Month: April 2007

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New Hairs Are Growing In Wavy and Wirey After Transplant 6 Months Ago – Hair Loss Information by Dr. William Rassman

I am into my 6 month since my procedure of 3571 grafts and notice that the donor hair excised from the rear of my scalp which was previously long and straight are now growing out somewhat wavy and wirey – similar to beard/pubic hair.

Is this something to expect and that is normal at this time frame? Will these donors eventually be “re-trained” and straighten from regular combing/styling to evenly match my surrounding hairs???

WavyIt is possible that the microscopic scars at the level of the recipient graft is influencing the direction of hair growth and the character of the hair. Also, I have seen some changes in the texture of the hair shaft after a hair transplant which often (when it happens) corrects after one hair cycle (approximately 3 years). Also, many people have reported that the recipient area is more wavy than it was originally which might be the manifestation of what I just discussed. It could be that the hair was just thicker and healthier, so what you could be observing is just the normal hair (not the miniaturized hair that was normally in the front which is finer and may have a very poor character). Rarely, transplanted hair can become kinky, but I only recall having seeing this a couple of times. The use of gels, mousses, and good conditioners will help you gain control over this new hair — just experiment and find out what works for you.

Balding Forum - Hair Loss Discussion

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How Do Doctors Know That Finasteride Only Affects the Hairs that Were Destined to Fall Out? – Hair Loss Information by Dr. William Rassman

Recently I have noticed thinning at the front of my hairline. I would like to start using propecia but I have heard horror stories from my friends. I was told by one that it actually increased his balding. Apparently he started shedding more with propecia, and what started as a receding hairline also started affecting him in the crown. Is this possible? Can propecia actually speed up balding, or were those just hairs that were falling out anyways? I also heard that once off propecia, the rate of balding increases. I understand “catch up” time, but how do doctors actually know that propecia just affects hair that was destined to fall out? Thank you for your time! Hope to hear from you soon!

When a person who is not balding takes Propecia, nothing happens to the hair. That clearly shows that Propecia does not impact normal hair.

Balding Forum - Hair Loss Discussion

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BaldingBlog Live Chat Announcement! – Hair Loss Information by Dr. William Rassman

Just a quick announcement –

We’re going to try out a new live support feature all next week — starting Monday, April 9th. The online live chat will be available for one-on-one virtual hair transplant consultations with a New Hair Institute physician (Dr. Rassman or Dr. Pak) from 11am-1pm PT.

This is a great opportunity to get your hair transplant questions answered by an expert ASAP. Look for the “live chat” graphic in the right column once the chat is active.

This live chat system will be considered an experiment for now, but if it’s anything like the amount of emails we receive daily, this should be a big success.

Have a nice weekend!

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Hair Loss InformationThe Pros and Cons for FUE / Strip Harvesting – Hair Loss Information – Balding Blog

I’ve put together a nice list of things to consider if you’re interested in having a hair transplant, particularly when comparing the Follicular Unit Extraction (FUE) technique and the Follicular Unit Transplant (FUT / strip) technique.

FUE pros

  • There will not be a detectable scar in donor area. Of course the scar will be present after every skin incision, but since scars are very small and scattered in a larger area, they are not detectable even on a head with a close crew cut.
  • There are no sutures or staples to be removed. The small pointy wounds on the back of the head will be left to be closed on their own with no sutures or bandages.
  • There is minimal or no pain in donor area after the removing the grafts.

FUE cons

  • Not everyone is a good candidate for this procedure. We always test our patients before doing the actual procedure with several biopsies with different methods and view the grafts under microscope to see whether we can harvest them without damaging the hair follicles. If we see a lot of transected (damaged) follicles, we can not proceed with this procedure.
  • It is more expensive (almost double the cost compared to the strip procedure). Follicular Unit Extraction is very tedious and every graft should be individually extracted by the surgeon as opposed to the strip method where skin is removed first and grafts are harvested under a microscope.
  • It takes more time, sometimes up to twice the time when compared to a strip procedure for the same number of grafts. A procedure to harvest one thousand grafts may take six to eight hours.
  • A large area of the scalp needs to be shaved or clipped very short. This is not acceptable for many patients.

There are a few issues that are important to look at and understand. Hairs within a graft can be killed by improper harvesting (e.g. drying, cutting it at a critical point in the anatomy of the hair follicle within a follicular unit). This can happen if there is poor cutting techniques in strip harvesting, or in actual transection of hairs within a follicular unit during an FUE procedure. I personally do not believe most of the doctors who claim 95+% successful hair counts from FUE and I would love to pay a visit to some of these doctors and actually do the hair count from their FUE extracted grafts.

Thick grafts (those that are transplanted with fat around the follicular unit) can tolerate air exposure longer than a skinny graft (which can dry in seconds when exposed to the air). But tolerating air exposure for longer than 10-20 seconds suggests to me that hair follicle death may occur and the staff do not have strict quality control process implemented. What is important is not how many hairs are extracted successfully and anatomically intact. The important question to ask is, “Will they grow?”

The best part about strip harvesting is that there is a very high yield with the experienced team. The risks of scar formation that is detectable (greater than 3mm wide) is about 5% with the first procedure, 10% with a second procedure, and higher with a third procedure. Other than the scar possibilities and a slightly more painful recover period of a day or two, the strip procedure is more cost effective and more efficient from a time and yield point of view.

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Does DHT Cause Miniaturization or Shedding? – Hair Loss Information – Balding Blog

Does an increase in DHT cause hair shedding or does it just cause miniaturization for those who are prone? I understand its normal to loose about 100 hairs a day, but does the DHT increase the shedding to abnormally high levels including hairs that are not miniaturized already?

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The process of genetic balding is produced by DHT (Dihydrotestosterone). If there was no DHT, balding would not occur. The way to prove this is to remove the testicles. If genetic balding had not already started, it would certainly not start after removing the testicles. This has been shown classically when one of two identical twins had his testicles removed. The balding occurred only in the twin with testicles.

There are two ways in which balding occurs. You could go from normal thickness hair to miniaturized hair with progressive miniaturization as the hair shaft loses more and more of its thickness over time. Alternatively, the hair can go into its normal sleep cycle and never come out of it. You might look at this second way as normal thickness hair falling out.

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Young Daughter is Losing Eyelashes – Hair Loss Information by Dr. William Rassman

My 11 year old daughter recently began losing big clumps of her upper eyelashes. I have heard that hypothyroidism can cause this, but she is very small for her age and has none of the other symptoms. What else could cause this sudden loss of lashes?

Get her evaluated for medical problems such as thyroid disease, anemia …..

Balding Forum - Hair Loss Discussion

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Percocet, Gabapentin, and Female Hair Loss – Hair Loss Information by Dr. William Rassman

I fractured my C4 vertebra 3 months ago and underwent 2 spinal fusion surgeries within one week. Subsequently I was on multiple medications for pain and muscle spasms (percocet, gabapentin). I have weaned myself off the meds; however, in the past week I have noticed significant hair loss. When I brush or even just run my hand through my hair, it’s coming out in small bunches. I have a good diet and am taking a lot of vitamins and flaxseed oil. What do you think is causing the hair loss and what can I do to stop it? I do not take birth control pills, btw. Thank you.

People who have had surgery and stress, can lose their hair. Add to that birth control pills in combination with the surgery, and there are two contributing factors. I would have a complete medical work-up to determine if there are other contributing factors. Female hair loss is often associated with a variety of medical conditions.

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If Propecia’s Half-Life Is Short, How Can It Be Effective? – Hair Loss Information by Dr. William Rassman

Hi, Dr Rassman.

I’m a caucasian male, 30 years old.

Can thyroid problems hasten or kick start the balding process? I’ve been diagnosed with hypothyroidism and have experienced early signs of MPB around the same time. No member of my immediate family has severe hair loss and certainly hadn’t lost any by age 30.

If propecia’s half life is so short, and only reduces DHT in the body modestly, for only part of the day, why then can it be so effective at treating hair loss? Are there other, hidden attributes to Propecia that we do not yet understand that is helping millions of men stave off the shiny dome?

Thanks, Doc. You have a great site, and I’m a daily reader!!

Thyroid problems can precipitate hair loss and hair texture.

You are correct in stating that Propecia’s half life is short (about 4-5 hours). That is why you need to take it everyday. There is also tissue fixation of the drug that probably reflects a longer tissue hair life (not easy to measure) that may hold the effects on the hair follicles. The testing on hair regrowth and hair counts were done with various doses from 20mgs per day down to less than 1 mg per day. The results were published showing that the 1mg dose was as good as a higher dose in treating hair loss. As many of you know, finasteride is packaged in a 5mg dose as Proscar (or generics), which is used for treating prostate disease. Seeing as how Propecia is the same medication, it may also help your prostate health.

Balding Forum - Hair Loss Discussion

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Growing a Heart from Stem Cells – Hair Loss Information – Balding Blog

British scientists have just grown a heart valve from stem cells. Sir Magdi Yacoub, who led the team involved with the project, guesses that an entire heart may be grown using this technology in 10 years. Do you think that this advance will speed the process of hair cloning/multiplication any?

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HeartI am aware that stem cells can grow organs. Hair is an organ so if you can grow a heart, then one should be able to grow hair from stem cells. There are clinical trials presently underway that show stem cell placed in the heart, will grow heart cells.

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