Month: July 2006

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0.6mm Tool for FUE – Hair Loss Information by Dr. William Rassman

Hello or “Hej” – as we say in Sweden.

I did read a post from you talking about FUE instruments, you use 0.9mm and smaller tools will cause greater follicular holocaust, you said.

Recently I did read a blog entry from you where you talked about FUE and the development of smaller tools.

I’m confused. Here in Sweden we have an intresting option, 0.6mm. Is this pure nonsense or could this surgeon be that good? Method is called “FUE plus” and is said to transplant 120-180 hairs / cm2.

I did notice that you said that 200 hairs / cm2 is the original density provided by the “man above”.

Why increased follicular holocaust when using smaller instruments?

I am hopeful that some breakthrough will come about that will allow smaller instruments to be used, but alas I have not seen them yet. Without knowing the doctor who proclaims such miraculous instruments, as a betting man, I would wager that some lack of proper representation is the case here. Add to such a wonderful instrument, the ability to achieve within 90% of God density and you have FUE God Plus. That means that some doctors can improve on what God might do if he (or she, depending on your beliefs) was a transplant surgeon here on earth.

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Propecia and Follicular Neogenesis – Hair Loss Information – Balding Blog

Hello Doctor and thank you for this your answers on this forum. I was curious about two things. First, is it true that taking Propecia will SOMETIMES help maintain the other areas of hair you are not taking the medication for? In this, I mean if I were to take Propecia for very minimal vertex thinning, but my hairline and frontal hair are perfectly fine the way they are right now, will propecia help keep those hairs in perpetuity? (in general of course, I know there are no guarentees in all of this). Second, do you keep up on the latest information regarding the process currently being worked on called follicular neogenesis (the elusive “cure all” for baldness? I’ve heard from many sources (including Bosley reps) that within 8-10 years, all the kinks MIGHT finally be worked out of this, thus hopefully ending and curing baldness. I know the key word is “might,” but I was just curious how much you’ve heard about it and your thoughts. Thank you so much.

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Divide the term follicular neogenesis into three words and you get:

  • Neo: New
  • Follicular: Refers to hair unit of growth
  • Genesis: A biblical term suggesting source, creation, derivation of something, birth, the beginning or origin

Put them all together and you get a new technology — or at least the name of one. Sounds like a good name to me. There are many people working on technologies that will create new hair follicles from the source (possibly the stem cells that generate hair follicles) once we learn to control the stem cells. The success of forcing stem cells to create hair follicles is about 10% now with a great deal of randomness to the process. I have heard the same estimates of time (10 years) for the resolution of things related to cloning, etc…

Your first question has a problem with it. If the hair is thinning in the back, then there is genetic balding possibly in other areas as well. Thinning either means miniaturization of the hairs or loss of density. Propecia works better in decreasing the miniaturization (increasing the thickness of the hair shafts) than it does with restoring the density (growing new hair). I do not believe that Propecia (finasteride) will prevent the loss of either hair shaft thickness or loss of density, but I do believe that it will prolong the period of loss for years.

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What DHT Level Am I? – Balding Blog

I read this on one of your posts: “…but what about the young man with a stronger Type I and Type II DHT blocker”

Is there any such test to find out what type of DHT type / level / category I am? Cheers!

I think that you misunderstood what I was talking about (see Regrowth – Phase II FDA Hair Loss Study Results for Dutasteride). Each of us is the same with regard to the way these drugs work on us, so you don’t need to check yourself out to categorize yourself (as you asked). Dutasteride is more effective at blocking both type one and type two receptors, making it superior to finasteride, at least in theory. As what studies there are have incomplete clinical trials, we can not be sure what this all means and certainly we do not know enough about safety in the young man taking this drug for his lifetime.


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Thinning Runways an Indicator of Further Baldness? – Hair Loss Information by Dr. William Rassman

RunwayHello,

Thanks very much for answering my previous question. I thought of another question that I can’t find the answer to in previous posts. I know from your posts that recession at the temples and some recession in the frontal hairline is the sign of a “mature” hairline and will not necessarily lead to genetic baldness. Is slight thinning in the “runways” along the sides of the head or on the crown always an indicator of further baldness to come, or can thinning happen in these places as part of a normal mature hair pattern, without leading to further baldness?

Thinning in the runways or anywhere in the crown usually reflects miniaturized hairs. This is often the precursor for balding. Sorry if you don’t like that answer. Few do!

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Sexual Side Effects Months After Propecia Use – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

Last year I had a hair transplant done at the New Age Hair Clinic and along with that the recommendation of taking propecia to help prolongue losing more hair, which makes sense obviously. Propecia really worked for me and I was pleased with its results combined with the transplant, however, after six months I noticed those sexual side-effects I had been told about. I never worried about it because it had such a small percentage tagged to it so I figured I wouldn’t have to. But now I have no sex drive and difficulty achieving and maintaining erection…but others as well. There is no orgasm for me anymore and most of the time a loss of ejaculate and when something does come out, it’s almost like a gel… My penis has lost feeling and almost in a way “detached” shall we say from the body because i really can’t feel it that much anymore. This worries me because I have been off the drug for six weeks now. My real question is have you ever seen these adverse effects permanent in a patient? It’s really starting to scare and depress me… I figured it would take a few days to get out of my system and once I saw it was only temporary go back on it because I don’t want to lose what I worked at with the transplant, as is what my doctor recommended, but the effects seem worse now than when I was on it… Can you help me at all? Should I go back to using it or keep waiting till I see improvement and then perhaps use it? I would really appreciate any information you can give me… The dilemma of choosing between hair and sex drive is a hard one being I am only 23… I want both. My doctor can’t help me at all so maybe you can, I’m hoping. Also, have you ever heard of a hair-loss product called scalp-med? I saw it on tv and checked out their website at scalpmed.com and it looked good because they say no sexual side-effects because it’s applied directly to the scalp, but it all seems too good to be true so I was wondering if you knew if it was legitimate or not. Thanks for taking the time to read and respond to this. I appreciate it.

Propecia, hair loss, penis detachment, orgasm, ejaculation… OH MY! From the tone of your writing, I can see that you are very concerned about hair loss and sex. Worry not, for I would say you are like most men. If you obsess over something like your hair loss and image, you can produce impotence. Your sexual problems might be related to the Propecia use, but the problem should go away soon after discontinuing Propecia. Propecia certainly does not stay in your system for 6 weeks after stopping its use. Your sexual problems may be psychological or you may have an underlying medical condition that you have not been diagnosed with. If it continues to be a problem you should see a medical doctor for a formal evaluation. With respect to Scalpmed, there are numerous posts on the product here.

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Increased Scalp Testosterone with Dutasteride – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,
I have seen the results of the study that has shown significant increases in scalp testosterone with dutasteride (104% for 0.5 mg). Could this major increase in scalp testosterone contribute to further male pattern balding, since testosterone can also bind to the androgen receptors in hair follicles? Basically, is there any possibility that the decrease you get in DHT from dutasteride could be overwhelmed by this increase in testosterone? thanks very much.

What you are talking about is as much science as speculation. From what I have learned from doctors who use dutasteride in those patients who do not respond to finasteride (Propecia), the report is that it is stronger and more effective. I have addressed the scalp testosterone levels with dutasteride before here. More insights may be obtained by looking at pubmed.gov.

I only have a limited understanding of the pharmacology here, so I would rather just refer the readers to better authorities.

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Ibuprofen and Hair Loss? – Hair Loss Information by Dr. William Rassman

In November 2004 I took Ibuprofen for a knee injury and by the end of the week my pain was unbearable; the Ibuprofen did not help with the pain at all, but all of my hair fell out. Well, I used Nioxin and have been taking one Biotin and 3 Hair, Body, and Nail pills a day.

My hair on my head is growing back (finally) It’s very short and I can see differing lengths…. But I have also noticed very fine hairs growing on my face and not just where my eyebrows used to be. Is this the normal fuzz that was probably there before that I didn’t notice or are my vitamins trying to make me look like a man.

I’m 37 years old. Please help me.

While many drugs may cause hair loss, I suspect your hair loss may have been coincidental or from the physical stress caused by your knee injury. With respect to the fuzz you notice on your face, it is most likely that was there before and you had not noticed. You can see this in everybody. We’re all fuzzy!

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I Want to Lift Weights 2 Weeks After Hair Transplant Surgery – Hair Loss Information by Dr. William Rassman

Weightliftingregards doctor, my question is i have had a my surgery 2 weeks ago and have my staples removed I am going to wait a month to lift heavy waits but I am still concerned that it might be too soon and will stretch the scar and if so how much will it stretch or bleed. Really worried about that. and will working out heavy affect my grafts?

Working out will not impact graft growth, just the risk of scarring in the harvested donor area (assuming you had strip harvesting). I tell my patients that they can run a marathon in 7 days, but hold off anything that works the trapezius muscle as it might potentially stretch the scar in the back of the head.

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Hair Loss InformationInjecting Saline Into Scalp To Transplant Higher Density? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

A couple of years ago I remember reading an article about a hair transplant doctor at UCLA (I believe) that was able to transplant a higher amount of hair into a site by first having the scalp injected with a solution (possibly saline) to actually swell or enlarge the scalp area so more hair could be transplanted into the area. Later when the swelling receded the results would yield a higher density.

Can you comment on this. Is this something that you would recommend? Why or why not?
Thanks!

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Many hair transplant surgeons will inject saline into the scalp to accomplish just what you are talking about. The important thing to focus upon is graft survival. Are the grafts packed so closely that the blood supply may be compromised? It is possible. I recently saw a patient done by another doctor who had the skin in the recipient area develop gangrene from a decision to put too many grafts too close together in skin that could not tolerate dense packing of grafts. The details of what the surgeon does is not a simple one thing vs another thing. A good hair transplant is the result of a complex series of decisions and takes into account not only the size of the grafts and the nature of the skin, but many other judgments. I have heard doctors focus on one thing that makes them unique, but ask yourself, “Am I being pitched a sales line here?”