Patient Results – Amazing Change in Just 9 Months After 2781 Grafts (with Photos)

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

This patient is a doctor and appreciates the radical change in his hair over the past 9 months since he had his hair transplant. He told me that no one specifically noticed the change as his hair was growing in, but knew there was something going on that made him look around 10 years younger.

Some thought he was just exercising and eating better. He said that even when friends looked at his head, it wasn’t apparent to any of them that he had been growing hair where he was previously bald. But comparing his current look to his before photos, the change is quite apparent now.

Click the photos to enlarge.

After (2781 grafts in 1 procedure):

 

Before:

 

Tags: hair transplant, hairloss, hair loss, photos

Is Dutasteride Any Better Than Propecia for Treating Hair Loss?

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

Doctor Rassman/Pak thank you guys for the blog, you guys are truly amazing.

My question is, is Dutasteride really better than propecia? I know its no fda approved for hairloss, but in your opinion do you guys think it is better and more effective? Doctor Rassman/Pak I know you guys rarely prescribe dutasteride, but do you guys have any patients that are on it and have had better results than they did with propecia first? also do you have patients that did not respond to propecia at all, then went on dutasteride and had good response? or at the end of the day avodart and propecia are both the same, and the more dht reduction from avodart does not make any impact more than propecia in terms of hair?

thanks guys

You are correct in stating that we at NHI rarely, if ever, prescribe dutasteride. Some doctors in our community prescribe dutasteride and believe that they gets better results with it versus finasteride. There may be differences in their efficacy, but the higher risk of side effects and long term effects are unclear, especially the risks of sterility that have been reported.

I have occasionally seen patients who have taken dutasteride after taking finasteride, but in my opinion their results are equivocal.

Tags: dutasterude, avodart, hairloss, hair loss

My Crown Hair Loss Started at 36 Years Old

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

Hello Doctor. I have not found a satisfactory answer to my question. Please help me.

I am a 43 year old Caucasian male. I started losing hair at the crown at 36 years old. I have baldness on the crown (8cm in diameter). I have a few strands at the crown that are healthy. I’ve always had great hairline corners that have advanced very little (especially at the temples). My baldness would crown with NW2 NW3. I still have very straight hair, bulky, and heavy on my head. I have plans to have surgery at 46 years old because it will be the best time for me.

My questions are:

1) My crown will increase in size?
2) At what age can I feel safer?

Please, I know that the answers are hypothetical. But I wonder if baldness never ends.

Congratulations for your work. Thanks for your replies. Sorry my english.

You may continue to lose more hair in the crown, but I have no way to know for sure without examinations. There’s also no way for me to give you an age at which your hair loss will stop. Everyone is different, and there’s no math that will tell me exactly how long someone loses hair for.

The best treatment for crown loss is the drug finasteride, which is available by a doctor’s prescription (talk to your doctor).

Tags: crown hair loss, hairloss, hair loss

I Pulled Out Some Kinked and Coarse Hairs I Found Amongst My Normal Scalp Hair

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

A quick question that I haven’t seen addressed on here.

I had a bout of trichotillomania that lasted a few years and left a small sparsely populated patch just to the left of my crown. The reason I pulled from that area was that I had some hairs there that grew in very kinked and coarse; they were jet black and sort of twisty. My hair is normally dark brown and straight.

What causes those differently-textured hairs? Do they forecast hair loss?

Thank you!

Sometimes hair color and characteristics may vary in individuals. It can be totally normal. Kinked or coarse hairs do not forecast hair loss.

Tags: hair character

I Have Short Hairs in the Temples (with Photos)

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

Hello, I’m 21 and I always had much hair loss. I’ve gone 2 times (on 2010 and 2008) to a dermatologist who said it was a normal hair loss (and the fact that I have very long hair makes it even more normal). However I have always been quite nervous about it, I wash my hair every other day, the day I don’t wash it I lose about 45 to 65 hair all day, and on the days I wash it I lose between 165 to 190. I have some shorter hairs in the temples and I’m afraid that it may be a sign of miniaturization (they appear to be as thick as the other hairs tho).

I’ll send some pictures of my hairline (two from 2010 and the rest of them I took a couple of days ago), feel free to use them in your blog, and sorry for the bad grammar.

Thank you for allowing us to post your photos. Click them to enlarge.

 

Your pictures shows changes that are consistent with a developing mature hairline, but it does look more ‘ratty’ than I would expect it to look.

Losing 100-150 hairs per day is average as another 100-150 hairs grow out per day. These start off very short as they emerge from the scalp and then grow out at a rate of about 1/2 inch per month, so if you see short hairs, those probably reflect these new hairs. Between the hairs that fall out and then regrow there is a short 3 month cycle where the hairs rest before regrowing.

Miniaturization is where the hair shafts get thinner and thinner over time. I suspect that you need to see a doctor who can look for miniaturization and also do hair bulk measurements which will clearly tell you if you are balding. So I would need to have full access to your scalp and frontal hairline to determine what is actually going on.

Tags: hairline, hairloss, hair loss

Radio Interview with Dr. George Cotsarelis

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

Here is a radio show where doctor George Cotsarelis showed up and talked about hair loss. Although nothing new was mentioned it is an interesting study of psychological affects that baldness can cause

Link: Hair and who we are

I haven’t had time to listen to the show, but I thought I’d post this for those that are interested (thanks for sending us the link).

The description of the radio show says they talked with Albert Mannes (the author of the “bald men are dominant” study), interviewed Dr. Cotsarelis (one of the doctors that is researching PGD2), and spoke to a salon manager that lost her hair from chemotherapy.

Tags: cotsarelis, radio, interview, hairloss, hair loss

Should I Try Every Non-Surgical Treatment Before Going for a Hair Transplant at the Hairline?

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

Hello Dr. Rassman. I am in my early thirties and thinking of getting a transplant done. I have been on finasteride for quite some time with decent results. However, in the last few years my hair loss picked up in the front hair line but has slowed down up to this date. Should an individual, like myself, try ALL the available non surgery options like avodart, minoxodil, nizorol etc before going the hair transplant route?

Most of my hair loss im the frontal area. I still have decent coverage but I am thinning. Would I be at risk for severe shock loss even though I am on finasteride? Thank you.

Medications do not usually work to regrow hair in the frontal hairline, but hair transplant surgery generally address this area well. Whether you are ready or should undergo hair transplant surgery is between you and your doctor, and part of the Master Plan. Each and every patient is different, with different goals and expectations. There is no right answer to your question.

Many patients come to me and worry about shock hair loss, but this is part of the individual risk versus the benefit… as we discuss in the Master Plan. Most men in their 30’s with long term finasteride (Propecia) use and who are not rapidly losing hair, do not usually have shock loss. An ethical doctor would not recommend surgery to a patient if they feel the risk of shock loss is significant. I know I am a broken record on this, but this is why choosing a doctor and having a good Master Plan is very important.

Tags: hairloss, hair loss, shock loss, hair transplant

Swiss Clinic Offers Stem Cell Transplants to Regrow Hair

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

Hello,

I found a website about Ars Medical, a clinic in Switzerland that does stem cells autologous transplantation in order to regrow lost hair. Here is an excerpt: “In ARS Medical, the physicians perform Autologous Transplantation of your own Stem Cells that are harvested from your fat and are activated by specific technique before use. This hair treatment is absolutely natural and safe. There is no risk of side affects of other treatments , such as allergic reactions, infection or irritation to the skin of the scalp.”

Their website is available here: ardsmedical.info

Could you please tell me what is your opinion about this technique? Is is safe and effective?

I have read several articles and from what I could understand, the research is still in progress and not yet reliable.

Best regards

I do not know if it is safe or effective. I wonder if they will be publishing their research or results in peer reviewed journals. Without such publications I would put their claims into the trash heap, and coming to market prior to proof in the medical establishment is borderline scam territory. The site doesn’t show any photos of patients, doesn’t list any doctors that work there, and looks to focus more on selling their shampoos.

I think you said it best yourself, “not yet reliable.” What more can I add to that?

Tags: stem cells, hair transplant, hairloss, hair loss

Why Am I Losing My Eyebrows and Eyelashes?

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

Hello,
Can Androgenic Miniaturization occur in the eyebrows and eyelashes. I hear many reports that hair loss in these areas must be something else. I have exhausted all other possibilities; hormone checks, diet, fitness training, you name it. The hairs fell out in unison and the ones that grew back grew in thin and fragile. Could you tell me if Telogen Effluvium can present with the loss if thick hairs being replaced with thin (shaft diameter) slow growing hairs

I don’t know much about you and I obviously cannot diagnose your condition, but telogen effluvium can causes eyebrow loss in some cases. Some people just lose the outer 1/3 of their eyebrows as they age. If you have exhausted all possibilities and ruled out all medical issues, eyebrow hair transplantation may be an option. Have you seen a doctor?

Tags: telogen effluvium, hairloss, hair loss, eyebrows, eyelashes

Does Grapefruit Extract Affect Propecia?

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

hello dr

i want to ask you about this fat burner as it has grapefruit extract. does this product accelerate hair loss or affect propecia effects?

Grapefruit is problematic with many medications due to the way it metabolizes, and I’d expect grapefruit extract would be similar. In simple terms grapefruit can compete with the metabolism of many drugs including Propecia so you may end up with higher levels of Propecia in your blood stream. This is not necessarily good. If possible I would NOT take grapefruit and Propecia at the same time.

Tags: propecia, finasteride, grapefruit

Is There More DUPA Today or Are People Just More Aware of It?

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

Is there an influx in people with diffuse unpatterned alopecia nowadays or is the internet just making people more aware of this sort of hair loss?

I’ve been using the internet for the past 7 years and initially information about DUPA was scarce, in fact your website was the first place I ever saw a mention of it. and now you can find hundreds of topics from all over the web talking about DUPA.

when did you personally start noticing this type of hair loss?

When we wrote about DUPA in the medical literature back in 1995 (PDF here), the diagnosis required that the physician look at the donor area with high power magnification.

With my invention of the hair densitometer with patent issued in 1994 (U.S. Patent 5,331,472 – Method and Apparatus for Measuring Hair Density July, 1994) the ability to look at the donor area was made feasible. It took quite a few years and constant physician education by myself and Dr. Bernstein to show the importance of this diagnosis. Doctors who had hair transplant failures discovered DUPA and then began to be a big fan of doing the high powered examination to avoid tackling such patients with surgical procedures.

To answer your question, education takes time and the doctors slowly began including the diagnosis in the range of possibilities in patients. As a result, more and more emphasis of this technology was brought to the public. The internet and this site also probably helped get the word out.

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

I Lowered My Finasteride Dosage and Saw a Decrease in Shedding

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

Can cutting back on Fin have better results for some that don’t respond well?

I have recently decided to lower my dose of Fin. Since cutting back I have seen a large decrease in the daily hair shedding. I have been on 1.25 mg Fin for about 2 years now since I have been taking and my hair has continued to slowly get worse. It never really increased in density at all. I simply believe that I may be a non-responder.Now that I have been on .625mg, I believe that my daily loss has decreased as while after I dry my hair in the shower I do not see bunches of hair just falling out like I normally do.

My question is that, if someone is one of theses so called non-responders, could cutting back or even getting off of Fin actually help with the hair loss or will I soon see an large increase in the shedding due to my lowering the dose?

Thank you in advance

I do not know if lowering your normal finasteride dose will DECREASE shedding. It does not seem to correlate. You must also consider that your hair loss rate may not be consistent or at a constant rate, and the change in dose may be coincidental. Your perception of shedding may be just that — a perception and not a definitive fact. Without microscopic examination or bulk analysis (objective measurements), it is difficult to tell.

I do not know how lowering your dose will affect hair loss over time. I guess only time will tell. You should talk to your doctor about changing the dose.

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

Traction Alopecia from Tight Eyeglasses?

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

Hello,

from 2010 until September 2011 I was wearing eyeglasses that were too tight, and I suppose the tightly fitted frames lead to a pressure-induced alopecia at both lateral scalp sides, decreasing the blood flow passing through the external carotid artery. I have attached a photo which shows the right side of my scalp, and which shows the reduced hair density.

Is this due to an ischemic process? How do I know if the alopecia is scarring and if this process is reversible? Up until now the hair hasn’t regrown. Thanks a lot

I would think that it is almost impossible to reduce the blood supply enough in that area to produce ischemic changes. The fact that your hair is thin there could be the result of constant rubbing of your eyeglasses if they are as tight as you seem to think. Get glasses that don’t rub and see what happens. Give it 6 months to see if it improves.

Tags: traction alopecia, hairloss, hair loss

My Scalp Itches Like Something is Crawling On My Skin

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

I suffer from a very itchy scalp and hair loss. It feels like i have something crawling on my skin but i don’t. i do get spots as well which itch and scab over. i also have an underactive thyroid. Please help

This could be a variety of things, from allergy to fungus to lice to other diseases. You should meet with a dermatologist who can give you an answer to why your scalp is itchy and why you’re getting scabs on your scalp.

Tags: itch, scalp itch