Month: April 2014

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I Had 7 Scalp Reductions – What Can I Do to Reduce or Remove the Lump of Excess Scalp Skin? – BaldingBlog – Balding Blog

Hi Doctor Rassman:

I have a question about corrective surgery to repair Hair transplant scars and scalp reduction scars and lumps.

I had several hair transplants and a total of 7 scalp reductions back in the late 1980’s and early 1990’s from Dr. Martin Unger. With regards to the hair transplants, they were the typical 4 or 5 mm punch grafts I guess. The outcome was good but the donor area, which is covered pretty good by hair looks like a war zone if I were to shave my head or cut the hair anywhere shorter than a few cm’s on the sides and back.

I’d love to get FUE’s into the scar areas but I’m wondering how effective that would be in covering it up. I’m not interested in SMP cause if I do any corrective surgery, it is with the intention of wearing my hair very short and keeping it natural, using real hair.

With regards to the scalp reductions, as mentioned I had 7 of them. So I basically have hair up to the scalp reduction on both sides of the scar. I also have wavy hair so that helps to cover up the scar. But I would say the scar is about 5 or 6 inches long and maybe a quarter inch wide. Could that be filled up with FUE’s?

Another big problem after having 7 reductions is that at the crown / back of my head where the scar ends, there is a lump of excess skin left over from having the scalp excised seven times but excess skin build up behind the scar where the skin wasn’t cut out. It’s not a dog ear scar, just a lump, probably the size of quarter / half dollar and maybe 1cm high compared to the rest of the scalp, kinda like a mound. I’m sure you’ve seen that. It’s basically covered with moderate coating of hair but still visible if someone was looking at the back of my head from a close distance. God forbid if I let someone touch my hair. Even my wife and kids know NEVER to touch my hair. LOL!

So my question is, can that lump be excised or reduced in size?

Basically my intention is just to try to make my scalp, with very short hair, look as normal as possible. My hair, now if I keep it long looks like death. What I mean by that is it looks like it is on life support knowing that it should have fallen out decades ago but just as been kept growing by artificial means. LOL, hence I want to keep it short one or two cm long, shorter on the sides and back.

Back then I was young and naive and desperate and although I’m sure Dr. Unger had good intentions he never told me just to cut my hair short and move on. Now I’m using a shitload of treatment just to keep my hair for the sole purpose of not wanting to thin,especially on top so that the scalp reduction scar and is visible. Then I’d look like a freak. If I had no scars, hadn’t had any surgery, I’d just shave it cause hair to me now is not so important as it was back when I was 21 (I’m 49 now)

Just to show you how crazy my treatment is:
Proscar (5mg a day) Been on that since it first came out so going on 21 years.
Dutasteride (1 mg a day) been on that too since it first came out, maybe 8 years??
Minoxidil 5 and 15% daily
Nizoral shampoo
LLLT

Thanks!

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While you may say your case is “crazy”, there are many men in your similar predicament. Dr. Pak and I have seen and treated many men in your similar situation with a combination of a hair transplant, scar reduction, and SMP.

I really cannot advise you on your specific options without examining you in person. Repair cases like yours are unique with each person. BaldingBlog is more for general question and answers. If you would like a consultation please email me at hairdoc@newhair.com or call my office to speak to me or Dr. Pak at (310) 553-9113. It would be best if you email photographs (held absolutely confidential) and include your phone number, and either Dr. Pak or I will call you.

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Hair Loss InformationIn the News – Upcoming Hair Loss Treatments – Hair Loss Information – Balding Blog

Snippet from the article:

New hair loss treatments on the not-too-distant horizon may be game-changers.

“The development of new treatments, including drugs and cell-based approaches for hair loss, is at an all-time high,” says Kenneth J. Washenik, MD, PhD. He’s a clinical assistant professor at NYU Langone Medical Center and the medical director at Bosley Medical. “We have never had this many provocative treatments in the pipeline.”

Washenik spoke about advances in treating hair loss during March’s annual meeting of the American Academy of Dermatology in Denver.

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Read the rest — New Hair-Loss Treatments in the Pipeline

Topics included cell-based hair follicle regeneration, Latisse, combination therapy, FDA-approved medications, at-home treatments, and hair transplants.

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Hair Loss InformationPropecia as a Preventive Medication? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,
I am 19 years old with no signs of hair loss but I have a family history of mild MPB (Dad has thinning in crown + vertex, no recession). I was just wondering if there was anyway starting Propecia now could worsen my hair. I understand that it doesn’t make sense to take a drug if there is no hair loss, but I’d rather not play catch up. Also, have you had patients where there is no recession but thinning on the top near the mid scalp + crown? Thanks!

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Propecia (finasteride) is not something you take to prevent balding when you don’t have a diagnosis of androgenic alopecia. You don’t use an antibiotic when you are healthy to prevent getting an infection. You don’t take blood pressure lowering medication to prevent high blood pressure that you don’t have.

This is one of the many reasons that you need to see a doctor before starting medication. You should begin by finding a doctor who can examine your hair for possible miniaturization and/or bulk changes, and ONLY if you are diagnosed with androgenic alopecia can you consider taking Propecia.

This is not about catching up or waiting for hair loss to occur. It is about a medical process that is logical and safe for you.

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Hair Loss InformationI Only Get Peach Fuzz in the Crown from Minoxidil – Hair Loss Information – Balding Blog

Hi, am hoping you can provide a clinical opinion on my experience and usage with 5% minoxidil.

I am a 52 years old male. My main area of thinning/hair loss has always been my crown area (about a 2-3 inch diameter). My crown started thinning noticeably in my mid 40’s. I have been using 5% minoxidil for almost 4 years now. At first it seemed to definitely halt further hair loss in the crown, but it has never filled in that area. I only get peach fuzz type hairs that never fully develop into mature hairs. Am I wasting my time continuing to use minoxidil on my crown? I appreciate any response on this, thanking you in advance.

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Even though some people get good hair growth from minoxidil (Rogaine), the majority of people are like you, getting peach fuzz rather than really good, strong hair. Whether the limited results you’re seeing is wasting your time is up to you to decide.

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Hair Loss InformationI Chemically Treat My Hair, Wear a Ponytail, and I Saw Female Hair Loss – Hair Loss Information – Balding Blog

I am a 40 year old african american woman and I process my own hair. I also typically wear my hair in a ponytail. Couple of months ago I notice that I had experienced some hair loss at temple and back of head. It has slightly grown back. Is there anything I can do to prevent this from happening again and can I continue to chemically process my hair…

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What you are describing may be traction alopecia caused by pulling from a tight ponytail or possibly triangular alopecia, which can be genetic. The loss could even be from the chemicals if the process you used caused damage. I won’t know what type of hair loss you have without a physical exam.

If you feel your hair loss is from chemical damage (which may be the case, but again, I don’t know) then stop the chemical treatments. If you are wearing your ponytail too tight, then stop wearing a ponytail. If the loss is due to genetics, hormonal imbalance, or a vitamin deficiency, your doctor should be able to give you a better idea of what you can do.

I apologize for such a basic answer, but there isn’t much I can say without an exam and further history.

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Hair Loss InformationCorrelation Between Loss of Temple Peaks and Balding? – Hair Loss Information – Balding Blog

Doctors,

I have noticed that men with full heads of hair generally have full temple peaks as well. I mean the “pointy” area of hair truly over the temple. Like a temple widows peak. I have also noticed that balding/bald men seem to have lost these peaks on most occasions. My first question…is there a known correlation between the loss of these peaks and balding? It seems that since they appear to be in the permanent zone they would not fall out, but they certainly do. My second question is….if a man has a full head of hair, but has lost his temple peaks, can you assume he is on his way to balding?

Thank you.

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Hair loss on the side temples (the triangle area) is not particularly related to male pattern baldness, but some men who bald have that issue. I have seen many patients with Class 6 or 7 patterns who still maintain their “pointy” youthful temple peaks and I wrote about it in an article published last year in the Facial Plastic Surgery Clinics of North America.

There is no connection between the disappearance of temple peaks and balding, as they are independently genetically programmed. Ronald Reagan lost a good deal of the temple peaks, but remained with a full head of hair into his 80s.