I was wondering about the Platelet Derived Hair Growth Factor. The cost, availability, & how long the new hair growth last. Thanks
I believe much of this is still experimentation and I am learning more as the articles get published. We can wait for the answers as to whether it is better… and if so, how much better? I don’t have the answers at this time.
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Hi Doc,
Just wondering about the hair cycle.
In a normal situation (ie with no MPB) how much time would you expect for a hair to go from when it falls out through to when the hair is back to its previous length (lets say 5cm?)
And when you say ‘the time it takes to notice a difference in amount of hair’ do you mean when the hair has returned to the length of all other hair on your head or just when it has cracked the surface? (because different people notice different things – some might look very closely to the scalp and see hairs breaking through whereas others may not be as observant.)
And finally, have you got any super close up pictures of what hairs look like when they are coming through. (I am 16 weeks into proscar (large amount of shedding from weeks 2 – 10) and am seeing an abundance of hairs coming through at my hairline and temples and I want to tell if they are miniaturised or not)
And as an interesting side note i read somewhere on your site that everybody has miniaturised hairs on there hairline even if they are not balding, at about week 12 I noticed my miniaturised hairline hairs begininning to grow and then are now getting to normal length when they had sat at about 2-3cm for months and months and are now 5cm+.
Sorry for so much writing, very excited about my progress!
I am pleased you are seeing some positive results with finasteride and are excited about where things are headed. It generally takes about 6 to 12 months to see the difference after starting the medication. With respect to hair cycles, our hairs are constantly cycling with about 90% of them growing (anagen phase) and 10% shedding/resting (telogen/catagen). The entire cycle varies with people, sex, and age. The cycle can be as long as 7 years, but normally averages about 2-3 years. The growing phase lasts several years and the shedding/resting phase lasts a few weeks to months. This is why it takes several months to notice any changes in hair after starting finasteride.
I am not sure what difference it would make to see macro photos of hairs as they grow through the scalp, but I’ll see what I can come up with.
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Hi Doctors,
Thanks for all the great insight and help. Recently, you’ve had a few posts about frontal hair loss. My question relates to medical (non-surgical) options for treatment and why drugs only seem to be effective for the back/crown of the head. I realize that today’s most effective medicines, Rogaine and Propecia, only are scientifically proven to work in the back/crown of the head. However here is where I get caught up:
If DHT is one of the primary causes of MBP and these drugs, specifically Propecia, block DHT, why then are benefits not typically seen in the front? Likewise, why is Rogaine only medically proven to be effective in the back?
I realize that science doesn’t yet have the exact answer, but given your vast experience and exposure, could you venture a guess as to why these drugs do not affect frontal hair loss the way they affect back/crown loss? In your experience, do users of these drugs see a benefit in frontal loss as well?
Many thanks!
The impact of Propecia on the frontal hairline has not been impressive, but it clearly slows down loss in the frontal area. This is the results of observation on thousands of people. The same applies to the crown where both Propecia and Rogaine seem to have value. But everyone is different and responds differently to medication.
I do not know why there is less hair regrowth on the front than the crown with Propecia and I do not want to make a fool of myself for guessing.
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Today is Labor Day (the first Monday in September) in the US, so our office is closed for a long weekend. As such, we’re not blogging today, but we shall be back with more hair loss Q&A first thing tomorrow.
In just about 4 and a half years, there are over 7500 posts here on BaldingBlog, and I’m sure there are many articles you’ve never read. I know there’s a ton of content here… so to keep things interesting, we’ve added a random post option. Maybe you’ll find something interesting, perhaps even something hilarious.
Check it out — Random Post
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I was talking to a 40 year old patient the other day who reported that he connected up with an old high school friend via Facebook who commented that he hadn’t changed in the 20 years since they last met. We started to talk about what he might’ve looked like with a Norwood Class 4 pattern hair loss had he not gotten his hairline restored, and then he wondered why any man would let himself go bald when the techniques are available to allow you to look your best.
I came to the following conclusions:
Considering the changes in what a patient looks like, the naturalness of the results today, and the need to cling on to our youth, everyone should be lining up to get surgery, right? Interestingly, the ISHRS has just released some statistics about hair transplant surgeries and it turns out that there was a 26% increase since 2006, so maybe the fear factor is shrinking and more men are actually addressing their physical appearance.
Come visit us at one of the Open House events that we hold every month and meet men who have had hair transplants. If they hadn’t told you, you’d likely never know that they had hair restoration. Most important, they are normal, youthful focused men, even those in their 70s who come to these events.
Hi I am a 20 yr old female wondering about a hairline transplant. A previous question on your site about evening out a widows peak was the most similar to my request. I have had a high hairline on the sides for several years and a recent year on medications has now thinned out the hair on either side near the temple. I have always hated my hairline which is ill suited to my face shape and want to at least fill in the hairline around my temples. I am assuming hair grafts would be the correct procedure and want to know more about them.
HAving watched documentation of several female hairline transplants I wonder : Is the donor area for the grafts always left with a long scar? (example had one across the back of her head) CAn this be done without any scarring or difference to the doner area? and (of course) what would be the cost for this procedure?
There are 2 techniques for hair transplantation — the strip method (with the linear scar) and FUE (where you are left with small punctuate scars in the donor area). There’s no surgical procedure without some level of scarring, though trying to minimize the scarring is the best we can do. Everyone scars differently, and closure techniques for the strip method have resulted in extremely thin linear scars, and the length of the scar depends on the amount of grafts required. Costs also depend on how many grafts are needed, with FUE fees being higher due to the more time-intensive nature of the procedure. You can learn more about FUE at the following pages:
Hi Dr Rassman
I’ve been taking propecia and minoxidil for about 3 months. Now i feel there is improvement in my hair. I am thinking of quiting minoxidil and use propecia only. Would i maintain my hair if i use propecia only. Thanks.
If the minoxidil gave you any improvement, stopping it would see those benefits disappear. Propecia will not maintain any minoxidil benefits for you (and vice versa). If the improvement you saw was from the Propecia, then stopping the minoxidil will be fine. Unfortunately, since you started both at the same time, the only way you’ll really know which medication was working is by stopping one and hoping you made the right choice.
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ive been on propecia and minoxidil for four months and am going through a horrible shed, my whole temple point has thinned out, my hairline looks eaten and my hair feels horrible, from your experiece is this common?
thanks
I am not sure what “eaten” looks like other than some erosion that is asymmetrical. We are all different — and that includes hairlines. It could be accelerated shedding from either of the medications, but you need to see an expert in the field to give you and examination, or at the least send me a photo so I understand what is “eaten” about your hairline.
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i was wondering is rogaine safe. i hear that rogaine causes heart attacks but you know how people are. i just had a hair transplant and wanted to see if it was safe. thank you doctor
High doses of Rogaine (minoxidil) can drop your blood pressure and may not be a good idea if you have existing heart disease. I can imagine some case where a person uses minoxidil and has one of a variety of existing heart conditions, and the medication causes a drop in blood pressure leading to a heart attack… but that is theoretical and I have not actually heard that such a case exists.
So to answer your question, Rogaine does not cause heart attacks.
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Hello doctor Rassman,
with all the shady HT docs out there you seem to have a very good record of ethics; but recently I came across the first negative “report” that i’ve ever seen about you.
Quote
“Bobby Limmer presented FU style grafting in 1989. It took 10 years to gain a foothold even though it was clearly better. During this time there was an active movement by the practitioners in the industry to badmouth and prevent the adoption of this new technique. That’s right they were actively stopping the evolution of technique. If a patient asked about these techniques they’d be told false and baseless statistics about transection, etc. if they were lucky. If they were unlucky the doctors wouldn’t even present the option to them. Documented examples of this exist online.
“FUE grafting encountered the same resistance from the industry. Every trailblazing FUE practitioner has had false claims and allegations made against their results. Leading this badmouth charge was William Rassman from NHI. Dr. Woods has recorded evidence of this.
In fact FUE was known by the industry for several years and you couldn’t get any of the top clinics to admit its existence.”
Care to comment?
I originated many of the techniques done today (see medical publications) including the follicular unit extraction (FUE). Dr. Woods and I seem to have evolved it simultaneously, but I published the technique in 2001 and he kept his technique secret. In fact, I am still not sure just what he does, technique wise. I have taken lumps on my head as other doctors badmouthed me in the early 1990s, but after my patients got out to the market, the great results seemed to quiet down the accusations made against me. In 1994, I presented 23 patients with completed results to a group of about 500 hair transplant surgeons at an ISHRS meeting in Las Vegas. I would say that 95% of the doctors at that meeting were doing the old plug technique at the time. I did my presentation with live patients and compared what I did with the poor photography shown at the meeting by other doctors. My patient models spoke reams about the techniques I used, and that meeting seemed to be the actual end of the plugs as the standard of care.
I have been an outspoken critic of misrepresentations by doctors about their skills and techniques. After I announced FUE to the world, one doctor called me to ask how it is done. He had never done anything like it before. Within the week, he announced (over the internet) about the FUE technique he invented and his wonderful results from it. Now, when I meet that doctor I want to puke.
Nobody is without criticism and I am sure that some patients may not have reached their expectations with me as their surgeon, but setting up expectations is what I do and then the surgery is just a fulfillment of meeting those expectations. I show patients off every month at my office in Los Angeles and the experience of sharing has been central to my entire practice strategy.
