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    Not Hair Loss News – The Door — Did You Know This?

    Aug 31, 2014/by William Rassman, M.D./0 /Hair Loss Causes

    Ever walk into a room with some purpose in mind, only to completely forget what that purpose was?

    Turns out, doors themselves are to blame for these strange memory lapses.

    Psychologists at the University of Notre Dame have discovered that passing through a doorway triggers what’s known as an Event Boundary in the mind, separating one set of thoughts and memories from the next. Your brain files away the thoughts you had in the previous room and prepares a blank slate for the new locale.

    Thank goodness for studies like this. It’s not our age, it’s that damn door!

    Not Hair Loss News – Not Enough Young People Get Cancer Screening

    Aug 31, 2014/by William Rassman, M.D./0 /Hair Loss Causes

    Reuters (8/19, Seaman) reports that research published in JAMA Internal Medicine suggests that too many individuals are being screened for cancer near the end of their lives, not when they are young when early cancer screening can pick-up deadly cancers when they are curable.

    Bloomberg News (8/19, Ostrow) reports that researchers found that “more than half of men 65 and older who had a very high risk of dying in nine years were screened for prostate cancer, a slow-moving disease.” Nearly “38 percent of older women with a similar life expectancy were screened for breast cancer and 31 percent were screened for cervical cancer despite some having undergone a hysterectomy.”

    Vox (8/19) reports, “Among patients with the shortest life expectancies (about five years), 40 percent had been screened for colorectal cancer.”

    As baldingblog’s readership is largely young, you should ask yourself ‘what you are doing to detect an early cancer?’ Young people don’t think cancer, because they think that their bodies are fortresses and as such, are immune to cancer. Nothing can be more tragic then cancers in young people. Women who get ovarian cancer or colon cancer when they are under 40, have a high risk of early death because the disease is often picked up too late. Men who get colon cancer under 40, often die early. Smokers develop lung cancer at all ages. Early detection can address this problem at the diseases earliest stage. What is the message here? Go see your doctor and get a good history taken and have a physical examination and make sure you are screened for cancer. Don’t wait until you are 70, because you might just not make 70 or even 50 if you are victimized by some of these difficult diseases.

    Laser Vectus Hair Removal Now In Our Los Angeles Office – 15% Discount

    Aug 29, 2014/by William Rassman, M.D./0 /Hair Loss Causes, Other

    We just got the most up-to-date laser hair removal system in our office (The Laser Vectus System) and I stepped up to the plate as one of the earliest patients with this very new technology. My target was my back hair, my neck hair and most significantly my ear hair. I am sure you can see from the subject of this post that my vanity does dictate my actions. As for pain, it was barely detectable for me. Even if it hurt, I knew that the benefit for my ear hair was worth whatever pain it would cause, and once it was done, it was a non-event for me.

    From reading our previous posts on hair cycling addressing Anagen and Telogen hair cycles, back hair is like any body hair, which means than only about half of the hair is growing at any one time. The laser only kills hair in the Anagen phase of hair growth. With this knowledge, I expect that the next time I do it (about 8 weeks), there will be new hair on my back that came out of the Telogen phase and went into the Anagen phase. As the laser can only kill hairs in Anagen, at my second session, half of the hairs that remain will not show (as they are beneath the skin surface in some ‘stem cell’ form), so I will have to do it a third time about 8 weeks later to get those hairs that were not in Anagen. The more times I do it, the less Anagen hairs will appear until they will essentially be all gone. My neck hair will probably have a growth cycle similar to my back hair; however, possibly with longer Anagen hair cycles so I am hopeful that the ear hair will have an even higher Anagen to Telogen ratio that would therefore take less sessions.

    Now I am so excited about it, I might just tackle some of my chest and arm hair next, but my wife likes my chest hair so the problem is more of a ‘couple problem’ then a medical one. I knew women who did their bikini pubic area and underarm hair. We men may not be as bold and fearless as some women. If you are like me and your are in Southern California, you might now want to take advantage of our Laser Hair Removal Technology and make an appointment with us for an evaluation (see: https://www.newskin.com/z_vt_hair_removal.htm). This technology is not for everyone, especially for men with very dark skin (African Americans) or white hair (not easily killed in Anagen as the laser kills the darker hair only). We will offer anyone coming from this site a 15% discount off of our regular prices for hair removal to qualified candidates.

    vectus

    Tags: body hair, chest hair, neck hair, ear hair, hair removal, Anagen Cycling, Telogen Cycling

    Can You Take Finasteride Propecia for Diffuse Patterned Alopecia (DPA)?

    Aug 29, 2014/by William Rassman, M.D./1 /Hair Loss Causes


    1. Have DPA young patients (Early 20´s) more oportunities with finasteride in comparasion with a MBP who have a normal patron (NW 6).
    2. Have you ever seen a early 20´s with DPA who have a good response to finasteride for a long time (10 years)?

    I am a 21 years old and I have taken finasteride since I was 18 years.. My dermatologist prescribed it to me.

    Here you have photos of mine when I start the treatment (2012) and now
    (2014).

    You have my permission to publicly use it.
    dpa

    Diffuse Pattern Alopecia (DPA) is basically the same as Male Pattern Balding otherwise known as Androgenic Alopecia. DPA, as the term implies, shows up as diffuse hair loss that occur in a “pattern” such as you see in male pattern balding but the permanent zone on the back and side of your head not impacted.

    Finasteride (Propecia) is used for the treatment of this condition (DPA, AGA, MPB – they are all the same).

    There is another condition called Diffuse Unpatterned Alopecia (DUPA), which may be genetic, but does not respond to the drug finasteride (Propecia). DUPA is uncommon; however, it is critical to have your doctor make this diagnosis before being considered a candidate for hair transplant or medication. These DUPA male patients often get a failure of the transplant, even if on the drug finasteride.

    I cannot make a diagnosis with your photo and this blog is not a place for making diagnosis. I also cannot predict what will happen in 10 years. I am not a fortune teller. I have seen men in their early 20’s start finasteride for male pattern balding and has kept most of their hair. I have also seen them lose their hair rapidly despite being on finasteride as their genetic predisposition overtook the drugs ability to slow things down. It doesn’t mean that the drug didn’t work.

    Tags: hair transplnat, dpa, dupa, diagnosis

    SMP Scalp MicroPigmentation and Hair Transplant with Long Hair ? (Photos with Before and After)

    Aug 29, 2014/by William Rassman, M.D./1 /Density, FUE, Personal Stories, Photos, Pigments, Repair, Scalp MicroPigmentation, Scarring, Thinning, Tidbits

    Can I have a Scalp Micropigmentation (SMP) and later a hair transplant surgery? What if I want to grow out my hair as well? I don’t want to always keep my hair shaved.

    You ask a great question! We have been combining SMP with hair transplant surgeries using FUE or Strip FUT. After all we are a medical practice that specialize in all aspect of hair restoration!

    This patient came to us with a old hair transplant surgery scar. He had a strip FUT surgery which didn’t really give him a full head of hair and he just gave up with the idea of having a full head of hair. But he had the strip scar which he couldn’t hide when he decided to cut his hair short. So he went to local doctor for FUE to the strip scar. As we tell all our patients, FUE to the strip scar doesn’t really give perfect results when you are looking to shave your head. So he ended up with MORE SCAR, many ‘punctate scars’ from the FUE surgery. Needless to say he was angry and was very skeptical when he came to see us. We didn’t blame him. He didn’t trust any doctors at this point. Although Dr. Pak thought he would be a great candidate for the SMP procedure, he actually turned him down because the patient’s expectations seemed unrealistic with a bad attitude.

    Eventually, the patient came back for another consultation and even saw other SMP patients in person at our monthly Open House Seminars (where prospective patients can meet with former patients and see an actual SMP or Hair Transplant surgery taking place).

    This patient eventually had SMP to the entire scalp and covered his FUE scar and strip scar with great results. In the process he came to know and befriend Dr. Pak to trust his work. So after about a year he came back to Dr. Pak for a FUE procedure (about 1500 graft) to add density to the top and soften (corrective surgery) his front hair line from the old transplant work.

    While the FUE transplant didn’t give him the full density, the SMP provided a cosmetic benefit to provide a look of fullness. Now he has the option to shave or grow his hair out long.

    Old FUE and FUT Strip Scar addressed with SMP Scalp Micropigmenation

    Old FUE and FUT Strip Scar addressed with SMP Scalp Micropigmenation

    SMP Scalp Micropigment for a shaved look

    SMP Scalp Micropigment for a shaved look

    SMP Scalp Micropigment with FUE Hair Transplant for Fullness for Long Hair

    SMP Scalp Micropigment with FUE Hair Transplant for Fullness for Long Hair

    Bald Man Thrilled With His New Hair And New Look

    Aug 28, 2014/by William Rassman, M.D./0 /Hair Loss Causes

    After 5 years, this patient came to see me to show me the transition of his new look. Considering the degree of balding he had when he came in, his results were spectacular. He did comment that no one ever noticed the change from a bald look to this hairy look. That is what surprised him most. The two pictures tell the story without words.

    hair_transplant_NHI_19

    What Causes Graying of Hair

    Aug 28, 2014/by William Rassman, M.D./0 /Hair Loss Causes

    Doctor Rassman I want to know something about grey hair. Is grey hair caused by stress or simply genetics?

    Probably a little of both. Some people almost never go grey. Some people, even in their childhood years have grey hair. Some have total white hairs (Santa Clause). People with little or no stress get grey hairs. There is no clear cut rule.

    Aging has a part to do with it as well. If you think about it from a scientific approach with genetics as a partial cause, we all have a certain programmed destiny of the cells in our body. Environmental factors may alter some of this destiny but the point is that if the hairs go through several life cycles (anagen catagen telogen) over a person’s life some of those hairs may be pre-programmed to fall out and never regrow after an “x” number of cycles. Some may be pre-programmed to turn white or grey after an “y” number of cycles. This may be a simplistic way to view biology but it may help understand the variation and why some may lose hair or have hairs that turn grey.

    I Was Told I Should Start Finasteride But I Am Norwood 1

    Aug 27, 2014/by William Rassman, M.D./0 /Hair Loss Causes

    Hi, I went to see a ISHRS physician 7 months ago because I was concerned about family history. He told me he didn’t see anything but told me to come back in 6 months. I recently went back and he examined my crown and mid scalp and found miniaturization, however I am still a NW1. He confirmed I have MPB, and gave me Finasteride. My question is, provided finasteride works, can I expect to keep this hair for a while? My thinning is unnoticeable to the naked eye but is present on a microscope.

    I think you should ask this to your doctor since they examined you. If you have signs of male pattern balding (MPB), then finasteride 1mg (Propecia) is a medication to treat this condition. The thinning may not be detectable to the naked eye but it may be present under a microscope with signs of miniaturization. This is why we have always advocated the miniaturization (microscope) test. You can also consider a Bulk Measurement as well which is fairly accurate in detecting very early balding using the HAIR CHECK instrument. It is not necessary if you already have the diagnosis, but it can still document the progress of the hair gain or loss.

    Tags: early balding, miniaturization, bulk analysis, miniaturization, Propecia, Finasteride

    Does Propecia or Finasteride Cause Pain on Ejaculation?

    Aug 27, 2014/by William Rassman, M.D./1 /Hair Loss Causes

    I have been taking Finasteride for over 6 years. (I am 32 now) Over the last year or two I have been getting an intense pain when I ejaculate. The pain feels like it radiates from the base of my penis, then it dies down. It feels a bit like a burning sensation.

    The pain doesn’t occur every time I ejaculate, but quite often it does. I wonder if this may be caused by Finasteride in some way – such as the drug’s effect on the prostate. The only other side effect I have noticed is watery semen.

    std

    Painful ejaculation may be a sign of serious medical issue such as sexually transmitted disease (especially the burning sensation), prostatitis, prostate cancer, etc. I doubt it is related to a drug side effect especially after 6 years but such reports of pain with ejaculation are appearing over forums on the internet. As their appears to be legal actions taken against Merck (manufacturer of Propecia), the motivation for such reporting may be questionable and I do realize it is a very sensitive topic for many readers. In any event, you need to see your primary care provider or a urologist to see if there are medical issues associated with this complaint.

    I realize we answer many questions about side effects on Propecia here on Baldingblog. However, not all sexual or penis related symptoms are related to Propecia.

    Tags: painful ejaculation, finasteride, propecia, prostatitis

    Less Than 3% Transection Rate from FUE, What About the Artas® Robot and Other Doctors?

    Aug 27, 2014/by William Rassman, M.D./1 /Hair Loss Causes

    I’ve checked out Dr x’s website, and he claims that he can perform an FUE surgery with a transection rate of under 3 percent. I’ve read your article on FUE which was written near the end of 2007. In that article you mentions that “the transection rate by our NHI surgeons are still well within the 10% range for FUE and we make no pretenses that it is better than that routinely.” With Dr x’s experience and latest tools, has he overcome a major flaw within the FUE procedure?

    Also Dr x is marketing a new device which he created to improve the FUE procedure.

    Some doctors have big egos. Some claim to have a better mousetrap. I can not and will not comment on another doctor’s claims. There are now robots doing FUE with good success and low transection rates that are evaluated by independent third parties and trusted researchers. There are no independent judges or observer who can verify claims. You are stuck to doing your own research and then trusting that the doctor you selected was honest with you.

    The transection rate with FUE depends upon the skills and experience of the doctor, the instruments used and in many cases, the tissue make-up of the patient’s collagen. where the doctor (or robot) has no control. In the later case, it is individual PATIENT dependent.

    I would guess that normal transection rates still vary in the hands of good, experienced and honest surgeons, number less than 10 percent transection rates. The transection rate is not the critical element in an FUE procedure, rather it is the experience of the team in managing the grafts. Even with the Artas® robot, other than the coring of the grafts, the rest of the process is manual, so manual quality control processes determines the success or failure of graft growth. I have recently seen a patient who had FUE with the Artas® robot, and the procedure largely failed. Even if the transection rate was very low, the detail in the manual management of the grafts may have been an issue. Did you know, for example, that if a graft is left open to the hair for as little as 10 seconds, it will die. That death, will not be seen until 8 months after the transplant surgery is finished.

    I’ve seen Dr. Pak’s FUE surgery and his transection rate is not infrequently less than 3%, however, on the rare patient who has ’tissue’ differences in their collagen, the transection rate may go up to as high as 10%. We could ignore this singular result and report transection rate of under 3%, but that would not be honest. Our efficiency with FUE using our own internally developed tool is higher than most doctors in the world. It is not unusual for us to extract FUE grafts at the rate of 1,000-1,500 grafts/hour. We run an ‘open shop’ (open door policy) here which means that we hold open house events every month where our patients, happy or unhappy, can come to meet with people like you. Few doctors are that open with their patient population.

    I realize for marketing purposes and advertising to the public these numbers and stats would seem important, but I would rather that your ask to meet some of his patients and get the doctor’s results from the patient’s own mouth as well as see the results with your own eyes.

    Tags: fue, transection rate, follicular unit extraction, new tool, artas®

    Hair Transplant In Asian Men with Before After Photos

    Aug 26, 2014/by William Rassman, M.D./0 /Hair Loss Causes

    I read your post on Aug 13, 2014 on how Asian men have low density of hair. How successful is hair transplant in Asian men who have low density of hair?

    Asian men usually have dark black hair on fair skin giving them a high contrast that makes thinning stand out. Their hair is also straight and not wavy which does not cover the thinning as well. These factors are not as favorable when compared to blond, wavy hair on fair skin or dark curly hair on dark skin. Med with fine hair require more hair than men with medium of coarse hair. Asian men don’t have the high hair density of Caucasian males.

    However, we work with what we have and we have great results. It is more about managing expectations and individual goals. The following photos are of a Norwood 3a/ 4a patient who was in his early 20’s who looked like he was in his late 30’s with his hair loss pattern. While he may not have the full density, his styling and 1700 grafts provided a permanent front hair line and a new frame to his face. He looks his age.

    Hair Transplant at NHI - Asian Hair

    Hair Transplant at NHI – Asian Hair

    hair_transplant_NHI_18a

    Tags: hair transplant, asian men, high contrast, low density

    Can I Stop Taking Propecia?

    Aug 26, 2014/by William Rassman, M.D./1 /Hair Loss Causes

    I have been taking Propecia since my early 20’s and I am now 39. My crown was thinning back in the day and that’s what inspired me to start the drug. My brother is totally bald but my frontal hairline seems to be in near perfect shape all these years later. I am considering stopping taking it because I’m worried about the long term effects and I think as I age my hormones may change and I’ll develop issues from it. In your humble opinion at this point do you believe propecia is keeping my hairline intact? I’ve read that propecia rarely works on hairlines and I’ve heard you say it’s a tug of war between genetics and propecia. I just think I wouldn’t experienced some form of loss by now. The crown is ok but not what it was 6-7 years ago. You thoughts?

    catch up

    Please speak with your doctor for these issues. In general if you stop Propecia you can ‘have catch up hair loss’ where the hairs you kept or regrew over the time you took Propecia, may fall out on stopping the medication. Long term use of Propecia from studies show no adverse effects. There was a study that show high dose (finasteride 5mg) can even lower the risk of prostate cancer and many doctors believe that this benefit extends to the 1mg dose, but this particular point was not studied and is just conjecture.

    Tags: propecia, prostate cancer, hairline

    Does Your Skin Change Color After Eyebrow Transplant?

    Aug 26, 2014/by William Rassman, M.D./0 /Hair Loss Causes

    Hi, I’m wondering if the change in skin colour after hair/eyebrow transplant is ever permanent, I had eyebrow restoration 7 weeks ago and the area is still very pink/red. Does it completely return to skin colour eventually? Whats the longest it can stay discoloured for?

    Skin or scalp can have some color changes after a hair transplant or eyebrow transplant surgery. The skin can look a little red but this usually goes away after several days, weeks or to the extreme to several months. Every person is different and every surgeon’s techniques may be different. Please follow up with your doctor.

    Tags: eyebrow transplant, skin color

    PRP Skepticism On Hair Growth, Finasteride (Propecia), PRP, Replacement?

    Aug 25, 2014/by William Rassman, M.D./1 /Hair Loss Causes

    Hey doc. Love your work!!

    1) Why so sceptical over PRP when there are so many pics, videos and documents online supporting it as part of the overall treatment for baldness. Heck there’s even an article on the ishrs.org website so I’m guessing there must be something in it.

    2) Assuming all the research into PRP was true then would it make a good proscar replacement for people with ‘side effects’.

    3) Depending on the baldness scale / category one fits under is it possible that you might never have to take drugs again? I guess what I mean is that if your body is always producing dht does that mean after a while all your hair will eventually get effected or is some hair safe?

    4) I once spoke to a guy at a Clive Clinics who said if you don’t take proscar each day it’s a waste of time. The doc who prescribed it countered his opinion by saying although it might not be perfect less dht is being produced by your body so it must slow down your hair loss. I take it twice a week What do you think?

    Thanks heaps!!!

    PRP (Platelet Rich Plasma) is hype without good science behind its value on hair growth. Doctors make money offering it. Photos or videos on line do not prove anything. There’s documents, photos, and videos of aliens here on Earth but that does not mean it’s true. I need to see good science before I recommend it and try to cash in on it. It’s not that I’m a skeptic, but maybe it an ethical decision. I am just maintaining a scientific approach in expressing my opinions on BaldingBlog. I have been known to use Google and read Wikipedia for information but I also know that what I read may not be accurate. I encourage our readership to do their own research. But if you’re asking for my opinion on hair loss topics, I attempt to give you a sound clinical, scientific based answers.

    Stopping Propecia for something that does not work does not seem like a reasonable choice to me, but you are in the driver seat with the decisions you make. I do not believe that what you said as ‘gospel’.

    Tags: baldingblog, prp, platelet rich plasma, making money

    I Stopped Taking Propecia and I Got Increased Muscle, More Facial Hair, and Lost Buttock Fat

    Aug 25, 2014/by William Rassman, M.D./0 /Hair Loss Causes

    I’m a medical student from New York that has been taking propecia from 18-26 years old. Stopped for about 6 months and noticed growth of body hair, especially facial, in addition to additional muscle mass growth, increased libido, and decreased brain “fog”. The lack of facial hair wasn’t apparent to me as I attributed the smooth face to my own luck (even though my entire family has relatively pronounced facial hair) rather than the propecia. Learning more about hormones I got off the drug, lost some hair but lost body fat around my buttocks, face and thighs and gained muscle mass without change to any daily routines (not active in the gym or any exercise besides walking). I’m sure loss of body hair isn’t a side effect most men would consider negative, you shave far less and the embarrassing strands of chest hair are repelled, a major convenience that I can’t see many men reporting or taking issue with. Thank you for your time.

    In my 23 years in the hair restoration field having seen many men who were on finasteride Propecia, I have come across a handful of men (less than 10) who complained of less body hair growth, and brain fog. One to two percent of the patients speak of sexual side effect, consistent with reports by the drug company Merck. I have also seen many body builders who started, stopped, or restarted Propecia without any reported changes in muscle mass. So what you describe is not very common.

    I do believe what you’re saying and I have treated thousands of men on this drug, Perhaps you can send us your pictures (on and off Propecia) and with your cooperation it may be publishable in a medical journal as a case study.

    Tags: stopped propecia, muscle mass, brain fog
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