Month: January 2023

Can you please expand on what you mean by saying hair transplants accelerate balding, especially in younger men? Thank you

Younger men often don’t see their final pattern, but it is often there if they look through a hand microscope and see a lot of miniaturization present. A hair transplant causes many of these miniaturized hairs to fall out, and they RARELY come back. Remember, miniaturization doesn’t necessarily mean thread-like hair, as it could be hair that has lost only 30% of its thickness, not easily seen without extensive hand microscopic evaluation. With a 30% loss of hair thickness in most men, they will not see thinning or balding. I have seen many 23-year-old men who get hair transplants and never knew they had significant miniaturization with a miniaturization pattern that suggests a more advanced balding pattern.

Young men (under 26 years of age) who have hair transplants may see a Class 3 pattern, but they might have a Class 6 or 7 pattern, which would be a surprise. I don’t like surprises, nor should the patients. So many young me are going to Turkey, where technicians are in charge of the business. In most of these clinics, such evaluations seldom occur except for less than a dozen good doctors that I know personally. Shame on the doctors who do these surgeries without looking for and quantifying the miniaturization before they collect your money and do the surgery. Too many of today’s doctors, even in Western countries, are in it for the money and forget the oath they took when they became doctors, which states: ABOVE ALL, DO NO HARM.

I recently met with a 23-year-old male who came to me after having three hair transplants in the US at different clinics by less-than-honorable doctors. His entire donor supply was depleted, and so was his bank account. The hair transplant doesn’t even look normal to me. All of these transplants were in the first 3 inches of his hairline. When I examined the hair behind the transplanted 3 inches of his frontal area, I saw signs of miniaturization that went back to the crown. The miniaturization was very early, possibly too early to have fallen out with the transplant. He was lucky because he took finasteride, which often stops the loss of miniaturized hairs associated with a hair transplant. As this was a recent visit, I can’t tell you how it will turn out. I suspect he will live with the transplants, even with the defects of an imbalanced hairline and a lot of 2-3 hair grafts seen in the frontal edge of the hairline.

Doctor Rassman I want to know something about grey hair. Is grey hair caused by stress or simply genetics?

Probably a little of both. Some people almost never go grey. Some people, even in their childhood years have grey hair. Some have total white hairs (Santa Clause). People with little or no stress get grey hairs. There is no clear cut rule.

Aging has a part to do with it as well. If you think about it from a scientific approach with genetics as a partial cause, we all have a certain programmed destiny of the cells in our body. Environmental factors may alter some of this destiny but the point is that if the hairs go through several life cycles (anagen catagen telogen) over a person’s life some of those hairs may be pre-programmed to fall out and never regrow after an “x” number of cycles. Some may be pre-programmed to turn white or grey after an “y” number of cycles. This may be a simplistic way to view biology but it may help understand the variation and why some may lose hair or have hairs that turn grey.

Hairlines changing to mature hairlines are still hairloss caused by DHT right? Would propecia help slow or stop the hairline moving back to a mature hairline? I see some people with no recession at all. I want to be one of those people. If propecia doesnt stop a mature hairline, then what besides DHT causes this hairloss?

When baby seals (harp seals) are born, they have a beautiful white insulative coat. As they mature, they lose this coat. It’s in their genes. Likewise, for Caucasians, a maturing hairline in present in 95% of men nd it is in their genes (in part due to DHT). Thus theoretically, a DHT inhibitor like Propecia may halt the maturing hair line. You should note, however, I used the term ‘in part’ which means that there are other factors that may be responsible for the change, not just DHT.

There are few points to consider:

1. Male pattern baldness is not a maturing hair line. Otherwise it would be called a maturing bald line.
2. Propecia’s effect is best seen to work on the crown of the head and not the corners or the frontal hairline.

If you have completely healed, you can have Scalp Micropigmentation to address this problem, see here: https://scalpmicropigmentation.com/scar-covering/. Your problem should be a warning to many men to have their FUE pushed high especially when non-trained people are doing it and don’t understand the math of supply and demand for donor hair nor the necessity to remove the FUE grafts uniformly.