I’m Intrigued By Your Attitude on Shock Loss
Dear Balding Blog Contributors, I mean no offense by this post-I am genuinely just intrigued.
After reading 32 pages of baldingblog.com blog posts which mentioned shock loss, I was intrigued by the attitude that was expressed, which seemed to be ‘shock loss happens, deal with it-propecia may help’.
What intrigues me is that this attitude seems to be contrary to your role as pioneering doctors in this field. After seeing shock loss affect and no doubt traumatize patients paying large sums of money to GAIN hair, should you not be investigating treatments which may help to reduce it? I’m no expert, but off the top of my head I can think of drugs to reduce the immune system’s rejection of hairs, drugs to calm inflammation or stress in the body, topical drugs for the same end, dietary supplements etc.
Am I missing something, or is the attitude I have interpreted you as expressing a little negligent of the well being of hair transplant patients?
Maybe you are missing the point. We (at least here at NHI) do not recommend hair transplants to patients who are at risk for significant shock loss, but some hair loss will occur that is inevitable with or without any medication. There will also be some form of nerve damage with surgery (both strip and FUE) in the small cutaneous nerves that are all over the scalp. This will make the scalp feel numb for several weeks to months, more in some areas than others. There will also be some pain while we’re at it, which may persist after the procedure (minor pain to some and rarely severe to others). These are just a few of the risks associated with surgery. We do not take this lightly. It is an educational and informed process that all surgery candidates go through. You don’t just show up to have surgery and get great hair. There are always these risks that need to be considered for the benefit of looking better (more hair). If any of the risks are unacceptable to both the patient and the surgeon we do not go ahead with the surgery.
Some patients are rightfully concerned about shock loss with hair transplant surgery, but they should not be obsessed with it. Reality is that even without surgery, hair loss will happen if you have the balding gene (pattern). That is the reason why people have surgery, right? And the timing of surgery is highly variable for each individual who comes for a consultation. If the risk of shock hair loss is too great then we will hold off on surgery with medication until the benefits will outweigh the risks. An example of this would be someone in their early 20’s who is rapidly losing hair and is not on medications (like finasteride), but still has a decent amount of existing hair to cover their thinning. These are things that cannot be conveyed completely on a blog, as each case is different.
To be clear, there have been no medications that completely stop genetic hair loss or shock hair loss. At best what we have seen in our 20+ years in practice is that Propecia helps with shock loss. If you can point out the drugs you are referring to which “reduce the immune systems rejection of hairs”, please let us know. Immune suppression is a dangerous process. Take note, however, anti-rejection types of drugs you may be referring to have many unfavorable and sometimes dangerous or deadly side effects. One minor side side effect is… hair loss. Not so simple, eh?
Benjamin
“Why” would Dr Rassman know why there hasn’t been any ways to prevent shock loss? “Why’ does anyone know why something has not been discovered? Give it a rest.
Benjamin,
Its pretty obvious. He is a transplant surgeon. Its like asking a mechanic why they don’t design engine parts. That is not the role of his (meaning any transplant surgeon) job. His job is to take research and apply it to his practice. He implements medicine. He does not research it, develop formulas, design and fund clinical trials, etc.
You need to ask universities and pharma companies this question. As soon as they asnwer these questions, then I am sure the good Dr will implement it in his practice. Until a clinical trial is run, there are no vitamins, anti-inflammatories, lifestyle changes, etc that affect shockloss from the point of view of a medical practitioner. There is a process here. Medicine is not based on speculation.
Any competent hair transplant doctor will ensure a prospective patient is taking either finasteride or dutasteride for some period before the transplant procedure, and for some time after. I personally have been on dutasteride for 2 years, and experienced virtually no shock loss even after having a 4,000 graft procedure.
I think my question was very reasonable, and I respect the few reasonable responses I got. But in light of Jacob’s spiteful response-exactly what blog conduct should not be like-i’ll stop here. Calling people idiotic and rude without grounds is rather ironic, no? I also never asked for a cure on my behalf-you know nothing of ‘my behalf’. Lastly, he says ‘there are some patients who should be rightfully concerned’-not that it is a minor issue, as you say. Yes, Dr. Rassman wouldn’t operate on these patients-but if the risk could be reduced/eliminated further in any way, then maybe he could.
The reason I posted this question was because Dr. Rassman is more than just a doctor who gives people hair-he is heavily invested in RESEARCH and in his patient’s wellbeing. I thus wondered why there had been no research (across the whole field-not just at NHI) into further reducing/eliminating shock loss risks for patients who are often younger and thus more personally affected by hair loss. Dr. Rassman chose to put the post on the blog-so it’s obviously not as ‘stupid’ or ‘idiotic’ as you say.
I just wish comments could be declined, because yours most definitely should be.
Dr. Rassman you are doing an amazing job with this website.
However, I hate how a select few on this blog attack anybody that questions Dr.Rassman or doesn’t exactly conform to his views. We are not in a political debate here people, it is anybodies right to question the Dr. if they so wish, that is the point of this whole question and comments section.
Lets say a surgeon knows an individual is going to experience shock loss, what steps are taken to ensure the patient will still get the look he desires (what I mean by this, are more grafts placed in the area where shock loss will occur to compensate for the loss)?