Month: January 2023

Minoxidil is causing vellus hairs to grow around my eyebrows and cheekbones, but doesn’t seem to be doing much for my head. It’s given me more hair growing out my nose, on my toes, armpits and chest. I’ve got 1000 hairs in my tush. But where I want the it the most, on my head, it’s packing its bags. Mother nature has a dark sense of humour and she’s pranking us boys.

When minoxidil gets absorbed, some people end up with a lot of hair almost everywhere. That is why, when minoxidil was introduced in the 1960s as an anti-hypertensive agent, we saw a lot of hairy women from the drug which was not very effective consistent high blood pressure.

In regards to the thread of Low testosterone and low LH……..

Doesnt hair miniaturization happen between growth cycles? When an old hair is shed then a new finer/thinner hair replaces it, correct? The way my hair is progressing is that it is miniaturizing as it is growing… I have no shedding, my hair is continuing to grow as it miniaturizes… is that normal?

The hair that is miniaturized is not the hair that appears between cycles as you postulated. Miniaturized hair grows until it becomes so thin that it is thread-like, but miniaturized hair does grow, albeit slower than normal hairs.

Hi guys, i got this problem with my Beard. I used to have strong beard before minoxidil, which im using none-stop for the last 10 years. Now its growing too wild. My Beard is growing all the way up to the eyes area. Im shaving it every day to achieve normal beard Line. It became pain in the ass. I can see beard dots 3 hours from shaving. Super fast growth. I also have very soft skin, so shaving wounds my skin. I cant stop using minoxidil because i will loose all my hair gains. Any way to get around it? Maybe a shaving machine that shaves close? Or a laser hair removal? If any one had experience like that when using minoxidil i would like to heat.

Facial hair growth in places where you might not want it is a known side effect of minoxidil. Stopping it reverses it. It happened to my wife and she stopped it, and the facial hair went away.

I started using min and ive noticed very tiny hairs growing on my forehead way below my hairline and temple are between my eyes and hairline. Is this an unusual sign or is this common? Also my temples are receding slightly and the top is fine.

Hair growth in unwanted areas is a known side effect of systemic absorption of the minoxidil. Women have real problems if they develop a beard or mustache on minoxidil; also a known side effect.

Hi Dr.Rassman,
I’d be very grateful if you could reply to the following questions:

1. How do the technicians slivering the donor strip record the Follicular Units. Is this done as a running total on a sheet of paper for type 1, 2, 3 units? Is the total of these units then recorded?

2. How do the placers, placing the Follicular Units record the Incisions created. Is this similar to Q.1 above.

3. Is it true that each incision site created can only contain ONE Follicular Unit graft? Otherwise, more than one would be compressed, traumatized and die??

4.If the Incision count is LESS than the Grafts extracted from the donor strip, what would that indicate.

5. What would increase a hair transplant procedure between 2 patients having the same amount of grafts transplanted and the same number of medical staff in attendance? For example, if one of the patients had blond hair, would it be more difficult to see such grafts under a stereomicroscope?

I often get these type of questions asked in different ways. It is a very good question that also can be seen as a trust between doctor and patient. In other words, how do you know if you are receiving the number of grafts agreed up on (which relates to how much you paid for).

It is also a great question merely from purely a technical point of view of how one keeps track of thousands of grafts and incisions on one’s head.

I cannot speak for all the hair transplant doctors in the world as there is no standardization on how one keeps track of grafts. I will try to explain your question from a general perspective as well as what I personally have been doing in my practice for the last 23+ years.

1. Our staff keeps track of each graft dissected on a paper as they cut about 25 to 50 grafts at a time. They record and sort out single hair to multiple hair grafts individually as they dissect the grafts. A team leader then double checks the numbers as the day progress and add up the total number of grafts on a master sheet. Finally when all the grafts are dissected, another accounting in made on a computer Excel spread sheet. Usually we double check numbers with another staff individually adding up the numbers separately.

2. The placers do not keep track of the grafts being placed. Instead the doctor keeps track of how many incisions were made. If there was 1000 grafts cut, the doctor makes 1000 incisions and the placers have to find individual incisions to place the grafts. It sounds tedious and difficult but that is why the experience of a good staff and the reputation of a medical practice is important. This is one of the critical steps in the hair transplant surgery where this task need to be completed as fast and most efficiently as possible to accomplish a successful surgery. Longer this takes, your hair grafts may not grow to its full potential as it is kept out of your body and handled by an inexperienced staff trying to find the incision.

3. One incision usually has one graft. Sometimes where there is an over abundance of single grafts, the doctor instructs the staff to place two single hair grafts in one incision (or one single hair and one double hair grafts in the incision). If the staff is experienced there should be no issue with compression (we call it “piggybacking”) and trauma to the grafts. If the staff is inexperienced they may inadvertently place on graft on top of one another and cause trauma and poor growth. If the doctor is planning on “doubling” grafts he appropriately makes less incisions than the grafts that are being cut. He also makes the incision differently with a different needle to indicate to the staff where the double grafts should go. This a very subtle thing that has huge implications and requires a very well trained staff.

4. If the incision count is less than the grafts extracted, then more incisions have to be made. Or if the grafts are less than the incisions made then more grafts have to be harvested or you have to leave the incisions empty. Another subtle thing that takes coordination between staff and doctor.

5. Every patient is different even when the same number of grafts are planned (even with same colored hairs). In general curly hair and white hair is more challenging. Some patients have different textured scalp which cause the grafts to “pop” out and not stay in its place.