Dr. William Rassman – Page 1098

May 13, 2011

Couldn’t I Have BHT If I Want to Keep My Hair Short? – Hair Loss Information – Balding Blog

My opinion is that it wouldn’t be that bad to use body hair especially if one wanted to keep a short cropped look. This way, if one ever wanted or needed to shave their head, there would not be any scar.

Plus, I have so much body hair, it would be a blessing to remove it and use it on my head!

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Well, I believe I have answered this many times. Body hair transplants are not considered the gold standard in hair transplant surgery. It generally does not grow the same or have the same texture. I realize that there are doctors who perform body hair transplantation (BHT) surgery, but if I were you, I would ask to meet many patients before I would go forward.

Plus, if you wanted to add hair to your scalp… why would you want to shave your head at some point? If hair is important enough to you that you’d want to go through surgery to get it back, I don’t think I understand why you’d want to have it gone.

May 13, 2011

Hair Loss InformationSeasonal Alopecia Areata? – Hair Loss Information – Balding Blog

(female)
I was diagnosed with alopecia areata about 15 years ago and received various treatments for same. After wearing a wig for 2 years my hair grew back enough to dispense with it. My hair starts falling out rapidly in April and May with new bald spots appearing but then starts to regrow around July. Any idea why and do you know of others with this seasonal hair loss?

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Alopecia areata is a lifelong condition, though it may only flare up every few years. So what you are experiencing may be another onset of alopecia areata. I would follow up with your doctor for a diagnosis and confirmation.

To date, there is no proven medical treatments for alopecia areata. The good news is that in time, the hairs will grow back. For more about alopecia areata, including support and research information, check out the National Alopecia Areata Foundation.

May 13, 2011

10 Months After Tuberculosis Treatment, I Have Bald Spots – Hair Loss Information – Balding Blog

(female)
I was treated for TB last year I was on treatment for double the time I have read is recommended. Now 10 months after treatment I have bald spots atthe nape of my neck and on my crown. My hair started thinning when before I was dignosed but when I was ill – my hair went from thick to fine. Is there anything that I can do to turn this around.
Thanks

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Hair loss from stress of an illness is more likely reversible, but it may take up to a year for you to notice any difference. Aside from this waiting game, you can see a doctor for a diagnosis and a possible treatment plan (because your hair loss may not be related to TB). I’ve written about this in the past here.

May 12, 2011

Hair Loss InformationI Have Diffuse Loss That Will Likely Go to a Class 7 – Hair Loss Information – Balding Blog

Hello Dr. Rassman:

Thank you for your blog; it has answered many of my questions. At this time I appear to have most of my head of hair. I do have thinning in the Crown region. I was told by a very respectable physician in Vancouver that I am not a good transplant candidate because I have diffused minaturization with a Norwood 6 – likely 7 pattern.

Understandably, I was taken aback, given that I’m 32; and this level of balding isn’t all that obvious amongst the men in my family. The hair surgeon recommended that I continue with my proscar (I’ve been on it roughly 2 years with pretty good results – i.e. stability).

My question is 1) given that I am 32; my hair loss appears to have stablized but I have diffuse minaturization, what is my timeline, i.e., will I be a slow progressor to Norwood 7? Does the fact that I have minaturization mean that the propecia will not be able to assist me with those hairs?

Also, with the doctor’s advice, I’m increasing to half or 2.5 mg of proscar.

Finally, what is the status of Acell? Do you think someone like me (Norwood 7) will one day be a good candidate for a hair transplant?

Cheers

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First, you need a good Master Plan. You seem pretty lost without one, unsure about what to do or where to go next. I have no idea what kind of timeline you’re looking at, but why would you want to have surgery when your hair loss is stable? It sounds like you’re considering surgery to prevent hair loss, which shouldn’t be the case.

1mg is really all the finasteride you need for treating genetic androgenic alopecia. Taking more will not necessarily help. No matter what you do, if you are going to lose hair, it will happen. Doubling a dose of medication will not guarantee it slows down, but you will increase the risks of a drop in libido. I’m not sure why your doctor is advising you to increase the dosage. I’d follow up with him about that.

The ACell study is still unproven and we will likely not know until the end of 2011 if the study was a success. We’ve received a lot of emails about it, and we’ve only been tight-lipped because there’s nothing to report at this time.

May 12, 2011

My College-Age Daughter Was Prescribed Finateride – Balding Blog

Dr. Rassman, my daughter is presently attending college in Houston Texas and was just diagnosed with Androgenic Alopecia. Her dermatologist came to that conclusion after she did a biopsy. What concerns me is, she prescribed a treatment of Minoxidil and 0.5 mg of Propecia daily. I understand the Minoxidil but I thought Propecia was for men only?

She did inform her of the pregnancy risks associated with taking the drug but it has me concerned and I asked her not to take it until I get more info. I’m not questioning this doctor’s diagnosis of the problem, just her remedy. Would you think an appointment with a proven hair loss professional would render any alternative advice? It seems this sort of hair loss in women is difficult to treat but I would think there are options available other than Propecia. Do you have any colleagues in the Houston area you might recommend? We may just wait a couple weeks and make an appointment at your office when she comes out for the summer. I appreciate your time.

Androgenic alopecia is not diagnosed with a scalp biopsy! More importantly Propecia (finasteride) is not to be taken by young women! It may cause birth defects if they get pregnant. There are a minority of women past their childbearing years who do take finasteride for very specific reasons, but even those women have equivocal results. Unfortunately, minoxidil is the only FDA approved hair loss treatment for women.

Perhaps your daughter should get a second opinion by another doctor. I don’t have any personal recommendations in your area, but you can check for physicians using the doctor search at ISHRS.org… or of course, contact our office for an appointment here in Los Angeles.

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May 11, 2011

Hair Loss Information » Harvesting 7600 Grafts from a Beard?? – Balding Blog

Hello Doctor

a very well known doctor claims that he was able to harvest 7600 grafts from a patients beard and transplanted it to its scalp. Now is that possible?

I have done several beard to hair transplants and they are relatively easy, but I really don’t know if the beard contains 7600 movable grafts. Is it possible? I suppose. Some people may have very high density hair in their beard.

May 11, 2011

Will the FUE Robot Make Surgery Cheaper? – Balding Blog

Hi Dr.Rassman. If you were to incorporate one of those fue robots in your practice would it lower the cost of an fue session? I know time limit would be lessened. Which method of the fue session is most labor intensive, the extraction process or the implanting one? I heard you have an interest in the success of these robotic systems. Please educate the public docter.

Robot I am told the robot will cost about $250,000. I think that this has to be paid down and the result should be a more expensive hair transplant. At least initially. I am just speculating, though, as we don’t have the robot in our practice.

This may be an issue of quality, not cost alone. Don’t focus on costs. A poorly done FUE procedure will cause permanent loss of your donor hair (not uncommon) and that costs you much of your future hair supply. How does one put a price on quality?

Note: The robot at the right is not going to be doing the FUE procedure, though it would be kind of neat to see.

May 10, 2011

Hair Loss InformationUsing SMP to Create More Fullness in Transplanted Patient (with Photos) – Hair Loss Information – Balding Blog

This patient received 1260 grafts in 1998, but over the years he continued to thin in the front and top of his head. He came in last month for Scalp MicroPigmentation (SMP) in hopes of adding fullness to the area immediately behind the frontal hairline. The results are spectacular and he avoided another surgery as a result.

The use of SMP for patients who were previously transplanted to create the illusion of fullness in areas where there is existing hair is nicely demonstrated with this patient. Click the photos to enlarge.

AFTER SMP:

BEFORE SMP:

May 10, 2011

Scarring Alopecia and SMP? – Hair Loss Information – Balding Blog

I’m an African-American man, I have scarring aolpecia, especially on my crown. Will this Scalp Micro-Pigmentation (SMP) work work me?

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In all likelihood, you would be a great candidate for Scalp MicroPigmentation (SMP), because hair transplantation is definitely not an option for men with scarring alopecia. SMP is also great for people with alopecia areata or alopecia totalis.

See here for FAQ and more information about SMP.

May 10, 2011

Why Is Topical Finasteride Considered Such a Radical Idea? – Balding Blog

My question is about the use and effectiveness of topical finasteride. Are there any recent studies as to the effectiveness or safety of such a treatment? I have read both previous posts about “Xandrox Sales Stopped by the FDA”. From what I understand about the use of topical finasteride, it appears to me that the jury is still out and it is not so easy to dismiss altogether. Granted Dr. Lee may have had no “proven” scientific basis for claims about the effectiveness of his topical finasteride treatment, Xandrox, however that does not preclude its viability as a hairgrowth alternative to the popular propecia pill just because its effectiveness is simply not known.

Topical finasteride has already been studied. For example: 1997 JOURNAL Of DERMATOLOGICAL TREATMENT 8(3):189-192
mazzarella f; Loconsole f; Cammisa A; Mastrolonardo M; Vena GA.

The use of topical finasteride is also discussed at length in the original patent application for propecia by Merck:

[0033] For the treatment of androgenic alopecia including male pattern baldness, acne vulgaris, seborrhea, and female hirsutism, the 5.alpha.-reductase 2 inhibitor compounds may be administered in a pharmaceutical composition comprising the active compound in combination with a pharmaceutically acceptable carrier adapted for topical administration. Topical pharmaceutical compositions may be, e.g., in the form of a solution, cream, ointment, gel, lotion, shampoo or aerosol formulation adapted for application to the skin. Topical pharmaceutical compositions useful in the method of treatment of the present invention may include about 0.001% to 0.1% of the active compound in admixture with a pharmaceutically acceptable carrier.

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So the topical concept does not seem like some radical idea to me but rather more of a potentially common sense alternative. Is there some known fundamental chemical problem that prevents the drug effectiveness when it is administered topically? If not, I can see no reason to discount it. Am I wrong?

I understand the medication has not been FDA approved this way, but I don’t understand what could happen from topical use that could not already happen from taking a finasteride pill orally?

Drug delivery through the skin is not as simple as making a drug topical. I’m not a pharmacologist, and to be honest, I do not know more than you summarized for the readers.