Dr. William Rassman – Page 1260

October 1, 2009

Density of Hair Transplants – Hair Loss Information – Balding Blog

Hello, I just had a wonderful procedure. Their offices were clean, procedures were excellent, and the staff was very accommodating. In 2002 I had 800 grafts done by another group in San Francisco and then again I just did 3500 grafts. The follicles were transplanted throughout my scalp approximately 25 FU/CM2. I have a very nice NW2 hairline. Also, I had a very high number of 4-hair grafts. Over 400 of them! They excised a strip of 3500 grafts and got 3703!!!

Do most of your patients get about 25FU/cm2 and are happy with it? I think it will be ok but just need reassurance.

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A normal person will have 1250 hairs or 600 two-hair follicular units. When converted to cm/square, that would extrapolate to 100 follicular units per square cm. If you received 25 follicular units in 1 cm, that would suggest that in one procedure, the doctor returned 25% of your normal density on the transplanted area. This is often not really the case, as some areas will have higher densities put in and other areas lower densities. For a person with average weight hair, olive skin, and brown hair, 50% densities overall should be more than enough to produce a full appearance. If you had a high number of four-hair grafts, then that might mean that your overall densities are higher than average. I generally target 25% density return on the first session, but at times I will go higher or lower depending upon other factors.

October 1, 2009

Did Steroids Make My Hair Fall Out? – Hair Loss Information – Balding Blog

I took steroids for 2 months and it made my hair on the top of my head thin dramatically. I do not have a receding hairline but I have lost a lot of density up top. My question is did the steroids kill my hair follicle within 2 months and it is gone never to come back or did the steroids I take make the follicles go into telogen? I was under the assumption that MPB takes more than a couple of months and a prolonged period for the follicle to die. It makes a big difference to know whether this hair loss is temporary versus permanent!!! THANKS IN ADVANCE

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Steroids do not “kill” your hair follicles, but they can accelerate androgenic alopecia (this is assuming that you have androgenic alopecia). Each person reacts differently to the steroid, so I really can not answer your question. Your doctor may elect to take miniaturization measurements of your hair, do a work up for telogen effluvium, and start you on finasteride (Propecia) or minoxidil (Rogaine) if he feels that these things will help return your hair to normal. The worst part of steroid use is it occasionally starts a latent state of genetic alopecia and moves it along faster. You need to be under the care of a good doctor.

October 1, 2009

In the News – Biker Chick Fights Breast Cancer, Loses Hair to Chemo – Hair Loss Information – Balding Blog

Snippet from the article:

In the early ’80s, Robin Kettlewell had a thing for punk rock and a haircut that showed it: purple, with three stripes shaved into one side of her head.

So when she faced losing her hair during chemotherapy for breast cancer this summer, she knew what to do. First she had her long golden brown hair cut off for Locks of Love. That soon became a brush cut that she dyed pink. A few days later, that turned into a pink Mohawk.

Now though, 11 weeks into chemotherapy, she goes proudly and completely bald. Shopping. At restaurants. In her Saturn Sky convertible. But when riding on either of her two Harley-Davidson motorcycles, she always wears a helmet – always. She’s not going to do anything stupid, after all.

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Read the full article: Breast cancer patient faces the disease “head first and no looking back”

Robin is taking back control of her life and is showing the world that even cancer can’t keep her down. She’s able to spread breast cancer awareness by being so brave. Check out the blog Robin created to share her journey.

We wish her the best of luck!

October 1, 2009

Are Miniaturized Temples Part of the Mature Hairline? – Hair Loss Information – Balding Blog

hey dr rassman,
thanks for answering all my questions. first off, my question today is about temporal hair loss and its relation to the maturing hair line process. is this loss (temporal) related to the maturing of the hairline? can one lose his temples and have his hairline only mature and not be considered genetic balding? or is the temporal loss due to more recession to come in the future?

thank you

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The maturing hairline is as seen here. If the hairline goes up further, then it is most probably genetic balding. The appearance of a mature hairline has nothing to do with male patterned genetic balding and temporal loss doesn’t necessarily indicate future loss.

September 30, 2009

Hair Loss InformationWhat Percentage of People Are Happy with Hair Transplants? – Hair Loss Information – Balding Blog

Thanks for the forum Dr. Rassmun, it has been very informative. I do a lot of research on the internet and it seems that people are all for hair translplants or they are all against them with many failure and nightmare stories. I saw something you wrote saying hair grows for 99% of translpants, but gaging from other sites it seems like 50,50. I was wondering if you could give me a ballpark number in your experience of people who are happy with their transplant to people who are not.

Anyways I am 24 and have pretty accelerated hair loss, but the back and sides of my hair is pretty strong and thick. Does the regrowth of transplanted hair in the mid 20s have a better look than transplanted hair later in life? Its seems the pictures Ive seen have led me to believe this, thank you for your time and keep up the good work.

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Generally, delaying hair transplants just increases the suffering time for those individuals who are bothered by the balding process. Why delay a hair transplant when the young man needs and wants the youthful impact of a full head of hair? If you wait until you are 60 years old, then you will look older until the day you decide to be transplanted. A 25 year old may look 40, a 40 year old may look 50 or 60, and a balding 60 year old may look 80. A hairy 25 year old will look 25 and that is what most 25 year old people want. I have transplanted many 40, 50, and 60 year old men who look 10-20 years younger with hair.

Satisfaction rates in my practice are very high, not just because we are good surgeons and know what we are doing, but because we set expectations correctly, do not employ salesmen who get a commission for selling you what you may not really want or afford, and we give all of our patients access to previously transplant patients at our monthly open house events. Patient education is at the foundation of satisfied patients.

September 30, 2009

Hair Loss InformationMy Hair Loss Stopped When I Stopped Taking Lexapro! – Hair Loss Information – Balding Blog

I recently went through about 4-5 months of hair loss. I stopped taking Lexapro and it stopped falling out completely within 6 weeks or so. Do you believe this hair loss is permanent? Do you have any advice on what to use to promote hair growth? I hope this medication did not actually damage the follicles and I will have spots forever. I am worried. Thank you for responding.

45 year old women very nervous.

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Lexapro In medicine, as in life, things are not so clear cut. I cannot say for sure if your hair loss was due to a medication such as Lexapro (escitalopram oxalate), but there are reports of hair loss with this medication. In fact, I’ve written about it in the past. So if it is the Lexapro, I would expect that this loss is temporary and you’ll need to wait with great patience for regrowth to occur. There may be other factors involved, though. This is something you need to explore with your physician and have a medical work up and a good history of events.

September 30, 2009

Hair Loss InformationI Have Random Jet Black, Thick Hairs On My Body – Hair Loss Information – Balding Blog

I have a few very unusual hair characteristics. The first is that all over my body (including head), i have a few random hairs that are literally a few times the thickness of a normal hair, like an eyelash, jet black, and they don’t stop growing at a certain length. Is this normal?

The second is that I have always had a norwood two-ish hairline on one side of my head, I guess that isn’t too unusual but the hair i have at the concave part of my hairline towards the middle don’t point down, it points straight to the side. Is this normal? I also have semi-curly hair, which I think may have developed during puberty? and I can’t find anyone in my family tree tree with any of these characteristics, which sucks because I have no idea what-so-ever who I may take after balding-wise. are any of these things normal or indicative of anything?

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I am not sure what you are asking and I would have to see you, or at the very least I’d need some good photos to understand what you are referring to. We are different and at times one part of the scalp will be different from another. Sometimes unusual hair can grow from a nevus (birthmark/mole). Is that what you see? If what you are describing is more radical, then maybe your hair demonstrates a chimeric process. See a good doctor who can research your problem for you.

With regard to the hair direction, the frontal hairline often has hair that points to one side. When I transplant such individuals, I usually discuss hair direction choices with them.

September 30, 2009

Hair Loss InformationTake 1mg Finasteride Every 12 Hours? – Hair Loss Information – Balding Blog

Hi doctor, you mentioned [editor’s note: this post] that “Another more important reason is that the half life (the time it takes for half of the drug to be eliminated by the body) is only 5 to 6 hours”.

So does that mean it will be more effective to take 1mg at 12 hours interval since 1 mg will be eliminated by the body in about 10-12 hours time.

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Taking more than 1mg per day of finasteride to treat hair loss just increases the risk of side effects. One does not need to sustain a constant blood level, as it is the tissue fixation that really is doing the work to prevent your hair loss, not the blood level.

September 30, 2009

Propecia and Urine Testing – Hair Loss Information by Dr. William Rassman

Hi Dr Rassman,

Will Propecia show up on my Insurance or my company’s medical report, namely the urine sample test? I’ve been on Propecia 1 mg for 2 months now, and I’m 24 years old. I am taking Propecia without a prescription, my local pharmacist sold it to me

Should I tell the insurance people about the Propecia, or is it nothing to worry about?…Personally, I’d like to keep it to myself..

Thanks a bunch doc

Peeing I am not sure what you are worrying about. Is it illegal to take Propecia in your country? Propecia is not a controlled or illegal substance. In any case it is ALWAYS a good idea to tell your health care professional what medical issues you have and what medication you are taking. Always tell the truth! I doubt that any insurance company or government agency will react to your taking finasteride, unless you’re competing in sports where finasteride is still banned (though most bans should’ve been lifted).

There’s info about Propecia’s detectability in urine tests at Google Answers. The author of that post concludes that it is around 90 hours, and provides links and the math to back up his calculation.

Paid advertisements (not an endorsement):

September 29, 2009

Hair Loss InformationUsing Nizoral and Propecia Together – Hair Loss Information – Balding Blog

Hi Dr.,

I have a question concerning Nizoral shampoo. I take Propecia once a day, and have been using Nizoral every few days for the past month since there seems to be a great deal of praise for it as a supplemental item when using a treatment like finasteride (no decent clinical studies to back that up, I know). My question is, have you come across any recent evidence that suggests it has negative consequences/interactions as part of being on a regimen like Propecia.

Thanks

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Nizoral The use of both Nizoral (ketoconazole) and Propecia (finasteride) together seems to have great popularity to many of this site’s visitors. I have not seen negative reports from using both of these products together, so that’s good. There was a small study published in Journal of Dermatology in August, 2002 about using a ketoconazole and finasteride combination. From the study:

“One hundered male patients with AGA of Hamilton grades II to IV were enrolled in an open, randomized, parallel-group study, designed to evaluate and compare the efficacy of oral finasteride (1 mg per day), topical 2% minoxidil solution and topical 2% ketoconazole shampoo alone and in combination. They were randomized into four groups.

Group I (30 patients) was administered oral finasteride, Group II (36 patients) was given a combination of finasteride and topical minoxidil, Group III (24 patients) applied minoxidil alone and Group IV (10 patients) was administered finasteride with topical ketoconazole. Treatment efficacy was assessed on the basis of patient and physician assessment scores and global photographic review during the study period of one year.

At the end of one year, hair growth was observed in all the groups with best results recorded with a combination of finasteride and minoxidil (Group II) followed by groups IV, I and III. Subjects receiving finasteride alone or in combination with minoxidil or ketoconazole showed statistically significant improvement (p<0.05) over minoxidil only recipients. No signifcant side-effects related to the drugs were observed. “

There are possibly more recent studies on using ketoconazole as a hair loss treatment (there’s one from 2007 with no abstract available), but this one from 2002 includes combining the medications and was the first such study I could find. If anyone using both treatments together has a story to share, feel free to send it or leave it in the comments section.