Month: January 2023

Dr Rassman,

I appreciate your reponse regarding sebum question in whether it causes hairloss. You responded by saying it doesnt cause hairloss but it may cause your hair to be stuck to your scalp, then pulled out when combing or brushing, which leads me to 2questions.

1) IF hair is pulled out, would that loss of hair be permenant or would you regrow it once consistant washing resumes?

2) To put simply can hygiene like my case of not washing my scalp consistantly for 4yrs cause permenant hairloss? Like I said, its possible I went up to a month w/o washing with shampoo although the scalp got wet everyday because I did take a shower daily. Are all the factors that contribute to hairloss below the scalp, so even if a scalp was dirty or oily, it wouldnt make a difference?

As I said in my last response to you, not washing your hair will not cause hair loss, even for years.

If hair is pulled out once, twice or just a few times, it will usually regrow. If it is consistent, we call the hair loss traction alopecia (caused by pulling) and it can be permanent.

I remember a patient of mine with a beautiful hair transplant (one time surgery). He was mugged and the gang that mugged him, held him by his hair while they beat him and robbed him. After they finished with him, they yanked out his transplanted hair, laughed and left him with a broken nose, lacerations on the face, torn lip and scalp bleeding. He was taken to my office looking like a train wreck because he refused to go to a hospital Emergency Room. He only cared about the hair that was pulled out and gone. I told him that his hair would come back and sent him on to a hospital emergency room with the ambulance that brought him to my office. Later that year, he told me that all of his hair grew back within 4-6 months.

Humans do not have seasonal shedding of their hair. People keep a constant amount of hair on their head except for their normal daily loss of about 100 hairs/day. Other mammals shed.

good afternoon Dr. Wrassman, I would like your opinion on the use of HCG to reverse the effects of PFS. This user reports reversal in 6 months after HCG administration: https://raypeatforum.com/community/threads/finally-cured-from-post-finasteride-syndrome.33215/ “…After nearly 4 years of suffering, I have finally & fully recovered from Post Finasteride Syndrome

All my symptoms have subsided and improved with this method which takes a while but I am fully functional It’s H.C.G (HCG) dosed at 250IU Monday, Wednesday and Friday only. I did this for 6 months straight but at the 10th week or so, the improvements were weekly. That is 250IU, not a typo… so you’ll mix your 5000iu HCG with 5CC water and take 1/4 CC intramuscular three times a week using an insulin needle…”

Have you heard about it?

I am not aware of the use of Human Growth Hormone in the treatment for Post Finasteride Syndrome. I did a limited search and did not find other such claims. Worth exploring possibly for those people who have not found a cure.

This was a complication arising out of a hair transplant performed by unskilled technicians in Turkey. The patient most likely was a smoker. This complication is called ‘Necrosis’ which means in this situation, all of the skin in the area that is now an open crater has died. Fortunately, he either sloughed off the dead skin or a surgeon removed it. I will eventually heal with a huge scar and transplants into the scar may correct the defect after everything has settled down.

https://www.huffingtonpost.ca/alan-j-bauman/hair-loss-treatment_b_3039650.html

I spent about an hour tonight on youtube reviewing a Denmark based hair stem cell clinic with other offices in Europe (https://www.youtube.com/watch?v=uu-pNdl7z38). I watched three videos about a half an hour each. What I saw was flamboyance with 8 star offices. One office was based in a castle, very impressive spokesperson, communicative in multiple languages including English, and lots of fluff. When it got down to the reality of what they were doing, it was FUE, plain and simple. It was a limited procedure that they demonstrated, and despite the claims that they were extracting stem cells and that one hair would produce two, and two would produce forr and so on, the reality of what my professional eye was seeing was nothing more than a limited FUE procedure with no stem cells other then those normally found in an FUE graft and no cloning. I am asked many times about Dr. Gho’s stem cell technique and heretofore, have not commented on it. I teach my patients a very basic principle about balding, that there is a limit to the amount of hair that one has. Short of an act of God, no doctor has yet gotten two healthy hairs from one, four hairs from two and so on. Somehow, Dr. Gho did not look like the God I know. People with advanced balding patterns must have limited goals. What I saw were a few patients who could never achieve any sense of reasonable results for the balding patterns they showed and with the number of grafts that were offered. I know that pomp and fluff sells and the dream of hair transplant patient world-wide is to have either stem cells or cloning solve their hair shortage problem, but I would suggest that readers of this blog follow the old adage that ‘let the the buyer beware’ and let it be a guiding principle for everyone looking into hair transplantation. I must be lucky because most of the patients I see, educate themselves about this hair restoration process and would never fall for scams. When patients just don’t know, I push them to get educated and this is why the editors write this blog, to educate our readership.

What is the % of white men that eventually go completely bald, and partly the worry about the male baldness is my son’s best friend is almost completely bald with very thin follicles on top at age 27, how young does one start to experience MPB to have this stage of loss by age 27, he’s literally NW 6 1/2 if that’s on the Norwood scale

The statistics are that about 45% of men will have some clinical balding by the time they are 45. I have seen the process start at 16 years old and some reports have placed it as early as 12 years old. Most of the really bald men see some sign of balding by the time they are 21 (clearly evident on high magnification views with miniaturized hairs with thin shafts). The real question still unanswered is can this all be stopped when the advanced balding young men start Propecia early enough. At the age of 27, the pattern in the man you are talking about will probably be a Norwood Class 7 balding pattern. Class 7 on the Norwood scale.