Month: January 2023

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Contrast Between Scalp and Hair

Female – I have been thinning for years and as a result, have been bleaching my hair. My rationale is that this lessens the contrast between the scalp and the hair and makes the hair loss less noticable. Recently, I went to a new stylist who told me that my theory is false and that dark hair will make the hair less transparent and therefore less noticable. It’s been three days since she did my hair and I have to say that I think I was right. I think the new darker shade makes the hair loss more noticable. Am I nuts? Should I go back to being a blonde or should I stay a brunette?

When the scalp and the skin are closer in color (white skin and blonde hair) the impact of thin, see-through hair is less obvious. Styling with puffed-up hair styles are popular in women who also dye their hair to get a fuller look. That is more of a styling issue. Don’t worry, you’re not nuts. If you’re more comfortable with being blonde, I’d say you should go blonde. Go with what you’re comfortable doing, and with what you think looks the best.

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Contraindications of Strip Surgery?

Dear Dr. Rassman,

What are some possible contraindications in a strip surgery?

Also, is there any difference in the end cosmetic quality between FUE and strip? For example, would there be any difference in transplanted densities between the two?

Finally, if I were to get an FUE procedure done, would I most likely be able to shave my head later without noticeable “dot scarring”. I read on another forum that FUE creates a “confluence of scarring” where the tiny dot scars seem to merge into one another to create a big scar. Can you possibly clarify this?

Thanks

See the recent post, Is an FUE Procedure a Less Successful Hair Transplant?, which shows that if the quality of the extracted grafts are good, the end result will be the same for FUE or traditional strip surgery. Many FUE grafts are less than ideal, so there might be a difference if the extracted grafts are not perfect. ‘Dot’ scars may or may not be visible with a shaved scalp (razor shave). If your healing is good and the punch size is very small (0.9mm or less), the ‘dots’ may not be visible unless you look very closely. A short hair clipping (1/4 inch length) will not generally show ‘dots’.


2006-12-21 09:31:36Contraindications of Strip Surgery?

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Continued Thinning After a Hair Transplant

I’m thinking about a hair transplant procedure, but had some reservations about what happened if one continued to lose hair. The transplanted hair is supposed to permanent, so what happens to the rest of the hair on the crown if you get hair transplanted to the front hairline area? Does it stay and the rest of it go?

Assuming you are a male, have genetic hair loss, and you are taking Propecia (finasteride), then the hair loss should stabilize so that as you add transplanted hair you are gaining, not losing hair. Hair loss is a progressive process, arrested by finasteride in most men. Hair transplants in the front will frame your face and finasteride for the crown should stabilize or reverse the hair loss. Get you scalp mapped out for miniaturization to be sure of the diagnosis and then you can get a transplant if that is part of your Master Plan.

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Continued shedding despite minoxidil

Hello Dr Rassman, I have a question. I am on 5mg of oral Minoxodil a day. I have been told by a few people it may be too much. Thing is, my hair is not getting better. Been on it for 8 months, hairloss is rapidly increasing to the point I am nearing NW3 when I was barely even NW1 8 months ago (Shedding hundreds of hairs over the sink) My question is, if I lower my Minoxodil dose to 2.5mg every day, will that cause even more hairloss? I’m worried about being stuck on 5mg of minoxodil for the rest of my life

This is a balancing act between safety and effectiveness. Lowering the dose to 2.5mgs shouldn’t have an impact on you; however, with continued shedding, maybe finasteride is worth considering

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Continued Balding After Hair Transplant

I have read a lot about mega sessions and micrografts, etc, and don’t doubt that they can produce satisfactory results if done properly. My question is: what happens as time goes on and balding continues in the untreated areas? I assume a patient would have to keep coming back every so many years to fill in the newly balding areas. How many times can someone go “back to the well” as it were. I am 43 years now, and have a receding hairline (especially at the temples). My concern is that when I am 60 or 70, I will look ridiculous with a perfect hairline but balding at the crown.
Thanks

This is a good quesiton which I have answered in many ways before. Generally the hair loss for most people tends to plateau after the age of 35, and by the time someone reaches your age, the final pattern can be estimated by mapping out the scalp and hair for miniaturization so that you do not play ‘blind man’s bluff’ with your hair. If you will advance to a very balding pattern, then some of the hair in that pattern will be miniaturizing now, so it will be easy to see under high powered imaging.

If you take drugs like Propecia, it has several advantages, including reduction of the progressive nature of the hair loss, and probably preventing prostate cancer. Both are desirable side effects of the drug.

In most men of your age, chasing the hair loss is unusual. It is usually more of a problem with men in their 20s who get a transplant, are destined to become very bald, and who do not take Propecia. With a good Master Plan, you should never look ridiculous at any age after having a transplant, providing that you have the conversation with your surgeon and he/she is honest about his/her answers and not a salesman going for the cash that is your bank account and wanting it to be in his instead.

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Should I Continue Taking Finasteride?

I have been taking Propecia for two months for aggressive male pattern baldness at age 23 (Norwood 3 approaching). It has restricted my hair loss. I want to continue the medication. I have normal morning erections, but my libido has decreased. I want to be on the medication for at least one year. This is a personal choice.

If you are willing to manage the decreased libido to maintain your hair, then by all means continue the drug.


2019-01-07 08:55:09Should I Continue Taking Finasteride?

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Contact Dermatitis and Hair Loss

Can you please help me? I have a contact dermatitis and have been picking it- is the hair loss permanent or temporary?

Can you also recommend a good dermatolgist and endorcolgist in London? We have bupa but my gp is not good with hair problems.

Thank you . I am very impressed with the time you give others with this awful, life destroying conditon

Contact dermatitis usually is not related to hair loss. However, you seem to describe a condition of compulsive hair-pulling (called trichotillomania) and it may be secondary to your contact dermatitis. Hair loss from pulling is often permanent if it goes on for any length of time. Fortunately if you stop pulling at it, your hair may still grow back. People who pull at their hair often have some obsessive/compulsive elements in their personalities and may require medications to stop the process.

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Consumer Driven Website Appears on Internet ‘attacking’ Doctors Who are Unethical

The ethics of plumbers, contractors, auto-mechanics, and many other have always been questioned. Because there are a few rotten apples in every bucket of apples, that does not mean that all apples in the bucket are rotten. This metaphor applies to plastic surgeons, all professionals including cosmetic dentists and hair restoration surgeons, as well of which I am one of them. So here is the site I just mentioned: https://www.angelfire.com/indie/hairtransplant/

Some of my quotes have been used to validate doctors who have been targeted by this website. I will not make any reference to particular doctors or groups of doctors nor endorse this website as a quality source of information. I do, however, hope that everyone researches the doctors that they choose and their research should include: industry bulletin boards, consumer driven websites, and the state medical boards which have records of doctors who have infractions on their medical license. As a consumer, it is a ‘BUYER BEWARE” problem for everyone wanting to get cosmetic surgery of any type. I see, too often, patients who did not use their common sense when selecting doctors. I always tell patients to ask the doctor to introduce you to a few of his/her patients so that you can see the quality of the work they do and also to understand something about their humanity.


2017-04-05 14:44:59Consumer Driven Website Appears on Internet ‘attacking’ Doctors Who are Unethical

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Consultation That Push to Get Your Money and Do It Under Pressure (from Reddit)

A proper consultation include building a relationship between the doctor and the patient, not a salesperson. Unfortunately, too many doctors see $$$ when they see patients. I often see patients and tell them that they are not good candidates for a hair transplant or that the timing is too early. I always build a Master Plan with the patient, so the patient has both a short and long-term plan which may or many not include a hair transplant. My favorite part of what I do is meeting the patient. My practice may be unusual in that I have many celebrities and CEOs of big companies, but I also get truck drivers or students too young for hair transplants. I try to give them the materials that equips them to handle their “balding problems” and balance it with their lives.

FUE Hair transplant consultation results from tressless


2018-06-22 12:12:33Consultation That Push to Get Your Money and Do It Under Pressure (from Reddit)