September 2012 – Page 6

September 11, 2012

Hair Loss InformationWould Mini-FUE Be Ideal for Treating Possible Triangular Alopecia? – Hair Loss Information – Balding Blog

Good day Dr Rassman,
I wonder if i would be an ideal candidate for your new FUE harvesting technique!

I have been in contact with you before. I am a 44yr old male with a small (1 inch) bald spot on my right side in front of the ear. i have never seen anyone else with this particular condition, i wonder if you have. i can resend pictures as no doubt you are unlikely to have the ones i sent to you some years ago. Hair miniaturised in this area probably at the start of my balding process (was gone by the time i was 30 i think). Many years of propecia and minoxidil have had no effect whilst they have had some effect on the top of my head.

A consultation with a dermatologist diagnosed triangular alopecia (although that was simply by looking and he may have just have piggy backed onto my suggestion that it was!!). A course of steroids both topical and injections have had no effect.

i wonder if this new technique could be the answer. My only concern is that if this is an immune system rejection of hair in that area, then i assume placing more hair there will be rejected as well but i am no expert just looking for a solution. many thanks

Block Quote

If you have a 1 inch area on one side of your head, a mini-FUE would possibly be ideal.

Before assuring your candidacy for surgery, I’d of course have to see precisely what you’re referring to and I’d want to know for sure what the diagnosis was. I don’t know why you’d think your immune system would reject hair transplanted into an area of your scalp.

September 10, 2012

Hair Loss InformationAvodart Dose for Male to Female Transsexuals? – Hair Loss Information – Balding Blog

Dear Dr., I am Male to Female Transsexual who’s been on (finasteride 5 mg, Spironolactone 100 mg, Estradiol and Progesterone) for 14 months now. I am 30 y/o, my body is responding well but my hair isn’t. I get some tiny hairs on my hairline but I loose them, I go through phases of shedding. Recently, I started to read a lot about Avodart but I am debating with my Dr. on the dose.

The 0.5 mg is not intended for Hair loss but higher doses are more effective. Is 1.0 mg better or shall I go with the 2.5 mg? Or is the 0.5 mg effective in my case since my T levels are low? I mentioned my case because my case is unlike any other cases, my body Chemistry is a woman’s but I did not have the Testosterone factory removed yet so I am pretty confused.

Please, I really need your kind advice. My Dr. is unfamiliar with Avodart and for financial issues, I cannot see anyone else. Thanks so much and kindly accept my gratitude.

Block Quote

I’ve answered a related question years ago — Transgender Male-to-Female Taking Dutasteride.

As you aren’t my patient, I am unable to give you specific dosing advice on how to use the various drugs which have an anti-androgen effect. This treatment for balding may not work at all if you triggered the hair loss when you had androgens working in your system. Avodart (dutasteride) may not reverse the hair loss, particularly since you’re looking to regrow the hairline, but it may slow down the loss process, possibly more than finasteride.

I have treated male-to-female transsexuals with hair transplants and provided that the balding pattern is not too advanced, the results are pretty good. I have not treated MTF patients with Avodart, though.

September 10, 2012

Off Topic — Water Wigs Photo Series – Balding Blog

Hey doc,
Have you seen these cool photos that have gone viral? A photographer made a series called “Water Wigs” where he used a high speed camera to capture water balloons bursting on bald heads.

The results are really really cool. here’s an interview with the photographer and some photos from the series.

Link: Tim Tadder’s Photo Series “Water Wigs” Captures Beautiful Intersection Of Baldness And Water Balloons

These are amazing photos by Tim Tadder. Very neat idea.

September 7, 2012

Patient Results – 4149 Grafts Restored His Hairline (with Photos) – Hair Loss Information – Balding Blog

This patient with straight, medium fine hair had presented a Norwood class 3A pattern when I first met with him years back. His first hair transplant surgery was 1927 grafts, and while it gave him a hairline that he had been missing for years, he decided to have another procedure (of 2222 grafts) a year later to fill it out a bit more. No further procedures are planned.

Click the photos to enlarge.

After (4149 grafts total over 2 procedures):

Before:

September 7, 2012

Press Release – ISHRS Celebrates 20th Anniversary – Balding Blog

Snippet from the press release:

As the International Society of Hair Restoration Surgery (ISHRS) prepares to kick off its 20th anniversary this October with a look back at the significant improvements made in the art and science of hair restoration surgery, millions of men and women around the world have better hair to show for the tremendous growth in this specialized field of medicine.

“Over the last 20 years, the ISHRS has grown to over 1,000 international members working in collaboration to establish the highest quality standards and best practices that have led to the modern-day hair transplant,” said ISHRS President Dr. Jennifer H. Martinick. “Now, results are natural looking and virtually undetectable, and ISHRS members are committed to pushing new frontiers in scientific research to further enhance results and possibly even reverse or delay the onset of hair loss.”

Read the rest — 20th Anniversary of World’s Leading Hair Restoration Medical Society Spotlights Greatest Advances in Combating Hair Loss, Potential Future Breakthroughs

September 6, 2012

Direction of Graft Growth – Hair Loss Information – Balding Blog

Hi Dr,

Can you explain how accurately a surgeon such as yourself can transplant grafts so that hairs grow in the same direction?

I have seen quite a few celebrity transplants where the hair still appears thin and the hair once grown out always looks messy because the direction of the grafts is not quite right.

How are you able to ensure that this doesn’t happen?

As someone with naturally fine and very straight hair then i imagine it would be essential that any transplant i had done should be performed by a top surgeon who is able to make sure that the angle of the transplanted graft is accurate. If i had thicker and naturally curly hair then i suppose this wouldn’t matter so much and is probably a part of the reason why those with curly make better candidates?

Thanks

Block Quote

Doctors have direct control of how the transplanted hair grows and how the transplanted hairs are distributed to give the most natural look. This is a very important point that most prospective patients do not take into account when searching for the right medical group for a hair transplant procedure.

You are correct in stating the fine straight hairs need careful attention to detail when undergoing a hair transplant procedure, but careful attention to detail is also a must for coarse hair, because each hair can have many times the bulk of a fine hair. A coarse hair put in the wrong direction will be more easily detected than a fine hair put in the wrong direction. Some surgeons, when placing the hairline, place the frontal hairs radially (like bicycle spokes). Is it possible that surgeons who do this do not understand the normal direction of the hair growth, just are ignorant of the facts? Sometimes I think so.

To be sure that these poor placement doesn’t happen to you, you have to do your own research and due diligence. There are many good doctors with great artistic skills. The best way to determine who these doctors are is to ask to meet some of their patients. My patients love showing off their results in the privacy of our office, so we set up circumstances once a month to allow this to happen. To me, this is just plain good medical education. This is why we have our monthly Open House events where anyone can come and see our former patients (up close) and speak with them face to face.

September 6, 2012

Teenage Acne and MPB? – Hair Loss Information – Balding Blog

Hi Doctors,

Do you believe that there is a link between suffering from acne in early teenage years and male pattern baldness? Being as acne spots are based around the hair follicles and hormones also have something to do with it, I am curious.

Thanks for looking at my question!

Block Quote

Changes in hormones are what is responsible for teenage acne and androgenic alopecia (AGA). In boys under 16, we rarely see patterned genetic balding being expressed, yet we see a great deal of acne in this age group. There is no direct linkage that I know of.

September 6, 2012

Hair Transplant from Non-Permanent Zones? – Balding Blog

Hi,

I’m in planning stages of surgery to fix some Norwood Class 3 corner recession, probably not more than 2000 grafts. Taking the grafts from the permanent zone has the disadvantage of setting me up for more surgery in the future, if finasteride doesn’t keep my hair, so I’m considering having the grafts taken from the midscalp instead. I will then have little to no need for additional surgeries, even if I keep thinning on top, as the transplanted hair will thin out along with
the rest of the hairs.

I understand that some might have a problem with a scar on the anterior mid scalp, but I already have a long scar there. It’s from an accident.

You need to discuss these issues with your surgeon and have a good basic concept of the Master Plan and future consequences. Mid-scalp harvesting can cause more scarring and an unnatural outcome. I do not know exactly what you are planning, but it does not sound realistic.

If the surgery is planned out well, you should not need more surgery because you continued to bald. You may look thinner over time, but it should still look natural, not prompting the need for another surgery. Wanting another surgery is a different story. Every surgery should stand on its own… at least, this has been my philosophy.

September 5, 2012

In the News – Identical Twins, but Only One Has Alopecia Universalis – Balding Blog

Snippet from the article:

As girls, they insisted on matching outfits, right down to the ribbons in their blonde pigtails. And as teenagers, identical twins Gwennan and Elin Thomas were inseparable, even going to the same university.

‘We were, and are, best friends,’ says Gwennan. ‘I had a freckle on my forehead as a baby – which disappeared – and that was how our parents told us apart. Looking at some childhood photos, we still argue about who is who.’ Yet, in 2002, a shocking, inexplicable event would mark the sisters apart.

That year, Gwennan, then 25, was diagnosed with alopecia, a condition that causes hair loss. She suffers from the most extreme form, alopecia universalis, and has lost all body hair, including her eyebrows and eyelashes. Ten years on, she can still remember the morning she woke to find clumps of hair on her pillow. ‘I burst into tears,’ she recalls. ‘My hair had been thinning for a while but then it started falling out in clumps pretty much overnight.’

Read the rest — One sister has alopecia and the other has a full head of hair

Identical twins… yet one has alopecia universalis and the other doesn’t. One of the leaders in alopecia research is Dr. Angela Christiano, and the rest of the article talks about how this case is causing her to rethink how this might occur in just one twin. Dr. Christiano said, “There may be something, for example reaction to stress, that causes the gene to express itself in one twin but not in the other.”

September 4, 2012

Hair Loss InformationI Take Excessive Retinoids and Have Hair Loss – Hair Loss Information – Balding Blog

I’ve been taking excessive retinoids for quite some time now. I started coincidentally thinning (just a little bit to the point of being 100% unnoticeable) around the end of last summer. I stopped taking the acne medications towards the end of the first semester of college (which was right around October/November). Then I went back on the retinoids in February, but developed a full, thick head of hair. I eventually upped my dosage and went on a more intense medication.

Side note: I also went vegan right before college. Second semester I ended the veganism. I was also taking a medication called doryx, which had reported side effects of hair loss, on and off. My slight hair thinning continued throughout the rest of the semester. I went to a dermatologist who didn’t really look at my hair, but prescribed propecia and rogaine. It completely ruined my hair and made it 70% thinner, more brittle, and with bald spots within 2 months. I took propecia and rogaine together for a total of 29 days.

My hair is still falling out rapidly. I also was taking acne medication throughout that period, but stopped in the middle of my propecia dose. I am no longer a vegan and no longer take retinoids or doryx, but my hair is still falling out severely. My dad started having thin hair in his 40s-same with my grandpa. I am only 19 years old. What exactly is going on?

Block Quote

Oral retinoids have been linked to hair loss if you take excessive doses (source), but there’s really no way for me to pinpoint what the exact cause of your loss is considering the medication you took, the change in diet, and your age. I don’t know your complete family history, and just because your dad lost hair in his 40s, it doesn’t necessarily mean that you would too.

You may have the genes for balding and the diet change or medication caused the loss to begin sooner. Or your genetics alone could be responsible for the hair loss starting at 19. Or you don’t have genetic male pattern balding, but the medication or supplements are causing it.

There’s just too many variables that make it impossible to come to any definitive cause.