My Transplanted Hair Is Darker and Curlier Than My Native Hair

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

Hello Doctor

Last year I underwent a hair transplant. Seven months have passed and I am very happy with results, the regrowth is quite fast. I have noticed one thing I’d like to ask about, though. The color and the texture of the transplanted hair differs from my native hair. The transplanted hair grows darker and it’s somewhat kink and curly.

Is a texture change something that happens in the early phase of regrowth after transplant? When should my hair return to its normal state? Is this something I should worry about?

Thank you

Changes in hair texture are somewhat common, though kinky hair occurs less frequently. Usually patients that experience a characteristic change see their straight hair get more of a wave in the transplanted hair. It’s possible that you’ll need to wait out a full hair cycle (2-4 years for the average male) to see if the kinky change disappears.

The transplanted hair should replicate the native hair in the donor area and most changes in color reported reflect a comparison with miniaturized hairs in the recipient area when compared to the transplanted hair in the recipient area. I do not believe that transplants themselves influence changes in hair color, other than maybe accelerated aging issues like early graying.

One patient from 2006 showed changes from blonde to brown which is a process of color change that many blond people go through as they age. My three sons (born with blonde hair) saw their hair change from blonde to brown by the time they got into their late teens. So what you’re describing is unusual unless it is in the aging genetics that you have triggered ahead of schedule.

Tags: hair transplant, hair color, hair texture, hairloss, hair loss

Use of PRP and ACell in the Hair Transplant Process?

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

Im inquiring if dr rassman is treating people with thinning hair with acell and prp as a standalone treatment? (and if so can you give me some more info). Im intrested in this procedure before undergoing any surgery, i didnt see anything on the website but his name popped up on a web forum saying he does this?

Thanks kind regards

I do not use platelet rich plasma (PRP) or ACell prior to a hair transplant. There is no evidence that either of these produces value for the patient having a hair transplant. I’ve written about some doctors offering PRP, and we did try ACell for hair multiplication to no avail.

What gives value is a very high growth rate, which is produced by experienced surgeons with experienced, well-seasoned teams working under strict quality control conditions.

Tags: prp, platelet rich plasma, acell, hairloss, hair loss, hair transplant

Why Aren’t DHT Treatments Working for Some Men?

/by William Rassman, M.D./9 /

Drs. Rassman and Pak,

I’m a 23 year old man with fairly extensive loss. I was on 1mg Finasteride for over two years with no success (I know, of course, it’s impossible to tell how quickly my loss may have progressed had I not been on the drug, but the rate of loss while on the drug was certainly no slower than it had been prior to beginning the medication.) Finally giving up, I relucantly sought, and obtained, a Dutasteride prescription, and have been on 0.5mg for some considerable time now, again with little to no discernible success. Not least thanks to warnings issued on this blog, I’ve finally woken up to the fact that my health is more important than my hair, and that, especially given its apparent ineffectiveness in my case, Dutasteride is not worth the risks. I’m about to stop the drug and let nature take its course.

As someone who has had little to no benefit from two treatments widely known to be effective in most patients, my question is this: do you or any of your colleagues in the field have any thoughts on why the two major oral DHT blockers aren’t effective in some men? Is it simply that in some men they somehow fail to block the DHT, or is it rather that some men have so much DHT that the drugs, though they may reduce it by a massive amount, still leave sufficient DHT to impact upon the hair. (I wonder if this scenario might be true of young men with aggressive balding patterns, like myself?) Or, alternately, is the fact that DHT inhibitors aren’t always effective in treating androgenic alopecia evidence to suggest that there are factors other than DHT at play in the hair loss game?

Just a theoretical brainteaser really, but I’d be interested to hear your thoughts. Lastly, you have my thanks: whilst it’s unfortunate that, at my age, my ‘baldness journey’ ends with sanguine acceptance that for me there is no realistic ‘fix’ for my hair, and that therefore I’m to be a bald man pretty soon, the calm, well-informed and often witty advice you continue to offer here has over the years helped me greatly in coming to terms with my situation.

Read through the HairDX Test for Finasteride Response site and you will see some reflections on why some men do not respond to finasteride. Minoxidil is still another story.

You need to establish a good doctor-patient relationship and get the opinions of a good doctor who might help you. Sometimes, it just is what it is. I know it sounds cliche, but I don’t have all the answers and drugs do not solve all problems. Life isn’t that simple.

Tags: hairloss, hair loss, finasteride, dht

Are the Baldness Gene and Hair Characteristics Unrelated?

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

Dad and his family have been diffuse balding since his early 30s. He has super fine, thin hair. I have the same super fine, thin hair, though luckily no signs of balding yet. A cousin on my dad’s side has pretty severe diffuse balding, the other also has diffuse balding but not as severe.

All of the males in my mother’s family have very thick hair, and none of them are balding even though they’re well into their 60s.

Since I have my dad’s fine hair, does it mean that I’m more likely to have his balding gene? Or is the gene completely separate from the hairs’ characteristics?

Hair characteristics are unrelated to the genetic hair loss process. So just because you have fine hair from your father, doesn’t mean you’re guaranteed to have his hairline.

Tags: hairloss, hair loss, genetics

Patient Results – A New Hairline in 2926 Grafts (with Photos)

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

Here’s an awesome hair transplant result I want to share. This patient had one procedure of 2926 grafts, with the photos taken just under a year after his surgery.

He said that almost no one noticed the hair growth, but family members and friends that he hadn’t seen for a while did detect a change in appearance. Some people thought he lost weight, some thought he had a face lift, but a few did notice that he had hair that was not there the last time they saw him. He isn’t shy, so he’s allowed me to post his photos and I am appreciative that he agreed to share this remarkable change.

Click the photos to enlarge.

After (1 procedure of 2926 grafts):

 

Before:

 

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

I Think I’m In the Early Stages of a Norwood 6

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

Dr. Rassman –

On March 13, you wrote:

“Men in the process of losing their hair in a Norwood class 6 pattern may not be thinning uniformly. They may be losing more of the frontal hair faster, yet have the overall pattern of a class 6 that may or may not become complete. Some men who take finasteride will arrest much of the class 6 pattern thinning, especially in the top and crown of the head, but their frontal balding could actually be advanced.”

Could you explain this in more detail? Are you suggesting that finasteride might accelerate frontal balding, beyond what would have occurred without medication? Or are you just saying that finasteride might have relatively minor efficacy in the front?

I’m a 26-year-old caucasian male, and most male relatives on my mom’s side have Norwood 6 or 7 patterns. Like the guy who wrote on March 13, I appear to be in the early stages of thinning towards a Norwood 6 pattern. My own loss is heaviest in in the vertex, with some loss also in the middle and front (although I have a strong forelock). About three months ago, I started taking 1.25mg of finasteride daily. At my checkup a week ago, my dermatologist noted new growth in the vertex (hooray!) and agreed that my corners were a little worse.

I’m interested to hear your thoughts on how finasteride might impact my ultimate balding pattern, both in the front and back. And I’m interested in a clarification and elaboration of those comments from March 13! Thanks for all your work. Your blog is a great read.

Sorry if I wasn’t clear in my prior post.

A simple way to think about this is that Propecia does not stop hair loss completely, and it works best at the top / crown area. So if you are balding in a Norwood 6 or 7 pattern, Propecia will slow down the hair loss on the top / crown area while the front area will have faster hair loss than the top / crown.

Eventually, you may reach the Norwood 6 or 7 pattern, but if Propecia thwarts the hair loss process, you may be able to delay this for 10+ years if the drug works that way for you.

Tags: propecia, finasteride, hairloss, hair loss

In the News – Hair Loss in the UK

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

Came across this article about hair loss in the the daily mail. What are your views doctor rassman?

How a £30,000 hair transplant can still leave you going bald

That’s a nice looking transplant result in the first photo set in the article. The article goes over the various treatments that are available, and warns about scarring and shock hair loss following transplant surgery. Nothing new here that we haven’t written about dozens of times before on this site, unless I’m missing something. It appears to just be a general hair loss treatments article for the UK audience with a punchy headline to grab readers.

Tags: hair transplant, hairloss, hair loss

ACell Plucking from Harvested Grafts?

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

Doc, I understand Doctor Cooley is still doing plucked hair procedures but found they need to be done with grafts harvested from FUT or FUE.

What’s your comment on this

It is not considered plucked hair when you are using follicular unit grafts. That sounds like a regular hair transplant procedure. The pulled graft/hair will not grow back from its ‘plucked’ place. It is no longer considered hair multiplication.

If one believes that adding ACell to a hair transplant procedure for better growth, it needs to be studied and proven.

Tags: acell, hair multiplication, hairloss, hair loss, hair transplant

I’ve Been Taking Propecia for 4 Months But My Hairline is Eroding

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

I am a 31 year old male who started Propecia 4 1/2 months ago after noticing very slight corner recession. I have very thick hair and have always seemed to shed a fair amount. After starting Propecia the shedding immediately stopped. However, 4 1/2 months later, my hair has definitely thinned at the corners and my frontal hairline is eroding. While my hair loss is not yet noticeable, I feel my time is short.

Should I still hold out hope for Propecia at this point? Could I still retain those minaturized hairs? Or are they now beyond the drugs grasp? This is having a profound affect on my self-esteem. Any insights you could provide would be greatly appreciated. Thank you for your time.

Let’s start from the beginning with education and facts:

  1. There is no drug that permanently stops hair loss.
  2. Propecia takes about 8-12 months to see its maximum benefit. Sometimes it takes a little time beyond that.
  3. Propecia seems to work mainly on the top and crown area. It does not work well for the front and front corner areas. If it does, it is in a minority of people.

I understand you are trying to address the hair loss issue but you need to discuss these issues with a physician who can give you a realistic expectation and long term goals. We often refer to this as the Master Plan, which we are a big advocates of.

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

In the News – Cancer Vaccine Looks Good in Early Trials

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

Snippet from the article:

A vaccine that targets 90 percent of all cancers shows promise in early clinical trials. It seems to target the vast majority of cancers and it has produced encouraging preliminary results in phase I/II clinical trials, according to an announcement made on April 2 by the vaccine’s maker, Vaxil Biotherapeutics. The ImMucin vaccine consists of a 21 amino acid-long peptide that represents a key signaling region of Mucin 1, cell surface associated (or MUC1)—a glycoprotein expressed by 90 percent of solid and non-solid tumors.

Read the rest — A Universal Cancer Vaccine?

It’s not hair loss related, but it could prove to be more important than any development in the hair loss world. This is a very exciting announcement, even if it is very early in the grand scheme of things. This info is coming from a safety trial of just 10 patients, and there’s much more work to be done.

More info can be found here and in the study abstract here.

Tags: cancer, vaccine, medication

My Hair Falls Out When Shampooing Sore Parts of My Scalp

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

Hi Doctor,

When shampooing my hair, I notice that I lose the most hair from the sore parts of my scalp. What do you think could be causing this? I alternate between Head and Shoulders and Nizoral.

Thank you.

There’s no way for me to answer this question or even take a stab at an explanation without knowing your hair loss history. If you seriously want answers, you need to have your scalp examined by a physician.

Sore spots on your scalp could be a variety of things, from dermatitits to psoriasis to acne. The vast majority of hair loss in men is caused by genetic androgenic alopecia, but if you’re concerned you should see a dermatologist about your tender scalp.

Tags:
tender scalp, hairloss, hair loss, shampoo[/tags[

Donating Blood and Hair Loss?

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

Hello Doctor

I’ve read that blood donation could be shocking enough to the body to cause some sort of hair loss.

True or false ?

False. I’ve never heard of a case where donating blood has caused shock hair loss.

Tags: blood donation, hairloss, hair loss

I Haven’t Seen Any Side Effects from Propecia, But Now I’m Worried About the Lawsuit Talk

/by William Rassman, M.D./9 /,

Hello —

With all of the recent talk about the sexual side effects of Propecia and the impending class-action lawsuit against Merck I’m a bit concerned about having taken the drug since September 2008…At this point in time I have not noticed any side effects — I don’t have erectile dysfunction, my libido is fine, I havent noticed any increased tenderness in my breast. If I haven’t noticed any side effects from the drug yet — almost 4 years in — is it possible that these side effects may appear later on? Maybe 5-10 yrs later?

Thank you.

You are in the normal club of everyday patients. I would certainly not worry considering you’ve been taking the medication for years with no side effects… and if I were you, I would considering staying on the drug. Ultimately, I’m not your doctor and it isn’t a decision I am a part of, but if you’re truly concerned, talk to your prescribing physician.

It is unfortunate that we live in such a litigious society. Judging by the press releases I get via this site, the lawsuit talk is mostly generated by law firms seeking out people and looking to cash in.

While unrelated to hair, did you hear about the 80-something year old woman who is suing Apple for a million bucks, because she walked into the clear glass door of one of their retail stores?

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

I Was Recommended 4000 Grafts with No Crown Coverage

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

Hello Doctor,

I went for an initial consultation to a very reputable HT surgeon in Ontario a few months back… I was recommended a 4000 graft procedure, however this would not include any crown coverage. I was told I may want a second procedure in the future to cover the crown and I should have 3000 grafts left to accomplish this…I am around a Norwood 4 and in my late 30’s…The more I think about it, 4000 grafts with no crown coverage seems like a heck of a lot, or is it just me?

Yeah, that does sound like a lot! Maybe you have a large head… or really fine, almost invisible hair? If you’re concerned about the recommendation, get another opinion. I can’t really comment on what is appropriate for you without seeing / knowing more your hair loss. Also, are you sure the recommendation was 4000 grafts and not 4000 hairs? Each graft can contain multiple hairs.

Take a look at our patient photos and see what other people had done for their balding patterns. There are hundreds of patients (with thousands of pictures) on the site. This should be a reality check for you.

Tags: hair transplant, hairloss, hair loss

Is DUPA Just on the Scalp or Can It Be on My Face and Body?

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

Is there facial and body hair loss DUPA? And if not what type of hair loss could cause diffuse hair loss all over?

By definition, diffuse unpatterned alopecia (DUPA) can be over the face and body, but we generally only use the term to describe hair loss on the scalp. There are other conditions that cause hair loss on the face and body, such as alopecia areata or alopecia totalis.

Tags: alopecia areata, dupa, diffuse hair loss, hairloss