Could Hair Regrow on My Son’s Scalp Scar?

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

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

Do Vellus Hairs Turn Into Normal Hairs from Finasteride?

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

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 Thought MPB Started on the Sides

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

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

Baby Hairlines

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

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

Scalp Exercise Device?

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

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

In the News – Could Hair Club Be Purchased By Aderans (Bosley)?

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

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

What’s the Most Hair Loss Seen in Patients On Finasteride for Years?

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

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

I Saw Great Results From Propecia In the First Month, Then Stopped Taking It

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

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’m Bald After 13 Radiation Therapy Treatments

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

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

I Think My Propecia Finally Kicked In After a Full Year

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

I just want to thank you for all the help you have given me in the emails/balding blog questions, regarding my hair loss and Propecia.

On June 1st 2012 was my full year on it. Almost for the entire year I was losing a lot of hair (as you know from my previous emails) and I wanted to give up on Propecia, but you kept telling me to be patient and that sometimes Propecia needs time to kick in.

During the last year on Propecia I basically counted every hair I lost, whether from showering, pillow, comb, etc. I was losing a lot, I mean a lot. it was very scary. I thought Propecia was useless. The weirdest thing happened. On May 25, 2012, for the first time I basically saw no more hair loss during that day. Today is June 5, and still no more hair loss. On my pillow there is no more than 2 or 3 as before there would be at least 20. when I brushed after showering there would be up to maybe 30-35 hairs on the comb, and now there is like 2-3 at least. As if a miracle happened. I brushed my hair today so many time, more than 50 times in 5 minutes and only 2 hairs came out, as before there would tons and tons and tons. I would easily lose up to 150-175 hairs during a day.

Basically on May 25 2012, it seems Propecia just kicked in. Do you think Propecia just magically worked all of a sudden? Was I a late responder? In your opinion do you think I might even see some regrowth on the 2nd year?

I’m so happy, I just wanted to tell you the good news. Its a big mystery how just on one day the hair loss stopped in its tracks.

Sometimes we note something that we had not noticed before. I suspect that the hair loss has been gradually slowing on the drug and culminating this month. Regardless, it’s good that you’re finally pleased with the medication. Let’s hope it stays that way.

Tags: propecia, finasteride, hairloss, hair loss

Any Miraculous Results from Unusual Hair Loss Cases?

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

Hi Dr.

What is the most unusual case you have come across during your time dealing with hair loss patients.

Has there been any miraculous results or otherwise unusual results that may give some of us extra hope?

The usual hair loss cause in men the vast majority of the time is genetics. There’s not much you can do to change what your mom and dad gave you. At times the hair loss is not uniform or symmetrical and this leads to some interesting patterns. In many patients, I have seen one side balding much faster than the other. Unusual hair loss patterns in men include a completely Norwood class 7 pattern except for the first 1/2inch of the hairline, which is completely intact. Many of these men grow out the frontal hair and use it as a strange looking comb-back hair style, and it works.

For men, we can postpone the inevitable with drugs such as Propecia (finasteride 1mg) or Rogaine (minoxidil 5% topical). I suspect in the coming years, there may be new drugs or other medical breakthroughs such as cloning, but that may take years just to get FDA clearance.

The hair transplantation methods of the past have created many interesting problems today. In the old days, plugs were put into the crown before the hair was lost, and then as the balding progressed, an island of plugs remained in the middle of a bald crown — a very weird look. Hair transplant surgery today provides awesome results. Not to toot our horn, but our patients seem to think they get miraculous results… which is a prejudice induced because of the life changing nature of the process! Look at our photo galleries to see for yourself.

Tags: hair transplant, unusual, hairloss, hair loss

Any Radiation from Robot FUE Systems?

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

Hi. I’m a bit of a hypochondriac, but do the robotic FUE hair transplant systems like ARTAS and others emit radiation?

Thanks

I believe all electronic equipment, such as the computer monitor you are staring at and the microwave oven you cook your meals in, emit radiation. These aren’t hazardous levels of radiation, though.

The ARTAS FUE robot likely emits some level of radiation like any other electronic equipment, but it isn’t anything to be concerned about. The FDA’s Center for Devices and Radiological Health was likely involved at some level before the robot was made commercially available.

Tags: artas®, fue, follicular unit extraction, robot, hair transplant

Parting My Hair to Apply Rogaine Foam

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

I have a question about the application of Rogaine Foam. The instructions says to part the hairs in the balding area to maximize exposure to the scalp. But by parting the hair and exposing one area of scalp, aren’t you covering up surrounding areas of scalp and blocking them from the foam with the hair that was parted? I’ve never really understood that instruction. I just apply the foam by massaging it into my scalp without worrying about parting the hair. Would you recommend I begin trying to part my hair, or does it not make a difference?

I think the idea is to apply the foam to the scalp as much as possible. Maybe they are suggesting that you part your hair to apply the foam to the part, then part your hair again adjacent and apply the foam at the new part, then re-part your hair adjacent and apply, etc, etc.

The goal is to apply as little as possible to the hair and as much as possible to the scalp. Rogaine does not give a benefit when it is applied to the hair, only the scalp.

Tags: rogaine foam, minoxidil, application, hairloss, hair loss

Bald Booth App for Mobile Devices

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

Hey doctors,
I saw a funny app for the iPhone called Bald Booth that you should check out. I can see how I’ll look when I’m bald, and it’s a scary sight.

App — Bald Booth

I guess this could be entertaining for some, or a glimpse to a possible future for others. For those curious folks with an iPhone or iPad, you can find the app in the iTunes Store; and for those with Android devices, you can find it in the Google Play Store.

Tags: bald booth, iphone, ipad, tablet, android, hairloss, hair loss

Does Finasteride Eventually Stop Working Completely?

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

What happens when a drug like finasteride loses its effect?

I read somewhere that when finasteride loses its effect, you will actually advance to the stage you would be at if the drug was never used in the first place. Does this apply only for the hair that was regrown, or for the hair that was maintained as well.. so that if you started using the drug at a nw2, you could rapidly become a nw4 when it loses effect?

I also read that the reason it loses effect is because the body starts producing more dht, if this theory and the above is true, wouldn’t you be even worse off than if you didn’t take anything at all, in other words completely bald before you should’ve been? I realize this might just be a crazy theory, but I would appreciate you giving a shot at it anyway.

I feel like I answer this type of question on a regular basis. The questions have little twists in them and are asked in different ways, but the answer remains the same. Male pattern baldness (MPB) or androgenic alopecia (AGA) is due to genetic causes. Men who are born with the gene will be susceptible to dihydrotestosterone (DHT). Controlling the DHT levels will not stop the balding forever, since genetics will have the final say.

In the grand scheme of things your genes win out over any drug; however, I have seen some men on finasteride for 13 years and have had complete reversal of the balding in the crown without any loss of effectiveness of the drug over this period of time. If you are going to lose your hair, it will happen. Drugs such as Propecia (finasteride 1mg) will prolong the inevitable, but as we don’t always know the timeline (as in the cases where a 13 year history is available), there’s no way we can really know how long you’ll see cessation of the hair loss. So it isn’t really about finasteride that stops working, but more about you aging and the gene(s) expressing its fate. Also note that everybody responds differently to drugs.

People also ask if the body produces more or less DHT to counteract the finasteride. In an article published in the Journal of the American Academy of Dermatology in 1999, they studied this very question and found that DHT levels went down under finasteride treatment at varying doses.

One of the interesting findings of this study is that the lower doses of finasteride (lower than the recommended hair loss treatment 1mg dose) shows significant reductions of DHT at the skin and blood level. This lends credence to our approach of reducing the dose (but continuing on the finasteride) when sexual or other side effects occur. The drug seems to continue to be effective at lower doses.

Tags: hairloss, hair loss, finasteride, propecia