Do I have to stop losing hair to get a hair transplant?

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

I have been experiencing hair loss for 6-7 years now and my density has kept on decreasing. I have never been on Fin, however, I did try out min for 2-3 months and then stopped using it. I see a lot of posts that suggest an HT only after your hair loss has stabilized. but how do you guys determine that? I lose hairs every day. Should I get on fin and see it I stop losing hair, and then process for an HT ?

You don’t have to wait until you get bald to get a hair transplant. Stabilization is not always possible, even with finasteride. The key is to be able to predict with reasonable certainty, what your long term hair loss pattern will be. Most men must be 26 to be able to make this prediction and that allows the surgeon to build a proper long-term Master Plan for your future hair loss. I have had men keep up with their balding without running out of donor hair in the 29 years I have been doing this type of surgery.

How I treated my Gynecomastia

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

Background: I took fin for a month starting in March 2019. During this time, among many other sides, I felt pain in my breasts, but I didn’t stop as I thought it would go away on its own. A month later, I had large, permanent gyno. Even after that first month, it took a few weeks for the “hard lumps” under the nipples to form which made me think it would reverse itself with discontinued use of fin, but it did not, and I developed unmistakable pointy nipples with hard gyno lumps under them.

I’ve now been taking zinc supplements for 2 weeks, and my gyno is getting a lot better. The size is still larger, and the breast matter is still under the nipples, but the shape is starting to go down and they’re less puffy/pointy or feminine. I’m wondering if this is permanent or if this will go away once I stop taking zinc. The brand I got is the regular amazon essentials brand.

Not good to continue with finasteride if you have gynecomastia as it only gets worse.  You might consider switching to oral minoxidil

What do you think of my donor area? (photo)

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

You need your donor area examined with a video microscope and get a hair count and a measurement of the thickness of your hair. You want to make sure that you don’t have DUPA which can be diagnosed with the hand microscope. If you want to know your original donor density and your Hair Mass Index along with your total available donor graft supply for your lifetime, see an expert in the field.

Class 7, low density, fine hair, what can be done?

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

What can be accomplished for someone with that low of a donor density and finer hair though? Especially if they’re like a NW7. Have you ever had such a patient with satisfactory results? I’ve seen your results on some NW7 patients and they are brilliant. But don’t those guys have a higher than average donor density?

Take a look at the second man in this post. He had super fine hair and had a Class 7 pattern. What we couldn’t get with hair, we got with SMP. Of course, in this situation, I would want to examine you in advance and make sure that you understood the risks and balanced your expectations with reality. I have found that men with fine hair generally understand that their hair is not great, so that they expect less but still can get good results as shown in man #s here: https://baldingblog.com/two-class-7-patients-treated-with-hair-transplants-and-smp/

Previously took Propecia and had no side effects

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

I took propecia from 2010-2015 with no crazy side effects, but got off it when recovering from a concussion. I held onto most of my hair that I regrew for about 3 years. Now it’s starting to go really fast. If I have already taken propecia years ago, is there any reason to believe I’d get sides now? Does generic make a difference?

The generic should be no different if it is not fake. Your previous experience should be the same now

Waking up dormant hair follicles with Vixarelimab

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

Researchers have found that a molecule called «oncostatin m» is what keeps the hair follicles in a dormant stage.

Vixarelimab is a drug that is supposed to be used for a skin condition called Prurigo nodularis. It is a oncostatin m receptor blocker. My theory is that this drug can block the oncostatin m molecule which comes from JAK-stat5 signalling. And thus it may «wake up» the dormant hair follicles.

Oncostatin M blockade with vixarelimab were supposedly well tolerated and no adverse effects were found under clinical trials.

When a hair follicle ‘wakes up’ from its normal sleep cycle (teolgen), it requires certain signaling molecules to kick start the stem cells that create the anagen hair growth. Many researchers believe that the absence of an important signaling molecule that is genetic, is what causes genetic patterned hair loss. This is clearly a different explanation than you have proposed. Your idea would have to be tested in animal models and human clinical trials if indicated after the animal studies are done successfully.

Finasteride and Masturbating

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

Does masturbating somehow effect finasteride effect? I had my med school exam around the time I started using finasteride and I was masturbating everyday to release stress. I have been on finasteride for six months now and my hair fall hasn’t slowed down

Masturbating is a healthy release! Finasteride is good for hair loss. I am sure that the stress from your examinations added to the hair loss process.  The two are not related.

Dad bald, 3 brothers bald 1 brother not bald, what are my chances?

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

Question

Dad is bald at 68 but I he had most of his hair at 30 I think

Eldest brother at 31 is balding at the back but barely any hair loss, don’t think his temples are bad but would never notice

Next brother at 28 shaved his head

Next one at 25 shaved his head

Next one at 22 has significant hair loss noticeable when he puts his hair up

What are my chances? It is supposed to be a 50/50 on the mom’s chromosomes yeah?

Please god help me as this is ruining me

If you are 16, you won’t know yet. As you get closer to 21, you might see some balding changes. By the time you are 26, you will know. If you want to know in advance of what you see, connect with a doctor who has a HARICHECK instrument (https://baldingblog.com/haircheck-test-how-it-is-done-video/) and have your hair measured yearly which will pick up early balding before you can see it.