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    I’m developing a Class 7 pattern

    Sep 12, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    I’m pretty close if not completely norwood 7+. I realize this severely limits what I can expect from a hair transplant. I am currently 40 years old, and have been balding since 20. So I’ve been on fin and minox on and off throughout the years.  I know there’s only so much you can say if you don’t see me personally, but I just wanted your opinion as an expert. At a norwood 7, would it be possible to have graft or FUE done to the “top” of my head so that I have coverage on the top enough to create an “undercut” look. Currently, I shave my head completely. If I had the transplant done, I would still plan on shaving the sides and “under” the top. I realize this would possibly make scarring visible and obvious, which I understand is a very important thing to consider. I would think micropigmentation would help with this, right?

    I was just curious if you had ever performed this kind of look, and whether or not you thought it would be viable with such advanced hair loss.

    I have performed hair transplants on hundreds of Class 7 pattern patients. Some have had a very high number of transplantable grafts and some have not. See: https://baldingblog.com/question-about-class-6-pattern-of-balding/. If you want to consult with me, write to me at williamrassman33@gmail.com. To evaluate you correctly, I need to see some photos to show your balding, and one of them should be a frontal view with your hair pulled back and your eyebrows lifted high so that the creases on the forehead show up. This will show me anatomical landmarks to measure where your hairline belongs and more about the shape. Tell me what you don’t like about your hairline and overall hair situation. Please include your phone number and the best times to reach you.

    Very low juvenile hairline

    Sep 11, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    I have seen a few of these hairlines that almost touch the eyebrows.  I saw one that was solid at about 1.5cm above the eyebrows.  Usually, if the hairline matures, these juvenile hairlines will disappear with age.  It could take until 29 years of age.  In some ethnic cultures like Indians, hairlines this low are more common, and some men will maintain such a hairline into adulthood as they never develop a classic mature hairline.  This is rare.

    3 months minoxidil, finasteride and microneedling (photo)

    Sep 11, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    Great change in the hairline in this man. 

    Topical minoxidil and Rosemary Oil 1 year

    Sep 10, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    DUPA and Aging, are they the same?

    Sep 10, 2023/by William Rassman, M.D./0 /Hair Loss Causes

     Are Dupa (Diffuse Unpatterned Alopecia) and Age related thinning the same condition, just that the former name is applied if it develops in a young person whereas the latter name is applied when it develops in a person of advanced age?

    No, these are not the same.  DUPA usually has miniaturization well over 50%, if not 70% or more, while aging expresses itself in two manners, (1) Age Related Thnning.  This appears with thinning of the hair shafts that are universal and uniform of (2) loss of hair follicles in the follicular unit.  This appears as a drop in total hair count per follicular unit and the entire head. 

    Aggressive balding at 17, can it be stopped?

    Sep 7, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    I read some comments around here on posts from people who are 17, 18 years old. Many say that there is not much that can be done in those cases, and that one should simply accept that all is lost. I’m 18 and I think my baldness is aggressive. My hairline has always been high, but at 16 I saw it was receding a bit. Two years later, I have a nw2.5-ish hairline, and it turns out that my alopecia is retrograde. However, my hair is very thick on top. On the sides and back, not much, due to the fact that it is retrograde.

    One year ago, I realized that things were getting a lot worse. From May to December, I can say that I went from quite-good-hair to obviously balding. I started topical minoxidil in November, and I’ve been using it to this day. Finasteride only started being part of my regimen three months ago (almost four), at the end of January. I’m losing about 100 hairs a day in the shower, but I can say that my hair is still the same as it was at the beginning of the year. Considering how aggressive the progression was, I don’t know what my hair would look like now if I hadn’t done anything to combat the baldness.

    I’ve heard reports of guys saying that they started going bald around the time I did, that they had started treatment, but at 24-27 years old ended up losing all their hair. Therefore, I would like to know if it is true that attempting to combat aggressive baldness at a young age is in vain.

    I have seen men 17-18 whose fathers had a Class 7 pattern by the age of 22 and they are now looking just like their dads.  I am not sure that today’s medications can stop this balding process, but it is worth a try.  Most men can get a hair transplant and prevent the balding appearance; however, most reputable hair surgeons will not tackle a 17-year-old even with parental consent because of maturity and financial issues.  Too many young men can’t handle the decisions on hair transplants at 18.

    Matching donor supply with balding patterns and age

    Sep 7, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    How is the donor area approached and managed for a hair transplant based on the balding pattern? What I mean is the donor area for a Norwood 4 is going to be larger than for a person with a Norwood 7 whose crown dips down and cuts into much of the donor area.

    A good doctor will plan for the unexpected balding pattern that might sneak up on his patient.  That means that the Personalized Master Plan that I write so much about expects a Class 7 pattern of balding on each and every one of his patients. This is what separates the great doctors from the poor ones. 

    3 months finasteride, minoxidil and microneedling (photos)

    Sep 6, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    Activity after FUE

    Sep 6, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    I have a hair transplant programmed in 2 months. My doctor told me to avoid all kind of exercise for 2 weeks prior and 4 weeks post-transplant. I will ask him for more details about it, I mean, can’t I do a few sets of really low weights just to maintain the muscle? or is it absolutely nothing at all? Also, I find it strange that he didn’t tell me anything about having sex, it is a super high-intensity exercise…

    If you are going to have FUE, then exercise up to the day of the surgery and then you should be able to start up again 5 days later. I don’t know where your doctor got his information from. Full activities include sex, possibly as early as 3 days after FUE. sweating doesn’t harm the grafts or cause infections that I know of.

    Finasteride 0.25mgs/day?

    Sep 5, 2023/by William Rassman, M.D./0 /Hair Loss Causes
    Statistically, based upon the original Marck studies, 0.25 mgs daily was 50% effective. Every other day will reduce its effectiveness even further. It will have some value, but certainly not like 1mg/day. If this is a way to slowly increase the dosage every few weeks until you get to a real solid dose of at least 0.5mgs daily which is 83% as effective as the 1mg dose, then your plan makes sense to me.

    Napoleon, Impact of balding on his troops in 1812

    Sep 5, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    During Napoleon’s retreat from Russia after the defeat of 1812, more than 4500 of the original force of 500,000 men died for all causes, battle wounds, heat, starvation, and especially the cold.  Many of them went to sleep and froze to death. Daron Larrey, the army’s Chisleetef Surgeon, noticed that bald men died of the cold before those with hair. 

    11 months minoxidil and finasteride (photo)

    Sep 1, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    The photos speak for themselves.  The corner recession is often responsive to these medications in men under 25. 

    12 months on finasteride (photo)

    Sep 1, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    This man was 19 when he started t treat the thinning that he had.  In just 12 months, the diffuse thinning returned to normal.  Finasteride is a micacle drug for such young men. 

     

    Do hair transplants last more than 10 years

    Sep 1, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    I have been doing hair transplants for 32 years.   Some of my patients from 25-30 years ago, call me from time to time and tell me that their hair transplants have held up very well.  One who recently spoke to me 22 years out, send photos and it seemed that his transplants thinned.  This happens to a minority of hair transplant patients

    PRP with hair transplants

    Sep 1, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    Should I get PRP with or immediately after a hair transplant?

    I have never used PRP with hair transplants. My hair transplants grow regardless of what one does after. I personally believe that it is a waste of money.

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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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