Author: Dr. William Rassman

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Hair Loss InformationIn the News – Offshore Stem Cells Treatments Offer False Hope – Hair Loss Information – Balding Blog

Snippet from the article:

Dr. George Q. Daley sits at his keyboard and types “stem cell treatments.” In less than a second he gets 13.4 million Google hits.

“Here’s a website where they claim over 1,500 patients treated,” says Daley, one of the world’s foremost stem cell researchers. “That doesn’t mean they’ve been treated successfully. It’s ‘buyer beware!’”

But consumers have a hard time sorting out all the stem cell claims out there. Websites often look professional and convincing. Typically they feature distinguished-looking white-coated doctors posed in front of bookcases, technicians holding up flasks with mysterious colored liquids, and happy, healthy-looking clients cavorting on beaches.

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NPRRead the full story at NPR — Offshore Stem Cell Clinics Sell Hope, Not Science

This is a good article about scams and selling false promises online. Although it targets the people looking for stem cell treatments that don’t exist, much of this can be applied to the same people seeking out a hair loss “cure”.

Bottom line, there are unscrupulous people that are more than willing to take money from desperate folks looking for miraculous medical treatment via the web.

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Hair Loss InformationMy Aunt Got a Chemical Burn a Year Ago and Still Has a Bald Spot – Hair Loss Information – Balding Blog

Hi there it has been 1 year since my aunt has burnt my scalp with a relaxer it was red then healed but now there is a bald spot will my hair grow back and i am 14. what can i do to help it grow back? how fast will it grow? please help!

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Honestly, I do not know. Your aunt’s hair may never grow back if the damage is significant and the burn went down to the root of the hair. If it was to grow back, I’d expect it might have grown back by now (since it’s been a year) or at least some regrowth should’ve occurred.

She should have the burned area examined by a dermatologist.

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Hair Loss InformationMy Hair Looks Worse After Each Transplant! – Hair Loss Information – Balding Blog

Doctor,

I started noticing hair loss around the age of 26. I tried the laser for a year and did not believe it worked and took propecia, but felt that did not provide help either. In 2009 I decided to have a hair transplant surgery 2,000 hairs. 1,000 in the front and 1,000 in the back.

After the transplant I began finasteride and rogaine to maintain the amount. I was so happy after the first 6 months, until I started noticed thinning in the front again. Everytime I go to the doctor who will remain nameless they say things are fine. I went for the second procedure a year later to thicken up the front. It has been 5 months and the front looks worse and the back is starting to thin out on the sides and a little in the middle. I have a few questions.

  1. Can the initial surgery cause this shedding to occur and then stop?
  2. Could the rogaine cause an adverse affect? Every time I use the rogaine and start combing my hair at least 10-20 hairs come out. I read somewhere that if shedding does not stop after 5 months then stop.
  3. Does the finasteride not work as well as the propecia? These 2 drugs should keep the back fine, but that is not the case.
  4. Also could transplanted hair fall out?

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I cannot comment too much on your particular issues, because I’ve never examined you… but I suspect there was no Master Plan associated with your hair loss issue and you were chasing after a goal that wasn’t clearly laid out. It’s possible you were never given realistic expectations. Perhaps you should see another surgeon for his/her opinion.

1. I do not know what your initial surgery was, what it was suppose to do, or even if it was successful. In general, you can have shock hair loss from the surgery itself. That’s one possibility. The shedding from shock hair loss is permanent.

2. Rogaine is a topical medication to grow hair, not lose hair. If you have an adverse reaction, then ask your doctor for an examination. Losing 10-20 hairs is normal with or without Rogaine. Finally, some patients report slightly more hair loss when starting Rogaine treatment, but as you continue to use it there should not be a problem. The initial hair loss from Rogaine is thought of as a “cycling” of the old hair falling out in preparation of new hairs to grow.

3. Propecia is finasteride in 1mg strength. There is no difference as it is the same medication. Propecia is the marketing name, like Tylenol is the marketing name for acetaminophen… or Rogaine is the name for minoxidil. I’m not sure what you mean by the “back” … is it the back of the head (donor area) or the top/crown?

4. Transplanted hairs are considered permanent as your donor hair. They do fall out as the hairs cycle, but it regrows.

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Hair Loss InformationMaking Sense of Hair Loss Drug Stats – Hair Loss Information – Balding Blog

Dr. Rassman, you have said before that minoxidil works for about half of men. The box says that minoxidil has only been proven to work for men experiencing hair loss at the apex/top of head and not for men that are balding from the front. Are these clinical studies made up of men that are already “good candidates”, meaning they have the right kind of balding for the drug to work? Or are all types of balding patterns included in the trials?

I am 34 years old, been on finasteride for a year and noticed that it slowed things down, but didn’t stop it completely. I have since added minoxidil. I would appear to be a perfect candidate from what I have read. I caught it early, I don’t think most people would even realize I am losing my hair, it is still pretty thick. I am losing my hair at the apex/top of head area, my hairline looks good. Is someone like me almost guaranteed to get a good result? Or am I still just a 50/50?

Thanks so much, your site is a huge help!

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There is no guarantees in life (other than death and taxes). If it works for you it’s 100%. If it doesn’t work for you it’s 0%. Statistics do not apply when it’s you… and you won’t know until you try. That being said, I’ve found that these medications tend to work best in the early stages of hair loss. So while I’m hesitant to “guarantee” anything from the medications, I’d suspect you’d have a better chance at seeing benefits than someone that started the medication after losing hair for 20 years.

Selective patients for these studies would discredit the studies. Minoxidil is very effective in about 15% of patients and mild benefits can be seen in half of those who are thinning in the crown (more stats here). With regard to the frontal area, the reports indicate it is less effective than when used on the crown.

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Hair Loss InformationFungal Infection In Recipient Area a Month After My Transplant – Hair Loss Information – Balding Blog

Hi, I received a hair transplant FUE type, nearly two months ago. I am a male and aged 46 years. After the first month i developed bumps of dry scalp on the transplanted area only. The Doctor stated that this was a fungal infection, so i started using Nizoral shampoo after using this shampoo for 15 day’s the condition has cleared. My question is, will this effect the hair transplant and the growth of the graphs, to become a successful hair transplant.

Thanking you for you professional advice.

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I’ve never seen a fungal infection following a hair transplant, so I have no experience with this type of situation as a point of reference. I would think that if the infection is gone it should not impact your hair growth, particularly since the infection occurred a month after the transplant. That being said, I would ask these questions to your surgeon and hope for the best!

If one of my patients had a fungal infection, I would get the opinion of an expert who works with fungal infections (perhaps a dermatologist). Good luck.

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Donor Scarring from Hair Plugs Done About 30 Years Ago – Hair Loss Information – Balding Blog

Thirty years ago I had 4 or 5 sessions hair transplant sessions done using the old punch graph method. For most of those years I was fairly satisfied. Lately that has not been the case. The appearance of corn rows is starting to show in the front and it is getting harder to cover up the donor area in the back. Twenty years ago I spoke to a specialist in Philadelphia who disappointed in the methods used in my procedures and he implied that I was not a good candidate for future transplants. If this is the case I would prefer to shave my head instead of continuing trying to cover up, which can only become more problematic in future years.

The scarring at the donor site is a concern. Are there any procedures to reduce this scarring? Thank you in advance for any information and/or advice you can give me based on this limited description.

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We have routinely performed surgeries for men who are in your situation. You can read about one patient’s journey here and see some of my repair patients here.

As you undoubtedly know, everyone is different and unique so I really cannot comment on your particular case without examining you. Many patients who had 4-5 sessions of the old hair plugs have heavily depleted donor areas, and a skilled surgeon with experience in this field can often soften the plugs by harvesting the recipient plugs as well as redistribute some of the remaining donor area. If you want to explore options, please send me photos and set up at the least a phone consultation with me.

There is no simple answer to your problems, and each person must be evaluated one on one before recommendations can be made. This goes for both repairing/removing the “corn rows” and seeing what can be done about fixing the donor scars.

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Hair Loss InformationDoes a Hairline Shift When Closing a Strip Procedure? – Hair Loss Information – Balding Blog

Hi, doc. I’ve been researching hair-transplantation, and I have a question concerning F.U.T. (strip-harvesting): I understand, in this method, a strip is excised from the back of the scalp, the wound then closed. I wonder, then, is not the overall surface of the scalp reduced in this procedure? After two or three procedures, especially, (or even after one large session) — when, totally, a reasonably wide portion of the scalp has been removed, will not a patient’s hairline, in accordance, also be shifted?

That is, the front hairline would move back by the amount of scalp excised, or, more likely, the “rear hairline” (which ends at the back of the neck) must certainly be “moved upward.” At least, this is how I imagine it would be. Is my logic flawed? I’ve been trying to understand this in researching the procedure, but the point still evades me.

I understand a physician will take into consideration laxity of the scalp, so what I’m talking about might not be immediately noticed — I also hear doctors will try to cut out strips that are longer rather than wider, to reduce tension — but, ultimately (again, especially when a large number of grafts must be harvested), will not the hairlines (front and certainly rear) be affected? If not, why not? If so, is this effect permanent? The piece of scalp taken out can’t “regenerate,” can it (and, if it could, would it regenerate hair follicles, too)?

Sorry for this long question, but certainly I’d appreciate your taking the time to answer. Thank you very much.

P.S. Just one other question (a brief one): Can hair that’s already been transplanted to a new location be removed and successfully retransplanted in another area (e.g., back to front, then, later, if need be, north of that region)?

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The hairline never shifts, but the scalp itself does stretch a little with each procedure so that the donor density reduces a bit. I’ve answered a similar question before.

Neither the front hairline nor the neck hair moves as a result of these excised areas. The only part of the scalp that is impacted is either the posterior scalp (which would be stretched) or in a small group of these patients, the redundancy of the scalp (scalp laxity) reduces. The scalp is attached to the galea and then to the skull. This keeps the movement from one area to another minimal, if at all. Scalp and follicles can’t regenerate.

As for your P.S. — Yes, we often move previously transplanted hair when the work is not good, but there are limitations to moving a great deal of transplanted hair. This is commonly done in repair procedures.

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Hair Loss InformationIn the News – Prince Kept His Hair By Playing Guitar? – Hair Loss Information – Balding Blog

Snippet from the article:

PrincePrince believes playing the electric guitar has stopped him from going bald.

The 52-year-old pop legend – who can play 27 different instruments – is convinced the electricity that flows through a guitar when he strums it is the reason he still has luscious locks.

He said: “Playing electric guitar your whole life does something to you. I’m convinced all that electricity racing through your body made me keep my hair.”

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Read the full story — Prince: Playing the electric guitar prevented hair loss

So there you go, folks. The secret to keeping your hair — learn the guitar. Be sure to get a nice electric guitar with a huge, loud amp (bonus points if you live with people that are not musicians, since they will love to hear you learn).

I’m kidding, of course. Hair loss is from genetics… not electricity racing through your body.

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Hair Loss InformationI Just Moved and Now I’m Losing Hair – Hair Loss Information – Balding Blog

I recently moved to US (bay area) and have been noticing a lot of hair fall. Slightly pulling my hair causes them to come out. I have no serious illness etc. What could be causing the increased hair loss?

Thanks!

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It could be a variety of things. Perhaps it is your genetics and the timing was coincidental to the move… or it could be stress-induced (moving can do that)… or it could be allergy… etc, etc. I really have no way to know based on your email with limited information. You should see a doctor if you’re concerned.