PDO Scalp Threading?

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

The treatment itself is relatively quick and painless, with no downtime and very little recovery. A local anesthetic is used for patient comfort .Very fine, hollow needles (think acupuncture) are inserted under the scalp, leaving behind a nearly microscopic thread which will create a foreign body response, triggering the bodies’ own natural healing mechanism. Threads dissolve naturally, absorbed by the body over the course of 4-6 months. This process of forced cellular activity will promote new tissue growth, improve circulation and ultimately help to regenerate the hair follicle.

PDO scalp threading is new to me. I want to see some published articles on it and its benefits and liabilities. I would not recommend it until I see some good published data.  It actually makes no sense to me because putting a foreign body in the scalp can only produce down sides that I can only imagine

Dutasteride vs finasteride

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

Hi Dr. Rassman, i have a couple of questions. I’ve been on fin for almost 4 years and I think I’m seeing thinning the frontal area if I get a prescription for dutasteride is it likely I will respond to dutasteride? And if I take my last Finasteride pill and then, the next day I take a dutasteride pill will dutasteride work instantly to stop DHT? Or is it over time?

I don’t have personal experience with dutasteride; however, it is about 15-20% more potent. It may therefore have more side effects as well. Dutasteride should be prescribed by a doctor as daily doses may be too much considering the half life of the drug which is 5-6 weeks.

What can I expect after FUE?

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

I just scheduled an FUT procedure that is estimated for about 2500–3000 grafts in my crown, with any extra going to the corners of my hairline. About 18 days after the procedure, I have a two-week-long unavoidable work obligation where I will need to interact with clients in-person. (Aside from this obligation, I can work from home for a while, which is why I scheduled the procedure for this time). I’ve done a little bit of research and haven’t really found any crown photos at 18 days post FUT, so I am wondering what I can expect. Will the redness still be obvious? This is more of a concern if I ended up having my hairline worked on, but I would like to know what to expect nonetheless.

I am surprised that you are having any problems. I would go back and see your surgeon. By the end of one week, all of the redness is usually gone along with any swelling and most people should not be able to tell that you had a hair transplant.  Most of my patients have an undetectable hair transplant within a couple of days. Here is an example of an FUE with 3200 grafts just 6 days after surgery: https://baldingblog.com/post-op-photos-6-days-after-3320-grafts/ 

Triggers for Alopecia areata

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

There are many triggers when you have the genetics for alopecia areata. A scalp surgery such as a hair transplant is a known trigger as well as other stresses in your life.  To get Alopecia Areata, you must have the genetics for it, as it is an inherited disease.

Is this early balding?

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

Does this look like the beginning stages of MPB? Have an appointment with a dermatologist in two weeks. Is finasteride my best option?

This could be early crown loss. Have the dermatologist look for miniaturization with a hand trichoscope. If it is, finasteride is a good drug for this

Norwood Class 7 transplanted density

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

Let’s say a man with Norwood stage 7 goes for hair transplant. Will the surgeon implants hair with uniform density everywhere or would the surgeon differ the density in different regions of the scalp? How does density differ across regions of scalp in people who does not have hair loss?

In a Class 7 patients, weighting the hair transplant is critical to achieving good results. The frontal frame to the face (hairline) should be stronger than the crown.

Miniaturization should be less than 20%

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

By the normal 20% or below miniaturization, does this include long terminal hairs that are thinner than normal ones? Dr. Parsa Mohebi refers to this normal level of miniaturization as “recycling follicles” so these normally cycling miniaturized hairs come back as normal terminal ones eventually?

Miniaturized hairs generally don’t grow as long as normal terminal hairs. As they get thinner and thinner, they usually get shorter and shorter and may just stop growing before falling out..