Author: Dr. William Rassman

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Australia Hair Transplant Recommendation? – Balding Blog

Hi, im from Australia. Unfortunately i can’t come visit you for a consultation due to the distance and all, so i was wondering, if you could suggest any hair restoration clinics here in australia, or doctors? I heard Dr. Richard C. Shiell is good? any suggestions?

thanks in advance

I rarely give specific endorsements of doctors. I would suggest you see as many doctors as possible, find a fit with your personality, and ask the doctor to see their patients results in person. Before/after photos may be a good starting point, but nothing compares to seeing results in person and speaking with unbiased past patients.

Also, I believe that Dr. Richard Shiell has retired from surgery, but there are physicians at his clinic that he trained. You shouldn’t consider this a personal recommendation, but it might be worth researching it further — Shiell-Knudsen Clinic. Or you can find other doctors in your area by using the physician search at ISHRS.org.




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Balding Forum - Hair Loss Discussion

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Hair Loss from SSRIs? – Hair Loss Information – Balding Blog

I’ve seen several sources on the internet saying that SSRI’s like Zoloft CAN cause hair loss. But how likely are they to cause hair loss in terms of percentages? Do they have a 10% chance to cause hair loss, or maybe a 20% chance?

I’m a 31 year old male and have been taking Zoloft for the past 6 or 7 years, often at 250 milligrams, or 2 and a half pills per day. Whenever I got out of the shower, I always noticed that hair would be clogging up the drain. However, I never worried about it because I never looked like my hair was thinning or balding. Now though, my hair has been noticeably thinning for about 1 and a half years with a receding hair line on both sides and thinning on top and in front. Is it likely that taking Zoloft over an extended period of time caused me to lose hair at such an early age? Or could the Zoloft have caused male pattern baldness to affect my hair sooner (at 30 years old) rather than later? Could that likely have happened?

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ZoloftAs we’ve said over and over, the most common cause of hair loss in men is androgenic alopecia (AGA). This is often referred to as male pattern baldness (MPB). It’s a genetic issue and just as the term implies, the hair loss happens mostly at front and top (as you describe, in a pattern). Certainly many medications may list “hair loss” as one of its MANY side effects, but medications are often the last culprit. In other words, your loss may be completely unrelated to the medication.

There is no documented percentage of patients who experience hair loss from SSRIs that I am aware of, but in the end you need to speak with a doctor about this. With your doctor, you can discuss your options and obtain a good diagnosis of your particular cause of hair loss.

On a side note, for those who are always preoccupied about the sexual side effect risks of Propecia (1-2%), I believe SSRIs have a much higher percentage of sexual side effects than Propecia has.

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Hair Loss InformationHair Loss After Mammaplasty – Hair Loss Information – Balding Blog

I had a reduction mammaplasty under general anaesthesia for 6 hours in early June. In early October, my hair suddenly started to fall out more at first and only got worse till now (24th December). Could this be TE? How long is this expected to last?

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I am aware that some patients report diffuse hair loss after a major surgery. If it is telogen effluvium, then it may take 6 to 12 months to recover. However, I have often noticed that many patients do not fully recover (or regrow) all of their hair. It is my general advice that one gets a good physical examination by their physician to rule out other causes of hair loss as well.

I realize you (like many others) are looking for answers on the Internet, but I doubt you will find it… even here on BaldingBlog. This may be a good place to start, but as you explore the web you will be lost and confused, possibly ending up in a well-designed website promising you a cure for just three easy payments of only $19.95 (as an example). As I stated many times, seek out your medical issues with your doctor, one on one.

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Rogaine Has Recently Lost Effectiveness in My Crown – Hair Loss Information – Balding Blog

Thanks for the great site everyone!

Here are my questions:

I have been on proscar for over 10 years. I have virtually no frontal hair loss, but the crown has been fighting me the whole decade. Rogaine has been great but has lost its effectiveness recently. My crown is not noticeable (mild combover) but it’s thin to me. What is the best option for a guy like me?

I’d like to do an FUE because although I’m not bald, I’m in my mid 30’s and I want to enjoy life. I should mention I have VERY thick hair everywhere else on my head..

Help guys… What do I do?

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A good examination is critical to giving you realistic expectations. With lots of hair, crown loss can be transplanted very effectively. For example, I (Dr. Rassman), had 1600 grafts in the crown many years ago.

With regard to Rogaine, it may run out of steam over time. Short of transplants, there is often little that can be done… but definitely maintain your finasteride.

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Scalp Laxity and Hair Transplants – Hair Loss Information – Balding Blog

Wonderful blog you have up here, Dr. Rassman. I just wanted to know how scalp laxity affects a person who is willing to get a hair transplant. If i have a very loose scalp, how will it benefit me when i am getting a hair transplant procedure done?

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Increased scalp laxity will allow the surgeon to harvest more hair in one surgery. It is like pinching a part of your skin. The more you can pinch your scalp (skin), the more hair comes with it.

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Hair Loss InformationDo Blondes Have More Hair Than Brown or Red Heads? – Hair Loss Information – Balding Blog

What do you think of the comment in the side box, “Do blonds have more fun ? No – but they do have more hair. People with blond hair have more hair on their head than people with brown or red hair“.

Link: KidsHealth.org – Taking Care of Your Hair

That’s wrong, Isnt it?

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Blonde hairI don’t know that there is a significant difference in hair densities between blondes and those with darker hair, even though it is recorded in various places on the web. I’ve seen pages like this one, but can’t find a source for their information. I have made a point to check the hair densities of the blondes who have come into the office to see me over the years since I started the hair practice nearly 20 years ago, and I couldn’t find any real difference.

However, there is a difference in hair densities between different ethnic/racial groups. Caucasians have the most hairs on their head. African/black hair types have the least amount of hair on their head. Asians fit somewhere in the middle. The reason for this difference is not clear, but Caucasians probably need the most hair on their head because their hairs are the finest. This fine character requires more hair to look like the equivalent of say, Africans, who have the least amount of hair, but their curly hair makes up the volumes. Asian hairs are often coarse, so they may make up for the less numbers that way.

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Minoxidil Applicator Brush? – Hair Loss Information – Balding Blog

I just saw a commercial for the Minoxidil applicator brush. Do you(or your patients) have any experience with this product. Do you consider it an advancement in terms of effectiveness or ease of use?

Link: Ultra-Mox Applicator Brush

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Minoxidil brushI haven’t seen this one before. So from what I gather, you load the brush with the minoxidil and then comb it through your hair to dispense the medication. It’s a clever idea, but I don’t really consider it any advancement in the drug arena or a game-changer in the effectiveness of minoxidil. If it’s worth $100 to you to not apply the minoxidil with your hand, I suppose this is an item you could use.

So while I don’t have any experience with this minoxidil brush product, I wish the makers well. It is a free economy. For the record, I also don’t own automatic tie rotating hangers or other extraneous late night TV gadgets. Any readers out there use this applicator brush? If so, we’d love to hear your thoughts on it.

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Hair Loss InformationMen’s Health Selects Bosley Shampoo for Thinning Hair? – Hair Loss Information – Balding Blog

Hello,
I recently purchased an issue of mens health and they were discussing shampoos for various hair types. They listed Bosley Professional Strength Nourishing shampoo as their shampoo of choice for thinning hair. The website for Bosley describes the shampoo as saying:

Gentle, sulfate-free cleanser that helps to recondition hair and rejuvenate the scalp. Cleanses and removes toxins such as DHT, a primary cause of thinning hair and hair loss, from the hair and scalp. LifeXtend complex contains Saw Palmetto extract to help promote healthy follicles. Pentapeptides help stimulate production of root-strengthening Keratin Protein. Soy Amino Acids help restore strength, thickness and volume. Vegetable Protein helps fortify hair shafts. Plankton Extract helps protect from photo-aging, frequent washing & damage from brushing.

Is there any benefit to purchasing this shampoo for around 20 bucks a bottle or is everything claimed false. Thanks!

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Men's HealthThe claims are extensive and suggestive, and the various elements in the shampoo have never been proven to treat thinning hair any better than other shampoos. If Men’s Health feels that the Bosley Pro is a good shampoo, it may be worth a try… but I truly doubt that it will treat hair loss in the way that balding men may hope.

Also, I have no idea if this was just a paid product placement or if there is some study the magazine conducted that lead them to the conclusion they made.

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Hair Loss InformationIn the News – The Placebo Effect Works – Hair Loss Information – Balding Blog

Snippet from the article:

There’s little doubt that the placebo effect’s real, but it has always been argued that a person feels better because they think the pill is the real deal. But what if it works even when you know it’s a fake?

According to Ted Kaptchuk at Harvard Medical School and his colleagues at least one condition can be calmed by placebo, even when everyone knows it’s just an inert pill. This raises a thorny question: should we start offering sugar pills for ailments without a treatment?

In the latest study, Kaptchuk tested the effect of placebo versus no treatment in 80 people with irritable bowel syndrome. Twice a day, 37 people swallowed an inert pill could not be absorbed by the body. The researchers told participants that it could improve symptoms through the placebo effect.

While 35 per cent of the patients who had not received any treatment reported an improvement, 59 per cent of the placebo group felt better. “The placebo was almost twice as effective as the control,” says Kaptchuk. “That would be a great result if it was seen in a normal clinical trial of a drug.”

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Read the full story at Gizmodo — Placebos Can Work Even When You Know They’re Fakes

I am certain that the placebo effect also applies to side effects. If you hear you may get erectile dysfunction from taking a drug, how many people will report the side effect from taking the placebo?