January 2009 – Page 10

January 13, 2009

Eyebrow Hair Stopped Growing After Waxing! – Hair Loss Information by Dr. William Rassman

(female)
Hello! i use to go and get my eyebrows waxed. The last time i did was about 7 months ago and every since then they haven’t grown back, they are very thin (it looks like i dont have any eyebrows) and there are a few bald spots.. What could of caused that? and is there anyway i can get them to grown back?

If you pluck out your eyebrows all the time, eventually some hairs may never grow back. Think of it as causing small trauma to the hair follicle over and over and eventually the hair follicle will stop producing hair. Wait it out for a full year. If it does not return, you can have a hair transplant to put them back, using hair from your scalp.

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January 12, 2009

FUE Scarring? – Hair Loss Information – Balding Blog

Hi Doctor,

If one were to get a FUE or FUE2, and in the future decide to shave it all, will there be left over dotted scars in the back from the donoring?

What kind of scarring can one expect from FUE or FUE2?

Thanks

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Pencil Yes, any incision made to the scalp will result in a scar of some kind. It is not an entirely scarless procedure and any doctor that tells you there are no scars is feeding you a load of bull. Scarring for FUE will be a small pinhole… like a pencil mark. If your density is low, scarring can be a problem with the follicular unit extraction (FUE) procedure, because the amount of hair to cover the donor excisions will be less. If the density is high, it hides well. Shaving your head like your facial hair, will leave ‘dots’ of white circles measuring between 0.7 – 1mm wide, or if your surgeon used a wider instrument, it will be even wider.

I just saw a patient who had 3300 grafts with a FUE technique by another doctor and the back of the head looked like he was shot with 3300 holes from a pellet gun; few of the grafts grew after a year. Your skin and other factors will determine how visible these scars are with your head completely shaved to skin level — but why would you bother getting a transplant if you’re just going to shave your head anyway?

January 12, 2009

Any Restoration Robotics Update? – Hair Loss Information – Balding Blog

Hi,

Have you heard any recent news on the robotic hair transplant procedure from Restoration Robotics? I had read a while ago they were conduction clinical trials at the end of this year, but haven’t heard anything since.

Do you know if they are accepting volunteers for the clinical trials? If so I’d be interested in participating.

Thanks

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The last I heard was that they were moving forward with clinical trials on a limited basis, and a Google search reveals that they were hiring for a clinical trials manager just a few months ago (see job listing). There’s info about the trials in a posting at HairSite, although it is from about 6 months ago. Unfortunately, Restoration Robotics doesn’t have a website, so it’s difficult to find a central location for their current news.

January 12, 2009

Propecia is Working – Are My Results Normal or Bad? – Hair Loss Information – Balding Blog

I’m 22 years old with early frontal hair loss confirmed with a miniaturization test. Right now I’m a NW2 but going up if I don’t stop this. I’m 5 Â½ months into treatment with Propecia and nothing got worse since being on it. For the past 2 months I see way less hairs in the shower and during styling. And now I noticed a little thickening in the left side of my mid anterior which is good. But at the same time I noticed very little loss in the right side of my mid anterior as well. What is going on? Is this normal or very bad? This got me totally freaked.

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We do not bald evenly, and if you are experiencing regrowth from Propecia it wouldn’t surprise me to learn that it isn’t thickening the hair perfectly even, either. Don’t get freaked out, this is normal.

January 12, 2009

Should Teens Be Proactive About Hair Loss? – Hair Loss Information by Dr. William Rassman

Should teenagers be proactive about their hair i.e. can they take propecia as a safeguard against losing their hair in the future especially if both parents have experienced hair thinning? At what age can young men take finasteride?

The best way to be proactive is to get serial mapping of the scalp for miniaturization. When early hair loss occurs, the use of finasteride may be a good idea. You will need to get medical attention for this process.

Propecia studies that lead to the FDA approval were conducted on men age 18 and up, but if a doctor should prescribe to a 16 year old, for example, that is up to him/her ultimately. I would never recommend just popping a Propecia pill each day or applying minoxidil if you have no hair loss.

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January 12, 2009

Prostate Specific Antigen (PSA) and Hair – Hair Loss Information by Dr. William Rassman

I’ve read that finasteride reduces something called prostate specific antigen (PSA). What role does PSA have in hair loss? I’ve also read that PSA is a misnomer as it’s not really only in the prostate. This article says that saw palmetto does not lower serum PSA levels: AAFP.org

But propecia does lower PSA levels. Do PSA levels have any relationship to hair loss? In other words, if saw palmetto does work on the prostate but only in the prostate, does it not have any effect on male pattern baldness?

PSA levels should be very low in people without prostate cancer and higher than normal in those with prostate cancer. PSA has nothing to do with hair loss, it is just a protein found in the blood in high concentrations in those with prostate cancer. I have also read articles on saw palmetto that indicate that the mechanism of action is different than finasteride and the fact that it does not impact the PSA levels shows that.

Some people feel that saw palmetto has value in balding prevention, but I really do not know the answer to that point. Not enough studies have been done that have met my satisfaction.

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January 9, 2009

The Story of a 3,000 Graft FUE Procedure Failure – Hair Loss Information – Balding Blog

Story time! Although I can’t provide photos (by patient request), I’ll do my best to paint the picture…

A man in his early 20’s flew to Los Angeles from Alaska to see me last month. He already had two hair transplant procedures using the follicular unit extraction (FUE) technique — one surgery of 1,000 grafts, and another of 3,000 grafts — by two different doctors (that I won’t name) who each claim expertise in this process. The 1,000 FUE case by the patient’s estimate was about 50% successful, while the 3,000 FUE case had, according to the patient, no growth after a year. The donor area was heavily scarred from the FUE extractions and were easily seen by lifting up the hair. A strip procedure would have produced less scarring than this patient showed now. To compound the problem, those hairs that did grow from the first surgery were placed in a radial direction (like the spokes of a bicycle wheel) and the hair pointed to the sides, not the normal frontal position. So not only was he dealing with a huge failure of growth, but now he had to deal with poor placement for those grafts that did grow! Imagine a person with hair growing out of his head like the spokes of a bike?

This patient most certainly had a low donor density to start. I recommended a strip surgery to harvest the most grafts he can get and with the reduced donor density, I recommended about 1,300 grafts, which is possibly the most I can harvest. Fortunately, his hair loss was only in the first 1 1/2 inches of the hairline and by taking Propecia he might hold the rest of his hair in place, although there is miniaturization behind the frontal 2 inches, suggesting that he might bald further over time. He wanted to look normal, but I could only suggest that I would try to make him look better.

FUE is not a panacea for scars. As I have said here before, the follicular holocaust that is seen in FUE is substantial, even in the hands of those who claim success. This is a buyer beware market. You should always ask to see a number of patients who had the procedure and look carefully at the donor area. Another FUE procedure on this patient will be disastrous (even in my hands), as scarring is clearly a problem.

January 9, 2009

My Doctor Won’t Prescribe Proscar to Cut – Hair Loss Information by Dr. William Rassman

Hi,
My Dr gave me a prescription for propecia for my hair loss. He was not willing to write for proscar for me to split. What options do I have? Can I send my script to be rewritten to someone out there who is willing to write for the proscar?

You can always seek another opinion from another doctor. There are those that focus on patient finances and those who do not and tend to be more rigid (a proper approach, of course). Proscar and Propecia are the same medication in different dosages, but it is up to the doctor to prescribe it to you.

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January 9, 2009

I Want a Hair Transplant, But I Love Cocaine – Hair Loss Information by Dr. William Rassman

Hi

I’m thinking of having a hair transplant done but I have a question before I bother to consult with you.

I attend college and with college come wild parties. I spend most of my time studying but I do go to atleast one part per month. I usually like to do cocaine at the party. I do this recreationally and it’s only one time per month at most.

I don’t think I would be able to give up my one party per month for a hair transplant. Is it safe to get a hair transplant if you know you are going to be doing a gram of cocaine every month for the post operative period?

Cocaine Oh boy. So as a physician, did you expect that I’d be fine with telling you its alright to use cocaine at any point, let alone during your post-op period after a hair transplant procedure?! Come on, now. The obvious answer is to stop using illicit drugs, even if it’s just once a month. Cocaine is not only illegal, but it can also kill you.

I’m not your doctor, but I expect any doctor you talk to will have the same reaction to your question. Now that I’ve given my mini-lecture, here’s a link to another site where another physician has his take.

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January 9, 2009

I Still Have Redness After My Hair Transplant Years Ago! – Hair Loss Information by Dr. William Rassman

I had my first transplant almost four years ago and my second one last October. I STILL have redness on my right side from the FIRST transplant. It is almost as if I got sunburned and that area stayed burned. It is not really bad, but it is bad enough that the transplant area still looks “outlined” making it look a little unnatural. The other aspects of the surgeries are spectacular, just have this one issue. Is there anything I can do about it? Thanks!

This is the type of question you should be asking your surgeon. Redness can be helped with the judicious use of topical steroid, but this is not a good idea without medical supervision as the body can absorb the steroids if you use too much of it. Also, the redness should not last that long — certainly not years, as you describe. Please discuss this with your surgeon.

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