Density and Coverage From a Hair Transplant – Hair Loss Information – Balding Blog

This is in response to Why Don’t More Men Get Their Hair Back?

I believe that for many it is also the fact that the coverage and density you get from a hair transplant is not considered sufficient.

If you look at photos/videos of men having hair transplants, the density is at times not great – i.e. very much see through.

If density + coverage was good (cloning?!), then I believe alot more men would go and get it done even though the price would be fairly high.

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The amount of hair that is generally needed to give a man the coverage he wants/needs is upwards of 25% of his original density. As each man is different, the coverage of a single hair (one out of many) reflects:

  1. The thickness of the hair shaft (coarse hair has up to 5 times the coverage of fine hair)
  2. The color contrast between hair and skin color (white/blond hair and light skin does better than black hair and light skin)

… so the hair requirements must be tailored to the particular patient. At our Open House events held each month, there are often 2 patients who stop by with black hair/white skin and a medium hair weight, and their results are spectacular. Sports news personality Steve Hartman had it done in one session and he does not have a see-through look, probably because his hair character is very good and wavy.

Generally, I tell patients to visit an Open House event so that questions such as those that you raised can be answered by meeting patients who have already had the procedure done. You are correct, of course, that people with fine hair may not get the fullness (density) they want and need, but such issues are best raised with the transplant surgeon.

Hair Loss InformationI Read About Propecia Side Effects, So I’m Stopping it After 5 Years of Great Results – Hair Loss Information – Balding Blog

I have been using Propecia for five years with great results. I have been reading about the significant side effects. I have started to use Rogaine and plan to come off of Propecia. As an aside, I would like to start a family with my wife, which is the catalyst in my decision.

Will I keep all the good results from Propecia

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Propecia I am a little confused. You’ve taken Propecia for 5 years without side effects, and you are now stopping the medication because you’ve recently read about potential side effects (that you don’t have)? If you stop taking Propecia, you will lose all of the results and the hair that has remained with the help of the medication. Rogaine will not keep the hair grown that you saved while you were taking Propecia (and Propecia won’t keep any grown by Rogaine).

As for starting a family, I’m not sure what you’ve been reading, but I’ve written about this many times before. Here’s one from Merck, the drug maker, about this very issue.

I’m in My 60s and Losing Transplanted Hair – Would Avodart Stabilize That? – Hair Loss Information – Balding Blog

Hello Dr. Rassman,
In your opinion, would avodart as a substitute for propecia in my situation be ok to take & would the avodart dosage be more effective in stabilizing hair loss? I’m in my 60’s & the avodart sterility side effects don’t concern me. I have been taking propecia for approx. 8 years, & have been experiencing substantial hair loss in the last few years of even previously transplanted hairs from two HT’s as I was a Norwood 6-7, & had very thin, fine hair in my donor site, & quite bald on top.

I’m out of state now, but my surgeon is very well known & extremely skilled & I respect him & was enormously happy with my HT’s I had 7-8 years ago. I’m assuming my donor hair is one of the few cases where it wasn’t destined to last a lifetime. I still some have hairs on top, but quite thin & sparse.

I realize you won’t give specific suggestions concerning Avodart, but any direction would be appreciated. I don’ want to go back to wearing a hairpiece (over 30 years)! Thank you!

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Taking Avodart (dutasteride) for a man over 55 years old and not concerned about fathering more children is a reasonable approach. I have heard from the transplant physician community that when hair loss is not stopped with Propecia, the use of Avodart may help.

I am curious about the loss of your transplanted hair, however. This should not typically occur and should be discussed with your surgeon. Don’t just assume! Talk to your doctor!

I’m in My 60s and Worried About Possible Shock Loss – Hair Loss Information – Balding Blog

I’m thinking about an HT, and after reading all your topics I see my biggest concern is shock loss. I’m a 61 year old male and have a high degree of miniaturization in the proposed recipient area. In one of your responses, I believe you recommended not having an HT for thinning hair?

You often recommend Propecia for younger men and say it might prevent shock loss for possibly 90+ cases? You also recommend taking Propecia 2 weeks to a month in advance of the HT(but even the day before the HT is better than not at all?). Would this advice apply to an older guy like me? Or if I’m correct that you would not advise cases of older age onset thinning to not seek HT?

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Propecia works at any age to prevent shock loss. It is best to use this medication in advance of the surgery (at least 2-4 weeks). Older men generally have less hair transplant shock loss than younger men. I would need to know more about your miniaturization and your last 1-2 year history of hair loss. At 61 years old, few men are actively losing hair.

Age and Finasteride – Hair Loss Information – Balding Blog

Doc,

Do you find older men may need more that 1 mg of Propecia. I’m in my 50’s.

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Not usually. The dose is fairly standard and effective for treating hair loss at the 1mg level. More won’t hurt (possibly more side effects), but the impact just might be stronger in a slightly higher dose. Also remember that Proscar (finasteride 5mg) is commonly used for treating the prostate, something that older men should be concerned with.

14 Weeks Into Finasteride Treatment, My Permanent Zone is Starting to Thin – Hair Loss Information – Balding Blog

Hey Doc,

I have been on proscar split into 5 for 19 weeks. At about week 14 I noticed a lot of hair loss at the back of my head in the permanent area. The hairs that fall out are full thickness/growth and have a ‘bulb’ of skin from where it was joined to my scalp. I now lose more hair from here than anywhere else on my head and running my fingers through my hair just above my neck results in 5-10 hairs to come out at once.

Would you think this is TE? And if so would you recommend me to let it run its course? It doesn’t worry me because it is the permanent area I am just curious.

Regards

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Norwood 7For those that aren’t familiar with the “permanent zone” of hair — it is the sides and back, as seen in the remaining hair of a Norwood Class 7 balding person (see image at right). We call it the permanent zone (or “donor area”) because the hair is not effected by male pattern baldness.

I cannot say if you have telogen effluvium (TE) just from your description. It is quite unusual for finasteride to cause thinning in the permanent area… and in fact, I’ve never heard of it happening. I would go back to the doctor you received the medication from and have him/her reassess your permanent area that you are concerned about. Your description of seeing 5 to 10 hairs fall out when you run your fingers through your hair is subjective not scientific… and it will not give you the answers you need.

You should have gotten a donor hair density measurement, which shows how many hairs you have in a given area. You also should have gotten a miniaturization study evaluation to see if there were hairs that were thinning. Of course, this may be an ideal case scenario for some, but that is the standard way I run my medical practice.

Scalpure – Hair Loss Information – Balding Blog

Scalpure, this has to be a con right?

Scalpure.com

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ScalpureThis is a new one to me. I enjoy when readers bring products to my attention, and it seems like a new unproven hair loss product is available every day. And just like many of these unproven products, Scalpure claims to be a “natural” and “breakthrough” treatment. The ingredients listed do not seem to be anything breakthrough: various oils and apple cider vinegar, none of which are likely to do anything for treating genetic hair loss. The makers claim that it pulls DHT out of the scalp like a magnet, but offers no proof of this. I don’t want to call it a “con”, but here is what it seems to be offering — buzzwords. What does it lack? Science and proof.

If you want to use this, it’ll set you back about $55 for 2 months of Scalpure, including shipping. The price isn’t terrible, but how much is your patience, your time, and your hair worth to you?

Mature Hairline and Race – Hair Loss Information – Balding Blog

hey im really concerned because i noticed the corners of my hairline has went back a little. im only 17 and im african american and i heard its not just a maturing hairline because that only happens to caucasians. please help

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The hairlines of different races do vary and the mature hairline of an African American is different than a Caucasian. You need to see a good dermatologist to determine if you are now balding or if this is a maturing hairline you’re seeing. I would be happy to evaluate you if you’d like to send photos to the address on the Contact page. Otherwise, you can find a hair transplant doctor in your area by checking the physician search at ISHRS.org (I’m not suggesting you have surgery, but these doctors will know a lot about hair).

My Results from Rogaine are Leveling Off After 3 Years – Hair Loss Information – Balding Blog

I’m 61 years old and have been using Rogaine for about 3 years. I have had positive results, but they recently have been leveling off as I still have some bare spots where my hair simply won’t grow. Could this be because the hair follicles have miniturized to the point where they have simply vanished?

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I would need to map out your scalp for miniaturization to determine an answer to your question, but it is not unusual for minoxidil to level off on its value over time.

Coarse vs Fine Hair – Balding Blog

How can you tell the difference between course hair and fine hair. Does course hair have a kind of messy, split end type of look, whereas fine hair feels very smooth and silky? Also, does course hair have more volume than fine hair?

Yes, coarse hair has more volume than fine hair. Split ends occur when you abuse your hair with straighteners, hot blow drying, and too much junk on your hair. Your overall treatment of your hair should include a good shampoo with a conditioner added. Letting your hair dry by itself is always best.




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