February 2006 – Page 5

February 22, 2006

Woman with Thinning Crown – Balding Blog

I’m a 22 year old female whose hair started thinning around 17 years old. I had two children recently, a three year old and a one year old. Just recently my hair just started coming out everywhere. It’s very soft and as I run my fingers through it just keeps coming out, mainly in the crown area. There is an irregular shaped pattern and slight thinning on top. What might this sound like? thank you

You may experience more diffused hair loss than you think, but it is just more noticeble in the crown area due to its shape, location, and lighting. It is hard to judge unless I can map your head with a densitometer or magnifying video camera.

February 21, 2006

Not Satisfied With Hair Transplant – Hair Loss Information – Balding Blog

I had 1000 fue 13 months ago — 850 in crown and 150 in front middle of my hairline. I have had reasonable results on the crown, but you can still see a bald patch on my hairline. 150 were placed in a small area in the middle of my hairline, but only approx 50 have survived. A slight wind and it looks like a middle part. Do you think the clinic I went to should rectify this?

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Any individual clinic is not required to replace what does not grow, but doing so is a good business practice. As you know, a hair transplant is a surgical procedure. There are two causes for non-growth:

A technical failure in the hands of the surgeon or transplant team (common when it happens). Team failure is most common because the majority of the graft management is in their hands. A good quality control process is required and many doctors are just not that type of manager. A transplant is only as good as the weakest person on the team. The term for this failure is “H factor” (human team factor).
A failure on your side for healing, skin problems, diseases (such as autoimmune disease), poor blood supply (rare but made worse if the surgeon does not use proper judgment in creating the density and matching it with the ‘hole’ size used).

The public tends to think of a transplant as a commodity, offered by various clinics with a marketing program to ‘sell’ and ‘sell hard’ whatever solution to balding and vulnerable patients. I am not against these clinics at all, but realize that a few of them will give you a better quality of work than you may be able to purchase from a doctor who does one or two such surgeries per month. The doctors who dabble in this do not have an organized team, so either they reduce the size of the transplant sessions to match the team, or they develop sub-standard techniques that are not at the state of the art. Some of the larger clinics with many offices, have variable quality of teams (in turn, equals variable qualities of work). I have seen the same national U.S. clinic produce good work from one office and almost malpractice work from another, yet each office publicizes the best sum result of all the offices put together. I have two offices now, one in Southern California (14 years) and one in Northern California (10 years), so quality control has never been the problem for us.

February 21, 2006

Taking a Lower Dosage of Propecia? – Hair Loss Information – Balding Blog

What is your opinion on a lower dose of Propecia. I have heard that some doctors recommend every other (or every 3) days dosing. What is your stance on this?

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Propecia has a half life of 4 hours. That means within a day, it is essentially gone from your system. Taking it every 3 days makes no sense, for you are undoing the DHT block that Propecia impacts. If you are going to reduce the dosage, then take a half tablet a day. I am under the impression that 1/2 tablet is 80% as effective as one tablet and 1/4 tablet is basically ineffective. I would want to know why you want to reduce the dosage from the most effective dose? The goal here is to grow hair, not see how little Propecia you can take.

February 21, 2006

Products for Covering African American Hair Loss – Hair Loss Information – Balding Blog

Hello doctor. I am a 27 year old african american male, with only a small degree of hair loss on the sides (by the temple) that basically are about the size of a quarter on each side that messes up my hairline. I have been looking at a couple products to get that look ok, and was wondering what your recommendations would be. I heard that Dermatch was the best and easiest to apply to areas on the hairline. Will this look good in our hair? Would toppik or coueve be better than this? My hair is very short and looks great when it is first cut, but when my the rest of my hair grows out and outpaces the small receding areas it doesn’t look so good. Let me know your recommendations, and thanks.

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Best to try these products on your own, as they are not expensive and can be washed off in the shower. The problem may be that these products work well behind hair, but not in frontal bald spots. Nevertheless, I’d try it first. If it does not work for you, then hair transplants may be the only other option. If you are gentically balding, I suggest that you get a working diagnosis and consider Propecia (if indicated) at least to stop the hair loss.

February 21, 2006

14 Year Old with Thin Temples – Hair Loss Information – Balding Blog

Hello, I am 14 years old and I recently cut my hair very short. I noticed the the area near my temples seem a lot thinner than the rest of my hair. I am asian, chinese to be specific. I was wondering what is causing this, or is this normal?

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Considering your age, I would suspect that you are moving toward a normal maturing hairline. Your hairline (including the temples) that are shown in the photo you sent show that your frontal hairline is still your youthful hairline. Changes in both the frontal and temple hairlines occur as boys become men (usually at age 18-20, but it can start as young as 13). You can either wait and see what further changes occur or take the next step to have your hair mapped out with a densitometer or magnifying video-camera for miniaturization which will give you a more thorough evaluation by looking for the patterns of hair loss (unlikely based upon these photos) shown in the Norwood Classification chart. Look to your family’s male members and see if their temples reflect the changes you are experiencing, just further down the road. Also, get your parents involved with this — at only 14 years old, your parents should be able to help you along the way.

February 21, 2006

Hair Loss from Hair Coloring – Hair Loss Information – Balding Blog

Hello
About 4 months ago I had some red/copper low lights put in my hair. Within about a week I developed several hives/blisters on my head, the worst of which was towards the back of my head where 3/4 seemed clustered together. About 3-4 weeks after this my hair fell out from that particular area (about 3-4 cms across). I’ve been to my GP who wasn’t very helpful and said it may or may not be an allergic reaction, and she did not know why the hair had fallen out. It’s now 4 months later and I appear to have some regrowth but it’s like baby hair, very fine and short. I can feel it with my finger but it doesn’t cover the bald spot as I have very dark brown hair. Will my hair return in time, and what process does it take? Is it normal that the hair appears like baby hair? It may be an impossible one to answer, but roughly how long before the bald spot is covered and looking like my other hair?

I notice that most sites suggests hair grows on average 1/2 inch per month. Is this growth rate the same for hair that has fallen out and is growing back? I’m desperately looking every month for signs of 1/2 inch growth but wondered if the rate was slower/quicker for brand new hair. Thanks

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This is a tough hair loss question not only because it is tough for you to go through, but also because it is difficult to diagnose without an exam. You need to see a dermatologist or a hair loss specialist (but definitely an MD) so they can look at the spots with hair loss on your head. The reason is that the hair loss pattern and sequence that you describe could have been caused by many things including 1) a chemical alopecia (reaction to the chemicals used on your head) 2) an allergic reaction, 3) an infection of the skin on the scalp (by anything from a bacterial, fungal, or a viral source), or even 4) Alopecia Areata. Often, only a physical examination by a doctor and testing (sometimes including a scalp biopsy for microscopic analysis) will determine the cause.

The good news is that in most all the cases I have listed, the hair does grow back although it is impossible to predict how long it will take without a definitive diagnosis. In the meantime, see your dermatologist or hair doctor, stay away from the chemicals for hair, and take a photo to document for yourself how the growth is going.

February 21, 2006

Propecia After a Hair Transplant – Hair Loss Information by Dr. William Rassman

Dr. Rassman here’s my question. I am 40 years old and started to bald when I was about 36. Around then I bagan taking propecia and have encountered good results. Most of my hair has regrown. Anyway, here’s my question. From time to time I think about a hair transplant and I think about this as a means to stop taking Propecia. Am I fooling myself. Will I still be on Propecia after the hair transplant? Thanks.

With the good results you’ve reported, you should not consider stopping the Propecia. Hair transplants should be looked at as a way to augment the results, if you feel that the results now do not meet your objectives. If you stop the Propecia, you will go back to square one and lose all of the benefit you recieved from it in a matter of a few months. You need to sit down with your doctor and work this into a Master Plan for your present and future hair loss.

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February 20, 2006

Topamax, Low-Ogestrel, and Female Hair Loss – Hair Loss Information – Balding Blog

I have been taking Topamax sprinkle capsules for my migraines for almost a year (onyl 45 mg per day). After the first few months on the drug, I noticed more hair on the floor in my bathroom and that it was falling out when I ran my fingers through it. In November of this year, I switched my birth control pills to Low Ogestrel,a low dosage monophasic pill so as to keep my hormone levels more stable and keep headaches at bay. After doing this, I noticed an increase in my hair loss. Now, in the shower, there is hair everywhere. Hair on my pillow, and hair on my clothes. I’ve noticed that my hair looks thin at my widows peak and on the sides of my head. It’s frightening. I got off the Topamax two weeks ago and the hair loss has continued. I am going off the birth control this month to see if that stops it.

Just wondering if you’ve ever heard of these drugs causing hair loss? Perhaps the combo of the two has wreaked havoc on my body for some reason? My doctors keep saying “It’s possible, but uncommon.” I’ve had all my bloodwork done and every checked out ok.. I just want this to stop. If it is the pills, how long before it will stop?

Thanks for any help!

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Hair loss is associated with each and every one of the medications you use. I am sorry to report this to you, but these things have a cost in side effects and finding the balance can be difficult. Some people may be more sensitive than others. It may take months to see any regrowth after stopping or switching the medications. When medications are used in combination, it makes identifying the problem medication(s) more difficult.

February 20, 2006

Hyaluronic Acid, DHT, and Hair Loss – Hair Loss Information – Balding Blog

I want to know everything that you know about the connection between Hyaluronic Acid and hair loss. Why are there no products on the market combining this powerful connective tissue component with Minoxodil? Why can’t they just make a line of products that target hair loss from all ends, like tartar control, whitening toothpaste that fights gingevitis? By combining hyaluronic acid with collagen and minoxidil and DHT blockers wouldn’t hair be at its safest and sturdiest? Also, how come some people will have plenty of DHT and still not go bald? What is the specific chemical quality that constitutes vulnerability of a specific hair folicle to DHT? Instead of inhibiting DHT and affecting muscle mass, secondary sexual characteristics and sex drive, can’t the individual hair folicles be made immune to DHT’s causing hair growth to be inhibited. After all, isn’t DHT what made hair grow out of that folicle in the first place? I know I’m a bit of a hurricane, but I’m in love with a balding man and find myself as invested in his plights as he is, and I can see he is suffering from this.

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I found an article on the FDA website which addresses hyaluronic acid. See Science Meets Beauty: Using Medicine to Improve Appearances and do a “find in page” (usually CTRL+F) to search for hyaluronic acid.

DHT is only bad when you are talking about hair loss in genetically prone individuals. Maybe one of our ancestors understood the benefit of balding, but we have not figured it out. There are many solutions for hair loss in men. Propecia is a great drug if the hair loss is caught early enough. Also, hair transplantation works well for many people (see Before and After photos).

February 20, 2006

Tomato on Scalp Sunburn – Balding Blog

First let me congratulate you on an excellent website. It really inspires confidence. I get a buzz out reading the stories of people you have helped. If there is such a thing as Karma, then you’ll probably reincarnate with a full head of hair for the next thousand lifetimes! Ha ha.

Ok, serious now. I’m 36 and a class 4 or 5 balding. I am reasonably happy, however one day I got sun burnt on top. My girlfriend absolutely insisted on cutting up a tomato and placing it on my burnt balding head for relief, which I recall putting up with for about 15 mins. I swear that ever since that day, my hair has felt considerably thinner and has never felt the same since. My sun burn wasn’t THAT bad and I blame the tomato somehow. Can you offer some kind of perspective on this one? I’m curious to know if your surgery advocates using natural products like Olive or Peanut oil for scalp healing.

I do not know about tomato treatments, nor do I have any experience with olive or peanut oils on the scalp. People with miniaturized hair will burn easier, because the hair, which normally protects against sunburn, becomes less effective as it becomes thinner. It is not unusual that one of the first signs of recognizing genetic balding is the ’sunburn’. As the hair provides less coverage, the sun does more and more damage and people with considerable miniaturization will have a higher incidence of skin cancers. Many patients seek out a hair transplant to reduce the sun and ultraviolet effects which produce skin damage. As you seem to be a regular reader of this blog, you probably already know this, but you should have your scalp mapped out for miniaturization to determine if you have genetic type balding.