September 2011 – Page 3

September 23, 2011

Hair Loss Information2011 ISHRS Meeting Review, Part 1 – Hair Tools – Hair Loss Information – Balding Blog

ISHRS 2011

The annual meeting of hair surgeons was in held in Alaska this past week. The meeting was very well organized, but because of the location, many physicians chose not to travel the long distance. The weather was ideal, as good as California in its best season. About 15% of the 260 doctors who registered were new to the field and used this meeting as an educational opportunity to enter the world of hair restoration.

The following review is very selective and is biased by the things that were interesting to me (Dr. Rassman) and what I thought could be interesting to some of the readers. Since there’s so much to cover, I’ll break this up into multiple posts to make things easier. Stay tuned for more.

There were many innovations in surgical tools that may be too technical for most, so I won’t discuss them too much here. That said, I did write a little about some tools that might have some interest, so let’s begin with those…

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Tool for measuring scalp laxity

A new instrument for assessing the safety of strip excision as it correlates to the size of a donor strip was introduced by Dr. Parsa Mohebi. He presented the second version of his Laxometer, which should be used to measure the limits of the width of a donor strip.

Using HairCheck for bulk measurement

mentioned hair bulk analysis

The reason we like it is because it enables doctors to compare results over time with real numerical values, which shows the value of drugs like finasteride, and allows physicians to make the diagnosis of genetic hair loss in young men now more certain. Many young men with hair loss in the family who are concerned that they will also inherit the hair loss gene can now be evaluated for the presence of hair loss in its earliest stage. Proper diagnosis should cut down on unnecessary use of hair loss drugs.

Keep checking back for much more.

September 22, 2011

Large Donor Area? – Hair Loss Information – Balding Blog

Recently, when at the barbers, I was told that the hairline at the back of my head was very low. Like most guys, I’d never put ‘hairline’ and ‘back of head’ together. Now that I have, i’m wondering: does having a low hairline at the back of my head mean I have a larger donor area, and the potential for more grafts if needed?

Thanks

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Are you referring to hair at the nape of the neck? I’m a little confused as to what you mean by a low hairline at the back of the head. Neck hair may appear thick in some men, possibly even as thick as the hair in the true “donor area”. For people who have the narrow band of hair seen on Norwood 7 patients, there may be a limitation of your donor hair. However, you may have a very high density of hair, or your scalp may be very elastic, or your neck hair is very thick.

Neck hair is not considered permanent, as a substantial number of men will lose their neck hairs with age… so no matter how good your neck hair is, this should not be considered part of your donor area.

So there is no universal answer to your question without an actual examination by a physician. In matters of surgical recommendations, I would trust a doctor over a barber.

September 22, 2011

Hair Loss InformationMinoxidil Made Me Bald in Under 2 Months – Hair Loss Information – Balding Blog

Dr Rassman,
minoxidil is the worst product ever in the world. I started using it 1 and half month ago and then my hair loss reached a shocking amount .I quit minoxidil 15 days ago. My hair loss reduced but still there is some shedding. Now I am look like really bald. I am really worried about it. My social life also is affected. I dont wanna go outside or do something with people. I am really depressed. At the same time I am using propecia but as I said I am bald right now.

My questions are, will my lost hairs be replaced? If it will,how long it will take? I am 20 years old and my hair is really important to me. please help me.

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Hair is really important to a lot of men, so you’re not alone. I am sorry you are experiencing hair loss. Unfortunately, hair loss is mainly due to genetic causes and many men in their late teens or 20s will go through what you are going through.

There have been cases of initial shedding from minoxidil use, but this is usually temporary. I can’t say for sure how long it’ll persist or if those shed hairs will regrow. I do not know anything about you (e.g. age and family history). Please follow up with the doctor who prescribed you Propecia and discuss further options.

September 22, 2011

Hair Loss InformationIf Minoxidil Regrew Hair, Could Starting Finasteride Cause it to Shed? – Hair Loss Information – Balding Blog

I have been taking minoxil for roughly 8 months and have had decent results in the hairline area, especially the corners. I’m going to start finasteride soon however I have a question about shedding. As I understand it, the shedding that can happen on finasteride is due to the follicles that are DHT damaged shedding the hair to grow back stronger.

My question is: is hair grown back solely with minoxidil more likely to be shed when starting finasteride?

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The initial shedding is noted with the use of Rogaine (minoxidil) way more often than Propecia (finasteride). I’ve only rarely seen this problem in patients after starting finasteride, but I am seeing growing concerns from readers about it. It’s interesting how various claims can be given so much acceptance when it’s not something widely noted in large scale studies or amongst doctors with patients on the drug.

So unfortunately I don’t have an answer to your question, since I don’t have enough of a patient history that have experienced it.

September 22, 2011

Genetics vs Medication Tug of War – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

When a person’s genetics finally wins the tug of war against finasteride or/and minoxidil, will the hairloss then reassume in the form of a slow, steady process, or will the hair maintained by the drugs come off in large amounts within a short period of time?

Thank you for your time.

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The genetic progression of hair loss while on these medications (the “tug of war”) would likely be slow, in the order of months or years. It does not happen over a few days or weeks.

September 21, 2011

Off Topic – Heart Disease Contributors – Hair Loss Information – Balding Blog

Dr. Rassman,

Off topic, but as a former doctor working in the heart field and as a doctor who worked in the cardiac field what do you think are the biggest contributors to heart disease? Is there any one variable (e.g., high cholesterol, smoking, diabetes) that is most dangerous?

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Cards This is not a simple answer for a blog post. I will give a cursory answer to it nonetheless in the hope that what I have to say will help someone and possibly could even save a life. Apologies to those that come here for hair related posts, but this isn’t one of them.

Putting aside congenital heart disease, the things that are most dangerous for developing heart and vascular disease are the lifestyles and diets we have. There’s no one factor that I would be willing to pinpoint. What I tell people who ask heart related questions is that we are dealt a set of genetic cards… and if we win, it reflects the way we play those cards. If we keep ourselves healthy (good diet, exercise, no poisons in our system like cigarette smoking or excessive alcohol) we will live longer.

Some people are genetically programmed for high cholesterol and high body fats, so we must take control of those bad cards by going that extra mile. For example, the vegetarian who eats fruits and vegetables daily will have a lower cholesterol and lower body fat than the meat eater who sucks in daily milkshakes instead of water and consumes excessive calories with Big Macs a few times each week. Even the insulin dependent diabetic can improve his card deck with a good exercise program and controlled diet under good medical supervision. I’m not blowing any minds by saying this, I realize, but perhaps there’s one person out there that it’ll click with.

Just remember, life is fragile and you never realize it until you are given the bad news (like a cancer that you ignored when you notice rectal bleeding over the past few years or develop chest pain with your first heart attack). Those of you who think that your body is impenetrable, waking up with chest pain may indicate that you could be too late.

September 21, 2011

Treat a Norwood 7 with Scalp and Body Hair Transplants? – Hair Loss Information – Balding Blog

Is it possible to treat a Norwood 7 (not a head full of hair but a decent result) using Hair Transplant + Body Hair Transplant?

Thank you!

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At NHI, we do not recommend body hair transplants (BHT), as the results are highly variable and unpredictable.

We do have patients in our Photo Galleries that were Norwood 7 and had great hair transplant results from using scalp hair, but I must point out to the readers curious about hair restoration that every patient is different and the fullness will never be over the entire scalp. It’s about creating the illusion of a full head of hair by using the available donor hair efficiently. You just need to have a clear understanding of what “decent” result you are expecting.

September 21, 2011

Hair Loss InformationEltroxin and Female Hair Loss? – Hair Loss Information – Balding Blog

Does Eltroxin used for hypothyroidism cause hair loss. I am 47 yrs old and have menopause. Does low estrogen level cause hair loss. Will I need to take some preparation of Estrogen to prevent hair loss?

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Eltroxin (levothyroxine) is known to cause hair loss in some, though it is usually temporary (see side effects).

Low estrogen can also cause hair loss. You should talk to your doctor about these issues.

September 20, 2011

I Had My FUE Done Over a Year Ago and It Is Still Not Fully Grown – Hair Loss Information – Balding Blog

Hi Dr

I went thru my fue 15mths ago. Today i am still feeling some stubbles (transplanted graft) on the recipient area. These stubbles do not seems to be growing. Is there a possibility that newly transplanted graft stays as stubble – do not fall off neither grow out and become healthy hair? Or am i just a slow grower?

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While it is possible, is highly unlikely that you will start finally seeing growth at 15 months. You should have seen most growth at about 6 to 12 months following your surgery.

More importantly, the new hair growth will not appear as coarse stubble (like a beard). It’ll start off fine and grow as the months go by. Sometimes the stubble can be remnants of the original hair grafts that never fell out, but are just stuck in its place. You can test this by having someone find these stubbles and pulling on them with tweezers… or if you can reach it yourself, you can do this yourself. If the stubble is a dead hair shaft (old leftover follicle from 15 months ago), it should slide / slip right out.

The implication of this is that the surgery may have been a failure. Have you talked to your surgeon for a follow-up since your procedure?

September 20, 2011

I’m 16 and My Doctor Prescribed Propecia – Hair Loss Information – Balding Blog

Hey, I am a 16 years old and I have started to notice that I am losing my hair. My doctor has prescribed me propecia and I have been on it for almost 2 months now. I have noticed that a lot of hair has been falling out recently but I have heard this is common with propecia. Is this true?

I was also wondering if you have heard of anyone of my age who has been successful with propecia, since it is meant for people who are 18 and older. I’m not really looking to grow more hair, I just want to keep the amount of hair i have now and hope that I wont lose anymore.

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Propecia will slow the process down and sometimes provide some regrowth, but it won’t cure the loss completely. You will continue to lose hair at some rate, over time. I do not believe increased hair loss is common when you start Propecia use, but I have heard others mention it.

I would expect that a 16 year old will get a better response than a 21 year old with very early loss. We rarely see boys of your age go on the drug or have enough hair loss to warrant taking the drug, so I don’t have a wealth of past experience with teens on Propecia. Please follow up with your doctor.