The AHI Technique?

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

Have you heard of the Ahi technique based on FUE. Is this truly original or simply a marketing spin on the FUE method of hair transplant. The company in question is https://www.ailesburyhairclinic.com/

Their site says that it’s just follicular unit extraction (FUE) but the difference is, “the AHI variation of this method is that we use a specially designed implantation pen to place hair follicles…”

Many clinics use FUE extraction tools and the implantation instrument they’re likely using is called the Choi Implanter. The Choi implanter has had variable results in its use — many complete failures and some excellent results with those who have mastered it. The Choi is probably the most universally used instrument for implantation, but few use it in the US, where there is more accountability to failures of the transplant.

Dr. Richard Shiell recently reported: “I think the original device was invented by a non-doctor who was doing eyebrow grafts at a Leper hospital in Korea some 30 years ago.” There are many innovative people in this world who, when challenged, rise to the situation and create new technology.

Tags: fue, hair transplant, choi, ahi, ailesbury

After Taking Finasteride, I’ve Shed Short Hairs Near My Sideburns

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

Hello, I am 21 years old and have been on Finasteride for three months now. Since that time, I believe I have seen benefits from the medication (I no longer pull out any ‘stray’ hairs whenever I run my hands through my hair). However, I have been shedding some short, thin hairs on the sides of my head, specifically above my sideburns. The hair on my sides has always been a bit thinner than the rest of my hair, so is it possible that the medication is reacting harder to regions that are genetically weaker than elsewhere on my head?

Thanks.

I haven’t heard that before. Anything is possible, but likely not probable. Perhaps there are other issues and you do not have the correct diagnosis of androgenic alopecia.

There is also a rare condition known as triangle alopecia where men lose hair on the side of the scalp in the shape of a triangle at or near the temple peaks on the side of the head. This condition is usually genetic and may impact only one side. Generally Propecia does not work for triangle alopecia, and if this is what you have, transplants work well for it. This is all guessing on my part. You should follow up with your doctor.

Tags: hairloss, hair loss, propecia, finasteride

Is There a Good Way to Stop Taking Finasteride?

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

What is the best way to stop finasteride ? all of a sudden or gradually ? , can sudden withdrawal cause rebound effect and more worsening (speaking of side effects not hairloss) ? and if gradual withdrawal is the best then how can i do so ?

thanks

The half-life of the drug in your body is somewhere between 4-6 hours. That means essentially that most of the drug that you take today will be gone tomorrow. Once the drug levels drop below a certain level, you will lose the effectiveness of the drug and it may take 1-3 months for the impact of the loss to be seen in your hair falling out. Tissue levels may maintain the effect of the drug for a couple of weeks or so.

The answer to your question — there’s no “best” way to stop the medication.

Tags: finasteride, hairloss, hair loss, propecia

In the News – Genetic Defect Repair

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

Snippet from the article:

Doctors have treated a life-threatening blood disease by repairing flaws in the genetic code of a living animal, the first time such an ambitious feat has been achieved. The work raises the prospect of powerful new therapies that can target and repair the genetic defects behind a wide range of human diseases that cannot be tackled with modern medicines.

The new technique, called genome editing, holds particular promise for a group of illnesses that run in families and are caused by faults in genes that underpin the healthy working of the immune system, bone marrow and liver.

To demonstrate the therapy, researchers treated mice that were bred to develop haemophilia B, an inherited bleeding disorder that destroys the body’s ability to form blood clots. Normally, when the body suffers a cut or graze, proteins called clotting factors combine with platelet cells in the blood to make it sticky and form a clot that stops any bleeding.

Read the full story — Doctors make breakthrough in repairing genetic defects

This is fascinating… and while not directly about hair loss, imagine the possibilities for genome editing in the future.

Tags: genome, genetic, gene

When Does Finasteride Thicken Up Hair Shafts?

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

Does finasteride thicken up hair shafts DURING the growth phase, or (with good results of course) does it thicken up only when a new cycle begins?

I do not have a definite answer to your question, but I can venture a guess. As the usual hair cycle is over 2 years in most men and we see benefits from Propecia in 8-12 months, I would guess that as the hair shaft emerges from its source, the shaft thickens. Of course, as the hair growth above the skin grows at about 1/2 inch per month, I would expect that the thickening of the hair shaft starts quickly and increases over time.

All miniaturized hairs are not equal. Let’s say that the shafts that have lost 90% of their bulk will be slower to benefit (if they benefit at all) than those miniaturized hairs which have lost 20% of their bulk. The impact on new hair should be better if these new hairs are healthy ‘terminal’ hairs that have considerable life left in them. When I see patients for follow-up examinations and comparison studies, I see that there are less miniaturized hairs and more of thicker shaft hairs, and as we use the bulk analysis instrument on more patients, the answer to your questions will be much more clear.

I think you have a great question from a scientific perspective. I wish there was a time lapse photo of a hair shaft under the influence of Propecia (or even Rogaine).

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

Could There Be Hair Multiplication News at the ISHRS Meeting?

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

For all of us desperately following the advances in hair multiplication, do you think that any information would be available before the ISHRS annual meeting (September)in Alaska if discovered or is that venue the most likely outlet for bringing advances to the public? (So I can stop my daily obsessive searches.)

While anything is possible, if a company had a big announcement to make (such as hair multiplication being available to the general public), I doubt they’d wait to announce it just for the ISHRS meeting. These companies are usually looking for financial investors or commercial interest, so it wouldn’t necessarily make sense to hold back any good news just for an annual meeting of doctors. Now if a physician had a presentation for the meeting, that’s a different story.

Though new information could and hopefully will come out from the meeting in Anchorage, I wouldn’t expect a new hair multiplication procedure to be announced as available to the public this year. I guess we’ll find out in September.

Tags: ishrs, meeting, hair multiplication, hair cloning

My Endocrinologist Said Propecia Will Either Work or Destroy The Hairline

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

hey, doc. I have asked you guys a question about testosterone and hair loss, and you mentioned how testosterone does not cause hairloss by itself, and it only DHT.

I went to see an endocrinologist today and he said “everyone experiences temple recession(different from mpb), and that temple recession is caused by high testosterone, not DHT.” He also said that propecia is a good drug for hairloss but its basically a 50/50 risk when taking it. either it will work and stop hairloss, or destroy the hairline, but keep the crown. he was pretty confident with his statement. I asked if there is scientific proof, he said its common sense. not sure whether to take his theory with a grain of salt or its true.

what do you think doctor rassman? do you agree with him or disagree? your opinion on this is very important to me, and probably to others

This is not a place to get a second opinion and I do not like to second guess other doctors when I have not even examined the patient (you) myself.

That being said, Propecia does not “destroy” hairlines, and the percentage is better than 50/50 that you will see benefits. I cannot find a source that states temple hair loss is caused by high testosterone, so I’m not sure where your endocrinologist got that information.

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

Balding by Race?

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

Dear Doctor,

How do reconcile your two statements below?

“Studies have shown that there is little difference in balding statistics between races.” source – Sept 29, 2008

“Asians (non-balding) generally have less hair than their Caucasian counterpart and also have less balding than their Caucasian counterparts according to studies I have researched in the past.” source – March 11, 2009

Touché.

There is a common belief that Asians bald less, but I really do not know this. The only race that does not bald is the American Indians who migrated over the Alaska Bridge.

Tags: balding, hairloss, hair loss, asian, indian, race

Hiding Old Plugs So Nobody Can See Them (with Photos)

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

This patient came to see us in March 2007 for 1004 grafts and then for a follow-up procedure in May 2009 of another 1045 grafts. All of these grafts were placed into the hairline to cover up old plugs. On his recent visit to the office, I couldn’t even find the old plugs… and when I told him that, he smiled ear to ear. Click the photos to enlarge.

AFTER (2049 GRAFTS TOTAL):

 

BEFORE:

 

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

What if Prince William Had a Hair Transplant?

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

Is it possible for Prince William to have a hair transplant, and reach his father’s level of baldness ? Having a similar pattern of baldness I felt sorry for Prince William during his wedding. I believe his hair loss made him less attractive. In fact, my sister even said that Prince Harry is more attractive now. I can say the credit goes to the fullness of hair. Would a frontal coverage for that type of hair loss would be good in the long run. How would you apply a master plan toward a case like this ?

Prince WilliamBased on pictures alone, Prince William would likely be a great candidate for a hair transplant. We have treated many men with even more hair loss than he shows.

Here’s an open letter to the royal:

    Dear Prince William,

    It would be an honor if you would consider having NHI establish a Master Plan for your hair loss. If a hair transplant surgery could meet your goals, please consider us when choosing your doctors.

    Thank you and best regards!

Tags: prince william, royal, uk, hairloss, hair loss

Elevated Bilirubin Levels from Finasteride?

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

I am a 51 y/o male. I have been taking Finasteride for the past 4 yrs. I also take Lovastatin for my cholesterol. My latest blood test showed elevated levels of Bilirubin. My doctor stated that it might be from the Finastride and that it is a possible side effect of the drug. I can’t find any info on this claim and I find it hard to believe that it all of a sudden is causing this.

Can you help me? I don’t want to stop taking the Finasteride and lose the results. I also must add that Dr. Pak did a procedure on me just about 2 yrs. ago and I love the results. Thank You.

I’m glad you are enjoying the results of your hair transplant!

I would ask your doctor to look for another cause of liver dysfunction. I have not heard or read about finasteride causing this type of problem. Lovastatin and similar medications do report elevated bilirubin levels as a possible side effect, however.

Tags: lovastatin, finasteride, bilirubin, blood test

Correction – Propecia is Like Testosterone?

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

hi, doctor in one of the topics you said propecia is like testosterone. here is the link

I thought finasteride wasn’t a steroid hormone.

Thank you for pointing that out. It was an error in our part, and I guess it went unnoticed for nearly 6 years. It should have stated DHT (not Propecia) is like testosterone in that it is one of the male hormones.

We have corrected it. Sorry for the confusion.

Tags: propecia, finasteride, dht, testosterone, hormone

NHI ACell Update?

/by William Rassman, M.D./7 /

Dear Dr. Rassman

You posted on the 5th Nov 2010 that NHI was conducting a study using Acell for hair multiplication. As we are now half way through 2011 I am wondering if you have any updates in regards to the results you’ve experience so far. I’ve heard stuff from Dr. Cooley and Dr. Cole but nothing from yourself so far.

I look forward to your answer.

Regards

I have seen most of the half dozen people that I performed ACell plucking procedures. They averaged 200-300 plucked grafts. Although there was some growth from the plucked hairs, there was just as much growth in the control group as in the ACell treated group. I would conclude from this that I have not replicated the results reported by others.

With regard to the large number of patients where I used ACell in the wounds of strip surgeries, I have seen some value, although I have not called them all back to evaluate their wounds.

For hair multiplication, I am not considering performing more of these procedures until I view the results of others at the upcoming ISHRS meeting in Anchorage, Alaska this September.

Tags: acell, hair cloning, hair multiplication, plucking

After Years on Propecia, Does Hair Loss Start Rapidly?

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

I keep reading everywhere how many men were able to maintain their hair on Propecia for years and even a decade but they always state that once the drug can’t maintain their hair anymore they start to lose it rapidly! Why is it so? Why can’t it just gradually thin? This really is bad because once it appears the drug wears off before you know it you’re like half bald!

Where are you reading these things? I do not recall seeing any of my patients losing hair “rapidly” after taking Propecia for years… nor do I recall a case where the medication simply “wears off”.

Genetics play a large part in how men lose their hair. Propecia slows it down for all ages of adult men. It sometimes grows hair back and even seems to halt it for some time, but in the long run it is a slow process.

Tags: propecia, finasteride, hairloss, hair loss

Press Release – Another Law Firm Soliciting Propecia Patients

/by William Rassman, M.D./6 /

Snippet from the press release:

The Oklahoma law firm of Atkins & Markoff and its firm members who serve clients as defective drugs attorneys have made the decision to offer people who have used the medication known as Propecia an opportunity to obtain a free and confidential legal consultation regarding their potential legal rights and options regarding possible side effects of permanent sexual dysfunction and impotence.

These free initial legal consultations are meant to provide information and guidance to those who have used Propecia and who feel that they have suffered from alleged Propecia side effects. Consumers who believe they may have been harmed in this manner are encouraged to contact the firm immediately to schedule this free initial consultation.

Read the full press release — Law Firm of Atkins & Markoff Now Offering Free and Confidential Propecia Impotence and Sexual Dysfunction Lawsuit Consultations

The law firm says they specialize in these type of lawsuits, so if you feel wronged by Propecia and are looking for a pay day, they want to talk to you.

Tags: propecia, law, legal, finasteride