Author: Dr. William Rassman

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My Hair Loss Started Suddenly at Age 62! – Hair Loss Information – Balding Blog

I’m a healthy 62 yr old caucasion male. Throughout my life time I have enjoyed a full head of hair. Over the past month to two months, I have noticed significant hair loss in the front of my leading to baldness. I am concern for the abruptness that I started losing my hair. Is this unusal to happen at my age? I’ve been taking blood pressure medicine for the past several years as well as tamulosin and cholesterol medicine. I do not abuse drugs or alcohol. Thanks for you answer

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Genetic hair loss can start at any age, but as you suggested, this is unusual. If your medications have been the same medications you have always taken, then it is unlikely that they caused the recent thinning.

You should have your scalp mapped out for miniaturization to determine if you are miniaturizing hair and will progress with the balding process. I know if it were me, that I would want to know why I had it and where it is going, but that would best be determined by a visit to a focused doctor in the field.

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Actor Taylor Lautner’s Hairline – Hair Loss Information – Balding Blog

Taylor LautnerHello Dr Rassman, just a quick one here. Does Taylor Lautner look to be displaying the signs of early MPB, or is he simply sporting a mature hairline? What Norwood class do you think he would he be?

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I had to look up who this young man is (he’s in one of the Twilight movies), but it looks like he’s got a normal juvenile hairline, so a classification for hair loss does not apply. His rounded corners, which is typical of an immature hairline, has been lost in his recent photos but otherwise, I suspect he had the exact same hairline at 12 years old. There’s no early balding from the photos I’ve seen. He’s young though, so who knows where his hair will go.

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If My Juvenile Hairline Was Asymmetrical, Will My Mature Hairline Be Too? – Hair Loss Information – Balding Blog

Hey Doc,

My juvenile hair line was asymmetrical. The right side of my hair line was higher than my left.Now im starting to develeop a mature hairline. Do you think my mature hairline will be asymmetrical? Have you ever seen a asymmetrical mature hairline?

thank you for you great site.

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Only time will tell. It is possible that when and if the juvenile hairline is lost, that you will balance out what you see.

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Hair Loss InformationPropecia Benefits Won’t Last Forever? – Hair Loss Information – Balding Blog

Note: I believe these were from two different people, but the questions are related so I’ll answer them together…

Email #1

Now doc , i have a suggestion to make just like you do.You write “Every person will eventually lose the benefits of this drug, but the open question is when” – there is no proof for this , or you do have one ? Even if this statement is based on your experience , you are aware that this is not official and there is not way to be.The official one is that after 5 years only 10 % of the people lose some hair , and please attention – more of teh 50 % of the rest CONTINUED to improve even after this.So unless you can prove the opposite ,please flag those ones as “my opiniion ” or “may” or “might ” , but please do not make statements which are neither proven nor stuided in the medical literature – 10x

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Email #2

Why do you recommend Propecia to people that come to you for hair transplants if the effect is only temporary? I just ask because you emphasize a master plan for long term benefits, and it seems like as soon as the drug stops working, the hair it saved will fall out and the patient will have that embarrassing pluggy look -bald head with transplanted hairs. Isn’t it setting up people for more misery to take a drug that temporarily grows their hair back, only for it to fail and then they experience going bald again?

Thanks for your time

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Read the official study posted at Hairlosstalk.com and you can draw whatever conclusions you want from it. I believe that this drug has a forever component, but that does not mean that it will hold all of the initial benefits forever. Each person will react differently and I can’t give an exact timetable for when you’ll start to see thinning continuing (if ever). So yes, the medication does work “forever” as long as you continue taking, but the benefits may eventually appear to be less. It could be 5 years, it could be 20 years. The only facts at our hands are in the official Merck/FDA studies.

Propecia’s benefits aren’t quite temporary. It’s not just going to suddenly one day turn itself off 100%. The entire point of a Master Plan is to create a roadmap for a worst case scenario of hair loss so that nobody is taken by surprise if the progressive nature of MPB becomes more evident a decade after you start Propecia. With the modern hair transplantation, the “embarrassing pluggy look” you described shouldn’t occur.

Propecia is a miracle drug for many people, as it gets them some (or a lot) of their hair back… and it largely slows or stops the hair loss. Many of my patients swear by this medication. This is a type of medication in that if it grew hair back and stopped or slowed hair loss, them some benefit will probably last ‘forever’. Of course, you can test this by just stopping the drug and seeing what happens. Most people who saw substantial benefits and then stopped the medication saw hair loss, which suggests that the drug had some residual value. The alternative is that you can elect to take your natural balding process to its conclusion, reflecting your genetic makeup. Your choice, of course.

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Hair Loss InformationIs Minoxidil Giving Me a Tired, Darker Appearance? – Hair Loss Information – Balding Blog

Dr Rassman, I have been using minoxidil 2% for over 12 months with ok results but have noticed a change in my eyes. The lids are thicker and my eyes look darker, tired. The skin above my eyes also seems less smooth and hangs lower. Do you think is could be Minoxidil or something else. Thanks

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MinoxidilI don’t know how to answer your question without knowing more about you. How old are you, for example? If you are 60, maybe you are having changes that are age related and are now just noticing it. If you are 20, well that is a different story… but without seeing you myself, I don’t know.

Minoxidil should not impact your eyes or skin color on your face, but there are comments on an old post that would tend to disagree with that. Take those comments with a grain of salt, as none of them are independently verified and could just be people messing around or confused about the cause of their change in appearance. There might be something else going on, so I’d talk with your dermatologist.

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Hair Loss InformationTransplanting Hair Into a Cranial Morcellation Scar – Hair Loss Information – Balding Blog

I have a scar that is about the width of my pinky finger that goes from ear to ear on my head. This is a result of a surgery I had done when i was younger from cranial morcellation of my skull. I was wondering if there is anyway to get hair put into this scar.

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There are ways to address such scars, including hair transplantation (in some people) or scalp surgery by those who are experts in the field. From what you described, I can not tell you which way to go, but scar repairs from brain surgery is one of the areas where what I do works very well. I need to see some good digital photos of the scarring and possibly would need to meet you to examine your head before giving any real options. Tentatively though, it does seem like you have some options.

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Hair Loss InformationAzor, Toprol-XL, and Hair Loss – Hair Loss Information – Balding Blog

Hi,

I am currently taking Azore for high blood pressure and occassionally toprol xl for heart palpatations. Can these medicines cause hair loss of a significant nature?

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Azor (amlodipine and olmesartan) does list hair loss as a possible side effect. Taking Toprol-XL (metoprolol succinate) can also lead to hair loss in rare cases, as we’ve mentioned before. With the combination of these two drugs, you do have a higher likelihood of seeing thinning hair.

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If I Have Increased Libido from Propecia, Does That Mean I’ll Lose Hair? – Hair Loss Information by Dr. William Rassman

Drs

I have recently started a course of Propecia. Based on what I’ve read, I understand that the drug can, in rare cases, cause sexual side-effects, namely decreased libido, reduced ejaculate and even erectile dysfunction. I’ve found that it has had the reverse effects on me, that is, it has heightened my libido and increased my ejaculate, as well as the frequency with which I get erections.

Does that mean that the drug will, in my case, also have a reverse pathology on my hair loss (that is, make me lose more hair instead of arresting the hair loss process)?

Congrats! You are one of the few people with a good side effect appreciated by some men (but not all women married to those men). The results on saving your hair have no correlation with the sexual side effects of finasteride one way or the other.

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NeoGraft, a New FUE Instrument – Hair Loss Information – Balding Blog

Can you tell me about the Neograft technology. Is it better that what is out there?

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NeoGraftAutomation of the hair transplant process has been a goal of doctors from the earliest part of their career because of the tedious manual processes used today. In particular, with the large sessions, fatigue becomes a problem and the skill sets required of the staff take years to acquire proficiency.

I have been a pioneer of many of these devices, receiving patents on some of them. Included was the Carousel, and a series of follicular unit extraction (FUE) techniques devised for faster extraction. The NeoGraft machine is just one of the newer devices, but unfortunately it has its problems.

NeoGraft uses a vacuum system to assist in the removal of grafts that are first partially dissected with a sharp punch. The grafts that are “sucked” out of the scalp are collected in a chamber. The grafts are then removed from the chamber and drawn up, again by suction, into a needle and then injected into pre-made recipient sites using air pressure. The NeoGraft seems to eliminate some of the risks of mechanical injury to grafts in traditional FUE by not requiring forceps to remove grafts from the donor site or insert the grafts into the recipient area and, in theory, may save time by eliminating the need to extract grafts manually. A concern expressed by those who have seen the system in action is that the suction removal has a tendency to strip the surrounding tissue from the lower portion of the grafts or pull out just the upper part of the graft. Because the grafts are exposed to a great deal of air movement, the continuous flow of the vacuum adds to the risk of graft drying, a problem well known to be a major cause of poor graft survival. To our knowledge no independent studies have been performed to show that grafts are not harmed by this vacuum technique and it is our concern that the drying action of the air on the exposed grafts may limit their growth. As many of the grafts are stripped from their fat, the risks to the grafts are theoretically significant.

Restoration Robotics (RR) has a better way to do this with a robot, but it is not yet on the market and it will most probably be very expensive. RR have been successful at doing FUE, although slowly, but they have yet to demonstrate an ability to place grafts mechanically.

There is no substitute to learning and mastering the manual skills that are used in the best hair transplant clinics around the world. So without a good automation instrument, many of the doctors who use an unproven method for hair transplantation just makes the risks to the hair transplant procedure greater and the work by the doctors who use them possibly second class. Would you buy grafts from a second class surgical team and pay the consequences of poor growth?

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I’m Scared That Propecia Could Make My Hair Loss Worse Before it Makes it Better – Hair Loss Information – Balding Blog

I was recently prescribed propecia(finasteride) for hairloss. I am 24 years old. My hair is still thick but I have mild thinning at the crown of my head and some thinning in the mid scalp. I do have a receding hairline. Can Finasteride aggravate more hairloss at the front and hairline? I have read on numerous websites that it can cause more hairloss at the hairline due to the rise in testosterone. is that true? I dont want to take finasteride if it will make my hairline or hairloss even worse. Why do people claim that propecia makes there hairloss worse sometimes.

Why would merck make a drug designed to help hairloss, instead it make sit worse. Are these claims true? Does Testosterone on its own cause hairloss, or does it have to be converted to DHT to cause hairloss? For example, hypothetically lets say some has genetic balding in there genes and hypothetically he has 0% DHT, but he does have testosterone, can the testosterone on its own cause hairloss?

I asked my derm this question and he has no clue, and I have no idea how he he is qualified to be a dermatologist, so thats why I am asking you these questions. You seem to be an expert on hair restoration.

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Propecia (finasteride) won’t produce more balding in the traditional sense. On rare occasions, there have been reports that some hair shed may occur in the first 2 months of taking this drug, and if/when this occurs, it is thought to reflect an acceleration of normal hair cycling. That’s what I mean by it not being hair loss in a traditional sense. The shedding is short term and after the 1-2 months that it has been observed, a significant reduction in shedding occurs as the benefits kick in over the next many months.

Testosterone is converted to dihydrotestosterone (DHT), which has been discovered as one of the keys to the male pattern balding process. Without DHT, you’re not likely to lose hair… but it’s not possible to attain 0% DHT, though drugs like Propecia block much of it.