Month: May 2006

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Having Some Problems Five Months After Transplant – Hair Loss Information by Dr. William Rassman

i had hair transplantation surgery in november2005,all went well and i was satisfied with the results showing up.but now into my fifth month after surgery, iam having problems on my scalp.I have some bulged protrusions which are itchy and painful.they are there for few days and disappear.I noticed am losing more hair than ever before.iam worried i would lose all my hair.please tell me what caused this?or is this common.iam using 1ml 5%minoxidil and propecia since 4months.

The bumps from the recipient area may be secondary to ingrown hairs or an inflammatory process from the sebum which accumulates from transplanted oil glands that survive the initial transplant process. The sebum has no way out from beneath the skin until the hair emerges. I see this problem in a small percentage of patients and generally treat it with warm soaks to soften the skin so that the sebum finds its way out. If these cysts start enlarging, that could reflect a local inflammatory response or possibly an infection (may require antibiotics or drainage) whcih should be something your doctor needs to address. You should have your doctor give you an opinion on this and address the hair loss you are experiencing. Hair loss at 4 months could be some delayed shock loss or acceleration of the hair loss process, which is seen with men who are not protected with Propecia, especially the young men undergoing hair transplantation. The use of minoxidil will not cause this and may help.

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Can I Restart Using Rogaine to Regain Lost Hairs? – Hair Loss Information by Dr. William Rassman

Hello, I’m a 21 year old male who started using Rogaine at the age of 19. I was worried I was losing my hair because it is very prevalent in my mom’s family. After using Rogaine for over two years I decided to stop because of the irritation it was causing on my scalp. I stopped late last January and for the first three months I did not notice my hair count change at all, but in about the past three weeks my hair has been falling out by the handfulls. If this continues much longer I may be left with no hair at all. I have been using Rogaine again now for about a week and will continue, but do you think I will be able to get back in the large amount of hair I lost that was apparently dependent on Rogaine? Will reintroducing Rogaine to the follicles bring my hair back to what it was? thank you!

The only two FDA approved products approved for male pattern hair loss are topical minoxidil (Rogaine) and oral finasteride (Propecia). They both have limitations and work primarily by slowing hair loss than growing new hair. Only a small minority of men with genetic hair loss will experience great amounts of hair regrowth with minoxidil, while Propecia will show more predictable results in someone of your age. In your case, your genetic destiny may be catching up to you. It is doubtful that restarting Rogaine will regrow your hair, but Propecia, on the other hand, may reverse recent hair loss. Both drugs may slow the process of hair loss, but if you are genetically balding, Propecia attacks the cause of the hair loss and therefore is far superior. Get your diagnosis by mapping out your hair for miniaturization and with good measurement, you will be smarter about what is causing your hair loss and what benefits you may or may not get from doing whatever you choose to do.

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Alas, Bald Again (with Photos) – Hair Loss Information – Balding Blog

This patient came into my office yesterday and was committed to keeping his hair short to 1/8 inch length. He had plug hair transplants (certainly not at NHI) 13 years ago. It was complicated by complete loss of all residual hair in the front from shock hair loss and it was a shock to him as well, because he had some hair in the front of his head before the transplant was done. Today, he would have used Propecia to protect against shock loss and there would be no plugs there.

He started on a quest to go back to a clean slate and become a man with frontal balding. He told me that he had 12 laser hair removal procedure for about $10,000, and he had two dermabrasian procedures to the skin surface with a laser to try to get rid of the pits in the skin and the cobblestoning of the scalp surface (a few thousand dollars more). The hair removal was spread over years of treatment (although he lost all evidence of hair that may have still been left in the area), and his skin became smooth with a changed color (lost its pigmentation), leaving him with a skin color and texture difference between the area treated and the rest of his scalp. His real costs reflect the bad transplant (about $10,000 in 1994-1995), plus his time and his pain of living with a look that made him selfconscious. We did get into a discussion that maybe, if he knew that his results would be normal, he might try a transplant, but I suggested to him that considering his long road to become bald again, he should complete what he started before going at it again. The middle picture reflected wshere he might actually put hair if he got transplants, but I suggested that he should not go the transplant route at this time. Actually, I thought that he looked reasonably good, considering what he had and what he went through… except for the scars in the back of his head and the long time getter where he wanted to be.

He came to see me because:

  1. He has three awful scars in the high neck that he would like me to treat and fix (see photo below)
  2. He wanted to know what he could do about the skin color abnormalities

The scars are best treated with Follicular Unit Extraction (FUE) and can probably be subdued in one or two FUE procedures (there is no linear scar with this procedure as each hair follicular unit is removed one at a time). There is nothing I can do about the skin changes from the multiple laser treatments, but he might seek out the opinion of a dermatologist that transplants pigment into skin that lacks pigmentation. I suggested that he go on Propecia for his crown loss with the possibility that this hair may come back with this drug. The pictures below show a pink color to the area where the laser treatment were, but he tells me that when the pink color goes away, it becomes progressively more whitish.

I thought I would share this patient’s saga, with his permission of course. If he had come to see me before this all started. The process to fix it with today’s technology would have been faster and slicker, but that is another story I will tell later (they say pictures are worth 1000 words and the photogalary on our webstie newhair.com shows many people similar to this patient solved the problem by getting the old plugs hidden with normal looking hair, a less expensive and much faster process from start to finish). Here are this man’s photos — click to enlarge.




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Cloned Bladders, Cloned Hair? – Hair Loss Information – Balding Blog

I recently read an article about doctors implanting bladders into people grown from small biopsies of the owners own bladder. My knowledge is limited, but this sounds similiar to what Hair Multiplication doctors are trying to do (or are arleady doing according to Intercytex). Perhaps this offers hope that hair cloning may be a reality in the near future, and by near I mean within the next decade or so. Also, I tend to agree with the blogger who argued, in an unnecessarily distasteful manner, that HM wouldn’t take the same FDA approval process as a new drug would. Perhaps this bladder story is evidence of this. Of course, bladders are of more medical importance than hair, but I doubt they had to spend several years going through an approval process and I think the situation would be similar with HM. What do you think? Also, I say this everytime I post because I mean it, You are amazing for doing this blog. This is easily the most helpful hair loss site on the internet.

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Yes, hair cloning and multiplication may be possible, but not as soon as some people want or expect. I say, the sooner the better for all of us. There are many private investors out there who pump a great amount of money for such hair research. Thank you for your interesting insights.

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Saving Money On a Nose Job – Hair Loss Information – Balding Blog

Here’s a plastic surgery question I received this week. I’ve opened the blog to questions regarding cosmetic surgery, rather than limit it to strictly hair loss questions (at least on a trial basis). If you have plastic surgery questions, please write…

I have a question in regards to rhinoplasty. I feel that my nose is relatively large and has a bump on the bridge, and I am looking for a completely new nose. I have a consultation scheduled in june with a surgeon and I wanted to know would this bring the cost higher, and is this possible?

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Nose jobs (rhinoplasty) are one of the more difficult and artistic plastic surgical procedures. Some plastic surgeons do not take them on, while others feel that they have the artistic skills to create the nose that the patient wants. Costs vary significantly between surgeons and locations; the well known 5th Avenue (New York docs) and the Beverly Hills plastic surgeons are probably more expensive. You have to check out your doctor by finding out his/her experience with nose jobs, see many pictures of their work, speak to a few patients if that is possible, get to see that the number of patients he/she has done, etc.. Make sure you understand the risks from his/her perspective. Fixing the bump on the bridge of your nose is more common than other types of nose jobs where missing ‘bony’ infrastructure needs to be brought in. Do you bond with your doctor? Do you like the doctor as a person? Does he/she spend enough time to answer your questions and address your concerns, dealing with your worries with compasion? I use these rules for selecting any and all doctors.

Good luck.

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Hair Loss InformationFemale Hair Loss A Year After Pregnancy – Hair Loss Information – Balding Blog

I am in my early twenties, with two toddlers. A little while after my second child turned 1, my hair started to thin through out the length of my hair. At first, it was only on one side in the back. Then it kinda started to thin on right side. What I am left with is hair that is growing back unevenly and a very small amount that has not broken off. I know my hair grew too fast when I was pregnant. It was so long and all one length, but its not now. I have a very small amount of really long hair that remains, but the rest is shorter. I don’t have bald spots, just a lot of broken hairs. My question: Is this post pregnancy hair loss or some form of it, and how long can this expected before it completely stops. I have never had hair loss issues until now and my daughter is almost 3 now.

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What you are experiencing right now is postpartum hair loss and the shorter hair should eventually get longer. You will have to wait (possibly a year or two) to see if your hair becomes fuller. Sometimes, we see changes in the character of hair as we go through different aging periods. Infants have one type of hair, children another, young adults still another, and aging adults will see a thinning of the hair shaft. Although the last phase takes years, it does occur sometime in people in their 20s and 30s. You might see a doctor and get your hair mapped out for miniaturization just to get a base line in case things do not go the way you want. Measurements are important to document when you look for change.

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Pigmented Knuckles, Autoimmune Disease? – Hair Loss Information by Dr. William Rassman

18 month ago I noticed my hairline was receding and took propecia accordingly.

6 month later I began to notice that the hair on my arms, legs, eyebrowns, and in the public region were thinning. At 12 months, I began to notice pigmentation on my knuckles and small bumps on my nails – even sore joints – all signs of an autoimmune disorder.

I’ve noticed anecdotal evidence on the web that this can happen.
Is there further evidence to support this?

Autoimmune diseases can attack any organ in your body, including your hair. If you think that you have an autoimmune disease and there are many skin pigmentation changes, see a good dermatologist first. What you are describing is outside of my area of expertise.

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I’ve Tried Propecia for 6 Months and Have No Results – Hair Loss Information by Dr. William Rassman

Dr Rassman, I am a 39 year old male with very thin hair. i went to Dr bernstein about two years ago because i saw a change in the texture of my hair. It was getting thinner all over, especially in the front.Dr Bernstein said I was losing my hair and was on my way to becoming bald. He took a sample of my hair also. he said i was not a candidate for a transplant since the quality of the donor area was not good. He gave me a year prescription for propecia and told me to visit him in a year.I have been on propecia for six months now , but have not seen any results. it seems my hair is getting even thinner, especially at the hairline. does this mean that if the propecia does not work, i am out of options,since i am not a candidate for a transplant ? If the propecia does work, will that make me a candidate ? I didn,t want to visit dr bernstein again until i have been on the propecia for a full year and since it has not grown hair for me, would he be able to do anything for me?

In most patients over 30 years old, Propecia will help stop further hair loss instead of growing thicker hair. However, there are some fortunate patients who will have thicker or fuller hair after about a year on Propecia. If you experience further thinning after being on Propecia for a year or so, you may be continuing on the natural course of rapid hair loss.

If Dr. Bernstein said you were not a candidate for hair transplantation and he confirmed that you are balding, AND are not helped by Propecia after a year, then I might think (I am guessing here, since I have not examined you) that you have a condition called Diffuse Unpatterned Alopecia (DUPA), which is an extensive analysis of the diagnosis process for hair loss and planning for the future. It is important to revisit Dr. Bernstein after you have been on Propecia for a year.

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48 Years Old With Shock Loss After Transplant – Hair Loss Information by Dr. William Rassman

Dr Rassman
I recently had transplant surgery at a reputable office to combat thinning hair on top and a receding hair line. I am 48 years old. I was suprised by what I believe was a fair amount of shock loss around the graft areas given my age. I was not on propecia pre-surgery but began taking it a few days following the procedure after reading your column. Now I believe propecia can also cause shedding in the early months. Could you explain the difference between shedding and shock loss and what you believe I am experiencing. Maybe a combination of both.

Thank you

MilkIt sounds like you experienced shock loss and if this is in the miniaturized hair, the hair may not come back. Treating thinning with transplants is not something I do often. In many people with miniaturized hair, transplanting into that ‘unhealthy’ hair does little to really increase the fullness. I believe that for most people like you, any benefit you will get in the long term may be lost in the short term, making transplants a poor decision. I would think that Propecia should have been used in advance of your hair transplant procedure just to minimize this risk. The transplants done may offset the hair loss and the Propecia may bring some of the hair back. Only time will tell. Once the glass of milk falls and the milk spills out, it may be impossible to bring it back.