SMP Over the Years?

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

How does SMP look like after 5 years? 10 years or 20 years down the road. I’ve seen some really bad SMP jobs on YouTube where the color looks smeared all over the scalp. Maybe these SMP jobs were done by novices or bad tattoo artists but if only a handful of Dr’s do it and do it well. How can there be a guarantee that a Dr with proficiency will be around in 20 years performing SMP when I need a touch up? I am interested in the procedure but worried that the color fades too easily or the dots expand to form a cloudy look. The bad SMP jobs on YouTube make the head look like there is a permanent giant bruise on the entire head. Looks like some sort of disfigurement.

Has any of your SMP patients been unhappy with the results after so many years?

We have been performing Scalp Micropigmentation (SMP) now for two years, so I can not address a longer time frame. I have seen one patient who had scalp tattoos done elsewhere about 9 years ago and he touched it up often (possibly too often). His scalp took on the appearance of smeared color. The black ink turned green and when it covered the entire scalp, the scalp appeared green. Certainly, it was not a good end result. He was experimented on, so his result probably reflected the many techniques that evolved and possibly many different pigments.

With regard to our practice, yes, we have had dissatisfied patients. In analyzing the reason for the dissatisfaction, we concluded that: (a) they really did not understand what they were getting, (b) they were expecting Toppik level concealers which produces better camouflage and are much darker, (c) they noticed irregularities in the ‘dots’ where some of them were larger than others, (d) the pigments faded irregularly, (e) they came from long distances and needed touch-ups that required them to make another trip to California and (f) the color changes in the black to a green or blue tint was more than they expected to see.
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Does Propecia Lower the Libido Immediately?

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

Hi, Just wanted to say that your blog is amazing! It’s helped me to answer so many questions.

Now i was just wondering, i started propecia on monday (2 days ago) and have there been any reported cases of lowered libido immediately after taking propecia which die down in the coming months? Thanks

If you have a libido side effect from Propecia, it might take weeks or months to appear… not a couple of days. The power of suggestion is very significant in those who get libido effects, so worrying about it is going to do more harm than you may realize.

Then again, I suppose the power of suggestion from reading this post may be in competition from the power of suggestion from other information you are inundated with.

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

Taking Finasteride After a Hysterectomy?

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

Is it safe for a 50 year old woman that has no uterus to take Finasteride for hair loss

Yes. Finasteride is often tried in post-menopausal women, but the results are a mixed bag and the drug will not reliably return more hair to the thinning areas. There is an androgen sensitivity test for women by HairDX that could help determine if you’ll see possible benefits from the medication. Read more about that here.

Finasteride is a prescription drug, so you should discuss this further with your doctor.

Tags: finasteride, propecia, proscar, hairloss, hair loss, female hair loss

My 4 Year Old Has Hair Loss After She Had Chicken Pox

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

hi, my daughter is 4 years old. recently she had chicken pox after which she losses her hair every time with combing or sometimes without combing. the amount of loss hair is almost 30 or 35 hairs per combing. i really worry about her what should i do? thanks

The stress on the body from chicken pox could be causing your daughter’s hair loss, but you should take her to a pediatrician if you are concerned.

Tags: chicken pox, child, hairloss, hair loss

Can I Have a Transplant Now, Then Redistribute Those Same Grafts Years Later?

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

I’ve been reading on treatments for months after realizing I’m beginning to express an NW3 pattern on my head. I’m extremely worried about how silly I will look like, when Propecia wanes and hair loss accelerates in my 50s and beyond, if I have a hair transplant at 30 and use up too much donor hair.

So to tone down my worries, I’m conjuring a kind of modification of the “Master Plan”; one which will involve a transplanting those follicles now, then having a scarce few of them re-extracted in my 50s, if the hair loss gets too bad, and re-distribute these to go well with the decreased density of hair. Would you do a FUE like this twice on the same follicles?

It technically can be done… but that would not be a good plan. Generally, when the Norwood class 3 pattern is treated, it should remain untouched. If you are smart about your hair loss treatment and use the drug finasteride (Propecia), then hopefully you can prevent your migration of the hair loss as you age. That makes more sense.

On the other hand, if you progressed to a more extensive pattern and stay with the hair transplants in the front/top, the results should always look normal.

I get that you’re trying to plan for a worst case scenario, but Propecia doesn’t necessarily just stop working for everyone. Some men might see the effects wane after some years, but I’ve had patients taking it for over a decade with great results. Besides, in 20 years there could hopefully (fingers crossed) be new treatments available.

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

In the News – Bratz Dolls Go Bald in Canada

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

Snippet from the press release:


Bald is beautiful. MGA Entertainment Canada will launch a new range of hairless Bratz® dolls this summer at Toys”R”Us, Canada to support children dealing with hair loss due to illnesses such as cancer and alopecia, donating a portion of every sale to Starlight Children’s Foundation.

Under the banner True Hope Bratz®, MGA will release hairless versions of its hit dolls Cloe™, Yasmin™ and Cameron™, who will each come with one hat, a second outfit and a beaded bracelet.

BratzRead the rest — Bratz dolls go bald to support kids battling illnesses

Following in the footsteps of the bald Barbie doll for kids battling hair loss, the Bratz dolls will be produced without hair in Canada. I’ve only seen the announcement about the dolls being released in Canada, so no word on the rest of North America.

While I realize that a bald doll isn’t something most of the readers of this site are interested in, I know we have some visitors that are parents of children battling various hair loss causing illnesses.

Tags: doll, bratz, hairloss, hair loss, cancer, alopecia

Actor Andrew Lincoln’s Hairline?

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

Andrew LincolnHow would you classify Andrew Lincoln’s hairline?

Some photos — Photo 1, Photo 2, Photo 3

Andrew Lincoln, probably best known for his role in The Walking Dead, has a hairline that looks very straight (possibly due to styling or Hollywood “magic”) in some photos, but in other photos his hairline looks like it could be a Norwood class 2 or 3. Your guess is as good as mine without seeing his hair wet or up close.

Tags: andrew lincoln, actor, hollywood, walking dead, hairline

My Hair Looks Darker Now After Using Rogaine and Finasteride

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

Hi,

I’ve written previously on your blog. Big fan of this website. Im a 22 year old suffering from male pattern hair loss. Past few months I have been using rogaine foam and finasteride in the form of quarter proscar tablets. To be honest Ive been quite happy with the results as Ive noticed my hair loss stop completely & my hair is definitely now thickening. I previously had light brown hair but now it seems to look darker, not that I care that much really as long as I get regrowth.

My question is have you ever noticed in your practice users of rogaine having their hair darken after using it for a while. Also is there anything else I should use to maximise hair regrowth or is finasteride & minoxidil good enough for now. Love to hear your thoughts.

When the hair shaft gets thicker (as with the use of Rogaine and / or Propecia) the hair will change to its normal, possibly darker, color. Miniaturized hairs tend to be lighter.

Tags: hair color, hairloss, hair loss, finateride, rogaine, minoxidil, propecia

Pull Test and Telogen Effluvium

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

Why is a pull test positive in cases of telogen effluvium but not in mpb. If a pull test was positive is this a definate indication of telogen effluvium

The pull test can reflect many conditions, including a variety of autoimmune alopecias, telogen effluvium, possibly even androgenetic alopecia when it is very active. The test constitutes grasping about 60 hairs between two fingers near the scalp, then pulling gently (but firmly) on the hair. A positive test will yield 6 or more hairs and it is often done on 4 different parts of the scalp.

Do not wash your hair for 2 days prior to doing the test. If you decide to do the test on yourself, do not keep repeating it as you can pull out more hair than you really want.

This would not be a reliable test for male pattern balding diagnosis, because the hair loss from this condition varies. I suspect that when the process is not active (like when a patient is using finasteride / Propecia), the hair loss has stabilized so that the pull test would or should be negative. There are much better ways to make the diagnosis of MPB than by using the pull test.

Tags: telogen effluvium, pull test, hairloss, hair loss

Does Finasteride Stop the Hairline from Receding?

/by William Rassman, M.D./7 /

Would you agree with the results of this article?
Link: Finasteride in the treatment of men with frontal male pattern hair loss.

Also, even if it doesn’t promote regrowth, does Finasteride at least stops the hairline from receding further?

The results of that 1999 study you referenced says: “There was a significant increase in hair count in the frontal scalp of finasteride-treated patients (P < .001), as well as significant improvements in patient, investigator, and global photographic assessments. Efficacy was maintained or improved throughout the second year of the study. Finasteride was generally well tolerated.”

Based on what I’ve seen in my own practice, I do agree with it for the most part. I believe Propecia can slow down or stop the frontal hair loss in those genetically prone to frontal recession. It does regrow hair in the frontal hairline on rare occasions, but it has shown to work much better in the crown.

Tags: propecia, hairline, hairloss, hair loss

How Did Pro Hockey Player Ryan Getzlaf Lose Hair So Quickly?

/by William Rassman, M.D./5 /

Good day Dr.Rassman and company. Here is a picture of professional hockey player Ryan Getzlaf back in 2003 when he had gotten drafted to the Anaheim Ducks.

This is him in: 2003, 2010, 2012

How did he lose hair so fast?

According to Google, Ryan Getzlaf is 27 years old now… so he was a teenager in that first photo from 2003 and his juvenile hairline is clearly evident. In young men (under 35 years old) hair loss is not a steady process, as it may come in spurts. Hair loss over an 8-9 year time frame is not fast from a genetic point of view.

Tags: hairloss, hair loss, hockey, ryan getzlaf, nhl

If I Just Want a Mini Procedure, Should I Have a Strip or FUE?

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

If I just need a mini surgery in my temple area and a few hairs in the frontal line to thicken it up, let us say all together 200-300 hairs, would a doctor perform that small of a surgery?

Also would he do a strip method or FUE? I think a lot of doctors where I live don’t like to do FUE because they feel not all the grafts grow because some hairs die when you are plucking them. So, would it still be better to do a strip surgery for a mini procedure?

Without a good examination and knowing exactly your expectation (long term / short term) I have no way to know which surgical method is better for you. If a physician has already made a diagnosis and recommendation of number of grafts you may need, he/she should have also recommended which method of donor hair harvesting (FUE vs Strip) that you should consider. There is no right answer. Everyone and each surgeon is different, and I really can’t answer this question without knowing more about your needs and goals.

I will say that in general 200 to 300 hairs to thicken up your hairline AND your temple area is likely a very low number and I suspect your expectation may be off. Remember that each graft can include multiple hairs, so even 200-300 grafts might be too low to treat the areas you’re talking about.

Having said that, we do on occasion perform small touch up transplants at NHI as low as 100 grafts.

Tags: hairloss, hair loss, hair transplant

8 Months After Surgery, I’m Seeing Some of the New Hairs Falling Out

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

Greetings doctor,

I am 23 years old and I had a HT just over 8 months ago. I started thinning about 4 years ago at my temples, Going bald at such a young age made me very self conscious so I just had to do something about it.

I got 1200 grafts transplanted into my right and left temple areas. over the next few months some but not all of the grafts began to shed and I also experienced some ‘shock loss’ which is all normal I know. some of the grafts however stayed in place and continued growing.

I’m on my 8 month now and some of the grafts that stayed in place and grown all this time started falling out!! which got me very worried. there are also some bald patches on my temples where grafts got transplanted that haven’t shown any sign that they are growing yet.

Should I be concerned about any of this? I mean at 8 months I should start seeing the majority of the hairs coming out right? the only reason I can think of for this is that the grafts are just simply taking longer than usual to come out. I don’t however have any explanation for the transplanted hairs falling out after 8 months..

Please can you let know so I can set my mind at ease..

Kind regards

I cannot say what is going on without examining you in person. How would you know if the hairs you are losing are the transplanted hairs or native hairs? Or maybe transplanted hairs (like regular non-balding hairs) are going through their natural hair cycle of shedding before regrowing. I really cannot say.

At 8 months, you should see growth of the transplanted hair. You should definitely make an appointment with your surgeon to discuss what is happening and get a more definitive answer.

Tags: hair transplant, hairloss, hair loss

Maturing Hairline and a Widow’s Peak

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

I have never had a perfectly straight hairline and I have always had a widows peak. I recently noticed that my temples have receded just over an inch and it makes my widows peak more pronounced. I don’t appear to have any miniaturization beyond my hairline. Could it be that I have a mature hairline but the corners are set back more due to the fact I’ve always had a widows peak?

It might just be a mature hairline, but based on your description alone if you have recession in the corners it sounds like you may be developing a Norwood 3 hair loss pattern. That would make your widow’s peak appear more pronounced.

Tags: hairloss, hair loss, hairline