Month: January 2023

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Which Herbal Hair Oil Should I Use?

I am losing my hair. Which is better hair product of trichup?
1.- complete hair oil
2.- hair fall control oil

can i get my losing hair back?

3. None of the above.

I don’t know anything about you, but these magic oils don’t regrow your hair if you are losing hair from genetic causes. If you are serious about treating your hair loss, see a doctor who can map your scalp for miniaturization and analyze your hair bulk. Treating yourself with these ayurvedic tonics are almost surely going to leave you disappointed.


2013-07-11 19:17:28Which Herbal Hair Oil Should I Use?

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Which Hair Transplant Surgery Should I Get? Isn’t FUE Better? FUE vs FUSS Strip vs ARTAS Hair Transplant

What is the difference between FUE and FUSS – strip surgery? Which is better? I am confused. Doctor tells me that the strip surgery is not done anymore and it’s an old fashion surgery. That the future is the ARTAS. How is the ARTAS different than the FUE? There are so many choices it is confusing to decide how to choose a hair transplant surgery method.

Dr. Pak was an engineer working with me (Dr. Rassman) in the mid 1990s before he went off to medical school to be a doctor . We worked to invent a system or robot which would use cameras and special optical sighting system to target a hair follicle to automatically take out a follicle using the FUE technique. This work became U.S. Patent 6572625 that we licensed to Restoration Robotics, the company that sells the ARTAS robot. Dr. Pak and I since worked on many U.S. Patents used in the ARTAS as well as other hair harvesting and implanting devices.

Follicular Unit Extraction FUE robot concept 1998 by Jae Pak - before ARTAS results

Dr. Pak performs FUE at the New Hair Institute with a special FUE instrument he designed. He has at his disposal the ARTAS, or even NeoGraft. Even with all the technology (ARTAS, etc), his manual technique with his instrument is faster and just as precise (if not better).

He is just as fast and precise at the FUSS – strip technique. He can harvest a donor strip and close the wound and clean the area all under 5 minutes. There is a video of this on the Internet. Speed does not necessarily make you a better surgeon, but he has the experience and accuracy. Our experienced techs can dissect each FUSS strip into exact precision perfect grafts.

My point is that you should choose the type of surgery based on the merits of the doctor (not technology). Dr. Pak and I are very familiar with the FUE, ARTAS, NeoGraft, and all forms of harvesting hair follicles. We also offer all method of harvest. In terms of graft quality between FUE (ARTAS, Neograft) versus FUSS strip, the FUSS strip harvested grafts are generally better (which means better results). The exceptions are the doctors with unskilled staff. Then the ARTAS grafts will be better (or rather up to par or standard).

Many doctors push FUE or Neograft or ARTAS claiming “no scar” or “minimally invasive”.
Many doctors dissuade patients from strip surgery asking “why would you want a big scar”.

The focus should be on RESULTS. Not how a doctor takes out the grafts. From a donor scarring perspective, if you are ever going to shave your head or cut your hair really short, you should probably get the FUE. That is it! Line scars are not an issue for most men and women with long hair (minimum #3 or #2 hair clipper). Just remember a 4000 graft FUE scar is like having a collective open wound hole the size of a baseball on the back of the head. There is nothing minimally invasive about that. We end up performing Scalp MicroPigmentation (SMP) and fix horrible FUE scars routinely. These is nothing “scarless” about FUE. DR Pak has performed surgery on me and my family members using the strip technique. The linear scar on me is a pencil thin line you probably will have a hard time finding. It’s not that Dr. Pak is a better surgeon, it is because my body heals well. The point is, a strip surgery scar is not as terrible as the Internet makes it out to be and there are also terrible FUE scars.

Again, the focus should be on RESULTS.
A bad hair transplant result from FUE or Strip is like Herpes. You’ll carry it with you for life.

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Which Comes First in a Master Plan — SMP or Hair Transplant?

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!

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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Whey Protein Isolate Causes Hair Loss?

Dr. Rassman,
I read where one dermatologist (who specializes in hairloss) claims that whey isolate protein causes hair loss but whey concentrate (cheaper, less refined) does not. How could that be? To my knowledge, protein supplements do not affect hormonal levels at all. Do you know of any reputable studies to that effect? I take a whey isolate protein that agrees well with my stomach and I do not want to give it up unless there is some truth to that. Thanks for this blog.

I would also agree and ask “how could it be?” I don’t know of studies that backup those claims. Perhaps astute BaldingBlog readers can point us in the right direction.

Did your specialist offer an explanation?


2011-05-09 08:06:53Whey Protein Isolate Causes Hair Loss?

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Whey Protein and Hair Loss?

Dear Dr.Rassman,
Has consuming whey protein have anything to do with increasing DHT or accelerating the hair loss process/MPB?? I am a 26 year old guy from India and have hair lost only at the frontal temple areas while whenever I wet my hair i can see it thinning at the front. I am currently taking finax 1mg for the past 1 month. Do you suggest I take minoxidil along with it.

Thank you

I doubt whey protein is causing your hair loss. Finax is a generic version of Propecia (finasteride 1mg) sold in India by Dr. Reddy’s Labs. If you’re taking this, I’d hope that means it was prescribed to you. Nevertheless, you need to see a doctor to get the correct diagnosis. Don’t forget, the most common cause of frontal temple hair loss in young men is genetic balding. I wouldn’t look to whey protein as the problem, as it is more than likely your genes. You’re doing the right thing by taking the finasteride. I’d say that you should just be patient and the finasteride will at least stop the hair loss if not regrow some of the hair, especially in someone as young as you (about 30% chance of regrowth and 95% chance of slowing or stopping the hair loss). I would stick to the finasteride (per your doctor’s advice) and hold off on minoxidil for the first year to see what happens from the Finax.

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Where’s the Saw Palmetto Study? There’s Money to be Made!

Since there’s obviously a ton of money in hair loss products, why hasn’t anyone done a conclusive study on the effects of saw palmetto on hair loss? It seems like if it’s believed to help, a conclusive study would (if it’s found to slow loss) help products containing saw palmetto off the shelves

I agree that a better controlled study would help us understand the impact of saw palmetto on hair loss, provided it was dose response oriented. The reason that this is probably not being done is that there is no patent coverage available for this drug, so when a study comes out, anyone can profit from the sale of the drug (in this case it is an herbal remedy not a drug). So there’s money to be made if it shows the herb is effective… but one company financing the study will potentially open the floodgates for other companies to profit. This does not make for a good business proposition if you were paying for the study. In other words, studies are not cheap and who is going to finance it if the money can’t be made back?

There have been limited studies on this very subject in the past. One such study from 2002 contained only 19 men. Of those men, 60% showed “improvement”, but I don’t know if that means their hair looked thicker, darker, or there was actually more hair. Plus, it was just a pilot study and too small to be worthwhile in proving effectiveness.

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Where is Nizoral Lately?

Hi Dr,

I’m a patient of Dr. Pak who came to the office in March. For the past year or so, I have been using a combo of OTC Nizoral and T-gel to combat an itchy scalp. I alternate between the two each day.

However, I can no longer find Nizoral anywhere — it’s gone from Amazon, drugstore.com and any physical pharmacy I’ve gone to. Any idea what happened? I can’t find any substantiated reason for the disappearance online. Also, in the absence of Nizoral, do you have a suggested replacement I could put in my routine?

Many thanks.

I haven’t followed the sales or availability of Nizoral (ketoconazole) shampoo. I’ve had a few readers ask about it, but I’ve not been able to find any news. I have no suggestion on a replacement shampoo. Have you contacted the manufacturer?

So I’ll open it up to the readers — have you read anything about why Nizoral has disappeared from shelves?

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Where Does Shock Loss Happen?

Doctor,

I’ve recently had a HT on the front of the hair line, the mid-section and crown were untouched. Only thing is, 4weeks after the surgery I’ve noticed more and more hair falling out from the crown and mid areas!

Does shock loss effect every area prone to hair loss?

Thank you

Simple answer — yes.

Longer answer — Shock loss usually impacts miniaturized hairs, and can even occur when only an anesthetic is used on the scalp with no surgery (this is very rare). We know that advanced miniaturization and active ongoing hair loss have vulnerable hairs which can be impacted by any vascular change in the scalp or stressful situation (like a surgery). For this reason, young men (under 29 years old) are wise to take finasteride when they are having a hair transplant. Even if it is not a guarantee, it puts the odds in one’s favor for less shock loss (if any), especially if there is a greater degree of miniaturization present anywhere on the scalp.

The older the patient is, the less likely that they will be impacted by shock hair loss (e.g. a 50 year old man with stable hair loss)… and for these patients I do not insist on their use of finasteride before surgery.


2013-06-11 13:18:16Where Does Shock Loss Happen?

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Where does my hairline belong? (photo)

The hairline belongs about one finger breadth above the highest crease of the furrowed brow. This man will find that his hairline was transplanted unnaturally too high. I believe it belongs about 1 inch lower than the surgeon placed it about where I placed the arrow. In addition, the hairline is lower on the patient’s right side.


2021-03-08 20:00:47Where does my hairline belong? (photo)

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Where Did My Hair Genes Come From?

Hi Doc, I am 34 and I have receded about an inch at the temples. By this age, my father was at a much further along in the balding process. My maternal grandfather receded but never went bald. I’m just trying to figure out who’s “hair” genes I might have inherited. If it was from my father, would my balding develop at the same age and at the same speed as him? Is the next most likely person to pass on the hair gene my maternal grandfather? I hope so!

I have answered this question many times, but I will briefly summarize again: genetic hair loss does not follow specific predictable patterns. Many have hypothesized and observed that male pattern hair loss is slightly more dependent on the mother’s side. In the end if you have the gene, you will go bald according to the genetic balding pattern you inherited. As there are probably many genes involved in the inherited pattern, until we can define those genes and quantify how many there are and how they work, we can not predict what may happen to you as you age and may bald. Someday, everyone will have their genes mapped out and with that mapping, we will be able to tell much about what will happen to us in the future, not just with regard to balding, but to predicting diseases like cancer in their earliest stage. I hope that this all unfolds in my lifetime, but clearly for the young man like you, I am sure that it will unfold in your lifetime and when your children ask this question, my replacement will answer it with precision.