown area, so if you’re seeing good results elsewhere I’d hope you’d eventually see positive results in the crown. I would give it 6 to 12 months before you assess its efficacy. It takes up to one full year before you can judge what it is or is not doing.
I was born with an irregular hairline. Toward the center, it takes a sharp upward turn, almost like a large, reversed widows peak. I think it is due to a large bump on the back of my head from a cesarean birth. My hair is healthy, but it looks funny unless it is long enough to cover the spot. Is there a way to correct this?
Without examining you, I really can’t tell. We have corrected many hairlines and transplanted into scars. If you are in the area, you can always schedule a consultation. Our main office is located in Los Angeles.
A hair transplant may be an option, but you won’t really know what can be done until you are examined and seen by a doctor. Otherwise, it’s anybody’s guess.
Hi,
My doctor prescribed the use of topical propecia once a day, and 5% minoxidil that has retin-A in it (to be used twice a week). I’ve been on this treatment for about 3.5 weeks. In the last week my hair has been falling out in droves…pretty freaky. Anyways, is this normal or should I stop this regiment? I’ve also been directed to take Omega-3, biotin, follic acid, and iron. Anyways, I’ve read that minoxidil and increase hair shedding, but at the same time, being that I’m only directed to use it twice a week, should I be experiencing this much increased hair loss?
By the way, I’m a 26 year old Latina female, if that’s of any help.
Thanks
If there’s a topical finasteride (Propecia), I’d assume it was the doctor’s own formulation. Propecia is an oral pill made by Merck, and they don’t make a topical. Plus, there’s little evidence that topical finasteride works for treating hair loss in men, let alone women. Male hair loss is different from female hair loss (see here).
Finasteride is not recommended or FDA approved to treat hair loss in women, and it can cause serious health risks for those that are pregnant or can become pregnant.
Any hair loss you’re seeing could be from temporary shedding from the minoxidil, but I have no way to know for sure. I’d follow up with your doctor (call him/her to ask about this if you can’t make an appointment).
I have a non-hair transplant head scars and I was wondering if Acell would help this.
I realize the excitement level is pretty high for ACell right now, but it is not an answer to everything. It generated lots of interest and we are starting our clinical trials, but we aren’t looking at it for use in scar reduction at this time.
In your particular case, I do not even know where there scar is, how deep, wide, or even the shape. It may be that just a scar reduction surgery or a hair transplant may help. I do not know. Remember folks, at this stage ACell is being used for a study and there is no guarantee for success.
Hi Dr,
I took minoxidil topical and that too I have used it for 2 days. One sudden day I had pain in the heart and my heart beats 116 bpm when I checked.
I am wondering how long will it take the body to completely wash off all the topical that it absorbed?
Please go see your physician! Irregular or increased heart rate can be life threatening and although it is a known side effect of minoxidil, it might not be related (I don’t know your medical history). If you washed the medication off then you should be fine after one day.
I must repeat though… your heart issues may be unrelated to the medication and you should be evaluated by a physician.
Hello doctor. I wanted to know if you have to lose all your hair first in a certain area before u can get a transplant or can you transplant hairs in an area that has vellus or thin hairs still there, but wouldn’t there be shock loss?
Take care
There could be shock loss if you’re not taking finasteride first, but that is the risk one takes when having a hair transplant in a thinning area. Transplanting in a completely bald area obviously won’t have the same risk factors, because there’s no existing hair to succumb to shock loss.
i had a hair transplant done just a short while ago. I traveled a long way to have this doctor do it due to his high reputation as one of the best. My initial consultation with him was not even 3 minutes & he did no use any device that shows hair density. i had already been committed due to his requirement of a non refundable deposit in advance.
On the day of surgery he spent not even 15 minutes to do incision of 2400 FU Grafts. The only other time he came back was late in the afternoon to give me another 400 FU grafts incision. what really concerns me is that how he could not even once come back to check what is being done or how things are going the entire day. In the initial consultation he also told that i have extremely thin hair but i ended up getting more than 2800 FU Grafts, a lot more than what i was supposed to get. Is there anything to be concerned about here other than obviously so little caring or is this typical for any doctor to only do incisions & let his assistants do all the rest w/o any checking at all?
i wish i would have known about you before choosing this doctor & all i would have traveled would have been less than a very short distance. i was also told that i can do another 2000 grafts next year but i doubt if i will go back to someone who ended up spending not even a total of 25 minutes altogether for everything from consultation & doing a total of 2800 grafts.
Another concern even though i want to believe that i really got the number of grafts that i was told, but is there any way to determine or guess by an expert like you having trained eyes that i really got the number of FU or anything close to that? It will be just for my own curiosity & not anything else.
Thanks in advance for your reply.
I feel bad for your experience. I try to advocate for the readers and patients, but ultimately the burden is upon you to choose the doctor you feel comfortable with. It might be a little late, but read this post on Selecting a Hair Transplant Doctor.
During the procedure technicians place the grafts, but the doctor should have been in the operating room to make the recipient sites and remove the strip from the donor area (if that is the technique used). If he did not do this, then he broke the law. There are some doctors who routinely break the law with regard to allowing a non-physician to create recipient sites, but it sounds like he was at least there for creating the sites.
At this point, all you can hope for is good results. It is very unfortunate that you don’t trust your doctor enough to believe you got the number of grafts you paid for, but we have offered and performed many second opinions for patients that need counts done. What I mean is, I have consulted with patients such as yourself and attempted to count every single graft placed, but that would likely be too drastic at this point.
At the least, you can start out by asking the clinic for your complete operation sheet, which should have all the hair and graft counts written down. Be aware that not all doctors or medical groups may have this or provide it for you, but also know it is also your right to obtain your medical records (by law). Good luck.
I have been taking one mg. of Xanax with my first dose of Xyrem, to put me to sleep since May or June of 2009. I have fibromyalgia due to severe insomnia, and need these drugs to sleep. I have been experiencing hair loss since June of 2009. I started on Xyrem in March or April of 2009. My doctor is now in the process of weaning me off Xyrem, which he routinely does with his patients once they have been on it for a period of time. The hair loss continues unabated, so Xyrem is not the culprit. Could Xanax be?
Probably not. While many drugs do have hair loss as associated side effects, Xanax (alprazolam) isn’t one of them. It’s possible in rare cases, I suppose, but generally speaking, medications are usually one of the last things to consider as a cause for your hair loss.
As I mentioned before in an earlier blog post, “We hear from our patients who just got started on Xanax that they lose hair, but it is hard to prove that their hair loss is really associated with Xanax or if it has to do with anxiety itself.”