November 2011 – Page 7

November 4, 2011

Hair Loss InformationI Have DUPA and Need a Specialist in Toronto – Hair Loss Information – Balding Blog

Dear Dr Rassman,

I just wanted to thank you for all the inspirational information you have provided for men and women that suffer from hair loss. I currently suffer from DUPA and I’m very concerned that I will not have the necessary donor hair in order to do a hair transplant.

I was wondering if you could let me know which doctors in the Toronto, Ontario Canada area provide miniaturization testing.

I have seen several dermatoloigists and transplant surgeons. However, my diagnosis from all of them have been a mixed bag: some say I suffer from telogen effluvium others say I have MPB. My blood work is normal. My hair loss is not just limited to the crown area but I am thinning from the sides and back of my hair severly at a tremendous pace!

Any help and/or suggestions would be greatly appreciated! I just need a straight answer in order to make an informative decision in regards to the necessary treatment options for hair loss.

Thank you again for your exceptional work and in keeping members advised of hair loss treatment options.

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The straight answer is that there is no cure for diffuse unpatterned alopecia (DUPA), assuming that this is your correct diagnosis. I would recommend that you obtain a solid diagnosis of DUPA first (as it seems you may be self diagnosing this).

For a list of doctors in your area, you can try the physician search at ISHRS.org. I don’t have any personal recommendations in that area. Ask these doctors if they perform bulk analysis with the HairCheck instrument and miniaturization testing before you go and visit them.

November 4, 2011

Should I Cut My Hair Shorter to Reduce the Weight? – Balding Blog

(female)
I am 53 years old and wear my hair in natural locks. I have thinning hair in the crown an front hair line due to medication. Also the new growth is much softer than my natural texture. I understand that the hair should begin to regrow when treatment ends in a few months. Should I cut my locks shorter (currently shoulder length) to reduce the weight or cut them off and start over after treatment?

The weight of your hair shouldn’t have anything to do with its growth or loss, though if you cut your hair shorter you do reduce the risk of damage to weaker hairs you might have. If you would like to cut your hair to match a certain style or achieve a better look then by all means…

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November 3, 2011

Hair Loss InformationHave You Tried NeoGraft Yet? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I read where your colleague, Dr. Bernstein, recently decided to add the NeoGraft Unit to his office’s hair restoration offering – see his blog for more information. I was wondering if you have had an opportunity to try the NeoGraft and whether or not they have managed to overcome trauma to the grafts from “drying” and mechanical effects (during extraction and implanting)? I have read your blog concerning your (and Dr. Pak) device (hydro) and was really hoping that they might take a page from your book on this technique.

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I did try NeoGraft on one of our known FOX negative patients and the results were not good, but comparable to what we would have gotten using our own techniques in such a patient. A quick aside, the FOX test means that we ran a small FUE test to see if they are candidates for a full FUE procedure… and FOX negative means we do not recommend the FUE procedure for them.

The NeoGraft system did what we would have expected it to do. I believe (without direct experience) that the ARTAS robot would have also produced damage with this FOX negative patient, but as most patients are not FOX negative, the test of the NeoGraft on this patient was not a fair representation of what it should do.

I have asked for a loan of a NeoGraft system to help me find a place in my practice for it. I know that Dr. Bernstein is getting an ARTAS system and I am sure that when he has a FOX negative patient, I will find out what his experience is with such a patient.

November 3, 2011

Is It Realistic to Expect Finasteride to Keep My Hair for Decades? – Hair Loss Information – Balding Blog

I recently went to my Family doctor and told him about my hair loss problem. He prescribed me proscar which he said I have to cut in quarters and take it daily. I asked him how long my hair would last on this medication. He specifically told me as long as I am taking the medication I can have my hair forever, till the day I die sort of speak. He told me he has had patients on proscar for 15-20 years that still have all their hair and are well into their 30’s and 40’s now.

I am 28 years old, so I am hoping my hair loss stops by the time I am in my 30’s, b/c so far my hair loss hasn’t progressed that much since I started to 1st notice I was losing hair. Do you think me having hair well into my 40’s and 50’s is a realistic goal with proscar?

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I know how cliche this sounds, but nothing lasts forever and everyone is different. Propecia/Proscar (finasteride) is not a cure for hair loss. It helps slow down the process. Some patients respond very well to the drug, while others do not. I cannot predict how you will do with the medication.

One of my favorite patients has been on finasteride for 14 years and it completely reversed his crown loss, which is still the case today. So it is possible that the medication can help for a long time… but I have no idea if that will be the case for you.

November 3, 2011

Hair Loss InformationI’m Seeing Shedding a Couple Months After Starting Minoxidil – Hair Loss Information – Balding Blog

Dr.Rassman

Although I started noticing small vellus hairs growing at my hairline when I started taking minoxidil. I thought everything was working out perfectly, but then I also started noticing hair loss a couple months after I started taking minoxidil. Is this normal, I thought most of the shedding would happen earlier on like within the first month not after that?

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I’m surprised you saw hairline regrowth from using minoxidil. There are some reports that the short term use of minoxidil will cause shedding of hair and that this is a reversible process once you get out 3 months from the time you started it. If you are not seeing this, go to a specialist on this.

November 3, 2011

I Lose Spots of Hair That Regrow White Before Changing to My Normal Color – Balding Blog

Hi doc

Im 51 and for many yrs now, i some times lose my hair. its always in a circle, in different spots on my head. Now it always grows back in white at 1st then it changes back to my normal color..why does it do this ????

You may have a condition called alopecia areata, as the stigmata of this type of hair loss is (as you describe) in circular patches that eventually regrow over time. I haven’t heard of the changing of hair color, though. Follow up with a doctor for a diagnosis, as I am taking a wild guess here.

In any case, the diagnosis of this disease is by biopsy of the area around the lesion. If it does happen to be alopecia areata, you can find more info here — National Alopecia Areata Foundation.

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November 2, 2011

Hair Loss InformationDo Doctors Track Transection Rates in Hair Transplant Surgery? – Hair Loss Information – Balding Blog

I was curious if you know if any doctors track the survivability of the grafts? I know that there is quite a bit of information on transection rates for different surgeons but was wondering if anyone monitors this metric? If they do – how might the survivability be determined outside of just counting the grafts in the recipient area a few weeks/months after the surgery? Thanks

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This is a great question. We track transection rates when we perform FUE surgeries. The transection can vary from 5% to 50%. I believe 5 to 10% is an acceptable number. If there is a high transection rate then we will abort or never recommend surgery. This is the reason why at NHI we always pre-test all potential FUE patients, but I realize other clinics and doctors may not do this.

The data for other clinics and doctors is not available or well published in studies. I believe mainly it is directly linked to business. No one would publish poor results or high transection rates, as it is not good for business. As unfortunate as it may be, the consumers and patients are left to do their own due diligence and trust their doctor, probably by contacting patients who had it done by that doctor. One way around this would be for patients to ask about seeing actual patients in person or seeing their own surgical records of how the grafts were tracked (if it is done at all). In theory, the transection rate should be documented on the day of surgery, but I realize not all doctors will keep this record (as it is not mandatory) and some may refuse to show it to their patients. I can say this because I have heard these issues come up in consultations with some patients that have had procedures done elsewhere previously.

I know of one doctor who promotes and reports 96% good FUE grafts (4% or less transection), yet I have see many of his patients and found a high degree of failures in those of his patients who came to me for a second opinion. This is a buyer beware business. Sometimes you can expose poor practices through reports by the chamber of commerce or the courts in the areas where the doctors practice. I’ve also been asked to post the names of doctors to be weary of, but if I were to speak up and identify those who may not be honest in their representation, I would become a target for slander. I have better things to do than take up residence in the court system.

November 2, 2011

I Chemically Relax My Own Hair and See Hair Loss – Hair Loss Information – Balding Blog

Hello. I am a 42 year old black female that is experiencing hair loss. I am wondering if this is due to me chemically relaxing my hair myself. I do have a low thyroid condition that I take medication for daily. Could this be contributing to my hair loss. It seems to be getting worse. I recently permed my hair but I burned my scalp pretty bad. Will my hair grow back? Could you give me any suggestions of products to use that might help? Thank you

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Chemical damage and thyroid conditions can both contribute to hair loss, and there’s no way for me to try to pinpoint the cause via email. Try stopping the chemical use on your hair and give it a year or so to see if there is improvement. The hair could regrow, but it depends on the severity of the burn. At this point, all you can really do is wait it out to see.

November 2, 2011

Do I Need to Wash Off Concealers? – Hair Loss Information – Balding Blog

Hello Doctor

Is it necessary to wash off concealers ( such as dermatch or toppik ) daily or is it safe to use them daily but keep a 2 – 3 washes per week schedule

Thank you

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You don’t need to wash off these camouflaging agents every day. I’ve seen patients who keep these concealers on for 2 to 3 days (since they wash their hair that often), but it’s up to you. Concealers will not damage your hair or cause hair loss, even if you keep them on for a few days.

November 2, 2011

What’s the Difference Between Rogaines? – Balding Blog

Hello, We’re wondering about the difference between Rogaine for men, & Rogaine for women. Also, it would seem that by now something would be developed that you wouldn’t have to use twice a day, also something less sticky…

In today’s world of hi-tech advances (Latisse is one, & what a blessing for men/women who have had surgery), that something would come along that grows hair much easier.Just wondering…
Thank you

Rogaine Rogaine is a brand name for a topical formulation of a generic drug named minoxidil meant for topical application to the scalp (for hair growth). It comes in 5% strength for men and 2.5% strength for women and is available without a doctor’s prescription (over the counter). I’ve written about the ingredient differences before here.

Some formulations are very sticky, as you imply, and others are not. It all depends on the preparation of how it is mixed and packaged. The brand name Rogaine also comes in a foam and it is not sticky at all, but I believe it is slightly more expensive. In summary, there is consumer choice available to each of you and some experimenting with what is available maybe a good idea. All drugs have their limitations.

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