At 22, I think I am developing a Class 6 pattern of balding

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

Say I‘m 22 now and my final pattern is NW6 which I will reach by the time I turn 30. I am NW 2 now and my hair loss is not aggressive, medium I would say. Can I maintain the hair for long? If the final pattern is that severe?

The only possibility is the drug finasteride, but I don’t know if you can stop the pattern from developing but you can probably slow down its onset. Get a doctor who specializes in hair restoration like me, who can measure your balding accurately, your donor resources and then follow you as your hair loss situation may or may not change under treat,emt

Do I have DUPA (Diffuse Unpatterned Alopecia)? (Photo)

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

i’d really appreciate if you could have a glance at these pictures taken with a microscope to confirm whether i have dupa hair loss/miniaturization. pardon the oily hair and hair fragments (recent haircut) :)

There are 9 slightly miniaturized hairs (arrows point to them)  out of a total 50 hair count. This is not DUPA as it requires substantially more than 20% of the hairs.  Also it is important that these miniaturized hairs are usually part of a follicular unit with at least 2 normal terminal hairs, so your donor hair count may be just dropping slightly, something I see as boys become men, or as men get older.

Getting a hair transplant in your late 20s, what to know!

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

I’m getting an FUT procedure done next week. I’m excited and a little nervous. I’m 29. Still have some hair left on top of head. But my temples are completely bald. Can someone share their experience?

  • Was it worth the effort and money?

  • After how long did you see the results?

  • Any shock loss of existing hair? Did it come back?

  • Anything else I need to be aware of?

I believe that every man must develop a Master Plan when they start their hair loss, particularly when they start doing a hair transplant because hair loss is progressive and it may, depending upon your balding pattern, keep going if you inherited a Class 7 pattern (the most extreme pattern as this man did: https://baldingblog.com/norwood-class-7-pattern-patient-received-11000-grafts-plus-smp/ ). It is so important that the doctor that you bond with, cares about you and not the size of your bank account. In the example here, I donated the last half of his hair transplants at no charge in exchange for him helping me educate some of my patients, We both got a good deal and he kept his hair for his entire life. I also did his father and his brother and all of his balding friends.

Is there a science behind the Dermaroller?

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

What science there is relates to wound healing. When wounds occur, the body’s response it to mobilize a very aggressive healing process with the production of cytokines (a type of protein) that invokes the immune system and migration of healing cells. This may cause enough stimulation to invoke a hair response to the healing process as well. When this is done with the drug Minoxidil on board, it brings the effects of the minoxidil more to stimulate local absorption. We seem to read article suggesting that minoxidil with dermarollers, seem to work. That is my best guess.

Will finasteride maintain your hair as you get older if you stick to it?

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

Wondering if you have strong hairloss genes in our family that would make you end up at a NW 5-6 at a rather young age and start taking fin were you still able to maintain?

I have had many patients on finasteride since it came out and never had a hair transplant. These men found that it maintained their hair. A few stopped it and were shocked that they lost hair from stopping it and most quickly went back on it but not everyone grew back what they lost from stopping it. I don’t know if finasteride can stop the final progression of hair loss, but it does seem to hold on to some hair in almost everyone. I personally have been curious to see a person who became a Class 7 pattern male when he was 23, what would have happened to him had he been on finasteride. In other words, could it have stopped the progression to his Class 7 pattern?

Decision from The California Medical Board: Only doctors can perform a hair transplant

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

There has been a huge effort to get the California Board of Medicine to rule against doctor who use technicians to do their hair transplants in their surgical centers or their offices.  This has been a real problem in the field, as technicians have been hired by doctor to do this surgery so that the doctor can ‘CASH IN” on the huge rise in demand for FUE hair transplants. Many of these doctors are not trained in the field of hair restoration, never did a hair transplant and don’t understand the basics of the anesthesia or the surgery but, nevertheless, driven by a desire to MAKE MONEY. These doctors hire technicians, or companies that supply technicians or even nurses to do the surgery for them.  We have seen terrible complications, including one death in California from a surgery performed by someone who didn’t know what he was doing.  Now it is against the law and any doctor doing this type of phantom surgery (many doctors were not even in the operating room while the surgery was being done), will be subject to California Board of Medicine legal action and could lose their license to practice medicine.  Most states follow California on such policy matters so I hope that this ruling will propagate in other states and other countries as well.

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Given my family pictures, should I get a transplant?

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

 When I was 17 the temples of my hairline had receded and I now have very minimal crown loss . I’ve been using minoxidil with dermarolling for the last 3 months on my hairline but all I can see are very tiny vellus hairs along my hairline. However for the past couple days I’ve been having day long migraines and I suspect it might be the minoxidil so I’m stopping use until around next week.

Hair transplants are personal decisions. Knowing what you might look like by looking at family members might help you understand better, especially if you can speak with those that are still alive and ask them if they could get their hair back (an completely undetectable hair transplant) would they have done it. You need to sit down with an expert in this field (hair restoration) and get a Master Plan worked out for your future hair loss problems if your hair loss should occur.

More BS with a focus on self promotion (see link)

/by William Rassman, M.D./0 /
This is a self promoting link. PRP has never been proved to be effective or lasting if there is any effect at all. There have been no double blind studies done on PRP with objective measurement devices such as the HAIRCHECK instrument and one has to ask why not.  If it worked, there would be many such studies. The folks that wrote this link added nothing to the educational process for readers interested in hair loss.
The premise that hair transplants are not good and don’t last, are baseless. I have been doing hair transplants since 1991 and have seen many of my patients from the early 1990s, keep the hair that they got from the hair transplants.  Are article does not pose new science, in fact any science, just claims that are without foundation.  Yes, a few hair transplants don’t last the lifetime of the patient (less than2% of patients) but the large majority of patients who had either strip or FUE surgery show great results.  One of my first patients who had FUE (see here: https://baldingblog.com/first-fue-patient-north-america/) still comes to our Monthly Open House events to discuss his hair transplant. This is his look today and that alone answers any challenges to the idea that hair restoration is not a good solution to hair loss.

https://www.prnewswire.com/news-releases/prp-injections-the-holy-grail-for-hair-regrowth-gets-a-makeover-for-2019-300819493.html

Balding at 17

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

I have been slowly loosing since i was 15 about and i have nw 1.5 if that Means anything, anyways i am in a really early stage and i want to keep my hair for AS long AS possible. I am completely new to this and don’t know anything about what to do . Is there any products i should look into or buy straight away to slow down the hair loss. My dad Also did begin loosing HIS hair in an young age. My hair loss is my biggest insecurity and i would love to do something about IT. Thank you in advance (sorry for bad english and spelling errors but english is not my First Language)

Your language is fine and you communicated your problem very well. You need to find a doctor who can work with you, build a Master Plan for you, if they have a HAIRCHECK instrument (https://baldingblog.com/19-year-old-parent-told-not-balding-according-haircheck/) then use this as a guide to your treatment success. Finasteride is a great drug for you if you are really balding, you MUST have a doctor work with you for this.

33 year old with Class 7 balding pattern

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

What would you suggest for this man?

Advanced balding is not unusual in a man over 30 as most advanced balding patterns happen in men under 30. He could undergo Scalp Micropigmentation (https://scalpmicropigmentation.com/bold-shaved-look/ ) and look good or possibly get a hair transplant followed by Scalp Micropigmentation and with the two, he can get a full looking head of hair most of the time (see here: https://newhair.com/wp-content/uploads/2018/11/Combining_Follicular_Unit_Extraction_and_Scalp.98621.pdf) 

Neck hair on fin/min

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

Anybody else notice a major increase in neck hair after starting fin and min. I have never had hair like this run down the 2 sides of my neck. Going to shave it tomorrow but it’s interesting to see that the medication is possibly working right away . I only apply minoxodil to my temples and haven’t seen much change but I’ve only been on for about a month. I hope this is the medication telling me that it’s working very well!

Minoxidil, when absorbed, can increase hair elsewhere in your body. The neck hair increase may be caused by minoxidil.

I have scalp pain and crown thinning, is this normal?

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

Just turned 18 and having a lot of receding in the hairline and some thinning on the crown. All the males on my dads side of the family are bald and most the males on my moms side are bald also so i feel like MPB is inevitable just sucks that it started this early! But i am experiencing scalp pain on my crown just wondering if its normal or not

Scalp pain does not come from male patterned balding. Psychological pain is different