Technician doing hair transplants in his basement in Toronto

/by William Rassman, M.D./0 /

The person doing the surgery was arrested.  It is amazing not that he was doing transplants in his basement, but that someone would agree to it just for a reduced price.  The patient was told it wasn’t a surgery.  Death is a reasonable complication when you don’t know what you are doing as a surgeon. 

In the early 1990s, some tech working for a doctor, opened up his office for weekend and did the surgery over the weekend using the doctors’ own supplies.  They needed more help, so friends working for NYC garbage collection, worked for them, assisting them do the surgery.  It hit the front pages of the NY Newspapers (see:https://www.iahrs.org/hair-transplant-podcast/garbage-man-hair-transplant-surgeon-you-cant-make-this-stuff-up)

Topical liposomal finasteride vs oral finasteride

/by William Rassman, M.D./0 /

hello doc, is oral finasteride more effective than topical one? as i wanna switch from topical to oral and topical isn’t showing much results, also my doctor is saying as topical has various factors like skin ph humidity etc issues of absorption, oral is more reliable.  What do you think, should i start oral and be more optimistic about it?

I believe that it is more effective as the oral impacts all of the miniaturized hairs you don’t see while the topical only works where you apply it, that is, if it is the liposomal topical finasteride

microneedling vs hair transplant

/by William Rassman, M.D./0 /

Will Micro needling keep me from having a transplant? Does it damage the scalp in that way?

Microneedling may bring back your hair. It doesn’t always work but sooner or later, the hairs that grew from the microneedling, will eventually go through their Telogen cycle and disappear. We don’t know much about duration for the hairs to remain. A transplant will last and last in most people into old age.

6 months finasteride, microneeding and Vit D

/by William Rassman, M.D./0 /

Fantastic responder. I was suffering from insomnia as well and I couldn’t get tired for the life of me so I started taking Vit D and noticed my quality of sleep improved dramatically. I could only sleep in 2-3 hour chunks before suffering trying to fall back asleep again. With Vit D I am dead asleep for 7-9 hour chunks of time. I also noticed my hair grow a “teeny” bit thicker in the two months before trying anything else, and that lead me on the road to growing my hair back and finding other options. That’s when I added finasteride and microneedling to my routine. The small gain I got from the Vit D, became a massive gain with finasteride and microneedling. 

Very rapid hair loss at 18, why?

/by William Rassman, M.D./0 /

Not even a chronic masturbation addiction could effect any sort of hormone levels or anything? Please help I am trying to figure out what caused me to start balding so fast at 18

Hair follicles have a biologic clock that kicks in Apoptosis (cell death) in those men who have the genes for balding. I have seen young men (not common) rapidly lose their hair and develop a Class 7 pattern by the time they were 20. Statistically, that is probably not you unless you take after a father who was one of those rare men when he was young. Frequent masturbation has nothing to do with hair loss

Finasteride and reversal of hair loss

/by William Rassman, M.D./0 /

if you had to guess (rough estimate) what percent of your patients in early 20s experience regrowth in crown/vertex/midscalp when hairloss is very early. Assuming the mpb is caught very early in the young patient, does the finasteride generally regrow the crown/vertex/midscalp so that the hairloss is not-visible or aesthetically insignificant so as to make the balding undetectable to the average naked eye? Sorry for the long-winded questions. I really appreciate all of the time and effort you put into the community. Thanks again.

There is no study that I know of that will answer your basic questions; however, from my experience reversal is more likely in men under 25 with recent hair loss than men over 30

Class 3 at 26 years old

/by William Rassman, M.D./0 /

I started balding at 18 with a nw1.5 now i am 26 with a nw3 and it seems somewhat stable. Is it possible that my balding has stabilized and won’t get much worse?

Yes, that’s possible, but be prepared in case your balding pattern gets worse in time

Dutasteride and depression

/by William Rassman, M.D./0 /

Hello dr rassman Im from south korea and i ve heard about you from NHI in korea I ve took finasteride for over 10years with out side effects 2month ago i started dutasteride After 5-6weeks i felt depression. First time in my life. 8 weeks i finally give up taking dutasteride to go back to finasteride. Now its almost 10 days and still have depressive mood. I’m wondering is it ok to maintain finasteride 1mg untill dutasteride half life ends (i know its 5weeks)

The drug dutasteride will last a good 3 months or possibly more as there is tissue fixation that also occurs. Six weeks is the blood/serum half-life. Be patient.

 

Hair transplant turns deadly in India

/by William Rassman, M.D./0 /

https://www.barrons.com/news/hair-transplant-fad-turns-deadly-in-inda-01669949408

Cleanliness is close to Godliness.  I can’t comment too much about this tragic report; however, the surgery was apparently performed by a non-physician team, possibly without respect for the cleanliness required of a surgical procedure.   These Hair Transplant Black Markets, have reduced prices to induce naïve men to think that they are getting a bargain but these non-physicians don’t know about the toxicity of the anesthetics we use or many other issues related to the human body’s reaction to the surgery or the medications. Death is a high price to pay for a bargain.

 

Saw Palmetto vs Dutasteride

/by William Rassman, M.D./0 /

Do I need to stop saw palmetto now that I take dutasteride?

Saw Palmetto is a very weak DHT blocker while Dutasteride is a very strong DHT blocker. Yes, stop the Saw Palmetto. Many experts like me, don’t believe that Saw Palmetto works for hair loss at all

Locating a proper hairline!

/by William Rassman, M.D./0 /

Why with eyebrows raised up? Is that how the rule of 3rds supposed to work? Distance from bottom of nose to eyebrows line should be the same as the distance from eyebrows line to hairline? But that should be properly done with eyebrows lifted high?

The hairline ends at the frontalis muscle when you are 5 years old. Ask a 5 year old to lift their eyebrows and you will see their upper middle hairline touch the highest crease of their furrowed brow. The juvenile hairline is always located there. and as a male matures his hairline without balding, it will go up one finger breadth above that highest crease and change its shape from concave to convex taking in a V-Shape.  That is why I I always ask my patients to raise their eyebrows, to determine the proper location of the hairline.