Month: June 2006

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Doctor Advised Against FUE Due to Healing Dangers – Hair Loss Information by Dr. William Rassman

Hi Doctor,

I have been adviced by a hair transplant surgeon against FUE, instead he suggested FUT.

The reason he gave was – the scars of FUE, which are generally left open to heal are very dangerous in weather condition like south asia. The scars are prone to get infected. Also he mentioned about various types of sealing but he also added that it doesnt help much.

He advocated FUT over FUE for- its less prone to infection, it takes less time, its costing much less and the it suitable for large number of grafts (I need around 2000 grafts on frontal area).

I am confused as I dont want the scar involved in FUT, but want a safer procedure.

So is FUT more safer/better suited alternative than FUE for my condition?

First, if you are clean and wash your hair regularly, FUE is not a problem even in wet or warm climates.

I agree with your doctor otherwise. The FUT is less expensive, easier to get larger sessions, and probably in his hands, safer than FUE. I personally try to tell my patients that scarring above 3mm occurs in less than 5% of patients. The use of a trichophytic incision and fascial closures as discussed in this blog, should address the scarring risks in most patients.

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Hair Transplant, 10 Days After (with Photos) – Hair Loss Information – Balding Blog

I am constantly asked how long it will take for a typical patient to be able to go back to work. This patient is 10 days post-surgery and went back to work in 4 days. He had 1,677 grafts transplanted and is a class 3A on the Norwood scale. He has the advantage of a blonde hair so that the beard of transplanted hair is also blonde. There is a small beard if you look carefully. The skin of the transplant is still slightly swollen with a fine pink hue (he is sandy blonde with white skin, known for showing a pink hue) and this will subside over the next week or so. The hair he has presently covers these changes so that it had not been seen in either his work or in any social setting. Click photos to enlarge.




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Using Minoxidil When Pregnant – Hair Loss Information – Balding Blog

is minoxidil safe in pregnancy?

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Any medication that you take on the skin will go through the skin and into the body. If the baby gets exposed to this drug by absorption through the skin, there’d be at least one report of babies with more hair than normal. Unfortunately, good studies are not available to answer this question. This may be an issue of benefits vs risks, so I would suggest that you ask your OB doctor and see if that causes him/her concern.

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Folligen Spray, Dutasteride, and Sex Drive – Hair Loss Information – Balding Blog

I’m 25 and I used finasteride for more than 3 years now, with no sucess at all. I also had a lot of problems with dandruff and irritation on my face and scalp. I was really worried about this, than I decided to take dutasteride. I’m also taking now minoxidil 2%, and using folligen spray and revivogen shampoo. I noticed some very little hairs in my left temple. Not too many. But I also felt a difference in my sex drive, and some shedding. My dandruff desapired, I think because anf the folligen, it really resolved my irritation in the first week. Do you think I should keep this treatment? Should I worry about the shedding and libido, or this could be a transitional state?

thanks a bunch!

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Finasteride may be working by preventing hair loss progression, but just not growing new hair. I gather that the dutasteride has reduced your libido, which is not a surprise at all. Folligen spray contains copper peptides which have had some unsubstantialed scientific claims for hair re-growth. I am happy to hear of your positive response to the dandruff with the routine you are using. Hair shedding and libido having appeared brings you to a decision: Is the benefits (or proposed benefits) worth the price? How do you rate your sex drive balanced against having hair?

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Hair Loss and the Immune System – Hair Loss Information – Balding Blog

I recently read a posting on baldingblog where a women suggested the use of Visine to stop hairloss. I’ve heard of using visine to help sooth razorburn an ingrown hair as I assume it has antiflammatory medication.

I’ve read other places that some people think hairloss is a type of immune response of our body, where DHT causes the structure of the hair follicle to change. At some point our own immune systems reject the changed follicle and attack it, ultimately causing the phenomenon we see as balding. Somewhere else I read that in cases, such as people getting transplants take immune suppressing drugs such as Cyclocsporine, to stop organ rejection, actually noticed hair regrowth.

Going back to the woman who earlier spoke of the Visine treatment that she heard, this woman said that her hairloss got worse after she moved. Speaking from my own experience, I have noticed that certain immune responses happen when one changes environment. For instance, I grew up in New Jersey and never suffered any real allergies or medical problems. When I moved out to California when I was 16, notice an increase in my hyper-histamine.. or histamine positive response. I believe thats what you called it. In particular, I developed an allergic reaction to heat.

Anyhow, its interesting to think that environment may have a small role in a complex immune response that results in hair loss.

Is hairloss a more modern occurrence? I mean, does hairloss occur more in modern society? I remember reading an article recently in Wired that said that when comparing lab mice with sewer rats, the sewer rats had “better” immune systems because of their dirty environment. The immune systems of the lab rats tended to overreact to stimuli. On the other hand, the sewer rats immune systems better defended against real threats while not overreacting to things such as allergens. ( http://www.wired.com/news/wireservice/0,71185-0.html)

Anyway, thx for your blog, Dr Rassman. It’s always interesting and entertaining!

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I agree with you that although hair loss is caused by genes, it can be influenced by the environment where chemical products, drugs, malnutrition, and stress can induce the expression of balding genes. Hair loss is not a modern society occurrence. Men have been bald since the beginning of recorded time. Hats and wigs have been around since the earliest records in the history of civilization.

Are we more self conscious with hair loss today? Somehow I doubt that, but we do have better communication (like this blog and the internet in general) to share what is happening to us with others. We do know that autoimmune diseases can cause hair loss by creating antibodies attacking the hair follicles, but that may not mean that hair loss is always an immune modulated disorder. A famous doctor told me once that sooner or later (he predicts) that we will learn that every disease entity will arise from either infection or genetics. At this point though, who really knows?

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Hair Loss From Long Hair? – Hair Loss Information – Balding Blog

Hey Doc
I noticed when i started to grow hair out ive been losing strands of hair quite easily. My hair is about 3-4 inches long now, and i have a couple questions:
1. Because im growing my hair out does that mean its easier to fall out/ more noticible when it falls out?
2. And it appears that im losing hair from all sides of my head, basically every where the back, the top the sides exct. so does this mean that this is not male pattern baldness since there is no pattern to it?

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This could be that because of the long hair, its easier to fall out or pull it out with styling. Therefore, it will be more noticeable when it falls out as you suggested in your question.

It is also important to know that hair length is a reflection of the length of the hair cycle and each person has a different hair cycle lasting on average between 2-7 years. As hair grows at 1/2 inch per month, just calculate length over time. If you hair cycle is short (1 year) then every hair on your head will cycle every year (just an example here, as most people have at least a 2 year hair growth cycle).

If you are losing hair on the sides and back of your head, it may not be male pattern baldness, but could be an infection or disease. To be sure, and not cause yourself more worry, you should have your hair and scalp mapped for miniaturization so you and your doctor can know what is going on.

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My Head Got Bigger? – Hair Loss Information – Balding Blog

hi there.
im a 17 year old boy who is worried about receding. i have a full head of hair but it is a bit thin in the left hand side at the temple. i have been told it has always been like this. my mothers dad went bald before 30, my dads dad did not go bald. but my dad has receeded a bit on top. when my hair is dry u cannot see my scalp but when wet it parts alot and seems thin!!also i was told that my head may have got bigger which may make it seem like it has receded! am i worrying over nothing??

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Growing boys with growing and maturing heads, do not thin out their hair. You should get your scalp mapped out for miniaturization to find out if you have early genetic hair loss.

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Mother Is Always Right – Hair Loss Information – Balding Blog

Here’s a cute, brief story that I thought may be interesting to post…

When a patient of mine joined the US Marine Corp many years ago, he lost a great deal of hair, most likely from stress inducing his male pattern balding. His mother did not like the way he looked, so she complained to him that the Marine Corp was bad for his health. “If you get out of the military your hair will come back,” she would say. Eventually he got a hair transplant before leaving the military to restore what hair he lost. He visited his mother some months after getting out of the Marines and he told me she was quick to point out that because he left military service, his hair came back. It proved (to his mom) that mother is always right. She had no idea he had a hair transplant.

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Tangled Hair From Styling Products Used to Cover Bald Spot – Hair Loss Information – Balding Blog

Dear Dr. Rassman,
First of all thank you for caring enough about all our concerns to have this blog. I’m writing to ask you about tangled hair. I have kept the top of my hair long for many years now to comb back and cover the balding crown but my hair is coarse and somewhat curly. For some reason when I shampooed I began being unable to wash out all the build up of gel and hairspray and it was difficult to comb through. At the beginning I used to force the issue and would pull out lots of hair. Now I’m much more gentle but its still frustrating to not be able to comb through. I’m afraid I’m damaging my hair more and more. What would you recommend? Any shampoos that could clean this build up? What about detanglers?I haven’t fared better with them either. On another note, several years ago I had a transplant which I believ was good. But I now am planning to have another and am certain you or your staff at NHI will do it. I received your materials in the mail (Thank you), I’ve heard about your excellent reputation from other sources also.I like that you’re not ONLY interested in the $$$ but you have a passion in an artistic sense as well as a humanitarian love. God bless you and I look forward to hearing from you. Let me see you! A round trip from Las Vegas is very inexpensive now as the summer season comes into swing.

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I’d see a good hair stylist with experience in African hair (they understand tangling and how to untangle the hair without pulling it out). It sounds like you need to get styling control on what you use and how you use it. Traction alopecia can occur with pulling on normal hair, but imagine if you can lose normal hair by pulling on it — what would happen to weak hair that is miniaturized from the genetic balding process? Bad news.

Visit me in Los Angeles if you want a hands-on examination. I will map your scalp for genetic hair loss and give you a glimpse into what will happen to you in the future (by developing a Master Plan for you).

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I Lose Hair Transplant Grafts in My Sleep – Hair Loss Information – Balding Blog

I had a hair transplant last night and this morning I found grafts on my finger nails along with blood clots. My transplant surgeon told me not to worry about them after I said that there were about a dozen grafts that I could count. He said that he did not have to see me. What would you do for me in this situation?

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ReclinerI had a patient who picked his head in his sleep, just like you seemed to do. Knowing this, I had his wife make him wear ski gloves in his sleep the rest of that week. I did view the patient, but as the grafts had been already out of his body for hours, there was no point to put them back as they would not have grown. The grafts on this patient came from the crown, where he had 1500 grafts placed by me. He had about 10 grafts lost and they did not appear to be significant, considering the large number that we placed there.

I had another patient leave the office after the surgery and from the edge of the limo, he scraped the scalp removing about 150 grafts in the car’s gutter. We quickly retrieved them and washed the grafts with saline and put them right back into his head. Fortunately, the time out of the body and into the saline was only a minute or two. The grafts grew, but I think that we all had anxiety over this one.

I do not use bandages to cover the recipient site and I tell my patients the importance of keeping their hands off of the head and recipient area. I generally like a person to use a recliner chair for the first and second night, to keep the head elevated and make it more difficult to scratch the recipient area when they sleep. I have not had a problem like the ones I spoke about for over 10 years.