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    Can I stop a mature male hairline from developing with the drug finasteride

    Jan 19, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    I really do not know if finasteride can stop the maturing of a hair line in men. I have never had the opportunity to use it for this purpose, but I would expect that a maturing hair line will evolve even if you are on this drug. The reason I believe this, is that maturing hairlines usually reflect a process called apoptosis (cell death) which is, in men, tied to the number of hair cycles that the hair goes through. It is probably triggered by testosterine and maybe DHT. If a hair cycle is 3 years in length and let’s say that apoptosis is scheduled for 7 cycles, that person will lose the hair at the sage of 21. If you are committed to try this, I, as a doctor, would agree to prescribe this drug for you if you were my patient.

    I have lichen-planopilaris, what can I do about my hair loss?

    Jan 19, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    I don’t like to invent new scrips when there is an excellent review of this condition here: https://www.dermnetnz.org/topics/lichen-planopilaris/. “Lichen planopilaris is a rare inflammatory condition that results in patchy progressive permanent hair loss mainly on the scalp”

    I have a Class 3 pattern, will I eventually develop into a Class 7 pattern?

    Jan 19, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    The Norwood patterns that were published by Dr. Otar Norwood were genetic patterns that were developed by people directly. Contrary to popular belief that one evolves from, let’s say a Class 3 pattern into a Class 5 or Class 6 of Class 7 pattern, no such evolution occurs. People born with a Class 3 pattern of balding will not evolve into a Class 5 pattern of balding and will remain with a Class 3 pattern of balding

    norwoodscale.

    What is Post-finasteride Syndrome (PFD)?

    Jan 18, 2017/by William Rassman, M.D./1 /Hair Loss Causes

    This is a condition that is reported when a young man was on finasteride and developed sexual and other side effects that did not go away. This syndrome is highly suspect because of the litigation going on with Merck and two important observations: (1) The drive to profit from a Class Action law suit is present in some of the people complaining about the side effect and (2) the frequency of erectile dysfunction in men is 30% in 30 year olds, 40% in 40 year olds, 50% in 50 year olds and so on. Some men just lose their sex drive and their ability to get an erection with age and that is why drugs like Cialis and Viagra are so successful. Most men using these drugs were never on Propecia.

    What do you think of the 1 minute check for hair loss?

    Jan 18, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    “The test is to wash your hair vigorously for three days and then in the morning when you wake up, comb the hair and count hairs.” I don’t like this test as it is not as accurate as looking for miniaturization and I spoke about in previous posts. Total cost about $20 on Amazon (https://newhair.com/digital-microscope-examine-hair-balding/). I will be happy to interpret it for you by sending me a copy on my email

    How does a person’s body manage the Iron Oxides in your SMP pigment?

    Jan 17, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    We do not have any heavy metals or any type of metals in our pigments. Our pigments are purely organic and as a result you don’t have to worry about an MRI which can pull on the pigments and cause redness and pain or have your body react to substances it can not absorb. Many SMP doctors, cosmetologists and tattoists use pigments that contain some dangerous looking stuff in the solutions. We did an analysis of a ‘competitors’ pigment and after it was burned in the lab, the lab found the following material left in the remnants. You judge if this is what you want in your body, not me. This is why we use only organic pigments in our SMP pigments.

    If you are correctly wondering why the FDA does not control such substances with potential harm, the answer is that the FDA has told congress that they do not have the funds or the staff to investigate the tattoo industry. Within the United States, 22% of adults have had a tattoo with the type of materials shown in the chart below.

    ink analysis

    Can I do a hair transplant in many stages rather than one surgery?

    Jan 17, 2017/by William Rassman, M.D./1 /Hair Loss Causes

    Yes, if you have hair in the areas you want transplanted, you can do it in stages, slowly changing the look. Most men get away with less surgeries not more by doing it all in one session and then ask yourself, do you really want to undergo many surgeries when you can do it once and probably no one will ever know? I usually suggest that if privacy is a real issue, for the patient to grow out a beard if they do not have one, or take it off if they do. People focus on the face and not the head. You can also use the hair you have to style around the recipient area, but if you want to do it incrementally, we offer what I call ‘Lunch Time FUE” so you can come in for 2 hours at a time and get 200-300 grafts in each session until you achieve your goals.

    How many hairs are there in a hair graft?

    Jan 17, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    Hairs grow in groups of 1,2 3,4 and occasionally 5-6 hairs per group. These are called Follicular Units. Most doctors transplant Follicular Units and for simplicity call these units ‘grafts. When I do a hair transplant, regardless of the harvesting system (strip surgery or FUE), I charge by the graft. So depending upon your natural groupings of follicular units, the number of hair that I will transplant will vary with each individual. Some races have more hair than others. Caucasians have the highest hair densities but a fixed number of follicular units. The average number of hairs for a Caucasian is 2.3 hairs. For an Asian, on the other hand, the number of hairs per follicular unit are less than Caucasians, usually about 1.6 hairs/follicular unit. That means that the typical Asian, each hair group will have less hairs per graft so when they pay for a hair transplant based upon the number of grafts, they end up on the short-stick when compared with Caucasians. For this reason, a typical Asian might be better served having a strip surgery. Some doctors may confuse this issue by charging per hair just to earn more money. That does not do anyone any real service.

    Follicular Group

    I am planing to have my hernia fixed. Should I worry about a failure of my hair transplant before I fix it?

    Jan 17, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    Any surgery can impact hair growth but usually hair transplants done previously are very stable and will not be impacted by any surgery. If however, you are balding at a rapid rate and have a hernia repair or any surgery, the stress of a surgery runs a small risk of accelerating hair loss that is rapidly being lost.

    I am 19 and have no beard. Can I get my beard transplanted?

    Jan 17, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    Many young men want to accelerate their beard growth and ask about it. It takes age (genetic triggers which occur in family lines) so if you want to find out when your beard will grow out, you need to find out when your father or grandfather started to grow their beard. Hormones should have kicked in nicely by the time a man reaches 18 but he must wait out his genetics as hormones alone are not responsible for the onset of beard grown. Beard transplants can be done when the young man is a bit older (over 25) if the beard has not grown in yet

    I am male and I want to lower my hairline. Should I have a hairline lowering procedure?

    Jan 17, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    For men, my concern is in the potential balding that may occur in your future as most balding starts in young men and is progressive so it advances with age until the mid-thirties or even later. If that happened to you (your risk) then you will have to get a hair transplant to cover it as the frontal area is the place where genetic balding starts in most men. If you are under 24, you may become a set-up for hairline recession so that if you lower the hairline with an advancement surgery, hair loss that will occur behind the scar. If you develop balding, it will require a hair transplant to keep up with the recession and the scar from the advancement will show. A hairline advancement procedure is not the best option for a male but a hair transplant lowering procedure allows you to follow the recession back if and when it should occur.

    Can I keep my hair healthy if I just wash it once a month?

    Jan 16, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    Many homeless men seem to have long hair and rarely shampoo, but we do accumulate dirt and air pollutants on our hair from living in the city. Shampooing daily or every other day keeps the hair clean. For me, I like a clean hair and scalp and would personally feel bad if I started to develop an odor in my hair, which is common in people who do not wash it.

    What is the key to drying hair when you have balding present?

    Jan 16, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    The key to drying hair after a hair wash is to be gentle. Never rub it hard against the scalp because if there are miniaturized hairs, these will be easily pulled out. The use of a hair drier with long hair works if (1) you use a good conditioner to make the hair glide through brushes and comb and (2) use a low heat with the hair drier. Never pull on your hair when you have hair loss, even with a brush.

    Which is better, finasteride (Propecia) or minoxidil

    Jan 16, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    Finasteride attacks the cause of the hair loss by blocking the enzyme 5AR at the hair follicle level. Minoxidil produces hair in anyone who applies it topically, some time just fuzz, sometime some hair. The drug finasteride is a better and a more assured way to slow down or stop the hair loss.

    Can I see and actually count the grafts I had transplanted yesterday?

    Jan 13, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    This is an interesting question. I have had the opportunity to try to count all of the grafts that I put in. Even with good photography, it is difficult. I had a patient a while ago who paid me to count the 6100 grafts that he had done. I took 3 hours, with grids drawn on his head. I counted only 1900 grafts, nothing close to the 6100 grafts he claimed he got. If I was off on my counting, I don’t believe for a minute that I would have been off by ~4000 grafts in my count. This patient came back 8 months later and I counted the grafts that grew. Mu original estimate was close to what grew.

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    Over 21 million women and 35 million men in America suffer from hair loss. For many of these people, the psychological impact on their life is debilitating.

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    William R. Rassman, M.D.

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