Minoxidil and finasteride 2.5 years

/by William Rassman, M.D./0 /
Persistence is the plan that gets results in those people with sensitivity to these drugs. These drugs work nicely when you want to thicken up the thinning frontal area which indicates that the hairs that have miniaturized are probably still there and just need the boost.  This is a better result than a transplant can give you at much less cost. The main difference is that when it is medications that give you these benefits, you MUST stick to the medications or risk losing it all. A hair transplant doesn’t require any medications to keep it.

Beard hair vs Scalp Hair

/by William Rassman, M.D./0 /
I have a question about using beard-to-scalp transplants for additional coverage/density in people who have advanced balding and are out of head donor hair. I know that for beard hair grafts, there’s usually only one follicle per graft whereas for scalp hair grafts there’s usually two or more follicles per graft. On the other hand, however, beard hair is much thicker than scalp hair. So does that mean that if you are using beard hair to provide density/volume, you would need twice as many beard hair grafts to provide the same density as you would get if you were using scalp grafts? Or does the beard hair thickness offset that?

Alopecia Areata

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

The arrows show the irregular nature of the balding.  It is as if these areas are cut out of his scalp, devoid of hair.  This can be treated with appropriate medications in the hands of a skilled medical professional.  Too many young men who have such conditions, first try all of the medications offered on the internet through various forums. For me, it was an easy diagnosis and a diagnosis I would drill down by first performing a trichoscopic examination, then probably a biopsy to confirm what the trichoscopic examination showed me (signs of alopecia areata, of course)

Female hairline created for man in illegal clinic in Turkey

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

I somehow misplaced the photo.  It shows a man who went to an illegal clinic in Turkey and someone created a female hairline for him.  The arrow would have pointed to the temple peak which is largely covered with the hair transplant making his hairline presentation the perfect female hairline.  Sorry for the absence of the photo, but my point is that you should make sure that whoever is doing your transplant knows what they are doing.  Unfortunately, taking out these female pattern hair grafts is going to be expensive. If he keeps it, everyone will know that something is wrong with his look.

Am I receding?

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

A good photo to show your recession should be a frontal view with your hair pulled back and your eyebrows lifted high so that the creases on the forehead show up. This will show the anatomical landmarks to measure where your hairline belongs and more about what the shape should be. A normal hairline is one finger breadth above the highest crease of the furrowed brow. Anything higher is recession. I can only guess that this man doesn’t have recession because the frontal hairline is flat, which is an evolutionary step towards a mature hairline, but if he supplied me the photos as I outlined above, I could be more definitive.

 

Male gets female hairline in Turkey

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

When untrained people do hair transplant surgery, besides risking the lives of the patients, the things that are simple for me, a skilled hair transplant surgeon, is not understood by people who haven’t been trained in the field.  From my intelligence in the field, Turkey has hundreds of clinics staffed without a skilled surgeon doing the surgery.  Some clinics have a doctor who ‘fronts’ for the marketing operation but doesn’t know anything about doing a hair transplant.  Here is a picture of an unfortunate young man who saw a bargain and purchased a hair transplant in Turkey.  What he got it, was a female hairline that goes down to the temple peaks on the side.  I doubt that he wanted to have the hairline of a woman, but now he will have other problems once it grows..  The arrow points to where the temple peaks (now buried in the rounded female hairline) should be prominent.  

A doctor’s opinion on finasteride and pregnancy

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

“I don’t know of any data that shows finasteride deleterious for men wangling to conceive but I do tell my patients that if they know they are actively trying to conceive then it is prudent to go to topical. Although hundreds of thousands of men have probably conceived while on finasteride without any know association at the same time no one is going to study to issue to see if we get birth defects by taking medications purposefully while trying to conceive. It just depends on how conservative you wish to be.”

                    Ryan Welter, M.D., PhD

I AGREE WITH DR. WELTER

Hair loss from medications

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

I’ve been browsing your blog for weeks now trying to find an answer My hair loss progressed after taking two medications 4-5 months ago (sertraline and abilify) I also had some severe side effects due to these medication my hair line was changing prior to starting these meds but i feel like it has accelerated since the then

Many medications have hair loss as a known side effect, however, if you were thinning prior to taking these medications, it is highly likely that what you are now experiencing is the result of genetic balding. Contact a good doctor in your area to get confirmation of this.

Does finasteride make my hair better?

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

Is finasteride 3 times a week enough to strengthen my hair ?

Finasteride is not like a product that when you add it, you see immediate results. If it thickens the hair, it only does it because it is reversing miniaturization and therefore will not impact hairs that are not miniaturized.  Finasteride does one of three things well: (1) stops hair loss, (2) slows hair loss and (3) reverses hair loss. For these benefits you must continue using it or the benefits go away. The recommended dose is 1mg but for those who want to use less, a half dose is 80% as effective and a 1.4 dose is 50% as effective.

Hair drugs are for life!

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

Doc, it is known that stopping minox will cause minox-grown hairs to fall out. Therefore, minox is a “for life” drug. Is it the same story for topical rosemary oil? Also, do you know if rosemary works by dht inhibition like finasteride or by increasing circulation like minox?

I don’t know how Rosemay Oil works, but I suspect it is a DHT blocker. All of these drugs must be maintained to keep the benefits. The only way to not depend on any treatment is to get a Good Hair Transplant.  Minoxidil may increase circulation but that is not how it works to grow new hair