What Are My Options After 2 Failed Hair Transplants?

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

What are my options after 2 failed procedures?

I had hair transplant surgery around 2007 using strip form back of head method, by what I thought was a credible Dr. from reviews online, experience level etc…Paid alot of money for hundreds of graft and got very little result. In fact only a few strands grew in at the hairline and temples grew in. None of the grafts in the crown area, where he said he really “packed them in” grew. He kept saying “you had beautiful grafts” and seemed dumbfounded as to why they didn’t grow.

After the salesperson tried to convince me that there was something wrong with me, the Dr. finally admitted that it was a failed procedure and agreed to do another one at no cost, This time saying he was going to try less grafts in that area hoping for better blood circulation. Well that also yielded very little growth. Although after about a year and half, filled in a little,but very little. Which shows me that there was no scalp biopsy necessary as they initially tried to say there was something wrong with me. I did get some growth. If there was a problem with my scalp, wouldn’t I have gotten 0 growth??

Overall I consider my decision to be a poor one because now i cannot even shave my head or wear a low style because of this huge scar (even wider now from 2 procedures) on the back of my head.

So my question is a two part question. Is a future transplant out of the question for me or could it be that this Dr and staff blew it twice? It should be noted that I am of mixed race(black and white) 38 years old,(34 at time of procedures), with more of wave than a curl to my hair, not real kinky but thick and puffy and coarse when it grows long on back and sides. The Dr did say they had experience in afro american hair types and seemed very confident during consultation with my donor area and being able to handle my hair type

Any insight as to what might of went wrong? The balding area was pretty much completely bald so I am not seeing native area that has thinned out after surgery, but the area that never fully grew in after 2 procedures.

Also is it possible that 4-5 year later that some of those graft may still have ability to grow?? With the aid of a product like Nioxin??

Thanks in advance for your answers

That is one hell of a story! If that happened to one of my patients, I would want to get a biopsy of his scalp, looking for a disease like alopecia areata that would cause rejection of the hair grafts. Unfortunately, your story is far more common than our profession would care to admit. Doctors who lack competence often use salesmen to push hair transplants beyond their abilities to perform it well.

One of the reasons that I started BaldingBlog is to have a place to let people share their stories. Your situation is quite unfortunate. For those that are shopping around for a doctor, remember that it is critically important to have thorough research. I’ve written a “how to” guide of sorts for selecting your hair transplant doctor.

As for your options, I think you should see a doctor who specializes in fixing screw-ups. The grafts should be growing, and if there’s nothing there after 4 or 5 years, I wouldn’t expect them to suddenly appear. I would be happy to give you my opinion, but I would have to see you. I’m in Los Angeles… but as you are in the Northeastern United States, consider a visit to Dr. Robert Bernstein for an opinion. Best of luck to you.

Tags: hairloss, hair loss, hair transplant

I Stopped Taking Propecia, So How Much Catch-Up Hair Loss Should I Expect?

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

Hello Dr. Rassman!

First of all, thank you for this spectacular blog, it’s amazing.

I’m a 21 year old who has been on propecia for about a year. I’m unlucky in the sense that I started thinning all over except for the sides and back since I was 17. I however decided 2 weeks ago I didn’t want to take propecia anymore because damn it, I don’t care what society thinks. I’ll be bald, proud, and won’t let something like hair stand in my way. I’m a man. I’m not supposed to be pretty, but manly.

My question is, how much catch up hair loss is there likely to be? I don’t feel like propecia did much for me. It seems like my hair’s a bit thicker… but not really, so… Is there any possibility I’m one of those people propecia did nothing more than a placebo to?

Thank you for your time and all the best!

It’s possible that Propecia kept your hair loss from being worse than it is, but it’s also possible that you are a non-responder to the medication. I really have no way to know, as I don’t have any hair bulk analysis to compare before starting the medication and today. You can look into having a HairDX test done to predict your response to finasteride.

If you do see catch-up hair loss after stopping Propecia, I suppose that means the medication was working for you. Your hair loss will eventually catch up to the point you’d be at had you never started the medication. So if the Propecia worked to some degree, any benefits will eventually be gone.

Tags: hairloss, hair loss, propecia, finasteride

It’s Hot and Humid Here, and I Wear a Bike Helmet

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

Hi,
i have a quick question.Im 18 years old and live in chennai, india its pretty hot and humid here.

I have recently (2 months back) started driving a bike and hence started wearing a helmet regularly. i have noticed my hair thinning on the top. can it be due to wearing a helmet? is there any solution to this?

Thanks in advance

HelmetHelmets or hats or hot weather do not usually cause hair loss… unless perhaps your helmet is very tight and it is rubbing continuously on your scalp. It is more likely to be genetics than wearing a bike helmet.

There is no absolute solution / cure for hair loss, but if it is early genetic loss, the medications I would talk to your doctor about are finasteride and minoxidil.

Tags: hairloss, hair loss, helmet, humidity

How About a Minoxidil Styling Wax?

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

Can Minoxidil be in the form of a hair styling wax? The current minoxidil products on the market are mainly spray, foam or gel form.

Would the addition of Minoxidil into a wax be viable?

Minoxidil topical is used to grow hair, but you need to put it on your scalp, not hair. So if you make it into a wax for styling purposes, it would not be doing any good (unless you want to cake it on your scalp).

Tags: minoxidil, rogaine, wax, hair styling

Can the Microwave Oven Cause My Hair Loss?

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

My hair exposed from the heat of the microwave oven. is this possible that my hair will burned? what if i saw my hair been fall down. i saw pieces that is burned what are the effects of this?? Thank you

MicrowaveDid you stick your head in the microwave and manage to turn it on? There are safeguards in place in most (or all) microwave ovens to prevent you from turning it on while the door is open, but assuming you somehow did… I really don’t know what effect it would have on your hair.

If there was heat and you manged to burn your hair at the scalp level, causing 2nd degree burns to your scalp, I would venture to say you may have permanent hair loss.

Your question is very strange. But with that said… using a microwave oven in a normal way would not cause hair loss.

Tags: microwave, hairloss, hair loss

Does Finasteride Change a Woman’s Cycle?

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

Will taking finesteride alone cause changes in a woman’s cycle. I recently stopped birth control pills and continued the finesteride but have noticed some changes.

Thanks

Finasteride is NOT approved or recommended for women, especially those who are of childbearing age. Even more importantly, finasteride can potentially cause birth defects if you were to stop your birth control and become pregnant. You need to speak with your doctor and address your issues. I can’t imagine why any doctor would prescribe this medication to you at your age.

Since there have been no studies (that I know of) in women of child bearing age, I would not know how it would affect the woman’s cycle. There was a small study on finasteride in women experiencing postmenopausal hair loss, but this is clearly not the case for you.

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

Is Aderans Completing Phase 2?

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

hello dr
i think Aderans is very close to complete phase 2 and begin with the last phase which is phase 3

this is the link: Aderans Research Reaches Major Milestone in Phase 2 Clinical Study Enrollment

From the release — “Aderans Research reached a major milestone this month with the completion of enrollment in one of its key Phase 2 clinical protocols.”

I don’t know that they’re all that close to completing phase 2, based on the info in this press release. It says they’ve completed enrolling participants for phase 2, which sounds like it could still be pretty early in the phase.

Tags: aderans, hairloss, hair loss

I Don’t Have Hair Loss, But My Hair Is Thin — Should I Use Rogaine?

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

(female)
Hi Doctor

I am not experiencing hair loss, but my hair has always been very thin and sparse. What products could your recommend to stimulate hair growth? Is Rogaine foam a product to consider?

Thank you.

In my opinion, Rogaine does a poor job of thickening hair. Rogaine generally grows fine hairs, so using the medication would not really result in too much thickening of your existing hair. You can give it a try if you want to see for yourself.

Tags: rogaine, hairloss, hair loss, minoxidil, female hair loss

Differences Between Strip and FUE?

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

I’m told that there are two different processes for this procedure, one for a client with hair and another method for clients without hair. My understanding is the client must decide before the procedure which they want because the process for buzzed/shaved hair will not look right with the method used for longer hair and vice versa.

1. Is there two different methods, one for buzzed/shaved hair and one for hair with a longer length if so why and what is the difference between the two methods?
2. You indicated in an email that the same amount of dots are used for an individual with hair as one without. Why?
3. If the method for clients who want to leave some length to their hair is different from clients who have shaved/buzzed hair and the client must decide which method they want before the procedure, because the method for buzzed/shaved hair won’t look right with clients who leave some length to their hair what happens if the clients hair thins out in the future? Will it not look right?
4. I’m told the hair must be shaved/buzzed before the procedure. If that is the case, and the method for longer hair is used which they say doesn’t look right with shaved/buzzed hair is that going to look weird until the hair grows back?
5. How deep does the needle go?
6. For my situation being that I want to keep my hair longer than a buzzed/shaved length do you use dots or more of a blanket coverage. Can you explain? If you use dots what size would the follicle dot be?

There are two ways to harvest the donor hair for transplantation:

1. Take out the hairs one-by-one using a small (1mm diameter) punch. This is called the Follicular Unit Extraction (FUE) method. To do this, you need to shave the back of your scalp so that that hairs will fit into the small punch. Without shaving the area, you can individually thread each long hair into the small 1mm diameter punch, but that would be a very, very long and inefficient process. FUE will allow you to have a buzz cut or keep your hair very short later on (when everything has healed) without seeing scarring… but if you shave your head completely, you will see thousands of white dot scars. So there will be scarring there, just not a linear scar.

The needle goes in the depth of a follicle, which is about 5mm, and the dots of the FUE scar can range from 0.8mm to 2mm in diameter. It all depends on how each person heals and the size of the instruments used by the doctor. To read more about the pros and cons for FUE, see here.

2. Another method (strip surgery) is to cut out a small section of your scalp and stitch it back together, like if you had a cut to any part of your body. This section of removed scalp is taken and dissected under a microscope into individual follicles. Your body will heal with a line scar, which won’t be visible if you keep your hair relatively long. The shortest haircut should be with maybe a #2 guard on the clippers, though a #3 guard should hide the scar without any issue. If you shave your head, you will see a linear scar. This type of procedure can be done without any hair cut or shaved in the donor area, so that when you leave the office you will not be able to see any evidence of surgery, as your hair will immediately cover the incision.

You will, however, have redness in the area where the grafts were transplanted. The severity of the redness depends on your body and where the grafts are transplanted to (if it was to a completely bald area, it will be evident — if it was to an area that had some hair, you might be able to cover it with styling).

Acne, Hair Loss, and Numbing Pain in My Arms

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

First. It was nice to see a blog about hair loss authored by real doctors and thank you for that. I am from Philippines and there are not much doctors here that specializes in hair loss problem thus when I visited once before, i was not able to get answer. So i hope you could help me here.

I was 19 when my hair loss started together with some big acne. My mom said it is hereditary but what concerns me is the very very subtle tingling pain in the place where I am having hair loss (which is the front). Sometimes I feel it after I comb my hair.

Another are the acnes, is there a case that having an acne and hair loss at the same time is a symptom of something.

3rd is I always experience numbing pain in my arms that I have not experience before.

I am sorry if I have too many questions because I read a lot about hair loss but couldn’t find answer to why I am having one. Right now my hair is in a norwood 2. I tried to talk to one doctor before but his answer was because it was due to stress then gave me prescription for my acne not my hair loss. Sorry. This is already long but Thank You in advance.

Acne doesn’t cause hair loss, and hair loss doesn’t cause acne. Your loss may be stress-induced like your doctor said, but at 19 years old it’s entirely possible that you’re showing early patterned hair loss. A Norwood Class 2 could just be a mature hairline, though. That isn’t anything to be concerned with. I haven’t seen you, so I can’t make that determination.

I do not know what numbing pain in your arms has to do with having acne or hair loss. I think you may be trying to link everything into one. Unlike physics, there is no unifying theory about hair loss.

Tags: hairloss, hair loss, acne, numbness

My Doctor Said My Hair is Fine, But I Want You to Judge It

/by William Rassman, M.D./12 /,

Hey Doc,

I’ve been concerned about my hair for nearly two years now. I’m 21, nearly 22.

I went to my GP who said there wasn’t a problem with my hair, and that I didn’t need to go to a dermatologist. However, I’m still a bit iffy about it. I (think) I have a natural parting down the middle of my head. You be the judge. But either way, am concerned about miniaturisation and recession.

Based on those pictures (taken a couple of months ago), can you see if there is anything I should be concerned about with my hair? Hairline and crown/top of hair.

Feel free to post pics if this gets posted. Thanks.

 

I just chose a few photos to post out of the 35 or so you sent in the link, but I appreciate you allowing us to publish them.

I think you should listen to your doctor. Based on photos alone, your hair seems fine. I’m not seeing any cause for concern, and your hair looks great. We can let all the readers judge as well. Click the photos to enlarge.

Tags: hairline, hairloss, hair loss

Are My ED Problems Porn-Induced or From Propecia?

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

What is the longest time Propecia side effects can appear? I been on Propecia for almost 4 years and within the past several months I got ED when I have sex I can’t even get an erection to penetrate but when I masturbate to porn I can maintain a strong erection! After enough research I’m almost positive I got porn-induced ED! So now I’m in the process of recovery but since I’m on Propecia, I wonder now if possibly that after such a long time side effects could appear!

Propecia has halted my hair loss and I don’t wanna stop it. I’m 25yo it’s too early for me to be bald!

Side effects from any drug can appear at any time, but this is relatively rare. Most side effects would appear in the first few weeks — not after 4 years. If you think Propecia is causing your erectile dysfunction (ED), talk with your prescribing doctor and consider stopping the medication or cutting the dosage. If you think porn is causing your ED, stop watching porn or talk with your psychologist. I really have no way to know what is causing your erection troubles.

Here are some ED statistics that might be interesting to you (source: MMHC) —

  • One in 10 men in the world have erectile dysfunction.
  • 30 million men in the United States have erectile dysfunction.
  • 50% of men with diabetes have erectile dysfunction, frequently within 10 years of diagnosis.
  • The likelihood of erectile dysfunction increases with age: 39% at age 40, 65% over the age of 65.
  • Smokers have a higher likelihood of erectile dysfunction. Men who smoke more than 1 pack per day have a 50% higher chance of impotency than nonsmokers the same age.
Tags: erectile dysfunction, hairloss, hair loss, propecia, finasteride, porn

Tocotrienol?

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

Hi Doc,

thanks for your awesome website.

I stumbled across this article – Take this vitamin to halt hair loss

and this website – Tocotrienol.org

What can you comment about this? Would love to hear your comments. Thank you!

There are always new products that come out claiming to be hair loss cures. This is one of them. I cannot say if Tocotrienol works or not, but here are some things to keep in mind when doing your own research. Read the report carefully. Find out how many subjects were in the study group. Is it 10,000 or is it only 10? There is a difference, right? In this case, the study was 38 people. Ask if there was a financial or marketing incentive. Find out if the report was published in a well-respected journal (and realize that even if it is in a published journal, it does not necessarily mean it is good study).

Tocotrienol is an herbal vitamin E treatment, and I really have no significant comment to give other that “buyer beware”.

Tags: tocotrienol, vitamin e, herbal, hairloss, hair loss

In the News – Could Stem Cells Cure Multiple Sclerosis?

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

Snippet from the non-hair-loss-related article:


Human mesenchymal stem cells (hMSCs) have become a popular potential therapy for numerous autoimmune and neurological disorders. But while these bone marrow-derived stem cells have been studied in great detail in the dish, scientists know little about how they modulate the immune system and promote tissue repair in living organisms.

Now, one research team has uncovered a molecular mechanism by which hMSCs promote recovery in a mouse model of multiple sclerosis (MS).

According to research, published online Sunday (May 20) in Nature Neuroscience, a growth factor produced by hMSCs fights MS in two ways: blocking a destructive autoimmune response and repairing neuronal damage. The finding could help advance ongoing clinical trials testing hMSCs as a therapy for MS.

Read the rest at The Scientist — Could Stem Cells Cure MS?

Multiple sclerosis is an autoimmune disease that affects the brain and central nervous system, with millions of sufferers all over the world. I know this post isn’t hair-related, but regular visitors to this site know that I like to post interesting general health news/opinion.

Tags: ms, multiple sclerosis, stem cells