Hair Loss InformationPhone Consults for Prescriptions? – Hair Loss Information – Balding Blog

Do you offer phone consultations for prescribing propecia? If so…what is the cost? I have been on it in the past but my script ran out some time ago. I really do not want to go to my family doctor for this again.

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Before starting more medications, you should get a metric (measurement) by having your scalp mapped out for miniaturization to determine if you have premature genetic balding. I prefer that you visit in person for a Propecia renewal so that I can evaluate your hair better. However, if you can not come by, then I don’t mind doing phone consult with proper photographs. My charge for this assessment is $85.

Hair Loss InformationTissue Expansion – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

I have read in a few your blog responses about a procedure called Tissue Expansion involving the insertion and inflation of a balloon into the scalp to create new tissue allowing for a effective scar reduction. Are you familiar w/ patients w/ HT scars that have used TE and if so have they been successful?

I’m interested in learning more about this procedure and it’s viability. I live in LA – would it be possible for you to refer a Dr. who perfroms TE?

Thank you for your insight.

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I would be happy to see you myself, where I would first assess your scarring problem. One must command the problem before recommending a proper treatment. I have been involved with tissue expansion for the past few years, but it is not the solution for everyone. If I can not manage the process, my ego would not get in the way; I would then refer you to an appopriate expert, that is, if you needed another opinion. First, let’s start with a visit to my Los Angeles office. Please call 800-NEW-HAIR to setup a free consultation.

Hair Loss InformationFirst Step for Teen with Thinning Hair – Hair Loss Information – Balding Blog

Hi doctor, I have been recently been encountering certain problems with my hair over the past 5 months, I am 16 years old (male) and currently starting my first year of college. First signs of change were with the texture and build of the hair, as it started to become much drier and thinner. Then the amount of hair that started to fall out naturally started to drastically increase, although I have naturally thick hair the changes that I am experiencing seem too unnatural, one example is the fact that I never really used to be able to see my scalp, now I am really feeling concious about it. I have great foundations of friendship in the school that I go to and the worry of acceptance isn’t preying on my mind too much. I have asked my best friend about it and she seems to see no difference in the appearance of my hair, but I still believe there is something wrong.

My grandfather had troubles with baldness as a teenager and was completely bald on the top of his head at age 20. Confident self image is something that I always like to pursue, I style my hair using straightening irons and using gel based products, which I have been widely recognised at school for, for the past two years. A balding head it something that is not really seen around my social groups, and I’m not quite sure how my friends would react. I haven’t consulted my doctor about it and I would really like some impartial, friendly advice on what to do next, whether I should consult my family or keep it quiet and hope it will go away. I would really appreciate your help in this matter as I have only spoken to one person about this and I haven’t been able to research it myself much. Thank you

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Go get your head mapped out for miniaturization, which will show if you are in the early phases of genetic balding. Especially at your age, it is too important to guess or work the answer blindly through the internet.

Hair Loss InformationRemedies for Psoriasis? – Hair Loss Information – Balding Blog

Iam a 40 year old male that has only suffered from Psoriasis for the last 4 months. Previously I have very thick hair, but already my hair is thining down the front centre of my scalp. What causes this is hair loss? is it the thick crusts of skin or the red lesions ?

What course of action would you advise for me as this is now starting to really affect my day to day life ? Are there partucular shampoos or remedies you would suggest above others ?

Many thanks in anticipation

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Psoriasis can cause hair loss due to stress, scratching and picking it, and from normal genetic process that run in parallel to it. The best person to treat your psoriasis is your dermatologist. I recommend that you learn more about Psoriasis at the National Psoriasis Foundation site. Also, please review previous blog entries regarding this.

Hair Loss InformationMegasession Results (with Photos) – Hair Loss Information – Balding Blog

What does a 3000 graft operation look like in a person with a Class 6 Norwood balding pattern, fine hair and moderate contrast between hair and skin color?

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The below patient is in his late 60s and had one hair transplant procedure of 3,164 grafts. The grafts were placed to cover the entire balding area. In helping you understand the issues related to fullness, the area covered placed about 6000 hairs (in 3,164 grafts) in an area that originally had 50,000 hairs. That means that what you are looking at about 12% of his original hair density (before he went bald). Clearly, the math points out that a return to his original fullness is not possible. Many times people ask me how many grafts one needs to get a full head of hair. The answer to that question depends upon the thickness of the hair shaft, the character of the hair (straight or wavy), the color contrast between hair and skin color (the lower the contrast the better) and the size of the bald area being treated. I have placed 3000 grafts into an area 1/4 the size of this man’s bald area and the results were a much fuller appearance.

There is a general misconception in the hair restoration community that one can tackle a man with this degree of balding and replace the fullness to his original look in one session with as few as 1500 grafts. Many unethical doctors make that representation and I find it difficult to ‘compete’ with a doctor who promises a full head of hair with half the number of grafts I showed here (probably at half the price because of fewer numbers and salesmen that promote such misconceptions). I try to show how important it is for today’s buyer to understand just what he is buying and what he can expect. Be careful when a doctor shows you just a single view of a result, places the photo in a shadow, and does not really cover the entire transplanted area. That is the reason we have open house events monthly and have been doing them for 14 years. Visitors can see and interview patients, examining just what they are going to get without tricks of photography or slick salesmen to tell you what you might want to hear, true or not. With that said, the man shown below felt transformed in just the one procedure. He wanted a second session to increase the fullness further and after these pictures were taken, a second procedure of 3000 more grafts were done with a similar distribution, though it is far too early to show the results of that procedure. Please click each photo to enlarge.

The 1st set (below) are the before photos.




 

The 2nd set (below), are the after photos, taken 10 months after one procedure.




Hair Loss InformationItch and Dandruff from Propecia? – Hair Loss Information – Balding Blog

Hi Doc,
I recently came in for an open house at NHI and it was very helpful. Unfortunately, I forgot to ask one question. I’ve been on propecia for about a month, hoping that it reverses some of my miniaturization (you said about 50% in the crown and 40% in the mid scalp from what I remember). Almost immediately after starting propecia a month ago, my scalp started itching and I’ve noticed slight dandruff. I’ve seen other posts on propecia as a cause for this annoyance, but never any scientific evidence (I believe there is evidence that Rogaine causes thes same effects).

I’m not sure if this is expected or can cause further loss due to irritation of the scalp; any inputs? I’ve starting using Novarel 1% dandruff shampoo to hopefully manage the itching/slight dandruff.
Thanks!

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Treat your dandruff as you are doing, as there is no evidence that Propecia causes dandruff. Wait out the 8 months. Hopefully with good dandruff treatment and shampoos, the problem will abate. Glad to hear that you came to an NHI Open House and I hope that others reading this blog will do the same. Our next open house is on Thursday, January 12, from 4-7pm.

Hair Loss InformationUsing FUE to Touch-Up Straight Hairline – Hair Loss Information – Balding Blog

Hi Dr. Rassman…
First of all, I want to thank you so much for creating balding blog, it gives us very valuable information from one of the top and best surgeon in the world. About five months ago, I had a 3000 graft transplant with Dr. XXXX in toronto to restore my hairline and part of my midscalp. growth is coming in good so far but I really dont like the hairline design. it is densly packed however the grafts follow and curve almost on a straight line letting everyone know its a transplant. I like the more jagged style where the hairline is kind distruped to give a more natural look like I have seen in some of NHI pictures. so I was wondering if you can probably FUE some areas on my hairline to give a more natural look, maybe 50-100 grafts depending on what you think is best just enough to distrupt the line pattern. Is there a minumum number of grafts needed for FUE procedures?? also is it okay to perform this procedure after six months of my initial transplant as I want to get this done ASAP. Thanks again Dr. Rassman

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The problem with straight lines is that they are too orderly, like Count Dracula’s appearance in the movies of the 1930’s. They accentuate a hairline when the hairline should be a zone of transition from a bald forehead to a thick head of hair. I fix these types of hairlines all of the time. Depending upon the color of your hair, it usually takes between 200-600 grafts in the frontal hairline to build a good transition zone. I wasn’t 100% sure by your email if you’d already had an FUE procedure or just wanted to use FUE for some “touch-up” work. If you have already had a strip procedure, it would be less expensive to do it with another strip procedure. An FUE procedure will work as well, but at twice the cost.

Hair Loss InformationWhat is the Megasession? – Hair Loss Information – Balding Blog

I found this story in my local news [from November 2005], Patients Thrilled with Hair Transplants. In referring to Dr xxx, it says “He’s pioneered a painstaking process using one-to-two-thousand grafts at a time.” I thought you pioneered this with the megasession. I’m just curious if the ABC news was wrong or this doctor is doing something unique.

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There is certainly some misrepresentation or failure to do adequate research here. I published information about the megasession in in early 1990s, and discussed the 1000, 1500, 2000, 3000 and 4000 graft sessions over a period of two years before anyone was doing this type of large session. In 1995, I presented 23 completed hair restoration patients at a medical convention in Las Vegas who had megasessions when most doctors were just starting to consider doing them. Why is this important, you may ask?

  1. If the doctor was the source of this mininformation, then his integrity is reflected in the statement. My publications on this subject in the various journals in the industry (see: Follicular Unit Transplantation Megasessions from 1995 as an example)
  2. The ability to do them reflects the focus that I pushed early in the development of this technology, which is to try to get the patient finished with as few surgeries as possible. I had coined the term ‘FastTrack’ for the ability to accelerate the time-line for a hair transplants into as few as one or two surgical sessions. That means that there was much to innovate as the technology that was available at the time I started this process was ackward for getting many grafts done at once. Take a look at the NHI Timeline, which will show when we announced what we did and when we did it. I would challenge others to produce such documentation, because it just is not there.

In the case of the article you are referring to, I am going to just assume that it was poor wording / research by the article’s writer. Be sure to be a perceptive shopper, always keeping in mind the “let the buyer beware” adage in your buying process.

Hair Loss InformationPost-Transplant Shampoo Recommendation? – Hair Loss Information – Balding Blog

I had my HT one month ago and have been searching for a good shampoo and conditioner. On the blog I’vee seen entries talking about Regenix and Nioxin, which you seem to think have had anecdotal evidence of working. Would you recommend one over the other, or do you think its a waste of money. I just feel like I spent a lot of money and want to protect my investment as well as possible.
Thanks.

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Use whatever shampoo you like, as none will be better than the rest in getting you to where you finally want to be after a hair transplant. What is most important is to get the ‘scabs’ off with good washing and then keep clean. Do not scratch your recipient area.