We’re taking the day off for Labor Day (the first Monday in September), and so that I can travel to beautiful Montreal, Quebec Canada for the 16th annual meeting of the International Society of Hair Restoration Surgery (ISHRS). The meeting takes place from Wednesday through Sunday, and I’m moderating a discussion on trichophytic closure techniques on Thursday.

Dedicated as always, I’ll still be answering questions throughout the week, so while we may be off today, things will be back to the regularly scheduled blogging first thing tomorrow.

my derm told me that i had keloids in the back of my scalp. is it normal for a women to get them in there scalp? i have 7 of them in the lower back of the scalp and the and maybe 3 in the middle. they injected them with steroids 1 and they didnt get any better. just got a lil smaller, not to much though. i thought in the back of the scalp was more for men to have.

I would assume that your doctor is right if he diagnosed you with keloids. If you want a second opinion, you can try seeing another dermatologist. Keloids don’t discriminate.

Here is an excerpt from eMedicine: “The prevalence [of Keloids] has been reported to be higher in young females than in young males, probably reflecting the greater frequency of earlobe piercing among females. Keloids and hypertrophic scars affect both sexes equally in other age groups.”

Dr.Rassman, this question may sound ridiculous and from looking at your replies to many questions on this blog it seems you are a very modest person. My question is, would you say you are the best hair transplant surgeon in the world. you have the most extensive collection of before and after photos which i must say have not failed to impress. also i have looked on hundreds of other sites and they dont have even half the amount of photos you have., or (evidence) as i say. John lennon once said ‘we are the greatest band in the world and the greatest songwriters, we have had more number ones than any other artist’, what i think he is saying isnt arrogant he is simply saying that they have more number ones than any other act. as you have the best results and more results than any one else would you say for arguments sake you are at least one of the best hair transplant surgeons.

I don’t mean to toot my own horn, but the International Society of Hair Restoration Surgery (ISHRS) awarded me with the 2004 Golden Follicle Award, which reflects what the doctors around the world may think about me. Only about 14 physicians have ever received this award in the history of the society. Our hair transplant organization has outpatient surgery facilities which are certified by the Accreditation Association for Ambulatory Health Care (AAAHC), which is a national accrediting agency for outpatient surgery facilities and holds these facilities accountable to a known standard of care. In the field of hair transplantation, there is no requirement to build a certified facility, but I have been adhering to this standard for the past 10 years and every three years or so, we get a physician reviewer who comes in to judge the standard of care, the outcome of our work, the infection incidence, the accident status, and the things that go wrong. If we have not met some minimum standard, we do not get the accreditation. Few hair transplant centers in the United States undergo this process, because it is a difficult standard to meet and the cost to adhere to their requirements on quality cost us well over $100,000/year. Even with this high cost, the comments of the reviewers guarantees that we are constantly observed and criticized to help us improve our quality of care. I generally tell those patients who are considering us to be their doctors, to check out any doctor that they are considering for such national certification. Our facility and our standards are the best and it is backed up by the accreditation of the AAAHC. What I’m getting at is that we strive for the best, and if people see us as the best, then we’re doing our jobs.

I thank you for your direct question, but although I like a pat on the back as much as the next guy, what I see, read, and hear from patients at our monthly Open House events (which we have been holding for over 15 years) says it all for me. I love the people side of this field… the doctor/patient interaction from the patients I meet. The diversity of my patients is what stimulates me to work, to listen, and to help them, and that is what makes me what I am, whatever it is.

My question is simple but as of yet still unanswered by science: why can’t they find a cure for baldness? Are they not trying hard enough, getting enough funding, don’t want to cure it? It’s not surely as complicated as cancer or HIV.

I have given up on my medication as Propecia is a waste of time (in my opinion). Ugliness…here I come!

Propecia (finasteride 1mg) is the best medication for balding men and it works. You are looking for a miracle and there is no such thing. The rewards for finding the cure for balding will make another fortune like that of Bill Gates, so there is plenty of stimulus for it.

Hi Doctor,
I just made a trip to a local trichologist (Svenson Hair). They did a scalp and minituarisation study for me. She commented that I have a few hairs growing from the same pore, as well as minituarisation at same parts. She also said I had dandruff that was not flaky, and a sensitive scalp (some slight redness).

So she said that I had these problems:

1. Poor blood circulation (said my scalp was grey in some areas)
2. Dandruff clinging to my pores (thus blocking the new hair from growing out. Said it was worse than flaky dandruff)
3. Oily scalp

The treatment package was going to cost 5000 dollars, and she started to use the words VERY SEVERE as we got along, as she sensed my apprehension. However I’m not sure what she said was true. Can you help me verify the 3 points as above? Are they true??? I’m currently on Propecia.

Thank you very much. I hope no one gets pressured by such trichologists into a 5k package.

In my opinion, none of what your trichologist told you is true. We often grow multiple hair follicles (called follicular units) from one pore. If you have an oily scalp, you can treat it with shampoo formulated for oily hair/scalp, available at most drug stores or grocery stores. Grey scalp from poor circulation? Don’t waste your money! Now that I’ve saved you $5000, if that money is burning a hole in your pocket I suggest that you will get more satisfaction by donating some of it to charity.