i’d like to know the possibility of having a transplant if i’m Norwood 6. I’m 21, had a transplant when i was 19 for the hair line of 2000 grafts but my main problem was density all over. i think i have good density. i opted for a hair piece which i’m really satisfied with it, but i know it has a short timeline so i’m considering a transplant again

so my question is.. how many procedures one can have if he is TYPICAL norwood 6?

You may have serious problems if you had a 2000 graft transplant at the age of 19. I generally look at 19 years old (or even 21 in your case) as a person who is not a candidate for a hair transplant. You need a Master Plan by a competent and caring doctor. The doctor you had is suspicious if he is doing 2000 graft cases on 19 year olds. I would guess that the surgery did not work well, so the hair piece addressed that issue.

Your question on how many transplant procedures are needed for a Class 6 balding pattern does not reflect an understanding of supply and demand (please read this post).

I’m 20 years old and considering quitting finasteride after 15 months as I’ve seen no effect at all, but I’ve read finasteride can make you more sensitive to dht. Is this true? By quitting will I be more susceptible to dht than I was before taking it, or will it down regulate aftertime. Many thanks.

You will not be more sensitive to DHT, but you will lose all of the benefits of the drug if you stop it. Even though you say you’ve had no positive effects, it is possible that the medication at least slowed the rate of your loss. After you stop taking finasteride you may see hair loss which would have reflected the hair you would have lost 15 months ago had you not taken the drug in the first place (which I refer to as “catch-up” hair loss).

Hello. I am a 33 year old male and up until 2 years ago had a thick, full head of hair. I have been noticing significant thinning in the front and top portions of my head. There seems to be channels throughout the front and I can see deep past the hairline when I style my hair. Baldness and thinning are not on either side of my family. I don’t understand what is going on.

I have had trouble with my job due to the economy and my marriage of 10 years is about to end in divorce so I have never been so depressed or worried in my life. Could this be the cause? If so, if ever things smooth over will I experience any regrowth?

Also, I have used hair gel for about 18 years now. Could this possibly be the cause? Something weird though, it feels like my hair hurts their in the same area that it appears thinning. Any insight from you would be definitely appreciated. Thank you.

Hair gel isn’t the reason for your hair loss, but stress can cause hair loss… and you clearly have a lot of stress. See a good hair doctor to get some advice after a thorough examination of your hair and scalp.

I respect the fact that you advise using the medications first and clearly state the benefits of using Propecia. If I would not have read your blog I would have just tried Rogaine per my dermatologist. The information is just not out there to use this kinda of treatment / prevention. I was shocked to see some of the great results people have using this as a treatment alone. All you see or hear are the terrible things. I had no idea the drug even regrew hair for most people. Especially for men like me who are 30 with minimal thinning.

Anyway, I was scared to death to take this medicine. I am sure some people have had problems. People also have problems with cars, smoking, and beef. I am close to 90 days on treatment thus far and couldnt tell I have even taken it. The only side I have is feeling alot less stressed knowing I am at least on the proper medicine.

I think your blog is important and I truly believe there is so much misinformation online. Growing older and having some degree of hair loss is normal. I just had my hair cut this morning. I was again told I have tons of hair and this is all in my mind. Granted I dont have the same hair I did when I was 16. Men freak out.., I of course am one of them.

The absolute worst thing I have ever done for myself was trolling the internet. I cant believe I read and re-read these internet forums ( I am sure you are aware of the sites), where people talk about their experiences on these drugs and experimental treatments. I should have known that people who have great results on these drugs certainly do not write about it on hair loss forums. Lets me honest, have you ever had a great steak then written an online review of the place that cooked it? Its few and far between. Propecia is not a silver bullet. However, it is FDA approved and has undergone a battery of clinical tests over several years.

My main point here is, yes people need to do their due diligence in taking medicine. You would not buy a car without test driving it. No one writes anything positive. But be certain, if you have a bad experience you will tell everyone.

Thanks for your frank opinions. We have published many comments and some photos of people who have received wonderful benefits from Propecia over the years; however, seemingly just like on the TV news, you mostly only hear the bad news. The good news isn’t reported very often, because bad news sells and grabs the attention of the audience.

Your comment about reviewing a great steak is spot on. If your food wasn’t prepared to your satisfaction, you’re probably more likely to let people know how dissatisfied you are. As I’ve written before, those that feel wronged by something are generally the most vocal. Everyone else will just continue to live their lives.

(female)

My mother died in 10 months ago. The night before the service i washed my hair and noticed a patch of my hair was gone. It is now 10 months later and no hair has come back, but the patch has not gotten any bigger. what can i do?

See a good doctor to make an assessment of your problem. There are many causes for hair loss and an experienced doctor can give you a diagnosis after a good examination of your hair and scalp.

It’s possible the stress from the loss of your mother caused your loss, and if that is the case I would expect some hair to start growing within a year.

Hello doctor.

I have been using minoxidil 5% topical solution for a while now, and have always had this question on my mind. When I apply it, should I just get the substance spread out on my scalp and be done there, or should I actually rub the substance in thoroughly afterwards?

Thanks in advance, I am looking forward to hearing back from you.

A good application to the scalp is enough to get the benefits of minoxidil. Massage it gently into the scalp, but keep in mind that rubbing excessively could pull out the weak hairs on your head.

Dr. Rassman,
You have mentioned before that you have the classic mature hairline. Would it be possible for you to post a good size photo of yourself to get a better example of how deep the mature hairline is?

Thanks

There is no secret to a mature hairline. If your hairline seems too high for you, then it is too high for you (mature or not). The real issue is whether you are balding (getting a higher hairline over the months and years) and if you want to do anything about it. Keep in mind that a mature hairline is usually about one finger width above your highest forehead wrinkle. This isn’t necessarily a hard rule, but it generally works out that way.

Upon your request, here is a photo of myself (click to enlarge):

I am a 53 year old caucasion female (post menopausal) with fibromyalgia and some sub-clinical auto-immune syndromes, chronic pain syndrome, failed back syndrome, and on and on. I have also been experiencing hair loss from the entire head and have several plaques that my rheumatologist is concerned about, because the skin is tightening. I have also had numerous spots of alopecia areata. Mometosone furoate 0.05 cream has stopped the general shedding,but i am still dealing with the alopecia spots. I want to have injections (kenalog or similar) to get the hair growing fast in those spots, while they can still be treated. could you comment on some or all of the following treatments:

1) oral prednisone
2) aldacton
3) aldara
4) very brief and minimal use of mometasone furoate ointment 1/g on the worst spots.
5) if a woman begins treatment with rogaine, do she have to use it forever?

Thanks if you are able to answer any of these questions. i realize this is not the equivalent of seeing a physician.

I really can not go into the multiple medications you discussed, as I am not your treating physician and don’t have your medical history. Alopecia areata can come and go, and any doctor that is going to manage your medications and various conditions should be a doctor who you respect and like.

Rogaine (minoxidil), when used, takes at least 12 months. If it is effective, it must be considered a lifetime medication or any benefits will cease if the treatment is stopped.

Snippet from the article:

Hair loss is a common disorder that affects many men and women due to aging or medical conditions. Current FDA-approved drugs can minimize further hair loss but are unable to regrow new hair. The Institute of Bioengineering and Nanotechnology (IBN) has recently engineered a new hair follicle model that could help discover new drugs for hair regeneration1.

IBN Executive Director Professor Jackie Y. Ying said, “We have applied our cell and tissue engineering expertise to create a hair follicle-like structure that is very similar to the native hair follicle. This model allows us to better understand the mechanisms that control the development and growth of hair follicles. We hope that our invention would lead to novel ways to treat hair loss, which affects millions of people worldwide.”

Read the rest — New 3D hair follicle model to accelerate cure for baldness

The title of the article is quite hopeful, but essentially this is something they hope to sell to pharmaceutical companies to aid in their hair loss drug treatment development.

I was interested in getting a strip surgery in a couple of years. I was wondering if it better for a person to get a large session done at one time such as 4500 grafts? Or is it better for a person to get a smaller session such as 2500 grafts, and then wait for a few months and get additional 2000 grafts? Also, I have noticed that doctors provide a discount after 2500 grafts. Are they encouraging people get larger sessions done?

On the hair loss forums I have seen a person picture where he got 4000 grafts implanted through the FUE method. This man paid for 4000 grafts, but his surgery resulted in a failure. In the end he lost money, and had to live in embarrassment for the rest of this life. I was wondering if the strip surgery has similar risks for large sessions?

It is not all about numbers. You need a doctor who understands the progression of your hair loss — how to address future hair loss along with present hair loss. You need a plan rather than just thinking of short term goals. Each and every patient is different, with different needs and different hair loss degrees. To some it may be reasonable to have a 4000 graft surgery and be done with the entire ordeal. But with 4000 grafts at one time may come a large donor scar. My point is that your surgeon should discuss all of these factors and give you a Master Plan tailored to your genetic hair loss pattern and your social needs.

We are all born with a finite amount of hair. Some people have more donor hair and some people have less. The availability of hair is a demand (how much you need) / supply (how much you have) issue that must be understood by everyone who is going to have a hair transplant.

The cost of the surgery, while it is a factor, should not be the main factor in your decision making process. Hair transplant surgery is permanent and I am always flabbergasted at the patients who seek out the lowest bidder. This is not like buying a car. The surgeon and the medical group, no matter what they advertise, are ALL different in their techniques and results. Not all strip surgery is the same and not all FUE surgery is the same. As you clearly point out with the failure of the 4000 graft FUE surgery you saw on a forum, the results will be forever and any hair loss from failed or poorly done hair transplants can not be priced just by doing another transplant. The hair supply reduces with every transplant, so losing money can be replaced by more money, but if the hair is gone, then there is no solution. Valuable donor hair reflects more value than losing money.
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