June 2009 – Page 9 – Balding Blog

June 10, 2009

FUE2 vs FIT – Hair Loss Information – Balding Blog

I’m 32 years old with near norwood 4 loss and am still confused over both these techniques. There were two previous posts that you replied stating that both procedures are identical but according to Dr. Coles website he claims that FIT is much better than FUE.

My personal search has led me to either pursue your new FUEÂ² or Dr. Coles but I’m at a standstill and not sure which path would be better. IF both procedures are the same then the only criteria left for me in my decision would be $ cost per graft. My last question would be how much you charge per graft for a shaved head for a FUEÂ² procedure? Thank you!

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Follicular unit extraction (FUE) is the core terminology that I used to define the surgery when it was first published and is the recognized term worldwide. Could there be marketing hype used here? I would think so (my opinion). The tools have been overblown and unless the technique is substantially different, an FIT is an FUE. The FUEÂ² is different from the FUE in the basic technique deployed, because it uses a dissecting technique with high pressure fluid to assist in the extraction.

Our fees for FUE are as follows:

$10/graft for procedures done by Dr. Pak
$15/graft for those done by me (Dr. Rassman)

Some doctors charge more if the head hair is not allowed to be clipped close (shaved), though our fees are the same. At the moment though, by not allowing us to clip the hair, the total number of grafts available will be less.

June 10, 2009

Receding Hairline Corners – Is It Just a Mature Hairline? (with Photos) – Hair Loss Information – Balding Blog

Dear Mr Rassman,

First of all thank you for your very informative and helpful site.

I am 30 years old and lately I started worrying about my temples. I have a feeling that I have rececing temples and want to take action in case this is the case. Unfortunately I do not have old photos taken from the right angle to compare. Could you please tell me what you think and my Norwood class according to the attached photos. I do not have any balding or thinning on top.

By the way, you can use my photos on your blog if you please.

Kind regards

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Click the photos to enlarge:

First of all, thanks for allowing me to publish these. What I believe you’re talking about are the corners of the hairline, not the temples. The temples are below the corners (above the ear) and those look fine in the photos you provided. People seem to get the temples and corners confused all the time when labeling them.

It appears that your hairline is now convex in shape and the central area does meet the side areas, suggesting that the maturing hairline is locking into place. If there is no miniaturization present, I would do nothing other than observe your hairline yearly. This is a Norwood Class I or II.

June 10, 2009

Some Months My Transplanted Hair Looks Thick – Hair Loss Information by Dr. William Rassman

I had a hair transplant nearly two years ago now. every 6 months or so it looks thick and occasionally some months it doesnt. Now becuase the transplant to place maybe as the rest of my hair was at a resting phase, could the hair transplant section and the rest of the hair always be at a different rate of growth as in resting phase. I was wondering whether this was the reason for certain months it looking thick and more hair and other months lacking as much hair. Also as the transplant section isnt as dense and compact could it be that when some hairs fall out in order to be replaced it just isnt as thick?

Thanks NHI TEAM

The general hair cycling is somewhat random when we look at it. I can not imagine why your hair looks better sometimes than other times. We’ve all heard of a “bad hair day,” so maybe that is what you are talking about. Are you doing anything different with your hair during the periods in question?

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June 10, 2009

Prilosec (Omeprazole) and Hair Loss – Hair Loss Information by Dr. William Rassman

I too am taking omeprazole and finding that my hair is thinning severely. I want to weigh in on this because I see other comments to this effect on your site and others. I think you should not be too hasty to dismiss the connection.

On researching this, I did find references to a rare connection between Prilosec (omeprazole) and hair loss. As I’ve explained before, it is difficult to conclude whether omeprazole is the cause of your hair loss, as hair loss is quite common due to genetics. Hair loss reported from the medication is in less than 1% of cases. See eMedTV for more.

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June 10, 2009

Folliculitis and Hair Loss in the Crown – Balding Blog

I have folliculitis which has caused hairloss at the crown. Will minoxidil regrow this hair? If it does, will the hair be lost once application has stopped or will the hair continue to survive on its own as my dermatologist says I have no MPB only the folliculitis.

There is a condition called folliculitis decalvans, which is an autoimmune disease that often reflects extensive hair loss. First, one would have to make a diagnosis (something I can not do without seeing you myself). If it is just a small patch from the infection of a few hair follicles that caused hair to fall out and does not reflect an underlying disease, then it might regrow. Minoxidil may help. I can’t say much more without knowing much more about you, what it looks like, and more of your history with the folliculitis. There’s a lot of info and photos of folliculitis decalvans here.

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June 10, 2009

Does Sensitive Skin Mean Sensitive to DHT? – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman.

I have a theory, can the type of skin (texture, etc) determine if a person will go bald? Sensitive skin equals sensitive to DHT? For example a Caucasian male can freckle easy and have allergies easily.

Thanks.

I suggest that you scrap that theory. I assume by “sensitive to DHT” you’re equating it to mean genetic hair loss. What is below the skin and what is above the skin (what it looks like) are very different things.

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June 9, 2009

Surgeons and Multi-Blade Scalpels, Part 2 – Hair Loss Information by Dr. William Rassman

This is a follow-up to Should I Avoid Surgeons That Use a Multi-Blade Scalpel?

Your explanation makes perfect sense to me, but what does the “other side” say? Surely, a surgeon who would use a multi-blade knife (even an 8 blade) has some justification for its use. He would also have to have a reason ready to give to prospective patients to justify his selection if asked about it.

If I went to Doctor X who is using an 8 blade scalpel, for example, and said to him “Doctor, with all due respect, why are you using that? Doesn’t it cause unnecessary damage?” I don’t think he would say “well, I use it to save time.” I’m sure he would have a valid reason, if only in his mind, of why it’s really better. Do you know why their camp thinks the multi-blades are better and choose to use them besides “saving time?”

Scalpel The only reason to use a multi-bladed knife above 2 blades relates to the time efficiency of the work, the need for less well-trained technicians, and the surgeons ability to do more grafts with less staff. The real expense however, is in the damage done to the hair and the hair that is lost. There are no patient benefits when using an 8 bladed knife (for example) over visual dissection of the scalp under a high-powered microscope.

One surgeon (about 15 years ago) presented a paper before the ISHRS which essentially was titled, “How to do 1500 grafts in under 10 minutes“. What I saw was akin to a sushi knife carving up the scalp with no respect for the hair. I asked myself if a ‘blender’ that I use to chop onions with would work as well? I would guess that the kill rate for hair exceeded 50% using this “method”. The surgeon was somehow content or fooled himself into believing that what he produced was quality grafts. I am afraid that the answer to your question is that there is no rational explanation for use of multi-bladed instruments unless there is some unique breakthrough.

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June 9, 2009

Propecia Isn’t Stopping My Hairline from Going NW1 to NW2! – Hair Loss Information by Dr. William Rassman

Hi Doc,
I started propecia 5 months ago for a receding hairline. My hairline appears to still be a norwood 1, but it is closing in on the second one very quickly. I don’t think the propecia has helped at all. I don’t even think the recession is slowing down. Is there any way the propecia could help from here on in, even if it hasn’t even slowed down the hair loss in 5 months?

Propecia (finasteride) will not stop the appearance of a mature hairline, as that is what it sounds like you’re describing to me. You should send me photos and I will give you a more definitive answer. Mature hairlines are convex in shape, while juvenile hairlines are concave.

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June 9, 2009

My Dad, Grandfathers, and Brother All Have Their Hair — So Why Am I Balding? – Hair Loss Information by Dr. William Rassman

My dad has hair, both my grandpas have hair, and my brother who is four years older than me has hair. I don’t know if cousins matter, but I have four male ones that all have hair too. Its not just hair though, all these family members have full heads of hair, there is not one male in the my family who is balding, and yet im 18 and seem to be losing all my hair. Im trying to except it, but im curious if there is anything I can do?

The expression of the balding gene does skip generations, though I am not sure how many it could potentially skip. The more generations that are skipped, however, the less likely it will be. I’ve written about it before here.

As for what you can do — I’d see a doctor and ask about a prescription for Propecia. If you have early genetic hair loss, the drug should halt the progression for some time.

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June 9, 2009

I Want to Stop My Body Hair from Growing – Hair Loss Information by Dr. William Rassman

Hi!
i am 18 years student i have a lot of hairs on my body which are growing longer is there any simple and cheap way to stop growing them… please help me !

Thanks a lot!

Most people resort to shaving the chest and back as needed. There is no inexpensive way to manage the problem. Hair removal lasers can be expensive and painful, but that could also do the trick.

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