Month: July 2006

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My Transplanted Hairline Was Too Low – Hair Loss Information – Balding Blog

im 22 and had 500 grafts done in my receding temples about 6 months ago. i experienced severe MPB at 18-19 and hairloss had been stable since then. the hairline was carefully marked by myself before the surgery so i cannot blame the doc, but now i feel it could have been 1/2 further up. the hair are very fine and not very dense, just as i wanted them on temples(not too dense, just enough to cover). in the future can these be moved 1.2 up??

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Not really. It is very difficult to move transplanted hair. I tell patients that transplanted hair is always permanent and that is why it should be done right the first time. If removal was to be attempted, it would have to be done with a Follicular Unit Extraction (FUE) technique. You can have a brow lift which will give you a higher hairline, moving the transplanted hair upwards, but that is fairly radical surgery for someone of your age.

I am disturbed that some doctor would transplant a 22 year old and that the hairline would be placed low. The fact that there were only 500 grafts also disturbs me, because it indicates that the balding is not severe. Were you on Propecia? If not, then there is clear malpractice here. You need an expert to assess your situation.

A hair transplant is for life. That is why I constantly emphasize the Master Plan in hair restoration. To achieve the maximum cosmetic benefit from hair restoration surgery, a personalized Master Plan should combine the best information available with a realistic assessment of what your future hair loss may be. It is an integral part of the patient-doctor relationship.

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Chemical Burn from Foil Highlight – Hair Loss Information – Balding Blog

A customer is claiming she recieved a chemical burn in my salon but I don’t think it is the correct diagnosis. She claimed that several days after she recieved a foil highlight with bleach she noticed a bald spot in her hair. She was not burned on the skin and the hair is not broken off but a bald spot is present. She felt nothing unusual during the service but insists it is from the foil. Is it possible we are responsible even with no scalp irritation or does it seem more likely there is another explanation.

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Your question is a delicate matter in terms of liability and almost certainly will have legal implications. All chemicals and or medications may have a potential for side effects. It is impossible to know the cause of your customer’s hair loss without examining her scalp and hair. We all look for a cause and effect relationship, but sometimes the two may not be related and be serendipitous in terms of cause and effect. It is possible that the bald spot was there at the time of the bleaching (and not noticed) or that it would have developed, even without bleaching. Unfortunately, this person has control over what they will do about the bald spot. Aggressive lawyers may see $$$ while a doctor may look for a diagnosis like alopecia areata. The decision on her response is clearly out of your hands. In conclusion, there may or may not be a relationship with the bleaching she underwent. Even if there is a relationship, you may have done nothing wrong.

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15 Year Old Losing Hair From Sides and Back of Head – Hair Loss Information – Balding Blog

For the past year I have been noticing my hair loss, and it is getting to the point where I can’t hide it. The part that scares me is that I am only a 15 years old male. Could this be male patterned baldness at 15? It is not just falling off the top of my head but also falling out the sides and the back. Is any of this normal?

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While it may be normal (but rare) to be affected with male pattern hair loss at the age of 15, it should not affect the sides and the back of your head. You may consider visiting a medical doctor who can evaluate you for any treatable medical causes for hair loss, because your hair loss may be secondary to a medical issue. If you had a ‘typical’ case of genetic hair loss, there will be patterns of miniaturization seen in the distribution patterns typical of those defined in the Norwood chart. Mapping your head and scalp for miniaturization will show this if that is the case. Otherwise there are rare conditions such as alopecia areata or diffuse unpatterned alopecia (DUPA) which are generally not easily treatable conditions.

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Grafts Growing in Scarred Tissue – Hair Loss Information – Balding Blog

Does a graft always have the potential of growing? Even in an area of scarred tissue? Or where a hair has been extracted?

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If the scar tissue is healthy scar, it will support follicular units. Healthy scar actually bleeds when cut. Scars often have a rich vascular network, but some skin grafts (split thickness grafts) and burn scars may not have enough vascular support for a hair transplant. A healthy graft will grow anywhere it is placed when the blood supply is adequate. For example, a follicular unit placed on the end of the nose will grow to pony tail length.

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Hair Loss InformationFUE and Hair Cloning – Hair Loss Information – Balding Blog

I’ve been reading many of the blogs on your website, and they have come in quite handy, but one question I have, I could not find. I asked this question before on your website, but I didn’t get a response. I wanted to know if you extract a hair follicle with FUE, and then if something better came around such as hair cloning or something like that, then could I then replace the extracted hair. (e.g- If you extracted a hair, does it have the capability to grow another hair if a hair is then implanted back to that same spot? -Would really like to know. Thanks

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If you had a FUE procedure, where an individual hair follicle is taken from the back of your scalp one at a time and reimplanted to a balding part of your scalp, you would be left with a small punctate scar which would be virtually undetectable. It would be impractical to reimplant a hair follicle back to the FUE site, because the scars are too small. To the human eye, the FUE site would not even look thinner, because it takes over 50-60% of hair loss to detect any thinning.

To put it straight, if you could get a hair follicle or a follicular unit, or a cloned hair for that matter into an FUE scar, it would almost certainly grow.

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Hair Loss InformationWhat Causes Missing Facial Hair? – Hair Loss Information – Balding Blog

i just wanted to know what causes the bald spot in my beard and will it ever grow back? please help me

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A very short question without any detail is hard to answer…

  • If the bald spot is from a scar, it will likely not grow.
  • If the bald spot is genetic, it will never grow. American Indians and some Asian people do not have full facial hair and this is genetic, easily treated with transplants.
  • If the bald spot is from you pulling or plucking your hair, it will not grow unless you stop. If you pulled it too long, it may not grow.
  • If the bald spot is from a cancer, you should see a doctor.
  • If the bald spot is from shaving, it will grow back.

I hope this helps.

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ScalpMed and Propecia – Hair Loss Information – Balding Blog

I started Scalpmed and stopped taking Propecia. About that time I experienced hair loss. That was about 4 months ago. I thought that Scalpmed would do a better job. Do you think that it was not the right thing to do?

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I would suggest that you get back on Propecia, for its possible benefits. The result of stopping Propecia means that you played “catch-up hair loss” which means that you lost all of the benefits of the drug, something that happens over a period of about 4 months. I have seen some wonderful results and am generally enthusiastic about this drug as part of a master plan for stabilizing hair loss (at a minimum), but without the drug, you are exposed to the impact of DHT on the genetically impacted hair follicles.

ScalpMed appears to use minoxidil as an active ingredient but it does not stop the DHT from doing its job. Restart Propecia and pray. For more on ScalpMed (or Scalp Med), please see here.

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Desperate at 23 – Is a Hair Transplant Worthwhile to Me? – Hair Loss Information – Balding Blog

Letter from a person in Europe:

I am 23 years old and i am suffering from hairloss male pattern with a receeding hairline. I am contemplating a procredure and I want you to tell if it it is worthwhile. They assert to be the best in the industry. Can i trust them?. Have you heard of them?

Going through such a horrible condition at such a young age, as you can imagine is truly stressful. My personal doctor says nothing can be done and i have seen dertmotologists who say nothing can be done either. So i am taking things to the extreme.

Thanks

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I have reviewed your pictures today. You appear to be a Norwood Class 3V pattern. At the age of 23, I would rather that you start taking Propecia (finasteride) before you do anything. If you have a transplant without that drug, you will accelerate your hair loss and if you think you are miserable now, it will be worse if you became much balder immediately after a hair transplant. The issue always is: Where is your balding going and what is the Master Plan for what you will have to manage over the years in front of you? With the genetic balding that you are showing in the photos you sent to me, anybody that would recommend transplants without giving you at least 8 months of finasteride, would be in my opinion incompetent and immoral. There is no doubt that a transplant on you now will leave you more bald, not less so; PLEASE do not start transplants without 8 months of oral finasteride. Get your hair mapped out for miniaturization to anticipate your pattern of eventual hair loss and then get a competent doctor who will put a plan for your long term (you have years to live and I do not believe you want to live it as a bald man). I have seen too many unhappy men your age who go for a transplant out of desperation and then use up the valuable donor hair without any plan and no way to ever look normal again. Do you get what I am saying?

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My Doctor Told Me To Use These – I Need an Opinion – Hair Loss Information – Balding Blog

I was on Depo Provera for 9 months (3 shots) for ovarian cyst control and as of my last shot, my hair started falling out in large quantities all over my head. Some days it sheds a lot ( more than 150 hairs), other days it’s normal hair shedding, but I now have 1/2 the hair I had 3 months ago and my scalp tingles. My regular doctor said that shedding is possible with Depo and it should stop soon when the Depo wears off. I am now on Microgestin for the ovarian cyst control and just found out that it is high in androgens, so I’m not sure if that means my hair will take longer to grow back in. I feel fine on it, other than the continued hair loss. While on Depo, I was prescribed Nizoral shampoo 2% for the control of excessive dandruff and scalp flaking, but I am wondering if I should keep using it given my hair loss? Any helpful info would be appreciated.

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You should ALWAYS consult with your doctor for any medication changes. You may also benefit from seeing a good dermatologist for these problems and also explore any medical conditions (other than medication related) that may be responsible for your hair loss. Female hair loss is frustrating for doctors because there are few treatment options if the diagnosis is purely genetic.

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Treating Female Androgenetic Alopecia with Proscar and Avodart? – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

Thank you for your ongoing commitment to hair loss! You are a Godsend, my friend.

I have female androgenetic alopecia (first uncoverd after using Accutane) diagnosed at age 27 by scalp biopsy. I began using regular Rogaine, only available at that time. I am now 41 and use an advance regimen of Xandrox 5% BID topically, Proscar 5 mg QD, Spironolactone 100 mg BID, Avodart 2.5 mg (just started two weeks ago) as well as Saw Palmetto, Stinging Nettle, Pygeum, Soy Isoflavones, as well as a few other things like Viviscal and use the Laser Comb every other day. I try to keep up with the latest advanced and spend a lot of time and resources keeping my hair on my head.

My question is there is conflicting information in the literature about the best birth control pill to take to help with adrogenetic alopecia. I currently take Desogen but have tried Ortho Cyclen, Ortho Tri-Cyclen and Yasmin. I use the American Hair Loss Associations guidelines now. Can you weigh in?

Also, any idea when there will be a topical growth modultor that keeps the follicles in anagen? I’ve seen Dr. Kevin J. McElwee of the University of Vancouver’s work with mice and it is facinating.

Your thoughts on these issues as well as any other advice is much appreciated. Take care and thanks in advance for your kind reply.

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You are scaring me!

Finasteride currently does not have a FDA approval for use in women. Even if it did, Proscar (5mg finasteride) is a very high dose for androgenic alopecia and in the studies on men, it was shown that the 1mg dose was just as effective as the 5mg dose. That is why the recommended dose is 1mg for androgenic alopecia.

Avodart (dutasteride) is not FDA approved for the treatment of androgenic alopecia. There are many patients who still use Avodart for hair loss, but they typically do not use it in combination with Propecia or Proscar and I do not understand the logic for this therapy. Avodart has a very long half life (the time it take half of the drug to be cleared from the blood stream) measured in weeks or months (compared to a few hours for Propecia) and this makes its dosing a controversial issue because nobody really knows what the best dosage to use is. The most important factor for women taking these medication is its potential implication of cervical, uterine, ovarian, and breast cancer because of its hormonal interactions and its potential for birth defects (well proven in pregnancy).

General disclaimer that needs repeating — BaldingBlog is not meant to diagnose medical condition or give medical treatment plans or advise. It is meant to educate the general public on hair loss issues. Before taking or stopping any medication, please see your doctor and discuss any issues, but I can state categorically that you are on a plan that has little benefit in sight and great harm as a possible clinical outcome.