Removed My Hairline with Laser Removal, Now I Want to Cover the Scars

Hi Dr. Rassman…..I have a bit of a problem and I’d like your advice. I recieved two hair transplants in the 90’s and wound up with a low hairline. I’m 32 years old and a natural norwood 3/4. I just recently removed my hairline via laser hair removal. I’m now dealing with the underlying skin which is scarred. It’s not terrible but I’m very self conscious. I’ve decided on another hair transplant. I’d like to bring the hairline down to where it was to cover any scars. I’m thinking low density with good coverage. My doc estimates that I have about 4000 donor grafts left. Any feedback would be greatly appreciated.

It is difficult without pictures or seeing you in person to render an opinion that has real value to you. You can excise the frontal scarred hairline (done frequently) and then have those grafts transplanted with a normal soft transition zone of 1, 2, and 3 hair units. As you are on the east coast, Dr. Robert Bernstein in NY might be worth visiting for a second opinion. If you make it out to California, I’d be happy to see you.

Remedies for Psoriasis?

Iam a 40 year old male that has only suffered from Psoriasis for the last 4 months. Previously I have very thick hair, but already my hair is thining down the front centre of my scalp. What causes this is hair loss? is it the thick crusts of skin or the red lesions ?

What course of action would you advise for me as this is now starting to really affect my day to day life ? Are there partucular shampoos or remedies you would suggest above others ?

Many thanks in anticipation

Psoriasis can cause hair loss due to stress, scratching and picking it, and from normal genetic process that run in parallel to it. The best person to treat your psoriasis is your dermatologist. I recommend that you learn more about Psoriasis at the National Psoriasis Foundation site. Also, please review previous blog entries regarding this.


2005-12-29 11:01:44Remedies for Psoriasis?

Remaining Vellus Hairs from My Juvenile Hairline

As a rule, does miniaturization need to be present behind the frontal hair line to indicate genetic hair loss? What would you say to someone who presented you with an intact, albeit mature, hair line – with no thinning present behind but had noticeable vellus hairs along frontal edge particularly in the corners where the hair line had raised a little bit with age? These “straggler” vellus hairs look to be the remnants of a retreating hair line – from juvenile to mature – but its hard to tell and self-diagnosis is uncertain at best.

(33year old caucasian male, no significant family history of early hair loss)

On occasion, I have seen some men lose hair without going through miniaturization. This is more common in the process of developing a mature hairline, but anything is possible. At times, some vellus hairs remain in the frontal area where the juvenile hairline formerly was.


2010-08-03 11:19:53Remaining Vellus Hairs from My Juvenile Hairline

Releasing Clinical Trial Results, Follow-Up

FDANote: One of my favorite contributors to this site is a reader (that wishes to remain nameless) that has provided wonderful insight into areas like LLLT (hair lasers) and the FDA. I’m admittedly not an expert in everything (no matter how much I wish I was), and he’s corrected my initial thoughts about companies publishing ongoing clinical trial results. His email is as follows:

Dr Rassman,
As someone who has worked in the drug development industry, I try to keep your readers updated with accurate info on how this process works. One of your readers asked whether “Aderans…would send out an update on their Phase 2 trial data……..and whether there are rules requiring such info to be confidential.”

There are no rules to keep trial data confidential. The sole reason why data from an ongoing Phase 2 trial is not released is because it is not available. That is, no data is available to a sponsoring company until a drug study is complete (or in rare cases, when an “interim analysis” is done). When a company begins a trial the data (and identity of the participating patients) is kept secret from the company during the conduct of the trial. This is to ensure that no data is manipulated; extraordinary safeguards are put in place. Intentional violation of such safeguards with hiding of the act is a form of scientific fraud and would result in failure of drug approval and public sanction of the company by regulatory (and other)
authorities.

The FDA (and regulatory agencies, in general) have no jurisdiction of when a company reports data to the public (and do not care). However, public reporting of inaccurate data can result in sanctions from both regulatory agencies and, if the company is public, the US Securities and Exchange Commission (SEC). The latter relates to how public release of trial data typically affects a public stock (good data raises the stock price, bad data lowers it).

Nearly all public companies release Phase 2 clinical trial data (regardless of positive or negative) on trial completion for 2 reasons: (a) to communicate results to the scientific community, and (b) to communicate the results to shareholders. Withholding such data from shareholders can be perceived as having “inside information” of results that are considered “material” (i.e. important for shareholders to make decisions on purchase or sale of the stock). In cases where a company is private (rare when a company is at the stage of Phase 2), trial data is usually released to encourage future investors (positive data) or explain why a program is not moving forward (negative data).

Bottom line: Aderans can not send out a trial update because the data will not be known until study completion and analysis (the FDA has nothing to do with this). There are no rules to keep trial data confidential when a study is completed and, in fact, there are many reasons why public companies are required by the SEC to divulge these results. In fact, the SEC has brought legal action against some companies that they feel have not released “material” clinical trial data in a prompt fashion.

Is There A Relationship Between Erectile Dysfunction and Heart Disease? I Am 42 Years Old.

The arteries in the penis have a smaller diameter than the arteries in your heart, so it is not unusual for the first indications of atherosclerosis to appear in the penis with Erectile Dysfunction. To take the next step to find out the status of your heart, you can find a place (or speak with your doctor) and get a CT Calcium scoring of your heart. All men of your age with a standard American Diet almost certainly have atherosclerosis. This test tells you the status of your coronary arteries and what your coronary artery age is compared with others of your age. I tell people that the first sign of heart disease is death in 70% of people, but these men all have Erectile Dysfunction, which is a much earlier sign. The same is true for women if they have significant atherosclerosis. These women find that they have less sensitivity with their clitoris and less vaginal secretions when they have significant pelvic atherosclerosis. They, too, should get a CT Calcium scoring of their heart to find out if they have generalized atherosclerosis.


2018-06-22 09:40:44Is There A Relationship Between Erectile Dysfunction and Heart Disease? I Am 42 Years Old.

Relation Between Genetic Hair Loss and Oily Scalp

I have a question about the relationship between oily scalp and genetic hair loss, as I read a lot of your posts, it seems that the main reason of men hair loss is genetic factor, but I also heard that most balding men have a oily scalp, so my question is what the relation between oily scalp and hair loss? Thank you.

Oily scalp does not cause balding. Genetics cause male pattern balding. Other genes are likely responsible for oily scalp.

Rejection for Cosmetic Surgery

Do you ever reject a patient for plastic surgery?

I have seen a small number of patients who seemed dissatisfied with so many of their features (inappropriately), that I’ve recommended self-evaluation and/or psychotherapy instead of cosmetic surgery. Some of these patient admit to being harshly criticized by a parent during childhood, and may have severe self-esteem issues that will not be addressed by the cosmetic surgery process. It is important for patients to be mentally sound, able to understand what cosmetic surgery will and will not do for you. I try to probe the person behind the request to understand if what I can do will truly meet the objectives of the patient. This is a difficult process for the plastic surgeon because each patient does not undergo an extensive psychological analysis, so I have to trust the instincts I have developed over the years. I do reject patients who do not have realistic expectations or those who are psychologically imbalanced.

This question was answered in conjunction with Jon Perlman, M.D.


2006-05-25 22:30:34Rejection for Cosmetic Surgery