FUE Caused Necrosis of Patient’s Donor Area

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

A report published by the Journal of Plastic, Reconstructive & Aesthetic Surgery a couple years back has recently come to my attention. Here’s part of the abstract:

Follicular unit extraction (FUE) has been developed as one type of follicular unit transplantation surgery, a widely accepted hair-restoration technique. FUE has many advantages, including a small donor area scar, less pain and a slender graft without extra surrounding tissue. Complications are uncommon in the literature. We describe a case of donor-site necrosis after hair restoration with FUE, leading to cicatricial alopecia in the left half of the occipital region.

Read the rest of the abstract — Necrosis of the donor site after hair restoration with follicular unit extraction (FUE): a case report.

I have seen the impact of large sessions of grafts using FUE on patients who came to our office over the past 10 years. Most of these necrotic areas were small, so they were easily addressed by good, traditional surgical care. I expect that we will see more of these severe complications as more and more doctors start pushing the number of grafts performed in a single FUE session, just as we saw when doctors who did not know enough about FUT caused similar degrees of necrosis. I believe that those doing FUE procedures and their patients need to be aware of this risk. This complication, however, was a disastrous problem for the patient referenced in the above report, as he lost part of his scalp.

The full article states, “One hundred fifty cubic centilitres (cc) of 1/100 000 adrenaline solution was injected gradually into a 10 by 12 cm area in the left occipital region during surgery over 4 hours. Nine hundred fifty follicles were removed using 0.8-mm punches connected to the end of an electrical driver drill“. So less than 1000 grafts were transplanted with a small punch and yet the complication occurred. This punch size should have minimized the risk. The article does not discuss the density of the punch holes in the donor area. On the surface, nothing was really done wrong.

Read more

Can I Still Use Rogaine While Trying to Have a Baby?

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

Hi there,
I have been using 2% Rogaine for over 10 years with great success. I know I can’t use while pregnant- but what if it takes 8-9+ months TO get pregnant? Can I really not use while just trying if I intend to stop immediately once pregnant?
Thanks

This comes from Drugs.com: “Minoxidil topical has been assigned to pregnancy category C by the FDA. Animal studies using oral minoxidil have failed to reveal evidence of teratogenicity, but reduced conception rates and an increased incidence of fetal absorption have been observed in rabbits given 5 times the usual human oral dose. Minoxidil topical should not be administered to pregnant women.”

The key point in the above paragraph that relates to your question is about the rabbits given abnormally high doses of minoxidil. While it is probably not a problem for you to continue using Rogaine while conceiving, I would talk with your obstetrician.

Tags: rogaine, minoxidil, female hair loss, pregnancy

In the News – Actor Bradley Cooper Takes Propecia?

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

Snippet from the article:

Bradley CooperBradley Cooper rocked a hilarious perm for American Hustle, but in real life, RadarOnline.com has learned, his hair situation is no laughing matter.

According to a source, Cooper ”is so anxious about his receding hairline that he’s turned to [balding remedy] Propecia.”

Cooper, 39, “has a lot of bald guys in his family, so he’s been on Propecia for a couple of years,” the source claims. “And to his delight, it seems to be working.”

Read the rest — Bradley Cooper’s ‘Hustle’ Against Hair Loss! Actor Has ‘Turned to Propecia’ To Battle Baldness

It works for celebrities and non-celebrities alike.

Tags: propecia, finasteride, bradley cooper, hollywood, actor

A Doctor Told Me I Should Cut My Hair Short to Alleviate Thinning

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

Hi ! I am a 23 year old male NW2 and I have long hair that is thinning diffusely on top with scalp visible. I heard from another doctor that I should cut my hair very short and frequently for the next 6 months to a year to alleviate the thinning. She said that if the hair is too long, the capillary matrix underneath the scalp is deprived of too many nutrients and additionally the sebum glands in each follicle, whose sebum output are allegedly in a positive feedback loop with respect to the length of the hair, will burn out from being overworked, causing the hairs to eventually fall out if the man’s long hair is not cut short.

Is this true ?

That is false.

I do not like to correct other doctors recommendations or explanations, because what they may have told you may have been misunderstood. While the explanation that you were allegedly given may sound semi-plausible and even scientific, it is false. Cutting hair shorter or shaving your hair will not alleviate male pattern balding. Male pattern baldness is genetic.

Hair length has nothing to do with hair loss, unless perhaps your hair is getting caught on things and being pulled out. Men with short hair still go bald, and there are many men and women with long hair that don’t see thinning.

Tags: hair length, hairloss, hair loss

In the News – New Male Contraceptive That Prevents Prostate Cancer and Regrows Hair?

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

Snippet from the article:

It’s a male contraceptive that can prevent baldness, regenerate hair and prevent prostate cancer. So claims Sujoy K. Guha, a professor at IIT-Kharagpur, whose team has upgraded the RISUG contraceptive to this end.

The drug, originally developed at IIT-Kharagpur by Guha, has moved a notch up by using a world-first technology that will generate a new nano drug inside the human body. The project was funded by the ministry of Health and Family Welfare, and the research was coordinated by the Indian Council of Medical Research.

Reversible Inhibition of Sperm Under Guidance (RISUG), now in the last leg of its trials, is slated for a restricted, monitored launch by the end of this year.

Read the rest — Talk about a wonder drug! New contraceptive for men also prevents cancer and baldness

Take this news with a grain of salt. We’ll see what becomes of this after the trials are complete. I found an article from a few years ago about RISUG on Wired.com that has more information about the contraceptive part, though I’m unclear how the hair loss and prostate treatments come into play.

Tags: hairloss, hair loss, male contraceptive, prostate cancer, risug

Finasteride Didn’t Work for Me, But Minoxidil Did!

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

Dr I took finasteride for 3 years and 4 months, and during this period my hair continued to fall at the same rate when not used, many had itching and dandruff on the head (surely caused by MPB) I have to diffuse homogeneous nw6. So I decided to start with minoxidil and to my surprise, my head stopped itching, dandruff disappeared and stopped losing those hills wire miniaturized, felt the texture of hair greatly improved and increased volume. I’ve always heard that finasteride was the flagship of the treatment, but this seems not to apply in my case

Have you ever had a patient with a case similar to mine: Bad response to finasteride, but good response to minoxidil?

Everyone responds to medication differently. I have seen many men with great results from topical minoxidil (Rogaine) alone, but in more cases I’ve seen even better results from finasteride (Propecia).

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

What Makes a Good Female Hair Transplant Candidate?

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

hi,

i am a 17 year old female and my hair is thinning rapidly- to the point where i and others from a certain distance can see bits of my scalp at the top. I was just wondering about the procedure for hair transplants in female, what makes a good female candidate for a hair transplant, and the minimum age for doing so

thanks

A good female hair transplant patient will have:

  1. healthy hair around the back and sides of the head
  2. limited area of thinning or balding (example: frontal hair loss)
  3. medium or heavier hair
  4. good hair densities
  5. good medical health without any diseases that cause hair loss
  6. no medications taken that cause hair loss
  7. tried medical treatments such as minoxidil without results
  8. enough maturity to understand a hair loss Master Plan developed with her doctor for her life’s projected hair loss

Most women have generalized thinning which is not a good condition for a hair transplant. Scalp MicroPigmentation (SMP) works well for treating thinning (see our SMP gallery).

All females should have an extensive medical work-up for hair thinning, as there are conditions such as thyroid disease that can cause the loss. First you need to be checked out to make sure that you do not have some identifiable cause of the hair loss (e.g. extreme fluctuations in your weight). Once your doctor determines a possible cause for your loss, then a treatment path can be developed to attack any identifiable cause (e.g. thyroid disease). Hair restoration procedures such as hair transplantation or SMP should really be last options, not first ones for a 17 year old female.

Tags: hair transplant, pigment, hairloss, hair loss, female hair loss

HydraCell

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

I live in Denmark and just spotted this ad for “vaccination” against hairloss. They are doing trials of the product at a reduced price.

It’s is discussed here: Hairlosstalk.com

What your thoughts of this product “Hydracell” ?

I found the website for the clinic that markets HydraCell, and while I can’t read Danish, I did find a press release from 2011 in English: Hair Restoration Pioneer Brings ACell and New Hydr-ACell Solution to Norway Study

I read up on the mixture of ACell and PRP, and this is mostly hype. There is no basis for any value for either PRP or ACell for growing hair or vaccination against hair loss. I’m not impressed.

Tags: prp, acell, hair transplant, hairloss, hair loss

Not Hair Loss News – Antioxidants Accelerate Lung Cancer in Mice

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

Snippet from the article:

Although some people spend countless dollars on antioxidant supplements to improve their health, many studies have found that these would-be panaceas could actually exacerbate the diseases they claim to prevent.

Now, a team of Swedish scientists has shown that two antioxidants—vitamin E and N-acetylcysteine (NAC)—can fuel the growth of lung cancers in mice. The team also worked out why.

Antioxidants protect cells from chemically unstable molecules called reactive oxygen species (ROS), which can easily react with DNA and cause damage that leads to cancer. But Martin Bergo’s team at the University of Gothenburg showed that antioxidants neutralize ROS in tumors as well as healthy cells. “If we give extra antioxidants in the diet, we’re helping the tumor to reduce radicals that would otherwise block its growth,” Bergo said. “Then it can speed up all it wants.”

Read the rest — Antioxidants Speed Up Lung Cancer

This may bust the modern thought that antioxidants are good for everyone. Although this was discovered in mice, we need to pay attention to such publications.

Tags: lung cancer, mice, rodnt, antioxidant, cancer

Propecia or Minoxidil — Which Should I Try First to Treat My Receding Hairline?

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

I read that you don’t advise starting both minoxidil and propecia at the same time at the risk of not knowing which is helping, as well as addicting the hair to both types of treatment.

Here’s my question: As a 22-year-old male with about a 3-inch receding hairline (straight back, not up toward the crown), which should I try first? And how long should I stay on that first treatment before stopping and trying the second, or simply adding the second to the mix?

If you’re trying to treat a receding hairline, either medication isn’t likely to regrow the frontal region, though it’s not impossible. Propecia is a prescription medication, so you should see a doctor to learn more about it. Minoxidil is available over the counter, but does most of it’s regrowth in the crown (which you said isn’t a problem).

I’m not your doctor and haven’t examined you though, so I really can’t say which medication you should try first… but I will say that Propecia can halt the hair loss from progressing further back, so that might be your best bet if your doctor agrees and prescribes it to you.

As for how long you should wait before starting a 2nd medication, that’s really a judgment call. If you stop either medication, you will lose any benefits they gave you.

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

Thymosin Beta-4

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

Is there any truth that a peptide called TB-500 also know as Thymosin beta4 help with thinning hair?

Not that I’m aware of. There was a mouse and rat study published years ago that got companies excited to start marketing Thymosin beta-4 as the next great “cure”, but such studies are a long way away from human proof.

I haven’t seen anything about it in recent years, which leads me to believe it went nowhere. If anyone has more current info, please feel free to send it in!

Tags: thymosin, tb-500, hairloss, hair loss

Checking DHT Levels?

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

How does one go about getting their DHT levels checked? Do you require a requisition from a doctor etc?

Thanks

I would imaging that any good clinical laboratory would offer this test… but in my 23 years doing hair work, I have never ran a test for DHT.

Tags: dht, dihydrotestosterone

I’m in High School and I’ve Gone Completely Bald

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

At the age of twelve my barber first noticed that I was starting to get small bald spots and that I should see a doctor about it being Alopecia. I went to a dermatologist and they confirmed it was Alopecia.

The spots progressively got bigger and not one treatment had any effect. My hair was tolerable through Junior High School because the spots were hardly noticeable, but my Sophomore year in high school I suddenly went completely bald. I have worn a hat everyday of my life for the last two to two and a half years and simply cannot get over it.

I am afraid that I am missing out on all the perks of a normal childhood. I am now a senior in high school and I have absolutely no signs of anything changing. Any input on a solution, even though that seems completely out of the question considering what I’ve tried, please feel free to respond. Thank You.

The term “alopecia” just means hair loss, so if you went completely bald, I am going to assume your doctor diagnosed you with alopecia totalis (total scalp hair loss) or alopecia universalis (total scalp and body hair loss). I wish I had better news to give you, but unfortunately the treatments available for these types of alopecias are extremely limited — essentially just wigs and Scalp MicroPigmentation (SMP). You can learn more about treatments at the National Alopecia Areata Foundation.

We’ve performed SMP on alopecia totalis patients in the past, with one such example found here.

Tags: alopecia, alopecia totalis, smp, pigment, hairloss, hair loss

I’m Already Taking 5mg Finasteride for My Prostate

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

I am on 5mg of finasteride for my prostate. Being on this dosage, will I get the same benefits as 1 mg of propecia or do I need to divide my 5mg into 4ths?

If you’re already taking Proscar (finasteride 5mg) to treat your prostate issues, you’re covered. That dose works for hair about as well as the 1mg dose for the treatment of hair loss.

Tags: finasteride, proscar, propecia, hairloss, hair loss, prostate, bph

In the News – Suave Hair Loss Lawsuit Reaches Settlement

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

Snippet from the article:

Hair loss from Suave product causes Unilever to settle for 10.2 million dollar lawsuit. Women reported having their hair become discolored, breaking off, falling out in clumps and suffering scalp burns after using Suave Keratin Infusion treatments.

According to a report by Law 360 which was published on Feb. 10, in United States District Court in Illinois late last week, Unilever settled a class action lawsuit filed by consumers concerning their hair care product, Suave Keratin Infusion treatments.

The company reportedly agreed to pay $10.2 million. The settlement will be split into two separate settlement funds, a $250,000 reimbursement fund and a $10 million injury fund. Plaintiffs who simply purchased the kits and did not use them will receive a $10 refund from the reimbursement fund.

Read the rest — Unilever settles $10.2 million class action lawsuit

Tags: unilever, suave, hairloss, hair loss, shampoo