Author: Dr. William Rassman

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Hair Loss InformationSMP or MHT? – Hair Loss Information – Balding Blog

Dear Dr,
Like many readers of your blog, I cannot thank you enough for your contribution and this blog. I stumbled across the site for HIS hair clinic.

Seems like they like to promote SMP as their invention (specifically noting promotion of HIS hair clinic over NHI). Any thoughts?

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They did actually develop the technique and used it before we did. The biggest difference is that their work with clients does not have a medical focus. When they do the process, they can not use anesthesia and have little experience with treating hair problems since they are not doctors. As a medical group specializing in hair restoration, we focus on the Master Plan that may include SMP as well as hair transplant (FUE) and even medications. We have more than Scalp MicroPigmentation (SMP) in our arsenal for treating hair loss and we know the hair loss field far better than they do. This does not mean that HIS Hair Clinic is not good at what they do. They are just different with a different focus.

For the young man who has no medical problem or interest in a medical / hair evaluation, then HIS clinic works well if the client is in their area. It should be noted that they have licensed many individuals throughout the world, so quality control of the process may be an issue. Finally, the hairline creation and achieving a proper frame to the face is also something NHI has been doing for the last 21 years.

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Hair Loss InformationWhat Can I Do About Testicular Pain From Propecia? – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

First, I just want to state that I have been a follower of your blog for years. I am a fan of your work.

I have a question for you in regards to Propecia. Five years ago, I bought Propecia online. I started to take it once a day, and I suffered from enormous pains in my left testicle. After a few weeks, I stopped taking the drug. I bought this online without a prescription. Guys, do not buy your drugs online without a prescription!

This pain has lingered for a long time. I went to my family physician, and he prescribed me Proscar cut into quarters. I have been taking this for two years and it has halted my hair loss. I am very thin on my head, kind of like your SMP patients once they have completed the procedure. I clip my hair very short and it does not look bad.

However, I still have this pain in my left testicle. Now it hurts in my bladder area. I have taken 12 prescriptions, have been treated for epidydimitis, etc. I have done scrotal, rectal, kidney ultrasounds as well as a CT scan on that area. The specialists have found nothing wrong with me.

However, I still have pain, so here is my question: I know left testicle pain is a side effect of Propecia. Do you know what else I could do to track down this pain? I stopped the Propecia for two weeks and I still had the pain. So either way I have pain, I might as well keep taking it. I feel a throbbing pain in my left testicle and it burns.

If you could give me any advice I would appreciate it! Thanks.

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You are reporting a urological problem, so finding a good urologist is critically important as your source of information. Although testicular pain has been reported with the use of finasteride, one should rule out (as you have done with your GP and the above tests) the presence of other conditions that cause testicular pain.

Of course you should discuss changes in your medication with your prescribing doctor… but in general, stopping the drug is a good first step. The stoppage should not cause catch-up hair loss for 2 months or so. So in another month you will know the relationship between your pain and the drug once it is stopped.

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Hair Loss InformationMy Psoriasis Transferred with My Transplanted Hair – Hair Loss Information – Balding Blog

I just underwent a transplant 2 weeks ago. Regarding your post on Psoriasis i would have to respectfully disagree. I get have really bad psoriasis in the back of my head (donor area) and it definitely transferred to the recipient area, even so much as to go a little bit on my upper forehead just below where the grafts were placed. On day 7 post op i took a normal shower and with my fingertips rubs all the scabs off. Should i be worried that I could have harmed my potential new grafts? Also please let me know how you would treat this?

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If you transferred psoriasis, you would be the first patient I heard of that had experienced this. Rubbing scabs off always worries me, but it will not damage the grafts if it was not done roughly. Your psoriasis should be treated by your doctor, not me over the internet.

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Do Doctors Charge Per Graft or Per Hair? – Hair Loss Information – Balding Blog

I’ve been doing a bit of research and noticed when people get a hair transplant there are usually 2 numbers that come into play. folicular Unit grafts and the total hair transplanted. Do surgeons charge per graft or per hair? I think how it works is say a patient had 400 grafts done (per/unit graft) and a total of 1800 hairs. Each grafts varies whether there’d be 1 hair-5 hairs in the bundle. Correct me if i’m wrong.

thanks

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MoneyYou are correct. The fees actually vary by:

  1. Charges per session (small, medium, and large)
  2. Charges per graft (most common practice)
  3. Charges per the hair

The best quality graft is a follicular unit graft and the number of hairs you get varies from 1-4. When some clinics charge per hair, it makes the price to the patient higher, and if grafts contain a larger number of hairs that are naturally found on the patient’s scalp, they may look pluggy. That is why the follicular unit graft is superior to all other types of grafts. Follicular unit grafts can be obtained with a strip method of harvesting, as well as through follicular unit extraction (FUE).

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Thinning in the Middle of My Hairline Started In My Mid 40s – Hair Loss Information – Balding Blog

I am a 48 year old male. About 3 years ago I started noticing significant amounts of hair in the shower after showering. I didn’t think much about about it because my very full head of hair didn’t look any different. About a month ago I noticed that I have thinning in the middle of my hairline. The thinning goes back about 1 cm and is about an inch wide. There is no thinning at the temples or the top of my head at all.

Could this be an unusual presentation of MPB or could it be something else? Note that I am vegan and at one time I did have a zinc deficiency. Also my thyroid was borderline low at my last physical. Please advise.

Thanks in advance

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Unfortunately, I cannot really guess at what you have just based on an email, unless it seems specific and obvious. In other words, you’d need an examination. Keep in mind we have about 100,000 hairs on a non-balding scalp. You can lose 50,000 hairs and still look normal. If you have male pattern baldness, then it should occur in a pattern. Perhaps your hair loss is too early to see a pattern and it is just starting in the front? Maybe a miniaturization mapping to see the state of your hairs at a microscopic level may be helpful. You should see a doctor for this.

I am not sure how a zinc deficiency or being vegetarian has anything to do with what you describe.

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I Definitely Noticed a Body Hair Reduction from Propecia – Hair Loss Information – Balding Blog

I’m a 49 year old caucasian male who stopped using propecia because i can say with 99 percent certainty that it reduced the amount of hair on my legs and stomach. I had been off propecia for about six months and can already see hair returning to my stomach and legs. I also believe, though am less certain, that taking propecia contributed to a brief bout of alopecia on my face. Again, the hair in my beard is coming back now that i’m off propecia, though it’s growing back gray (i’m 49).

In short, I think the makers of this drug should DEFINITELY be required to list loss of body hair as a known side effect. And doesn’t it make sense that surpressing DHT would slow the loss of hair on the head while also increasing the loss of body hair in some people?

Feel free to use what i believe is an informed opinion of someone who will never go back to propecia after using it for about 8 years. Best regard

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I’ve heard reports of body hair reduction in a few cases with Propecia use. It may deserve to be in the official side effect list, but I haven’t seen any good study about the effect on body hair, and it doesn’t seem to be very common.

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Hair Loss InformationMy Hair Loss Isn’t Gradual and It’s Diffuse – Hair Loss Information – Balding Blog

Hi, great blog filled with lots of good tips and reassuring words of encouragement.

I’ve been suffering from diffuse shedding for a year and a half now, losing upwards to 100 strands per day. I’ve been diagnosed with male pattern baldness since my dermatologists were unable to find any other cause. I have my doubts as I’ve been lead to believe that male patter baldness is a gradual thing of the hair whereas I’m shedding hair all over.

I’ve had countless blood work done (all normal) and a scalp biopsy that showed the majority of my hair in the anagen phase.

what could be causing my loss? please please help!

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Your issue and statements are confusing and contradictory. I will outline some simple facts that may help.

It is normal to lose 100 – 150 hairs a day. In its place, more hairs are/will grow at other areas to compensate (for those who are not balding). So seeing or counting 100 hairs lost each day is not necessarily diagnostic, since non balding people can have 100-150 hairs lost in a day.

Diffuse shedding as you describe it may not be diffuse shedding in objective terms if you were diagnosed with male pattern baldness. If you have male pattern baldness it would not be diffuse. It would show a pattern. Generally for men hair loss is genetic and there is no specific blood test or biopsies to diagnose male pattern baldness (also known as androgenic alopecia). Male pattern hair loss is a diagnosis mostly made by a physical exam. Good bulk measurements can help establish a diagnosis, as well as a through microscopic examination of the scalp looking for signs of miniaturization. This is offered by many hair transplant doctors and if not, find one that does offer this service.

There is help, but you need to see a doctor for that. If you indeed have MPB, there are medications (Rogaine or Propecia) and surgeries as options.

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How Long Does Catch-Up Loss Take If I Take Propecia for Years and Then Stop? – Hair Loss Information – Balding Blog

Hi,

Thanks in advance. Couple questions –
1) How long does it take the hairline to recede…can it take 10 plus years?

2) If you take Propecia for years then quit, and if it was working, how long does it typically take to revert to the state as if you never took the medication? Is it possible that the loss can be worse in the 2nd year off the medecine?

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As a general rule, catch-up hair loss happens in the first 6 months after stopping Propecia. It occurs over several months, and usually brings you back to wherever you were in the hair loss process when you started the drug. The degree of hair loss or how much your hair will recede is based on YOUR genetics. Everyone is different.

If you stopped Propecia 2 years ago and are noticing hair loss now, it is not catch-up hair loss. It is likely natural genetic hair loss taking its natural course.

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Salesman Tried to Push a Bunch of Hair Care Products and Lies – Hair Loss Information – Balding Blog

Hi

I went to see a few trichologists in London. The first was a free consultation by [name removed] at The Westminster Practice. He told me I was losing my hair and it would get worse and I should pay £2200 upfront for a year treatment of Vitastim and Biostim and hair care products.

I saw 2 other trichologists who couldn’t see a problem with me except I have naturally fine hair. They had never heard of the products and I have since researched both those and [name removed] (who is not a registered trichologist) and found every single mention of these products online was written by [name removed]. I also found on the ITN website he was on a program called ‘Salesmen from Hell’ and he was recorded trying to push expensive products and was fired from his position for fraud.

I was very very close to handing over the money a few months ago until I took a second opinion and need to share my experience with others. However, he instilled a seed in my head that the products he mentioned could thicken my hair and give me a “curtain of hair better than I had before” and I am unable to put this seed out of my mind. Are these products available anywhere else under a different brand name?

Many thanks

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I blanked this person’s name because it is our policy not to slander anyone. I am free, however, to reference publications like newspapers or official news releases if they are in the public domain. You did the right thing to research the person who was selling you a line. Don’t believe people when the promises made are outlandish and not realistic. £2200 (around $3500 US) is a lot of money to gamble on a sales pitch.

There’s no magic product that will give you better, fuller hair than you had before you started losing it… particularly for women, since they have more limited treatment options.