Fat cells moved from thighs grew hair

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

https://www.dailymail.co.uk/health/article-12804951/Stop-balding-process-injecting-body-fat.html

Although this is not a scientific paper, we know that body fat contains stem cells, so it is not unreasonable to expect that injecting fat cells into a scalp might stimulate hair growth.  I would imagine, however, that these hairs will require continuous injections to keep them there.  The hair that grows is indeed the original native hairs whose stem cells were still present.  Unlike a hair transplant that brings genetically lifetime hairs to the balding area, these hairs will likely require continuous injections to keep them growing.

How long to wait for finasteride to work?

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

Man on here I only see „3 months progress fin/min“ and those guys always transform from nw6 to a full nw1. I am currently 3 months on fin about 5 on min and I am not sure if I have any results (diffuse thinning). Maybe I am shedding maybe not i dont even fking now anymore diffuse thinning your hair looks one day great and the next day like you are bald as fck. Just wanted some reasureance if anyone of you still saw great results afterwards bc I am becoming insane.

Many times, it takes up to a year to see the results from finasteride. Finasteride always works either by slowing, stopping, or reversing the hair loss.  Be patient.

Oral minoxiidl at 1mg, is this effective?

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

My derm prescribed me 1mg oral minoxidil as they wanted to evaluate the effects of the drug for a month before they increase the dose. I am wondering if 1mg is effective enough and if anyone has seen results when taking 1mg? I currently use topical minoxidil 2 times a day.

Since 60% of men will not respond to topical minoxidil, the oral works on 100% of men. The 1mg dose is a reasonable starting dose. Your dermatologist knows what she is doing.

Class 7 pattern with persistent frontal hairline

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

This man wants advice on which medications and actions he can take to get hair to regrow.  This was my response:  “Without knowing your age, I can’t tell what is the best approach to trying to regrow your hair. If you are over 30, it would be unlikely even with oral minoxidil in combination with finasteride would be my suggestion.  I would add microneedling weekly to this mix. The miconeedling produces a very different stimulus for hair growth and this combination has grown hair on even men over 30 at times. Even if you are successful, what we don’t know is how long this success will last.

A hair transplant remains an option as well, but you have to have your donor density and your hair mass measured before you will understand what is possible for a man with your hair loss pattern.”

Doing something about hair vs doing nothing

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

I’m 22 and have been thinning at the hairline and a little on the crown for years. Still have my hairline somehow (very very thin, used to be thick as when I was 20). I started fin a few days ago. It feels so good that I am at least doing something to stop the balding progress. If I see no progress, at least I’ll have the satisfaction of trying. I’ve been using minoxidil only on my beard and hope to not use it on my scalp any time soon.

I suspect that you will see value in what you are doing.  You are doing the right thing!

I plan on stopping minoxidil

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

hi i have been on 1.25 mg finasteride and 10 mg oral minoxidil (liquid), and i got really great results but I decided to stop oral minoxidil and continue using finasteride minoxidil gives me muscle pain and damaged my jawline.  If I stop the minoxidil, will there be shedding? How long will it last?

The dose of oral minoxidil is too high, so if you are getting side effects. I would reduce the dose to 1.25mgs. It is stopping minoxidil entirely which produces the risks of losing all of the benefits, which might be the hair that grew due to the medication. High doses of minoxidil produce many risks to your health and your present problem is included in this assessment. 

What is success rate of oral minoxidil?

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

Doc what would you say the success rate of oral minoxidil is? Will it reverse the loss of my widow’s peak?

Hair growth occurs with oral minoxidil. This hair growth is not restricted to the scalp and that is the problem for this drug in women who don’t want body or facial hair. The widow’s peak rarely recovers with minoxidil.

Taking vs not-taking finasteride

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

Here are two examples that I would like you to comment on

1.someone took finasteride from 25 years old to 40 years old, then stopped taking it.

2.that same person never took finasteride.

Who will have more hair at 50 years old? what Im basically trying to figure out is what’s better for your hair, taking finasteride then stopping completely, or never taking it in the first place? thanks!

The studies are clear from Merck.  Men who take finasteride will have less hair loss over time.  I have seen this in my practice, when men on finasteride who stop it, regardless of age, lose hair within the first 3 months and that loss can be dramatic. I have had men on finasteride for 20+ years and if they stop it, they always lose their natural hair that was held in place by finasteride. 

Necrosis of frontal recipient area

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

The skin has already come off, and two soppy holes are full of pus.  This patient needs local wound care, debridement of the wound, and patience until the wounds close.  It might take a few months. It will be replaced by tough scar tissue.  This area can be transplanted again sometime well after everything has calmed down. In the thousands of cases either I or a group of my fellow doctors, we have never seen this type of complication. 

 

What to watch out for when selecting a hair transplant surgeon

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

There are some simple flags that I advise my readers to watch out for.  

  1. Using salesmen to meet with patients should indicate that the doctor has too much financial focus in his practice. I would stay away from that doctor.
  2. If you don’t bond with the doctor or if you feel that he doesn’t focus on your agenda
  3. If he doesn’t spend enough time with you.  A 5-minute consultation can’t really get to your agenda properly. Ask if you can meet with some of his patients; he may have something to hide if he declines.  I held monthly open house events for at least 2 decades, where prospective patients could meet with my previous patients.  Also, any dissatisfied patient could come to an open house and destroy my reputation instantly. 
    • A funny story: A practice with a heavy marketing budget saw the effectiveness of my Open House events. When they publicized their first such event, many dissatisfied patients went to their Open House and were escorted out of the office by their security. The patients were prepared and held picket signs in front of their office to warn possible attendees to avoid that clinc. Their first Open House was their last Open House.
  4. Ask about their credentials. What makes them qualified to do your hair surgery. If Hair Transplants do not reflect at least 70% of their practice, they may not be totally focused on hair transplantation.
  5. Do they offer both FUE and Strip surgeries?  Well-trained doctors can do both.
  6. Do they discuss your lifetime donor supply (in numbers taken by measuring instruments they share with you)?  
  7. Do they discuss the value of donor hair thickness and hair mass as it reflects the value of your situation in the total scheme of hair transplant analytics?
  8. Finally, do you like the doctor and find that he is honest and sincere? If so, that is a good closing point for your decision.  

Terrible SMP

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

These two unfortunately patients had some operator who painted their scalp under their hair.  When good SMP is done, you don’t see it because they are small dots mixing with the base of the hair shafts and they are not taken up to the frontal hairline.  As a consumer, you must be on guard against this type of work.  The best way to protect yourself, is to ask to meet comparable patients to what it is that you are going to do with SMP.

Fate of Miniaturized Hairs?

/by William Rassman, M.D./0 /
Do miniaturized hairs from AGA always end up dying of apoptosis? In other words, when the  hairs from DHT susceptible follicles miniaturize, is it guaranteed that they will always end up falling out permanently and those follicles end up dying and not growing any new hair? Or can hair miniaturize and remain that way indefinitely without eventually permanently falling out and dying?  I ask because most bald men that I see, even those who are older and whose hair loss has been stabilized or remained the same for decades, they usually still seem to maintain some hair in their bald
I have seen men with a Class 7 pattern that keep a few miniaturized hairs on their scalps, often right in the middle of the bald area.  Human scalps have some areas of remnant hairs that never die and seem to never go away.  Is that what you are talking about?  This is not the usual situation.  Most miniaturized hairs will eventually die off.