Visual Differences Between Balding and Maturing Hairlines

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

Is there any difference in visual or physical characteristics between a balding hairline and a maturing one? Does one do something different than the other? Or will early balding look exactly like hairline maturation and vice versa?

Most men who ask this question are in their teens and twenties who see slight recession of their frontal hairline. Yes, it may be a sign of early balding, but each and every patient is different and only time will tell. Sorry. The difference between early hairline thinning and hairline maturing can be difficult to spot just by looking. Read through this older post about juvenile and mature hairlines (with photos), as it could provide some help.

You can also follow up with your doctor for miniaturization study and/of hair bulk measurement if he/she has the HairCheck tool available.

Tags: hairline, hair loss, hairloss, balding, mature hairline

Seeing Hair Loss After Using Nizoral

/by William Rassman, M.D./3 /,

Hi Dr.Rassman, I have a question about Nizoral and hair shedding. Whenever I use Nizoral for my saborhea dermatitis the next day i have alot more hairs fall out then usual. Is this normal or can it cause permanent damage?

Some people use Nizoral (ketoconazole) to minimize hair loss. Whether it works as a hair loss treatment hasn’t been proven to my satisfaction, though.

If you see a cause and effect relationship, then you can be the master of your own destiny. The simple act would be to stop using it. Perhaps a different dandruff treatment will work better for you.

Tags: nizoral, hairloss, hair loss, shampoo

In the News – Combing Hair Causes Thinning

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

Snippet from the article:


Put that comb back in your handbag — a study by an Israeli dermatologist has found that too much combing of the coiffure leads to hair loss, the daily Haaretz reported on Monday.

During a test 14 women recorded their daily hair loss and combing habits, with those combing more losing more hair, the research found.

Read the rest — Don’t brush with baldness: put down that comb

UghI realize this is a blog for posting hair loss issues, but sometimes we all must get a grip on studies and reports we find on the Internet. A report or a study does not necessarily validate a story or the truth.

Simply put, writing about 14 women combing their hairs really is not very compelling. But in this world it does give immediate Internet exposure to those who seek it out.

My other beef with the article is the following quote: “I was surprised by the results, as in medical circles the comb is believed to improve blood circulation and reduce hair loss“. This does not show brilliance on the part of the researcher making the statement. I’m not sure which medical circles he’s referring to, but there is no such circle of doctors I’m aware of that believe combing one’s hair will reduce hair loss or even promote blood circulation.

Tags: hairloss, hair loss, comb, brush

I’m Scared I May Have Developed Traction Alopecia!

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

Hello there. I thank you in advance for your time and efforts related to hair loss. I’m a twenty year-old Caucasian female and have recently detected signs of traction alopecia behind my ears (due to adding more wefts of hair extensions in recent months). I’m terrified that my hair will never grow back, and while I’ve worn extensions for approximately two years, I’ve only noticed the hair loss within the past four or five months. I’m completely devastated by the hair loss, as I’ve experienced body dysmorphia with my hair for the past ten years.

At this point, my hair is extremely short (bob-like cut), and I’ve loosely placed a few clip in extensions to add fullness to my hair (although they’re not placed in the location where hair-loss is evident). As noted, the level of devastation that I’m currently experiencing is beyond words–I feel as though I’ve been completely robbed of my femininity and any/all confidence that existed in me prior to the hair-loss discovery. I’m in dire need of help/advice/support. Will my hair grow back? And what can be done to speed up the process? I’m a college student on financial aid–thus, only capable of funding at-home remedies.

Again, thank you for your time and effort in this matter. It’s greatly appreciated.

Best regards

First and foremost, fear should not be a factor when you are dealing with hair loss. You need to empower yourself and find a reason — even a medical diagnosis. I do not know if you have traction alopecia, but constant pulling on the hair from hair extensions may cause it. There may be other unknown causes as well.

Keep in mind that it generally take over a year to see hairs to grow back (if they are going to grow back) and there is no product that I am aware of that speeds up this process. As a financial aid student, you should probably give it time rather than spend money on products that do not work.

Tags: hairloss, hair loss, female hair loss, traction alopecia

I Want to Pay for ACell Along with My Transplant

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

Hey Doc,

I’m wondering if I got a hair transplant within the next 2 to 4 months, after I’ve got a master plan and such, if you would use ACell if I gave my consent to use it on a normal transplant. Of course the hopeful result is that if you use it with the hair transplant alone that it helps heal faster and 50 to 400% more could potentially grow than what was transplanted. Since it’s considered harmless by the FDA, do you think it would hurt to just use it and see the results if there are any and if not, no harm done right? It wouldn’t affect the actual hair or anything if I’m not mistaken. And end result being if it doesn’t grow more hairs it would heal faster.

If this was possible could we just pay a little extra to you for the cost of using ACell and see if we get results? Not saying there would be an sort of expectations beyond the actual transplant, but would it hurt to use it just in case or do you think it would complicate the normal transplant in some way?

There are talks and unsupported reports that ACell can speed up the hair transplant healing process and help the REGULAR transplanted hair follicles to grow better/faster. This has yet to be proven satisfactorily, as far as I know.

If you want to pay the extra cost of the ACell to be incorporated in a hair transplant procedure (on the hair follicle), I do not have a problem with it. But you must also accept the fact that ACell can have the complete opposite effect of less than optimal hair growth. While I do not believe this would be the case, we really do not know at this point and must always assume the worst.

Tags: acell, hair transplant, hairloss, hair loss

My Hair Color is Different from My Dad’s — So Does That Mean I Won’t Bald Like Him?

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

Hi, I just had a quick question.

My dad started to bald somewhere between 18-19 and was nearly all the way bald by 20. My paternal grandfather is also bald. My mom’s side however has all of their hair, including my maternal grandfather. I’m 18 now and my hair color is much different than what my dad’s was at his age, his was auburn, mine is dark brown. It’s also still incredibly thick. I also seem to have the same soft hair as my mom but not fine hair or anything.

So my question is, will I go bald and if I do, will it start soon?

Thanks!

Hair color and balding are not linked. Just based on an email, I have no way to know if or when you’ll go bald. You’ll need to meet with a doctor for a miniaturization examination of your scalp, along with follow-ups over time to see if there is indeed any thinning.

Tags: hairloss, hair loss, hair color

Does Repairing Old Plugs Cost the Same as a Regular Transplant?

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

I had a hair transplant in Australia nineteen years ago…the hair transplant was so bad…it looks like a doll head…can I repair my hair transplant in NHI? How much it will cost? Is it the same price or different price? Thanks

RepairAt New Hair Institute (NHI), we perform corrective surgeries for patients who have had bad hair transplants (including the old doll hair looking “plugs”). You can see the before and after results of our repairs here. We’ve also created a complete step-by-step of one patient’s journey to fix his ugly hair plugs — see Dean’s Story. That’s Dean at the right before his repair procedures began.

If you would like a private consultation, please email us with detailed information (including pictures, if possible) or call us at (310) 553-9113 US.

The cost of a hair transplant and repairing old plugs generally ranges from $3000 to $10,000. As you can see with this wide range, each and every case is very different. There is usually no special fee to repair old plugs, and we charge the surgeries as in price per graft. Our fees are outlined here.

Tags: repair, hair transplant, hair plugs, hairloss, hair loss

Epigenetic Side Effects

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

Dear Dr. Rassman,

I believe that their is a possibility of very small subset of men experiencing continual sexual dysfunction from propecia after cessation of the medication. The underlying mechanism of why this happens may be similar to why a small subset of people experience continual sexual dysfunction after going off of SSRIs. This paper may offer some insight into what is going on in these rare situations when persistent side effects happen with these commonly used drugs.

Epigenetic side-effects of common pharmaceuticals: a potential new field in medicine and pharmacology.

It’s possible that there are a subset of men that experience epigenetic side effects. Thanks for sending this information. It’s more theory at this point, but interesting reading nonetheless.

Sometimes though, we must take a step back and look at what we are trying to do. If someone is scared of these side effects and do not want to start the medication, then it is their choice. If someone looks at the risks (or rather, the chance of this happening) and weigh it out with the benefits of what the drug can provide, they can make their own choice as well. I know I’ve said it many times before, but Propecia is an elective medication. I realize there are risks, but it is a medication I recommend to most of my patients as they understand the risks and benefits of ANYTHING that they do in life.

Tags: persistent side effects, side effects, pharmaceutical

Why Might I Have Reappearing Bald Spots in My Beard?

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

I saw your answer to the bald spots on facial hair. My experience has been that i had small bald spots appearing in my face (size approx 1 sqin) in different locations and then after several month they disappeared. Currently I have one and I wonder what is causing this. Could it be a nutritional thing? Any help/answer is appreciated.

Thanks

I would like to see you and use a video magnifier to view what is happening there. There could be some stress induced loss, or maybe it’s as simple as some gray hair that is looking like a bald spot. I don’t have any clear answer to give you to rectify the problem, unfortunately.

Tags: facial hair, beard, hair loss, hairloss, bald spots

Do Propecia Benefits Outweigh the Risk?

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

My doctor recently prescribed propecia to me, a 20 yr old male. After reading all this stuff through the web, and i know you even stated that the side effects seem a bit exaggerated, i am kinda skeptical about taking it. I really don’t want to have a decrease in arousal and definitely do not want to develop breasts. Do the benefits outweigh the chances of the side effects?

Also, whats the effect of lowing DHT on your muscles? It seems that the only answers i could find say that lowing DHT would lead to weight gain and muscle loss. This seems quite the opposite of what i have researched since DHT is not the main source used by skeletal muscle and the reduction of DHT would lead to higher levels of testosterone, the ultimate muscle booster. Thanks

Official studies have shown the side effects occur in 1-2% of men. The medication has shown benefits over 5 years in 77% of men (statistics here). So yes, the benefits outweigh the risk… but it depends on your priorities.

The real answer lies in what you think of yourself balding progressively over the years and what you will feel about yourself if you become bald. Balding is the natural way to go, but I am in business because other men do not want their genetic cards showing. If you’re truly concerned, don’t take Propecia. Remember, it’s an elective medication. If you think you could be one of the 2% that has problems, perhaps it isn’t worth it to you. Then again, you could fall within the 98% that has no side effects…

With regard to muscle mass, I have never seen any impact at all.

Tags: propecia, side effects, benefits, finasteride, hairloss, hair loss, muscle

What Hair Restoration Procedures Actually Work?

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

Assuming price is not an issue, what are the hair restoration procedures/companies that actually work? (It’s one thing to drop 20 grand and get results, it’s quite another for expensive snake oil).

What we do in hair transplants really work. The other day, I saw a man who had 2000 grafts about 14 years ago and he looked absolutely normal with no signs of balding. His pre-op pictures from oh-so-many years ago showed his Class 3A balding pattern clearly. I looked closely at this man’s hairline now and could not see any hint of surgery, even though I knew what was done.

I can only speak for my own practice and the work we do. You can and should research other clinics on the web, but always remember to meet with patients that had surgery with the doctor you choose. Photos are one thing, but seeing the hair in person is much better. We hold monthly open house events so potential patients can meet patients in person. Most doctors don’t do events like that, but you should ask to meet their patients nonetheless.

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

Donor Recharging — Using Body Hair to Fill Out the Scalp Hairs Used in FUE

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

Doc,
I have slowly come to rely and trust this site on a day to day basis, so thank you.

I am considering an FUE surgery and have been reading a lot about “donor recharging”, where body hair is placed into FUE sites to help the donor region out. Ive unfortunately been around the block with this whole field and now feel the only way FUE should be done is by adding body hair as you remove a follicle from the donor.

My Question… Why aren’t more FUE specialists offering this technique? Won’t an FUE surgery be detrimental as the area will thin to the point of very shallow density in anyone with a norwood 3 and beyond.

I was hoping that the A Cell treatments would make this more viable but no one seems to be talking about it. Hence my question and my wishes for a great day for you and your staff!

“Donor recharging” is an interesting term I have not heard before. I do not buy into recharging the donor area from the scalp with hair from the body. I am just not convinced that the quality of the body hair will make for a good substitute for the donor hair that has been transplanted earlier.

It is easy for a doctor to do this to make more money, but unless there is proven value, I do not want to get on that bandwagon.

Tags: body hair, bht, donor recharging, hair loss, hairloss, hair transplant, fue

I Still Form Scabs Years After My Hair Transplant

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

Hello

I had hair transplant 5 yrs ago and am very pleased w/ the results. My only question is this: I still have some scabs that form on the crown of my scalp, even after 5 yrs. They are irregular shaped and are off white and some have hair in them when they come off. One in particular is the size of an pencil eraser and it comes off, then later on, it reforms again in same place. The others are about pinhead sized and keep coming back too.

So is this going to be an ongoing thing? Thank you!

On rare occasions, I see patients with ingrown hairs that present this way. If a doctor should look closely at the exit of the hair, one might see what looks like two hair coming out of the same hole. One of those may be the ingrown hair, which can be teased out with a pair of forceps. Otherwise, I would have to see you to give you an opinion.

Tags: scab, ingrown hair, hair transplant

Hair Transplant Company Claiming “100% Natural Results”

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

I’ve just come across the DHI Direct Hair Implantation approach. DHI claims that it is better than FUE and Strip Surgery for reasons that include the following: (*) it leads to a 100% natural result, and (*) it involves no scars or holes. I do find it difficult to believe anyone claiming to have achieved 100% at anything. I also find the “no holes” idea self contradictory. However DHI seems to be rather convincing, except for the fact that no single Doctor’s career seems to be at stake. I have several questions, which I’ll limit to the following:

* Are you in a position to shed some light on the quality of the technique’s results? Perhaps in relation with FUE and strip surgery performed by average (and top notch) doctors?
* Are you aware of which method is used for the extraction of follicles? I couldn’t find this information on the company’s website.
* Is it possible for anyone to claim 100% natural results?

Finally, I’d like to disclose my personal situation and perhaps gain your opinion. I am 27 years old and have experienced gradual hairline recession. I’ve been on propecia for 1.5 years now. I’d like a lower hairline, but am in a position to wait at the expense of some self esteem issues. Should I go for a non-invasive technique such as DHI’s, or should I await the development of hair cloning techniques? Or might it be worth going for FUE or Strip?

Sorry for the difficult questions. I’m just confused, and I’m a PhD candidate researching informed consent!

If there is a cut on the skin, then you will certainly have a scar. All follicular unit extraction (FUE) procedures done, regardless of how small the instrument used, will produce some scar and from what I know about DHI, they are doing FUE. The point is that the small scars (dots or scar tissue) would not be as noticeable to the casual observer as a linear scar from strip surgery — especially when there is hair growing around it. If you sent a series of good pictures, I can offer you a telephone consultation.

As you have stated, you should always be cautious when someone (or some company) claims 100% of something. Sounds like marketing. With respect to certain medical groups, it is not my place here on BaldingBlog to endorse or discredit anyone. If you are interested in a particular doctor or clinic, you need to see the doctor, and meet some of their patients (in person). See if the claims stand up to your scrutiny. Anyone can have a convincing internet presence. Now you have to do the hard work of finding out the real truth.

You can wait for cloning, but it’s still in the early development stage and there’s no guarantees. It depends on how long you are willing to wait.

Tags: hairloss, hair loss, fue, dhi, claims, hair transplant

Neil Patrick Harris’s Hair

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

Hi Doctor, I was wondering if you think actor Neil Patrick Harris is balding or not…

I had the same rounded hairline as he had as a child (when he played doogie howser)and dont know many people who had that shape. Now he has a very high receded hairline, his temples have moved back and he has recessed corners. I seem to be moving in that direction as well but probably beyond it. If my recession stops where his is i would be thrilled but i’m not holding my breath since i seem to see miniaturization. anyways, let me know what you think!

I used Google Image Search to try to find some recent photos, but his hairline is not clearly shown in his current hairstyle (at least not that I could find). I suspect that his hairline has moved upward beyond maturing. Here’s photos of Neil Patrick Harris as an adult and as a child. The hairline seen in the childhood photo is a fairly typical juvenile hairline.

NPH

 

The best way to determine your hairline location is to measure the center from the highest crease of your wrinkled brow. If the height is more than one finger breadth above that crease, then your hairline is moving back. You might find a picture that shows what I am talking about or ask Doogie yourself.

Tags: neil patrick harris, how i met your mother, doogie howser, hairline, hairloss, hair loss