Month: January 2023

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What Percentage of People Are Happy with Hair Transplants?

Thanks for the forum Dr. Rassmun, it has been very informative. I do a lot of research on the internet and it seems that people are all for hair translplants or they are all against them with many failure and nightmare stories. I saw something you wrote saying hair grows for 99% of translpants, but gaging from other sites it seems like 50,50. I was wondering if you could give me a ballpark number in your experience of people who are happy with their transplant to people who are not.

Anyways I am 24 and have pretty accelerated hair loss, but the back and sides of my hair is pretty strong and thick. Does the regrowth of transplanted hair in the mid 20s have a better look than transplanted hair later in life? Its seems the pictures Ive seen have led me to believe this, thank you for your time and keep up the good work.

Generally, delaying hair transplants just increases the suffering time for those individuals who are bothered by the balding process. Why delay a hair transplant when the young man needs and wants the youthful impact of a full head of hair? If you wait until you are 60 years old, then you will look older until the day you decide to be transplanted. A 25 year old may look 40, a 40 year old may look 50 or 60, and a balding 60 year old may look 80. A hairy 25 year old will look 25 and that is what most 25 year old people want. I have transplanted many 40, 50, and 60 year old men who look 10-20 years younger with hair.

Satisfaction rates in my practice are very high, not just because we are good surgeons and know what we are doing, but because we set expectations correctly, do not employ salesmen who get a commission for selling you what you may not really want or afford, and we give all of our patients access to previously transplant patients at our monthly open house events. Patient education is at the foundation of satisfied patients.

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What Percentage of Middle Age Men Experience Each Norwood Class?

Hi,

I just wanted to know if there were any solid statistics on what percentage of men are norwood II, III etc. in middle age?

Thanks

There are two studies that I know of that were published on the subject. Drs. O’Tar Norwood and James Hamilton both did studies and each came up with different numbers.

Although there’s no general agreement on the statistics for the frequency of balding, it’s believed that advanced balding (defined as a Norwood Class 5, 6, or 7 pattern) occurs in about 35% of balding men. Balding itself is present in approximately half of all men over the age of 45. For those that fall into the 35% of Class 5, 6, or 7 pattern balding, this doesn’t mean that there’s a complete absence of hair in the balding area, as some hair may remain. Norwood Class 2 and 3 patterns appear in about 42% of middle aged men, however, I do not look at Class 2 patterns as much more than men with a mature male hairline.

Update: I removed the statistical breakdown from Dr. Hamilton’s study that I initially posted, because they’re unclear and they are widely different than other published statistics.


2008-05-09 19:29:54What Percentage of Middle Age Men Experience Each Norwood Class?

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What Percentage of Men Get to Norwood Class 6?

I’ve seen that you say only 7% of balding men will hit stage seven on the Norwood Scale. What about stage six? Theoretical if there were no treatments would most men (93%) be destined for stage six on the Norwood Scale? And is whether or not you reach seven on the Norwood scale genetic?
Thanks

This is not an easy question to answer because of judgment problems in those that wrote the original charts. The best statistics I could find indicate that the Class 6 and 7 patterns in men over 50 years old are present between 23-30%. Assuming that the Class 7 pattern is 7%, then the Class 6 pattern is twice as common.

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What Percentage of a Chance Do You Give Laser Treatment of Working?

Hi Doc,

I am going to be starting the LUCE lds 100 laser treatment soon. Ive been losing hair for about a yr and half. I am currently 22. From your experience, what chances do you see of the treatment working on me? I’ve been on propecia for 5 months. Thinning on my crown is noticeable if pointed out. And the temples have receded slightly.

Thank you

In my personal opinion, lasers do not work to regrow hair. I base this on my experience with seeing many patients who have tried all sorts of lasers (from the big ones in clinics to the handheld models), and I have not seen it work. As I’ve mentioned before, I had a medical grade laser in my office for a year and offered free treatment, of which some patients chose to take advantage. None objectively grew any hair unless they used some medication like finasteride or minoxidil. I recall one patient who spent nearly $5000 on such laser treatments with another doctor for over a year, and as much as he wished and hoped that his money wasn’t wasted, the laser simply didn’t work for him.

If you are balding, there is no simple cure. You wanted a statistical assessment, so I’ll say that my best guess is a 0% chance of laser treatment working to regrow your hair. There are medications and/or surgery to address it, but there are always limitations.

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What Percent of Your Propecia Patients Find Lumps in their Chests?

Dear Dr Rassman, thanks again for the great blog and thoughtful responses.

Afraid I have yet another propecia related inquiry! I noticed in a recent post you informed another reader that there have been cases of your patients on propecia developing lumps in the breast region and that your are now working with another Dr to treat this side effect.

While I’m aware these are not necessarily related to their propecia course I was wondering if you could give an approximate indication of what percent of your patients have suffered this side effect?

Many many thanks again

I believe what you are referring to is gynecomastia (enlargement of breast tissue). They are not necessarily “lumps”. I believe the reported incidence is about 1 in 300 to 1 in 700 or so. In my clinical practice I think the incidence is lower.

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What Percent of Men Keep Frontal Hair After Taking Propecia for Over 5 Years?

I been reading that 90% of men still retain their hair on Propecia even after 5 years on the crown and mid anterior. But i couldn’t find any info about the front. I know it works there too but can it retain the front for 90% of men after 5 years as well? Or is that number a lot less?

From my experience, the same seems to apply (what happens in the mid-anterior head will happen in the frontal area) providing that the Propecia (finasteride 1mg) is strictly adhered to. Without a good controlled study, I can not be sure.

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What Other Drugs Cause Hair Growth as a Side Effect?

Dear Dr Rassman
In the past we had minoxidil, Proscar, and Avodart which had side effects of growing hair. Do you know of any other drug companys that are saying their drugs have a side effect that grows hair as well?
Thanks

I am not aware of any drug or any drug in development that cause side effect of hair growth to the scalp. I’m certain some company is working on a new drug for hair loss treatment, especially considering the market for such a medication, but there’s nothing that has been made public that I’m aware of. Many companies claim hair growth from shampoos, lotions, etc, but I don’t have a list off the top of my head… and I doubt the validity of most of those claims anyway.


2008-11-25 14:44:43What Other Drugs Cause Hair Growth as a Side Effect?

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What meds can produce hair loss?

Drug side effects — Hair loss can be a side effect of certain medications, including lithium, beta-blockers, warfarin, heparin, amphetamines and levodopa (Atamet, Larodopa, Sinemet). In addition, many medications used in cancer chemotherapy — such as doxorubicin (Adriamycin) — commonly cause sudden hair loss affecting the entire head and some of these medications can actually trigger the genes for hair loss in men and women.

Symptom of a medical illness — Hair loss can be one of the symptoms of a medical illness, such as systemic lupus erythematosus (lupus), syphilis, a thyroid disorder (such as hypothyroidism or hyperthyroidism), a sex-hormone imbalance or a serious nutritional problem, especially a deficiency of protein, iron, zinc or biotin. These deficiencies are most common in people on restrictive diets and women who have very heavy menstrual flow.

I can’t write a book on it, and I am sure that there are MANY drugs that I have not mentioned in this group.

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What Makes a Norwood Class 7 Not a Good Transplant Candidate?

I have heard many people say that Norwood 7s are not good hair transplant candidates. However, two of the most successful hair transplants (Bobman and Jotronic) from another medical group were both Norwood 6’s heading towards level 7. What stops them from progressing further after their transplants? If you get a transplant as a 6, is it really that noticeable if you slowly progress to a 7? Is there something I’m missing altogether?

I have many Class 6 and 7 patients with great results from a hair transplant, so yes, it can be done well, but this is an issue of supply and demand with regard to donor hair. In other words, is there enough supply in the back of the head to meet the demands of the bald top? Take a look at Patient ZU from a past blog post (photos below) — now he has 9900 grafts and yet still has plenty of donor hair for more transplant procedures (which he does not need now) and that is because of two reasons:

  1. His scalp had a great laxity to it.
  2. He had a donor density which reflected an original hair population of 175,000 hairs on his head (normal is about 100,000 hairs).

Not everyone is a candidate and the issues that the doctor and the patient must face are one of realistic expectations and an excellent doctor/patient relationship.

Patient ZU – Before:
 Patient ZU – After:

 

Update: More photos! Click to enlarge.

 


2008-05-13 14:47:07What Makes a Norwood Class 7 Not a Good Transplant Candidate?

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What makes a good transplant candidate? (reddit)

This Reddit poster did a good job at summarizing the key elements everyone must understand. I would add:

1- understand that genetic balding is progressive and over the years more hair loss may occur until you reach your final genetic pattern so your Personalized Master Plan should account for this possibility

2- be sure you research the doctor you are going to use and develop a Personalized Master Plan for your hair loss with that doctor so you can set realistic expectations. Although coarse hair is the best hair caliber, many men get great results with medium weight hair and even fine hair if the balding pattern is not very extensive.

3- realize that over the years, hair character changes with age, often becoming finer so plan for these changes in your Personalized Master Plan

What Makes a Good Candidate for Hair Transplantation Surgery from tressless