Hi Doc,
If a cure for baldness does arise whIle this blog is still active, how would you choose to celebrate?
I’m not a drinker, but if a real hair loss cure were to come out, that would be a good reason to have a bash and get drunk in celebration.
Is SMP for longer hair a different technique when doing it on people who keep their hair short. I have had many hair transplants so I have good coverage but not enough density. If I had SMP but elected to keep my hair longer would SMP consist of dots or shading?
Thank you
This is a very important question. Scalp Micropigmentation (SMP), as we do it, mimics the shaved hair follicle as it emerges from the scalp, having no length. This is not a piece of art in the classic manner with shading and depth color. Some people want their scalp to become darker, so they use products like Toppik (a concealer) to darken the scalp and match their hair color. That is not what we do with SMP. For this reason, SMP has more limited application and it can not match the powders or concealers.
When used with longer hair, one can still see the scalp between the hair, and the tattoo impact from the SMP is not dramatic. For this reason, we want most people to get realistic expectations. We do not paint the scalp with tattoo dye — that is not SMP — but we do create a stippled appearance of the scalp skin between the existing hair follicles when we do it for people with longer hair.
Tags: pigment, smp, scalp micropigmentation
Hi doctor Rassman,
I’m a 30 year old man from Belgium. For about 2 years I am following your blog daily. Thanks for this blog, because it reduced my concerns dramatically!
To keep my story short, I have severe depression and anxiety since January 2009. A couple of months after the start of my disease in 2009, I lost my hair density with a more see through scalp as result. Since then I lost more than 100 hairs daily, which made my disease worse. I lost everything, including my wife.
Now 3.5 years later I still have good coverage and I still can style my hair in such a way that people think that I have zero hairloss. I am using proscar 1.25 mg for about a year now, and the hairs I am losing in the shower are much thicker than they used to be. However, I am still depressed and obsessed with my hair, I really don’t know what to do. Please help me doctor Rassman :(
I visited your country about a year ago and love the place and its people.
You need to get a doctor to explore if this drug is impacting your state of mind (a potential very rare side effect). If I were your doctor, we would get to know each other… but I can not manage you from this distance. You need to get your depression under control, which may or may not be related to finasteride, since you said you had severe depression before starting the drug.
Tags: hairloss, hair loss, propecia, finasteride, depression
I have been seeing a great amount of hair loss for about 5 years. It appears to be much worse lately. I am 81 years old. Could it be attributed to post menopause ? I also have really bad dandruff. It all seemed to start when my husband died.
Stress can cause hair loss in someone your age. I would have to examine you and possibly do some special blood tests to determine if these is a cause for the hair loss that can be treated. Female hair loss could be caused by a variety of issues, but the death of a spouse is obviously a very stressful situation and can cause the loss you’re seeing.
Tags: hairloss, hair loss, female hair loss, stress
I am searching for legal help!
After applying “Minoxidil” to a bald spot on my scalp I had a severe life threatening reaction. My pulse rate gradually climbed to 240+ at which time my wife dialed 911. I could not be moved from my home until EMS and an EMS physician who was rushed in could lower my heart rate. I am now in constant fear of a recurrence and will not be without emergency medication that I carry in my wallet. I came very close to death!
The worse part of this scenario is the fact that the EMS team (2 were in my home) did not know how to stop the rapid pulse rate, my wife and I heard them ask the ER physician what to do the next time they have a similar situation! My health has been permanently and adversely affected, I have an almost constant irregular heartbeat and I’m unable to be involved with any activity that causes stress, have not been able to work since the initial adverse reaction.
I’m just now inquiring about a possible lawsuit after an associate mentioned hearing about the connection between rapid uncontrolled pulse rate and Minoxidil/Rogaine, the EMS trip to the local hospital took place March 18th 2010, my medical condition is worsening. Until now anyone associated with this disaster ever relayed the connection or any info between this dangerous drug and what happened to me, not in the ER or our family physician?
Please advise…
I am not a lawyer and the purpose of the blog is to give medical information, not legal advice.
Minoxidil can drop blood pressure if greatly absorbed from heavy applications; however, I have never heard of anything like you reported.
Tags: minoxidil, rogaine, blood pressure, heart rate
I’m almost 26 years old and been using Fin 1.25mg for exactly 4 years for early hair loss. Since starting fin my hair loss ceased completely, I still look the same like 4 years ago! For the past few years I also saw way less hair shedding.
For the past 2 months I see a much bigger increase in hair shedding including weak hairs. My hair length is always the same (medium long) and I been using the same hair products gel & mousse all the time. When fin loses effects is increased hair shedding the first sign? So far my hair still looks the same but I’m definitely very worried.
I have said this over and over here on BaldingBlog: There is no way to completely stop hair loss (your genetics win out in the end).
Finasteride (Propecia) will help, but everyone is different in how they respond and how their genetic predisposition will work out. There is no sign that indicates finasteride is not working, but it is more about how your genetics is winning. It might just be semantics, but I want to be sure everyone is clear. If you see the loss start up again, finasteride is still working, but your genetics are winning out. It doesn’t just stop working.
I can’t explain your recent increase in hair loss, but if you’re concerned you should pay a visit to your prescribing doctor for a follow-up exam. If your doctor made bulk measurements before you started the medication, he could tell if your hair loss has picked up again. Get some good measurements of your hair loss so that in the future, you can tell what is really going on.
Tags: hairloss, hair loss, finasteride, propecia
my son got a big scar on his head from one ear to other due to head operation. his age is just eight years. can hair grow on on that area?
Hair won’t regrow on its own into scar tissue in most cases (depending on the wound closure technique done). I don’t know what kind of operation he had or how big the scar is, but when he gets older a hair transplant could be an option. I wouldn’t expect any non-surgical treatment will get the hair to regrow on the scar tissue.
At 8 years old, I wouldn’t suggest a hair transplant as the route to take just yet, but if it’s something very bothersome you can take your son to a surgeon to see what options might be available.
Tags: scarring, scalp scar, hair loss, hairloss, hair growth
Is is safe to assume that vellus hairs turn into normal hairs on finasteride?
Vellus hairs stay as vellus hairs. In every follicular unit, there are one or two vellus hairs (short like stunted hairs). Miniaturized hairs, on the other hand, are terminal hairs (normal hairs) that lost their bulk and these are the hairs that get positively impacted from finasteride by increasing their shaft thickness when they are miniaturized.
Tags: finasteride, propecia, vellus hair, hairloss, hair loss
I have been to many dermatologists and i have been told by one that my scalp was red and i was sent a shampoo but to no avail. A second dermatologist said it was simply male pattern baldness. The only issue is that i am losing my hair from the middle all the way from the front to the back, is this male pattern baldness? as far as i understood it usually starts on the sides and moves in, mine is strictly a big strip in the middle.
There’s no way for me to know what is going on without an exam, but male pattern baldness does not start on the sides of the head. Actually, the only hair that should be untouched by hair loss should be the hair on the sides. If there’s redness, that’s something your dermatologist can treat.
Tags: hairloss, hair loss, mpb
Why is it that when a baby’s hair is growing in, it starts with the pattern of the receding hairline? Thinner on top with a forelock and nothing at the temples?
On another note…is the hair at the temples and crown slightly thinner in even non balding people? I notice that women and children also seem to have lighter/thinner looking hair at the temples.
I just had my first grandchild on May 1st, and she was born with a Norwood class 4A balding pattern… so of course, the jokes ran around that we were going to transplant the new addition to our family. The proud daddy laughed and laughed. Over the course of 4 weeks, the hair loss pattern got better and now she almost has a full head of hair. I don’t have an explanation as to why some babies are born with less hair that quickly grows in, but it’s not uncommon. Some of my own kids were born with a gorilla look (hair-wise) instead of the class 4A pattern on my granddaughter. Don’t focus too much, as things in the hair side change rapidly in babies.
With regard to your second unrelated question, I don’t really see much of a difference around differing parts of the scalp, but hair in the very frontal hairline and the neck is often finer.
Tags: hairline, baby, infant
As an innovator in the field and with many patents to your name I am curious as to whether you have ever given thought to inventing a “scalp exercise” device. Imagine a motorized device strapped around one’s head moving the scalp up and down to increase one’s laxity in preparation for a future transplant. It would basically work as a scalp massage.
For a couple hundred dollars I’m sure many transplant patients would invest in one to maximize their graft numbers. Doing these exercises with the hands can get quite exhausting just after a few minutes.
It’s a good idea, but there have been a few patients who have came up with their own scalp exercise ideas that they are pursuing. In the grand scheme of things, scalp exercises are not the rate limiting step, nor do the exercises have a drastic impact on the success or planning of a hair transplant procedure in most situations.
Believe it or not, if I were to create a device for scalp massages and claimed it could loosen the scalp, it would be a medical device from the FDA’s perspective. It would then have to be proven safe and effective, a tall and expensive undertaking I might say.
Tags: scalp exercise, hair transplant, fda, device, inventions
Snippet from the article:
A group of doctors contracted by Hair Club for Men and Women, a unit of Regis Corp., is seeking to block the possible sale of the unit to Aderans Co., according to documents obtained by the Star Tribune.
In a recent letter to Regis Chief Operating Officer Eric Bakken, the doctors say they fear the Japanese hair company will eliminate Hair Club’s surgical business, their financial lifeblood, citing previous statements from Aderans executives.
Read the rest — 10 doctors try to derail Regis’ sale of Hair Club
If the sale should occur, it will reduce the 800 pound gorilla numbers from two to one. Aderans (owners of Bosley) purchased another hair transplant chain, Medical Hair Restoration, in 2007 and merged the two under the Bosley name a few years later.
Tags: aderans, hair club, bosley, mhr
Hello Drs. Rassman + Pak, thank you for creating this amazing website.
You recently posted regarding the (encouraging) 10 year Finasteride usage clinical results. And, I believe, you have stated that some NHI patients have used Finasteride for 10+ years and maintained their hair almost completely.
I was wondering about the flip side of the coin — what is the MOST hair loss you’ve seen among patients who have stayed on Finasteride?
I ask because I’m nervous about my own future (as a 28-year-old Norwood 3 on Finasteride who just had a transplant).
Thank you!
I am not sure how to quantify the most hair loss I’ve seen. When I meet with patients and examine their hair loss, I generally give them a Master Plan as to where their hair loss is going. So if an 18 year old male with a full head of hair comes for an examination and I see that they have almost all miniaturized hairs on the front and top in a Norwood 6 pattern, I can explain to them they may progress to a Norwood 6. I would then likely put them on Propecia and after a year they may grow some hair back, or at the least maintain what they have.
Over the following years, I suspect they would lose more and more hair, but at a much slower rate than if they were never on Propecia. Eventually, after 10 or 20 years, they would end up as a Norwood 6, but before this happens they may choose to have a hair transplant surgery to avoid looking bald. This is an example of what I mean by a Master Plan. I don’t immediate recommend surgery, but plan out how someone may lose hair and bald, which is why we come up with a road map to address their hair loss issues (with medication and surgery).
But to give you the short answer — I have seen someone still go bald, despite being on Propecia. Genetics will always win out and I can’t guarantee the medication works the same for everyone that takes it.
Tags: propecia, finasteride, hairloss, hair loss
hello, sorry for disturbing you. i have used propecia for hair thinning and hair loss. i have seen great results just in a month. hair loss totally stopped from the first week and hair became very thick just with in 30 days of use. but i stopped using the medicine. after some days again my hair started shedding and thinning.
after five months again i started taking the medicine. i have completed one month on the medicine but still my hair sheds a lot and hair appears very thin. it is not working as it worked before. what might be the problem? is my body showing tolerance towards the medicine? should i continue or discontinue the medicine? please tell me…..
I have a hard time believing the Propecia caused your hair to become very thick in just a month. Maybe it was a placebo effect. Propecia usually takes about 6+ months to start working to that degree. It works on the new hair that is growing out of the skin, which grows at about 1/2 inch per month. Regardless, why did you stop after a month and then decide 5 months later to restart? The medication has to be continued daily for it to be effective, but I can’t tell you whether you should take a prescription medication (I am not your prescribing doctor).
Please follow up with your doctor who prescribed you the medication and discuss these issues to determine your next course of action. You need a good solid diagnosis of your hair loss and measurement of a baseline (miniaturization study, photographs, bulk measurement, etc).
Tags: propecia, finasteride, hairloss, hair loss
I am bald now after 13 treatments of radiation therapy for a brain tumor. Is there a treatment for my dead hair follicles other than just wearing a wig? Now I cover my head with scarves but they fly away when the wind blows.
It is possible that some of the hairs will grow back within a year after the radiation. There is no medication or treatment to bring back hair lost from radiation treatment. All you can do is wait. Temporary hair loss is more common, but hair loss is known to be permanent depending on the dose. A small study about this was published in 2004.
There are other options that may be available, but one can not guess wildly here without waiting out the year.
Tags: chemotherapy, radiation, chemo, hairloss, hair loss
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