Month: January 2023

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Hair Obsession

i have had a full head of thin, wavy hair most of my life, and am now 53 years old. I had some loss many years ago from using alcohol based mousse, and had one transplant(okay). Recently, I had some hair color (nasty alcohol based stuff from Walgreen’s)in my hair for Halloween 2004. Anyway, I left it in for a day(extremely stupid), and then had several weeks of an itchy scalp in December, which I treated with tea tree/jojoba oil. I noticed some hair loss in January, had 1000 grafts put in and now I just had another ” greater loss” bout in July and August of this year, which I am extremely unhappy about. I now have a minor tingling on the left side of my frontal area, and I am extremely parnoid I am losing more. I am using tea tree oil shampoo/conditioner. I went to back to the doctors who did my transplants, who told me I would look worse if I had not been given the 1000 grafts, which I have a hard time seeing where they are.(as some were supposed to be put in the area that has receded!)I asked to possibly get my old hairline back, and the doctor said that only celebrities and media people only wanted a “1”, and now me. They offered to put in another 1000 grafts for $4/graft, but I want an effective job this time, asI do not have unlimited donor area. The more I think about it, the more I am insulted. The doctor said I had no infection/disease in the scalp. I want more work, but done right. PLEASE, PLEASE ADVISE.

You are hair obsessed. Please don’t take this comment the wrong way, but you are probably causing your own problems because of this obsession. I too would be insulted if the doctor who precipitated reactive hair loss with the second transplant (that is what it sounds like), told me that I needed another one at a discounted price to solve the failure of the last transplant (which was supposed to solve your problem). Sounds more like a huckster is playing you for your hair obsession and selling you hair like you needed a new car.

On this blog, I often say that you need to have a good doctor make an assessment of what is really happening to you. This is a buyer beware field and it is easy to sell hair to a hair obsessed person like you. I am not saying that you did not need a hair transplant, but it sounds like you were not clearly informed of what you were buying into. I often take a stand against transplants when I am not convinced that hair transplants will address the problem. I am rarely wrong but some of the patients who I turn down just go to another doctor who might be enthusiastic to take his money. Talk to a good doctor, not a huckster and find out what happened and what is going on with your hair problem.

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Hair Not Growing Back After Chemotherapy

Dr. Rassman,
I am a woman who finished an intense bout of chemotherapy and radiation about a year and a half ago. Since then most of my hair has grown back on the sides and back of the head. The center top and crown is still very bald. My dermatologist says it is a typical female balding pattern. Can you give me feedback on this subject? Is it possible I could be a candidate for hair transplants? Thank you.

Your dermatologist sounds correct. Some women develop patterned loss, which is less common than unpatterned loss. Hair transplants work better in patterned loss, assuming that your donor hair is adequate in quantity and quality. If there is diffuse thinning in the sides and back, you may not have enough supply for a transplant. A good assessment by a competent hair surgeon will give you insights into your supply for quality hair transplants.


2005-10-24 15:53:55Hair Not Growing Back After Chemotherapy

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Hair Multiplication Won’t Give a Full Head of Hair

Hello Dr,
I have been looking at articles in relation to hair cloning recently and something caught my attention. Researchers are warning that the first available hair multiplication procedures won’t give a full head of hair. If this is the case do you think hair multiplication will be able to give a full head of hair in the near future? Do you think these kinks will be ironed out? Your views on this would be much appreciated.

The solution where one hair can make many, is years away. We really do not understand the process and can not replicate it at this time. Too much hype, in my opinion and years away from a solution. When ever I report this, I get many emails that knock my pessimism — but I can’t please everyone.


2006-11-09 09:08:33Hair Multiplication Won’t Give a Full Head of Hair

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Hair Mildew?

I keep hearing of “hair mildew”. I can’t find it anywhere on the net.

I was wondering what HAIR MILDEW is,exactly, how do you get it and what would be the symptoms? And, is there any cure for it or would you have to cut out all of your hair?

Thanks alot

I’m sure each of us has been near someone who doesn’t dry their hair, which can sometimes develop an odor to it. Perhaps that is what one is talking about with the term “hair mildew”. If this mildew is a problem for someone, using a hair dryer after a wash should eliminate the problem. I’ve never heard this term used before, though, so I’m just assuming this is what you mean.


2007-11-21 10:32:52Hair Mildew?

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Hair Mapping for Miniaturization

Dr.Rassman, What is hair mapping? I have a derm doctor. He did a biopsy that showed AGA. I am 59, female. I started taking Prempro again, with hope of keeping what hair I have. Who do you think I should see in the Orland Park IL. area? I have lost more than half of my beautiful hair! I am at the moment using steroid gel on the bald spots every day, I really value your opinion.Where do I go from here? I will travel any where…

P.S. My doctor loves your site/ He said he would follow your instructions!

Hair mapping means that a physician is using a densitometer or video magnifying camera to look for miniaturized hairs at multiple sites on your head. The percentage of miniaturized hairs and the thickness change in those miniaturized hairs will determine:

  1. if a balding process is going on
  2. the pattern of the balding process
  3. over time and advancement or regression of the balding process

Based upon the many different published patterns of hair loss, the doctor can determine:

  1. what pattern of hair loss you are demonstrating or probably evolving into
  2. a look into your future hair loss based upon his/her experience with that particular pattern of hair loss as it conforms to the published patterns (e.g. Norwood Chart)
  3. the overall health of the hair in different parts of the scalp

For example, if a man has extensive miniaturization of hair in the Norwood Class 6 pattern (under microscopic examination), he may advance to a fully bald Class 6 pattern (even if it is not evident to the naked eye). Miniaturization is looked at in two ways; first, the total number of normal vs miniaturized (narrow shafted) hair, and second, the degree of overall miniaturization on a per hair basis (e.g. 80% of the hairs are miniaturized with an average hair loss 50% of its original diameter). If, over time, the percentage of miniaturized hairs stay the same, but the diameter of the hair shafts increase to, let’s say, 80% of their original diameter with a person on Propecia, the change can be documented as benefiting from the Propecia, or reduced to 20% of its original diameter, indicating a progression of the miniaturization and a failure to respond to the Propecia.

For women with genetic hair loss, miniaturized hair follows very different patterns than for most men. For the transplant surgeon, it is critical to know the miniaturization that is going on in the proposed ‘donor area’, for if the hair in that area shows significant miniaturization (diameter reductions and the percentage of hair involved in the process), then most of the hair that is used for donor hair will fail to survive a transplant, because the miniaturized hair will not have value in the new location. As an example, if a woman needs hair in the frontal hairline but has 80% miniaturized hair in the sides and back of the head, then one would assume that 80% of the hairs that are transplanted will fail when moved from this donor area.

For the male patient who is going on Propecia, getting baseline measurements will tell something about the changes in the hair after a reasonable treatment period. An example of this would be: a young man who had 90% miniaturized hairs in the hair population from a balding area measuring a 3 inch circle in the back of the head. Let’s say he was started on Propecia and then 8 months later, the miniaturization came down to 50% of the hair in the circle. That means the drug is working nicely and some reversal of the impact of genetic balding on the 3 inch circle in the back of the head had responded to treatment.

So you can see that the value of measurements here are both for diagnosis (what is causing the hair loss and how bad it is) and prognosis (predicting the future with and without treatment). If measurements are not made, then there is no sense of control for the doctor or the patient and the cause of the hair loss can not be followed intelligently. Measurements are the foundation for clinical science. A patient with compromised kidney function gets a blood test to see the progress of the disease and the value of any treatments given. The electrocardiogram (ECG) measures the damage of the heart after a heart attack or predicts a pending heart attack. I can go on and on here, but basically, hair should not be treated any differently than other sick organ systems. There must be an end of the days when a doctor runs his fingers through your thin hair and says (somewhat magically) that he knows what is wrong and how to fix it, he knows that the density is good or you are not going bald.

Blood work will help rule out other causes of hair loss such as hypothyroidism, anemia, hormone imbalance, and malnutrition.


2008-01-18 13:45:27Hair Mapping for Miniaturization

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Hair makes the world of difference in bringing out the ‘Younger You’ (photos)

What a difference a single hair transplant makes. Now the man in the mirror is young looking because he has a frame to his face with a natural looking hairline from the single hair transplant procedure. He had a bit more than half of his head covered from his first procedure of 2800 grafts. A second hair transplant will fill up the crown which he has now scheduled to have done very shortly.


2019-09-25 08:36:53Hair makes the world of difference in bringing out the ‘Younger You’ (photos)

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Hair makes a difference (transplants 5 months growth – photo)

There is no doubt that a hair transplant puts hair on the balding head and does it in a timely and predictable manner, in this case in just 5 months. I would expect that more length and possibly more hair is yet to grow in this man. If you are over 25, it is a very good option.


2020-12-02 07:05:57Hair makes a difference (transplants 5 months growth – photo)