June 2008 – Page 8 – Balding Blog

June 16, 2008

Hair Loss InformationI Want to Sue My Hair Transplant Doctor! – Hair Loss Information – Balding Blog

Dr. Rassman,

Hi doctor. I wish I could be writing to you under different circumstances, but I’ve got a major problem that I need some advice on. I had a hair transplant with a doctor here in Canada about 10 months ago and I really, really hate the results. This doctor completely ruined my appearance. I’m considering legal action due to what I feel are unethical practices. A couple thousand dense-packed grafts were placed in the hairline (some of them were placed at the wrong angles), and many 2-hair grafts were also placed there. My hair is dark and coarse, so it just does not look right! I’m considering electrolysis to try to undo this and maybe start over elsewhere. I need help!

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Electrolysis

It is quite hard to remove hair by electrolysis and lasers without creating hypopigmentation (loss of skin color) in the area where the grafts are taken out. Surgically removing the hairline could work, but it would require real expertise in doing this. Hairs transplanted in the wrong direction / angle should be a real concern and some of the solutions can be as difficult to achieve as the actual problem you are trying to solve.

I always tell the patients I see to talk with their doctor. Most doctors care about the results you got and the doctor should be able to address your problem in detail. I always tell patients that the good news and the bad news about a hair transplant is that it is permanent. It is very hard to undo them if they are not done properly. I couldn’t tell you if legal action is the way to go — what I can do is try to help get you back to normal looking. You do have a very real problem, but I would have to see you in-person to determine what can be done to help your particular case. Whatever happens, you must know and set realistic expectations on what can be achieved with any ‘repair’ that you undergo.

June 16, 2008

Eradicating Baldness – Hair Loss Information by Dr. William Rassman

Hi Doc!

Don’t you think male-pattern-baldness will be extinguished over time, without proper medication? I mean, the society we live in tend to get more shallow each year, and for that reason the percentage of women choosing balding men over non-balding men seems to decrease significantly. Since genes are playing a big part in determining one’s final balding pattern, I guess “bad genes” will be replaced with “good genes” over time if women are giving birth to children conceived mostly by non-balding men.

Assuming that you are right (women choose non-balding men), it would take many, many generations to wipe out the balding gene. I really don’t believe that women will choose only non-bald men anyway. We are, as a society, not so shallow!

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June 16, 2008

Coloring Hair After Chemotherapy – Hair Loss Information by Dr. William Rassman

How soon after chemo is it safe to dye the hair??

If the hair has not fallen out and you have passed that critical phase where it would normally fall out, then you can use a gentle semi-permanent dye to color your hair. Semi-permanent dyes that are acidic are made of small molecules which can pass through into the cortex of the hair. As all of these dyes are water soluble, they can be easily washed out. They may last for between 1-6 weeks depending upon what dyes are used, but they lose their effectiveness with frequent washings. These are generally safe and can be used at home. Since these do not contain bleach they can not lighten the hair, but darkening gray hair is reasonable.

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June 16, 2008

An All-Too-Common Problem — Restarting Propecia After Realizing that Stopping It Was a Mistake – Hair Loss Information by Dr. William Rassman

I was taking propecia last year. I have read on your blogs that stopping the medication is not good if one has to achieve effective results.

However, now that i have restarted taking it, I was wondering can propecia + 5% minoxidil bring back lost hair? Or it just treats existing miniaturization? How many years of lost hair can one gain back, That is if the medication is effective?

Basically, i’m looking for hope, considering i did the mistake of discontinuing….Thx.

Propecia Unfortunately, there is no way to answer your question other than provide these points:

You need to see a doctor who can follow your hair loss and establish a good plan for your specific situation (this may involve starting Propecia or minoxidil or even nothing at all).
I doubt you will regain what you have lost and the stopping of the drug did you no service. Undoing it is something we may or may not observe, but it is worth a try.
There is always hope as long as there are reasonable expectations.

I hope that our readers really take note to what has happened here, because it seems that so many people start the drug, do not give it a chance, stop the drug for a variety of illogical reasons (not observed side effects), and then they want to undo the decision. This hair loss problem is progressive and you never make up what you lost in terms of the opportunity to stop the hair loss early.

June 16, 2008

Age-Related Thinning – Hair Loss Information by Dr. William Rassman

Hi Doc,

I’ve been working at the same office for 17 years. Many of the same guys I started with are still there. As I looked at pictures of the group over the years I noticed every guy has less hair. Not bald, but you can see a decreasing hairline or slight thinning in the crown over time. Do drugs such as Rogaine and propecia prevent or regrow age related thinning which appears to happen to most men over time?

About half of the male population will have genetic hair loss so what you may be observing is just that. Not everyone with genetic balding gets very bald.

I’m unclear about what you mean by “age related thinning”. If you’re talking about the natural maturing of the hairline or the thinning that occurs as men age, then no, it is not likely that medication will regrow this hair. If you happen to work at a place where the men all coincidentally have some degree of genetic male pattern hair loss, then yes, those medications will likely help in some degree.

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June 16, 2008

After Switching to Avodart, I’m Losing More Hair – Hair Loss Information by Dr. William Rassman

I have recently begun taking avodart (.5mg) after taking propecia for ten years. I began the avodart due to research suggesting it to be more effective. I have been using avodart 7 mos. I feel I have lost more hair in my temple areas. Should I have expected more positive results by now or could I be experiencing some shedding due to the change in meds as is sometimes the case when patients usually start a new hair loss therapy.

Avodart Although it does sound unusual, I can not explain what you experienced with the switch to Avodart (dutasteride). I have no real experience with Avodart and only know what I read. There were clinical trials conducted in Korea for dutasteride to treat hair loss, but I’ve yet to see them published. At this time, Propecia (finasteride) is the best FDA-approved oral drug for slowing or stopping the hair loss process, but if you have the genes for male pattern baldness, you will still eventually bald, although at a slower rate with the medication. If/when Avodart is approved to treat hair loss, I’ll look into revising that statement.

Propecia has a poor record of slowing frontal / temporal recession, but it (in my hands and I suspect the hands of many other doctors) does slow or stop even frontal loss in many, but not all, patients — and therefore we can expect Avodart to do at least the same.

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June 13, 2008

What Are the Chances That My Hair Loss Has Stabilized at Age 35? – Hair Loss Information – Balding Blog

Hi Dr. I love this site, been reading like crazy. Thank-You. I first realized that I was developing some balding at the right front side area when I was 29. I didn’t pay much more attention until about 32/ 33 because my hair covered up okay and frankly I had never heard of propecia as an option. As I type this I’m now 34 and have been on propecia for just 10 weeks (no side effects) as my hairloss is more noticeable in the front. My hair is full in the sides / top and back with virtually no balding at the vertex but if you look at me from the front I have the shape of hairloss in and upside down U with the centre still intact at the original hairline . I’m taking the propecia as a defense measure against any further balding and because I NEED to keep this middle centre portion to have any chance of styling at all. My question is …. At nearly 35 is there a good chance I have stabilized ? I am committed to propecia for life because a pill a day is no big deal….is there a chance I could turn those “thinned” out hairs into better coverage hairs in the ” upside down u”. Thanks.

P.s the generosity of your time here is very appreciated.

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Genetic hair loss is progressive, and although it does generally slow down, that may not apply to you. From your history, you did not really lose enough of your hair to notice it until you were in your early 30s. That means that you were a late starter and that your hair loss will be progressive later in life than the general rule in the majority of young men.

Get your hair mapped out for miniaturization ASAP so that you can compare the impact of finasteride 1 year after you started taking it. Between the two measurements and the degree of miniaturization that is there now, you and your doctor may be able to predict what will happen to you in the future.

June 13, 2008

Hair Loss InformationPossible Alopecia Areata, Plus Hair Loss from Prednisone? – Hair Loss Information – Balding Blog

Hello Doctor,

I’ve been treated for alopecia for about 3 years – mostly on the back of my head. After taking prednisone for the first time, large areas of back scalp balded, instead of just the typical circles. I was then given a larger dose and hair grew back – but very fine, white color, and short – like baby hair. Is there a chance I will get “real” hair back or may my follicles have been damaged.

Thank you

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Prednisone is known to cause hair loss, but based on your description, I would guess that you also have alopecia areata (you mentioned alopecia, but also said that you used to have “typical circles” of hair loss). Have the circles of hair loss regrown in the past?

This is a complex problem with many presentations and many progressions. However, guessing so blindly is not what doctoring is about unless I am treating you and I have all of the facts. You need to present these questions to your doctor, who can examine you in person and hopefully diagnose your problem.

June 13, 2008

What’s Up With Hair Transplant Surgeons That Make a Low, Straight Hairline? – Balding Blog

Dr Rassman,

I have always been a fan of yr ‘Master Plan’ approach to dealing with hair transplant surgically. However, recently, through some hair transplant blogs, I managed to find a few patients undergoing ‘dense-packing’ method up front the hairline area and crown.

This very well-known and highly-regarded hair transplant surgeon seems to be a complete opposite of what you are doing. A look at this patient’s photo gallery, one can only be flabbergasted (more than impressed) by the transformation the patients went through. This is especially so in the hairline constructed – usually thick, low and virtually straight. Also, per hair line procedure, grafts from 1500 to up to 3150 grafts are usually used. Leaving only aother 2000-3000 grafts avaialble for future transplant. I am an advocate for careful hair transplant Master Plan, but seeing such amazing hairline done, one can only be moved and inclined to doing it with this surgeon.

Did you think this surgeon would have considered the impact of future hair loss in these patients or it is simply an amazing surgeon at work?

I can probably guess who this surgeon is, though I won’t do that here. If I am correct though, this surgeon basically does 3000 grafts on almost everyone that he sees (even those who are not balding very much). I would assume that he has loaded the very front of the hairline with very dense packing of the hair amongst other existing hairs that have not fallen out.

In my experience, some patients with fine hair just don’t get those densities. I would question if he’s cherry-picking the patients that he wishes to show. You are correct in your analysis, as many of these patients will not have much hair left after he finishes his first one or two sessions. Maybe there is a Master Plan, but it may not be in the interest of his patients.

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June 13, 2008

Site Software Upgrade – Hair Loss Information by Dr. William Rassman

~~We’re doing an upgrade of the blogging software this morning, so there might be some intermittent problems. Things should be back to normal ASAP (if they leave the “normal” state at all)…~~

In the meantime, feel free to email us with any ideas for the site that you may have. This site would be nothing without the support of our readers, so I’d love your feedback. I’ve had a few readers ask for a full message board, for example. Do you want a full message board, where you can create your own topics and discuss them amongst yourselves? Let us know!

Update: Software upgrade complete. No major hiccups.

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