Month: January 2008

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My Hairline is Very Asymmetric – Hair Loss Information by Dr. William Rassman

Hey there, I have been battling with a receding hairline for a while now. I’m a 23 year old male and have noticed that my hair has been receding on my right side, this has caused my hairline to be very asymmetric. I noticed my hair thinning quite considerably a the back center and top of my head however i’ve recently been taking finpecia and this has thickened right up. In a moment of madness i decided to shave my head and its very noticeable that the one side has receded a ”lot” more than the other side which remains as if it hasn’t receded at all. I’ve haven’t seen anyone else with this problem and i have had a few comments from family and friends on my hairline since shaving it. Is there anything i can do, it looks terrible.

Balding is a dynamic process and it may occur asymmetric. While hair transplants and medications such as Propecia and Rogaine can help, there are limitations and there is no “quick” fix. You can take some comfort in knowing that the other side will likely catch up in receding, but I doubt it is much comfort. If you are concerned about hair loss, you should see a hair transplant doctor. Remember that surgery is not the only option.


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My Hair Loss from Accutane is Different – Hair Loss Information by Dr. William Rassman

Hey, I am currently going through Accutane hair loss for 9 months. I was diagnose with ‘Diffuse Alopecia Areata’ by my derm. and currently on steroids. The question is, what can I expect in the future? My hair loss is unusual compared to other Accutane hair loss sufferers. I shed mainly short and medium hair, only occasionally would I notice long hairs being lost. Some of the hair strands that I loose are finer compared to the rest which are thick in comparison. I only receded only at my right temple while the left is perfectly fine. Also both the hairs above my ears have receded at least an inches above, and its skin bald. What can I expect in the future? Thank you

I don’t know what to expect for your future. If you have diffuse alopecia areata, the hair loss may not be predictable. What did your dermatologist tell you? You need to seek the advice of your doctors who know you, not me who only sees a brief outline of your situation via email.

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My Hair Transplant Is Growing At an Unnatural Angle (with Photo) – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

Thank you so much for the service you provide the public with this site. It must be alot of extra uncompensated work for you, I appreciate it.

I got a 1300 hair graft about 9 months ago to the area that I roughly outlined in red (on both sides of my head of course, I am only showing one side). As you can see it is growing at nearly a 90 degree angle on my head whereas my natural hair falls forward. Even though I cut my hair at the same length, the transplanted area looks twice as long because it is growing directly ‘up’. My two questions are this: 1. Is this a lack of skill on the doctors part that it is growing at an unnatural angle? and 2) if I keep trying to comb it forward can you gradually adjust the natural angle of the hair so that it matches with the rest of my hair as to the angle that it grows (or will the transplanted area permanently be at odds with my natural hair growth angle)?

My doctor recommends a second procedure because as you can see the transplanted area looks quite thin. I am 26, do you see any concerns with having a second procedure done with this doctor, or do you sense a lack of skill and I should look elsewhere? I have minor thinning in the crown area as well, but I do not plan on transplanting anything to that area. I have been on propecia for 9 months, and while it has not totally regrown the crown area, I am hoping that it will prevent further loss in that area.

Many thanks, and feel free to post the picture.

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Thank you for permission to post your photo. Please click the photo to enlarge.

You are correct. It seems your hair was transplanted at different angle than your native hair. The surgeon planning for the correct angle and direction of hair is a very important factor in a hair transplant procedure. Unfortunately, this is very difficult to correct and relatively impossible to reverse. Your transplanted hair will always grow in that unnatural direction. One of your options is to have another transplant procedure and make sure that the new transplants are in the correct direction to “blend” in with your hair.

With respect to a second surgery with the same doctor, you need to be able to trust the doctor before having any procedure. Doctors are human beings and they can make mistakes or misjudge the many decisions that are before them in a treatment plan. If you and your doctor have a good trusting relationship, I am sure he/she will see the difference in angle and your concerns and will be more than happy to accommodate accordingly. The key here is to directly discuss this with your doctor first, and then make decisions on the value of the doctor/patient relationship.

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Hair Loss InformationCan Scalp Exercises Cause Traction Alopecia? – Hair Loss Information – Balding Blog

Hello doctor

Could exercises that many doctors are recommending to increase the looseness of the scalp, when performed for a long time, cause any problems ( e.g. traction alopecia ) ?

Thank you

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Scalp exercises are used to increase the laxity to the scalp, as shown in this video:

 

As long as you are pushing down on the scalp and not creating constant pull 24 hours a day, you should not have traction alopecia from this. Traction alopecia occurs when you keep your hair pulled or braided too tight constantly over the course of many months. Traction alopecia and scalp exercises are two different things.

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Two Cases of Significant Sperm Count Reduction While on Propecia – Hair Loss Information by Dr. William Rassman

See Propecia-induced spermatogenic failure: A report of two cases. by Liu KE, Binsaleh S, Lo KC, Jarvi K.

The conclusion of the article states:
Two cases of infertile patients with azoospermia or severe oligospermia who showed significant improvements in sperm concentrations 6 months after the discontinuation of finasteride. In one case, improvement in semen parameters prevented the need for testicular biopsy and corrected the azoospermia. Stopping finasteride in the infertility population may improve semen parameters, and may allow for less invasive fertility treatments.

We have already heard about similar, more frequent side effects with Avodart (dutasteride). While I am not completely surprised, I suspect the frequency is very low. I’ve written about sperm count and Propecia in the past:

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Tooth Abscess and Hair Loss? – Hair Loss Information by Dr. William Rassman

i am a 21 year old male and i have been experiencing diffuse hairloss for the past 2 years give or take…my family tells me im crazy but i believe my hair has thinned alot….if i dont put it in exactly the right place u can see right threw into my scalp….my problem is that it doesnt appear to be male pattern baldness because it didnt start at the back of my head or my temples it started in the middle of my part (i used to have long hair) it honestly resembles female pattern baldness more than male pattern baldness-although recently my hairline did start to move back on the right side(only about a 1/4 inch if that)… my question is can an abcess tooth gone untreated be causing this???…after racking my brain for a reason this seems to be the only logical thing since the hairloss started happening just after i hurt my tooth…but my hairloss hurts me more than my tooth :) also my older brother who is 23 still has his hair and my little brother 19 still has his hair though my dad waas completely bald by 26 and acctually i naturally have thicker hair than both of them….please let me know i want to get this taken care of…. thanks alot!

A tooth abscess should not produce hair loss, other than an added stress in your life (stress can cause hair loss in some people or accelerate genetic hair loss if the stress is prolonged). You need a diagnosis, which I really couldn’t begin to help you with unless I see you.

If you are balding, then you do not have to start at the back and move forward with your balding process. Every man is different. What you are calling female balding is what I call diffuse unpatterned alopecia (DUPA) and that diagnosis can be made by mapping out the scalp for miniaturization. Get a diagnosis by seeing a good doctor and then develop a Master Plan for what you might go. You do want to for sure know what’s going on with your hair loss, right?

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Can the LaserComb Cause a Mole to Become Malignant? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I have two questions about the use of low-level laser light therapy (laser combs). I have forwarded these questions to the makers of the Hairmax and they could not answer them or even venture a guess. I was disappointed because they advertise this big team of highly touted medical advisors, but their customer service department would not even check with one of these so-called advisors for an educated guess. So, what good are they?

Anyway, here are my questions. If a clear, ready answer is not available, can you please use your medical and scientific education, training and experience to venture an educated guess? Please.

1.) If a person has a mole on their head, could the use of a laser comb somehow “activate” the mole and cause it to become malignant? Should this be a concern and is it even a remote possibility?

My next question is in regards to the use of a laser comb along with the use of photo-sensitive medications.

2.) As you know many medicines, and even some herbs, such as St. Johns Wort, have photo-sensitive properties. This means that if someone is taking a medicine or an herb such as St. Johns Wort, they should limit their sun exposure time and avoid tanning beds. If a person is taking something with photo-sensitive properties, what will the effect be using a laser comb? Is there a contraindication? Can the use of a laser comb, in this case, be harmful or contraindicated?

On the other hand, it has crossed my mind that it might actually enhance the benefits of the low-level laser therapy due to the synergistic effect of the medication potentiating the effect of the laser light.

Bottom line: Will the effect of using low-level laser therapy, along with a photo-sensitive agent be detrimental (adverse effects/use with caution?), beneficial (it will synergistically increase the benefits of the product?) or neutral (no effect either way/it doesn’t matter?)

Your email raises good questions that haven’t been asked here before, but I wish I had answers for you. Any answers to your questions would not have the proper data that can be depended upon. I would suspect that the amount of time exposed to the LLLT is not sufficient for the problems you are asking about, but that is just an assumption.

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After My Hair Was Chemically Straightened, It Smells Burned – Hair Loss Information by Dr. William Rassman

I has my hair straightened for a few days, and when I washed it, it smelled burned almost. I’ve washed it three times and the smell won’t go away. What’s wrong with it and how do I stop it.

You may just be smelling the chemical residue. It should wash off eventually.

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Bald Spot Started As Small Spot Months Ago, Now It is Growing – Hair Loss Information – Balding Blog

I have a spot on the left side of my head. It appeared in the summer as small as a pea and know is about 2 inches. The hair that falls out looks like an exclamation point it is thick and then really thin near the scalp it also is discolored. My hair is dark black so the ends near the scalp are light brown. The bald spot is very smooth no hair or subble. What might this be and what kind of doctor should I visit my doctor has no clue.

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I think that this is a test of my knowledge. ‘Exclamation point hair’ is a telltale sign found in certain diseases like alopecia areata (see Exclamation point hair). If the spot is expanding, then that may be your diagnosis. You need to see a dermatologist for your condition. Different diseases can cause this type of patchy hair loss, but the most common in western countries is ringworm (a fungal infection problem).

Alopecia areata is an autoimmune disorder in which hair is destroyed by the body’s defense mechanism. For those that have it, there is a genetic component which can be identified in the DNA. Hair loss could be seen anywhere in the body and is more obvious on the head and face, because of the density of hair in those areas. Recovery is spontaneous, but may take several months to years and it may not reverse. Some medications may facilitate recovery from this condition, but the best treatments are in the hands of a few doctors who have a particular interest in this disease.