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    I followed your advice on my brain fog from finasteride

    Dec 29, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    My condition with “brain fog” was able to improve by lowering my dose to 0.5mg every day in the mornings. I still experience some mild effects upon initially taking the pill that taper off throughout the day. My question for you is, after a month of taking the medication and still experiencing mild side effects, would you recommend dropping down to 0.25mg or staying at 0.5mg and taking the medication before bedtime in the evening instead?

    If you reduce the dose to 1/4 pill, it will still be half as effective as the full dose.  Try it

    One area of my transplanted hairline did not grow. What should I do? (photo)

    Dec 29, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    From the picture, it does seem that one section of the frontal hairline did not grow. Sometimes such a problem reflects a technical issue at the time of the surgery so return to your surgeon and ask your surgeon why this area failed.  Hopefully, you will give you an honest answer and will make it ‘right’ with you and fix the defect.

    local area of HT failure

    Can one lose hair getting Scalp Micropigmentation?

    Dec 29, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    If you recieve an anesthetic, SMP can cause shedding because a temporary impact of the local lidocaine on the blood supply of the scalp can cause shedding of the advanced miniaturized hairs. This is distincly a male problem in our experience.

    How many grafts do I need? (photo)

    Dec 28, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    I just met with a doctor who recommended 3500 grafts. Do you think that this is appropriate?

    No, doctors who recommend that number of grafts have an eye on your wallet not your hair. This should take no more than 1500-1800 grafts depending upon the thickness of your hair. This is half of the number you were recommended.

    how many grafts2

    It looks like my temple peaks on the sides grow slower than my scalp hair, is this normal?

    Dec 28, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    Yes, the temple peaks on the side of your hairline do grow slower than your regular scalp hair so when we transplant the scalp hair into the temple peaks, patient may have to trim it to balance it out

    Over 5000 FUE grafts in a single session and this man now is balding in the back of his head

    Dec 27, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    More than 5000 grafts performed in this limited space with FUE will deplete the donor area and this many will now have this huge discrepency between his donor area that was not harvested and the area that was harvested.  Ther are two solutions for this type of balding (1) is  scalp micropigmentation (https://scalpmicropigmentation.com/scar-covering/) and the second might be just to grow the hair he has long enough to cover the donor area. The over-harvested FUE means that he can never keep his hair short unless he has scalp micropigmentation.

    depleted donor 40

    finasteride and many side effects in a short time

    Dec 27, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    I hope this message meets you well!  I’d like to ask a question I’m sure you’ve answered hundreds of times. I greatly appreciate your time. I was recently prescribed finasteride, I have only taken it 3 times at 1.25mg consecutive days, and a week later, 3 more times at ~.7mg, spaced 3-4 days apart. I suffered from side effects (low libido, terrible brain fog, difficulty getting erection, and difficulty maintaining one) during this time. I’d like to continue the drug but I’m scared, honestly. Is it likely these side effects will disappear?

    For the record, I’m 24, 200lbs 9% body fat and in good shape. I don’t take any other medication. I use minoxidil, I take biotin, and today I purchased zinc. Thank you again for your time, and for your help!

    Sound like the drug and you are not good for each other. I would stop the medication

    Non-physicians doing the surgery and I can’t get an accurate surgical record of my surgery

    Dec 26, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    I have ask my Dr for the count of my graft on the first and second day after the surgery to find out how many graft were implanted. I am getting a run0around.  First I was told that he was going to email me, then he told me he was sending a copy to my home. Is there is a way he can altered since we got into a huge argument because my hairline one side is higher than the other and the grafts were sparce out too far. It doesn’t look like the 2000 graft I paid for.  What should I do?

    When technicans do the surgery, it is an illegal process as only a doctor can do the surgery. I would report the doctor to the medical board and they will take an action against that doctor.  People like you put their life and the looks on the line and do not deserve that type of medical care

    Minoxidil after a hair transplant to preserve native hair

    Dec 26, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    I had some hair in the middle  before the surgery and now I can’t see it. I may have lost it. Should I take minoxidil to get it back as that is what my doctor suggested?  

    Existing native hair may fall out in young men unless they are treated with finasteride to prevent hair transplant loss prior to the hair transplant. Rogaine (minoxidil) is good only if you were on it prior to the transplant and the existing hairs are dependent upon it. It does not do much to make the new transplanted hairs grow.

    What is the problem curing curable diseases? Read below

    Dec 23, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    Why Aren’t We Curing the World’s Most Curable Diseases?

    Wed, 12/20/2017 – 11:10am

    by Katherine J. Wu, Harvard University, The Conversation

    Once upon a time, the world suffered.

    In 1987, 20 million people across the world were plagued by a debilitating, painful and potentially blinding disease called river blindness. This parasitic infection caused pain, discomfort, severe itching, skin irritation and, ultimately, irreversible blindness, leaving men, women and children across Africa unable to work, care for their families and lead normal lives.

    But the recent discovery of a drug called ivermectin was about to change it all. Not only was ivermectin cheap and easily synthesized, but it was also a powerful cure: With only one dose a year, it was possible to completely rid patients of disease and even halt the progression toward blindness. In short, ivermectin was a miracle drug – one whose discovery would lead to Satoshi Omura and William Campbell winning the Nobel Prize in medicine in 2015.

    There was no time to be wasted. Recognizing that the populations most at risk of disease were those least able to afford treatment, Merck & Co. pledged to join the fight to end river blindness. Thirty years ago this October, the pharmaceutical company vowed that it would immediately begin distributing the drug free of charge, to any country that requested it, “for as long as needed.” It was the final piece of the puzzle: an effective drug for a tragic and completely preventable disease. And we all lived happily ever after.

    Only… we didn’t.

    Merck’s generous offer should have been the final chapter of a brief story with an upbeat ending – the eradication of a tragic and preventable disease that had plagued humankind for centuries. But such was not the case: 30 years later, in 2017, river blindness rages on across the world, afflicting as many as 37 million people, 270,000 of whom have been left permanently blind.

    Neglected tropical diseases like river blindness stand in stark contrast to those like tuberculosis, which is estimated to affect a third of the world’s population due to the increasing prevalence of highly antibiotic resistant strains.

    In short, tuberculosis has stuck around because medicine has run out of drugs with which to treat it – which is why, as a molecular biologist, I am researching new ways we can finally defeat this stubborn disease.

    But this only increases the urgency for river blindness and other widespread diseases for which, unlike tuberculosis, science does have effective cures – and inexpensive ones at that. Even with all the necessary tools, the world has failed to cure the curable.

    Turning a blind eye

    One-and-a-half billion people across the world suffer from neglected tropical diseases, a group of infectious diseases that prevail in tropical and subtropical countries lacking good health care infrastructure and medical resources. These diseases typically do not kill immediately but instead blind and disable, leading to terrible suffering, creating losses of capital, worker productivity and economic growth.

    Thirteen diseases are universally recognized as neglected tropical diseases. At least eight of these diseases, including river blindness, already have inexpensive, safe and effective treatments or interventions.

    For less than 50 cents per person, the United States could cure a fifth of the world’s population of these severely debilitating and unnecessary diseases. In spite of this, the United States allocates nearly as little to treating and preventing neglected tropical diseases around the world as it does to drugs for erectile dysfunction.

    The forgotten fevers

    Consider dracunculiasis, or Guinea worm infection, which occurs when people consume water contaminated with fleas carrying parasitic worms. The worms mature and mate inside the human body, where they can grow to be two to three feet long.

    Adult females eventually emerge from painful blisters at the extremities to lay eggs in stagnant water, where offspring will infect water fleas and begin the cycle anew.

    No drug exists that can cure Guinea worm, but because of a cohort of mostly privately funded public health efforts, the number of Guinea worm infections worldwide has dropped from 3.5 million in the 1980s to only 25 in 2016.

    Funding from the U.S. and other countries could help in the final push to eradication, and some argue that funding from the individual countries themselves could help.

    Another example, albeit more grim, is the group of soil-transmitted helminths, or worms. Roundworm, hookworm and whipworm collectively affect over a billion people across the world, all in the poorest areas of the poorest countries. All these worms infect the human intestines and can cause severe iron deficiency, leading to increased mortality in pregnant women, infants and children. Furthermore, hookworm infections in children retard growth and mental development, leading to absences from school and dramatically reduced labor productivity.

    However, soil-transmitted helminths can be expelled from the body with a single pill, each of which costs only one penny. What’s more, preventing infection in the first place is completely achievable through increased awareness and sanitation.

    The purse strings of nationalism

    Without drastic increases in funding and public awareness, the plight of people affected by the neglected tropical diseases is unlikely to budge anytime soon.

    The U.S. spends over US$8,000 per person per year on health expenditures, compared to countries in Africa that spend around $10. While this opens the door to a critique on efficiency, it’s far more indicative of the disparities in health resources.

    Less than 20 percent of the world’s population lives in some of the most developed and economically high-functioning countries, including the United States – and nearly 90 percent of the world’s total financial resources are devoted to the citizens of these nations. And yet, low-income countries bear the majority of the world’s infectious disease burden. In short, the rest of the world does not suffer the same diseases the United States does, and Americans are doing little to nothing about it.

    At first glance, this is not so surprising. As a whole, the world suffers – but how many neglected tropical diseases currently penetrate American borders?

    Some experts predict that eliminating or controlling the neglected tropical diseases in sub-Saharan Africa alone, which shoulders over 40 percent of the global burden of neglected tropical diseases, could save the world $52 billion and over 100 million years of life otherwise lost to disease.

    Conversely, some global health experts estimate that for every dollar spent on neglected tropical disease control, we get back over $50 in increased economic productivity. By increasing awareness and funding of neglected tropical disease eradication, the United States will be making one of the best global investments possible. The rest of the world has waited long enough.

    Katherine J. Wu, Ph.D. Candidate in Microbiology, Harvard University

    I just found out about the hair among the Yao people living in rural China

    Dec 22, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    The women can grow their hair 2.5 meters long and I never was aware that a human can grow hair that long. They never  cut their hair. They keep it in a bun and take it out of the bun for periodic washing.

    I have written about this before here:  https://baldingblog.com/2006/09/28/rapunzel-let-down-your-long-golden-hair/ and at that time I focused on the long hair of my grandmother which was really dreads, not real hair length. I have seen some women who have let their hair grow down to reach their upper thigh, but that length is not 2.5 meters, rather a little over a meter.

    This population must have a mutan gene that keeps the anagen cycle (growth hair cycle) growing for more than 10 years. Do the math, if hair grows at a rate of 1/2 inch per month, how long does it take to get hair that is 2.5 meters long?

    What do you think of my recent FUE now 10 days after the surgery? (photo)

    Dec 22, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    Your post operative care is terrible with crusts that should have been washed off immediately after the surgery. Now you will have to shampoo it often and wait until the crusts come off on their own. Use gentle finger massage and do not pick the crusts off as they run the risk of losing the grafts if you do.  I don’t like the design of your hairline as it is not a normal looking male hairline

    terrible crusting3

    Dec 21, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    Guest Article addressing addiction

    Seniors in Addiction Recovery: Making Amends and Reclaiming Your Life this Holiday Season

    Picture1

    Photo Credit: Jessica Monte, Stock Snap

    With the holidays approaching, we enter a time of the year when emotions can run high. The holiday season is meant to be festive and fun, but it is not always joyous. Sometimes parents do something that ruins the relationship with their children, and the holiday season is a painful reminder of the relationship that they lost. If you are one of these individuals, follow some tips to turn this year into the year that you make amends and reclaim your life and your relationship.

    “Children, by their nature, want to love their parents. That longing never leaves,” says Huffington Post. There are many reasons why parent-child relationships become estranged, but reunion is always at least a possibility. However, it is typically not going to just happen. If you have made a mistake, you will need to make a solid effort to try to rebuild those bonds. For example, if you’re a senior who has struggled with addiction in the past, it’s not too late to make amends, even if your past substance abuse created a rift.

    Making amends is a process, and you start by apologizing. Own up to your mistakes and shortcomings. Say that you are sorry and ask what you can do, if anything, to set right the wrong you did. Once you have apologized, you have to hold out hope that your child will forgive you and accept your apology. The timetable for that acceptance and forgiveness is not up to you, but is solely up to your child.

    Let go of your expectations. Even if you apologize, there is no guarantee that you will be forgiven, and even if you are forgiven, your child may still not want you in his or her life. Remember that you are not apologizing so that the relationship will improve; you are apologizing because you are genuinely sorry and wish to portray that remorse. However, you should also remember that your sobriety and happiness do not depend on anyone else but yourself, so do not let your disappointment result in a relapse.

    Try to understand how your child wants to receive love. People express and receive love in different ways, and if you want to work on mending the relationship, you have to “speak your child’s love language.” If your child equates quality time to love, then showering him or her with gifts will not show your love and may make your child feel as though you are not listening to or thinking of his or her wants and needs.

    If your child is struggling to forgive you or welcome you back into his or her life, acknowledge that your child’s perspective is valid. You may wonder whether or not your child can see that you are really trying. While your child may recognize your efforts, that does not make his or her pain disappear. Accept this as a fact, and let your child speak openly about the ways in which he or she was hurt or is hurting.

    If you want the relationship to prosper, then you must put in the effort to mend the fences. Even if your child is open to your apology and building a relationship with you, the work is still yours to do. If the relationship is truly important to you, keep working on yourself and reaching out in healthy ways. If you are doing the work, there is always a chance, and eventually, your child may respond positively if you’re consistent. While making amends isn’t easy, reclaiming your life, sobriety, and relationship will be well worth the effort.

    I’m 26 and I have stress and hair loss

    Dec 21, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    You should see a good doctor who cares about you, not just your money. Your doctor should develop a Master Plan for you, not just for now, but down the road as hair loss is a progressive process in men. Researching transplants is a good idea as you may find out that hair transplants are the only permanent solution for hair loss.

    I had 3600 grafts 6 months ago, can I expect more growth from the hair transplant? (photo)

    Dec 21, 2017/by William Rassman, M.D./0 /Hair Loss Causes

    The growth does not look like 3600 grafts but you still might see more growth over the next few months. If there is not much more growth, go back and see your surgeon and ask if there was some problem with the surgery. Most failures are technical in nature and reflect some quality control issues at the time of the surgery.

    8 month growth

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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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    This site exists to educate about hair loss and hair restoration.

    William R. Rassman, M.D.

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    This site is intended to educate the public on hair loss topics based on personal experience and opinions from Dr. William Rassman and contributing physician editors. Information provided on BaldingBlog.com should not be used for the purpose of medical diagnosis or treatment.

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