Can you explain what hair weight actually means? Is it the thickness of individual strands of hair or the hair bulk altogether?

https://pubmed.ncbi.nlm.nih.gov/16781295/

The experts call it Hair Mass Index, which reflects the value of the thickness of the hair shafts of your hair. It runs in simple terms, fine, medium or coarse. Fine hair has the least coverage value on its own. The article shows that men with miniaturized hairs may reverse miniaturized hair with a thicker hair shaft with finasteride but the thickness will only go as far as your normal hair thickness. A new publication by Dr. James Harris, he uses a simpler term “Hair Diameter Index”.

Dr Rassman, quick question for you…obviously this guy had hair follicles which he was able to ‘wake up’ with medication….some people might have gone straight for a transplant to fix the recession. If follicles are transplanted then aren’t they just being placed on top of follicles that maybe could have been reawakened if they’d have tried treatment? Is there a danger that by going for a transplant before trying medication that you kill off follicles that could have come ‘back to life’, so to speak?

I have seen a patient who had 3000 grafts and never had balding. I used the HAIRCHECK instrument (https://baldingblog.com/haircheck-test-how-it-is-done-video/) to determine if there was more hair in the transplanted area than the donor area.  What I found was that the 3000 grafts grew and increased his hair bulk as expected so I can conclude that damaging hair with a hair transplant doesn’t stop new or existing hair from growing. Of course, you ask why would a man who is not balding get 3000 grafts, well the answer is he had a scummy doctor who made him believe he was balding because his father was bald and the doctor saw him as $$$ for his pocket. Deplorable behavior.

I am a 27 year old male who recently ascribed to getting finasteride, and I was wondering in your experience how often have you met patients who had serious side effects on it? I am well read on the subject(I think) of sides, as well as the ‘nocebo’ effect. And I could not care less about loss of libido/sex drive as I am unfortunately very riled up to put it pleasantly most of the time. Watery semen as well does not bother me, nor does ED.

However the effects I do ponder on are about the mental ones i.e. serious depression/anxiety/brain fog as well as gyno. Have you had many patients within your care that reported on these symptoms? If so, did they discontinue after a while? Thank you in advance for your time Doctor, I appreciate it as well your contribution to the help of the psyches and confidences of men and women across the globe.

I would never discount the impact of permanent side effects, although very rare, I believe. The other side effects that you are worried about are also rare and they have mostly gone away within a month or two of stopping the medication if you are one of the unfortunate people who gets them

The total donor hair supply usually reflects 25% of your total hair count which is the capacity of the donor area for available hair. This post elaborates on how this is measured: https://baldingblog.com/how-do-you-determine-your-donor-density/. Assuming that the typical Caucasian has 110,000 hairs and 50,000 Follicular Units on his scalp, the number of grafts available are most likely between 50-65% of the Follicular units can be moved in a person with a hair thickness that is average (60 microns thick). If your hair is finer than that, the number of grafts plummets.

https://ventsmagazine.com/2021/02/24/man-dies-a-day-after-his-hair-transplant/

I remember a 33 year old marathon runner that dropped dead at the peak of his health.  Nobody knows why it happened. One can suspect that his heart had an ectopic beat that came in a particular part of the cardiac cycle and induced Ventricular Fibrillation (no heart beat).  I knew a 40 year old close friend of the family, who died in a field 100 feet from his house.  Nobody knew why.

There are reports of death after having your dentist give you Xylocaine for a local anesthetic.  It happens.  One of my patients had a heart attack the evening before his hair transplant. It could have happened during the transplant I feared.  The key for good doctors is to know how to respond to the unpredictable.  For those of you who go to Turkey and have a clinic without a doctor, beware as who would address any catastrophe?

In the above magazine example, I saw them mention that this man had significant facial swelling and was hospitalized suggesting something strange happened after the surgery. Could it have been an allergic reaction to a medication he was given?  I don’t know why it happened but lack of blood tests for healthy men is the standard of care in the US today for all ambulatory surgery done under local anesthesia in young healthy surgical candidates so I would be critical of that complaint by the writer of the article.   I always get a medical history on my patients before the surgery and make sure that they are healthy without complaints or on-going medical conditions.

For those of you not actively seeing dermatologists or have prescriptions, how do you get yours? I see sites like ‘all day chemist’ but they ask for an upload of files… yet you can skip this part i think. I’m not sure if they’ll call or email you afterward asking. Also found a thailand pharmacy site that doesn’t require paperwork. Anyway as the title says, what’s the easiest way to get a hold of some? Thanks

This is a prescription drug when given orally. See an expert doctor. An old saying says: “If you treat yourself, you have a fool for a doctor”.

Medications don’t always work, but it is important as you explore these medical options, to be realistic, knowing that they may not work.  Your genetic balding could be too strong and not responsive. With regard to finasteride, over 90% of men on this drug get at the least, some slowing of the hair loss. This has been well documented, but slowing from what?  That is a hard question to answer.

The hair transplant option is a good option for those of you who are not responders to medications or microneedling. The best part of a hair transplant is that once it is done on a person who has stabilized their hair loss (usually someone over 25), they can get their hair back and stop worrying. This is what my patients tell me over and over again. It is worth considering and saving up enough money to do it with the right doctor, the right plan and as said in the title of this post, setting realistic expectations.