May 2010 – Page 8 – Balding Blog

May 5, 2010

I Pull Out My Hair and My Doctor Recommended Propecia – Hair Loss Information by Dr. William Rassman

hello doctor,
my hair is thin and i dont know if all the hair that falls out is because of the telogen stage. my family has no balding but my hair getting thinner and always falling out. i keep on pulling it out all the time and i am always stressed about it so i am all day pulling and freaking out. i went to a doc but she recommend me propecia right away. i dont know if i wanna be on a medication. what should i do? thanks!

Did you tell your doctor about your hair pulling before the Propecia was recommended? Propecia might help if you are a man with genetic hair loss, but it won’t stop you from pulling the hair out.

It sounds like what you’ve got is an obsessive compulsive disorder called trichotillomania. I’m not an expert on OCD, but a good place to learn more and seek treatment help is at the Trichotillomania Learning Center.

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May 4, 2010

FUE Megasessions? – Hair Loss Information – Balding Blog

if this is answered in your blogs forgive me and just send a link. i am clear i want a ht. i have done much research and am still meeting with docs. i can do in thailand, uk, usa. my one reservation has been the scarring and after effect, plus temporary nerve damage on the head. after realising FUE could be done in a megasession i feel this is it for me, (told i need 3-4000 hairs/grafts). as i research so many are careful, sceptical of it. i have come across you (dr. Rassman) and dr. cole. i understand a skilled physician is necessary. will FUE of 3-4000 grafts megasession handle it for me (norwood 3v to a 4)? do you recommend it more than strip or not? is it a very viable option? with dr. cole or you? thank you.

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A skilled physician is necessary for any surgery you have, and one that specializes in the cosmetic surgery you’re looking into is absolutely something I’d recommend. If you’re asking me whether you should go to me for your hair transplant or go to another surgeon, well, I think the answer would be pretty obvious. However, I cannot recommend surgery options for you at this point, as I have not examined you or know of your medical history. Everyone is different and all surgery has its risks and benefits (FUE vs strip, etc).

What I can tell you is that I have never performed a 3000 to 4000 graft follicular unit extraction (FUE) procedure in one session. I think I can say this with some authority, as I was the one who introduced the FUE technique to the international community in 2002, but an FUE procedure of that size will likely lead to a higher transection rate due to physician fatigue.

I realize it has been 8 years since the technique was introduced and other physicians have performed and tried to perfect the technique, but there are factors that the general public do not know of in such surgery. To the general public, FUE sounds slick and the best of all worlds (you get hair with minimal scarring). But there are some thing you need to look out for. Please read about these in my post from a few years back — What Doctors Don’t Want You to Know About FUE.

May 4, 2010

I Want to Move Every Hair from the Back and Sides to the Top! – Hair Loss Information – Balding Blog

Hi…I was wondering if this was possible. Say I wanted all my hairs on the back and side of my head to be transplanted to the top of my head. Not just the 9 thousand graphs or whatever donor supply most people have, but all your permanent hair on the back and sides, would you be willing to do this? Then the hairs on back and the side can be tattooed to look like a hair buzzed with a 0 clipper and the top can be clipped to a one or two.

What do you think of this?

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Kid N Play I love the creativity of some of you that write in. You’re wanting to move every hair from the donor area (sides and back of the head) up to the top of your head and then tattoo hair all along the formerly-hairy donor area? That just isn’t possible. It sounds like you’re looking for one of those hairstyles that was popular in the late 80s or early 90s…

To move every single hair from your donor to the top of your head would create tremendous scarring. And if it was possible, I wouldn’t want to perform this procedure anyway, because even if you are enthusiastic about the results today, you will likely regret it tomorrow.

May 4, 2010

How Bad Could the Hair Loss Be After Stopping Propecia? – Hair Loss Information – Balding Blog

Hello Dr.,
Thank you for answering all questions and thank you for this blog.

You have mentioned that catch up hair loss could be very dramatic after stopping propecia. Do you have any examples that you can provide us? (i.e a NW 2 going to a NW6).

Thank you

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Let’s say you now show a Norwood Class 3A pattern and have been on finasteride for 10 years. Upon stopping the medication your hair could remain the same… or you could begin to show progress to a Norwood Class 5, 6, or even a 7. The catching up of the hair loss just means you’ll go to the pattern you would’ve been had you never taken the medication in the first place. So what you are asking is a look into your future, but you’ll need to see an experienced gypsy for that.

May 4, 2010

In the News – Prostate Cancer Vaccine is FDA Approved – Hair Loss Information – Balding Blog

Snippet from the article:

A vaccine treatment for prostate cancer has become the first therapy of its kind to win approval for use in U.S. patients.

The U.S. Food and Drug Administration approved Provenge, a novel technique for fighting prostate cancer, on Thursday. The treatment involves taking a patient’s own white blood cells and using a drug that trains them to more actively attack cancer cells.

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Read the full article — ‘Landmark’ cancer vaccine gets FDA approval

May 4, 2010

Am I Losing My Transplants After a Shower? – Balding Blog

Hi Dr Rassman,

I had two transplant done. One in aug2008 and another one in January 2010. Total about 5000 grafts altogether. Sometimes after showering I see 2 to 3 hairs in the towel with a bulb. the hair that falls out is also thick. Do you think I am loosing a root? or its normal hair cycle. Please advice. I am not sure if the hair that is lost will grow back .

thanks

Everyone goes through normal hair cycling, meaning every hair will fall out and then after a few months in the telogen phase, it will regrow. I can not comment on any particular hair loss that you are reporting, because I don’t know exactly what you’re seeing. Both transplants would’ve taken hold by now, so those 2-3 hairs on the towel are likely nothing to worry about. You should go back to your surgeon for his/her confirmation of that. Hopefully, the transplanted area will hold its overall fullness and that will be the best indicator of the permanent nature of those hairs.

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May 3, 2010

Hair Loss InformationMy Transplanted Hairs Don’t Look Like My Natural Hairs! – Hair Loss Information – Balding Blog

Hi Doc,

I am 27, and stupidly got two procedures (~800 grafts each) done about three years ago. Have been taking propecia since the age of 18 and just started on rogaine a few months ago. I guess I’m about a Norwood 3, moving towards a 4 (except no thinning on crown).

Anyway, the problem is that the transplanted hairs came in much thicker and more wiry than the natural hairs, and they were not always individual hairs, so I’m about a year into getting them removed as best I can via electrolysis. The skin is slightly scarred, but I’m unsure exactly how it will end up looking once it gets time to really heal and start to fade.

I’m trying to weigh my options for proceeding as my hairline continues to recede, and am deciding if I should continue to get the rest of the plugs removed as my natural hair goes or if it’s worth more transplantation but done with more care. The question is really do you have any knowledge about different types of hair responding differently to transplantation? My hair is dark brown and curly, would it be more susceptible to coming in thick and kinky than someone with finer straight hair? Because the last thing I want to do is get more transplants and have them be obviously fake and just compound my problem!

Thanks a lot, and I love your site.

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As I’ve said many times before, the good news about a hair transplant is that it is forever… but if you have a bad hair transplant, then you probably aren’t looking at that news as being too good. Even removing the hairs may still leave a scar and cause an unnatural hairline, as you’re noticing with the electrolysis. Something concerning me though is that you’ve had 2 procedures at 27 years old of what you describe as “plugs”. I hope you aren’t referring to the ugly, old hair plugs that you commonly see in men that had surgery decades ago. Perhaps you’re just using the wrong term and you meant “grafts”, which are made up of 1-4 hairs. Modern hair transplants will look natural and the hair shouldn’t change character or color.

There are still options even though you may have a bad transplant, but BaldingBlog is not a place for second opinions. You’ll need to have an evaluation to see what options are available to you since each repair case is unique, so you should see a hair transplant physician (just don’t go to the one you already had two surgeries with, obviously). If you want to come out to Los Angeles, our consults are free and we have plenty of experience with patients who are in your situation. We have performed corrective procedures on many sub-par hair transplants.

See Dean’s Story for an example of a repair process, and check the Repair category for even more posts about this.

May 3, 2010

Hair Loss from Alcohol Abuse? – Hair Loss Information – Balding Blog

I’m 43 years of age. I just quit drinking 6 months ago, my liver was in bad shape to the point my doctor didn’t think I was going to make it. Since then I changed my diet, abstained from using alcohol and anything else that might be hard on my liver. Blood tests that I’ve got recently show my liver to be functioning normal. My health according to my doctor is good. All symptoms like extreme bloating, sight loss due to water leakage from blood vessels, and anxiety attacks, which was the reason why I started to drink in the first place, have gone. The problem I have is that I’m losing hair in large amounts. I NEVER had any noticeable hair loss before and this started 3 months after all my symptoms of alcohol abuse were gone. I still smoke (trying to quit). I take vitamin supplements. my diet is good. what can cause this? Stress?

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Alcohol Diet and an adequate daily intake of vitamins are often a problem with alcoholics, and as you appear to have started to address these issues, it will hopefully become better in the long term. This is a complex problem in that you may have genetic factors in addition to what has impacted your general nutritional issues in the past.

A good examination by a competent hair doctor will show the degree of miniaturization and balding you may have, the status of your donor hair as compared with the areas of loss, and the presence or absence of a telogen effluvium can be evaluated. The long term impact of your past drinking history may still have ramifications for you. I can not help you more directly without examining you.

May 3, 2010

Waiting Period If Switching from Propecia to Avodart? – Hair Loss Information – Balding Blog

After reading your blog, I understand your concerns over prescibing Avodart for hairloss. However, if someone were to make an informed decision to switch from Propecia to Avodart for hopefully better results, would you advise them to switch immediately or stop taking Propecia for a while before taking Avodart? Lastly, would the switch in medication return the user to stage one i.e. they would be starting to tackle hairloss all over again, or would the Avodart immmediately “follow up” or add to the effects of the Propecia in limiting DHT etc?

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Avodart When switching from Propecia (finasteride) to Avodart (dutasteride), I wouldn’t think that any waiting period is needed. I’m not sure how informed your decision in switching medications is since dosing information hasn’t been established when taking Avodart to treat hair loss, but since both are prescription medications I’d hope these are things you and your physician have worked out. For those curious, you will not need to maintain the Propecia upon switching since Avodart is also a DHT blocker. The two medications work in similar ways, so I’d guess that it would just pick up right from where Propecia left off.

May 3, 2010

Should I Trust This New Hair Transplant Surgeon? – Hair Loss Information – Balding Blog

Hello,

I an from India and wish to get a HT done. I approached [a doctor] but I found out that the medical trip could be quite above my spending capacity and also I cannot find enough time fo the same. There is a new surgeon in India who is a ISHRS fellow and incidentally also happened to work under [the other doctor] (according to his website). I have also seen her results and I find them better than what others in India have produced.

The only thing that stops me from going to her is that she is into practice less than a year(but i don’t have any information about her past experience). Can I trust her bald head to this new doctor or should I wait for a while and get it done abroad?

Regards

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I can’t tell you who to trust. I’m not familiar with that doctor or her work, so you might want to use Google to research the doctor a bit more or ask around in various hair loss forums. Be sure to ask the doctor herself for any information about her past experiences that you wish to know. Also, ask to meet with live patient models so you can see the quality of her work in person (this is better than just seeing photos).

Don’t rush into surgery because the price is cheap. Go with whichever doctor you’re most comfortable with (and results that you like), and if it means you have to wait to save up your money, then you should do that.