Dr. William Rassman – Page 1250

October 30, 2009

Hair Loss InformationHow Common is Hair Loss Following Gastric Bypass? – Hair Loss Information – Balding Blog

Hello Doctors,

I just read an article from a writer for the local paper about her 100 pound weight loss following gastric bypass, which is something I’ve considered doing for myself. One thing that stuck out to me was that she says, “One common post-surgery side effect is hair loss. And I have been losing my hair. I knew about this before surgery, so I am dealing with it. I don’t like it, but it will grow back, and I have also lost most of my eyebrows, but that too will grow back.” See article here.

So my question is, how common is this loss? Scalp hair loss is a problem in itself, but to lose my eyebrows too would be devastating. How long could something like this take to regrow (or will it not regrow)? My husband visits this site quite frequently and when I mentioned the story, he suggested I write to you. Thanks for your help.

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A gastric bypass surgery causes weight loss and in many cases can produce signs of malnutrition. Weight loss is often associated with hair loss, particularly in men who have genetic hair loss. For women who do not have genetic hair loss, the hair loss may reverse as nutrition gets better and the weight stabilizes, but for men with genetic hair loss, it often accelerates the genetic process. For men in this situation, it’s best to take finasteride prior to having the gastric bypass, and maintaining this drug for life. Even with the DHT block offered by the drug finasteride, hair loss may still occur.

The good news is that hair transplantation can be used to replace the lost hair in the same way as in a person with hair loss that didn’t have the gastric bypass. As far as eyebrow loss, it would be unusual, but again, hair transplants into the eyebrow easily can solve that problem as well.

October 30, 2009

Hair Loss InformationTransplanting a Mohawk into a Norwood 7? – Hair Loss Information – Balding Blog

hi, i want to ask, hypothetically could a NW7 get an FUE but instead of getting a natural hairline get his grafts redistributed to a Mohawk so he would have no hair growing out of the sides but instead have all his hair concentrated to a 1 inch thick line going from the front to back and if that could be done, how many grafts would that be?

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Mr. T's mohawk I’ve never had that request before, but yes, it is distinctly possible. What I tell all my patients is that the good and bad news about hair transplants is that they are absolutely permanent. As a young man, a mohawk may be a great idea for your particular look, but at 60 years old, will it still be great? Depending upon how thick you want it, it might take between 2500-6000 grafts.

Note: The image to the right is of the iconic Mr. T — and as far as I know, he didn’t transplant the mohawk to his scalp. I’m just using the photo as an example of the hair style.

October 30, 2009

Hair Loss InformationFake Reviews on the Web Mislead Shoppers – Hair Loss Information – Balding Blog

Interesting new press release about fake reviews on merchant websites. There is a reference to ‘hair loss preventing shampoos’.

Millions Of British Shoppers Misled By Fake Reviews

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Thanks for sending this!

Here’s an interesting bit from the press release: “According to the research, shoppers are taken in by highly promising reviews of beauty products including acne and anti-aging creams, laser-hair removal kits, hairloss-preventing shampoos, teeth whitening pastes and diet pills. They soon find out that customer reviews, even when provided by ‘real people’, exaggerated the benefits.”

This is unfortunate, but it is just like I’ve said over and over. Many forums have people (or sometimes the same person under various different names) that will feed you lies about a proven solution and steer you towards some scam product that earns them a commission. Think about that the next time you see those ridiculous “Trust Timmy” and “Honest Harry” type of websites.

October 30, 2009

Hair Loss InformationIs My Shedding From Propecia or Minoxidil? – Hair Loss Information – Balding Blog

About 3 weeks ago, I was prescribed generic finasteride by a physician (and told to use Rogaine, as well), but after I experienced some side effects he suggested that I stop the finasteride.

Since that time, I’ve continued using Rogaine and have experienced an increase in shedding which, while expected, is still pretty unnerving. I still have full coverage of my scalp for the most part, but my concern is that I’m shedding what appear to be strong, dark hairs rather than light, miniaturized hairs.

Should the quality of the hair I’m losing be a concern or is this type of shedding normal? Also, is it possible for the Propecia to still be inducing shedding even though I only took it for 9 days and stopped about 2 weeks ago?

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If / when the shedding occurs with either medication (minoxidil or finasteride), it usually lasts no more than 3 months, often less. Be patient, wait it out, and stay the course. I couldn’t tell you which medication is causing it, though.

October 29, 2009

Hair Loss InformationSome Hair Transplants in Asia May Not Be Well Done! – Hair Loss Information – Balding Blog

I recently met with a hair transplant doctor from Asia who confided with me that the results from those doctors who use the Choi implanter are generally poor. For reasons unclear to me, it seems that many of the doctors in Asia have not mastered the techniques for manual preparation and the placing of grafts. Many Asian doctors depend upon the Choi implanter to perform the task of implanting the grafts. Because the Choi implanter requires very closely trimmed grafts for the grafts to fit inside the small needles, I would assume that the failures of hair transplants to grow reflect damage produced by very close trimming of the grafts and the longer periods of time that the grafts are kept out of the body. The skinny grafts produced for the Choi implanter can dry out fast and the grafts can die in a matter of 10-20 seconds when they are exposed to the air. I’ve written about Choi failures in the past. Of interest, there are very few North American doctors using the Choi implanter.

Apparently the public’s perception of the quality of results are well known in some of these countries and many patients flee to the United States and Canada for higher quality hair transplant services. Because I need to protect the identity of my informant physician, I will not report even the name of the specific countries he was talking about, but I have heard of this problem at the annual medical meetings from other sources as well. Do your research and keep this information in mind if you’re considering a transplant and always ask to see patients who have had it done.

October 29, 2009

Hair Loss InformationSwelling the Scalp Before Inserting Grafts? – Hair Loss Information – Balding Blog

I have heard that another hair transplant firm injects something into your scalp that swells your scalp before inserting the grafts?

I also want to get eyelid surgery. Should the eyes or hair come first? How much time should elapse before the second surgery? It would be nice to heal from both at the same time.

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I do not inject anything into the recipient area to swell the scalp. The doctors who do these injections think that by stretching the scalp with saline, the grafts can be put closer together. I do not believe that this is the case.
It might be better to do the hair transplant before the eye surgery, because if swelling occurs after a hair transplant and the eyes were freshly done, that could cause more discomfort. I’d give it about 2 weeks after your hair transplant before you undergo the eyelid procedure.

October 29, 2009

Hair Loss InformationIn the News – Comedian Chris Rock’s Documentary About Hair – Hair Loss Information – Balding Blog

Snippet from the article:

While Chris Rock’s new documentary, Good Hair, is certain to get laughs, it’s sure to leave the audience talking. And that’s the point, the comedian says.

“When you talk about something with some weight to it, like hair, even when it’s over, you’re still in people’s heads,” Rock said. “That’s what I wanted with this film.”

The movie, which opened Friday, examines the issue of hair in the African-American community and the pressure to straighten or lengthen naturally coily hair.

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Read the article and interview with Chris Rock at Chron.com.

I believe hair is important to people of all races, but Chris Rock explores the issues that black women have with their hair, including the use of chemical straighteners, weaves, wigs, and other things I’m sure I’m forgetting. The movie trailer looks hilarious and I’m interested in seeing it at some point.

October 29, 2009

DHT Tagging? – Balding Blog

Dr. Rassman,

I was given a single dose of oral testosterone by my endocrinologist and I had not taken my daily Propecia. I’m afraid that the DHT surge did some damage by “tagging” follicles. Is there truth to the DHT “tagging” myth? In otherwords: does DHT “tag” hair follicles and activate within them some sequence of irreversible self-destruction? Or, does fresh DHT need to continually bind to receptors on a follicle to cause it to lose function? Or, is the DHT binding cumulative? Does a hair follice only begin to lose function once a certain number of DHT receptors have been bound with DHT?

Castration is rumored to halt balding. Therefore, wouldn’t this indicate that the effect of DHT stops once the DHT is gone? However, their hair does not regrow. So, is DHT “stuck” to the follicles, or are the follicles just not able to revive?

DHT does not stay in the hair follicle for a long time, as the body will metabolize it. If you were to stop taking your daily Propecia (finasteride 1mg) and took testosterone at about the same time, I expect that more hair loss will occur. Each genetically impacted hair follicle has a number of hair cycles which is usually less than genetically non-impacted hair follicles. That is why we lose hair in different parts of the scalp and different points in our lives. The DHT will not stick to the hair follicle beyond a week or two, so those hair follicles that are not due to undergo apoptosis (cell death) will most likely live until their time to die comes.

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October 29, 2009

Tissue Fixation After a Decade on Propecia? – Hair Loss Information by Dr. William Rassman

I understand what you’ve said about side effects from Propecia taking a few weeks to go away because of tissue fixation. But what if the patient has been taking Propecia for a long time, such as 10 years? Would it take several months for side effects to go away in your opinion?

Tissue fixation is a few week phenomenon. Some men talk about the disappearance of side effects in a week or less, and some talk about side effects lasting up to a month. I can not comment on what to expect.

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October 28, 2009

Hair Loss InformationExercise, Propecia, Age, and Side Effects – Hair Loss Information – Balding Blog

Hello,

Thank you for putting time into this website. It has proved helpful. I had a few questions about finasteride.

Does exercise have any effect on increasing or decreasing side effects?>

Does exercise have any effect on how well it would work?

What do you think of taking iron supplements to get finasteride to work better? (I am iron deficient, but I am not sure if it is enough to effect my hair. Going to a doctor soon to get my iron checked again.) Link

Since I am 21, I have the best chances of finasteride to work. Do you see it work with almost everyone my age, especially at the very beginning of MPB? What about how common the side effects are at my age?

I am going to see a hair transplant doctor soon. If miniaturization is found and the doctor is not willing to give me a prescription for generic proscar, can you? (Not sure of the legality of this. I hope I am not putting you in a bad position.)

Thank you for your time.

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No. Exercise won’t increase or decrease side effects if you happen to get them.
No. Exercise won’t mess with the effectiveness of finasteride.
Get your iron checked and be under the care of a good doctor. I don’t see any value in trying to make finasteride work better, though.
Finasteride works well in young men, but a few who are destined to develop advanced balding may find it doesn’t work as well. Side effects are possible, but it is a very slim chance. There are reports on the internet that are overblown.
You should do a miniaturization study and take pictures of various parts of your scalp. The presence of significant miniaturization will indicate genetic causes of hair loss.
You aren’t putting me in a bad position by just asking, but let’s get a telephone consultation (call 800-NEW-HAIR) and see what’s happening. Any doctor can write the prescription so once you know the diagnosis (miniaturization pictures taken by you and sent to me), you can start finasteride if it is in your best interest. Your family physician will often prescribe it for you.