How would you describe CBS news anchor Scott Pelly’s hair? It looks natural looking to me and for a 54-year- old man he seems to have a great head of hair.

Photo

Scott PelleyThe normal distance between the tip of the chin and the tip of the nose should generally be the same distance as between the hollow at the top of the nose (between the eyes) and the leading edge of the hairline at its center point. That is the case in probably in 80-90% of men with mature hairlines.

Scott Pelley’s hairline is V shaped, and from one of the pictures I was able to find, it appears that the highest crease on his forehead suggests that it meets my criteria for a normal mature man’s frontal hairline location. From these pictures, the forehead appears higher than the chin to nose measurement, suggesting that he has a higher natural forehead or some very early erosion of the frontal hairline. The gray hair makes it difficult for me to state emphatically that he does not have some frontal recession/erosion, but I would need more in-depth pictures of him with one frowning. The natural higher hairline may reflect just a well exercised brain giving him many career opportunities.

In general, 50% of men will NEVER go bald and have great hair. Some notable people would be our former presidents, Ronald Reagan and Bill Clinton.

Tags: scott pelley, cbs, news, celebrity

(female)
Does contact dermatitis affect my chances of having hair implanted. Over the past two years, my dermatitis has caused my hair to fall out and I want to get implant hair. Can I? That’s the question. Please let me know.

Thank you.

At NHI, we have performed surgery on many patients with dermatitis or even psoriasis. Each and every patient is different and if you are interested in surgery, you need to be evaluated by a competent hair transplant surgeon.

There are cautions with regard to the pretreatment of active areas of local dermatitis or psoriasis for example, as complications do occur with such findings as a Koebner phenomenon in the areas where incisions are made in active areas of psoriasis or dermatitis.

Tags: dermatitis, hair transplant, surgery

4 years ago my brows were week from plucking in hopes of finding the best shape for my face. I had Dr Pak first perform some eyebrow restoration. Later that year Dr. Pak progressed w/ the first treatment w/ another treatment for density. The results were excellent…But being a perfectionist, I continued to pluck & reshaped the brows to being what I always wanted.

This last week I met with Dr Pak, who is a both a wonderful person & an expert Artist in this particular field of specialty for hair restoration. He performed a delicate procedure that was exactly what I was seeking and that resulted finally in a classic slanted full brow.

I could not be happier and many thanks to Dr Jae Pak as well as his assistant, who I found to be extremely kind & professional and who went the extra mile…so sweet & professional as well as fast & efficient. Dr Pak is incredible…one of a kind…understanding & extremely professional & another kiss to his assistant….love you both.

As I’ve written on this site before, we have done many of these types of procedures and the results are very good, but there is an art in the transplant process and a technical skill that is very difficult for many doctors.

I’m glad your expectations have been met (or surpassed). Knowing how pleased you are with the results and the experience is the best part of what we do. Thank you for your incredibly kind words.

Tags: eyebrow transplant, hair transplant, eyebrows

You’ve mentioned a few times that stress can increase the rate of balding in those with the genetics for MPB. Is this scientifically proven?

By what mechanism does this happen or is this not known? (i.e does stress increase levels of DHT?)

thanks

Stress has been observed by many doctors as a cause contributing to the hair loss equation. Keep in mind that hair loss has other genetic factors that are influenced by environmental factors, and stress is one of the more obvious mechanisms. I do not believe stress increases DHT levels.

Tags: stress, hairloss, hair loss

Hi,
I read about Scalp MicroPigmentation (SMP) and I think this might be a good choice for me, because I am not candidates for hair transplant surgery. However, I am waiting for the day that the hair cloning technology can be used by people like me. My question is: Is SMP a barrier for future hair cloning?

Thanks

When properly designed, Scalp MicroPigmentation (SMP) can work with hair transplants and possibly with a good cloning process once cloning is practical. Hair cloning is “not ready for prime time”, but I expect that once it is viable, any good cloning procedure must restore a normal appearance, including the leading edge of the hairline which is critical to a normal look.

This process is often ignored by tattoo people who do SMP type of work, partly because the patient pushes a hairline design that may not be normal, or the tattoo person does not appreciate the blend between the natural balding process, the maturing hairline, and what they should look like.

The influence of someone like Dr. Pak (who designs all of our SMP work) is critical to the excellent results we obtain. I would imagine that the same conditions would apply to the cloning process.

Tags: pigment, smp, hair cloning, hairloss, hair loss

I’ve been taking Finasteride 1mg for about 8 years now. I’m looking to start a family and I think I will stop taking the drug for the mean time. How long does it take for finastaride 1mg to leave my body. Thank you

Finasteride is cleared from the blood stream within 24-48 hours (its half life is 4-6 hours) and it is cleared from the body’s tissues within a week. I understand your concern that finasteride might impact the baby in some way, but experience with the drug has not shown birth defects in babies born from men who were actively taking the drug at conception. Significant amounts of finasteride have not been found in a man’s semen.

When asked about this, I often suggest that the men who are concerned should stop the drug about 7 days after the woman’s menstrual period starts and hold off taking it for a total of 10 days In a woman with a normal 28 day menstrual cycle, fertility usually occurs between the 12th and the 16th day.

Tags: finasteride, conception, pregnancy, pregnant, family, propecia, hairloss, hair loss

Snippet from the article/interview:

For over a decade, leading hair biology scientists. Dr. Rolf Hoffmann and Dr. Kevin McElwee, have been studying the potential of dermal sheath cup cells to spark hair regeneration and the rejuvenation of miniaturized hair follicles. Hoffmann, RepliCel’s Chief Medical Officer, discusses his research, the process of developing this treatment, and the critical steps the company is taking along the way to ensure that it is successful.

Read the rest — Equities.com Interviews Dr. Rolf Hoffmann, Chief Medical Officer, RepliCel Life Sciences Inc.

Interesting reading! What little I know of RepliCel has been written before here, but this interview explains about their study of the dermal sheath cup cells and how this differs from others doing similar research.

Tags: replicel, stem cells, hair loss, hairloss, hair restoration

Dear Dr!
First, excuse my “not so good” English as I am not native English speaking. I had a FUE (1500 grafts) hair transplant done 3 weeks ago. Today, I joined a short flight (half an hour) with a small (2 seats) air-screw-plane with my brother in law who is an enthusiastic hobby-pilot.

i know that there is no problem to fly with a regular (big) commercial airplane. but these planes have cabins with controlled air pressure and so on. what about these small planes where there is no hermetic cabin and no controlled air pressure? we were flying as high as 3000 meters and during the descent i experienced some headache behind my front (the space right above my eyebrows). now I am worried that the change of air pressure during the flight only 3 weeks after the

transplant could have damaged my grafts due to changes of the vasculature. are these worries without any reason or not? I am very concerned about this.

Thank you very much for your answer. kind regards.

Hair transplants should be considered fully healed by the third week after the procedure, which means that nothing that you would reasonably do can negatively impact the growth of the grafts… even flying, as you have described.

Tags: hair transplant, hairloss, hair loss, air pressure

Doctor Rassman.

How are you. I love the website. My question surrounds the importance of finding an ethical doctor who is not just about the money. As a layman (like myself) I am not that experienced in hair transplants and what to do, I rely solely on the doctor. The only experience or knowledge I have is by coming on your website and reading things about hair loss on the internet.

So, How would I know who is a good doctor, what is the proper number of grafts I should receive, and if the doctor places grafts into my head is he placing them in the right spot so I won’t have shock loss etc etc.

I would mostly go with what the doctor says because I am putting my trust in him, unless he says something totally absurd then I know to back off.

I can read all day on the internet about hair loss and what to do, but how do we truly know whatever the doctor says is in a patients best interest and isn’t about the money, because every patient and situation is different.

Thanks

I put together a guide for patients, where I detailed the approach I would take if I selected any doctor for any reason. If you go for a consultation and end up meeting a salesman, then I would generally suggest that selling is the doctor’s priority. If you come to my open house events, you can meet many patients face-to-face and look at the quality you will get (as what you see is what you get). Photographs can be misleading and show what the photographer wants the viewer to see. Photos of a doctor’s work should be augmented by meeting real patients in person.

We all have instincts which we must rely on, so use your instincts to know if you met the greatest bullsh*tter of all time. Some of the worst doctors in this business have a style like a con man and the looks of Brad Pitt. Can you tell a con man when you meet one? The recommendation of the doctor, with regard to the work you will need, should match other opinions you should get from other doctors. If they do not match up, then you need to challenge both recommendations and see if they make sense.

Fortunately, I have written many books and articles which cover most everything that you need to know (see our Medical Publications, where everything is documented). Lastly, ask yourself if you like the doctor personally, and if you trust him/her to be there when you need him/her. I carry my cell phone 24/7 and every patient has 24/7 access to me. That is my way of telling the patient that I will always be there if he needs me at any time. Over the years, I have helped men who had heart problems, having nothing to do with the hair business, so that is my way of saying “trust me”.

Tags: hairloss, hair loss, hair transplant, con man, salesman

Hi Dr. Rassman,
Thanks for writing such an informative and entertaining blog. Keep up the great work. I have some questions:

(1) Everyday the grafts fall out from the head with the follicle on one end, is it possible to collect these grafts and preserve them in a certain condition for future surgeries? If possible, how? And for how long can they live?

(2)If I use tapes to attach a toupee 5 hours every month, will it hurt the scalp which will house the grafts of future transplants?

Thanks!

The hairs that naturally fall out of your scalp are those that have gone through the normal cycling of hair (telogen, catagen, and anagen) and there is nothing on them that is ‘alive’. We all cycle our hair and when the hair falls out, its root goes into a resting stage and then re-grows a new hair 2-6 months later. Since the hairs that fall out are not alive, there is no chance that it will ever grow again, as dead is dead.

The tapes used on the scalp for attaching wigs can still cause traction alopecia (hair loss where the tapes are attached), even if the adhesive is kept on for long periods of time. Traction alopecia occurs in these areas, as I have seen in my exposure to such patients. The tape should not harm the skin or prevent future transplants into the area.

Tags: hairloss, hair loss, hair transplant, wigs, toupee

About 2.5 months post op from my tranplant (4,000 grafts) I developed a case of Seborrheic Dermatitis. Medicated shampoos were not working so my dermatologist prescribed a desonide/ciclopirox cream (mild steroid/anti-fungal) to be applied 2x per day. Will a cream block my pores and stunt my transplant growth?

Since it’s already over 2 months since your hair transplant, I wouldn’t be concerned. You should play it safe and talk with your surgeon about this.

Tags: hair transplant, dermatitis, hair growth

We’re taking a long weekend for the Thanksgiving holiday and will be back on Monday, November 28!

Happy Thanksgiving

What’s up with comic book legend Stan Lee’s hairline? I’ve been watching a show he hosts on History Channel and his hairline is bugging me. Is it a flap or something? It looks like there’s a white line right around the edge of it. It’s a very unusual shape, but if it was a flap wouldn’t the color on top be the same as on the sides? I guess he could dye it though. What do you think?

Stan LeeYears ago, there were a variety of surgeries that produced many deformities in people that wanted to get hair. They were courageous enough to “lead the pack” of people getting hair transplants, but the worst of the deformities were the old plugs (pencil size grouping of hairs put into corn rows that looked like doll’s hair).

Since I entered the hair restoration field 20 year ago, I have treated many men who had these procedures in the 1950s – 1990s. Most of these men sought a fix-it solution, with the two most effective being:

  1. Excision of the grafts where the hair in these big plugs was removed and then divided into follicular units and then re-transplanted
  2. Camouflage the plugs with natural hair placed in front to hide and bury the grafts if the plugs were high on the head

Fortunately, many of the old plugs did not have even a 50% survival of the hairs, so the impact was benefited from the poor techniques of those original transplants. Despite this, the skin from the transplanted grafts lived, creating a cobblestone effect on the scalp that added to the ‘dolls head’ deformities. These unfortunate pioneer recipients of hair transplants suffered ridicule by everyone — their friends talked behind their backs, and those who were in the public eye were tagged with not-so-pleasant names. One celebrity that comes to mind told me that comedians were very cruel with their jokes about his hair plugs. In the first 10 years of my practice in this business, I performed hair restoration repairs on many men, making great friends along the way, including this one particular celebrity whose nightmare ended after the transplants grew.

Based on some photos I’ve seen using Google Image Search, I believe that Stan Lee had some corrective surgery to fix what might have been the old type of plugs. There’s a high-resolution photo here. The scar in front on the left side and the imbalance between the two sides suggest this to me. If I were to see him and could find enough hair still present, I would excise the plugs that remain and rebuild a new hairline in the normal position. With his white hair, this should be relatively easy.

Tags: comic books, stan lee, hairloss, hair loss, repair

I have a Class 6 pattern of balding. Which is the best procedure for me? An FUE or the strip FUT?

Norwood 6For someone with Norwood class 6 pattern balding, the FUT (strip) technique will allow the entire job to be done in one or two sessions easily, allowing for ranges of between 2500-3500 grafts per session. A class 6 patient needs somewhere between 4,000-6,500 grafts. The wide range of transplants reflect the variations seen in the Class 6 patterns and the quality/thickness of the hair shafts. Men with fine hair, generally require more grafts but those with more confined Class 6 patterns and with medium or more coarse hair, can often get away with just one session.

The other technique, contrary to what you may read or hear, are generally limited to 1000-2000 grafts per session in the best of hands. For ideal work, you need to have a good quality of hair and enough donor density to allow for a safe surgery.

Tags: hairloss, hair loss, hair transplant

Hi doc,

If you have very early bulk reductions in a certain area of the scalp, does this necessarily mean that you will be bald in those areas, or can someone’s final pattern only reflect thinning in certain areas? I am a NW2-3 with very early bulk reductions on the top and crown of my head, does this mean I am destined to be at least a NW6?

We all have some genetic pattern, but not all balding men will develop advanced balding patterns. These patterns are often final, so a class 3 may remain a class 3 pattern for life. This is why I’d want to perform a bulk assessment of the hair on your head, everywhere on your scalp. If the bulk is reduced, that may point to the final pattern you will develop. Also, by making these measurements, we can follow the success or failure in the treatment of hair loss with drugs like finasteride (Propecia).

Stop worrying and get yourself evaluated. We are often more frightened by what might happen than what will happen.

Tags: hairloss, hair loss, patterns