Month: August 2012

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My Husband Took Propecia for 8 Years and Now We Want to Get Pregnant – Hair Loss Information – Balding Blog

My husband has taken Propecia for hair loss for 8 years and I am concerned about his sperm count because we want to get pregnant. How long does it take to leave the body? Is there a danger to the fetus? Does it cause fertility problems? I am very concerned and wish he never took this drug.

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In general, men can continue to take Propecia while trying to conceive. This is safe and there should not be a danger to the fetus. However, in my practice I generally advise men to stop taking Propecia for the two week mid-cycle so that there can be no question as to the safety issue and to put the patient’s mind at ease. Propecia is out of the blood stream within 24 hours and out of the tissue in a few days.

The most important part to this is to talk with your doctor and discuss these concerns with them.

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Hair Loss InformationWhat’s the Average Number of Grafts That Can Be Transplanted in a Lifetime? – Hair Loss Information – Balding Blog

Many thanks doctors for providing help to all of us!! Your blog is very interesting.

How many grafts it is possible to extract from a caucasian male with an average donor supply over the course of his life? Does it make a difference whether it is a FUE or strip? 9,000?

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Generally there are around 6,000 to 10,000, but it is depending on many factors, including race, ethnicity, scalp laxity, and hair density. We have transplanted as high as 10,000 grafts in a few of our patients over several surgeries. Others we max out at 6,000. Every patient is different.

The second part of your question was answered here — Can You Get More Grafts from Strip or FUE Over a Lifetime?

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Hair Loss InformationWhat Can I Do About a Scar On My Forehead? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,
I am still waiting to do my first surgery with you in the LA office. An off-topic question today:

I have a 0.7cm scar in my forehead that resulted from a home accident by opening a door. Do you know of good doctors, laser surgery or other means, in the Los Angeles area who can remove such a scar?

I am thinking to do it along with my first strip surgery on a trip to California. All the best doctor.

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There is no such product that exists that removes scars. Some scars can be modified in the hands of a good plastic surgeon. There may be ways to minimize the appearance of scars, but this is very specialized to the individual and the type of scar.

We will look at you when you come in and we’ll be able to give you an opinion then.

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Not Hair Loss News – Egg Yolks Can Be Dangerous to Your Health? – Hair Loss Information – Balding Blog

Snippet from the non-hair-loss article:

Researchers who have long argued that egg-yolk consumption contributes to cardiovascular disease have now published a study showing that lifelong consumption of egg yolks is correlated to development of carotid artery plaques and therefore should be avoided by anyone at risk for cardiovascular disease.

Dr J David Spence (Robarts Research Institute, London, ON) publish the results of a study of 1262 consecutive patients attending vascular prevention clinics in Canada online August 1, 2012 in Atherosclerosis. All of the subjects had baseline measurement of total carotid plaque area by ultrasound and filled out questionnaires about their diet and lifestyle, including medications they take, smoking, and the number of egg yolks they’ve eaten per week times the number of years they’ve kept that dietary pattern (egg-yolk years).

The results show that carotid plaque area increased linearly with age after age 40 and increased exponentially with both pack-years of smoking and egg-yolk years.

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Egg yolkRead the rest — Debate Over Dangers of Egg-Yolk Consumption Continues With New Study

The article goes on to point out that the egg industry says the study was poorly done by a longtime critic of the industry, and they cite a small study that disputes the findings. So while this could potentially be important health news, I guess it depends on who you believe.

Still, this might be something to keep this in mind what you eat eggs. I personally only like the eggs if there is a yolk in it, so I guess that stops another bit of goodness from my healthy diet.

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Hair Loss InformationI Had Brain Surgery and Want to Fill in the Scar, But I Also Have Early Balding – Hair Loss Information – Balding Blog

I have a scar from a previous brain surgery. I went to hair transplant surgeon and he estimated that it would take about 300 to 400 grafts to adequately cover the scar.

However, I am 18, and I’m already experiencing balding. My dad (and most of my male relatives on his side) are diffuse NW6s, so I’ll probably be heading in that direction. Furthermore, I have straight black hair and brown skin, with a lower-than-average density.

Would it be smart to put off the filling in of the scar?

Basically, I don’t want to unnecessarily deplete my donor supply.

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At NHI, we have good experience in addressing brain surgery / craniotomy scars with hair transplants. In general, patients usually need more than one surgery to be adequately satisfied, so be prepared.

If you are balding to a Norwood class 5 or 6 it may not be advisable to fill in the scar unless you plan on having a full hair transplant surgery and have adequate supplies of donor hair.

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How Is it Even Possible for Finasteride to Worsen or Accelerate a Receding Hairline? – Hair Loss Information – Balding Blog

Some claim that finasteride has, overtime, worsened and accelerated their receding hairlines. Is this medically possible? Or is what they’re seeing just a result of aggressive MPB that hasn’t responded to the drug?

Thanks!

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I do not know why finasteride would worsen hair loss. It is a drug treatment that slows down hair loss. Finasteride does not work well on frontal hairlines, but this does not mean it makes it worse. Perhaps in the process of slowing down the top/crown area drastically with not much effect on the front hairline, the overall perception may seem as if the front is worsening faster. I really do not know, though. This is just my speculation.

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If a Man Gets Castrated While Losing Hair, Does the Loss Just Stop Immediately? – Hair Loss Information – Balding Blog

Doctor Rassman and Pak

I have a question about castration. Does castration only stop hairloss if a person were to be castrated before puberty(hence before male pattern baldness starts), or does it also stop hairloss once hairloss has started as well? for example lets say there is a 30 year old with active hairloss, he gets castrated, does the loss stop, or will it still continue regardless of the castration?

Im not thinking about castration lol, just want to know for knowledge purposes

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My educated guess is that once the hair loss starts you cannot completely stop the process even with castration for the hair that is scheduled to be lost (i.e. apoptosis). I could be way off base, though. I’m not going to suggest castration to prove it one way or the other.

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Is Having 3600 Grafts Transplanted in One Procedure Safe? – Hair Loss Information – Balding Blog

Hi Drs. Rassman and Pak:

I was concerned about the recent story you posted today (8/9/12) of the guy who had a 3,000 graft transplant that failed. I consulted a very reputable transplant doctor in La Jolla (who will remain unnamed) who was/is prepared to transplant 3,600 FUs in one session on me because I have good scalp laxity and a good donor supply (I’m 54 by the way and never had any hair loss until about age 45 or so).

But now I am worried. Is this safe to do (3,600) in one procedure? Don’t you usually limit your procedures to about 2,000 grafts at a time, give or take (that’s all you did for Jon Gosselin on the TV show that was broadcast)?

Incidentally, and I don’t know if this is important, but I am one of those anti-Propecia people. I want hair, but not at the cost of taking Propecia. Never took it and never will. I’m not trying to stir that pot again, so don’t get me wrong, and I know many people disagree with me and that is fine. But I have made the decision never to take Propecia, ever. It’s just a horrible drug, in my opinion. If other people want to take it, that’s their business, it’s their funeral as far as I’m concerned and I couldn’t care less. Another way of looking at it is it’s none of my business.

So again, is 3,600 FUs all at once over the top, crazy? Risky? You know what the great British entrepreneur, Freddie Laker (of the now defunct Laker Airways fame),once said, “The only way to get ahead in life is to take a little risk and have a little luck.” I think that is very true. True with hair transplants too.

Thanks for the great blog.

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We have performed as many as 5400 grafts in one surgery at NHI. That particular patient had an unusually high donor hair density and very loose scalp laxity. In general, a 3600 graft procedure is considered a high number, but along with this high number of grafts comes the price of a longer and/or higher scar. As I’ve written on this site before, I’ve had three strip surgeries totaling 2200 grafts and have a barely detectable scar. If your laxity allows it and your donor supply is good, the 3600 grafts in one surgery might be achievable.

I hope you can realize that every person is unique, and their goals and needs are highly individualized. Some people may not care and want one large surgery to be done with the process. Some people choose to have the procedure in stages (multiple procedures over time). This is why choosing your doctor and having them explain all these options is critical.

I often get emails from patients who are price shopping and care only about the monetary cost involved. They miss the point that cosmetic surgery / hair transplant surgery is not like buying a car where you get the same vehicle at a variety of dealerships.

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FUE Without Shaving the Donor Area for African Americans? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I want to thank you for developing the new FUE technique that does not require shaving the donor area. I am wondering if this technique has been tried and tested on African Americans given the curly nature of their hair. When I came for my FUE, I actually had to keep indoors and avoid contact with the general public.

I would certainly consider this technique for future transplants if it works for African Americans.

Thanks

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I have not tested or tried the long hair FUE procedure (mini FUE, mFUE) on the kinky hair character of African-Americans. I do not see any barriers for the technique itself as we have been doing this type of surgery (FUE) on African-Americans for many years.

The difficulties of performing FUE on kinky hair should be the same with the hair long or short. In general, FUE on kinky hair is difficult for the obvious reason that the hair turns into a ‘screw’ shape below the scalp skin.

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I Was Diagnosed with Telogen Effluvium a Year Ago, But My Hair is Still Falling Out – Hair Loss Information – Balding Blog

Hello

I am a 30 year old woman and I have been experiencing hair thinning especially in the front. I did a hormonal test a couple of years back and it came ok. Last year a dermatologist in Atlanta did a Hair and I was diagnosed with TE. He did nothing but to prescribe vitamins. My hair loss has not stopped. What shall I do? can you suggest a doctor or a treatment?

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You should perhaps consider seeing another doctor for a second opinion, though I don’t have any personal recommendations in the Atlanta area.

In general, there is no definitive cure for women’s hair loss once other medical causes have been ruled out (anemia, thyroid conditions, etc). If you do have telogen effluvium, hair generally grows back after about one year.