Should I Use Vaseline On My Eyebrow Transplants?

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

VaselineDoctor, compare about eyebrow transplant and hair transplant. Which has higher success rate and why?

3-4 days after eyebrow transplant I have a very little crust and scabs. Is it a good sign? Do I have to use vaseline petroleum to my eyebrow right away after procedure?

Hair transplant results are the same for eyebrow or scalp. The eyebrows tend to crust less, but the key to keeping crusting down is to use a good washing technique daily after the transplant. I have never recommended Vaseline petroleum after a hair transplant.

Tags: eyebrow transplant, hair transplant, vaseline, hair loss, hairloss

Is It Genetic Hair Loss or a Mature Hairline? (with Photos)

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

I know my hairline has receded in the last few years, but I’m not sure if I’m showing signs of genetic hairloss or if it is a mature hairline. I’ve been to a dermatologist and a thricologist and neither seemed to take a serious look and just said it didn’t look to bad, but I wasn’t really convinced.

I am a 25 year old male. My dad is bald and probably started balding in his 20’s, my older half brother is bald and my two uncles on my mother’s side are bald. My mother’s father never went bald but had a high hairline, and my dad’s father started balding probably in his 50’s. I’ve realised that I’ve always had a fairly high hairline, and it has always been a bit higher on my right side. I can remember I used to part my fringe a certain way when I used to gel my hair when I was in my mid teens.

In terms of just measurements, my hairline corner (right side) is 1 inch above my wrinkled brow, and 2.5 inches above my eye brow. The middle of my hairline is 1 inch lower than that. The hairs in the corners of my hairline seem finer and less dense I think so I don’t know if that means it’s going to move up higher up.

Thanks again and thanks for the site, it’s very helpful. I wish I could stop by in person but unfortunately I’m on the other side of the Atlantic.

Click the photos to enlarge:

 

You sent a lot of photos, but I chose the above three that tend to show the best angles. Thanks for sending them.

It appears that you have a Norwood class 3V balding pattern (not a maturing hairline) and the frontal area appears to be thinning where you have hair. The crown is early in the balding process. The photos aren’t the crispest or in the best light, so it is difficult to really make any specific determination. You need to see a good dermatologist or hair transplant doctor to be evaluated. Medications like Propecia (finasteride) are the only way you may halt the progression of the hair loss.

Since you’re on the other side of the Atlantic, you can visit Dr. Bessam Farjo in London or Manchester. Or if you happen to be planning a trip out to Los Angeles, we’d be happy to see you.

Tags: hairline, hairloss, hair loss, photos

I Have Seborrhoeic Dermatitis, Chronic Telogen Effluvium, and Possibly MPB!

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

Hello,

I am 25 and have been gradually losing my hair for a couple for years now. In addition to what I would confidently call MPB, I also suffer from seborrhoeic dermatitis and chronic telogen effluvium.

1. Is the chronic TE linked to MPB or seb derm? I’ve suffered from TE for over a year and a half now and always assumed that losing hairs in this way was part of MPB. It constantly gets me down as I am constantly shedding hairs. A small pinch from anywhere from the top of my scalp can produce up to 20 plus hairs. It’s as if 50% of my hair isn’t even attached to my scalp. Several websites state that chronic TE is due to illness, whilst others say that it is the early stages of MPB.

2. Will the seb derm cause any hair loss if left untreated? Even though the seb derm is quite bad (thick yellow, oily scales all over my scalp), the condition is not yet visible to others and causes me no discomfort. I am worried about washing my hair every day with the recommended treatments because I lose so many hairs due to the TE.

Please help me! I’ve seen two doctors regarding my MPB and both told me that nothing could be done. I only discovered propecia etc. through google. I have been taking it for nearly 4 months now.

Many thanks for an enlightening website

We are not, I suspect, one of the two doctors you have seen. I have no real experience in doing transplants on someone who has a pull test like you reported as evidence of chronic telogen effluvium. I am actually surprised that this has not come before me at an earlier time.

The seborrhea will not produce hair loss as long as you do not scratch or pick in involved areas. Transplants may be contra-indicated with a chronic telogen effluvium.

Tags: telogen effluvium, hairloss, hair loss, dermatitis

In the News – L’Oreal Invents Liquid To Reawaken Dormant Hair Cells

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

Snippet from the article:

Scientists at cosmetic company L’Oreal claim to have invented the first product which can actually “reawaken” dormant hair cells and allow them to grow back. It could offer hope to millions affected by male pattern baldness or just the thinning of hair through old age or for medical reasons.

Already demand for the new treatment has seen salons taking thousands of pre-orders even though the recommended three month treatment costs nearly £300.

After 90 days researchers claim that the liquid “Kérastase Densifique”, when applied to the roots, can promote the growth of more than 1500 new hairs.

Read the rest — Breakthrough hair loss product works on stem cells

The real question is whether I should buy stock in L’Oreal. The study they cite saw 101 people over 3 months with some regrowth, but I have no idea how many people were actually in the study or why it lasted only 3 months. As more news becomes available we’ll look into it further.

Tags: loreal, densifique, stemoxydine, hairloss, hair loss

In the News – Small PRP Study Showed Significant Regrowth in Alopecia Areata Patients

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

Snippet from the article:

In the latest research by scientists at the International Hair Research Foundation, the University of Brescia in Italy and the Hebrew University Medical Centre in Israel, used 45 sufferers with alopecia areata, affecting two per cent of the population.

The patients had injections on one half of their head. Some were given the PRP, some traditional steroid cream, while others received a placebo. Three treatments were given every month. Hair growth was checked by measuring the area where new hairs grew on the bald scalp. Results showed the plasma injections led to significant hair regrowth in the bald patches, compared with the placebo and the steroid treatment.

Following the publication of the study in the British Journal of Dermatology, the scientists are hoping to develop a cream, so needles won’t need to be used.

Read the rest — The vampire ‘cure’ for baldness: Scientists inject patient’s own blood into head to stimulate hair growth’

It is important that the readers do not confuse the alopecia areata (an autoimmune disease that causes hair loss) with the genetic male pattern balding condition called androgenic alopecia. Applying platelet-rich plasma (PRP) to androgenic alopecia has been tried over and over again, and despite many attempts to use this treatment for androgenic alopecia, hair growth has never been shown in a clinically valid, controlled study.

Although Dr Fabio Rinaldi told the Telegraph that the new treatment could also help those suffering more common hair problems like male-pattern baldness, I think he has gone overboard when he stated, “We think it can help to regrow hair on people with androgenic alopecia“. I strongly suggest that those people with classic male patterned baldness (androgenic alopecia) to not get suckered into the many doctors who have been selling this treatment for years.

Tags: prp, platelet rich plasma, alopecia areata, hairloss, hair loss

In Around 5 Months, My Bald Spot at the Back of My Head Has Grown (with Photo)

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

I am 25 years of age and i am concerned about my bald spot. I noticed it about 4 or 5 months ago. At first it was the size of a dime and now its bigger than a half a dollar coin. I am worried about my bald spot and i don’t know what to do. I also do not have any family history of balding.

Is there any treatment for my balding spot? Help me

Click the photo to enlarge:

 

An examination by a good doctor is critical. The bald spot looks bare and I wonder about whether this could be alopecia areata, as part of the differential diagnosis to genetic balding. It could also be an infection of some sort. Get to a good dermatologist as the first step in your travel through this process.

Tags: bald spot, hair loss, hairloss

In the News – Gray Hair Could Be Reversible?

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

Snippet from the press release —

In a new research report published online in The FASEB Journal people who are going gray develop massive oxidative stress via accumulation of hydrogen peroxide in the hair follicle, which causes our hair to bleach itself from the inside out, and most importantly, the report shows that this massive accumulation of hydrogen peroxide can be remedied with a proprietary treatment developed by the researchers described as a topical, UVB-activated compound called PC-KUS (a modified pseudocatalase).

Read the rest — Gray hair and vitiligo reversed at the root

This is a interesting discovery, that gray hair is caused by peroxide bleaching the hair at the root. If it is true, anything that can remove the peroxide will reverse gray hair. The author showed that catalase (a known enzyme that catalyzes the hydrolysis of peroxide) can reverse the gray hair.

Tags: gray hair, grey hair, peroxide

My Doctor Said I Wasn’t Programmed to Have Crown Loss, So Propecia Wasn’t Necessary

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


First, I can’t thank you enough for maintaining this resource–it’s alleviated a lot of my anxiety about hair loss simply by giving my a place to find answers to my questions.

I recently had a consultation with a surgeon about reshaping my temples. I’m 29, and probably a NW2-3. (I’ve had relatively high temples since high school, though the spaces have expanded slowly since though then.) He ultimately recommended 1100 grafts to fill in my temples and create a relatively straight hairline.

I have two questions:

1. He told me that diet has a significant impact on hair loss, second to genetics. He advised a vitamin regimen of L-Lysine, Vitamin E, Saw Palmetto, MSM, Glucosamine, Chondroitin Sulfate, and Ester-C. In addition, he recommended that I stop consuming creatine, and eat a sulphite/nitrite-free diet that’s rich in antioxidants and low in refined sugar and bleached flour. I realize that much of this might be good health advice generally, but does it have any non-negligible connection to hair loss? I appreciate interest in my general welfare, but this had me a tad skeptical.

2. After examining the entirety of my hair, he told me that I’m “programmed” for hair loss not beyond a NW3. He did not conduct a miniaturization study; this was a “naked eyeball” examination. Because he didn’t think I’m “programmed” for any crown-area loss, he said Propecia wouldn’t be necessary. Should I take this pronouncement with a grain of salt, or could he accurately reach that conclusion via the type of examination he made?

Many thanks, and all the best. If it’s at all relevant, he did not recommend any type of hairline lowering, but simply filling in the temples and leaving the forelock as is.

While it is possible that you won’t advance beyond a Norwood class 3 hairline, I don’t trust doctors who give eyeball opinions for predicting hair loss. There are some good tests (miniaturization mapping and better yet, bulk analysis) that will tell you with some certainty if you are balding.

The decision to take drugs like finasteride should be based upon clinical evidence of balding. You might want to consider getting a second opinion, hopefully from a doctor that can give you a more thorough analysis of your hair. If you aren’t balding, Propecia isn’t necessary (though you should consider it to prevent shock loss from any hair transplant you may have). If you do have early balding, now would be the best time to start the medication.

As for the recommended vitamins, I am not a nutritionist, so your doctor’s suggestions may be good ones for your overall health. I wouldn’t expect to see lush hair growth upon taking them, though. None of those have satisfactory evidence linking them to treating genetic hair loss.

Tags: hairloss, hair loss, propecia, finasteride

Do I Need a HairDX Test to Truly Know if Finasteride is Working?

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

Hello Doctor. I took minoxidil and finasteride for about a year then switched to minoxidil and avodart. i have no side effects but i can’t understand tell if finasteride or dutasteride is working on me, because i still am shedding. Some hair is growing, some hair is minimizing, and i think the medications haven’t stopped miniaturising progress. Is the only way to understand that finasteride or dutasteride works on me is to do the Hair DX test?

Thank you

The HairDX Test for Finasteride Response should be able to tell you if you are a good responder to the medication, but the best test to find out if finasteride or dutasteride is working is to get a bulk measurement of the scalp hair in 4 different locations. It should’ve be done before the drug is taken and then at about a year after. This test (HairCheck) is the most sensitive test available today. Good documentation should include progressive photographs with the hair length the same.

With all the medication switching, what has your prescribing doctor had to say?

Tags: hairdx, finasteride, propecia, avodart, dutasteride, hairloss, hair loss

In the News – Child With Alopecia Sent Home from School

/by William Rassman, M.D./4 /,

Snippet from the article:

A Philadelphia boy with a chronic balding illness was sent home by his school for having too much hair.

Eight-year-old Zion Williams has been receiving medical treatment for the illness called alopecia at Drexel University which includes painful injections to the scalp. Doctors at the Philadelphia university’s medical program told Williams’ mother Talia Mann to let his hair grow for at least ten weeks.

Last Wednesday, Williams was turned away from the Shiloh Christian Academy in Philadelphia for violating the school’s mandatory short hair policy. Mann said she even filed a doctor’s note with the school to allow her son to attend with slightly lengthened hair.

Read the rest — Eight-Year-Old With Alopecia, Hair Loss Disease, Asked To Leave School For ‘Long Hair’

I suspect that this young boy has alopecia areata (an inherited autoimmune disease). The simplest solution to me would be to waive their short hair requirement for a few months so that it would not impact his treatment, but it seems that the school was inflexible in its policies and victimized this boy.

Tags: alopecia areata, hairloss, hair loss, child

Using Toppik for Norwood 6 or 7 Patients That Can’t Have Full Coverage from a Transplant

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

Dr. Rassman,

What is your opinion on using products such as Toppik to enhance a hair transplant on a Norwood 6 or 7 patient who cannot achieve full coverage? Obviously the need to use a product like Toppik long-term may not be ideal, but for a man whose hair loss is too extensive to achieve full coverage from donor hair, a keratin hair-binding product combined with a hair transplant may be the most effective and natural looking solution for a lot of men with extensive balding.

A bald Norwood class 6 or 7 patient does not do well with a concealer like Toppik, which works better with some hair. Many men who use this product without hair in the bald area will actually show the Toppik itself, which is often irregular in the way it is put down. If used to enhance a hair transplant that is not thick enough, it might work if it can be applied so that the Toppik can not be detected. The keratin hair granular product has significant disadvantages, as it can come off on your clothes, your sheets and pillows, and when someone runs their fingers through your hair.

There is another treatment which is a permanent concealer that can thicken up a hair transplant look — Scalp MicroPigmentation (SMP). If you look at the SMP site, you will see examples of this type of concealer and most of these patients (who have hair that is just not thick enough) can avoid another hair transplant with the SMP alone. We have successfully used this SMP technique to address individuals whose balding patterns are too large and the transplants too few to get the coverage they want.

As everyone is different, I would suggest that you request a virtual consultation with me and send photographs in good lighting so that I can understand your problem as you see it. Also, please include a phone number.

Tags: toppik, hair transplant, hairloss, hair loss, smp

What Are the Reasons for My Hair Loss and How Can I Quickly Regrow It All?

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

Hi Doctor,

When I was young, I was born with an amazing volume of hair. However, I am unsure of what reasons, I started having hair thinning when I was 18. Now I am 32 and my hair volume is only 1/4 of what I was. I am not taking any medication and my family does not have a history of thinning hair.

Can I check what are the possible reasons and what are the steps I can take to quickly regain all my hair?

Thank you.

There is nothing you can do to “quickly” regain your hair. If it was that easy, I doubt we’d see people with balding and this site would be a single post explaining how to regrow all your hair. Unfortunately, the magic you’re seeking isn’t a reality.

You should see a doctor to go over your options. If you have male pattern (genetic) hair loss, finasteride could be a possible treatment for you. Genes are the most common reason for hair loss in men.

Tags: hairloss, hair loss

In the News – Bimatoprost Scalp Failed to Provide Sufficient Efficacy

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

Snippet from the article:

A mid-stage trial of Allergan’s hair loss treatment Bimatoprost Scalp also failed to provide sufficient efficacy to proceed to a late-stage study, and the company said it will be extending the mid-stage development program.

Link: Allergan delays eye drug, shares fall

I found the above tidbit buried within an article about Allergan’s delay of their eye drug to treat age-related macular degeneration. Many folks were hoping bimatoprost (the eyelash treatment also known as Latisse) used on the scalp would be the next FDA approved hair loss treatment, but it seems that will be delayed for some time.

Tags: allergan, latisse, bimatoprost, hairloss, hair loss

My Surgeon Talked Me Into Having More Hair Transplants That I Probably Didn’t Need

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

I’ve had a total of 5 transplants. Two in the front (700 grafts each) and one on the crown (1000 grafts). These three surgeries together produced a beautiful result. I should have stopped there but I was under the illusion that another transplant (1.5 years later) would give me even thicker hair. The Doctor that did the transplants is a pioneer and very well known and respected. I’m not going to mention his name because you would automatically know who he is.

Nine months after the fourth transplant (600 grafts in the front) I did not see any additional density. Three years later I went in for a consult about the front again and he told me that I did not need the fourth transplant but he would be able to do a small one (500 grafts) at that time so I had it done. Six months later I did notice a difference and was pleased with the end result.

It has been six years since and I still have all of my hair. My question to you is: Why would he do a transplant when I didn’t need it? I look back and feel that the grafts were wasted and I was taken advantage of. Like I stated earlier this individual is a pioneer and respected. He certainly did not need the money. Even the nurses joked with me saying that I had “a lot of beautiful hair” hinting that I didn’t need to have the last transplant. What is your opinion on this?

I speak of the importance of ethics at medical meetings. Some doctors push for surgery even if the patient does not need it. This is commonly seen in young men who are too early in the balding process where drugs like Propecia (finasteride) suffice for the sole treatment, and 80% of women with thinning who are not candidates for surgery, yet the doctor recommends surgery on many of them who feel that they must do something about their thinning. For them, the surgical option is an easy sell, even if there is no value for surgery.

My job as a hair transplant surgeon is to always be a patient advocate, pushing those who do not need surgery away from the FUE punch or the surgical knife. It is always good business when I can create a trusted following of patients who believe in my ethics, especially when I steer them away from a surgical decision in examples as those discussed above (majority of women, young men). Many times it is harder to talk patients away from wanting surgery than it is to recommend surgery for an actual candidate. By that, I mean I have to spend more time with each such patient educating them on the ‘whys’ of my decision process.

Tags: hair transplant, surgery, ethics

My Hair Loss Started at 14 Years Old!

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

I grabbed this from a comment left on another post on BaldingBlog…

I know how you feel I’ve been losing my hair since i was 14 as well, now at 18 I’m almost completely bald. I started using rogain when i was 15 and saw great results within the first 6 months and most of my hairline had grown back but all out sudden it fell and my hairline receded back to where it was previously. Now at 18 I’ve been on propecia for 7 months and have seen no results by itself but hopefully now that I’ve added rogaine the last couple weeks I will see better results.

Anyways I hope you have better luck then me because i know how it feels to lose hair at such a young age which complete destroyed my high school experience. Visit your doctor before its too late.

Rogaine (minoxidil) is not effective a thwarting genetic balding when it is aggressive, particularly in someone as young as 14 years old. Finasteride (Propecia) may have been a better choice when you were 14, though on a counter note, finasteride can also have an impact in growth potential of young men going through puberty. So each and every case is different and the doctor treating the patient needs to exercise good clinical judgement when recommending treatment with risks and benefits in mind.

Tags: rogaine, minoxidil, propecia, finasteride, youth, hairloss, hair loss, teenager