Does being poor mean I can’t get good hair treatments?

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

Just say that a cure was found, I am 100000000% sure that you’ll be only able to get it done in a professional environment (like PRP), also unless its patent drops it’ll be ridiculiously expensive (I think at least 300 bucks a month at best). Richer people will be cured, having hair will be a financial statement. Us, the middle class-lower class balders will be received even worse by the population. 

AS PRP doesn’t work predictably, you are not losing out. Microneedling with minoxidil works as good if not better than PRP and it is far less expensive, see here: https://baldingblog.com/go-looking-prp-used-hair-transplant-good-thing/

The Best Hair Transplant in the world (from Reddit)

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

It will look like this:(but with super dense hair on top). https://www.instagram.com/p/B3mu4kVATpY/?igshid=1m9ypmz655qgo. We have in the safe zone about 16k Follicles in the donor zone which resist to DHT (hair for life).  But in HT the surgeon don’t want to over harvest ur donor zone .  So u can get 7-8k follicles which can create full coverage. (Kinda) . But what if he pull all the 16k? Ur hair will be super dense with dht resistant. Next step : go to smp on the donor zone and shave the horse shoe every 2-3 days. Results the most maximum dense HT in the world , with clean shaved looking side and back.

There is no such thing as the best hair transplant in the world. Everything is relative so I will play this out a bit for fun. Assume that a very bald man has lost 75%+ of his hair, so realistically, nobody can replace hair for hair the 75% of the lost hair with half of the remaining 25% hair in the permanent hair around the back and sides of the head. If you move the entire 25% of the permanent hair to cover the advanced balding pattern (crazy to do this), then at best the new density would be only one quarter of the original donor density in the balding area AND the entire donor area would be completely bald. If someone then moves to add SMP, it wouldn’t be hair in the donor area.  Hair transplantation has limits and achieving your original density is rarely needed nor appropriate to have a full looking head of hair.

What is the final word on sexual side effects and finasteride?

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

I’ve heard stories about people who quit fin after 10 or so years and feel so much more better, or people who suddenly start experiencing side effects after a long time of taking fin. Is fin safe to take over a long term period?

I have been on it for years and many of my patients as well. If you don’t get the sexual side effects (which are real in 2-4% of men), then most of the changes over decades on the drug are most likely related to normal changes seen in men who develop Erectile Dysfunction.

Hair loss following rapid weight loss

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

I have been shedding hair like crazy during the last month. It may be from shock due to losing 10 lbs of weight but I don’t know how rapidly I lost the weight. I am eating less carbs and more protein though. If the hair loss is due to shock how do I reverse this? I don’t want to start eating loads and regain the weight. 

Rapid hair loss following a loss of rapid weight loss is common. If you have the genes for hair loss, then the hair loss induced by the weight loss may not be reversible in men.

Did my finasteride fail to work?

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

26 male, just over 8 months on finasteride 1mg. No crown thinning but recessed temples at Norwood 2.5. Nothing has changed progress-wise. If anything my hair has thinned more around the temples. I hate styling my hair. Is there no hope?

Many times, finasteride works by slowing or stopping the hair loss, not reversing it. If your on it for a while and then stop it, you might find out the hard way that it was working for you. If you are not having side effects as most men don’t, then continue with it because it does slow down the hair loss as shown here: https://baldingblog.com/5-year-growth-plotted-with-propecia-compared-to-control-group/ . This chart shows that finasteride does slow the loss down.

Hair and self-confidence

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

I’m balding since i’m 23 and since then i never stopped looking at my hair in the mirror every time or looking at older pictures and my eyes goes to my hairs. Or also when i’m outside looking at peoples hair and comparing to mine or telling that guy has beautiful hair why not me..  Even now i’m 31 and i still do it it’s been more than 8 years that i do that. Fin saved me and got my hairline from 3 years ago (where my hair loss wasn’t so obvious) So i’m less sensitive to that but i’m still looking at other hairs and also mine every day

Your story is typical.  Most men who see hair loss recognize for the first time that they are aging and nobody likes that reality. One of my sons noticed that his soccer skills have precipitously fallen down in the past few years and as he was always #1 in scoring, he now plays second class to the younger guys.  We all, sooner or later, will recognize that we are getting older, sometimes it’s the hair, sometimes it’s the body’s performance, sometimes it is in the death of a friend way before his time.  From the many celebrities (actors and musicians) I have worked with over the years, I found that their hair was critical to their art. Getting their hair back with drugs or a hair transplant gave them peace of mind so that they can focus on the things that are really important once their hair situation is a thing that they don’t have to deal with in the present.

I want two FUE and one FUT

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

If a patient gets two FUE’s and then later wants to do an FUT, will there be a risk that the two FUE’s will deplete the donor hairs for FUT regions in the future? I am thinking of getting two FUE’s in Turkey and then later when I can afford it get a big FUT in America with maybe Dr. Lindsey in Richmond because I can stay with family near there

Suppose the patient is like a NW2 with a very large / dense donor supply.

In an ideal world, if you are going to do both FUE and FUT in separate surgeries, you are better starting with FUT because the reduction on donor density is less and the FUE will be more successful in harvesting more grafts. The reason for this is that the entire back of the head stretches, reducing the impact on the 3 inch high donor area with the first a large FUT session.

I generally like to put together a Personalized Master Plan for each patient balancing donor supply with the present and potential balding.  You may be over-doing the grafting without such a plan.  Be careful not to jump on the bandwagon with too many grafts harvested from the donor area and get a balding donor area.

Damaged hair grafts from FUE (photos)

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

The surgical team placed all of these grafts so that can be placed into the recipient area and possibly to marvel on the job that they did; however, they shouldn’t have been so proud of these FUE grafts as many of these grafts will never grow. Note that the hairs within the grafts are cut in portions (transected).  See the zoomed in section identified (on the right)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Zoomed in area on the left

17 y/o female with possibly PCOS and hair loss

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

More and more often I’m getting comments from my family about having a balding area right in the front of my hairline. I’m only 17, and my mom and older brother don’t have any kind of hair loss like I do.  I’ve speculated that I have PCOS because of hair growth around my neck and missing periods and I didn’t know if hair loss was linked to that. Do any of you have advice or have battled this issue? It’s very embarrassing especially as a woman to have hair loss and I hope I can reverse these effects somehow before it becomes obvious to everyone around me.

Women with PCOS often get ‘male like presentations’ in their hair loss with hairline changes. The good news is that most PCOS women don’t bald to the extremes of men. See your OB/GYN and find out if you have PCOS. If you do, sit down with a good hair expert to map out what you are going to do about the hair loss.

19 with hair loss and in a panic (photo)

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

I’m 19 and went to a doctor about my hair and he refused to give me finasteride.  What can I do?  I am very depressed about this situation.

Find another doctor! Connect with me at williamrassman33@gmail.com and we can talk and I will prescribe it if indicated. You may not be balding and just maturing your hairline but I can work with you on this over the phone to find out what it is that is bothering you.

 

Microneedling without finasteride, is this OK?

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

I have decided to start microneedling but I do not want to use minoxidil or finasteride. I am very worried about the possible side effects and also, I heard that once I stop taking them, hair fall is going to begin again. Finasteride is a definite no no for me, as I used to suffer from depression and anxiety and I am not willing to experiment with it again.  So should I bother to start microneedling without these? Is it worth my time, effort and money?

The report indicate the adding minoxidil to microneedling is better than microneedling alone.