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Dr Rassman
Do you have a list of doctors in the US that use and are skillful with the Densitometer?
Thank you

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Go to the ISHRS website to look up doctors who specialize in hair diagnosis, treatment or hair restoration. Good dermatologists should also fall into this category. When you call their offices, before you make the actual appointment, ask them if they map out the degree of miniaturization on the scalp for quantifying the extent of balding or thinning. That is a better probing question than asking about an instrument I invented, since other doctors may not know it by the actual name I gave it. (FYI, the U.S. Patent I obtained for this was U.S. Patent #5,331,472 ‘Method and apparatus for measuring hair density’, issued July 1994).

 

Hello Doctor,
How effective would a combination of propecia and Minoxidil be to fighting hair loss in the initial stages ? My hair started thinning in the past 11 months and now the scalp is noticeable. I recently started propecia and the Dermatologist advised taking Minoxidil 5% with it. I cant do it twice a day so he advised to apply it at least once a day at night. My question is I cant commit to the cumbersome process of applying it for more than 3 months. Will it benefit me if i take the combo for 3 months and then stop minoxidil 5% but continue on propecia indefinitely ? Will I gain/thicken my hair with minoxidil 5% once a day and will it sustain after 3 months once I stop taking it ? Please Reply
Thanks so much

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I get this question quite a bit. Using minoxidil once a day has limited value. Using it for 3 months and then stopping has no long term value — once you stop it, you will lose any hair you may have gained. For men, Propecia is the right thing to do for hair loss caused by genetics. I generally tell people to start Propecia first, then to consider minoxidil after a year, only if the result from Propecia does not get them what they want. There is no guarantee that one or both will work for you.

Using the higher 5% dose of minoxidil may be more effective than the 2% solution, but unless you are really willing to commit to the process required for either of the drugs, do not embark on that path.

 

Hello, I am 19 years of age. Over the past year I have found that I have lost alot of hair. All my life I have had thick hair. my whole family has relatively high hairlines, even my 13 year old brother. I have always had one although there was always alot of hair around the hairline. In recent months my hairline has been receeding noticably and I have found that hairs have come out when showering, sometimes just randomly in the day, and I find them in my mouth. There are no patchy bald spots. However the hairline is extremly thin and around the crown it has also thinned out. Even the hair at the sides do not feel half as weighty as they used to. I used to badly need a haircut every two weeks, now although I still do at times, it is more in the vain hope it will make my hair look better. It is whispy looking on top also. I also find my scalp feels odd although this could be in the mind. It has all happened suddenly.

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You need to have your scalp mapped out for miniaturization to determine if you have genetic balding. If you do, it will follow a pattern much like those shown on the Norwood chart, as your hair starts to thin in these patterns before it becomes bald. Over 50 years ago, General MacArthur said, “Old Soldiers never die, they just fade away”. I will rework his quote by saying, “Hair never dies, it just fades away”. Some day, when hair cloning starts up or we figure out the missing link in the pathway that stops the hair from cycling in the normal manner, we might be able to revive those hairs that are present even in the baldest of men, but at age 19, lets start to crawl before we walk. Don’t live in fear of what may not be. Get a good doctor to diagnose you and then treat you appropriately, if treatment is needed.

 

In a recent article in the Journal of Urology, an article was published which addressed the relationship between prostate cancer and the drug finasteride. The authors came out of various universities (Dr. G. Andriole was the lead author, Ref: J Urol. 2005 Dec;174(6):2098-2104)

Simply stated, what I read suggested to me that they reviewed the 7 year Prostate Cancer Prevention Trial that was finished a few years ago and published in the New England Journal of Medicine. The conclusions of the original study showed that this drug (finasteride 5mgs) reduced the appearance of prostate cancer by a statistically significant degree. There were some questions about the ‘control’ group when compared to those that actually received the drug. These authors suggested that the difference in the severity of the malignancies that were identified between the two groups may not have been real, but rather they were the results of patient selection criteria based upon blood testing, amongst other things. This group still did feel that prostate cancer chemoprevention with finasteride needs further research, although I personally believe that they are ignoring good statistical evidence to the contrary. Keeping an open mind is always good.

Please note that I just wanted to share what I read with the readers of this blog. I do not own Merck stock and can not benefit from any opinions expressed here.

 

hi, i’ve had two hair transplant procedures in the past. over the last couple of years i have just been shaving my head. i feel very uncomfortable going anywhere without a hat because of my scars. i would just like to be able to shave my head without the scars being so obvious. they are mostly right at my front hairline. can i go to a physician to have the transplants removed? and if they are removed will my scalp where the transpants are taken out heal so those little puncture holes are not as noticible? or could a procedure such a dermabrasion or laser help to smooth out the area? thank you

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Without seeing you it would be difficult to make an assessment. Please send photos to the email address on the Contact page.

Generally, it is difficult to put you back in time to the days before you had your hair transplanted. With that said, we can reverse it in many ways, and sometimes it might be brought back to the “before” status. I like to tell my patients that I have good news and bad news about hair transplants: they are permanent, so get it done right the first time. If you are amongst the unfortunate that did not time your procedure correctly with current technology, then the good news is that there is a great deal of experience now in removing or hiding the ugly plugs of the older types of hair transplants.

 

What are your opinions on the techniques and procedures of Dr. John Cole, such as his FIT procedures which he acknowledges was developed from your FUE. However, the FIT is allegedly an improvement. Also, what do think about his claims regarding Body Hair Transplants. I know you have made previous comments regarding BHT’s. However, I am asking specifically about Dr. Coles procedures regarding BHT.

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FUE and FIT is exactly the same procedure, with some technique variations. There are a number of technical ways to do it and FIT is a proprietary brand name developed by Dr. Cole to show some unique identification for him. Body hair transplants are new with not much validation from other doctors. There are only a few patients with any history to the process and we do not know much about success rates in, let’s say, 100 patients overall. I am not surprised that they may work, but body hair is limited in numbers, usually growing as a single hair unit although there are some two-hair groups. The hair has a different character than scalp hair, but Dr. Cole’s claims have no real science with them, although I am not saying that it is not true, just not proven scientifically. I would not jump into it just yet. It is, in my opinion, still an experimental procedure.

 

Dear Dr.
I am a recovered burn patient from childhood with forehead scars that extend to my left temple area. I was able to grow my hair to cover it as a young man until my late 30’s. My hair started to thin and I now wear a hair system to cover and blend the non hair scarred area. Are hair transplants now being able to be transplanted into scarred areas that are cosemetically acceptable. I have been told that bloodflow below my scarred areas is still good. Thank you for your response.

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If your skin is what we call a full thickness, hair may be able to grow from it. If it is covered with a split thickness of skin and scar, it may not support hair growth. There are things that can be done today to bring your hair-baring skin here and may include a variety of surgeries like flaps, and balloon-stretching the normal scalp and rearranging it to cover the bare area. Some of the results are remarkable. I would be happy to give you an opinion and as you’ve indicated that you are in Southern California, I would suggest that you make an appointment with me and maybe together, we can address your problem. Please call my office at 800-NEW-HAIR to set up a free consultation.

 

Hi Dr. Rassman,
I was searching the web on the current state of hair cloning and came across an article from WebMD. From the article, Dr. Washenik talks about how hair cloning will be ready in 3 or 4 years. What’s your take on that? Thanks

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Dr. Washenik is a reliable source. Like me, he is overly optimistic on some things, but I believe that his timeline have not panned out in the past, so I would expect the same for the future. I do believe that hair cloning will come, but because of legislative challenges, I would doubt that we would be allowed to offer it without FDA and government policy changes, which will take years. The priority of organ cloning must go to the people who are at risk to life (liver, heart, and brain problems) well before the government will allow it for its cosmetic value (in my opinion, of course).

 

How many sideburn transplants have you performed and what is the success rate? How much do you charge per follicular unit? Where are you located?

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Although I couldn’t guess the exact number, we have done many sideburn transplants, more in women who had plastic surgery problems following a face lift, rather than men. However, they work wonderfully for both sexes (see Other Hair Restoration Photos).

The fee is $6/graft, or for those with more flexible schedules we have a Standby fee at $5/graft. We have a minimum surgical fee of $3000 (this includes everything except a basic blood test. Our fee includes anesthesia fees, medications after surgery, etc). My personal charge is higher per graft; the minimum fee is $3,500 with me at $10/graft, whichever is greater. We have locations in Los Angeles and San Jose, California.

For more info on pricing and locations, please see:

 

I am 22 years old and have been taking Propecia for 2 years. Although the hair loss slowed a bit, I now see the rim of hair that my dad has around the back and sides of his head. What can I do? Are hair transplants the only option left for me?

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You situation reflects that there will be progression of hair loss over a period of months/years, probably taking you to your father’s pattern sooner or later (sounds like sooner, rather than later). The variable response to finasteride speaks to the complexity of the factors at play. Included in these factors are variables like the sensitivity of your androgen receptors, as expressed by androgen receptor gene polymorphism. Simply stated, we can not come up with one treatment for all people, as each of us are different and have different sensitivities to the hormone environment in our body. We make androgens in our adrenal glands as well, and these androgens impact the hair end organ as well as DHT.

It is possible that you might respond better to Avodart, but even that medication may not do what you want. Avodart is not approved by the FDA for hair loss, so if you find a doctor willing to prescribe it, you should weigh the disadvantages of taking it (see previous blog entries) and the safety factors that may relate to having children when you are on the pill.

If you can already see the Class 7 pattern in the mirror that your father is showing, much of what you have lost may not be reversible. You should be checked out for other diseases, but in the probable event that your hair loss in only genetic, then hair transplantation is an option that you might consider. If your densities are good, if you have blonde hair or become blonde, if your hair thickness is reasonable, if you are willing to style your hair to take advantage of hair redistribution, you might have an amazingly good response to hair transplantation. As a general rule of thumb, most good hair transplant doctors do not take on young men prior to 25 years old, but with good support from your family, adequate financial planning, and a maturity that can allow you (best with the help of a parent) to make an informed decision, then you should explore the hair transplant option with an ethical and experienced hair transplant surgeon if you do not try the Avodart option or if the Avodart option fails to solve your problem.

 

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