September 2008 – Page 6

September 19, 2008

I Have Dense Body Hair — Experiment on Me! – Hair Loss Information by Dr. William Rassman

This is for Dr.Rassman. You have done a great job having this blog for awareness and information but I was hoping if you could help me out or advise me regarding hair transplantation. I have already mentioned this a while ago to you that I didn’t see the 100% growth on my crown area because the Doctor i had done it from was just making money out of me. He didn’t inform me that my donor area is not sufficient to provide good follicles. Anyhow, i have seen your replies on BHT. As an east Asian (Pakistan) I have the genes of being hairy, my back,chest,abdominal areas are just hairy. And they are pretty dense. I guess this is my last chance because cloning is not even near. I am going to be married next year but i have told every one that my hairs are back because i didn’t want to be embarrassed. My only question to you is How much is BHT and please Dr. is there any way I can be your object,trial,experiment? i am student and facing the worst time of my life. Thought you may have something for me.

In my opinion, results of body hair transplants are not well documented. I appreciate your desperate cry for some solution, but sometimes the best advice a doctor can give is just by making the patient aware of limitations in medicine. Moreover, I don’t like to experiment on patients when I know the the technology and the results may well be very poor.

September 19, 2008

Gray Hair in a 7 Year Old – Hair Loss Information by Dr. William Rassman

Hi, My son is 7 years old and I noticed a strand of grey hair on his head. Please let me know as to how this is happening and what can I do to prevent it further.

This is a genetic process, so my initial thought was that genetics would be the likely cause. Something has probably triggered the premature graying. Some people feel that this is an errant gene, like a chimerism in your son. There are a series of vitamin deficiencies that could also cause it, including vitamin B-12, although these are found in many foods. Some disease syndromes can be associated with it as well. See DrGreene.com for more information.

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September 19, 2008

Finasteride and Type I Collagen – Balding Blog

Hello Dr. Rassman
Please tell me what is the effect of Finasteride on type I collagen (I think its the same which is found in skin) as stated in this study in simplified manner

Perifollicular Fibrosis: Pathogenetic Role in Androgenetic Alopecia (PDF file)

thanks!

That is quite an article. I am not sure that I can extract the answer to your question from reading the article quickly. Those individuals with miniaturization seem to develop a thicker capsule to the follicular unit, but the effects of finasteride on this finding are not clearly stated in the article. The impact of DHT appears to be about 5 times more sensitive on the androgen receptor than with testosterone alone.

The study requires an astute understanding of the biochemistry of androgen receptor activity on the collagen in the dermis. I recommend the reading of this article for those scientists in the audience. I’m the wrong person to simplify this study, but if anyone else wants to contribute, please feel free to post a comment.

September 19, 2008

After 6 Weeks, The Transplanted Hairs Didn’t Fall Out But Also Didn’t Grow – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,
It has been exactly 6 weeks today post off, for a FEU of 2000graphs. Now I had experienced a some shock loss after my operation for a while, still have but has been minimized a little, but with that being said most of the hairs that were transplanted have no ’shed’. Infact they are still in tract but the only problem is that they are not growing. I was told by my doctor that all the transplanted hair would fall off within the first month. Should I be worried? Does this mean the procedure is working slower on me?

Thanks

Your doctor advised you correctly — they will shed sooner or later. I have seen some hairs remain up to a year and the hair transplants grew around them. If you pull on those short hairs, they usually come right out with no traction on them, because they are not attached to a bulb or to the underlying tissue, and have no muscle attachment on them. The shock loss you are talking about is independent of the short hairs that remain.

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September 18, 2008

What Should I Do After Propecia? – Hair Loss Information by Dr. William Rassman

I’m 22 and have early frontal hair loss which I noticed 6 months ago and been on Propecia for 2 months now. I got a miniturization study done and the doc said I have it in the frontal area and a little on my mid anterior and he said it’s significant for my age (well in my opinion any thinning my age shouldn’t happen!). You always say Propecia works best for young men my age and we have a good chance of reversal and halt the hair loss but since men who start thinning my age are usually the baldest and have faster hair loss the others, how good in the long can Propecia work then? I know I’ll be fine for about 2-3 years but what then?

And it’s funny how weak MPB is in my family. Nobody except my father and mom’s brother had MPB but not until theirs 30s. My father is a NW5 at age 64 and my uncle is a NW3 with mid anterior thinning as well at age 40.

I have many male patients that first got great benefits from Propecia at your age, and now 10 years later they still have those benefits. I’m not sure how to answer your question — as I’ve said before, I can’t tell the future. Maybe there will be another drug available? Maybe your hair loss stops completely? Maybe you decide in 10 years that you hate hair and would rather shave your head? For now, stick with what is proven to work (Propecia).

There are patient results statistics for after 2 years and after 5 years on Propecia available here, and hopefully that will give you a little more peace of mind.

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September 18, 2008

Scalp Flexibility and Lack of Blood Flow – Hair Loss Information by Dr. William Rassman

Hi,

I’ve noticed that my thinning area’s scalp is also very thin and stretched very tightly onto the skull, unlike the area where I have no thinning which has a thicker scalp with more cushion and flexiblity. What causes this? Is it the lack of bloodflow to the area? This only occurs on the thinning areas…

You are very observant. The loss of hair produces the loss of infrastructure, which is all of the associated parts of the hair organ including blood vessels, dermal fat, collagen, nerves, and muscles associated with the hair that take space and causes that cushion you are noticing.

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September 18, 2008

Galeatomy Procedure – Balding Blog

Dear Dr. Rassman,

The question is in regards to the galeotomy procedure – originally pioneered by Dr. Lars Engstrand out of Sweden – I believe. The procedure was also popularized by the late prolific health writer Paavo Airola in his many writings.

I find this sunbject very interesting and have noticed an increasing interest for this procedure on the hair-loss forums, but very little information exists. I have heard that this procedure is quite effective and yet it seems to be totally ignored (or suppressed) in this country. What do you know about this procedure? Do you think it works? Do you have any first hand experience with anyone who has had it done? Do you, or can you, perform it? Does anyone in the U.S. perform it?

Please take the time to share what you know about this interesting topic.

Galea The galeatomy has been around for years. For those of you who do not know, above the skull lies the periosteum (the living membrane above the bone) and then the galea. Above the galea lies the scalp, which is very mobile (try to move your scalp around and you will see just how mobile it is). The scalp has a clear blood supply coming from the front, sides, and back of your head. The blood supply lies above the galea, so cutting the galea makes no sense. It is not easy to get to the galea unless you cut open the scalp. We have done galeatomies years ago with scalp reductions and today’s hairline lowering procedures, and brow lifts will frequently dissect the galea as part of the mobilization of the scalp. As working below the galea is relatively bloodless, it is a terrific surgical plane to work in. Cutting the galea will not increase the blood supply to the scalp, but will just produce morbidity if it is done in isolation of some good surgical reason to do it.

Competent doctors do not do perform this barbaric procedure for the treatment of hair loss.

September 18, 2008

Forehead Feels Cool, Seeing Wrinkles After Using Minoxidil – Balding Blog

I have used minoxidil for my hair thinning on the vertex and hairline and it is working great! Except I’m noticing a disturbing, growing sensation on my forehead since I have been using it.

Whenever I would apply the minoxidil, my forehead would have a cool, wet sensation for about 20 minutes as if cooled water was running over it but it wasn’t the minoxidil or water. Nevertheless, I have been using it for 2 months and my forehead feels STIFF and I’m noticing wrinkles! I’ve read the 2 archived topics about wrinkles & minoxidil (i.e.”Using Propecia at Temples, Wrinkles From Minoxidil…” ) but I found documented studies about how it effects collagen synthesis (see: Medscape & Investigative Ophthalmology & Visual Science)

I’m assuming that minoxidil would be the cause of my facial stiffness (so bad, it feels like my forehead is duct taped) and gradual appearance of wrinkles. I’m a 25 year old male. I would greatly appreciate it if you could reply. Thank you so much!

Aside from that previous post from a reader, I’ve never heard complaints about wrinkles being caused by minoxidil. None of my patients have reported that to me. The studies you sent are interesting, but I’m not convinced that minoxidil will cause wrinkles. You might have some kind of allergic skin reaction to an ingredient in your formulation of minoxidil. I’m just speculating, of course.

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September 18, 2008

Born with a Bald Spot – Hair Loss Information by Dr. William Rassman

ive had a bald spot on the side of my head since birth. hair has never grown there before. the spot is about 1.5 in. by .75 in. can a hair transplant fix this? would it look natural? and how much would a spot like that cost?

What you describe seems simple enough. A hair transplant should generally cover the area well and with natural results. It would likely involve a few hundred grafts. Our surgery fees are listed on our website, but our minimum fee is $3000 for any procedure. Sometimes if the spot is small, a reduced fee can be arranged under special circumstances.

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September 18, 2008

Blocking DHT in Post-Menopausal Women? – Hair Loss Information by Dr. William Rassman

What is the best form of DHT blocking for post menopausal women. Is it safe to use propecia in my case?

Dihydrotestosterone (DHT) does not usually cause hair loss in women. As mentioned before (Female Genetic Hair Loss Is Different From Male Genetic Hair Loss), the common causes of women’s hair loss are different than typical causes of men’s hair loss.

Although the DHT blocker Propecia (finasteride 1mg) is not approved by the FDA for use in women, there are doctors that will sometimes prescribe it for women, but these are highly individualized cases that require patient education and informed consent. First, the woman should make sure that they are not carrying the breast cancer genes. If they are not, then there is little downside that I know of. Many, many doctors are prescribing Propecia for post menopausal women because the protective effect of estrogen is reduced. The reports, however, are anecdotal and not trustworthy.

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