Month: December 2013

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Hair Loss InformationCould My Hair Loss Be Related to My Face Lift from Years Ago? – Hair Loss Information – Balding Blog

(female)
Hello:

I had a face lift 4 years ago. I lost hair at the incision lines on my scalp and it has not grown back, which I expected. But 5 months ago, my hair began thinning all over my scalp, more so at the top. I have seen a dermatologist who diagnosed this as telogen effluvium

My question is could this be a delayed reaction to the face lift of 4 years ago, and if so, is the hair loss associated with a face left permanent? Why would it take 4 years to thin? My surgery went well, i was happy with the results and there were no complications.

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A face lift can cause hair loss around the scar. If no hair has grown back in over a year, then it is likely permanent. I do not know why you are noticing scalp loss after 4 years, but if what you’re experiencing is telogen effluvium, it is unrelated to the face lift. The effluvium does cause overall thinning and this may be causing you to notice the hair loss around the scar that was always present.

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Which Comes First in a Master Plan – SMP or Hair Transplant? – Hair Loss Information – Balding Blog

Dr. Rassman / Dr. Pak,
If, after consulting with you and establishing a masterplan, a patient were to undergo SMP with the intention of having a hair transplant in the near future, are there aspects of the procedure that require particular consideration?

For example:-
(a) Would the SMP hairline have to be positioned slightly further back than the original hairline to allow for the creation of a transition zone during an HT?
(b) Are the SMP dots used as a template for an HT?
(c) Would the integrity and visual effect of SMP ink be damaged or compromised by HT-surgery incisions?
(d) Do you advocate using a darker pigment to provide better camouflage to the scalp, or do you always match the ink to the patient’s existing hair colour, even if it’s greying/white?

Or is it advisable to have SMP after a hair transplant? Thank you.

Merry Christmas & Happy New Year!

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Each and every patient is different and there is no rule. You can have Scalp MicroPigmentation (SMP) first and a hair transplant later. Or you can have the transplant first and SMP later. I have had patients who had SMP on a completely bald scalp and later had a small FUE surgery to add texture to the hairline.

The hairline for SMP and a hair transplant is placed in the same proportionate height according to what the patient and doctor agrees on. If a patient ever considers having a full HT later on in life they should let the doctor know of this possibility so the SMP hairline can be placed slightly back to make room for some transition zone… but in my experience (in practice) this rarely happens, because most bald patients who are undergoing SMP will never consider a full HT since it will never give them complete full hair coverage. Most bald SMP patients would rather have a good hairline and later consider an FUE option for added texture (not fullness).

I do not advocate darker ink for better camouflage. I advocate a specific shade of ink that matches the complexion of skin and hair combination. If the patient’s hair turns grey later on in life, the SMP shade will make the roots look dark. If you apply SMP all over the scalp it would not matter if the hair turns grey, because there is a base SMP color. Many patients with grey hair have SMP and it actually makes their hair look less grey and they look a little younger. If there is ever a drastic mismatch where your hair turns completely white (not grey) like Santa Claus, then I suppose one must consider dying their hair. Completely white hair will not work with SMP unless you shave the white hair.

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Hair Loss InformationDoes Drug-Induced Hair Loss Fall Out the Same Way as MPB? – Hair Loss Information – Balding Blog

Dear Doctors:

I am a 22 year old male with mildly active Crohn’s Disease and in the next few weeks I hope to be going on Humira. I know that both the disease and the Humira can cause hair loss.

My question is this: Does hair loss from drugs and disease miniaturize and fall out in the same fashion as MPB? I would like to know if there is a difference, because if it’s the disease/drugs, I can’t do anything about it and no need to waste money on it either. Thanks for reading.

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The biggest difference is that in male pattern baldness, there is a pattern to the hair loss, as seen in the Norwood classification chart (see below). Drug induced hair loss is usually generalized loss all over the head without a pattern.

Norwood chart

 

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Hair Loss InformationMature Hairline Measurements – Hair Loss Information – Balding Blog

Dear Dr Rassman,

I know you’re probably sick of hearing questions about this but here goes… I read in one of your more recent posts that ‘a mature hairline is usually about one finger width above your highest forehead wrinkle.’

Doesn’t this seem to contradict earlier measurements which suggest it can rise as high as an inch and a half in the corners? Or in this post are you referring to the center? If the corners receded by only a finger width (which is like half an inch) wouldn’t that be more like a NW 1.5?

The problem I am having with my hairline at the moment is that the sides are moving up (probably by just over an inch) but the center isn’t really moving. This is creating a weird angle. I actually want some of the middle to recede to even it out!

I have seen you describe this as ‘persistent forelock’ — but is a persistent forelock a greater indication of MPB than maturation?

In fact, the part of the center which persists actually seems to be more to the right, and the whole right side of my hairline is still thicker than the left. So maybe this isn’t a persistent central forelock and actually indicates the point remaining which still touches the highest forehead crease should fall out?

Just on a side note it seems as though a lot of males have a juvenile hairline whose central point is actually higher than the corners, kind of like David Schwimmer from Friends. So when their hairlines mature some of the corners recede and their hairline still looks straight. However, my central point was probably a tad lower than the corners (furrowing my brow shows a slight ‘dip’ in the middle’) and I still have hair touching the lowest line in that dip.

Thanks

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This really is not that complicated. If you think you are losing hair and you want to do something about it, see a doctor. Even if you have a juvenile hairline or a “weird” hairline and you are bothered by it, you can address it with hair transplant surgery. If you can live with it, then leave it alone. If you think it will get worse, then have it examined by a doctor.

There is no point breaking straws and going over a definition of a juvenile hairline or a NW 1.5 versus NW 1.75 versus NW 2, etc. Nobody has a perfectly even hairline.

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Hair Loss InformationI’ve Had Great Success with Finasteride, But Could Side Effects Suddenly Happen Over Time? – Hair Loss Information – Balding Blog

Hi Doc,

Had a question about finasteride…after all the scary stories, decided to take the plunge either way as hair transplants are not in my budget and am fairly young…been on it for 1.5 years now with great success (no regrowth but have seemed to stop at a norwood 3, and I was going pretty fast lol).

Anyways my question is this, do the drugs side effects increase with time, I mean by the looks of it until something better comes out, ppl have to be on this drug indefinitely ..if they want to maintain…and there are ppl like spencer kobren whose been on it for 20 years with great success…my question for you is do you personally have any patients who have been on the drug for such a long period of time, and if so how was their continued success/side effect profile

At the moment I am happy, stopped the hairloss and I decided to go with the science and not the crazy over blown stories on the net..but then again i’m paranoid too ,, you hear about people who had been on it for 6 years…great success no side effects and then boom after 6 years they are claiming ED, pain in the groin, shrinkage god knows what not…what are your thoughts?

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Side effects from any drugs (including Propecia) usually are seen in the beginning and not after 20 years, but it is possible. I have seen many patients over the years and I do not recall anyone off hand who suddenly had a side effect after years of use.

If you don’t have side effect with a medication then leave it alone. If you think you have a side effect, speak with your doctor to make sure it is indeed a side effect and not an unrelated medical condition. In your case, I would just continue to enjoy the benefits of your halted hair loss.

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Hair Loss InformationNot Hair Loss News – Type of Anesthesia Might Influence Prostate Cancer’s Return – Hair Loss Information – Balding Blog

Snippet from the article:

For men having prostate cancer surgery, the type of anesthesia doctors use might make a difference in the odds of the cancer returning, a new study suggests.

Researchers found that of nearly 3,300 men who underwent prostate cancer surgery, those who were given both general and regional anesthesia had a lower risk of seeing their cancer progress than men who received only general anesthesia.

Over a period of 15 years, about 5 percent of men given only general anesthesia had their cancer recur in their bones or other sites, the researchers said. That compared with 3 percent of men who also received regional anesthesia, which typically meant a spinal injection of the painkiller morphine, plus a numbing agent.

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Read the rest — Type of Surgical Anesthesia Might Influence Prostate Cancer’s Return

Correlation does not imply causation, but the research is interesting.

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Hair Loss InformationI’ve Seen Hair Loss Since Starting Birth Control! – Hair Loss Information – Balding Blog

Dear Doctor,

I am a 22 year old female who just started birth control four months ago. For the past month or so, I’ve been noticing hair loss, which I think I’ve identified as telogen effluvium. At first I didn’t worry too much about it, but I’ve become increasingly worried as I see more and more of my hair fall out and more and more of my scalp. The shedding seems to be diffuse, and I’m starting to see a few short hairs come in along my scalpline, but I’m still worried because I’m not sure the shedding is completely going away. I’ve been continuing with the same birth control pill, but I’m wondering if I should discontinue the pill. I don’t want to do any more damage to my hair than the pill has already done, and although I know this might be a long process, I’d like to do all I can to help it.

I saw my gynocologist, and she didn’t seem concerned at all about the hair loss. Do you think I should see a dermatologist or will this clear up by itself with time? Most of all I want to know if I should go off the medication or not. At 22 I want to make sure I get my hair back!

Thank you very much

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The decision to go off or even start any medication should be made by you and your doctor (not over the internet). I have not examined you, but I will take your word that you are losing hair. While it is possible that your birth control is causing or contributing to the loss, you don’t know for sure if it is actually related. It seems that you have self-diagnosed telogen effluvium, but it would be in your best interest to establish or confirm this diagnosis before considering a treatment plan.

In general, telogen effluvium can cause hair loss for several weeks to months before it stops and there is no medication or products you can use to speed this along. If it is telogen effluvium, your hair will grow back and it can take well over a year for this to happen. But at this point you are speculating, so I would suggest meeting with another doctor to have a diagnosis confirmed.

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Hair Loss InformationDo You Think I Should Add Rogaine to My Propecia Regimen? – Hair Loss Information – Balding Blog

Dear Drs Rassman & Pak,

I’m 34 years old, white male with dark brown hair. I have been on propecia since age 29 for a thinning crown. My current results are in the photos attached. Results have been excellent, substantial reversal and the hair fall when I touched or washed. My hair ceased. I would like to know if you think adding rogaine would give even some minimal improvement in thickness and/or crown coverage, or if adding minoxidil could be harmful and damage my Finasteride results. I am aware of the compliance issues.

Thank you very much, any advice greatly appreciated. You may post these photos.

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The photos you sent were basically the same, so I opted to just post one of them. The photo doesn’t really show me much, since I don’t know what I’m comparing it to. Lighting and hair style could play a role in what I’m seeing.

As I’m sure you know, Rogaine is an over-the-counter medication for treating hair loss. While some people have noted an initial shedding they experience, I would think if Rogaine harms the hair it would not last or be sold in the free market. If you want to add it to your regimen to treat hair loss, it is your prerogative. You can also discuss this options with your doctor. Many patients use both Propecia and Rogaine, and there should be no problem with using both if you have the time and commitment to each for a lifetime.

It would be ideal if you can have some baseline measurements such as a bulk measurement value or even a miniaturization study to document what you are treating or how effective the treatment is.

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Hair Loss InformationHair Transplant Rejection? – Hair Loss Information – Balding Blog

Hello doctor

Is is possible for transplanted grafts to be rejected months or years after a successful HT? If so how often and to what extent does that happen?

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For men, the hair on the back of the scalp is considered permanent. It may thin a bit with aging, but even old men in their 80s, 90s, 100s will have hair at the back of their heads. So if you harvest the hairs from this permanent area, the transplanted hairs will act like the hairs on the back of the head and will have the same life span. This concept is called “donor dominance”. This is why hair transplants work for men. For women, it may be different and there is a small risk the transplanted hairs may not be as permanent as men.

Theoretically it is not possible for successfully transplanted hairs to be “rejected” years or months after it has grown, but I have seen a handful of patients over the last 20 years who have had transplanted hairs fall out. This may be due to a diagnosed condition such as DUPA (diffuse unpatterned alopecia) or other esoteric medical conditions.

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Hair Loss InformationI Have a History of Heart Palpitations – Can I Still Use Rogaine? – Hair Loss Information – Balding Blog

Hello, I am looking to use rogaine to regrow my hair. But before i use this product i have a history of heart palpitations and have had two episodes of atrial fib. I am 30 years old and am otherwise very healthy. the doctors never found anything wrong with my body to be causing atrial fib. my question is, can i use rogaine? and if not what can i use otherwise to stop my hair loss and regrow my hair

Thank you

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Minoxidil (Rogaine) can cause heart palpitations on rare occasions, but with your history of cardiac issues, I suspect that your doctor can better advise you about whether it’ll be safe for you to use it. Please ask this question to your doctor.

I think you would be better off asking your doctor about Propecia (finasteride) to treat your hair loss. It is a prescription medication, and it doesn’t have the heart-related side effect risks.