Is this a hair system? (photos)

/by William Rassman, M.D./0 /
The photo on the left: Some good laced systems have some fiber/plastic leading edge that create a good frontal hairline that looks completely natural. These system are generally very expensive but still must be changed every couple of weeks as the patient’s own hair grows out from under them. From a close up view, you almost always can detect the laced element of a hair system. I can’t see close enough to determine if this is a very good laced system as this man claims it  is. If this is a laced  hair system, then this is what I believe that Donald Trump uses.   
The photo on the right, is a more typical hair system.  Most men never show the hairline of a hair system because of the obvious lack of a good transition zone between the bare forehead and the hair.  With the hair combed over the hairline, this hair system on the right can look good.  All hair systems need to be adjusted for hair growth every few weeks which makes the user dependent upon the hair system folks who sold it to them.  
Both of these hair systems are glued to the scalp.  

Stopping finasteride

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

Just had a question about finasteride. I have to get surgery and needed to stop finasteride. If I’m off finasteride for a month or 3 weeks will there be a lot of catch up loss making my finasteride use worthless?

Usually, finasteride stays in your hair follicles for about 2-3 weeks.  Ask your doctor about reducing the period to 2 weeks for the holdout. 

When do you know if minoxidil is working?

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

If patients are not seeing results with topical >6 months into treatment, do you think a switch is advisable then?

If you are taking the oral, then you should see some benefit in 6-12 months or less. That may not be true for the topical because better than half of the men using topical get no response at all.  This is because for minoxidil to work, it needs a special enzyme , see here: https://baldingblog.com/sulfotransferases-and-minoxidil/

Palpitations on minoxidil, what should I do?

/by William Rassman, M.D./0 /
I am 23 years old. I was told to start topical Minoxidil (rogaine) a few months ago by a specialist in my city as a preventative measure for hair loss.  However, I started having heart palpitations and chest pain while using the medication. It’s a bit difficult to reach the specialist on short notice, so I thought I would reach out to you.  Do you suggest that I stop using Minoxidil while I wait for an appointment? I’ve been using it for three to four months now so I imagine I’ll begin shedding heavily after stopping it. 
Maybe you should take a look at the dose of the minoxidil.  If it is the 5% solution, switch it to the 2% solution.  Call you doctor for, at the minimum, a phone call. 

This is a list of drug that commonly cause hair loss

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

 

 

Finasteride made my hair worse

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

I’m 8 months in and my hair is significantly worse from when I started. My hairline was not to my liking before finasteride but it has significantly gotten worse and it’s pretty discouraging.

I suspect it wasn’t the finasteride that made your hair worse. It may be your genetic balding in an accelerated phase. See a good hair doctor

FUE without taking finasteride

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

I did research and saw it’s important to take fin for a year prior to FUE, but did my research a little too late, and discovered this sub after I had my FUE a week ago….  It’s too late to turn back time, and I started taking fin now post-op, but I have anxiety that my FUE will be a waste and unsuccessful. Will my transplanted hairs survive if I never took any fin/min prior to FUE, but will continue to do treatment after my FUE?

FUE harvests the hair from the back and sides of the head which are never DHT sensitive, so finasteride has no impact on these hairs. If the FUE was done by a good surgeon with a good team, they will grow and last your lifetime; however, your native hair around the hair transplant may still be impacted by your balding process made worse by the FUE surgery. This is particularly relevant if you are in your early 20s, so I don’t do surgery on men under 26. The older you get, the more secure your native hair will be.  Finasteride started prior to your FUE will protect the native hair in most men.

Trump uses hair clips, why?

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

These clips are likely used to fix a hair system to the side hair that is the permanent hair that never is lost on every man who has genetic balding.  I believe that he uses a very expensive lace hair system which is glued in the front and attached with clips on the side and back.  That would mean that there are three clips used for side and back security. This photo shows the existence of one of those clips.  The fine frontal hair it attached to silk lace which is then glued on a shaved or bald frontal scalp.