Author: Dr. William Rassman

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Do I Have a Funny Hairline or Am I Going Bald? – Hair Loss Information – Balding Blog

Hey so I’ve always noticed that the right side of my hairline goes up a little farther than my left side. I’ve also noticed that the temple “triangle” has been shaped differently. As long as I can remember (and looking back at photos from when I was in HS), my hairline has never been straight. My maternal grandfather had a full thick head of hair, but my grandmother’s father was bald (on my moms side).

Is it possible that I have just a funny hairline and that I’m not going bald? All around my head the hair seems to have a uniform thickness and I really only see some hair in my towel after I shower. How can I tell if my hairline is pushing back?

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TowelYou’d have to take measurements and compare them over time to see if the hairline is receding, but having an asymmetrical hairline isn’t unusual and doesn’t necessarily mean you’re losing your hair.

As for seeing hair on the towel — that can be normal. We lose 100-150 hairs a day normally as new hairs grow in. With styling product in your hair, sometimes those hairs can get trapped on the scalp and a hot shower will break up the gel or whatever you might use and release those hairs… and the towel or the drain is usually where you’ll find them.

Photo source: Flickr

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In the News – Humans Regrowing Body Parts – Hair Loss Information – Balding Blog

Snippet from the article:

Researchers have found that the gene p21 appears to block the healing power still enjoyed by some creatures including amphibians but lost through evolution to all other animals. By turning off p21, the process can be miraculously switched back on.

Academics from The Wistar Institute in Philadelphia found that mice lacking the p21 gene gain the ability to regenerate lost or damaged tissue. Unlike typical mammals, which heal wounds by forming a scar, these mice begin by forming a blastema, a structure associated with rapid cell growth.

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Read the full article — Humans could regrow body parts like some amphibians

Essentially, their research shows that blocking this gene will cause cells to act like stem cells, which would allow them to create new tissue rather than just heal the damaged tissue. This, of course, is incredibly early research and has not been studied in humans. We’ll see where this goes.

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After a Week on Propecia, My Hair Doesn’t Come Out When I Pull It – Hair Loss Information – Balding Blog

Recently restarted Propecia on Dr. Bernstein’s advice. After one week, pulling out crown hair takes as much effort as hair in the permanent zone. Previously crown hair would come out with the slightest of force. Now it really hurts to pull crown hair like permanent zone hair. Does this mean it is working? Pity is, not much crown hair is left.

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It probably means that the Propecia is working, though it might be a bit late for you though. I have reports from patients that have started the medication and saw their hair loss stop cold in just a few weeks. My advice — stop pulling on your hair.

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The Master Plan as I Continue to Bald – Hair Loss Information – Balding Blog

I’m a Class 4 evolving to a Class 6 pattern. My concern is if I have a transplant now and am happy with the result, but the hair loss pattern continues to a Class 6, that I may find myself chasing this problem for potentially many transplants and then run out of donor hair and regret the decision altogether. I’d hate to have an un-natural hair loss pattern many years from now because of this. As I understand it, you can do a test to map the scalp for miniaturization which can help in developing a long term Master Plan and help determine if the hair in the donor area is healthy and how much is available for moving. Can you comment ?

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After mapping out your scalp for miniaturization and knowing your donor density, scalp laxity, and your hair and skin characteristics, I can usually tell where your hair loss pattern is going. Your question is appropriate about a long term Master Plan. Generally, if we transplant the frontal area to a line drawn between your ears, that area can almost always be made to look normal and the density in that area is something that is worked out with your surgeon. The area from the line between the ears to the very back of your head (the crown area) is significant if your density is low. If your density is average or higher and you want the back of your head transplanted, we must ascertain the available donor supply to do that in a worst case scenario.

If you take drugs like Propecia (finasteride) then the hair loss to a Norwood class 6 may be improbable. Most of our patients focus on the frontal area first, and then based upon desire, the crown if there is enough donor hair to manage a possible expanding crown. A frontal to mid-head reconstruction works for most people, as the man in the mirror is who most men want transplanted. Under a worst case scenario where you progress to crown loss, you can look perfectly normal with a full front and a thin or balding crown (which can be covered like this patient did).

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Hair Loss InformationIn the News – Baldness Good for Your Health? – Hair Loss Information – Balding Blog

Snippet from the article:

A receding hairline can be a good thing, according to US scientists, who say men who go bald by 30 appear to be less likely to develop prostate cancer.

Researchers at the University of Washington School of Medicine studied 2,000 men aged between 40 and 47. They were able to link high levels of the male hormone testosterone in those who lose their hair earlier with a lower risk of tumours. The findings are published in the journal Cancer Epidemiology.

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Read the full article at BBC — Baldness ‘could be good for your health’ say scientists

This article runs contrary to a report published just over 10 years ago in the Journal of the American Medical Association that pointed out that men with only vertex balding in the crown had a higher incidence of heart disease than the general population of no-balding or full-balding men.

Studies like these are interesting, but they’re really more about polling and compiling the data than trying to make a definitive connection. One group reports their data says X, and another group reports their data says Y… which means there’s a lot of room for disagreement and further study. Plus, an important note that the article does point out at the end — “The results hinge on asking men between ages 40 and 70 to remember whether their hair was thinning when they were 30, which does not provide a very reliable measurement“.

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I Got Gum In My Hair – Hair Loss Information by Dr. William Rassman

Hi, about two months ago I got gum in my hair and my girlfriend ripped it out and with it came a chunk of hair. I didn’t worry about it all that much because you couldn’t really see the bald spot because my other hair covered it pretty well. Well it’s been two months and I got a buzz cut and now I still have a quarter sized bald spot a little bit above my left ear. How long will it take for this hair to grow back? Will it even grow back at all? I’m starting to get worried about permanent damage seeing as how it’s been two months and it’s still as smooth as a babies butt. Thanks.

GumThe hair should grow back within the next few months. I have seen many cases of a one-time hair pull before (from a fight, mugging , gum situation, prank gone wrong)… and the hair has always regrown. You’ll just need to be patient.

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Prescribing Medication to Canadian Patients? – Hair Loss Information by Dr. William Rassman

Hi Doc,
I am a Canadian and will be in Los Angeles in two weeks time. Would you be able to prescribe me Proscar even though I am not a U.S. citizen? Is there a cost to visit you for a prescription and miniaturization mapping??

First, we should set you up with an appointment to be sure I can get you in on the day you want to come in. You can contact my office at 800-NEW-HAIR (or 310-553-9113). The consultation is free and includes a mapping of your scalp for miniaturization. If I prescribe medication, there is a $85 (USD) fee. The prescriptions can generally be filled in the US and most Canadian pharmacies recognize an American doctor’s prescription.

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Scoliosis and Hair Loss? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman, how goes it? Thanks for taking the time to update this blog, much appreciated.

I was wondering if scoliosis would have any effect on triggering MPB or hairloss in general. My sternum is under chronic pressure and stress which causes constant discomfort. I’m 24 years old and have had scoliosis for about 11 years. Both sides of my family have moderate to no balding and my father does have slight thinning in the crown. The unlucky family members who did encounter hairloss didn’t experience it til well past 40, even 50. I’m experiencing some diffuse thinning (still have juvenile hairline) and minor thinning in the crown that has been noticeable since I was 16-17. Luckily balding in the crown hasn’t progressed rapidly, but is certainly present.

Oh, one more thing. Stress is a cause for hairloss, but how so physiologically? For example, does stress cause insufficient nutrition to the follicles or an increase in DHT?

Hi! It goes well. Thanks for asking.

Scoliosis (spine curvature) has no direct relationship to hair loss, but stress can play a role. Clearly, you sound stressed. The mechanism for the stress-induced hair loss is unknown. You are the type of patient I would love to see, build a Master Plan for and help. The one-on-one relationship with a good doctor is the best way to start your search for a cause of your hair loss. Assuming genetic hair loss is the cause, Propecia (finasteride) is the best thing to initially do for a 24 year old. The hair loss gene can skip generations, so I don’t know how far back in your family tree you were looking…

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Concerns About NeoGraft – Hair Loss Information – Balding Blog

NeoGraftJust after I published a post about the NeoGraft tool, a phenomenon began occurring in the community. I’ve been seeing an increasing number of press releases that get brought to my attention from readers and from Google Alerts, announcing that some doctor with no experience in the art of hair restoration is now the first in his area to offer hair transplant surgery using this new NeoGraft tool. It could just be due to the marketing efforts of the makers of NeoGraft or it could be doctors following other doctors in issuing these press releases (and also the machine being shown on the Rachael Ray show)… but some of these physicians often have no real training, and this machine offers them another source of revenue with the ability to do what we have been doing manually.

Michael Oakes, president of NeoGraft Resource Group (makers of NeoGraft), even brags about the ability to sell the tool to doctors that have no prior experience performing hair transplants. In his Plaxo.com public profile, Oakes writes that the NeoGraft machine “opens up opportunity for non transplant physicains [sic] to add to there [sic] exsisting [sic] practice.” This is quite alarming to me!

I am writing this as a warning for those who are considering a NeoGraft transplant. Some additional comments that Dr. Robert Bernstein made on his site about the risks of the NeoGraft tool suggest real problems that will, almost certainly, produce failures of the transplant. I have seen one such failure recently from an experienced surgeon who used it. If you’re still considering having surgery with this tool, just be sure to check out the technology and the doctor who is performing it. Ask about the physician’s training and also ask to meet some patients who have had successful hair transplants with this tool. The proof is in the pudding.

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Placement of Grafts to Create a Natural Hairline? – Hair Loss Information – Balding Blog

I had a hair transplant done over a year ago. My hair grew in great but I feel my hairline is a little too far back. I would like to move it forward 3/8 of an inch. I understand when creating a hairline it looks more natural when grafts of single and double hairs are used. So my question is how far back are the grafts of single and double hairs placed? My concern is whether or not I could the procedure done by the means of the strip method or would I have to get it done with the FUE method? (Also, do you have a rough estimate of how many grafts would be needed? Medium course, fairly straight, blonde hair)

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At the very least, I would need to see a good digital photograph with your eyebrows lifted high so that the forehead creases are visible. This would help to determine placement. Some surgeons do not put single hairs in the front, so I can not comment on what you had done without seeing you. Clearly with a medium coarse blonde hair, you should require less grafts than those with darker fine hair, but again, I would have to see how wide the area which will be transplanted has to be lowered to meet your goals. Follicular unit extraction (FUE) or strip harvesting can address a transplant successfully.