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    FUE scarring (photo)

    Nov 30, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    Sometimes the wounds stretch or the instruments that are used are large. These scars show up on any short haircut and even with longer hair.  The only good treatment for this is Scalp Micropigmentation.

    Shedding after starting finasteride

    Nov 30, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    What constitutes to be as a “massive” shed which retreats my hairline – in all honesty, may not be all that bad to someone with more severe balding. I did shed a ton, but my hair was largely intact. My hairline, however – was a different story.

    I also think, due to the shifting of phases between hair follicles – a hair shed is almost inevitable and is certainly a sign which isn’t only regular, but honestly quite indicative of treatment working. Whilst you, personally, may not have encountered sheds, I have seen you interact with countless people on forums who do mention it. 

    For peace of mind purposes, it should be clearly stated; if you notice an increased shedding in the weeks following starting or restarting a new hairloss treatment method, it’s likely the treatment working! The odds that your genetics suddenly decided to get worse when you started treatment and thus resulted in a mass shed is absolutely minimal.

    I don’t have evidence in published articles that link a significant shed from finasteride as a predictor of how it will work.

    Low DHT and ALS (Amyotrophic lateral sclerosis)

    Nov 29, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    According to this study (https://onlinelibrary.wiley.com/doi/full/10.1002/brb3.1645#brb31645-sec-0008-title) lower DHT levels are associated with ALS! I’m worried that this means finasteride, something that lowers DHT, can maybe cause ALS even thought it’s rare! Thoughts?

    From reading the article quickly, I did not see a 1:1 connection between low DHT and ALS. The authors postulated that low DHT may have a role, but the evidence is not strong.

    How long should my hair be for an examination?

    Nov 29, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I generally like the hair long, at least 2 inches so I have the option to perform a HAIRCHECK test on all of my initial patients (https://baldingblog.com/haircheck-test-how-it-is-done-video/) and I can see the effects of miniaturization better when the hair has length.

    Failure of my Artas transplant, why?

    Nov 29, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I had an ARTAS FUE transplant one year ago and roughly 15% of the transplanted hair has grown in. To say it is a massively expensive disappointment is an understatement. I’m planning on asking the company/surgeon for at least a partial refund, but I’m curious – does anyone know how a transplant could fail to such a degree? What could the potential reasons be? I’m not seeing much online around the topic of hair transplant failures. Has this happened to any of you, and if so, were you able to get a refund? Any thoughts welcome.

    The causes for failures of growth for any transplant are generally the same. It reflects on failures to control quality control process such as time the grafts are exposed to the air, transection of the grafts, out of body time for the grafts, trauma when placing the grafts from crush injuries and other mechanical injuries.  Most failures are team failures.  There are also diseases of the scalp that can cause a hair transplant failure including FFA, LLP and a variety of scarring alopecias.

    A “Cure for Hair loss”

    Nov 28, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    https://www.timesnownews.com/health/article/baldness-cure-on-the-way-harvard-study-on-hair-growth-protein-gas6-stress-cortisol-permanent-fix-hfsc/827613

    Mouse models have failed consistently to cross over to human subjects.  As the findings are mouse studies, I am skeptical without seeing human testing that this is a cure or a treatment for balding.

    finasteride, intercourse and pregnancy

    Nov 26, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I’ve read that you should stop using Finasteride if you’re trying to conceive since there’s a small risk that the baby will be negatively affected by it. However, if you’re not trying to conceive and the woman is using some kind of contraception, like birth control pills or an IUD, is it then safe to have sex without a condom? Can the small amounts of finasteride found in semen be harmful to women’s health in any way in this kind of scenario? Trying to figure out if condom is the only way to go.

    The amounts of finasteride found in semen has been reported to be found in very, very small concentrations. The question must be framed in the context of a pregnant woman early in her pregnancy and if the finasteride in such a low dose, would have to cross into the uterus, across the placenta and into the fetus. I don’t know if this has been documented, but it might be best to be extra-cautious using a condemn to avoid the risk. Finasteride itself can not

    Should I get a Transplant at 23?

    Nov 26, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    You need to develop a Personalized Master Plan with a good doctor. That will allow you to try various options short of a hair transplant to see if you can get your hair back such as finasteride, minoxidil and microneedling.  Give this approach a full years.  When all else fails and you are at least 25, them a hair transplant is a reasonable option,  Read this:  https://baldingblog.com/creating-a-personalized-master-plan-for-present-and-future-balding-photos/

    Cupping for hair growth?

    Nov 24, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I never heard about this but was just thinking about it, shouldn’t it help with hair growth? Minoxidil works because of the improved blood flow in the area so the cupping should work too ?

    Blood flow decreases in the scalp as balding progresses, not the other way around. Increasing blood flow will not alter balding, of that I am sure

    40 and worried about balding

    Nov 24, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    Hi there if someone take fin and/or dut, given that they respond to it without sides, how viable is a hair transplant over the long term. I see many people with aggressive mbp in the past have gone for HTs and ended up having to shave it all off. Will taking dut, fin, min prevent this outcome for similar candidates?

    You must develop a Personalized Master Plan with a good hair restoration surgeon to determine where you are in the process, what you can and can not do and when. A good plan will include good metrics on your hair mass index, donor density and lifetime donor supply tied to your family history with a worst case scenario planned for. Finasteride still can have value at your age.

    Good sexual side effect from finasteride

    Nov 24, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I don’t know if this is happening to anyone else but on .5 finasteride I have been able to last longer, my penis is harder, and it has gotten a little longer (I was not well endowed before so I can tell). Is this normal I always hear the opposite of this? It’s only been a month and a half. I would like to know why this is happening

    One of my son’s had this side effect and an increased sex drive as well. He loved the drug!

    Can a gray beard be replaced by black scalp hair

    Nov 23, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    Scalp hair is often used as a donor source for beard hair. If you would use black hair as a filler, it would bring the black hair into the beard.  Sooner or later, these black (or brown) hairs may turn gray.  There is no guarantee that your re-transplanted scalp hair in the beard location wouldn’t turn gray again sooner or later.  I believe that your question is academic because no doctor I know, would transplant into a full beard with scalp hair just for color effects.

    Posts

     

    Risk from breathing in Toppik?

    Nov 23, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I am sure that if you breath in the fibers in Toppik or any other concealer that it will potentially lodge in the lungs and can produce a foreign body reaction.  Doing it once by accident shouldn’t be a big deal but repeated such events will cause you harm.

    Is topical finasteride a replacement for oral Finasteride?

    Nov 22, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    It works well when the areas are relatively targeted. See here: https://baldingblog.com/the-use-of-topical-finasteride-with-minoxidil-produces-remarkable-results-in-a-study-on-300-male-patients-with-genetic-balding/

    Hairline restored with finasteride

    Nov 22, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    This young man showed his before and after the use of finasteride for a year. Most articles on this subject suggest that finasteride doesn’t work well on hairlines, but we see exceptions to this rule all of the time.

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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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