Month: January 2023

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Male Eyebrow Transplants (with Photos)

Hello Doctors
I am a 39 year old man and had a problem with my eyebrows since I was probably in my 20s. My eyebrows aren’t very thick. I never plucked them and do not know why they appear thin around the edges or when it exactly happened ,but I wanted to talk to you about what a transplant looks like in that area for men. My hair is otherwise great on the scalp and I have a strong hairline. Have you done any man eyebrow transplants? Thanks

Here’s a male patient we haven’t shown before, with some beautiful eyebrow transplant results. I placed 189 grafts into his eyebrows with almost all single hair grafts taken from the scalp using follicular unit extraction (FUE).

In general, eyebrows are difficult to get control of the direction of the hair as it exits the skin, but these results turned out great! The after photo was taken about 7 months following his hair transplant.

Before photo on left // After photo on right. Click to enlarge.

 

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Male Balding and DHT

I have just started balding and I’ve just found out about DHT and hormones affecting hair loss. What can I do to remove DHT in my scalp without shampoos specifically for hair loss? Will Pine Tar shampoo work?

The cause of hair loss in men is almost always due to genetic causes, and it is known as male pattern baldness (MPB) or androgenic alopecia (AGA). Scientists have discovered that genetic balding is linked to a hormone called dihydrotestosterone (DHT), a byproduct of testosterone. While everybody (men and women, balding and non-balding) has DHT, it is the men who have the genetic trait of balding that will lose hair in a specific “male pattern”… and DHT must be present. The hair follicle makes DHT. It may have nothing to do with DHT blood levels, but you must have the genetic predisposition for hair loss.

There are medications, such as Propecia, which block the impact of DHT on the hair follicle and it may stop or reverse the balding process, but it is not a cure. To date, there is no cure for hair loss. Pine tar shampoo won’t stop, slow down, or reverse genetic hair loss.


2009-11-03 15:06:39Male Balding and DHT

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Malaysia Miss Universe Contestant

This link was sent to me by a researcher who has been looking into the ‘hairy mole’ found in people. He believes that these moles may hold an effective treatment for hair loss and we are working with him to that end. This is a beautiful women with many moles and was contestant in the Miss Universe contest in 2016. She admirable that nothing holds her back!

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Making Sense of Hair Loss Drug Stats

Dr. Rassman, you have said before that minoxidil works for about half of men. The box says that minoxidil has only been proven to work for men experiencing hair loss at the apex/top of head and not for men that are balding from the front. Are these clinical studies made up of men that are already “good candidates”, meaning they have the right kind of balding for the drug to work? Or are all types of balding patterns included in the trials?

I am 34 years old, been on finasteride for a year and noticed that it slowed things down, but didn’t stop it completely. I have since added minoxidil. I would appear to be a perfect candidate from what I have read. I caught it early, I don’t think most people would even realize I am losing my hair, it is still pretty thick. I am losing my hair at the apex/top of head area, my hairline looks good. Is someone like me almost guaranteed to get a good result? Or am I still just a 50/50?

Thanks so much, your site is a huge help!

There is no guarantees in life (other than death and taxes). If it works for you it’s 100%. If it doesn’t work for you it’s 0%. Statistics do not apply when it’s you… and you won’t know until you try. That being said, I’ve found that these medications tend to work best in the early stages of hair loss. So while I’m hesitant to “guarantee” anything from the medications, I’d suspect you’d have a better chance at seeing benefits than someone that started the medication after losing hair for 20 years.

Selective patients for these studies would discredit the studies. Minoxidil is very effective in about 15% of patients and mild benefits can be seen in half of those who are thinning in the crown (more stats here). With regard to the frontal area, the reports indicate it is less effective than when used on the crown.

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Make sure that your surgery is actually being done by a licensed MD with an active medical license (from Reddit)

If the woman actually doing the FUE in this video is not a DOCTOR, then the surgeon and his organization has broken the law in all States in the US and in most European and South American countries. I am not saying that this is the case here, but I am surprised to see the plastic surgeon who is discussing the surgery, was not the person performing the FUE (time 2:54-4:00 minutes). Sometimes doctors who don’t know how to do modern hair transplant surgery bring in teams of technicians to do the actual surgery for them (the FUE part of the surgery and even creating the recipient sites where the grafts are placed). This would not be proper, safe or legal.
As a side issue, I noted that the doctor is not using a mask yet talking to the audience directly over the patient. When a person speaks, they OFTEN (almost always) propel saliva. In this case, the ‘plastic surgeon’ had to be propelling his saliva on the patient exposing the patient to potential infections (he should have warn a surgical mask and known better).
If you suspect that the surgery you are having done is not being performed by the doctor who you believed was supposed to be doing the surgery, then it might be appropriate to ask the State Board of Medical Examiners in your state of country to check the situation out. In the surgery in this video, I would expect that the women who performed the FUE to be a licensed MD possibly working with the doctor. If that was NOT the case then she would be practicing surgery without a license, see the statement from the State of California in this issue here: https://baldingblog.com/decision-from-the-california-medical-board-only-doctors-can-perform-a-hair-transplant/ ).
I would suggest that you watch this very informative very short video on this subject here: https://baldingblog.com/warning-watch-his-very-short-video-if-you-are-thinking-about-getting-a-hair-transplant/ The warning is simple: Make sure that you have a real, licensed doctor trained in the field of hair transplantation PERFORMING your surgery. Many doctors do this just for the money and leave the operating room once the patient is sedated. The patient’s welfare is then in the hands of a team of technicians overseeing the surgery who are not trained for emergencies or for things that go wrong. I have reported one death in California from a hair transplant ( https://baldingblog.com/hair-transplants-by-john-lord/) which is a warning that without a competent doctor in the operating room you are risking your life if anything goes wrong. The man who died (that I referred to) was young with 2 small children.

3rd Treatment of Neograft hair transplant If you are interested in seeing the results from tressless


2019-11-05 13:36:01Make sure that your surgery is actually being done by a licensed MD with an active medical license (from Reddit)

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Major Shedding During and After Rogaine Use

Hi. I recently tried using Rogaine 5% as a hair loss prevention regiment as I noticed a mild thinning of the crown area. Let me stress that my hair thinning was just mild and that as 28 yrs old, it seemed like it was a good time to start early before it got too late years after.

However I stopped using Rogaine 5% after just 20 days! I was shedding far too many hair and did not like the texture effect it made on my hair. Most of all, I was shedding too much hair! May I add that I have never noticed any shedding of hair prior to Rogaine! However, its been over 15 days since last using Rogaine and I am still shedding like crazy!!! By just running my fingers thru my hair, I see mature hair and younger looking hair fall out.

I am extremely upset by this response. I am a healthy 28 yr old male. I talked with my doc and am now on Propecia. He was not able to decifer why I was still shedding considering everything is normal. My question is whether if you have any information why shedding of hair is still continuing after stopping use of rogaine 15 days ago?? (Also considering I have only used it for just 20 days). Also, if propecia will stop the shedding due to Rogaine. May i add again, there was no blatant shedding or any problem of hair shedding prior to Rogaine.

Thank you so much

Assuming that you have genetic hair loss, perhaps Propecia would be the better drug for you. I don’t believe Rogaine (minoxidil) was the right choice for treatment and it is known to produce hair shedding for a short while after starting it. The shedding should stop in a month or two.


2006-08-22 12:39:18Major Shedding During and After Rogaine Use

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Major Hair Loss After Stopping Propecia

Dr. Rassman,

I am 46 years old. My father and brother have extensive hairloss on top. I am blonde and have very fine hair. No hair loss on maternal side. About a year ago I noticed some thinning at the hairline after many years of very slight creeping at the temples…still a NW 1-2 with very good density and caliber. I became alarmed given the extent of loss of my younger brother whose loss started as a 20 yr. old.

After doing what I thought was sufficient research and an recommendation from my Dermatologist who had used Propecia very successfully for 7 years, I started on the drug in early March of this year. I noticed little difference in my hair other than very slow thinning in front and on top. At 6 months (Labor Day) loss of libido had become an issue and E.D. became a problem. Watery and loss of ejaculate also surfaced. I wasted no time and quit the drug cold turkey. The sexual sides resolved in a couple of weeks, but that was just the beginning. After a few weeks my hair began shedding like crazy from all parts of my scalp..front, top, back, sides, nape of neck, sideburns, eyebrows, arms and hands too! This has continued steadily and I have lost an enormous amount of hair in 4 months…probably 30-40% of total! I am very depressed, nearly paralyzed and suffering severe anxiety..can’t sleep and having trouble functioning in my professional career. My life is cascading downward rapidly.

I am afraid there has been some sort of androgen/dht backlash. My hair seems to have miniaturized all over my head in a few months. Remaining hair is very fine and wispy ..hard to manage. The falling hairs seem to be very fine and less pigmented as well. This was not nearly as evident until a couple of months ago. I feel like I have the hair of an 80 year old man all of the sudden.

I have experienced “burning scalp” symptoms where MPB would normally be evident. I am terrified by the speed in which things have occured. I have not done anything in terms of treatment for fear of more shedding. Can you please suggest a course of action. I have no one to turn to. There are no reputable hair restoration physicians up here in Oregon.

Propecia is often effective at slowing hair loss, however, once it is stopped your hair loss can appear to accelerate. Your hair loss plays ‘catch-up’ to get to the point where your balding would have been without having taken the drug in the first place. This therefore, may look like accelerated hair loss. If this happens, you may continue to lose whatever hair that had been saved by Propecia and then continue the loss at whatever rate would have been ‘programmed’ for you by your genetic code (assuming your have genetic hair loss). An important question to consider: ‘Could you have been at the beginning of a rapid hair loss period from genetic or medical causes?’ Your situation does sound more complicated than simple genetic hair loss and this means to me that you might need a full medical work-up looking for other causes of hair loss (including appropriate blood tests). Stress can add substantially to the rate of hair loss and you are clearly being heavily stressed now.

Men in their 40s often (40%) will have ED (Erection Dysfunction) and Viagra might be worth trying (you need a doctor’s prescription) for any sexual ED problems you might have. If you feel that you are the 1% of patients who get a decrease in your libido from Propecia, then you should probably not take the drug, but you need a good, caring doctor to evaluate you along the lines as I have discussed in this blog over and over again. Your strong words above say a lot to me. You are VERY concerned and you want to take charge of the process that is impacting your hair, so be smart about it and whatever you do, do it the right way, ‘partnering’ with a good doctor. We have an office in San Jose and Los Angeles and a trip to one of these offices may be in your best interest. If you see me in Los Angeles, there will be no charge for the visit.


2006-01-11 20:24:10Major Hair Loss After Stopping Propecia

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Major Hair Loss After 5th Hair Transplant

OK, I will start at the age of 18. I took accutane and started losing hair 6 months later. I was scared so I got a hairpiece. At 30 I was talked into a HT. I then recieved 5 more over 5 years but I do not see a large portion of what was transplanted. I had great results after the fourth surgery but it seems that I am at a great loss at the moment. I am 9 weeks into the last surgery and see a “lot” of hair loss. I mean worse than I ever was. I am on everything.. propecia, minox, avacor, nizoral. I spoke with my doc and he said wait, its just a shock. I have a full head of hair except for the first 1 1/2 inch frontal. I am thinking about going back into a hairpiece after $30,000 and lots of heartache but I cannot take this roller coaster anymore. I can’t sleep, work, or think. I’m 36 and feel lost on what to do….help

Going to a hair piece to deal with a temporary problem of shock hair loss may end up making it permanent. You may have made mistakes in the past, just do not make them now. Shock hair loss is very, very, very rare after the first procedure with a person on Propecia. The few times I have seen it, the process reversed at the time the new hair came in. I would expect you to be where you want at about 8 months.


2006-02-03 12:49:06Major Hair Loss After 5th Hair Transplant

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Magnetic Helmet for Hair Re-growth

read in the news yesterday that a ‘helmet’ had been launched in the UK which uses electromagnetic waves to combat balding.It costs £750. Have you heard about this latest ‘baldness cure?’

Also – if someone has hair miniaturisation – does that indicate that those hairs will definitely be lost or is there a chance that they will just stay thin?

Thanks again Dr!

I have heard that electromagnetic waves can have a positive impact on hair re-growth. In fact, I was approached by a company wanting my endorsement on this type of therapy, but as there is no science behind these claims, I did not agree to what they were asking.

Miniaturization means that the hair shafts have a reduced diameter. In the balding process, the hair diameter generally gets thinner and thinner, eventually disappearing. Without doing something, this process is progressive. There is never any guarantee that these miniaturized hairs will all fall out. Many people who can profit from claims of producing hair re-growth and companies pushing such products are hopeful that the hair looks fuller. If that happened, one might think that miniaturization is reversed.