5 Months After My Transplant, Nothing Has Grown In and Now I’m Losing Hair All Over!

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

Hi Dr. Rassman,

I find your blog to be incredibly informative and helpful to those with concerns after their hair transplants. I decided to undergo a transplant exactly 5 months ago as preventative maintenance. 1,700 grafts to fill-in the thinning top portion of my head. I still have hair on my head, but under direct light you could visibly see through to my scalp. I followed my doctor’s instructions and had no major issues after the surgery.

At 5 months, the incision scar is still pink and I have occasional pimples on the top of my head (with what seems to be a noticeable increase in grease on my head). Also, after the surgery I had shock fallout. But it seems that ever since my surgery for the last five months my shedding has been consistently increased. Not just from the top of my head, but all over (sides and back). I have yet to see any growth from the grafts. But I have noticed white streaks in my hair. I have pitch black hair, and there are now random strips of white developing throughout my hair (I had never had white hair before the surgery). Is it possible that the shock of surgery would cause some of my hairs to begin to turn white?

And I’m also concerned at this point that my grafts will not grow in and that I will continue to get thinner and thinner since my fallout has increased. Thank you for your input and advice.

In my practice, we never recommend a hair transplant surgery for “preventive maintenance”, mainly because most patients would not likely see much of a result as they continue to bald and run the risk of being worse off. There is also a good possibility that the surgically induced hair loss might make it look worse, something we call “shock loss”.

If you are really losing hair on the sides, maybe something else is going on like diffuse unpatterned alopecia (DUPA). Shock loss doesn’t usually cause hair to fall out from the back and sides of the head. White hair does appear with stress on some people, but I really do not understand the cause. It sounds like you need a good doctor to talk with and be examined by. Perhaps the surgeon that did your transplant would be a place to start.

In general it takes about 6 to 8 months before you can see results and I tell my patients that most people can see 80% of the impact from a hair transplant in 8 months. You should notice growth beginning about now and see improvement in the next 3 months. If you are young and had the transplant without taking the drug finasteride, and assuming that your preventive hair transplants were not really needed, then you will most likely not have as much hair as you did before the transplant (based upon what you are saying here). Hopefully though, over the next 3 months you’ll see some gains.

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

My Doctor Said Propecia Could Stop My Bone Growth at 17 Years Old

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

Hey, Dr

I first noticed my hairline receiding and the top of my head was thinning when I was 15, doctor told me to use rogaine but 2 years later I stopped because of no results and was tired of putting it on everyday. Now that I’m 17 my doctor said propecia will still be too risky for me because he is worried that propecia could eventually stop my development (bone growth). What are your thought on what effects propecia could have on a 17 year old?

Thanks

I’ve never heard of Propecia stopping or impeding “bone growth” on an adolescent, however it has been theorized and I’ve written about that before here.

If your doctor is worried then that is his/her opinion and medical recommendation. If you would like a second opinion you need to see another doctor. If you do not want a second opinion, you should ask your doctor about the reasoning behind his/her statements and even ask to see (or pointed) to the literature he/she is basing the statement from. After all, that is your doctor and you have a right to ask these questions.

Tags: development, bone growth, propecia, finasteride

I Started Using Minoxidil The Day After My Hair Transplant!

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

Very worried about something. Had hair transplant surgery three weeks ago and it went great… walked out after 12 hours with 4190 grafts. The doctor gave me a rx for propecia and also recommended using minoxidil. He didn’t mention WHEN to start using it; as a result, I started using the minoxodil the next day, and continued for about 5 days-week. There was no bleeding, etc., but I know there was a high degree of alcohol in it (Costco brand) and am now worried I did something to destroy or disrupt the grafts. All of the grafts have by two weeks.

Can’t find anything on the web that gives me info on this, other than to wait at least two weeks. Have you heard of this happening and causing any damage? I called his office and spoke with a surgical tech, who told me he should have told me to wait at least 3-4 days, but she didn’t think it could be harmful. Thanks for any advice you can give me…

We advise patients to wait at least 3 to 4 days (maybe a week) following a hair transplant before they resume the use of products like Rogaine (minoxidil). If you are asking if the use of Rogaine the day after surgery has harmed your grafts (due to its alcohol content), I really cannot say. I suppose time will tell.

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

Is Hair Cloning Advancing At All?

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

Doc

Do you think we will ever see a day when someone with complete male pattern baldness (I.e. Horse shoe shaped) will be able to get a full head of hair? It seems like hair cloning has fallen off the radar. Is anyone/company still pursuing this? Do doctors and researchers still believe that we will be able to make it work? Will we see a solution in the near future? If so how long? There must be industry discussions and gossip about where we are with it. It seems like we have been waiting for ages

There are private companies that are still working on hair cloning. It has not fallen off the radar, but the progress has been slow. I can’t put a timeline on when it’ll be a reality available to the public, but I hope it will be available within my lifetime.

Tags: hair cloning, hairloss, hair loss

Lixilis Lotion, a FGF-5 Inhibitor?

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

hello dr rassman/ pak
i want a comment on this product which can inhibit fgf-5, as they say.

Link: Lexilis lotion

thanks

According to that link, the product is described as a scalp lotion that contains “leaf extract from Loquat (Eriobotrya japonica)” and “Senburi, a whole plant extract from Japanese green gentian (Swertia japonica)“. These ingredients don’t hold a lot of value to me, but if someone wants to give it a try, that is your choice to make (though at nearly $130 per bottle, that is also a financial risk you’re going to have to be willing to make).

There are a lot of herbal products out there that make unsubstantiated claims based on poorly done studies. I can’t say if this is such a product since I’ve never heard of it before, but Advangen (the maker of Lexilis) offers a few topical products that claim to inhibit FGF-5. Why are they making a big deal about FGF-5? Well, they claim it will extend the hair cycle. And it seems that they’re basing that on a study the company says they conducted on 39 people and an unknown amount of mice.

I get asked about herbal products all the time, and people are desperate to try anything to treat hair loss, so there’s a huge market out there full of snake oils, lotions, and potions that will do nothing but line the pockets of those willing to take advantage of balding folks. That’s why I always remind people of one important thing — buyer beware. You can give this one a try if you’d like, but even if the hair cycle is extended, I don’t see how that actually treats hair loss.

Tags: fgf5, fgf-5, hair cycle, hairloss, hair loss, lotion, herbal, lexilis

I’m 17 and Balding in a NW 7 Pattern — Can I Take Propecia Now?!

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

Dr Rassman would you please kindly help me. I am a 17 year who has very strong hair loss. My hairloss started when I was 15. Am losing hair in a NW 7 pattern. Hairloss runs strong in my family but not at this age.

I have spoken to my doctor about propecia he said its upto me if I want to take. I honestly want to take it but I don’t know how it will affect my body development.

So my question is to you is will you prescribe propecia to a 17 year old (if one came to your office) and what are the risk

Propecia is an elective medication. If you do not want to take it, then do not take it. This decision is ultimately yours. If someone under 18 years old comes to see me at my office, they need to be accompanied by their legal guardian or parent before I see them or recommend any treatments.

You need a diagnosis by a physician before starting on any medical regimen. You need a doctor who knows the science of balding and there are many of us from around the world. Since you noted in your email that you’re in the UK, there is a first class doctor there — Dr. Bessam Farjo — and I would suggest that you arrange to see him.

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

Equate (Minoxidil)

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

Costco has stopped selling it’s 5 percent Kirkland brand of Minoxidil liquid, and only the foam is offered now. I want to still use a liquid instead of the foam and have found that Walmart carries a brand call Equate from Israel. any feed back on the product?

I wasn’t aware that Costco stopped selling their Kirkland Minoxidil liquid, but Equate appears to be just another name that generic minoxidil is sold as. In other words, though I don’t have specific experience with Equate, I’d expect it would be the same as the Kirkland, Rogaine, and other products that contain 5% minoxidil as the active ingredient.

There are some short reviews of Equate on the Walmart site.

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

Is Density Up Top Normally Lower than the Back of the Head?

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

Is it normal for hair volume to be less dense on top of your head than the lower back of head / neck area if you still have a full hair line up front above your face?

On a non-balding person the hair density is similar throughout the scalp, but there are areas where the density may be lower, like the sides of the head (above the ears).

Only the area in the back of the head (a 2 1/2 inch area) is considered permanent, as shown in the hair that remains in the Norwood class 7 pattern.

Tags: density, hair growth

Finasteride Was Great for the First Few Months, Then I Started Shedding

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

Hi,

Dr. Rassman, i am on Finasteride treatment since 1 year. However im not happy with the result. Firstly, i saw that my hairs were darking so quickly in the first 3-4 months. i was happy and i was getting results from Finasteride. My hairs was really good and i was feeling that it gets better day by day. Then i had a shedding phase, i was shedding like crazy, then my hairs was less thicker after this shedding phase.

Then, My hairs came back until 8th month. yet i had another shedding phase during 8th month and i lost my hair density again. Then my hairs come back later but i shedded crazy again. i had my hairs shedding during shower,on my pillow, on my laptop. (1 cm or less length hairs)

i just finished my 12th month, with the shedding phase, (or shedding period) My hairs are worse than ever, after the last shedding phase which occured 1 month ago.

Should i give up on treatment or will my hairs will come back? or when they will come back? Thanks in advance Dr. Rassman.

You need to follow up with the doctor who prescribed you the medication. What you describe is very strange and I would hope the doctor you saw has some good objective notes, measurements, or photographs that he/she can use to validate your complaints.

The decision to stop or start Propecia (other any other medication) should be between you and your doctor.

In general, Propecia (finasteride) does not work the way you are describing. It usually takes 6 months to a year before you notice any effects. It does not “darken” your hair. The medication should not start and stop the shedding of hair in cycles like you’re describing. Many patients continue to lose some hair while taking Propecia, but the key point is that they lose a lot less hair than if they were not taking the medication at all.

Tags: propecia, finasteride, hairloss, hair loss

I Have an Undefined Hair Loss Pattern

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

I wanted to know, if you have an undefined hair loss pattern, for example thinning in ur frontal hairline in one corner then some in the middle and none on the right hand side. Would propecia be effective in treating that, and would the hairloss be aggressive since it has an undefined pattern or would it not be aggressive?

Thank you.

It sounds like you do not have a clear diagnosis of your hair loss. Propecia is for the treatment of male pattern baldness (MPB), but if you indeed have diffuse unpatterned alopecia (DUPA) then Propecia would not likely help. Some patients mistake MPB for DUPA when hair loss is worse on one side.

Eventually (especially under the microscope) the hair loss pattern may emerge, thus a good examination and diagnosis is important. The status of the hair in the very back of your head will tell the doctor if you have DUPA or not.

Tags: hairloss, hair loss, propecia, dupa

Should I Take a 1 Week Break from Minoxidil to Increase Effectiveness?

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

My effectiveness with Minoxidil decreased in the last months. (im on it for 18 months) Some friend keep telling me that 1 week break will increase its effectiveness and will be great for my skin? is it true? Do you recommend it for me?

I do not know how taking a one week break would help in minoxidil’s effectiveness. That’s a new one to me.

Tags: minoxidil, rogaine, hairloss, hair loss