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I am considering a hair transplant procedure. would you rank the following doctors based on the quality of their work (detectable transplant and actual results):

Five names were suggested by the sender but omitted by me:

Thank you.

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I feel that it would be wrong of me to pass judgments on doctors in this forum. I would rather ask you to look to my blog posting, The Truth About Cheap Hair Transplants. Although the article appears on the surface to be about cheap hair transplants, it actually is a piece about the very subject you asked about. I took a great deal of time to focus upon physician integrity and the quality of the transplants that are delivered, linking ethics and results of what is done, to the doctor and the medical practice. Essentially I provided the basis of a buyer’s guide to selecting a hair restoration surgeon. I also wrote a book, which you can get by download or mail. Our newhair.com site extensively makes points on how to educate yourself on becoming a smart buyer. I always suggest that you ask any doctor to attend something like our open house events so that you can determine first hand what the doctor is actually doing and what his patients think of him. The hidden benefit of such events is that most of the attendees, like yourself, have shopped around a great deal and they share stories about their experiences, so the shopping process becomes like a consumer report with first hand reports obtained from sources you could never get otherwise.

 

I had really thick hair up until I was 16 years old. Since then it is about 1/3 the thickness. I have tried vitamins and have tried to eat alot of protein etc to help. I am 52 (female) and after all these years I cannot help but notice a pattern. During the winter months after December my hair will have regrowth with new hair and actually thicken to the point that my scalp is not visible. Is is possible that cold and sinus medicines such as sudafed, cough syrups, and antibiotics [non penicilin] have ingredients that would contribute to hair growth? As soon as the weather heats up in the summer my hair starts falling out again by the brush full. What do you think? Thank you for your time and consideration.

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What you say is logical, it is just not what we normally see in humans. Why humans have developed asynchronous hair growth, why we do not grow and shed hair all at once and the evolution of this is not known. What you are suggesting is that in you there is some seasonal variation in your hair density and that shedding may occur as the seasons get warmer, I do not doubt your observations, but I do not have a basis for understanding it. I am convinced that in the summer when we sweat a great deal and get our hair wet from sweat, we may actually produce more friction when we brush or comb the hair. That might account for the hair that comes out when you brush your hair in the summer. Also, some people wash their hair more frequently in the summer when they are out and about because they get it ‘dirty’ more easily. That might explain what you are observing. Clearly, there is a suggestion that there is some middle ground in your history and that some climate problems do occur in the summer in your situation. Do you live in a warm/hot climate?

 

I am 22. I have always have had thin hair. Three years ago I was thought to have alopecia areata, and was given kinacrt injections for about 4 months. They helped a bit, then I took natural cream for a while. How do you find out what you have and if you have the MPG gene? Does body building itself (without the use of steroids), given the fact you have a ok diet,impair your hair or help hair loss? There is talk about some steroids being safe for your hair. Does this include people that have thin hair or are suffering from MPB? Thank you

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Steroids are not always safe to use, and that is why it is regulated by prescription administration. I think that your question is: Will body workouts where muscle mass is built cause hair loss without taking exogenous steroids? If that is the question, I would think not. But if you had Alopecia Areata, then there is much going on that requires an expert to understand your questions. Please address them more specifically either with your doctor or to me if I did not answer what you had on your mind.

 

Dear Dr. Rassman,
I am a 17 year old and have been losing my hair for about a year and a half. I started losing it while I was taking Accutane, and it hasn’t stopped since. I went to a dermatologist and he said that it was MPB, and he recommended I take Propecia. Is there anything else I could take or use that you would recommend, such as Revivogen or the LaserComb instead, as I am frightened of the possible side effects, considering that my cousin took Propecia and had sexual side effects?

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If you have MPB, then Propecia is the appropriate medication for you. Although the other things MAY have value (I am not saying they do), Propecia is in your best interest in that it WILL have value to you. Don’t gamble with your hair, for unlike a slot machine where you can always win more money, the hair gamble is irreversible; you can’t go out there and win more.

 

Happy New Year Dr. Rassman, thanks for your great work on this site and in real life. Baldingblog is not only informative, but it’s usually fun to read too.

My question is about your reference (in a previous blog answer) to the conference about FUE this past year. Who was the one doctor who you said showed good FUE yield?

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Thanks for your kind words. To be honest, I am not comfortable with identifying doctors that are better (by rumor) than others, unless I personally observe them myself over a few difficult cases. It can be easy to get close to 100% yield from an FUE in a “FOX positive” patient, but as I do not know the classification of the patients presented at the conference, I can not rate any doctor based on their yield unless they were classified on the FOX system that we defined. If I recommended one doctor who has 100% yield on a FOX 1 class patient and then if you went to him and were a FOX 5 class patient with a poor yield, then I would have done a disservice to you (see Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation for full details about the FOX test). Your best bet is to challenge the doctor by asking for his yield. If he does not want to address this or did not understand your question, then you should get out of there. I always classify my patients before doing the surgery.

 

I am a 39 year old female experiencing hairloss all over, with more concentration in the frontal area. I became infertile with low estrogen in my early 30s, went on testosterone cream supplement for 8-9 months after that, but primarily suspect that my hair loss is due to the L-tryptophan I’ve been taking for the last 2 years for my mood, which has worked wonderfully for me as an antidepressant (from 1000 mg to 2500 mg.).

If I get off the Tryptophan will my hair grow back? Otherwise, I may need a referral for a doctor in the San Jose or San Francisco Bay Area, and to find another anti-depressant…that doesn’t cause hair loss???

Thank you

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There are some suggestions that tryptophan can cause hair loss and yet other suggestions that it does not effect hair loss. As a metabolic intermediate in the conversion of tryptophan into serotonin (5-HTP), some believe that in selective sensitive patients it may cause hair loss in its derivative form. Chemotoxicity is not my specialty and this is frankly beyond my skills and knowledge. Your conclusions on finding a doctor that can manage your anti-depressant medications is appropriate, but I do not have a referral for you. Sorry I couldn’t be of more help.

 

Im 20 years old and I am noticing my hair thinning on both the front left and front right sides of my head. Receding hair does exist in my family, however, for a while I had been excessively masturbating. This may have also been a cause, so Ive heard. What do you think? Is it possible for my hair to grow back thicker? And what would be the best thing for me to do?

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Thinning hair does come from family genetics and I gather from your question that you have the genetics in your family history, which may point to the most probable cause of your hair loss. Genetic hair loss is caused by the interaction between your genes, your testosterone (and DHT levels), time, and stress. The young man has a great deal of circulating testosterone (which creates DHT, which causes hair loss and thinning on the negative side and hair growth in beard, chest hair, and hair almost everywhere else on the body, except the scalp). Because testosterone levels are high, the sex drive in young men is also very high. Frequent erections (in some teenage boys as many as 20 times per hour in some situations) produce a desire to masturbate (when the opportunity is right) to relieve the sexual drive. High testosterone levels and the desire to masturbate are a perfectly normal response to both your erections and the hormone levels driving them. As a culture, we hide our masturbating with some shame but the process is a normal process.

Your frequency of masturbation will not impact your hair loss; only things like genetics, hormones and hormone blocking agents like Propecia will impact your hair loss/thinning. You should have your scalp evaluated for miniaturization and balding patterns. If you do have genetic hair loss, you should get on the appropriate treatment (like Propecia), for if you do not treat it, the family pattern may prevail. It is said that men who are bald, are more sexually active than hairy men. I do not know if this is correct or not or if that means that bald men try harder. There are better statistics for hair loss than the masturbating habits of young, balding men. I would suggest that you masturbate all you want, just focus upon getting your hair diagnosis and treatment going in the right direction by taking action, rather than ignoring the proper approach to your problem. Keep hair loss and your penis agenda separate and give both, the attention they need. If you are able to come to Los Angeles, visit me and I would be happy to evaluate your hair loss and recommend the appropriate treatment for you.

 

I’m 18 yars old and I noticed that my hair is thinning, turning dry, losing it’s silkiness and my hair density is a lot less than it was before. I don’t know how to say it, but my hair line is pushed back more than before. I also hair a couple of white hairs.

My hair used to be extremely healthy about 5 years ago, now after every time I use any shampoo or conditioner, my hair dries out and combing it is impossible.

My hair is just not the same as before and I would like to know what I can do to fix this problem. People have actually noticed me lossing hair!

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You should be checked out for miniaturization to be sure that you are not developing male patterned balding (assuming you are a male). Sometimes, our hair does change in character as we move from being a teenager to an adult. The movement of your hairline upward is common in men between 18-29 and it may move about 2/3rd of an inch back for the normal childhood ‘boyish’ hairline to reflect the mature hairline in a Caucasian male. Most Caucasian males (95%) experience such upward movement of the hairline. Frequent shampooing may tend to dry your hair by washing out the protective elements of sebum which can cause the situation you are talking about. By all means, visit an expert doctor for a consultation to make sure that male patterned genetic balding is not occuring.

 

what do you mean by “sufficient donor hair” …any link where there is a pic differentating between “sufficient donor hair” and “insufficient donor hair”?

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Hair transplantation requires that the supply of hair is more than adeqaute to meet the demand for hair. The smaller the balding area, the less will be the requirement for donor hair. There is also a ‘must’ where the donor hair must be in adequate quantities (density) and adequate quality (healthy). Low densities or poor quality of donor hair (the presence of Diffuse Unpatterned Alopecia, for example) means that the donor supply is insufficient to support a hair transplant.

 

i am a 23 year old woman, who has always had VERY thick curly hair. I have noticed that my hair is much thinner and requires many more wraps of the hair tie to put it up in a pony tail. I am very upset and wondered if you had any clue what is going on. I do not have a receeding hair line or anything. how stressed out does a person have to be inorder to affect their hair? thanks

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The internet is no place to get a good examination of your head, scalp, and hair. A good dermatologist should be a starting point. Some people get hair changes with age that is not necessarily diseased hair, and others get hair thinning and loss from medical problems (see Female Hair Loss on this site to see other posts that reference the many medical conditions that can cause hair loss). You need a good doctor to make an assessment of you and your problem. If you have genetic female hair loss, then hair loss can be a problem anytime you experience stress.

 

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