Month: July 2006

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Rogaine After Hair Transplant in Woman – Hair Loss Information by Dr. William Rassman

Thank you for your forum…. it is so helpful. My question is I had a HT of 1480 units about 2 weeks ago. How long should I wait to start using Rogaine again? As a female can I use any oral medication to help maintain the hair I have?

You can start using topical Rogaine after about 1 to 2 weeks after a hair transplant, and it may be a good idea to use it at least for the first 4-5 months after surgery. To date there have been no FDA-approved oral medications available for female hair loss. Propecia is not recommended for women.

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Propecia and Working Out – Hair Loss Information by Dr. William Rassman

Hi.

I’m 35 and loosing hair. It’s likely that Propecia could be one good solution. However, from what I understand Propecia blocks DHT by limiting the creation of testosterone which is why it can stop balding process.

Now, I am working out seriously 4 times a week and trying to add on muscle. Muscle growth is due to testoterone. My question: how can my work out be still beneficial in terms of muscle growth if the testosterone is lowered because of use of Proprecia.

Thanks for your time.

Propecia does not decrease testosterone. It decreases the byproduct of testosterone known as dihydrotestosterone (DHT). DHT is what is implicated in male pattern hair loss. Taking Propecia increases testosterone by about 15% and benefit (although not proven) muscle building. Propecia can also apparently be used to mask muscle enhancers. You may recall from the recent Olympic games the controversy surrounding Propecia — Olympic Athlete Banned from Competition for Propecia Use.

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I’ve Experienced Severe Diffuse Thinning in Just 4 Months – Hair Loss Information by Dr. William Rassman

I am a 22 year old who has experience fairly severe diffuse thinning over a period of just four months. I first noticed the problem in March eventually going to see my doctor in April. He said he could see nothing wrong with my hair but noted that I have two patches of Alopecia Areata and some form of dermatitis on my scalp. My hair continued to thin and in June visited a dermatologist who was similarly distracted by the patches of alopecia and inflamed scalp and also said he could see no sign of MPB. However I feel my hair has continued to thin rapidly since then so I have booked another dermatologists appointment for two weeks on Wednesday but fear I will have little hair left by then.

Is four months considered rapid progression?
I have had an extremely stressful year so far but feel I can rule out T.E because I read you can not have A.A in conjunction with it.
My diet is admittedly poor but a blood test in April turned out to be fine.

Do you have any thoughts?

Thanks

I am assuming that you are a male. Men with genetic hair loss do, at times, develop alopecia areata. There is no connection between the two. With that said, if your hair thinning is diffuse and reflective of some other form of hair loss like diffuse telogen effluvium or diffuse unpatterned alopecia, you should have your scalp mapped out for miniaturization to find out if you have an early subtle patterned genetic hair loss. A hair pull test would also have value for you. Has your doctor done both of these things? Have you had blood tests for endocrine abnormalities such a thyroid disease? The stress you are having can accelerate genetic hair loss or diffuse unpatterned alopecia. If you get the idea, you need a doctor to make the differential diagnosis here.

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I Stopped Propecia for a Month, Then Restarted — It’s Not Working the Same! – Hair Loss Information by Dr. William Rassman

I am only 18 but I have been noticing hair falling out since I was little, and it only became more pronounced a couple of years ago. Last year, I began taking Propecia and I was on it for about four months. It was so expensive that I stopped for one month but decided that I really needed to continue with it. I have now been back on it again for just over a month, but I’m still noticing a large number of hairs falling out daily. After stopping treatment for a month, will I never experience the previous effects of Propecia, or do I just need to be patient for it to start working again?

Other men, older and wiser than you, have come to me almost in tears about the same experience they had when they stopped using Propecia and experienced an accerated hair loss. Usually, they stopped for longer than a month. In theory, the drug should remain in the hair follicles to some level up to a month or so, but the blood levels disappear in a day. It is unfortunate, but if you are losing hair from stopping the drug, your hair loss may be permanant, though it is possible that much of it may reverse because of maintained tissue levels. It is probable that some hair may come back if you go back on the Propecia immediately to replenish the tissue levels of the drug in the hair follicles. On the brighter side, Propecia may prevent further hair loss.

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I Don’t Have The Kind of Money to Spend on Treatments – Hair Loss Information by Dr. William Rassman

Hello!
I recently had a free consolt at the Hair Club for Women to discuss options for my thinning hair. I was disappointed with the options I was left with, which were: use the hair care products their company sells for $2400, or do nothing and continue losing hair. Since I have nowhere near that kind of money to spend, I was unable to purchase their product. Now I am left trying to find another option. They talked to me about taking vitamins, but I was never told what kind would be helpful. I am only 25 years old and it makes to sick to think that I may be close to blad by the time I’m 40. I have been losing hair for the past 10 years, and I have probably only half the hair I had as a child. Is there anything you can suggest for me to take or do that will help regrow my hair, or at least stop from further hair loss, that will not drain my bank account?

I would suggest that you should be evaluated by a medical doctor to find any medical causes of your hair loss. Once you have been evaluated for any treatable medical causes of hair loss, you may want to be evaluated by a hair transplant surgeon or dermatologist that can map your scalp hair for hair loss patterns that may shed more light into the cause and the prospect of future hair loss. I agree that $2400 is a significant amount of money to spend on hair loss, but consumers spend billions of dollars on hair loss products each year. Vitamins, special shampoos, and hair loss supplements all promise hair growth, but it is a buyer beware market. Good luck.

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Why Would a Doctor Limit to 1000 Grafts Per Session? – Hair Loss Information by Dr. William Rassman

hi Dr,
i am considering getiing FUT done in the near future. i am from Ireland and there are limited surgeons here. one surgeon, has an excellent reputation, and an impressive bio, but limits his sessions to 1000. I would need about 2500 to 3000. what would be the reason for the limitation, and do you know of Doctors that also limit their sessions?

The limitation on the number of follicular units transplanted may be due to the limitations of the doctor’s staff and time. For example at New Hair Institute, we are capable of transplanting 3000-5000+ grafts in a day. This is possible because of our experienced staff, mastery of the tools we use, and techniques we have refined over many, many years. We were the first medical group in the world performing sessions of 1000, 2000, 3000 and even 4000 grafts (in 1994). The key to doing these larger sessions must address reasonable limits based upon each patient’s dynamics, skin laxity and supply/demand considerations. Then, the doctor’s team should become a focus and one should never push a doctor or his team to do more than they can competently handle. The level of competence with these large sessions varies between doctors.

If you are referring to Follicular Unit Extraction (some doctors may use different terms) where individual hair follicles are harvested one at a time, 1000 may be a reasonable number because it is a very laborious process, but here too, as the originator of the FUE process, we have performed as many as 2200 grafts in a single session in appropriate candidates. It is all a matter of experienced teams of doctors and staff working together after years of training. If your doctor is unwilling to perform a larger session, either stick with him/her and do more surgeries with smaller numbers of grafts or find another surgical team able to perform larger sessions with lots of experience doing them.

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Is DHT Produced in All Men? – Hair Loss Information by Dr. William Rassman

So DHT is the hormone that causes male pattern baldness? And that hormone is produced in all men who will experience from male pattern baldness after puberty? So is DHT only produced in men who will experience male pattern baldness or is it produced in all men? And if DHT is produced in all men after puberty do they only start experiencing baldness when another gene triggers it? How do you tell if you are genetically going to have male pattern baldness? My dad does and so did his dad and so did my mums dad but my uncles (on my dads side and my mums side) dont and both have full sets of hair at 55 and 58? So how do i know if i too will experience it ?

All men produce DHT, unless they are born with a genetic defect and missing a particular enzyme that makes DHT. There is no way (at the moment) to tell who has the gene for hair loss and if they did know, they wouldn’t know if or when it will be expressed in the lifetime of any particular man.

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I Want My Donor Area Repaired So I Can Shave My Head – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I am looking to have the donor area from an earlier procedure eliminated so that I could wear my hair extremely short or shaved.

Please let me know what you recommend.

Thanks in advance.

All cuts on the skin will produce a scar and most cannot be completely eliminated. Scars can certainly be minimized depending on the individual healing characteristics so that short hair is a reasonable option. At New Hair Institute (NHI), we continually strive to incorporate scar minimizing techniques in all our procedures and will tackle repairs of scars if they are there. Please refer to Techniques to Minimize Donor Scarring. Your original hair transplant surgeon should be able to address your scar. If not, I would be happy to meet with you in person or by phone to discuss your options.

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Bioidenticals and Female Hair Loss – Hair Loss Information by Dr. William Rassman

Two years ago I had my ovaries removed due to solid cysts. I have had problems with HRTs. Some of the physical problems I had with synthetic hormones went away when I started bioidentical hormones. As soon as I started bioidenticals, I could literally watch the hair fall out of my head. The loss has alternately slowed or stopped,however, on a lower dose of estrogen my scalp is very sore to the touch & itchy. (The soreness is not because I have been scratching my head. I haven’t). What causes this?

Also, I had hormone levels tested before going on bioidenticals(18months after surgery & 16 months after HRT) and it showed I had very high androgen levels, but doctors & pharmacists can’t seem to tell me why, or what I can do about it. Any suggestions?

See Bioidentical Hormone Replacement – HRT Without the Side Effects.

Taking out the ovaries will produce an imbalance in your female to male hormone ratios. Many doctors treat women with HRT (Hormone Replacement Therapy) to adjust to the changes associated with surgically induced menopause, which follows the loss of your ovaries. I have no doubt that naturally occurring herbs will supply hormones that have the capacities that you outlined, but the amounts of hormones that you are mimicking with these herbs are clearly producing hair loss. This suggests that the testosterone and androgenic effects are inducing the genetic hair loss that you have programmed in your genes. I would generally tell you to stop taking the bioidentical hormone replacement and see the effects on your hair loss. Seek out the advice of a competent doctor to try to manage what you are treating.

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Are the Propecia Site Photos Altered? – Hair Loss Information by Dr. William Rassman

dr. Rassman,

I read one of your articles about laser light therapy and the results of the pictures from the LLT could be altered or they could have been touched up to make it look as if more hair growth occurred. Saying that, how do we know that the people on the propecia.com website didn’t alter their images or the images you see from propecia or avodart results are altered?

Yeah, propecia could work, but to what degree and I personally thing propecia just maintains what you have unless you use minoxidil. What do you think?

The studies that show the benefits of Propecia used in Merck’s material are the results of well controlled and audited scientific studies, some of them done under FDA guidance. I would trust official Propecia photographs from Merck, but I would not trust many of the commercial photographs that are produced just to ‘prove’ that the changes are real. If you look carefully on many photographs used for the various potions, lotions, and herbal solutions for hair loss, the lighting, the hair length, the view — they are all different. On some photographs I have even seen scalp coloring agents used in advertisements, particularly for the crown shots on many commercial products.

So, always check the authority of photograph sourcing. For hair transplantation, I offer open house events at both of my offices just because even from the photographs on our website, the average person may have difficulty in determining just what the change really is. When you meet a patient face to face, what you see is reality and not the best view or an illusion created by the person taking the pictures. Of interest, at each of our open house events, we often have a person present who had created all of the benefits on Propecia alone (no transplants) and they have their before shots to prove where they came from. I still believe and preach: Let the Buyer Beware.