May 2006 – Page 16 – Balding Blog

May 3, 2006

I Don’t Like Having a Mature Hairline – Hair Loss Information by Dr. William Rassman

I am 23 and notice I have a mature hairline. its a 2 on the scale. I dont like my hairline though and would like to get the hair around my temples back. Is there any procedure that can fix this? If so please tell me

I have transplanted the juvenile hairline back in some men, but I do so only under certain conditions:

There is no evidence of advanced balding either on examination or in the family line.
I want to get to know the patient and he must be mature and able to understand the ‘worst case’ scenario that could happen (in your age the worst case thing is advanced balding).
I look at the value of the various elements of hair quality, skin color, hair density, and overall donor supply characteristics and connect it with potential demand considerations.

I have clearly done this more than once, but in my present memory the only ones I have done under 25 years old were professional actors, television soap opera sexy men, or models whose livelihood depends upon that ‘youthful’ look.

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May 3, 2006

Hair Coloring and Scar Visibility After Transplantation? – Hair Loss Information by Dr. William Rassman

Hi-
Over the past 3+ years, I’ve had 3 transplant surgeries and I’m tremendously happy with the results. Some years ago, I used to occasionally double process my hair blond (it’s dark brown naturally) and I liked the results. Is this still a possibiliy or is it to risky for my hair. Will it make the scars more visible? Needless to say, I wouldn’t want to damage my transplants in any way. Many thanks

Colored Hair Your hair is your hair and a hair transplant, once done correctly, means you can dye it, cut it, perm it, spike it, etc. The beauty of a good hair transplant is that it is just like you never had lost your hair. As for the scars, I couldn’t tell you for sure, as there are a number of factors such as width/length of your scars (I am assuming you had strip procedures) and the length of your hair. However, I do not think the scar visibility will be an issue with processing your hair blonde, but the only way to know for sure is to try it once. Generally, the only time the scar has a chance of being seen is when the hair is cut way too short (like crew-cut length).

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May 3, 2006

Cymbalta, Atenolol, and Female Hair Loss – Hair Loss Information by Dr. William Rassman

Hi I’m a 24 yr old female, with some questions I would like to ask you about my hair that is thinning. About 10 months ago I was getting a haircut and the stylist had mentioned to me that my hair was thinning a lil at the crown of my head…It wasn’t very noticable, so I didnt think anything of it, and just went on with my life…I had started taking an Anti-depresent called Cymbalta, and a high blood pressure medicine called Atenolol, at around that time as well. Well in january of 2006 I noticed that my front part of my scalp, maybe from my hairline & back 2 inches was very thin. I couldn’t understand why, because it was an over nite thing, I would have noticed if my hair was thin, and i even look back at christmas pics from the month before and my hair was like usual, so I know it was a very immidiate thing. I had disconntinued my anti-depressent and blood pressure meds, like 1-2 months earlier, because I could no longer afford health insurance, so I had been med free for about a month when I noticed the thinning frontline. its now almost 3 months later and im starting to think the thinning is getting worse in this reigion only…i started to take folic acid and a prenatal pill, because I read folic acid helps with re-growth, but I dont know what to do..I cant see a Dr, for another month untill govt health insurance kicks in, but in the meantime what should I do??..i know I had blood test run before about 8 months ago checking for throid disease, but it came back normal, so could something medical cause this..because no one in my family has a balding problem, my mom is 47 and just started to thin, and thats only because she used many products in her hair for so many years. do you think my hair will grow back or get worse?…I heard it takes about 3 months for the hair growing process to start showing, but its been about that much time and i dont see any improvments…Ive looked through the internet and read some scary stuff that can cause hairloss…but im so down about this, becuase i am soooo young, and I dont know why my hair is falling out…please help me if you could, thanks alot and have a wonderful day.

You are in need of a good doctor and there is no substitute for what the doctor does. Problems like yours can not be managed well by a doctor through the internet, nor can you manage depression and high blood pressure combined with hair loss by yourself. Look through the many posts in this blog on female hair loss to educate yourself and then get a good doctor.

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May 3, 2006

Concerned About Possible Gynecomastia from Propecia – Balding Blog

Dear Dr. Rassman:
I have some questions regarding the possible side effects of taking propecia, and I am wondering if you can help to answer them?

After a patient starts his medication on propecia, how long will it take for the possible side effects, such as gynocomastia to occur?

If gynocomastia does occur, would it be completely reversible after the patience stop using propecia?

If a patient stopped using propecia, will the severity of hair loss process accelerate? Or would the patient simply lose the hair gained from using propecia? If that assumption is valid, would a patience who stopped taking propecia only 1 or 2 weeks into the medication also experience acceleration of hair loss?

Thank you so much for you patience and time.

Breast enlargement or nodules is a rare side effect of Propecia (I suspect one in 500 people might see it at the 1mg dose) and it will usually occur in the first month.
If breast problems do occur, they will disappear within a month or so upon stopping the medication.
Stopping Propecia for 1-2 weeks probably will produce some withdrawal hair loss, but I suspect it will be hard to see and relatively small. The longer you stop the medication, the worse the withdrawal loss will be and the more irreversible it will become.

May 3, 2006

A Transplant Doctor Told Me I Need Multiple Procedures – Hair Loss Information by Dr. William Rassman

I am not bald and have a thick head of hair. My only problem is my naturally deep temples which I want to fill in so that my hair line looks straight.

I was recently told by a hair doctor that only a certain number of grafts can be performed on the temples of my head in 1 session since the number of hair follicles in my hair which is very dense. He states it is impossible to graft too many or the follicles will compete for blood supply and the instrument’s pressure will cause adjacent grafts to pop out. The area I want to fix is rather small. However, he says I will probably need two transplants.

Is this true or is it just a way for him to make more money?

Without knowing the size of the area, the number of grafts, or the thickness of your hair it is hard for me to answer this question. Generally you can safely put 40-50 follicular units into a square cm (normal densities are 100 follicular units per square cm), but that depends upon various mechanical factors. The average person does not need to achieve normal densities to get adequate fullness. With a small balding area I would assume that your blood supply should be very good. Dense packing of the grafts was pioneered by me in 1993. I believe that there are situations where one doctor can put too many grafts too close so that growth might be impacted. Some doctors have extensive experience in dense packing and can do it safely, others have not built the skills and would prefer not to dense pack the grafts. Whatever the doctor is comfortable with is what is probably best in that particular situation. Never push the doctor to do more than his comfort level is. Plus, you always have the option to visit with a different doctor.

May 3, 2006

2 Years After Transplant, I’ve Lost My Original And Transplanted Hair – Hair Loss Information by Dr. William Rassman

Hi Sir,
I’m 24 now (My birth Year 1982) had a transplant in august 2004 on my front portion but at that time i had hairs on my top left and right. Now in 2006 i have lost most of my hairs both my original and my transplanted. How can i have my hairs back. Im too worried, Please guide me what to do. Reply me soon.

Loss of transplanted hair generally means that the hair that was transplanted was not from the permanent zone (the wreath around the side and back of the head), or that the hair that you lost was really the original hair not the transplants itself, or the hair came from the neck rather than the scalp (hair from the neck is not really permanent hair), or that you might have another type of alopecia (most commonly Diffuse Unpatterned Alopecia – DUPA). You need to get your hair mapped out for miniaturization and that will clearly show the status of the permanent hair zone. If the permanent zone has miniaturized hair, that means that you might have never been a candidate for hair transplantation. This is the most common cause for what you are telling me about. Finasteride benefits this condition in about 50% of patients with DUPA.

Please get your donor area mapped out to be sure that the quality of the donor hair is good.

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May 2, 2006

Should I Try Rogaine? – Hair Loss Information by Dr. William Rassman

Hello Sir,

My age is 23 and like many people around the world i am also very much worried about my receding hair line (from the centre of my crown till my temple ). The density of my hair has become very less from past one and half years after i started to work for a call centre. Most call centre jobs in India are out sourced, which means i work mostly at night.

I do have read a lot of blogs on your wonderful website about hair loss and treatment. But i really wanted to know whether is it okay if i start using minoxidil for retaining my remaining hair or you would suggest me to visit a trychologist and then get the prescribed medication.

Also can a hair transplant will show the same density as normal hair..after the transplnt has been done..

thank you

If you are balding at 23, you should buy finasteride and take 1mg of this drug daily. In India, there are generic versions of this drug on the market and this is the best drug to stop, slow down, or reverse early hair loss in a young balding man. I can’t vouch for the authenticity of the generic versions available though. Minoxidil (Rogaine) is not the best first choice for a drug in a young man, as it is not reliable and it does not block the balding process from happening. Transplants should not be considered unless after a year on finasteride you still show significant balding. Doctor selection is a real problem in most countries, and I am sure that a trip to the United States may be out of the question, but take great care in selecting a doctor there for hair transplants.

May 2, 2006

Shedding Hairs Get Thin At Root – Hair Loss Information by Dr. William Rassman

Hi Doc, I’ve been on propecia for 4+ months. Ive started the infamous sheds about a week ago. I would say 90% of the hairs I shed are extremely thin. The ones that look like they are about dead. What’s weird about it, and what worries me, is that so many of the shed hairs seem like it thins out at the end (closer to the root). What trips me out is that my hair is about 4 inches long, so I get to see the trend of hair thickness from before propecia to now. And the fact that it looks like my shed hairs gets thinner at the roots gets me a little paranoid. Are shed hairs, whether affected by MPB or not, usually meant to thin at the end? Or is this a classic sign of MPB attacking my hair? Thanks Doctor!

What you are seeing is the shedding of the miniaturized hairs. Some physicians believe that the shedding impacts these miniaturized hair as they are forced into the hair cycling. The hair on the scalp follows three life cycles:

Anagen
Telogen
Catagen

Once the hair falls out, I would expect that it would be replaced by a new, stronger hair coming into its Anogen phase.

May 2, 2006

Shakespeare’s Hair Loss – Hair Loss Information by Dr. William Rassman

How did 16th Century playwright William Shakespeare lose his hair? I’m sure you find yourself pondering that question every waking day of your life. Well, perhaps not. At any rate, I stumbled upon this year and a half old article that has an interesting take on why Shakespeare possibly lost his hair. The title of the article gives away the punchline, but enjoy…

Shakespeare probably had syphilis and lost his hair as a result of it

Ouch.

May 2, 2006

ScalpMed and Hair Growth Rate – Hair Loss Information by Dr. William Rassman

Hello Dr. William Rassman. I have heard that scalpmed supposedly thickens your hair but what I want to know is does it speed up the rate of hair growth as well? For example if my hair normally grows a half an inch in a month, could scalpmed make it grow an inch or more in a month?

Nope. The ScalpMed people are promoting their product very heavily and the claims that seem to be coming through internet chatter is unsubstantiated. There is nothing in that product that can make hair grow faster, because in fact, there is no drug anywhere that will make hair grow faster.