I am the doctor who pioneered FUE between 1996-2002, publishing the first journal article on the subject in 2002 as a result of 6 years of experimental work with many cooperative patients. I am the original inventor of he hair transplant robot holding two US Patents on it. I licensed the robot technology to Restoration Robotics, who made the ARTAS and we eventually purchased one, using it for a few years, eventually selling it. We found that the manual systems that were developed after the commercial robot were fully developed allowed us to perform FUE faster and more accurate than the ARTAS. Speed was important. Also, we found that the transection rate was higher with the ARTAS than with the good manual systems so we focused on the best of the manual system. We purchase every manual system available to compare one to the other and eventually found that some worked better in some situations and others in other situations. Having many types of manual systems allows us to always use the best system for our patients.
Has anyone had this happen? I’m using fin for MPB (obviously) but I noticed the other day, a hair I lost was part grey at the end, and suddenly turned black about halfway thru up to the root. And I just brushed this off, but I noticed the same thing on a couple of other hair today again too. I know for a lot of people fin darkens their hair. Mine is already pretty much black or extremely dark brown.
The change back to the original color may reflect reversal of miniaturization in some white hairs. This means that the drug is working. Not a usual finding however.
Dr, if my condition is not just stabilizing but actively accelerating would that indicate the treatment is ineffective? Should I be considering upping the dose of finasteride?
Many times when genetic hair loss accelerates, it can not be impacted by increasing the dosage of medications. Adding options might help. The choices are 1) finasteride dosed at 1mg (higher dosages are not better), 2) minoxidil 5%, 3) add microneedling if you are not doing it. Unfortunately, we don’t have the answer to many of those whose hair loss is moving fast to balding. Keep in mind that the genetically impacted hairs have a genetic life time which is defined by the number of hair cycles they can go through. Balding is the consequence at this time. Maybe soon there will be better drugs or approaches, but unfortunately the hair transplant seems to be the last stop on that train.
Please tell me about post finasteride syndrome, is it real? Is taking finasteride worthy it? Can you havd pfs for taking one to two months of using finasteride? your experience from finasteride? Thank you
If someone complains about permanent sexual side effects, to him it is real. Many doctors doubt the existence of PFS, but from the patient’s perspective, it must be recognized as a risk factor when taking finasteride for any reasonable length of time. I tell young men who have reported sexual side effect that it can’t be fixed with a lower dose, to stop taking the medication and as a result of this advice, I have never seen this in my practice patient population.
Minoxidil common topical side effects are:
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severe scalp irritation
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unwanted growth of facial hair
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chest pain, fast heartbeats
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swelling in your hands or feet, rapid weight gain
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a light-headed feeling, like you might pass out
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headache, dizziness, confusion
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flushing (warmth, redness, or tingly feeling)
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Allergy, flaking of the skin, dry skin
The one photos that is labeled one month old, shows the area beyond the necrosis where maybe the scalp skin will survive, but the hair most likely will not. The necrotic center of this lesion looks ‘angry’ to me which means it might have some infection around it. The second patient shows a more extensive necrosis and I would expect all of the skin will not survive and be replaced by scar without hair. Both men will need more work to fix this terrible complication which I believe reflects poor surgical management and anesthetic management with too much epinephrine
Hi Dr. Rassman, best regards. I recently did a blood test as per recommendation of my doctor before starting fin. I have 0.41nmol/l of DHT (pre fin). Should I reconsider my usage of fin based on these results?
The blood level of your DHT should not dictate the dose of finasteride that you take. The dose curve shows that 1mg is the best dose, 1/2 mg is 80% as effective, and .25mg is 50% as effective as the full dose. See the graphic that demonstrates it here: https://baldingblog.com/finasteride-competes-with-dht-at-the-receptor-graphic/
The stem cells you want to reach start at 1 – 1.5 mm below the skin edge. You want the needles to get to these stem cells, so 1 – 1.5mm needles should do the job
David shows that he still has his rounded juvenile hairline that he had when he was 5 years old. No sign of balding and I suspect it will stick with him for the rest of his life.
I felt terribly sorry for the poor man who went to a provider to get Scalp Micropigmentation as shown in these photos. Hopefully, they can be removed with an appropriate laser. Be sure that your provider knows how to do SMP by asking to see a few of his patients.
Hello Doctor, may I ask if microneedling could induce hair regrowth in an area of the hairline that is completely bald?
I believe that it may be associated more with how long it has been bald there. If you are under 26 years of age, then the balding area might still have active stem cells but if you are 60, the stem cells might have died off by now.
Calling Men ‘Bald’ Counts as Sexual Harassment, UK Tribunal Rules – Bloomberg
Rassman Opinion: I believe that the context of the use ‘Bald” is the main issue. If it is used as part of other derogatory smears, then it may be clearly used as part of some ‘harassment’. Many men use the ‘balding’ term as part of their conversations with me and I likewise, will use it in a medical or social context as part of my work and would not consider it sexual harassment when I ask a man for his family balding history. Men use it as well, often in conversation without mal-intent.
As promised I am entering in the 7 months with complete photos took each month.
Routine:
finasteride 1mg every morning when i wake up
minoxidil twice a day
zinc + D vitamin 3 months cure After dinner
cafein + kératin 3 months cure After dinner for better absorption
microneedling once every 2 weeks at 0.5 to 0.75mm with 16 needle dermapen . If i go more than 0.75mm = bleeding which i do not want
15mn head massage twice a month
t gel shampoo once a week max.
essentiel oil shampoo that i have made (Cedar + ginger oil)
Amazing! This is strongly the work of microneedling plus help from everything else.
I am very impressed with the results, especially the new growth that is evident over the past 2 months since he added minoxidil (you can see the 2 month growth because the hairs are short). He added minoxidil just 2 months before the last picture was taken and he is clearly a minoxidil responder
