My Job Requires I Wear a Helmet for Hours Each Day — Can I Get a Hair Transplant?

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

Hi great doctors,

I’m planning to go for a hair transplant. However I need to go back to work about 1 week after my transplant, and my job requires me to wear a helmet for 4-5 hours each day. What are your thoughts on the helmet affecting my donor area or grafts?

Appreciate your kind advice. Thank you

HelmetI would need to know what your balding pattern is, where the transplants will be going, and what type of harvesting technique (FUE or strip surgery) you plan on having. It would also be helpful to know the type of helmet that you intend to use. I might be able to ascertain your situation from this information.

In the past, we’ve had patients that are firefighters, daily motorcycle riders, race car drivers, pilots, and other professions that wear helmets on a regular daily basis and they have had no issues with having a hair transplant surgery. We generally recommend one to two weeks without wearing a helmet following a hair transplant, though.

Tags: helmet, hair transplant, surgery, hairloss, hair loss

If I Have Another Strip Procedure, Will The Scar Be More Noticeable?

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

hello
16 months ago i had a hair transplant using the strip method which has left me a scar on the back of my head. if i was to have another transplant with the trichophytic closure procedure, would this problem of the scar not be so visible if i were to cut my hair shorter?

i would appreciate some advice just so i can be sorted out. kind regards

A second strip surgery in a person who had a sizable scar after the first surgery can produce an even larger scar the second time, but this is not always the case. There are times that a second surgery can reduce the scar from the first surgery. Considering the size of the scar, it might be excised and then closed with a trichophytic closure; however, the scar may return nevertheless.

One of the new and innovative ways to treat a hair transplant scar is with Scalp MicroPigmentation (SMP). See examples here.

Tags: hair transplant, scar, scarring, hairloss, hair loss, smp

In the News – Is Suave Keratin Infusion Kit Causing Hair Loss?

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

Snippet from the article:

Dozens of women across the country are suing the parent company of Suave over allegations that a product they bought at their grocery store left them with bald spots. FOX 7 investigates what caused the problems in the first place.

Could sleek, shiny hair be just a shampoo away? “So smooth so sleek…” Commercials for the Suave Infusion 30 day keratin infusion kit promises that quick transformation.

“What I got was the exact opposite of that,” said Tanya Millet, who claims the product damaged her scalp. But, Millet says her results were disastrous. “I just sat in the bathroom and cried and thought what am I going to do now?” Millet said. Millet says she bought the treatment at a local retailer, hoping it would prevent frizz on an island vacation. Instead she ended up making an emergency call to her stylist.

“And she said to me ‘I don’t know how to tell you this but your hair is chemically melted'” Millet said.

Read the rest — Dozens of women sue Unilever, claim hair product left bald spots

I just noticed this was from late August, but it is still relevant. Any readers of this site have problems with this shampoo?

Tags: suave, shampoo, hairloss, hair loss

Can I Use Minoxidil for Treating Chronic Telogen Effluvium?

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

Hello doc,

I’m 26, almost 27 years old and have chronic telogen effluvium for almost 18 months. I’m losing a lot of hair everyday on top, front and in the back; all-over. My question is.. Is it possible that CTE can recede a hairline a little? Less volume.. and little receding.. Is it possible to use minoxidil for CTE? What side-effects does minoxidil have with collagen, acne and wrinkles?

I do not believe there is a medication that really works (or proven to work) for treating telogen effluvium. If you have a diagnosis of chronic telogen effluvium, I would unfortunately think that your response to a drug would be even less. I don’t think it would help to a point that you’ll be able to notice worthwhile gains, but I suppose it doesn’t hurt to try.

Take note that some people who try Rogaine (minoxidil) report increased shedding in the first several weeks. I don’t know of any studies that show minoxidil causes wrinkles or aging in humans, though there was a mouse study about minoxidil on collagen synthesis from from years ago. Lots of anecdotal stories are on the Internet though, so take that as you will.

If you apply the minoxidil all over your head, be aware of the complications and/or side effects listed in the literature given in the package insert.

Tags: minoxidil, rogaine, collagen, wrinkles, hairloss, hair loss

After Taking Finasteride for a Month, I Felt Numbness Under My Eye

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

Hi,
I’m 19 and i have currently been taking proscar cut into 4 for nearly a month now. i have no real problems apart from the top of my cheek on the left side of my face under my eye feeling a bit weird like it is numb. at first it was really annoying so i stopped taking the proscar until it went away, which was about a week. After it went i started to take the drug again to see if it came back, which it did, but it is less noticeable and it fades off a bit during the day.

I have looked around on the internet and i have seen little on this side effect so was wondering if any of your patients have had this and if they ended up getting more serious side effects later due to this or not? I cant go to my doctor about this because i order off one of them online sites and he does not believe any hair loss drug such as finasteride or Minoxidil work anyway, so would be wasting time. so wondering if you know anything about this?

It would be highly unusual in my experience, but there are very rare reports of mild neurologic sensory side effects reported. I personally have never seen it at my practice in thousands of patients whom I have treated.

Whenever you have a complaint, you need to see a doctor, as it would be wrong to attribute your symptoms to the drug alone. For example, a brain tumor could present this way. I did not mean to scare you, but just to show you that this is not a mix and match (symptoms and disease) on a random basis. Doctors significantly add value to the analysis of complaints such as yours.

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

Are People Abusing Finasteride?

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

I am a pharmacist and I think someone is “playing” me to get some finasteride. He got #60 5mg tabs yesterday (a Saturday) and told me this morning that a hotel maid threw them away when she cleaned his room. I do not know the patient; he has traveled here for work. He is young and told me that he cuts the 5mg in quarters for hair loss. I told him I would contact his MD Monday morning. This bugged me all day and I can’t find much about finasteride abuse but none of it is sitting right with me.

I saw this page on your site (The Impact of Higher Doses of Propecia). Are people abusing finasteride? I don’t really want to provide this guy with more finasteride, even if I get a new prescription from his physician. I’d appreciate your help.

You may be right, and the lost prescription may be a ‘tool’ for supplying his friends with the drug. Or it could just be that a hotel maid threw out his pills. This is a judgment call for you as a pharmacist and for his doctor who would know him better.

Finasteride is not an addictive painkiller or something like that which tends to be abused.

Tags: finasteride, propecia, proscar, drug abuse

My Pharmacy Stopped Giving Me Propecia In the Bottle with Silica Packet

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

I have been on propecia for about 10 years now with great results. Still a NW1-1.5. Just last year my pharmacy stopped putting my propecia in the original bottle with the silica packet/capsule to keep it fresh and block out humidity. They started putting it in those orange plastic cylinder bottles. So this past year I have noticed more hair thinning in the crown a bit and on the right side. I have been using this non original bottled propecia for about a year now and noticing thinning. Haven’t noticed much shedding but thinning though. This past month I went to a another popular retail chain and got propecia in the regular bottle with the silica packets/capsules in like how I had it before. I am noticing sheds now around 15-25 hairs but most of them are regular thick dark hairs. Maybe 5 of those hairs on thin miniaturized ones.

My question is was the non original bottle propecia pills destroyed by not having the capsules in it? Is losing 15-30 hairs a day in the shower a sign of propecia working again and I am going through a mini shed that will grow back as a start of a new treatments since the destroyed propecia didnt count as medication since they were not working? Are thick dark hairs a bad sign to shed compared to thin miniaturized ones?

I am so confused on what to do..Any help would be greatly appreciated

SilicaI am not a drug manufacturer or a pharmacist, so I can’t speak with direct knowledge about pharmaceutical packaging. Silica packet are there to absorb moisture, so unless you are storing your medication in a sauna, it’s my opinion that it would not have much impact on the efficacy of the drug.

Normal non-balding men and women can lose 100+ a hairs a day, but I don’t quite follow the questions you posed at the end of your email. Losing 15-30 hairs in the shower doesn’t prove that Propecia is working or not. There is a big market for counterfeit drugs, even in good pharmacies, so you should be careful when buying these drugs.

With all that said, I am not sure if a Norwood 1 would really even benefit from Propecia, but that is another topic.

Tags: propecia, finasteride, packaging

Fun Time – The Tom Hanks Movie-Hair Quiz

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

From the article:

Tom HanksTom Hanks is in his fourth decade of being a national treasure. And when you’re around that long, you find yourself with a lot of very different parts — as in hair parts. From the rich, dark curls of his younger days to the short, hairline-showcasing look of today and all the weird beardy and shoulder-length ones in between, Hanks can make any cut look iconic. On the occasion of the Friday release of his new movie, Captain Phillips (short hair with a bonus goatee), this quiz tests how familiar you are with all of his past movie looks.

Take the quiz — Take the Tom Hanks Movie-Hair Quiz

For the record, I got 10 out of 13. Many of them were just guesses, though.

Tags: quiz, hair, movies

Not Hair Loss News – Higher Radiation Doesn’t Help Prostate Cancer Treatment

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

Snippet from the article:

Escalated-dose radiation therapy for localized prostate cancer did not significantly affect the frequency of biochemical or clinical failure compared with a standard protocol, a randomized trial showed.

Men treated by the standard radiotherapy protocol had a 5-year rate of combined biochemical and clinical failure of 21.43%, whereas the escalated-dose, or hypofractionated, protocol was associated with failure rate of 23.3%.

The incidence of late toxicity did not differ between protocols, but hypofractionated therapy worsened urinary function in men who had urinary problems at baseline, Alan Pollack, MD, PhD, of the University of Miami, and co-authors reported online in the Journal of Clinical Oncology.

Read the rest — Higher Radiation Dose No Help in Prostate Cancer

Tags: prostate, prostate cancer, radiation

HairDX Showed I Had Only a 30% Chance of Propecia Response

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

Dr Rassman, If you had a male patient who was 43 years old and is only approaching a Norwood 2A pattern, showed to have the balding gene based upon the HairDX testing and showed to have only a 30% chance to respond to Propecia based upon the HairDX, would you still advise the patient still continue taking Propecia. Also has father who is a NW7 and started balding at 18.

Secondly, would he still be a good candidate for a hair transplant to thicken the hairline even if he may not respond well to Propecia? My doctor advised me to continue taking the Propecia. Would you do the same?

I am not your doctor and you need to discuss your treatment option with the doctor who ordered the HairDX test. Is a 30% chance a worthwhile investment for you to take a pill a day? You can discuss your risks and benefits with your doctor.

I would not know if you would be a good candidate for hair transplant surgery because I do not know what you want or what your goals and expectations are, as I have not examined you. If you indeed have a Norwood class 2A pattern of “balding”, I would doubt that you are a candidate for a hair transplant at your age, but I would have to see you (or at least see some good pictures) before drawing any conclusions.

Hair transplantation is an elective cosmetic surgery. If want to lower or thicken your hairline and change your look that is your prerogative, but your response to Propecia and your candidacy for surgery are not related. The hair transplant surgeon’s job is to guide you, give you realistic expectations, and an overall Master Plan.

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

I’m Taking Steroids for Chronic Sinus Inflammation and I’m Seeing Hair Loss

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

(male)
Due to chronic sinus inflammation and infections, as well as mild asthma, I have been on Steroids (Prednisone and Advair 500/50) for about 5 years now. In that time I have experienced many minor side effects. One thing that has happened is hair loss. Not rapidly or in large quantities but progressively each day. Going way back in my family (both sides), we have been blessed with thick healthy hair and I carried that trait until I started getting sick and jumping on these drugs. I did some initial research online and discovered others who have either made the connection or question the connection to steroid use. Is this a path I should pursue? If I saw a hair loss specialist, would they be able to help determine cause?

Thank you for your advise.

Corticosteroids in general can cause many systemic problems (not only hair loss), but hair loss from steroid use is not uncommon in those with the genetic hair loss gene. In general, hair loss in men is mainly from genetic androgenic alopecia without steroids.

You may want to note if your hair loss is diffuse or limited to certain areas. If you want a clear diagnosis, see a doctor.

Tags: steroid, hairloss, hair loss, corticosteroid

Rogaine Regrew My Hairline!

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

Hi Doc

Just want to share a success story. I had my hair mapped for miniturisation, it was apparent that i was thinning in the temple region and starting in the crown area. I have been using 5% minoxidil ever since for about a year now and I have experience exceptional regrowth in the temple region(although the regrown hair is shorter than the rest of my hair-2cm long, the rest of my hair is 5cm long in the front). I heard that minoxidil does not grow hair there!

The regrown hair has covered the receding hairline making my hairline appear more full, I now have a mature hairline, could even be a lower than a mature hairline. I have just started propecia 40 days ago to maintain what I got on my head, at the moment i’m very happy!! By the way i’m 20 years old..

Your results are terrific by your own description; however, at your age the pull of the balding process will be great, so the minoxidil and the Propecia you just started on may not hold the hair there forever (particularly lower than a mature hairline).

Tags: rogaine, minoxidil, propecia, finasteride, hairline, hairloss, hair loss

Shady Hair Transplant Centers Require Research to Identify

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

Where can I turn to if I feel like I was ripped off by my hair transplant doc? After looking him up on the web I am now not even sure he is a legit doctor.

I’m not sure where this doctor (or fake doctor) is located, but if he is in California, then I would contact the Medical Board of California. They are looking for victims who have been harmed through unauthorized treatments, to come forward so that they can investigate and if appropriate prosecute doctors and clinics that break the law. Some people pass themselves as licensed doctors and their victims are reluctant to go to the medical board in many situations.

Here’s an example of a fake doctor that we’ve reported on before —

Tags: scam, hair transplant, john lord, medical board, fraud, criminal, death

Could I Develop Traction Alopecia From Touching My Hair Over and Over?

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

Is it possible to develop mild traction alopecia from constant touching/feeling of the hair with your hands? Ive been touching my hair for over a year and I think it is thinner in certain areas where I touch it the most than it was a year ago. I cant seem to stop touching it. I really want to. The hair loss is only noticeable to me so I think if i stop touching now the hair might grow back in a few months. What do you think?

I guess it depends on how much and how hard you are pulling on your hair. Touching your hair shouldn’t be an issue. If you have an issue where you cannot get yourself to stop touching your hair, it may be some form of an obsessive compulsive act and you should follow up with a doctor. In general, hair loss in men is mostly due to genetic androgenic alopecia (not traction alopecia).

Without an exam and medical history, I have no way to tell you what you have or if your hairs will grow back.

Tags: hairloss, hair loss, traction alopecia, ocd

I’m a Diffuse Norwood 6/7 at 21 Years Old

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

I started losing my hair when I was only 13 years old and now at 21, I’m a very diffused NW 6/7. My permanent zone is also not as thick what it was used to be. My father and grandfather both have good density in their permanent zone but they both started losing their hair after mid twenties.

Does permanent zone of young MPB sufferer thin out too?

You need to see a doctor and get a good diagnosis of your hair loss and its cause. You may have diffuse thinning (including your donor area) or you may just be a Norwood 6/7 with fine hair. I do not know this. Permanent zones do not undergo thinning with typical male pattern baldness.

Tags: hairloss, hair loss