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    In the News – Are Your Stem Cells a Drug to be Regulated by the FDA?

    Aug 30, 2013/by William Rassman, M.D./0 /Other

    Snippet from the article:

    There’s trouble brewing over stem cells in Texas, and it raises a big question for the future of medicine. How should we regulate treatments that use cells taken from a patient’s own body?

    If the cells are grown in culture, then the US Food and Drug Administration (FDA) views them as “drugs”, which must undergo a lengthy approval process. That has enraged clients of a company in Houston called Celltex, who argue that the government has no business telling them what they can and can’t do with their own body parts.

    Read the rest — Whose stem cells are they anyway?

    It seems like nearly every day I am asked, “When will we have stem cells to grow our hair?” The author of the above editorial published in New Scientist earlier this month wonders about regulating our own cells. Unfortunately, the FDA says that if cells are grown in cultures, they will be treated as drugs which must undergo a lengthy approval process, possibly costing us far more in time and money than we can afford. This impacts cancer treatments as much as the search for the “hair holly grail” from which we can extract stem cells.

    There are arguments raised that simple transplants are the practice of medicine and therefore not under FDA control. There seems to be some direction to this controversy. “Strict drug-style regulations” seem appropriate for extensively manipulated cells. What that means is still unclear, but the questions are the start of agreements on differentiating the practice of medicine from FDA safeguards for drugs.

    So this is what I tell my patients — Any solution for hair regeneration will most likely go through some regulatory process which will slow down the availability of any “cure” coming out of stem cell research. Don’t hold your breath!

    Tags: stem cells, fda, treatment, hairloss, hair loss

    Regrowing Hair After Chemotherapy

    Aug 30, 2013/by William Rassman, M.D./0 /Diseases, Hair Loss Causes

    I am trying to find a product that will help grow my hair back a little faster after chemo therapy. Is there any product that you can recomend to use to help?

    I meet a lady that used some amino acid and her hair grew really fast

    I don’t know of any commercially available product that accelerates the return of hair after chemotherapy. We have written about cold cap therapy before, but that is something that is used during chemotherapy to maintain the hair, not to regrow it faster after the chemo treatments are complete.

    I realize this information doesn’t help you if you’ve already lost hair, but it is the only chemotherapy-related hair loss treatment I am familiar with. At this point, just being patient for the hair to regrow is likely going to be the best course of action.

    Tags: chemotherapy, hairloss, hair loss

    Could Laser Tattoo Removal Cause Any Problem with My Hair Transplant?

    Aug 30, 2013/by William Rassman, M.D./0 /Other

    Is there any possibility for laser removal of a shoulder tattoo to have an impact on hair follicles? I had a transplant done and continued laser removal one month after it. I wanted to know if the laser might bounce somehow from the shoulder skin to the transplanted area or if there are some other ways that the laser might do harm to the transplanted follicles.

    I’ve asked this question to four different tattoo removal experts and they all say no way in a million years could it have any impact. So i guess it only has effect on the skin where the tattoo is and don’t really go anywhere from that. When you have put over $15,000 into two surgeries you become pretty stressed about the outcome.

    I am by no means an expert in laser tattoo removal, but I don’t see how a targeted laser to remove pigment on your shoulder could cause any impact to your scalp hair (transplanted or otherwise). I wouldn’t be concerned.

    Tags: tattoo, hairloss, hair loss, laser tattoo removal

    I Have a Full Head of Hair and I’m Constantly in Fear of Losing It

    Aug 29, 2013/by William Rassman, M.D./1 /Hair Loss Causes

    I have started worrying about losing my hair. Until recently I hadn’t worried about losing my hair since my temples receded slightly as a young man. I had no reason to believe I was losing my hair. Since I have started worrying (triggered off by the fact that I am about to turn 33 and feel that as a hairy bodied man, I must start losing my hair soon) I have started to spot signs of losing hair.

    I have looked at the hairs from the top of my head and they seem to be finer than the hairs at the back of my head. However, I have no way of knowing whether this was always the case. The hair seems a little thinner in the temples and doesn’t seem as thick overall as it used to but I am aware that hair naturally thins over your life and this isn’t necessarily MPB.

    Basically this has become a problem for me because I can’t stop worrying about it and constantly check my hair, look for information on the internet, and stress out. If you saw me you would think that I was worrying about nothing – I have a full head of hair at 33 and as such am unlikely to go completely bald, if at all. Also, balding in older men is often part of the aging process so I am effectively worrying about getting old. Am I just being neurotic?

    If you’re not actually seeing any hair loss, but THINK your hair MIGHT be getting thinner up top, the only thing I’d recommend doing is getting your hair bulk analyzed with the HairCheck instrument. Beyond that, stressing out and worrying about maybe losing your hair might actually cause hair loss due to the stress. I hope I didn’t stress you out more by saying that!

    There’s no point in being anxious about possibly losing your hair, especially since you’re in your 30s and aren’t seeing loss by now. Most men that are destined to lose hair due to their genetics will start to see the process starting in their 20s.

    Tags: hairloss, hair loss, hair bulk

    I’m Losing Hair at the Temples, Sides of the Head, and Nape of the Neck

    Aug 29, 2013/by William Rassman, M.D./0 /Hair Loss Causes

    I have dramatic hair loss these last three months. Also on sides and behind the head on the neck (not in donor area). Also having too much dandruff and also losing hair on the temple.

    Can dupa cause so much dandruff? Can hair loss on sides be caused by aggressive MPB? Can any chemical or toxin cause DUPA by consuming it once? Thanks for answers!

    Diffuse unpatterned alopecia (DUPA) is unrelated to dandruff. Male pattern baldness (MPB) does not include hair loss on the sides of the head. I don’t know that you even have DUPA. There is nothing I can tell you other than what you told me. You need to see a good doctor to give us an opportunity to make a diagnosis.

    Tags: hairloss, hair loss, dupa, dandruff

    Could I Be Allergic to my Chemical Hair Relaxer?

    Aug 29, 2013/by William Rassman, M.D./0 /African American, Female Hair Loss, Hair Products

    Hello,
    I am experiencing hair loss in the crown of my head the size of a quarter. I am an african american woman. When I keep my hair braided with no chemicals, the hair grows back, so I know that it has the ability to grow. When I put a relaxer on my hair, I experience itching from within in only one area, then a month or so later the hair will fall out, but it only comes out in the same area. Could I be just allergic and sensitive in only one section of my hair. What do you recommend?

    Yes, an allergy would be highly probable. It might also be a chemical burn. I have no suggestions other than speak with your stylist or your dermatologist.

    Tags: allergy, chemical burn, hairloss, hair loss, relaxer

    Why Does Propecia Eventually Lose the Battle to Genetics?

    Aug 28, 2013/by William Rassman, M.D./2 /Drugs

    Dr. Rassman, hi again.

    I’m a long-time follower and fan of your blog. Besides enjoying the quality of the information you share, I really admire your realistic and down-to-earth approach when making comments about new treatments and current research. Some people consider your view to be pessimistic but I find it downright sincere. Thanks for the great job.

    My question today refers to something I find in your comments quite often: the idea that even if someone has been on Propecia for quite a while, he will eventually lose the battle against hair loss. Now, assuming my understanding is correct, Propecia will keep DHT levels low for as long as the patient takes it, correct? If that’s a fact, why do we eventually “lose the battle”? Is it because the % of DHT that is not blocked by Propecia is enough to eventually affect the hair we retain or is it because besides DHT, there are other root causes still unknown to us?

    Thanks a lot, Dr. Rassman!

    Propecia generally impacts only 70% of the DHT by a process called competitive inhibition. This means that the drug competes with DHT at its receptor site. We really do not know much more about this competitive process, but we know that some people get great responses from the drug at the 1mg dose, while others do not. I think that the sensitivity of the receptors varies as the genetic process advances.

    I have discussed apoptosis in the past, which is cell death, and this hits the hair follicles at the end of their lives. The drugs can not give back the life that the process takes away. Take a look at the various posts in the past that discuss apoptosis here.

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

    Can a Man Have Hairline Lowering at 20 Years Old?

    Aug 28, 2013/by William Rassman, M.D./0 /Hairlines

    Hello Doctor,

    I’m a 20 year-old male with what I consider to be a high hairline (7cms from brow ridge to hairline). I know it falls between the male average of 6-8cms, but I have rather effeminate features that cause it to look disproportionate.

    I recently talked to a highly regarded hair transplant specialist in my area to inquire about lowering my hairline with a hair transplant. He told me that my hairline was fine, and if I did go through with a transplant it would look fake and I would be very unhappy with it. Is this true? Or is it just because of the risk of further balding later in life?

    Decisions like this are made between the doctor and the patient. As for whether any surgery would look fake, I suppose that depends on the skill of the surgeon. But if your doctor is recommending you not have a procedure, I’d defer to him. If you want a second opinion, I am unable to give you one over the internet.

    I am generally averse to doing any hair transplant or hairline lowering process on someone who might be balding in their future. At 20 years old, it probably wouldn’t be in your best interest.

    Tags: hairline, hairline lowering

    A Few Weeks After Switching from Finasteride to Avodart, I Saw Major Shedding

    Aug 28, 2013/by William Rassman, M.D./1 /Drugs

    Hello Doctor,

    My question is: Ive been taking proscar 2.5 mg for a while with good results, after some time i felt that it wasnt working that good anymore. Regardless, one day i visited a local hair surgeon and after a brief talk about surgery the discussion moved on to hair medications, which he told me that i should switch to avodart (which he’s taking as well) so i did.

    The first few weeks was awesome, after that i am experiencing major shedding which continued for the past 2 months (i’ve been on it for 2 1/2 months) so i dont know whether to switch back to finasteride or wait to see what happens with the avodart?

    Honestly, you need to ask your doctor. This is a prescription medication that I did not prescribe to you. I can’t tell you whether you should switch between medications. Sorry.

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

    Board Certification in Hair Transplantation

    Aug 27, 2013/by William Rassman, M.D./0 /Hair Transplantation, Training

    Hi Doctor Rassman,

    I’ve been trying to make sense of all the internet literature that states that “Board Certified” by ABHRS is not technically certification by medical standards. What would be the difference if ABMS were to include ABHRS? Would that keep incompetency to a minimum or make me safer?

    Other statements made by AHLA such as, “the AHLC uses remarkably outdated information that is dangerous so avoid them etc.” It’s hard for me, to get a real confident feeling, not knowing how to determine whether I’m safe in my decision.

    Thank you very much for your time and professional opinion

    Hair transplant surgery is NOT technically certified by medical standards. In the United States there are 24 approved medical specialty boards that are overseen by the American Board of Medical Specialties (ABMS), a not-for-profit organization. Certification by an ABMS Member Board has long been considered the gold standard in physician credentialing. To be ABMS board certified means that the physician has undergone formal educational and clinical training at a medical institution after earning their medical degree, and has successfully passed a level of competence via written or practical or oral examinations. I (Dr. Rassman) am ABMS Board Certified in General Surgery and my colleague Dr. Jae Pak is ABMS Board Certified in Emergency Medicine.

    Hair transplant surgery is not a part of the ABMS so there can not be any physicians that are board certified as a hair transplant surgeon. This is mainly because there is no formal training or credentialing in hair transplant surgery. There is no standard curriculum. There is no oversight or direct review of the quality of the work being done. Unfortunately, there is no ABMS sanctioned facility to enroll and learn hair transplant surgery. To date, the only way to learn how to perform hair transplant surgery is to read a book, attend a seminar, or become an apprentice to a private practice hair transplant surgeon. Even ABMS board certified plastic surgeons do not receive training in hair transplant surgery as part of their formal training.

    In the mid-1990s the American Board of Hair Restoration Surgery (ABHRS) was formed by a group of hair transplant surgeons to create an organization that could independently certify hair transplant surgeons. But the ABHRS does not monitor doctor’s training quality and once the testing process is complete, they do not have any authority to enforce any form of discipline. In states like California, doctors are not allowed to call themselves “Board Certified” if the only certification they have is from the ABHRS or other non-ABMS approved boards. They must qualify which board they are claiming.

    Tags: hair transplant, surgery, board certified, medical board, hairloss, hair loss

    Do Hairs Within a Trichophytic Closure Grow At the Same Rate as the Newly Transplanted Hairs?

    Aug 27, 2013/by William Rassman, M.D./0 /Hair Transplantation, Post-Operative

    Hello Doctor,

    I had a hair transplant with the Trichophytic closure method, I was wondering, does the hairs within the scar take the same amount of time to grow through the scar as the newly transplanted ones?

    My scar looks good..however, I’ve noticed some small patches where hair hasn’t grown through yet.

    Thanks again for this fantastic website

    After a hair transplant surgery you may experience hair loss around the donor area with or without trichophytic closure. There can even be large patches of hair loss. The hair loss is temporary and it usually grows back after several months and it can take as long as a year. Transplanted hair takes several months to grow as well (up to one year). The hairs in the trichophytic area should grow at the same rate as the recipient area hairs.

    Tags: trichophytic, hair transplant, wound healing, hairloss, hair loss, hair growth

    How Long Does Shock Loss Last?

    Aug 27, 2013/by William Rassman, M.D./0 /Hair Loss Causes, Hair Transplantation

    I had a hair transplant done 4 weeks ago and noticed i had thinned considerably on the front side of my scalp. I hear this “shock loss” process is a temporary stage.

    How long would you say that this “shock loss” process will end?

    Shock loss following a hair transplant usually occurs within 1-4 months of the surgery. The process might be temporary, but the results are likely permanent (the hair won’t regrow).

    I just wrote a blog post about shock loss last week that explains more about ways to avoid it and why it occurs.

    Tags: shock loss, hairloss, hair loss, hair transplant

    Where Do the Temple Peaks Come From?

    Aug 26, 2013/by William Rassman, M.D./0 /Hairlines

    This is probably a stupid question but your blog popped up in Google when I search the subject and figured you probably would know the answer. Does every guy have those “triangle points” or whatever they are called kinda by the eyes? I have seen some guys with a full head of hair without them and some guys that are slick bald on top but have really full points. Even some guys with just one. I never really noticed this before until someone at work was “lined up” at the barber and had crazy designs put in his. I don’t have them nor do I think I ever did (I kinda have some on one side I guess).

    I am not bald by no means even confirmed by my dermatologist. Id ask them this question but I don’t go back in there for months for my check up. Anyway I know its probably stupid but I was just curious as I dont think any of the guys in my family have them, but I see all kinds of combos throughout the day. Maybe its just genetic makeup like hair color or fine vs coarse hair. Thanks for your time.

    Actually, this is a good question. There are two areas where people have peaks in their hairline. Both men and women get them, because these peaks (temple peaks on the sides and widow’s peaks in the center of the hairline) evolve from a concave juvenile hairline that is present in all children of all races. By children, I am talking about those boys and girls ages 5-7. As these children age, there are changes that happen as the hairline recedes either upward (in the center) or back (on the sides). In many men and women, the temple peaks are often left behind as the hair from the juvenile hairlines recede.

    Take a look at Ronald Reagan as a young man here. What you will see is an eroded central hairline with the mid-portion slightly lower than the sides of his hairline. Please note the temple peaks. Now if you take a look at a later photo of President Reagan, you will see that these prominent temple peaks are mostly gone. There are some men who retain their temple peaks no matter how bald they become. I have patients with a Norwood class 7 hair loss pattern who retained their temple peaks even after they lost the majority of their scalp hair.

    So to answer your question, temple peaks evolve in many men from the young 5 year old hairline and they may keep it their entire lives, or lose part of it or even all of it as you age. I just wrote a paper on this very subject, which will be published this week in the Journal of Facial Plastic Surgery.

    Tags: hairloss, hair loss, hairline, temple peaks

    In the News – Home Remedies from Over 100 Years Ago Were Very Dangerous

    Aug 26, 2013/by William Rassman, M.D./1 /Other

    Snippet from the list:

    10. If you find you’re losing some hair, here’s a quick and easy fix: Make some sage tea. Now mix it with an equal part whisky. Now take a sip, then add “a dash of quinine” to the cup and spray, paint or rinse over the scalp as often as needed, at least twice a day.

    11. A slightly stronger anti-hairloss method (and one that’s “guaranteed” to produce results) is to rub a blend of almond oil, rosemary extract, wine, distilled water, and mercury bichloride into the scalp every morning until your hair grows back or unexplained death, whichever comes first.

    Read the rest at Mental Floss — 19 Wildly Dangerous Home Remedies From 100 Years Ago

    Death stops hair loss!

    Check out the rest of the list for some crazy ways people treated ringworm (with gunpowder) and lice infestation (with mercury). Yikes!

    Tags: hairloss, hair loss, home remedies, century, history

    In the News – The Longest Dreadlocks in the World

    Aug 26, 2013/by William Rassman, M.D./0 /Other

    Snippet from the article:

    Meet Asha Mandela – whose amazing 55ft locks are longer than a bus. The 47-year-old already has a world record but wants to go even bigger – despite doctors warning it could paralyse her.

    “My hair has become part of me. It is my life. I will never cut it,” said the mother-of-one, from Atlanta, Georgia. “Cutting it would be equivalent to suicide. It would be like being a zombie.”

    Asha, who calls her dreadlocks “her baby”, credits them with helping her overcome cancer, two strokes and two heart-attacks. Her incredible hair has also brought her fans across the world and she has launched her own secret hair formula on the back of her success.

    Read the rest — Incredible photos and video of world’s longest dreadlocks that are longer than a BUS

    Her dreadlocks weigh in at around 39 lbs, causing a curvature to her spine. She began growing her hair long around 25 years ago. I wrote extensively about this super long Rapunzel-like hair before and it is worthy to review the subject of this article.

    Tags: dreadlocks, hair growth
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