Month: September 2011

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Hair Loss InformationScalp Scar After Motorcycle Accident – Will Hair Regrow There? – Hair Loss Information – Balding Blog

I recently had a motorcycle accident about a month and a half ago. unfortunately i was stupid and wasnt wearing a helmet causing a minor injury on my head. i went to the hospital and was told by the doctor that i would need plastic surgery to make sure my wound closed. however throughout the whole process of taking care of paper work and insurance to cover the plastic surgery my wound closed out perfectly fine. even the doctor told me i didnt need the surgery anymore.

however i have a scar about the size of a quarter, a little bigger id say, and i have no hair there. but people say i am gonna grow hair being that everything closed out normal no stitches or anything. i just wanted to clarify that. thanks

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I would wait about 6 to 12 months to see if hair will regrow. If not, you can have that scar dealt with, either by having the scar revised or perhaps hair transplanted into the scar. At this point, you’re going to have to wait and see, and if the hair doesn’t return you can meet with your doctor to determine the next step.

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Hair Loss InformationI Want My Juvenile Hairline Restored with High Density – Hair Loss Information – Balding Blog

Hello. I needed to know if you have any high resolution before and after photos for male patients who have had transplants at NHI to restore their juvenile hairline with a high density. I was trying to find some on the newhair.com site, but couldn’t. I know that this is not a common procedure in men as many guys do not commit to taking propecia early on in the balding process and come in when the hair is only restorable to the mature position, but I’m sure juvenile hairline restoration has been done as for certain modeling/acting careers the thick Juvenile hairline is the aesthetic-standard.

The mature position is unacceptable for some of us, especially with how the aesthetic standard is becoming more stringent in 2011 due to many popular icons who lack the balding genes. I am considering doing hair transplantation for my career at your practice and was recommended to have FUE by my doctor (if I really wanted it). I do not have advanced balding or miniaturization beyond the hairline.

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In general, we do not restore juvenile hairlines or any hairline with high density, especially with one surgery for most patients… perhaps with the exception of young male actors or models that have careers dependent on a specific look. You probably will not see these patients at our website, because many are convinced that their hairline will put them at risk for recognition if shown online. We don’t force patients to sign a photo release, so we can only post what we have permission for.

We don’t recommend transplanting a low hairline in men, because you are setting yourself up for disappointment if you develop a more advanced balding pattern over time. More specifically, I do not know what your expectation of “high density” and your desire for a “juvenile” hairline is.

If you want to see examples of hairline density, just attend one of our open house events in Los Angeles and see some of our patients in person. A few of them who regularly attend do have high density, and meeting them to see for yourself in person is a great way to get an idea of what can be done. Our next open house event in Los Angeles is this Saturday the October 1st, and you can find our upcoming free open house events listed here.

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Hair Loss InformationTransplanting a Non-Balding Person’s Hairline? – Hair Loss Information – Balding Blog

Have you ever transplanted grafts along a non balding person’s hairline not to lower, but to thicken the hairline so that they could grow a fuller fringe if they had fairly fine hair?

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In dealing with hairlines, transplanting a normal hairline just to thicken it is not advisable, as the transplant could damage the existing hair. I have fixed defective looking hairlines on male actors and models who need perfect frontal hairlines for their careers, so I have worked to keep their juvenile hairline intact.

For women who have normally high, non-balding hairlines, these can also be addressed with either frontal hair transplants to bring the hairline down or hairline lowering surgery. Many women have these procedures done.

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Hair Loss InformationCould a Hair Transplant Cause Tinnitus? – Hair Loss Information – Balding Blog

Hi Doc,

I suffer from tinnitus due to tension in my neck. I am unable to figure out anything about it besides that when I am nervous or I am slouching for a long time, it comes.

My question is – Is there any swelling in the neck area or behind the ears or in the sinuses from a hair transplant? If so, would there be anyway to avoid it? Have you heard of a transplant causing tinnitus? I’d like to get a transplant but the thought of it worsening my tinnitus makes me nervous!

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I’ve never heard of a hair transplant causing tinnitus. Tinnitus generally has to do with the inner ear problems or even certain brain pathology. I would follow up with a specialist.

With hair transplant surgery, you may have swelling of the neck and ear area. I would follow up and raise these concerns with your doctor before having any surgery.

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Hair Loss Information2011 ISHRS Meeting Review, Part 8 – Minoxidil – Hair Loss Information – Balding Blog

ISHRS 2011

Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.

This is part 8… and final part. Thanks for sticking with me on this!

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Minoxidil as a systemic medication?

    Dr. Damkerng Pathomvanich (award winning doctor from Thailand) experimented with the use of minoxidil as a systemic medication on patients. This medication is used in many Asian countries as a treatment for hair loss. He commented that when spironolactone is added to systemic use of minoxidil, there is an enhancement of the hair benefits and a reversal of hair loss in many people. Although the reported side effects of this approach were small, there are still many side effects with these medications (e.g. significant drops in blood pressure, weight gain, fluid retention, rapid heart rate).

    These systemic medications are not FDA approved in the United States for the treatment of hair loss, as well as many other countries. Minoxidil was originally used in the 1960s as a treatment drug for high blood pressure, but its impact was not consistent with lowering blood pressure. Many of these earlier patients developed a reversal of their hair loss and many women treated with it developed facial and chest hair.

 
Aspirin and hair transplantation?

    A hair transplant surgeon who is also a cardiologist suggested that a person on low dose aspirin can have a hair transplant without stopping the aspirin.

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Hair Loss Information2011 ISHRS Meeting Review, Part 6 – Finasteride – Hair Loss Information – Balding Blog

ISHRS 2011

Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.

This is part 6. More to come…

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Does finasteride induce mood and other psychiatric changes?

    A case report and literature review showed a connection between finasteride and mood changes. In one case presented, a patient suffered from severe disabling mood changes on finasteride, which ceased within a week after stopping the medication. After a short time period he restarted finasteride, and the mood changes returned within a few days. Other cases were reviewed with similar problems. There is little doubt that in some patients, mood changes and other psychiatric problems appeared with the use of finasteride.

    I believe that these case reports are the exception to what we commonly see and that finasteride is generally safe, but if a patient feels that they have changes in their personality or mood since the drug was started or if a family member sees changes in their mental state, they should meet with their doctor to discuss the appropriateness of their continued use of the drug.

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Hair Loss Information2011 ISHRS Meeting Review, Part 5 – Finasteride – Hair Loss Information – Balding Blog

ISHRS 2011

Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.

This is part 5. More to come…

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Does finasteride (Propecia) impact the body’s inflammation response in hair loss?

    Dr. Marty Sawaya produced evidence that there is a connection between genetic hair loss and inflammation of the hair follicle. She believes that DHT may have a direct impact on the inflammatory process. With this insight, other potential treatments for genetic hair loss and other hair and skin disease may evolve.

 
Are finasteride’s sexual side effects overstated?

    Despite internet complaints to the contrary, there are no case reports of sexual dysfunction that remained after finasteride was stopped in those patients who reported sexual side effects. The medical literature shows that sexual dysfunction is present in 40+ percent of men over age 50, so it was difficult to assess the 2% occurrence of sexual side effects in a comparable population. Despite this, changes in warning labels have been mandated in the United Kingdom, Sweden and most recently the US.

    One joke on the floor I overheard was that based upon the internet reports, the average 50 year old had a better than 40% risk of sexual side effects, but that reduced to only 2% for those reporting side effects from Propecia, making Propecia less risky for those side effects.

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2011 ISHRS Meeting Review, Part 3 – ACell – Hair Loss Information – Balding Blog

ISHRS 2011

Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.

This is part 3. More to come…

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Dr. Hitzig and ACell

    I had breakfast with Dr. Hitzig, known for popularizing the use of ACell for plucking hairs. For those unfamiliar, the idea was that by plucking a hair and keeping some of the genetic material in the original donor area, that plucked hair would grow into a full hair (with the use of ACell), along with the regrowth of the hair in the donor area. Essentially getting two hairs out of one.

    I shared my experience with him (100% failure to have plucked hair regrow into new hairs in a balding area of the scalp). After considerable discussion, Dr. Hitzig seemed to retract his stance that ACell works with plucked hairs in a bald scalp. His present view is that these plucked hairs have to be put into an area where there is already hair present. This appears to be a 180 degree turnaround position from his previous reports that it can grow hair.

    Of course, if it can not grow a hair, then obtaining two hairs from one is not possible, and the hair multiplication process is improperly named for this technique. I was a bit angry, considering that I offered this procedure to multiple patients (at no charge of course).

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2011 ISHRS Meeting Review, Part 2 – Female Hair Loss – Hair Loss Information – Balding Blog

ISHRS 2011

Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.

This is part 2. More to come…

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What is the role of immunity in the development of androgenic alopecia in women?

    In men and women, it was suggested that there is an immune response in genetic hair loss that could either trigger the process or be an early sign that hair loss is about to start. Dr. Neil Sadick of New York has been following female hair loss for years. He showed his results from scalp biopsies of the scalp in women with hair loss. What he saw were findings that were similar to the conditions found in diseases like lupus (an autoimmune disease). He believes that female pattern hair loss is attributable to immune driven inflammation and he believes that this interferes with hair stem cell activity as they enter into the growth phase of the hair cycle.

    The earliest symptoms of many women and some men start with pain and itching of the scalp, a set of symptoms that reflect the inflammatory response that he believes is always present, but often ignored. He raises the issue that if the connection is correct, the scalp may respond to the use of steroids in the earliest phases of the hair loss process.


 
Double trichophytic closures

    Double trichophytic closures were demonstrated in a poster presentation, suggesting that this procedure can “wipe out” scars from FUE in 99% of patients. I personally doubt this claim. This reflects first time surgery patients only, as these patients are at a lower risk for significant scarring.