Month: March 2010

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Does Dr. Rassman Still Take Propecia? – Hair Loss Information – Balding Blog

Hi Doctor Rassman. Thanks for this very informative blog. My question is: Do you personally take propecia? and if so, for how long? Be honest about it lol

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Although I’ve written in older blog entries that I took the medication, I actually do not take Propecia at this time. I used it for years starting when it first came out, but at my age I did not think I had progressing hair loss and eventually realized that the drug would not be too valuable to me. I know I’ve said that you run the risk of “catch-up” hair loss when stopping Propecia, but I did not believe that I benefited from the drug and the decision appeared to be correct when I did not lose hair after stopping it. I had no libido problems on the medication, though.

One of my sons takes Propecia daily and it clearly stopped his frontal hair loss, and in fact, he was the exception to the rule as it did regrow some frontal hair in the area that was heavily miniaturized. Frontal regrowth isn’t a common occurrence in most patients.

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Transplanting Between Miniaturized Hairs – Hair Loss Information – Balding Blog

Hey doc. How are you today?
I have been diagnosed as a Norwood 5 thinning pattern. Originally when I started finasteride I was a Norwood 3 vertex only, but obviously the medication is only slowing the process down. I had a consultation with a reputable Toronto Dr and he said it would not be be worthwhile performing surgery at that time. But now that things have progressed is it possible to perform surgery just to give me more density? I am fine with my hair line. Or is it dangerous transplanting in between miniaturized hairs? I’m 22 and have been on finasteride for 2 and a half years with a gradual decline in my hair count but hairline is still thick for some reason. What do you think ?

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I am fine. Thank you for asking.

Transplanting between the miniaturized hairs may likely result in you losing those weak hairs, so you won’t be any better off than you are now (except with less donor hair and less money in your bank account). I can’t say for sure since I haven’t seen you, but based on your description the surgeon you saw might have done you a favor.

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Propecia and Coffee – Hair Loss Information – Balding Blog

I had a casual conversation with a dermatologist recently, who suggested that taking Propecia in the morning might not be the best idea given I drink around 4 (on rare occasion 5) cups of coffee every morning. The dermatologist said that, generally speaking coffee/tea reduces the absorption effectiveness of finasteride and many other drugs.

Otherwise, he stated that mornings are generally a good time to take medication. He further suggested that 1-2 cups of coffee would be less problematic. Any thoughts on this suggestion?

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There are some suggestions I’ve read about on the web that point to some decreased absorption with coffee or alcohol because of the increased frequency of urination… but there’s no certain connection that I know of between drinking coffee and Propecia absorption. You should be fine with the coffee, but grapefruits have been shown to decrease finasteride’s absorption.

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Hair Loss InformationTemple Hair Loss and Transplantation (with Photos) – Hair Loss Information – Balding Blog

Hey Doc,great site!
I know people ask about temple thinning a lot, but are usually referring to the corners of the hairline. Well, I have a question about the real temple area (above the sideburns). If this area is thinning does that point to MPB or something else? Thanks!

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Losing hair in the area that I call the “temple peaks” may be part of the balding process in some men. Hair transplants to this area takes a special skill to make it look truly natural. I have seen more problems with the transplants done in this area from doctors who have not mastered the hair process. I posted an example of one such patient that came to see me for a repair after he went to a doctor that obviously didn’t understand the art of transplanting to the temple area — Temple Hair Transplanted in the Wrong Direction.

Here’s a patient we did at NHI with 150-200 grafts places into each temple. The before photo is on the left, after on the right. Click the photos to enlarge.

 

And here are even more patient temple hair transplant examples:

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Propecia and Rapid Heartbeat? – Hair Loss Information – Balding Blog

I am 46 years old, and my baldness can be described as worse than your Class 6 patient. I am not planning on having any more children. I have a rapid heartbeat (mytral valve prolapse). Here are my questions..

1. Would I be a candidate for hair transplantation?
2. Would I be asked to start taking Propecia or Avodart before or after the procedure?
3. Would taking any of these medications aggravate rapid heartbeat?

Thanks

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  1. If you have male pattern baldness and your donor hair is in good standing, I would assume that you could be a hair transplant candidate. In fact, patients like you (Norwood class 6) are some of the happiest after a hair transplant, because it can dramatically change your appearance (for the better). See our galleries of hundreds of before/after patients to get an idea of what to expect.
  2. I generally recommend Propecia (not Avodart) for patients with male pattern baldness, but it is not a mandatory requirement. You are asking me about generalizations without an examination, so my answers are generalized.
  3. Propecia would not produce a rapid heartbeat.

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Hair Loss InformationI Want to Get Rid of My Hair Plugs! – Hair Loss Information – Balding Blog

I had an old fashion hair transplant using the large plug method. Now, I would like to cut my hair short (or shave my head). The plugs on the top of my head are virtually undetectable. I can probably have a laser treatment to completely hide them. No hair really grew anyway. But here is the real question, how do I get rid of the .75 inch high by 4 inch long rows of plugs where the donor area exists? I have spoken to several surgeons and have been told things from FUE to simply cutting around the entire area and sewing it back together. I am no surgeon, but cutting the area out and sewing it back together just seems like a waste of good tissue and hair follicles. Why can’t a surgeon simply re-cut the existing holes and sew them back together leaving the surrounding skin and hair intact. This is similar to the way he/she would do it if removing plugs on the top area of someone’s head? Any thoughts or comments would be greatly appreciated.

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There is an art to managing this problem and we published the various methods of repair in distinguished medical journals in the 1990s. One way, when the hairline is too low, is to remove the frontal hairline surgically — and then re-transplant it with modern techniques. This approach leaves minimal scarring and what scar may be developed is completely covered by the hair transplant. Another approach is to remove the big plugs one at a time. Using FUE, we can often just thin the plugs.

As you indicated you’re in the Los Angeles area, you should come in for a free consultation and then allow us to make a recommendation. Also, see past posts about Repair, many of which are about fixing old plugs.

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All of My Scalp and Body Hair Has Thinned! – Hair Loss Information – Balding Blog

Hi I have something weird that happened. All of my hair on my head has minimized. On the sides, back, front all over. Is this DUPA? I went to my dermatologist and he brushed me off and didn’t even know what DUPA was. The weird thing is is that it’s all over my body hair, genital hair and underarm hair.

Is this DUPA or is it hormonal?

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To answer your question with regard to DUPA, I would need to map your entire scalp for miniaturization. In men, DUPA shows significant miniaturization in the donor area. That would start answering your question.

With regard to body hair, I think that you are lucky (as I hate my body hair), but we do see changes in body hair with age in some people and this may be genetic in men. With that personal candid view, I don’t want to minimize the importance of getting a doctor involved so that the ‘rare’ conditions that are either genetic or hormonal are not overlooked.

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Asymmetrical Hairline After Hair Transplant (with Photos) – Hair Loss Information – Balding Blog

Hi Doctor Rassman. I had a hair transplant a few years back by a very respectable doctor, and while I’m generally quite pleased with the results, my hairline is a bit asymmetrical. How normal is it for a natural hairline to be higher on one side?

Thanks!

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In nature, the hairlines of non-balding males are usually symmetrical, but occasionally they are not. I do not have statistics on this. In the balding hairline that is receding, it is common for one side to recede higher and faster than the other side.

I have, even under the best of conditions, noticed the hairline slightly off balance after the transplant. I routinely draw the hairline and then have the patient (and if he’d like, his family and my surgical staff) provide input and between all of us, we usually hit it correctly. Just this week, I saw a patient who had the hairline higher by 1/8th inch on one side. Here’s his photos — click to enlarge:

Before (left) / After (right):

 

The after photo is 8 months since I did a single surgery of 2328 grafts. Upon seeing the slight unevenness, I offered to fix it the following day at no charge. He was visiting California from across the country and I wanted to address it before he went home. It took 249 grafts on the one side to balance it out. I won’t have photos of the final hairline for a while since the procedure was just done, but here is the area I’m talking about:

 

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If I’m a NW3, When Will My Advancing to NW6 Be Evident? – Hair Loss Information – Balding Blog

I’m currently a 3 on the Norwood scale and I see some miniaturization in my crown. Someday I’ll probably reach a 6 on the Norwood scale like my father did, but lets say for some reason I were to progress as far as a 7, when would that miniaturization be present? Would a doctor be able to find it now even though I’m only a 3?

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PsychicI am not a psychic and I cannot predict the future. If I could, I’d be 100% correct with my Oscar picks. Alas, I was not.

Not everyone loses hair at the same rate from a Norwood 3 to a 6. More importantly, you may never progress to Norwood class 6 or 7. Maybe you will just be a Norwood class 3 or 3V. The Norwood Classification is not meant to be seen as a progression of balding. It just describes the many variations of how bald men look. You can, however, influence what type of balding pattern you will get by treating it with medication (finasteride) which may halt your hair loss. It almost certainly will slow down the rate of progression if you will follow in your father’s footsteps.