Month: January 2023

I had 4500 grafts and can’t seem to get these scabs off . It is now 30 days since my surgery and although there are less scabs, they seem to remain. What do you think of the FUE area?

These crusts should never have formed. You should have been instructed in a washing protocol after the surgery that would give you no crusting. I’l bet you also had crust in the recipient area as well and had to wear a hat for cover. The donor area where the FUE was performed is too large, too high and too low which means that some of the grafts that were removed are not permanent hairs. The doctor seemed to want to push the numbers high so he/she extended the donor area outside the safe area. Is that what you asked the doctor to do?

I have been following your blog for quite a few years now and it is an excellent source of information on balding.

I am 24 years old (male) and will begin my medical studies in California (or Alberta, Canada if I receive an acceptance there as well). I have been thinning for a while and have been paying attention, perhaps too closely, to hairlines and hair in general to the point that I believe I have a very good eye as to what looks good and natural and what doesn’t.

As such, I am wondering if it would be possible for me to someday work for you in the field of hair transplantation. If that were the case, what kind of residency would you think would be most appropriate for me to pursue?

Thank you for your time.

It is great to hear you are interested in the field of hair transplantation. You can read about Board Certification and what it means in Hair Transplant Surgery here

There is no clear prerequisite training in the field of hair transplantation nor an approved American Board of Medical Specialties (ABMS) board certification. Most hair transplant doctors receive training from mentors or apprenticeship programs. Of course you should have fundamental medical knowledge, surgical skills, and artistic skills. I cannot say which residency program will best prepare you. Many people think plastic surgeons will be best equipped but it does not mean they will make the best hair transplant surgeons.

According to what I read regarding Male pattern Baldness It is a problem of Hair Follicles being sensitive to DHT rather than excessive DHT.

1. What does this really mean?

2. How did I develop this condition?

3. Is there any way to reverse this sensitivity?

4. If not then why aren’t researchers and scientists working on it?

5. Why is it so that DHT gets attached to my scalp follicles more than other parts of my body like my face?

6. Does DHT lead to bone growth?

Note: I’m losing hair and I have a receding hairline and I’m thinning on the top. I still don’t have a proper beard.

DHT is a trigger in people who have the genes for balding. Each hair on your head has a life cycle (usually 3 years) and it sheds and regrows over and over again, unless, it has a limit genetically set on how many cycles you get. Some men (in the balding areas) have limits on these cycles, so when that limit is hit, the hairs miniaturize and eventually fall out. Finasteride slows this process down and is the ONLY medication available that is known to work.

FUE scars can show on a shaved head, especially if you had (1) many FUEs and (2) a large punch used to create the FUEs. If you shave your head you will see the areas where the follicular units were removed. Longer hair can always grow out to cover it. For people who have significant scarring in their donor area, we often do Scalp Micropgimentation (https://scalpmicropigmentation.com/). The people with most detectable scars, when the surgery was performed with small punches, are those people who may have had a lower donor density so that the missing follicular units are more detectable. In people who have higher donor densities, there is enough hair not to notice the missing follicular units.

Good day Dr.Rassman and company. Here is a picture of professional hockey player Ryan Getzlaf back in 2003 when he had gotten drafted to the Anaheim Ducks.

This is him in: 2003, 2010, 2012

How did he lose hair so fast?

According to Google, Ryan Getzlaf is 27 years old now… so he was a teenager in that first photo from 2003 and his juvenile hairline is clearly evident. In young men (under 35 years old) hair loss is not a steady process, as it may come in spurts. Hair loss over an 8-9 year time frame is not fast from a genetic point of view.

Dear Dr Rassman,

I was reading your blog the other day and was interested to see you comment that a person may have a norwood six balding pattern but still look like they have a full head of hair and also that a person who shows a Norwood 3 balding pattern would almost never advance to a norwood 6.

I am confused because in another post of yours you stated that thinning can begin in different areas at different ages. Can you clarify? I really would like to get an idea of what my final norwood pattern would be if bulk analysis can do that but now I’m not sure it can (?) what do you mean when you say that someone with NW3 thinning will rarely ever progress to a NW6?

If someone had slightly thinning temples and a thinner patch at the crown does this mean they are likely to be a higher NW pattern?

Many Thanks

Men in the process of losing their hair in a Norwood class 6 pattern may not be thinning uniformly. They may be losing more of the frontal hair faster, yet have the overall pattern of a class 6 that may or may not become complete. Some men who take finasteride will arrest much of the class 6 pattern thinning, especially in the top and crown of the head, but their frontal balding could actually be advanced.

I like to tell patients where they are going with their balding pattern, and where they are now during the evaluation.