Month: January 2023

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Is Stress Scientifically Proven to Increase Hair Loss Rates?

You’ve mentioned a few times that stress can increase the rate of balding in those with the genetics for MPB. Is this scientifically proven?

By what mechanism does this happen or is this not known? (i.e does stress increase levels of DHT?)

thanks

Stress has been observed by many doctors as a cause contributing to the hair loss equation. Keep in mind that hair loss has other genetic factors that are influenced by environmental factors, and stress is one of the more obvious mechanisms. I do not believe stress increases DHT levels.

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Is SMP Worth Doing?

Scalp Micropigmentation (SMP) is a cosmetic tattoo. It is not hair and should not be looked at as if it was hair. However, for people with thinning hair, SMP may be the single most effective approach for treating diffuse thinning, giving the patient more value for the amount spent doing it. Hair transplants are much more expensive than SMP. When thinning hair occurs in many people, hair transplants work poorly, particularly when the thinning is diffuse (covers much of the scalp). Many doctors who do not know how to do SMP seem to gravitate to what they do know. So, these doctors recommend hair transplants rather than SMP, even though an SMP procedure would be better for the patient. For diffuse thinning (a common finding in 50% of women with hair loss), hair transplants can’t obtain enough grafts to increase the overall density to a level that will satisfy the patients. SMP, on the other hand, reduces the contrast between hair and skin color so well that it increases the appearance of fullness to a normal level in most people. A comparable hair transplant, if a patient have enough hair, could cost tens of thousands of dollars. Even if one could afford the procedure, few people have enough hair to fill in a diffuse thinning hair pattern (in either women or men). So, we offer SMP for patients with thinning hair, regardless of the cause. These patients are the happiest patients we have. I would say that our overall satisfaction rate far exceeds 95% because, unlike hair transplant where the hair loss continues to progress, SMP addresses the entire thinning problem in the short time frame while it is being done, regardless of the hair loss progression that may be present. Patients who had SMP rarely return for more treatments once the process is complete.

 


2018-06-22 11:48:35Is SMP Worth Doing?

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Is SMP risky for people with hair?

Looking to get the opinion of Males or Females that have gotten it. I find SMP to be riskier than a transplant, half the People who are bald and get it regret it. There aren’t a lot of stories of people with hair that get it.

We have done quite a few men and women with thinning hair applying tattoo pigments with great responses and happy patients, see here: https://scalpmicropigmentation.com/gallery/thinning-hair/ . It is a great adjunct for people with thinning hair especially for women who have no other options when they are post-menopausal.


2020-11-04 08:46:59Is SMP risky for people with hair?

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Is SMP Basically a Permanent DermMatch?

Hello dr Rassman
Am thinking about having SMP but am not sure if i will get the same result as dermmatch. i had HT about 8000 grafts, and now when i use dermmatch with a little of toppic fiber my hair looks perfect but i want something permanent. so please i need help to decide.

DermMatch is a kind of powdered paint (albeit a crude description) — it is not permanent and while it is not detectable up close when applied correctly, you can feel it and it does come off on your pillow and hands if you rub your scalp. Toppik is a similar temporary camouflaging product, but it adds little fibers to existing hairs to provide a visual bulk.

On the other hand, Scalp MicroPigmentation (SMP) is permanent, you can not feel it by touch, and if it is done by someone that knows what they are doing it should not be detectable up-close. Everyone is different and whether this is what you want to do is a something you’ll need to decide on.

What I would suggest is that you attend one of our Open House events in Los Angeles. We hold them every month in our office and we show off actual patients who have had SMP done so you can see it being done, feel it (with the permission of the patient) and look at it up-close to judge the answer to your questions yourself. Seeing and touching is believing.

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Is Shock Loss Permanent?

In the interest of keeping things as private as possible, I have removed the Doctor’s name from this email I received…

Hi Dr. Rassman,
I read your recent comment about young guys under 30 years old who get an HT and are not on Propecia. I fit into that profile. I recently had a HT with [another doctor] and its 4 months post -op now. had a lot of shockloss of original hair post op and am really concerned now that I read your comment online [see: Hair Loss After Transplants]. Since I had sexual side effects when on Propecia, I had to quit it and cannot tolerate being on it.

I received a total of 3366 grafts in total. Am attaching Before Hair transplant pictures with this email and 6 weeks post op pictures. According to [my hair transplant doctor], he feels that the shockloss will mostly come back and eventually I will have good results. He recently asked me to take Saw Palmetto and see if I can tolerate being on it. Started taking 320 mg of Saw Palmetto twice a day recently.

Please advice what I can expect from the procedure. Do you think that I will permenantly lose a lot of original hair that has fallen due to shockloss for good? Or will it mostly come back?

I’m seeing growth in the 4th month but not sure if the shockloss hair is coming back or it is the new grafts that are growing in. To highlight my case, I mostly had diffuse thinning in frontal 1/4 of my scalp. The hair that was there was strong and had a thick shaft, there might be other miniaturized hairs, but looking at my pre-op pictures you will get an idea of the state of the existing hair follicle.

Thanks a lot for your time and effort.

My current regimen includes : minoxidil 5%, topical Spironolactone 5% cream from Lee’s, 3000 Mg of MSM, 2% Nizoral trice a week, Recently added : betnovate topical lotion, 320 mg Saw palmetto twice a day, Folligen lotion.

I have had an opportunity to review your questions and photographs. For our general audience who are reading this, I will summarize the salient points.

You appeared to have a large surgical session with dense packing based upon the number of grafts reported by you. The frontal area appears to have been shaved for the procedure and the growth of the hair does not reflect the normal growth that one would expect in 3 months. This is a case of hair loss transplant shock in a young man, just as my previous responsive email reported to another young man. There is a possibility that the hair that you lost may come back. Most likely though, it will not return. Other medications have not been shown to be effective (like Propecia). In people like you, I generally try to cover the short term transplant period with half of the Propecia dose, even if it causes some drop in sexual performance just to protect the hair.

The good news however is that the new grafts that you had done should (hopefully) more than offset any loss you may have. You will know reasonably well at about the 7-8th month by comparing the two sides. The left side that seemed to suffer more of the reactive hair loss needs to be compared to the right side. If the hair loss was reversed, the densities of the two sides will be the same. Please drop me a line or send me photographs at the 7-8th month and I would be happy to give you further insights. Good luck.


2005-04-20 15:38:33Is Shock Loss Permanent?

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Is Scarring Common at the Recipient Sites?

Thank you for the time and effort you put into answering all of our questions. My question regards scarring. I have heard some people say that scar tissue forms where the hairs are implanted during a transplant, and that this can result in bumps or raised spots on the hairline. Is this true? If so, is it common? If not, why don’t scars form where the hairs are implanted? After all, a wound of sorts must be made to implant the hair, so how would do you prevent hundreds or thousands of scars from forming after a hair transplant?

With the technique we pioneered, we do two things that minimize recipient site scarring —

  1. We make very small wounds in the skin, essentially slits that approximate the size of the grafts. These heal very fast.
  2. When preparing the grafts for implantation, we cut off the skin disk at the skin level. To minimize the skin disk, we remove the top layer of the graft skin from the surface of the graft. This prevents the skin from surviving the transplant which could, in some individuals, produce the bump seen in recipient areas. The same process is done with grafts taken from strip surgery.

When doctors use grafts that have a larger surface area than what I described above, the bumps you referenced get more prominent. We have seen from the old days when plugs were done and the graft sizes ranged from 3-5 mm across, the skin always was deformed. Clearly the more skin that survives at the top of the graft, the more detectable will be the existence of the transplanted graft.

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Is Saw Palmetto a good drug for blocking DHT?

Hi, I didn’t understand if Saw Palmetto can decrease dht levels in blood and if it can do a visible results in hair health. Because i know that finasteride is the n#1 remedy used for AGA. Saw Palmetto should be a sort of ‘natural propecia’, less effective but without relevant sides as finasteride. But i really don’t understand if a man can have results in hair density and regrowth taking only saw palmetto. I mean if the starting situation of hair is not so bad (a little thinning hair but not bald at all).

There are many studies that show that Saw Palmetto is a very weak and poor DHT blocker for hair loss. Intersting read: https://baldingblog.com/general-questions-on-dht-blocking-supplements-have-birth-defect-risks/

 

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Is Rogaine Making it Hard to Concentrate and Changing My Head Shape?

Hi doctor,
I know its a really silly question but I am really obsessed with this issue. I am applying rogaine solution on my scalp everyday since I was 17. I am 23 now. I think I noticed that my head shape have dramatically changed due to the constant pressure. Its getting longer and slimmer and there is a bulge on my head. Is minoxidil or constant pressure to my head causing this situation? And my last question is, does rogaine affect my learning ability? When I apply this product, it retains me to concentrate on my daily issues. And I hardly understand what I read.

Thank you,
Regards

Feeling a “constant pressure” on your scalp doesn’t sound like something that I’ve encountered from Rogaine (minoxidil). I doubt that your head shape has changed, and while the drug does get absorbed your body, I also doubt that it is impacting your ability to learn or concentrate.

You should see a doctor about what you’re describing for an exam, as it could be unrelated to the medication.

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Is Rogaine Foam Making My Hair Thinner?

Hello doctor. First of all, I appreciate that you provide us with such valuable information, it truly helps. Anyway, I began using Rogaine foam about 4 months ago, but I only have been using it once a day. Since then my hair has become increasingly thinner. I am going to quit using it and continue taking Propecia. Could it be the Rogaine that is making my hair thinner, or do you believe it is just coincidental timing?

If you are not having an allergic reaction to Rogaine Foam (minoxidil), I doubt it will cause hair loss. Once a day use is inadequate for maximum benefit, as it requires twice daily use. Rogaine Foam and hair loss may not be related at all.