Is Triangular Alopecia from Menopause?

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

I saw some of your pictures of triangular alopecia and it seems to be what I’m experiencing except that it is not congenital and I am a 53 years old. Could it be menopause? Is there is anything I could do about it?

Triangular alopecia is not related to menopause. Triangular alopecia is an entity in and of itself, which both men and women may get and could appear almost any time, but usually is congenital. It can be treated with a hair transplant surgery very successfully.

Triangular alopecia has many appearances, but the common thread is that the hair loss is on the front/side of the scalp. These pictures from Google Image Search give some good examples of the diversity of its presentation.

Tags: triangular alopecia, menopause, hairloss, hair loss

Taking Male Enhancement Supplements to Combat Any Possible Finasteride Side Effects?

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

If one takes male enhancement supplements while in finasteride would that combat any possible male member negative effects from finasteride? Thanks

We all know about the prescription medications like Cialis and Viagra, but I do not know if there are any valid male enhancement supplements out there that really work. I realize they are advertised as such, but scientific research and actual effectiveness attached to these supplements are vague.

That being said, if you are having side effects from Propecia / finasteride, please speak with your doctor and make sure there are no other medical issues.

Tags: male enhancement, supplement, hairloss, hair loss, propecia, finasteride

Whatever Happened to Dr Cooley’s Auto-Cloning Procedures?

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

Hey Guys,

I was reading something on Dr. Jerry Cooley and him already doing the auto cloning procedures and that it takes better when implanted in areas of already implanted sites. I think I remember a few years ago that you guys were starting to test this. Are you guys doing this now? I would love to thicken out my front of my head without taking anymore from the back of my head since I’ve had 5 surgeries already. Thanks.

To put it in a politically correct way, the claim could not be validated by us and it did not work in our hands. Many prominent doctors/peers and medical clinics tried to replicate the research and method, and it does not hold up to the claims. If he is still promoting it, then I would ask him personally.

Tags: cooley, auto-cloning, hairloss, hair loss, cloning

Big Problem – Dealing with Unmanageable Scars

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

The pluggy hair transplants of the 1980s and 90s, and even the strip surgeries in the years following that, caused considerable scarring in some percentage of patients. Few of them complained unless their donor area was depleted from multiple surgeries so that long hair would not cover it. Even today, scars from follicular unit extraction (FUE) are causing problems for some patients who have had donor area depletion. I’ve seen a few men for consultations recently that have shown a see-through appearance at the back of their heads, asking us what they could do to help make this less noticeable, and prompting me to write this post.

The best solution for unmanageable scars was introduced by us in 2010 — Scalp MicroPigmentation (SMP) — and it can be effectively used to camouflage scars so that they can be made undetectable. Scars are more of a problem when patients have multiple surgeries, each surgery adding to the amount of scarring.

In the past, we have recommended scar revisions with variable success. Usually the scar would be reduced following the revision, but the biggest problem we found with this solution is in the patients who get poor scarring after strip surgery, get it because that is the way they heal. So when trying to repair it, we found limited value with occasional good results, but always leaving some level of detectable scar. There are people like me (three strip surgeries and no detectable scar) who heal very well, but there are some that aren’t as lucky. Treating these scars with SMP seems to always work regardless of the patients tendency to scar.

We’ve posted some outstanding results in the treatment of scars of all types and this is usually what happens to all patients, not the select few shown on this website.

Tags: scarring, hairloss, hair loss, hair transplant, smp, pigment, scar

Does Avodart Minimize Shock Loss Like Propecia Would?

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

I stopped using Propecia (Generic) approx 2 yrs. ago & switched to Avodart as Finasteride was no longer effective after 10 + yrs. of use.

What is the possibility that Avodart would be comparable to Propecia in minimizing shock loss before another transplant? Also, although you have strong reservations about this, what are the “possibilities” Avodart would have a similar effect used in conjunction with 2% ketoconazole on hair growth as propecia does?

Just wondering if you have any feedback from other physicians. Thanks again for a superior forum!!

Avodart (dutasteride) is not approved for the treatment of androgenic alopecia, but I realize some doctors and patients out there use it for that purpose anyway. The results and its effectiveness over Propecia (finasteride) are unclear, but at best, in my opinion, you get about the same result with a higher side effect potential. Did you have your hair bulk measured before you started the Avodart so that you could compare it to today, 2 years later? I’m curious to know what you saw.

As to the minimization of shock loss from Avodart… I do not know, but I would expect it will have value at preventing it, just as Propecia does.

Tags: avodart, dutasteride, hairloss, hair loss, shock loss

What Info Can Be Gathered from Fallen Hairs Found in the Bath?

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

Hi.

May I ask, is there anything to be gathered from the quality of hairs I find in the bath after washing my hair?

I have always noticed quite a lot of hair floating on the top of the bath. My mum has the same problem and we both have thick, coarse hair. There’s about 100 hairs after every bath, but it has been like that for as long as I can remember. Some of the hairs in the bath are thinner/finer than others. Does this support the idea that my hair is miniaturizing?

100-150 hairs lost each day is considered normal, but if they’re all coming out in the bath at once that might be a little much. Do you wear a hat all day and trap in the hairs that would normally fall out during the hair cycling process?

If you are concerned about hair loss, please see a doctor. I cannot possibly diagnose or understand your hair loss issue from 100 thin hairs in the bath water. The only info you can gather is that hair is falling out, either from genetic loss or just normal hair cycling.

Tags: hairloss, hair loss

Should I Wear Goggles When Applying Minoxidil?

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

Dear Doctor
Do you know any possible ways of avoiding eye irritation because of minoxidil lotion usage?
*Does it make any good if i put goggles on when i am applying it on my scalp?
*Does it make any good if i close my eyes during application?
*Does it make any good if i wash my forehead with a wet cloth after application?

Thanks..

You should not get eye irritation from minoxidil use. If you are having eye irritation you are likely allergic to the medication or you are doing something wrong. Goggles are not likely the answer.

Tags: rogaine, minoxidil, eye irritation

Why Do You Carry Revivogen In Your Office Now?

/by William Rassman, M.D./10 /

Dr. Rassman,

I noticed you sell Revivogen in your office. I thought you do not endorse or believe these products work! What gives?

For the record, I do not endorse many products out there. I still maintain my buyer beware mantra, and I will be the first to say this to all my patients. But I also recently acquired a Dermatology / Cosmetic practice (Wilshire Center for Dermatology) and expanded my medical services with new physicians who offer non-hair related services.

The office also sells a variety of skin and hair care products, and Revivogen is just one of the many products we offer. Revivogen is a natural supplement (non-medical) line of products.

Tags: revivogen, hair product

The Back and Sides of My Head Are Decreasing in Density

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

Hi guys,

I started thinning when I was 19 and this continued slowly up until I turned 25 when it became far more aggressive and has continued in that vein for 18 months now. I had tried Minoxidil over a year to seemingly no effect and I had significant side effects from using finasteride. Overall in the past 18 months I’ve gone from a Norwood II to a Norwood IV and adjusting has been extremely difficult.

The back and sides appear to be decreasing in density at a similar rate (although they have more hair than across the top, as you would expect) and for that reason I’m very concerned I would not be a good candidate for hair transplant surgery.

I guess my question is whether this is attributable to only androgenetic alopecia, or could there be an additional problem? (be it some sort of telogen effluvium etc)

Thanks :)

The basis of good clinical medicine is to establish metrics (measurements) that give baselines from where we started. If you take such measurements yearly, you will be able to document the degree of thinning and this will help in the diagnosis.

Your story is not one that I hear too often, but to give you any insights I would have to examine you, take a good history from you, take bulk and miniaturization measurements of your scalp (sides and back, as well as front and crown). I can say that the back and sides of the head should not be decreasing in density, but only after you are examined can I do a better job of answering your questions.

Tags: hairloss, hair loss, density

Would Any Product Work for Treating Traction Alopecia?

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

I have lost my hair at the crown due to tight braiding. Before I try a transplant if it’s even necessary, what products would be best for me as a 43yr old African American Woman? Thanks

In general, traction alopecia is considered permanent hair loss, particularly if it has been present more than a year. Some women try Rogaine with mixed success, and some women go through hair transplant procedures, which work very well. Every case is different.

Tags: traction alopecia, hairloss, hair loss

Even More Hair Transplant Failures Keep Showing Up

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

Two more hair transplant failures showed up in our office last week from other doctors — one was an FUE technique and one was a strip harvest. I’ve written about the topic of surgical failures a few times already, and the last thing I want to do is scare people off the idea of having a hair transplant completely, but I want to keep our readers informed about what they must learn about the doctor or clinic that they’re considering for their hair transplant procedure.

When I talk about these failures, I mean that there is a large percentage of the transplanted grafts that didn’t grow. You have a finite amount of donor hair, so when there are grafts that are damaged or killed because of poor techniques in surgery, you’re losing your valuable donor hair (and you’re getting financially ripped off). So before you choose a doctor, try to research the doctor.

Does the doctor have a high failure rate? And how would you even go about finding out?

  1. Go to the medical board of your state and look up the doctor. Complaints are filed and published by the medical boards.
  2. Check out the Better Business Bureau, where people who are not satisfied with a service will voice their concerns.
  3. Ask your doctor about their malpractice record. How many cases have they had in the past 10 years? You can verify their answers by looking them up in the courts of your area.

The patients who present with these failures usually did little comparative shopping or investigative work. They may have based their decision on the cheapest price they could find or just whoever is the closest practice in their area, but what surprises me the most is that many patients didn’t get more than one opinion before having surgery. It doesn’t hurt to get a second opinion, and it’s worth noting that the New Hair Institute does offer travel programs for those individual from out of the area. Half of our practice reflects people who fly in, so just getting surgery from the closest place to your home shouldn’t be an excuse.

When you shop, you can get the benefits of our long experience by reading our featured post — Selecting a Hair Transplant Doctor.

Tags: hair transplant, failure, hairloss, hair loss, surgery, scam

If I’m Too Young for a Hair Transplant, Can I Just Have a Forehead Reduction Now?

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

Hi,

I have done a lot of research in relation to hair transplants and forehead reduction as I have been experiencing hair loss over the last few years and I also have a large forehead. As I am only 20 years old I know it’s not recommended to have a hair transplant as there may not be enough donor hair to be transplanted to keep up with further hair loss I may experience over time.

Would it be possible to have forehead reduction surgery to lower my hairline and reduce the size of my forehead and also have a hair transplant to replace hair that I have already lost? I have dark red, wavy/straight hair and my hair is thick at the back where the donor area would be (not sure if this would make a difference).

I’m currently at the Norwood II stage and I am already extremely self conscious about my hairloss and large forehead and it has effected my confidence. I’ve considered using Propecia and Rogaine but I’m terrified in case I experience excessive shedding or erection problems from Propecia as I have read a lot of reviews from people who experienced these side effects.

I am getting desperate now so any advice you could give me would be much appreciated.

Thanks

Great question. I assume you are a male. This makes a difference, as females with this problem can safely have a hairline lowering procedure, as they will not lose the hair above that was moved down. A male with active hair loss will most likely lose the lower hairline and be no better off (possibly worse off) after a hairline lowering procedure.

At 20 years old with no clear examination or diagnosis of male pattern baldness, a forehead reduction may make things worse if you progress to a Norwood 6 (for example). You need a Master Plan and a clear diagnosis. You are young, so let’s start it right, come pay us a visit at the New Hair Institute to have the degree of your hair loss diagnosed.

Tags: hairline lowering, hairloss, hair loss, hair transplant

Transplanting Hair from the Back of the Head to the Sides of the Head

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

Hello Dr. Rassman,

In researching hair transplantation, I have been unable to find an answer to what seems to me to be a pretty basic question: Can donor hair be relocated to the sides of the head? If so, would this be an option for me?

Here is a rundown of my situation: I am not sure what my pattern is, but I have lost a good amount off my hairline and the front 1/4’s of the sides of my head. The back of my head is pretty full, and the back 3/4 of the sides and area beyond the hairline on top are also relatively full.

Thanks so much for all your nice work

In men, hairs from the back of the head are considered permanent. This is the donor area in hair transplant surgery. You can transplant it anywhere on the body and it should grow. Thus, you can transplant hair from the back to the sides.

As to what you are referring to as “the sides” remains to be seen, as I do not know what you are exactly describing. If you would like a consultation you can always email us at hairdoc@newhair.com with photos.

Tags: hair transplant, hairloss, hair loss

Does Having a Lot of Body Hair Cause Faster Balding?

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

Hello, i’m a 16 year old male sophomore. I’ve tried searching for the answer to my question, but no one seems to have a definite answer to it yet. Does having a lot of body hair cause baldness faster/cause baldness? I ask this because, while I may not be completely covered in hair (at least not yet…I hope not though) my legs are very very hairy.

My arms have more hair then most, but its not to out of control, and my chest is mostly clear of hair, theres nothing noticeable. But I won’t lie, I am scared to have body hair, I don’t particularly like it, and i’ve also noticed that men who have more body hair seem to have less head hair, I don’t know if this is just a coincidence, but nonetheless I am still concerned, even though I still have a full head of hair. I’m just not sure how the future will play out for my body. Though I can say that while my dads side has a lot of hairy men, no one in my family has ever truly gone bald before. However, I could be an unlucky exception.

Thanks for reading, and hopefully my question is answered!

Body hair and head hair do not relate to each other, as they are separately genetic coded. Men with hairy bodies can have hairy heads with or without balding on the scalp. If you think that you are losing hair, then visit a good hair doctor who will determine if you are losing hair on your head or not.

Tags: body hair, hairloss, hair loss

Hair Transplant Patients Under 30 Years Old?

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

Hello Dr.Rassman

Really informative website, love it. I just have a couple questions.

1. Just wanted to know how come there is a lack of hair transplant photos on the NHI website of patients 30 and under?
2. How many patients under the age of 30 that you have done surgeries on, either in the front or crown of the scalp, have to come back for more additional procedures to make it look thicker and fill in areas or because they are losing hair behind their transplanted hair?

Thank you kindly.

There are many photos on our NHI website, and I’m sure there are some younger patients in there. If there is a lack of these younger patients, it isn’t on purpose — we post the photos that our patients allow us to post, and many of the younger patients don’t wish to appear on our site.

Our average age for transplant patients is around 30 to 40s, but we have done surgery in men as young as 20 (who was a bald NW 6) to as old as 80. This becomes a one-on-one assessment comparing the risks of too early transplants with waiting too long. It’s not something that I can easily convey here in this post.

Men with frontal hairline loss often come to surgery earlier, because they are bothered by the man in the mirror. Younger men who are rapidly losing hair will likely benefit from finasteride (Propecia) over surgery in certain cases. It is not unusual for a young man under 30 with fine hair to have two procedures with us.

Tags: hair transplant, age, hairloss, hair loss