Month: July 2006

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Hair Loss InformationReducing Donor Scar – Hair Loss Information – Balding Blog

This blog is very informative. I have had transplants in the past, which look very natural (in my opinion). My concern is with the donor patches in the back. I would like to get more transplants, but the patches become noticable when my hair is short and any more bare spots would be obvious. Is there a surgical method/technique to minimize these blank spots? Thanks for the information.

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I have addressed this question many times. This is a problem more of the past than of the present. See: Techniques to Minimize Donor Area Scarring and Trichophytic Closure Photos.

You need a Master Plan developed to deal with scars and the need for hair in maximizing the value of the remaining donor hair. Scars can be dealt with in most people using the techniques described in the referenced blog entries above. After you read them, call me at 800-NEW-HAIR or write to me again if there are unanswered questions (be sure to reference this blog posting).

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Hair Loss InformationAvodart and Androgenic Alopecia in Women – Hair Loss Information – Balding Blog

What information did you learn about Avodart’s effectiveness in treating androgenic alopecia at the Sept. ’05 conference in Sydney, Aust.? Any hope for female pattern hair loss?

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Avodart (dutasteride) may have value in those men where Propecia (finasteride) fails to work, but as it is not FDA approved for treating hair loss I can not in good conscience wholeheartedly endorse it. It does not show value in women.

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Hair Loss InformationOxymetholone and Androgenic Alopecia – Hair Loss Information – Balding Blog

How soon into a three week period of Oxymetholone therapy will androgenic alopecia become aggravated?

If Oxymetholone does worsen pre-existing MPB, are the effects reversible upon discontinuation of the drug or possibly improved by other means?

Thank you.

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Why are you undergoing Oxymetholone therapy? Do you have a major health problem? If so, you might look to that problem as a cause of your hair loss. I am sorry but there is no magic number and no way to tell, but this steroid is known to cause hair loss and once it kicks in, it may not be reversible. In determining if it might reverse, you may want to know if you have genetic balding and determine the degree of miniaturization you have.

Hair loss and the degree of hair loss can be a very subjective observation until one day you notice you are bald, since you can lose up to half your hair density and still look normal.

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Hair Loss InformationHair Breaks on Top of Scalp – Hair Loss Information – Balding Blog

I am 33 years old female and I am having a problem with hair breakage, it is been going on for about 5 years .The breakage is only in the top of my head ,and that part of my scalp is very sore. I do not know what to can you please tell me if you know about this condition. thank you

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I am having trouble connecting the breakage of your hair with the soreness of your scalp. I think that an examination by a good doctor may be helpful. Most dermatologists can address this problem for you.

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Testicles and Balding – Hair Loss Information – Balding Blog

I recently heard of a story(second hand) where a pair of identical twins, due to an unfortunate accident, were part of an interesting experiment.

Apparently at the age of 21 one of the pair lost his testis in some motor vehicle accident. Now both are in their fifties, the one who was in this accident has a full head of hair, and his identical twin is quite bald. Does this mean that removing your testis stops balding?

I am terribly sorry if this a very silly question.

Thanks for your time

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Good question! I have not heard of that story, but that is a very real possibility. Male pattern hair loss is in part due to a hormone called dihydrotestosterone (DHT). DHT is a breakdown product of testosterone. If a man is missing his testicles, which is the source of the majority of testosterone in his body, he will have a very low level of DHT and should not bald.

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Hair Loss InformationCutting One Follicle to Make Two – Hair Loss Information – Balding Blog

When a hair is extracted with FUE, why doesn’t it grow back? I mean, couldn’t you just extract the greater part of the follicle, and leave a small portion still in the dermis, and it could generate two hair, like follicular multiplication?

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When performing the FUE procedure, you may potentially transect the follicle, thereby damaging it and causing the hair to not grow. The other possibility is that if the follicle is left behind without damage, then it might regrow. What you are postulating has been a study that was done by many people and published in medical journals (an interesting article that addresses this is: “Cloned” Hairlines: The Use of Bisected Hair Follicles to Create Finer Hairlines).

Basically, one hair will not make more than one hair. When a hair is cut in two, one part dies and the other part may grow, but if it does it is often thinner than it was before the damage was done.

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Hair Loss InformationMy Doctor Was Vague About Using Minoxidil and Propecia Together – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

My question concerns the reintroduction of minoxidil into hair loss management. I have been assessed as a norwood 3/3a by my hair restoration doctor in NYC — I’m 24, I noticed thinning at 19, and began using minoxidil 5% immediately. I used it for 4 years, maintaining most of my hairline, although losing some density, and about a year ago started taking Propecia. Unfortunately, around the time I started using Propecia, I lost some resolve, and stopped using the minoxidil. I noticed a dramatic change in my hair, with rapid receding near the temples. The Propecia seemed to be thicking the vertex, but not doing much for the hairline. 6 weeks ago, I had a 1900 graft procedure done (1300 to the frontal area, 600 between frontal and vertex area) and now I’m wondering if I should reintroduce the minoxidil along with Propecia? I’ve been using Propecia alone for 1 year, and my hairloss seems to have stabilized (i see very little hair on the pillow or in the shower). Is it worth it? What are the up/down sides? My doctor gave me a very vague response — something along the lines of “Sure, why not, it’s up to you.” I’m curious what your thoughts are on this situation?

Thanks!

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Relationship between you and your doctor should be a partnership and if you feel there is “vagueness” in his answer or you do not understand something you should approach him and ask your questions. When dealing with your doctor, be direct about not only the question of substance you are asking, but it you feel that he/she is evasive, say that and do not beat around the bush. Please remember you are the client and he/she is your hired agent and you can expect to hold your doctor to standards of communication so tell him/her that.

BaldingBlog is not meant to be a substitute for medical advice or second opinions. That being said, if topical minoxidil has worked for you in the past and you desire to start using it again I think it is your choice. I do not think it will negatively affect your hair transplants as long as it is after one week post surgery. It is my personal opinion that you should continue using Propecia. Minoxidil is not a substitute for Propecia, but it can be a good adjunct to it.

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Hair Grew Back Wavy After I Stopped Shaving My Head – Hair Loss Information – Balding Blog

Hey Dr. Rassman..My question might be a little stupid but I’m hoping you could help me out.. I’ve been on propecia for about 2 1/2 yrs now (I’m 26 yrs old).. During most of that time I shaved my head.. I grew my hair out recently and it came back very wavy. Since then I’ve noticed a large amount of hair shedding.. However the shedding is limited to only when I shower. Between washing my hair (40-50), towel drying it (10-12), and combing it (15), I see almost 80 hairs a day.. After that I put in alot of hair spray and gel and dont see a single hair fall out. Not on my pillow, not on my desk.. nothing.. Is the large number of hairs I’m seeing in the shower ones that just couldn’t come out randomly during the day? My hair is still fairly thick so I wasnt sure if they get caught in my wavy hair..

thanks for the help..

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It is normal to lose about 100 to 200 hairs a day. You may also benefit from following up with a doctor who can map your scalp hair for miniaturization to keep a quantitative record of your hair loss pattern as you continue your Propecia. With your hair short for many years, the hair loss you are now experiencing may have been happening with the short hairs such that you never noticed the fallout. The rougher you are with your longer hair, the more hair you may experience. Be gentle with the hair washing as hair that is miniaturized (impacted by genetic balding) is more far more fragile than thinning hair.

With regard to the change in hair character from straight to wavy, it is not unusual for hair character to change as we get older or as genetic balding starts to kick in. Stay on the Propecia.

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I Considered a Hair Transplant, But I Can’t Take Propecia – Hair Loss Information – Balding Blog

Hi Doc,

Thanks for such a wonderful site, it’s been very useful.

I’m 25 with thinning hair. I have taken propecia for couple of months but I have stopped it because of side effects. I have considered hair transplant but from what I read on your blog, you mentioned that it’ll be really bad to do hair transplant without taking propecia at the same time. So what are my options if I can’t take the drug, should I even consider transplant.

Thanks a lot.

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I don’t think I’ve ever stated that it was bad to have a hair transplant if you are not taking Propecia. If you can find a BaldingBlog entry where I did please let me know.

I often advise patients to take Propecia to prevent possible shock hair loss. However this is after a personal face-to-face consult on an individual basis and after I make an assessment of what the possible long term balding pattern might be. Everybody is different and there are many patients that have hair transplants without taking Propecia, but there is some risk of acceleration of the hair loss without it. The degree of miniaturization will be proportional to the risk of shock loss. There are some 25 year olds who do not have a great deal of miniaturization and they will be a lower risk for shock loss than a person with extensive miniaturization. Maybe a short term use of Propecia to protect yourself from shock loss would be worth trying. If you are considering a hair transplant you should see a good hair transplant doctor to have all your questions answered in person. Remember, there are some absolutes and if you have a hair loss pattern indicating extensive balding is probable, then you must be able to walk that line with your doctor so that you can keep you hair and understand the risks as well.