May 2008 – Page 11 – Balding Blog

May 7, 2008

Hair Loss InformationHair Continued Thinning After Hair Transplant, Now I Want to Undo It All – Hair Loss Information – Balding Blog

Dr. Rassman,

I had a transplant procedure 7 or so years ago. Since then, my hair has continued to thin and even though the hairline was done well, one can discern that they are transplants. If I was to have the donor scar repaired and buzz my head to a # 1 clipper, would the transplant sites be very discernable (on top of my head?) If I was to pluck them out, would the recipient sites have scars? I am not really sure what to do. If I hadn’t gotten the procedure done I would probably shave my head close. I would also like to know if I had additional procedures done, would I be able to go with a buzz (#1) cut? Thank You

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A hair transplant is forever, which means you shouldn’t do it unless you fully understand what is going to happen to you, even in the worst case scenario. I don’t know how to answer your question without seeing you. If the transplants were follicular unit transplants (FUTs), there is a good possibility you could shave the hairline, but based upon the what you describe, I suspect that the grafts were not follicular units. When there is any significant amount of skin in the transplanted graft, the skin will have some deformities associated with it. The larger the amounts of skin (which comes with procedures like minigrafts, micrografts, larger plugs, follicular families, double follicular units, etc), the harder it would be to get away with shaving the frontal scalp. Most people like you are easy to fix with more transplants, but it has to be done with FUTs and in enough numbers to fill in the problem area, but again I can not say this for sure without seeing you or your photos.

As you indicated that you’re in New Jersey, Dr. Robert Bernstein has offices in your area, so I would suggest that you see him for a straight answer, or you can send me photos to the address on the Contact page (reference this post, please).

May 7, 2008

Reduction of Childhood Scalp Scar – Hair Loss Information – Balding Blog

I have a childhood scar in the back of my head about 1 inch long and 1/2 inch wide. I’m looking to possibly get scar reduction surgery, and wanted to know how it’s works and an estimate of the cost? And any suggestion you may have.

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The ability to address scars on the head depend upon where it is located. I would have to see you, examine your scalp, and then make the determination. I can not quote a cost without seeing you directly, but most costs are $3,000 or less.

May 7, 2008

Propecia Success Rates – What’s Your Take? – Hair Loss Information – Balding Blog

Hello dr,
I have a question which i have searched all over the web seeking for answer and couldnt find it. i know merck say propecia have around 80% in stopping any further loss, my derm said that in his experiece it has only around 60% in doing so, I would really appreciate knowing what u make of the success rates and based on your experience what would u say the rates truly are in stopping any further loss?

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I tend to see that the rate of Propecia halting hair loss is quite high in young men, but I don’t have actual percentages. I do not make statistical analysis of the men that I prescribe Propecia to.

May 7, 2008

Why Don’t Hair Transplant Doctors Get Hair Transplants Themselves? – Hair Loss Information by Dr. William Rassman

I see a lot of hair transplant doctors’ pictures who have receding hairlines or who are bald. How come they don’t get hair transplants themselves?

Some doctors have had poor transplants themselves and although it might be hard to believe, comments made amongst the staff at the hotels that host our medical meetings have been overheard. People just don’t expect to see doctors with poor results, considering that they are in the business! Others decide that they do not want a hair transplant for personal reasons and I respect that the procedure is not for everyone. Quite a number of doctors in this business have had transplants and some even have their photographs on the Internet showing nice results, but of course, I can not tell you who they are for privacy reasons.

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May 7, 2008

Lost My Temple Hair 35 Years Ago and I Want to Grow it Back – Hair Loss Information by Dr. William Rassman

(female) i lost my temple hair when i was about 16. my mother said it was from using sponge hair curlers. i am 51 now i’ve tried everything. it starts to grow then comes back out. no one else in my family has this problem.what can i do help?

I’ve not heard of a complete loss of temple hair, following by regrowing and falling out over and over for decades like you’re describing, so I wouldn’t know what non-surgical solution to provide. On the surgery side of things, we have transplanted hair for women with temple hair loss. I would need to see photos of you before rendering an opinion though, because without seeing what you’re describing I really don’t know if you are a good candidate.

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May 7, 2008

Can You Keep This Patient’s Hair Looking Dense If He Loses More Hair? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman
Browsing the NHI site i found this 25 year-old man, Patient QE. Very good job. My question is that if this man becomes a type 4a in a few years, can you give him the density he has now?

Norwood Class 4A This is an important question, because the doctor is putting hair where it has disappeared, but the process of losing hair is not static. With progressive hair loss that comes with genetic alopecia, you need to have a Master Plan and a good doctor. The doctor should lay out the worst case scenario for you and the remaining hair after the hair reconstruction should be present in adequate reserves to make up for any progressive hair loss that should occur.

Your particular question is good, because the patient you are referring to could eventually develop a Class 4A pattern and almost everyone with a reasonable hair density can follow hair loss to the Norwood Class 4A or even a 5A pattern with another transplant procedure. If the patient stays on Propecia, then it is likely that the hair loss process will be slowed.

May 6, 2008

Hair Loss InformationWould Low Dose Accutane Still Cause Hair Loss? – Hair Loss Information – Balding Blog

Hi Dr.,
I have acne & a dermatologist keeps recommending accutane in a low dose (10mg) for about 20 weeks. I have rejected the idea cause Ive read enough to believe that it can cause hair loss, but Im wondering if the dosage matters, will taking a low dose like 10mg lessen the possibility of hair loss?

Thanks

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Firstly, you need to discuss these issues with your doctor. How can you simply reject the plan set up by a doctor who has (1) seen you, (2) examined you, (3) established a relationship with you, and (4) recommended a treatment plan with you — and then expect me to advise otherwise?

Accutane (isotretinoin) can cause hair loss, just as other medications can cause hair loss. The most common cause of hair loss in men is genetic balding. You and your doctor should decide what is the cause of your hair loss and if Accutane is the focus of that cause, then you have decisions to make with your doctor under his/her guidance. You also need to consider why you are taking the medication and think of the risks versus the benefits.

I can’t answer your question, because I simply don’t know. I don’t prescribe Accutane and from what I’ve researched on it, there isn’t one certain amount of Accutane that can cause hair loss. Accutane doesn’t cause hair loss for everyone that uses it.

May 6, 2008

Scalp Muscles – Hair Loss Information – Balding Blog

Dr. Rassman,

What are the various muscles of the scalp, and what purpose(s) do they serve? Does the location of these muscles have anything to do with the classic male balding pattern?

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There are no muscles actually in or below the scalp except the temporalis muscle extending from the side of the head and somewhat up the sides, the frontalis muscle below the forehead skin, and the occipitalis just in the very back of the head. All of these muscles end (roughly) at the scalp and form a fibrous tendon like fascia called the galea, which covers the bony skull and periosteum.

There is no connection between hair loss and the muscles of the head.

May 6, 2008

Wellbutrin and Hair Loss – Hair Loss Information by Dr. William Rassman

(female) Does wellbutrin cause excessive hair loss? I’ve been on it for almost a year and a half and started noticing hair loss 7 months after I started the medication. Now I’m loosing 115 or more hairs (I’ve counted – those are just the ones that didn’t go down the drain) just by washing it and styling it in the morning. More falls through the course of the day. My family doctor doesn’t think it’s the medication but internet research seems to indicate something different.

Wellbutrin (bupropion) is amongst a group of similar drugs known to cause hair loss as a side effect. As far as I am aware, any antidepressant medication can cause hair loss in some people. I have had patients report this Wellbutrin side effect to me directly and certainly the internet is replete with comments to that observation.

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May 6, 2008

Liver Problems and Facial Hair Loss? – Hair Loss Information by Dr. William Rassman

I was brought to your site by asking the question about missing facial hair. I am a 31 year old Male, I have first stage chyrosis of the liver, I was born with biliary atresia, other than that I have been very healthy throughout my life and lead an active lifestyle. Up until about Easter of 2008 I had a full face of hair, then a small spot appeared about the size of a pencil eraser, now I have three patches about the size of a silver dollar all located by the chin bone. Should I see skin specialist of just ask my Internist if this is related to my disease. Thank you.

It sounds like you are a fortunate man, as so many people do not live a good life with biliary atresia (see Wikipedia). I would imagine that you should first consult your primary doctor, then a good dermatologist. Patches of hair loss can reflect a wide variety of problems and I am uncomfortable with evaluating you for them over the Internet without examining you.

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