Fertility and finasteride in men

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

If my sperm count is reduced, does it go back to normal if you stop the drug to have a child?

If you have a fertility problem related to your sperm count from finasteride, you can expect that it might take months to return to normal. In the following publication: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205531/, the authors state: “A patient on finasteride (1 mg) for 1 year, diagnosed with oligospermia (impaired spermatogenesis) 5 years earlier, was found to have increased semen volume immediately after cessation of finasteride and his sperm concentration improved to more than 10 × 106/ml about 4 months later.” You should read more of this publication.

Is there a gene for balding?

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

On these sending DNA Sites you can see what your likelihood is of going bald. Is there a specific gene that causes this?

The genes (many genes) have not been fully identified. the company 23 & me is not reliable for predicting hair loss because even if you have the genes, these genes may not express themselves.

I grew my hair out for two years. When I cut it, I had noticeably less hair.

/by William Rassman, M.D./0 /
I am a 21 year old male. I grew my hair out for two years. 2 months ago, I buzzed my head. I noticed I hd significantly less hair. While I had long hair, I would pull my hair out from time to time due to knots etc. It’s been two months, and my hair is longer, but the total quantity of hair is still less than pre-long hair. Any possible causes/how can I help my hair grow back? No noteworthy baldness in the family or anything.
Hair length is clearly better for a fuller look when your hair density is low because you need the length of hair to produce hair bulk.

Cutting Proscar?

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

When you cut a proscar pill into 4 pieces does it lose it’s effectiveness ?  Where do you store the 3 other pieces ? I heard that oxygene lower the potency of the drug

NO, but you should only cut one pill at a time and use it within the week, keeping it dry in a pill bottle because you don’t want it to take up water from the air around the pill.

I want to do a hair transplant but I don’t want it to be seen by others

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

Considering getting a H.T to fill in the front corners of my hairline better. This isn’t a question of if I should get it I just want some info on the healing side of things.

Say I get a H.T in late December, I’ll have enough vacation time to go away until February and not see anyone from my real life during that time. Once I am back in February, will I be able to wear a hat freely? Will the transplant be obvious if I am not wearing a hat or will it just look like it did before the transplant?

Right now very few would see me as losing hair but I’ve lost enough in the corners to make it difficult to style it the way I like and would like to have a true nw1 I am just concerned with others noticing I had something done. Thanks

Keep your hair long so that the recipient area can be covered with the hair you have. Make sure that the doctor teaches you to wash your hair so that you are not crusty like this: https://baldingblog.com/terrible-crusting-one-week-fue-photo/ bur rather like this: https://baldingblog.com/one-day-post-op-with-photo/ because you should be able to go out in public within a day or two.

Does alcohol cause hair loss

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

Do you think that drinking alcohol could be a factor (if not significant factor) in male hair loss? I am a senior at a major east coast university that is known for its student body’s tendency to drink alcohol. I started to make an observation that a lot of the people that I know that have drank heavily for the past couple of years (they are now approx. age 21-23) have some degree of noticeable hair loss compared to the people who were more moderate with their drinking. I myself used to drink fairly heavily for about a year in college and ever since I slowed down I have noticed that my hair has begun to grow back thicker (perhaps because lowered my alcohol consumption) although the hair I have lost has not grown back yet, if at all Another example of this would be if you were to take a look at any major “party” fraternity at XYZ College. Of course course the older brothers are going to look more aged/mature than their younger counterparts, however in my experience I started to notice that the a decent amount of the older brothers in the major “party” frats at my school definitely show a greater degree of hair loss than some of the other same aged males at my school who were not known to go out and drink every weekend.

If alcohol can be a significant factor in hair loss at a young age is it possible that it served as a catalyst to speed up the balding process since these people may have been genetically disposed to experience hair loss at some point in their lives?

Drinking alcohol doesn’t cause hair loss but stress does and many people with genetic hair loss who drink are stressed.

Hair transplant (front hairline) + Hair system combo

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

Hairtransplant for front hairline (1cm-1.5cm but dense across) with a hairystem in the back. It will be absolutely undectable in theory.. i dont mind wearing a hairsystem forever lmao so the future doesnt bother me. I am vain when it comes to myself and i love keeping hair on my scalp.

As for future girlfriends or partners.. if they dont like a man wearing a hairsystem they can leave lol. The one thats for me will be able to see past this.

Ofc for anyone wondering, this is for my own confidence ans how i want to feel when i look in the mirror. Hairloss isnt just hairfall for me, its an identity loss thar occurs way faster than normal agind does on someones skin :(. Self confidence is more important that anything else, and 50% of my confidence is rooted in the way i feel qhwn i look in the mirror.

So does anyone have any experience or stories they want to share about the idea of a hairsystem and hairtransplamt combo

I have performed some frontal hair transplants in men that wore a hair system behind it so that the hair system wasn’t detectable. It reduces the overall cost of the initial hair transplant but maintains the cost of the hair system which is not low

Finasteride not working!

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

So I was on fin for around 1 year and then stopped for 2 months and have started again for 2 months (present day) and my hairline is progressively getting worse.

Finasteride doesn’t work for everyone but it often slows or stops the hair and as long as you can accept that, it is better than losing it

Finasteride & Minoxidil 4 months

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

This 23 year old male had taken finasteride and minoxidil for 4 months. This is a remarkable benefit in just 4 months; however, the hair length is clearly longer in the photo on the right.

The Ideal Hair Transplant

/by William Rassman, M.D./0 /
This man had his surgery done by Dr. Zarev (Sofia, Bulgaria) who put together an outstanding team to be able to perform up to 6,000 grafts in a single day. I have seen him working at various hair conferences with video access and therefore understand the way he organized his team.  Dr. Zarev is unusual in that he built a team that can exploit graft sessions that maximize the patient’s donor area in a one or two day surgery.  This patient was done in two sessions totally 11,620 grafts with spectacular results. Apparently he had still another session some 9 months later. I would warn the reader not to assume that they can get such results as explained below.
What was done: This is not the typical patient because to support 11,620 FUE grafts from the donor area, his donor density must have been substantially higher than the average man’s donor density. I have had only a few such patients, one shown here: https://baldingblog.com/norwood-class-7-pattern-patient-received-11000-grafts-plus-smp/.  For the typical person with an average donor density with an average Hair Mass Index, they would almost certainly develop a see-through donor area as shown here if they transplanted 11,620 grafts: https://baldingblog.com/another-case-of-an-over-harvested-donor-area-from-fue-photo/. They would avoid this if their donor density and Hair Mass Index was significantly above average. 
The Mathematical Analysis: Mathematically, to support this many grafts, the donor density must be at least 50% higher than the average man’s donor density [the average Caucasian man has 55,000 grafts on their head of which 25% or 13,750 grafts are found in the donor area].  Let’s say 2/3rds of the 13,750 grafts are removed from the donor area in this typical average Caucasian male. That would leave only 2,130 grafts remaining (13,750 grafts originally in the donor area -11,620 extracted = 2,130 grafts remaining). If this man only had 2,130 grafts in his donor area remaining, he would likely develop a see-through donor area which is clearly not the case as shown in the after picture here.
Working with men who have a high density and who have a better than average Hair Mass Index makes the surgeon perform ‘miracles’ as shown here. But what are we actually seeing?  Let’s dissect this ‘miracle’. We are seeing the results of 11,620 grafts covering an area that would normally contain approximately three to four times that  amount of grafts (34,860 – 46,480 grafts) that would have been present in the transplanted area before this man became bald. So clearly, what we see is the result of more than just hair. It is the result of the art of the surgeon who understands how to distribute these grafts and weight these grafts to look ‘full haired’ from every angle.  I would expect that the leading edge of the frontal hairline was built denser than other parts of the head. As you look at the donor area, this man still has more FUE grafts that can be used for future surgeries if needed. 
There is never a substitute for a great surgeon who put together a great surgical team. I have put this analysis together for those of you who really want to know the reality of the hair transplant process they often see or fail to see.
I congratulate both the patient and Dr. Zarev in the results shown here.

 

Two months on minoxidil (photos)

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

There is a suggestion of early results on the photos as they are, I assume, taken from the same place with a comb-over on the 2 month photo. It is always best to style the hair the same to see the differences clearly.

Questions about a small hair transplant

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

Considering getting a H.T to fill in the front corners of my hairline better. This isn’t a question of if I should get it I just want some info on the healing side of things.

Say I get a H.T in late December, I’ll have enough vacation time to go away until February and not see anyone from my real life during that time. Once I am back in February, will I be able to wear a hat freely? Will the transplant be obvious if I am not wearing a hat or will it just look like it did before the transplant? Right now very few would see me as losing hair but I’ve lost enough in the corners to make it difficult to style it the way I like and would like to have a true nw1 I am just concerned with others noticing I had something done. Thanks

A well done hair transplant can be done so that you don’t see it at anytime. You might have to take a few days off if you have FUE or if you are very bald. If it is just the corners, keep your hair long and use the long hair to cover anything that you think is detectable

What Type If Transplant Did Elton John Get?

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

He had so little hair before hand he couldn’t of gotten a FUE or FUT…right? Anyone got any more info?

Elton John–the story goes, had hair transplants when they were ‘PLUGS’ which left him devastated. He now uses a hair system, just like Frank Sinatra did after he was mutilated by the old type of PLUGS. This happened in the 1970s and 1980s.

Patient with classic Triangular Alopecia (photos)

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

This is an inherited form of hair loss that is often on both sides impacting the temple peak area and is easily fixed with hair transplant (the only solution)