Dr. William Rassman – Page 1212

March 2, 2010

I’m 21 Years Old and Had a Hair Transplant 10 Months Ago – Balding Blog

I read your posts everyday and I would like to thank you for educating me and keeping me up to date. I’ve noticed several different times that you say there is no official age limit for a hair transplant. I would agree. I’m 21 years old and I had a hair transplant 10 months ago. For the first six months things did move pretty slowly but I would like to say things are going great now. My hair is looking better than it has in years and should continue to get even better. At the time of the transplant my hair loss was an advanced Norwood 3. I had been on propecia for 12 months. My density is slightly above average and I have a lighter medium course hair. With all that being said I still don’t know if my doctor would have performed surgery on me had I not been as educated as I was.

My biggest piece of advice for all of the younger readers out there who are serious about getting a hair transplant is you have to be informed and know what you’re getting into. You have to understand the process; see if your hair loss is more than just a maturing hairline, find out how good of a candidate you are for the surgery and be able somehow finance it. Also, find a good caring doctor.

Obviously, if a teenager doesn’t like his maturing hairline, that doesn’t make him a candidate for surgery… but the “rules” about minimum age for hair transplantation are flexible to a point. As a physician, I won’t perform a procedure that wouldn’t be in the best interest of the patient down the line. Not all doctors follow these same guidelines, but educating yourself is key to not becoming a victim. Nobody should ever rush into a hair transplant, because this is a permanent procedure! I’m glad you found the site helpful and I hope your grafts grow in nicely.

March 2, 2010

My Hair Texture Has Recently Changed — Was it Stress Related? – Hair Loss Information by Dr. William Rassman

I have noticed a loss of hair and a change in texture in the last two months. I have been taking propecia for years and never had any trouble. I have been stressed and also cut my head open in a perfect vertical line in the front of the scalp. Could these be the reasons or is something else possible? There really is a difference and it is beginning to worry me. I have BDD and this is actually affecting my life. Thank you for your time.

Situations like this are why you need to see a doctor who will create a Master Plan for you. I don’t know the definitive cause of your texture change, though stress and injury could be contributing. That being said, body dysmorphic disorder (BDD) patients really need a good doctor or the imagination runs amok.

Paid advertisements (not an endorsement):

March 2, 2010

Youngest Person to Have a Hair Transplant? – Balding Blog

Hi Doc,
Firstly I would like to say great site!I have two questions:

This is speculative but could be me in a few years: I know that you are not reluctant in performing transplants to you people, but if a 23 year old male came into your office having taking propecia for 4 years with a norwood class 4A balding pattern would you carry out the transplant if this person insisted and that a master plan had been established?

What is the age of the youngest person that you have performed a hair transplant to?

NW4A If there is a balding pattern like a Norwood Class 4A, no matter what the age, he would probably be a candidate for a hair transplant provided that:

He had enough maturity and knowledge at hand with realistic expectations.
He understands the financial short and long-term nature of paying for the process.
His examination shows that he has the required donor hair to meet his needs.

As for the youngest… well, I have done hair transplants in a few children as a result of accidents, brain surgery, and birth defects. These are unique cases and not like re-establishing a hairline or crown swirl.

March 1, 2010

Still Losing Hair 7 Months After Starting Propecia – Hair Loss Information – Balding Blog

Since starting propecia 7 months ago, my hair loss has become significantly worse. In the 3 to 6 month period, my temples and mid-anterior scalp became noticeably thinner. Although “shedding” in these frontal areas slowed down/stopped at the 6 month stage, my crown is now thinning even though I had not noticed any hair loss in that area before beginning propecia. I have 3 questions:

is it possible that propecia is making my hair loss worse-has this ever happened to a patient of yours before?

is it possible that this shedding is a positive sign because I am young and in the early stages of hair loss i.e. as the drug has a lot of hair to act upon? Doctor Bernstein states on your website that shedding is fairly common and can be a positive sign.

is it common for propecia to take over 6 months to yield noticeable effects i.e. stopping hair loss and/or creating regrowth, or should I stop the drug and save my money?

Thanks

Block Quote

Your hair loss on Propecia probably has nothing to do with the drug, but rather the progressive nature of your genetic hair loss which (based on what you wrote) seems to be aggressive. Shedding at 9 months is not a good sign.
At 1-2 months shedding can be a positive sign as we interpret this as an acceleration of the normal hair cycling, but that acceleration should not occur over 9 months. Most people will see a reduction in shedding by the 4th month.
It generally takes about 6-12 months to see the difference after starting the medication. So you’re still in the time frame and I wouldn’t suggest stopping the medication at this point unless you have experienced any side effects that you can’t deal with.

March 1, 2010

Regrowing Stress-Induced Hair Loss? – Hair Loss Information – Balding Blog

Dr. Rassman,
I’m 28, been on propecia for 8 yrs with Diffuse Pattern Alopecia in the front. The drug has done a wonderful job at holding the loss. I wrote a couple weeks ago inquiring about upping a dose from 1mg to 2.5mg. My loss picked up in speed a couple months ago and from what I guess has slowed down the last few weeks. I had a chronic stressor 3mo. before the loss. I noticed about a month ago there was hair that appeared to be growing in my hairline, and in my thin area. I’ve monitored it every so often and noticed that it still is growing longer.

Can a person with genetic balding grow hair back after telogen effluvium or other stress related loss? If so, that would be great but i’m under the impression that when someone loses hair, stress or not, and also is destined to genetically bald, there is no way the lost hair will grow back. I’m hoping you can explain it better. I would be happy if theres a shot at getting a few back after that loss. Thanks for the sight, its been great having access to such information coming from a professional such as yourself.

Block Quote

Stress Telogen effluvium usually reverses by itself as the hair moves from telogen to anagen (see hair cycle info). This cycle varies between people, but usually the telogen phase lasts 3-7 months. Genetically impacted hair also cycles, so the answer to your question is that the finer hairs that are miniaturized will cycle and return, unless the time for apoptosis (timed hair death) occurs.

You do have a shot at regrowing your hair, but I can’t say how good that shot is. Only time will tell.

March 1, 2010

Gray Hair Diameter, Follow-Up? – Hair Loss Information – Balding Blog

Re: Gray Hair, Changing Diameter?

Did you ever do the measurements? I looked, but couldn’t find a follow up.

Block Quote

Gray No, I never did a follow-up to determine if the diameter of gray hair is thicker than non-gray. Sorry about that, but I find that I have too many projects going on to add a study into the mix. I know that’s a poor excuse, but I hope to find the time to do it at some point. I just shouldn’t have put the “few weeks” timetable on it.

Oh, and if there’s been a study regarding this that’s already been done, feel free to point me to it.

March 1, 2010

In the News – Simple Hair Loss Q&A – Hair Loss Information – Balding Blog

Snippet from the article:

Hair loss may sound relatively minor but it is both distressing and common. It should always be investigated, as it can be revealing in regard to your general state of health.

Block Quote

Read the questions and answers — Hair loss isn’t just a nuisance

This is one of those articles that doesn’t really offer anything new (just a heads up for regular readers of this site), but it does condense some of the more common questions into easy-to-digest answers. The topics covered are: hair loss after child birth, hair loss from stress, fungal infections, alopecia areata, thyroid problems, and medication induced hair loss.

March 1, 2010

Trichophytic Closure, Hair Transplant Scars, and Scalp Tattoos – Balding Blog

Hey Dr. Rassman,

I must tell you that your blog has become an important part of my daily routine and can not thank you enough for your continual work on it. I know you probably have your reserves about this head tattoo procedure, but how about getting it done just on the scars from a HT procedure, it seems like a great way to cover up scars for people who want to shave their heads, especially on the sides and back, where you do not have to worry about losing hair. I am thinning on the top and receding and I am hesitant to get the procedure done on the top of my head in case i ever want to grow my hair out again and continue receding, but at least on my HT scar it makes sense? What are your thoughts? Thanks.

Tattoos can work if they are stippled so that they look like hair, but changes in color of the tattoo can be a real problem (imagine a green tattoo over time). As I understand it, most inks won’t change color, but from the few patients I’ve seen with a tattooed scalp that hasn’t been the case. Be sure to research the tattoo issue, as I’m not that informed about the various inks and methods.

I am not sure if you had a hair transplant and have a scar or if you’re considering a hair transplant and are worried about the scar. In either case, scars can be largely prevented most of the time, but if you have one, a revision of the scar (at least one attempt) should be made. Each case is different, so a good doctor is what you want to have. Ask your doctor about the frequency of scars and the sizes that he/she sees. Consider sending me a photo of your scar if you have one.

The photo below is a 4 year old scar after a single procedure of 2090 grafts done here with a trichophytic closure. There is a scar, but it is barely noticeable, typical of trichophytic closures in my hands. Click to enlarge.

February 26, 2010

Hair Loss InformationRockstar Hairlines – Hair Loss Information – Balding Blog

I am slightly curious as to why many rockstar’s have such great hair and i can never tell if their hairlins is juvenile. I dont suppose you can tell me what class is Ian Watkins from lostprophets (Rock band) hairline appears to be?

To me it looks low at the middle but thinning on the sides? This man has always had a great head of hair and i dont think he is balding..just on this picture particularly it made me wonder though.
Photo: Ian Watkins

Thank you very much for your time Doc.

Block Quote

Chris Daughtry and Moby I looked at the photo of Ian Watkins, but it’s difficult to tell from one angle like that. I then used Google to try to find more photos, but all of the ones I see have his hair longer and covering the hairline. So truth be told, from the photo you sent it looks like a typical mature hairline, but I really don’t know for sure. I doubt he’s got any balding beyond that. He’s got good hair.

As for why rockstars have great hair, well, it is part of the image. There are always going to be musicians that have hair loss, but many of them will shave their heads bald, wear hats, take unique approaches to styling, or go the surgical route to restore their hair. I’ve performed transplants on musicians that want to keep the look their fans are accustomed to. Many record labels are more willing to sign a band if they have the image that goes with the marketable sound.

A guy like Art Garfunkel (of Simon and Garfunkel) probably would have a tough time getting signed on his own in today’s music business, but a rocker like American Idol runner-up Chris Daughtry can shave his head and be just fine. I’d imagine if Daughtry grew his hair out and showed off his thinning hair, it could make him appear older than he is and thus would not be easy to market in the way the record label wants to. Some other musicians have long hair that falls forward, covering the corners of their hairline and giving the illusion of a young, juvenile hairline. Then there are artists like Moby, who shaves his head but leaves just enough growth to see that there isn’t much hair there at all. Different looks work for different types of artists. It’s all about the marketing.

Update: Actually, TMZ says that Daughtry is growing his hair out now, but we’ll see what his scalp looks like when its time for an official photo shoot or when he’s making a music video.

February 26, 2010

Hair Loss InformationMasturbation and Hair Loss – A Different Perspective – Hair Loss Information – Balding Blog

Once and for all, in regards to thousands of emails i imagine you get, i have a question for you. I can see there is a miscommunication with the emails you receive regarding matsurbation and hairloss. The way people are wording the emails they send you such as ‘does masturbation cause hairloss’ isn’t what i think their trying to convey. My question is as follows:

I UNDERSTAND that masturbation doesn’t CAUSE MPB/hairloss/genetic hairloss, however for the people who are loosing there hair due to MPB can masturbation exacerbate their hair loss (make it worse). Put simply, the only cure for MPB would be castration (removing the testicles). To gain an erection and to ejaculate you need your testicles, so they can perform their functions to enable erections. So logically, if your stimulating your testicles to perform its functions such as:

-producing sperm (spermatozoa)
-producing male sex hormones of which testosterone is the best- known

your increasing testosterone inturn DHT and other androgens. So if castration is a cure for MPB they only thing you can do is try and replicate what casturation does (it stops you from being able to ejaculate) SO in conclusion try to limit sexual activity (which will reduce androgen activity and you can help to reduce its effect towards MPB

thank you for your continued replies NHI. great work!!

Block Quote

Pants If you are asking about what happens after one loses his testicles from castration, well, there will be no desire or ability to masturbate unless you take exogenous testosterone. I do not have experience with removing the testicles on anyone, so the subtleties of what you are asking are not my cup of tea. If you really want to know the answers to those questions, ask doctors who do sex change operations (male to female). They would know by experience, as sometimes they remove the testicles before they remove the penis.

If you are asking if a balding man increases his masturbating habits or sexual activities, will he accelerate his hair loss… I believe the answer is no. Theory is one thing, but to prove it is another. I’ve seen no such proof. Also, I posted a story about a year ago regarding China’s last eunuch going bald, so that is some food for thought — see here.