January 2007 – Page 13

January 9, 2007

I See Pitting Around Grafts After My Hair Transplant – Hair Loss Information by Dr. William Rassman

Hello,

I am 28 years old and had 700 grafts at the age of 23. Just over four months ago I went for a second procedure for 1450 grafts. I have noticed small pits where the grafts are when light shines down on my head. I am terribly regretful for starting this when I was young, just out of college and very emotional. why do I see pits? I went to a very reputable doctor. Is this normal when transplanting hair? My only hope is the new transplanted hair will mask the scarring.

Thanks

Just five years ago, few doctors were using Follicular Unit Transplantation (FUT). I might assume that the grafts that were used were relatively large, and those larger grafts tend to have more skin in the transplanted grafts that tend to form pits, cobblestoning and other changes in the recipient area. The techniques of FUT, which we defined in 1995, set the standard that had been slow to catch on. You should ask your doctor just what type of grafts he/she used. One way to tell is if your doctor used a microscope for the dissection, it showed that he/she probably was doing FUT. FUT does not pit as a rule.

You need to be evaluated by an expert in repairs who follows the rules outlined in our two classic articles on the subject Follicular Transplantation: Patient Evaluation and Surgical Planning? and The Aesthetics of Follicular Transplantation. The repair of a faulty transplant takes clear skills, so be sure that your doctor has those skills. Ask to see some of the patients that your doctor repaired to get one more step of confidence in your doctor’s skills.

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January 9, 2007

1000 Days for Hair Growth Process? – Hair Loss Information by Dr. William Rassman

Good evening, Dr Rassman,

Firstly, may I compliment you on a most professional and helpful site.

Secondly, I would like to know what time of the day is best to take Propecia. Also, I have read that the first stage in the hair growth process lasts for about 1000 days. So why does it take only 6 months for Propecia to start working?

Thank you.

I realize I just posted something similar to this earlier today, but I generally recommend that you take Propecia in the morning, for that is when the testosterone level is highest and the drug levels are highest in the first few hours of taking it. The half life is 4 hours, so by evening, the circulating levels of the drug will have substantially dropped. There are also ’tissue’ levels of the drug that last beyond the half life of the drug in the blood.

As for hair growth, there is no 1000 day rule. I believe that the drug kicks in a few months and may last for many, many years. It varies between patients. Please see Propecia and Hair Count.

January 8, 2007

Hair Loss InformationDishonest Doctors Are Still Out There – Hair Loss Information – Balding Blog

I am 23 years old and I want to tell you my story. I was worried sick as I saw my hairline starting to climb. I went to a doctor in Toronto who said that I was going to go bald and needed to take swift action to prevent it. After listening to him, I went into a panic, took out most of the money I saved to go to graduate school and got transplanted with 2700 grafts. The doctor lowered my hairline also (about 1/4 inch) as well and transplanted the entire front, top and back of my head. I did some comparative shopping when I was investigating who to see about my problem and found that the price he was charging me was very competitive at slightly under $4/graft Canadian ($10,000 in cash). After the transplant was done, I found my hair falling out faster than before. The doctor told me that the new hair will replace far more than I lost and that I was lucky to get to him before the the hair had fallen out. It is now 10 months since my surgery and I am worse off now than before the surgery. I have less hair and a hairline that is nothing like the pictures the doctor showed me when I was shopping. I am very depressed, so much so that I feel that what I did to myself has created a monster. I needed to tell someone about this, but I am not sure what I am asking of you. What would you advise your son to do if he screwed up like this?

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This is a tragic story, one that is hopefully not common today. To be blunt, you got taken advantage of. To do 2700 grafts on a 23 year old with little or no balding and only a receding hairline is not only malpractice, but (in my opinion) it is criminal. You got scammed and fleeced. The doctor who preyed upon you took advantage of his position, breached the Hippocratic Oath and probably violated the law.

I speak over and over again on the importance of commanding this process. You need to meet patients directly, one on one, and see the results for yourself. You need to examine the practice of the doctor you are intending to do the surgery to find out about his/her ethics. Their patients will tell you what you want to know. I can remember an unethical, scummy medical facility from many years ago that gave out a list of patients to call for references. I knew that these doctors were crooks, so when I got the list, I called down the list of patients. What each and every person on the list told me was that they would never recommend their doctor, that they were deformed by that doctor and that they felt cheated, raped, and ripped off. What I also learned from the patient victim that gave me the list is that he never called the patients on that list, because he assumed that these people were 500 good references for the doctor — clearly not the case.

What you should have learned here is that you must protect yourself from the unethical doctors out there. I would certainly notify the governmental agency that controls the doctor’s license. In America, you can file suit and clean up if this was the criminal process that it sounds like. Elective cosmetic surgery is a Buyer Beware business. There are good doctors out there who do practice ethical medicine. So for our audience of readers, I hope that you learn from this young man’s mistake — learn that it is your job to research your doctor before you buy.

I feel empathy for you. If you would like to talk with me, please set up a conference with me at 800-NEW-HAIR.

For more information, please see:

January 8, 2007

Minoxidil and Pregnancy – Hair Loss Information – Balding Blog

I am a 33 year old female who has been using 5% minoxidil for the last 2.5 years. The minoxidil has helped hair to grow in the thin/bald areas of my head and has been very sucessful.

I want to try and have a baby this year. I know it is not advisable to take minoxidil during pregnancy but my question is to when do I need to stop. Is it OK to be using it while I am trying to conceive and to stop as soon as I know I am pregnant? I’m worried that if I stop now and don’t conceive for a long period then I am going to have to suffer the bald patches again.

Thank you

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Topical minoxidil has small absorption from skin that can potentially affect the baby during pregnancy. There is not enough information on humans for the use of minoxidil during pregnancy, but animal studies showed some side effects on babies. To be on the safe side you should not use topical minoxidil during pregnancy. Of course, stopping the drug may cause reversal of the benefits in a short 3 month timeframe. Using minoxidil during lactation is thought to be safe. The good news is that your hormonal balance during pregnancy is toward protecting hair growth and strengthening hair via a surge of estrogen. Your hair loss may be affected adversely after pregnancy (telogen effluvium) and during this period you can restart taking topical minoxidil.

January 8, 2007

Why Are Treatments Not Effective in Temple Regions? – Hair Loss Information by Dr. William Rassman

hey,

why is it that propecia and minoxidil aren’t (as) effective in the temple regions? i happen to be thinning in the temple largely, and have been on propecia for approximately 2 months. should i continue and hope that there is regrowth in the temples or continue for posterity’s sake?

At two months, you can not draw any conclusions about the effectiveness of Propecia. You need 8-12 months. I only report what the drug company submitted to the FDA as the basis of my knowledge on this drug and the areas of effectiveness. When you talk about ‘temples’, many people believe that the temples are what I might call the corners of the frontal hairline. You need to either send me a photo and show what area you are calling the temples, or see me in person to give you an appropriate opinion.

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January 8, 2007

How Often Should I Be Washing My Hair? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I just would like to know if it is better to wash my hair every day or not so much – e.g. twice a week. Skin on my head seems to produce lot of sebum (hope it is the right word), so I think it is better to wash it more often but I read some articles stating it is quite unhealthy.

So I would like to know your skilled opinion.

Regards

When your scalp makes a great deal of sebum, the oily feel and appearance of the scalp can be managed with daily hair washes using a shampoo made for oily hair. I wash my hair daily.

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January 5, 2007

Covering Up a Hair Transplant Days After Surgery (with Photos) – Hair Loss Information – Balding Blog

This patient has black hair and white skin, so his short ‘beard’ shows at the hairline where he was transplanted just 3 days before these photos were taken (see photo to the left, below). He just combed his hair forward and to the side (as shown in the photo to the lower right) to camouflage his hair transplant. People who do not wash their transplants correctly, may scab more than those who do wash properly. When a patient has hair to use for cover, creativity in styling goes a long way to cover up transplants. Two days after this picture was taken, all of the ‘scabs’ shown in the below photos were gone. Please click to enlarge.

January 5, 2007

Masturbation and Hair Loss, Revisited – Hair Loss Information by Dr. William Rassman

I saw an article on masturbation leads to hair loss. Is it true?

http://www.herballove.com/article.asp?art=62

Does masturbating twice a week counts as over masturbation?

Masturbating absolutely does not lead to hair loss, no matter how often you do it.

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January 5, 2007

I’m 20 Years Old and Had a Hair Transplant 6 Months Ago – Hair Loss Information by Dr. William Rassman

HI! Doctor. I have been reading many blogs and I need to ask you one imporant question. I am a twenty year old male and its been six months since I had my transplant in the crown area. The only reason why I went for this transplant so early is that cause I had started losing my self confidence cause of really thin hair on my scalp. Now my crown area is becoming thick day by day. But on the other hand, I am losing my hair on the top of my head. Is there any way to retain my existing hair now? I am really worried and it would look really bad if I get bald at such an early age. I have been taking Genesis ‘finasteride’ and it has done a lot for me too. Like it helped me a lot before I had my transplant. But since transplant, I think it has started losing its affect . Please doc I need help. Is their anyway I can stop my existing hair?

Plane crash I am very concerned that you had a hair restoration procedure at such a young age, especially in the crown area and many doctors including myself might think that this is not an approach that an ethical doctor would do. Of course I do not have the luxury to examine you in person, but surgery is rarely recommend at such young age, particularly in the crown. More importantly, having surgery too early may actually accelerate hair loss and you may end up with negative (worse off) results. It sounds that way to me.

While finasteride (Propecia) is a great drug at slowing and sometimes reversing hair loss, it is not a cure either. Men of your age should start off with a one year course of finasteride first. This drug (in a 20 year old) may reverse hair loss in the crown. If it does not reverse, it will slow down the progression of hair loss, but if you have a transplant too early, the acceleration of the hair loss is an almost predictable conclusion. In one scenario, the hair loss you are experiencing may have been accelerated by your transplant and now you are faced with “chasing” the progression of hair loss. You could eventually run out of hair before completing the hair restoration process if you have one of the more advanced hair loss patterns. With the amount of hair loss you are telling us about, it sounds like you are well on the way to a more advanced balding pattern and may find yourself running out of hair. If anything, I would continue the finasteride treatment and have your scalp hair mapped for miniaturization to track the progression and the rate of your hair loss. You must create a long term Master Plan with a good, reputable, honest doctor before doing any more surgery. Don’t feel like you need to contribute to your doctor’s BMW car payment. Even after one mistake, you still might be able to build a plan that will work for you, but more surgery without a plan is like an airplane running out of fuel at 30,000 feet, for there is no soft landing.

January 5, 2007

I Have Psoriasis, Hair Loss, and Low Self Esteem – Balding Blog

hi,
i have psoriasis all in big regions of my body mainly my scalp and im balding on the top. my self esteem is already low. i want to keep my hair so bad to hide the disease . i need some answers. and i just started rogaine. no signs

I truly empathize with you. What you described is just what I went through. My psoriasis started in my scalp and moved through much of my body over the years. You need to get a good dermatologist to help you manage the psoriasis. Whatever you do, do not pick on the psoriasis flakes in the scalp, for you could get traction alopecia to compound your problem. There is no magic bullet for this condition. Some newer medications have allowed better control for the really bad psoriasis, but it still can’t be cured.