Day: January 1, 2023

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Penis Dysfunction- What To Do?

Thank You doctor for the advice on Propecia. I have started taking it now and within days my hair has improved. Yes, i do get proper erections but when i think of my penis….i dont…so i guess psychology is playing a part in not getting erection.

Anyways, can you please suggest some tests which i need to keep doing to check if my testeterone levels are normal (what i mean to say is tests which can check if my sexual organs are normal).

Thank You

There are doctors that specialize in sexual problems in men. If you are penis-focused, you may be causing your own sexual dysfunction, that is why a doctor who specializes in sexual problems may be a good starting point. They will be able to help differentiate between physical and emotional causes. You can have your doctor measure your testosterone levels to see if they are normal.

I am glad to hear that Propecia is helping, but I would expect that the benefits of it will take months, rather than days.

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Pearl I got from ISHRS meeting last week

Dr. Christine Shaver and other dermatologists are picking up diseases of the scalp in young balding men. These men present with itching, inflammation and hair loss. Upon biopsies taken by Dr Shaver, she identifies about one young male patient each week with a condition called Lichen Planopilaris or Frontal Fibrosing Alopecia, both autoimmune diseases of the scalp. In some men who eventually get a hair transplant, the hair transplant is likely to be rejected by the body. It may also reduce the growth or prevent growth in a hair transplant. If you have itching and inflammation, seek out a dermatologist and have two biopsies, one in the frontal where the inflammation and the itchiness is most prevalent and then a second biopsy from the Donor area in the back of the head. A biopsy read by an expert, will make the diagnosis and then special treatments are required. Catching it early is critical for everyone who has these diseases.

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Paying the Price for Hair Plugs from 25 Years Ago (with Photo)

As a young man 25 years ago, he had a hair transplant with the old fashion plugs. After seeing what it looked like (it was partly hidden with some hair at the time), he came to the conclusion that he made a mistake and immediately went to using a wig. Between his wig and a baseball cap, he had hidden his secret. About a year ago, he realized that maybe he could undo his plugs and after a year doing internet research, he came to my office to ask me an important question I’ve heard quite a few times before — “Can you just remove these plugs and make me bald so I can shave my head?”

Remember, this is NOT the standard of care today. Click the photo to enlarge.

 

To see the deformity, he lifted up his wig, which was tightly held to the scalp with tape. Although he is a Norwood Class 5A pattern with high density in the donor area, he never really wants to do hair transplants again, and just wants to be a normal bald man. This is a common finding in people who lived with the horror of the plug deformities of the old transplant work. Unfortunately, this type of problem is what so many people believe is today’s standard of care. Nothing could be farther from the truth as today’s hair transplants can not be told apart from a normal natural head of hair in a non-balding patient.

We agreed that I would remove each plug one-by-one and sew him up, making him a normal bald man. Removing these plugs may leave some minimal scarring. He wants me to transplant the hair extracted from these plugs and put them into the place they came from, to hide two obvious small neck scars. This should easily be done in one surgical session.

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Patterns of Hair Loss in Men

That is fascinating but it prompts a few thoughts. Why not use body hair for transplant processes? And why does the balding gene only impact on the top of the head and not the sides?

The sides of the hairline, as well as the 3 inch section at the bottom of the back of the head, is immune from genetic hair loss. Body hair can be used for hair transplants but it has a short growing cycle so if you transplant 100 body hairs, only half will be growing at any one time while the others are in the telogen (sleep) phase. This means that you generally only receive half the value when body hair is transplanted compared to scalp hair.


2018-09-19 06:20:20Patterns of Hair Loss in Men

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I Have Patterned Thining, What Can I Do for It? (From Reddit)

Background: I’m 34, 35 in May. I noticed that I was losing hair when I was 27. Crown first, then hairline. The hairline isn’t noticeable unless taken at an overhead angle as attached. I lose hair in a pattern, but it’s also thinning. I have the same hairline as when I was in my early 20’s, but it’s thinned out. My hairline has not moved upwards, meaning I don’t have a V shape. The crown is obviously thinning but it is only extremely noticeable in bright pictures. In some pictures, I just look as if I have a blonde spot in the midst of my dark brown hair.

The consensus is “wait, you may lose more hair,” but it has been the same if not a bit better (cause treatment) for probably 5 years. So I’m starting to think: if I do lose more, it will be a long time from now, or very slowly and I can react to it— so why not go for the HT now?

I dermaroll 1.5 weekly, minoxidil daily, 2% niz. I have tried finasteride 3 separate times, splitting pills in half, taking them every other day. I experienced side effects every time -brain fogg and low libido. Finasteride’s side effect profile for a cosmetic drug is not a good trade off in my opinion. I won’t be trying it again no matter the consequences.

I was going to post this on RealSelf, but the doctors seem to tend to reply with a lame copy and pasted response.

Thoughts on HT in my position?

You are correct to stay away from finasteride. One good option is that you get Scalp Micropigmentation which will create a thickened, much fuller look. You must be prepared, however, that over time the thinning MAY lead to balding, so a plan must be created to address your next step. I am big on a Master Plan for anything you do (see:https://scalpmicropigmentation.com/thinning-hair-gallery/)


2019-02-20 08:46:54I Have Patterned Thining, What Can I Do for It? (From Reddit)

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Patients That Opt for a Transplant That Still Shows Hairline Recession?

Hey doc, I noticed your blog here presents us with numerous demonstrations of surgeries, where a receding hair line is being restored to a full-blown NW1. However, the impact of surgery on donor area (whether FUT or FUE) has drawn me to weigh the benefits of smaller improvements.

But I don’t remember seeing here any pictures of patients who could easily (graft-wise) afford a Norwood 1 transformation, but have chosen a minimalistic path (for example, going from a Norwood 3 to a 2 or simply increasing the width of the forelock a bit to eliminate the steepness of its shape). Such visual representations will surely educate us about our options with surgery.

I’m sure we’ve posted examples of patients that didn’t want a fully restored hairline on this site in the past, and I know there have been plenty of men who have had surgery for a “minimalistic” path. A patient must give us permission before publishing their pictures, so we’re only able to post those that have given their consent. Not every patient wants their photos shown to others.

There are comprehensive before / after pictures in our NHI photo galleries that will show various examples of hairline restoration.

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Patients who respond to finasteride (many photos)

Dr. Robert Bernstein has put together a terrific group of before and after photos from people who used medications such as finasteride, without surgery. Look at this link: https://www.bernsteinmedical.com/medical-treatment/patient-photos/


2017-07-20 05:19:06Patients who respond to finasteride (many photos)