Dr. William Rassman – Page 1268

September 9, 2009

I’m Losing Hair at 21, But My Dad Lost His Hair at 36! – Hair Loss Information by Dr. William Rassman

Dear Doctor. Thank you for this blog. It has helped me so many times!

I was wondering…Im only 21 and I’m already beginning to loose my hair. Actually my hair loss already began in the age of 19. But I was looking at some old pictures of dad when he was about 33-35 years old, and his baldness first kicked in around the age of 36. I really dont understand why I’m already beginning to loose my hair? Is it just bad luck, because you can’t look at your dad and foreseen when your hair loss will start? I was just thinking that 15 years is a lot before my dad’s hair loss started! Can there be another reason to my hair loss besides genes? I’m in good shape and I’m eating healty. I can litterly “pull” oyt my hair when strokeing my fingers trough it. Or when I’m washing it my hands are full hair. Thank you for your time!

Best regards

The most common cause of hair loss in young men is genetic. There could be other causes, but it is much more likely that it is your genes. The fact that there is hair loss in the family tree helps, but you won’t necessarily follow the exact same timeline of loss as your father.

A direct examination of your scalp with mapping for miniaturization will tell you the diagnosis. Then if you are positive for genetic hair loss, Propecia is a great (prescription-only) drug taken daily to address the loss problem as it will slow down the loss, possibly stop it, and if you really lost hair it might even reverse it at your age. See a good doctor.

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September 9, 2009

My Transplant Wasn’t Cosmetically Adequate – Hair Loss Information by Dr. William Rassman

Hello,
I had a hair transplant in my crown area about 4 years ago. Although medically it was a success, cosmetically it did not adequately cover the bald spot and the bald spot is still obvious. I was fed up and tried shaving my head bald. This left the transplant scar clearly visible. The hair has grown back but I am now back to square one. I am not sure what to do. I think my options are to a) have more transplants in the crown, b) have hair transplants in the scar area and cut my hair short, or c) treat the scar. Are these my only options or are there other options. What would you recommend? I now feel I am in a catch-22, because I cannot cut my hair short, and I have noticeable hair loss.

Thanks

You probably didn’t get good counseling and were not given realistic expectations. Without seeing you, I can’t really give an opinion, as I do not know how “bald” you are. People have different views and I would need to see what you mean. Its all perspective. I could let you look at my (Rassman) transplanted crown and use my results as a yardstick of your expectations. If you have enough donor hair, you might be able to have more transplants to fill out the area.

Generally, it is very difficult to completely cover the bald spot on top of your head. Not because it is technically difficult, but because you might not have enough donor hair. You can transplant hair to the scar, but you will always have the scar there, although less visible. You can do a scar revision and this time the surgeon can use a trichophytic closure to hopefully make the scar even harder to detect (almost normal, but possibly not enough to shave your head). Another potential possibility is to use the FUE technique to extract hairs one-by-one and place them into the linear scar. Again, I can’t tell you what is actually possible without an exam first. For your crown, there are products like Toppik which work nicely to camouflage the area.

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September 8, 2009

Propecia Dosage, Genetics, and David Beckham – Hair Loss Information – Balding Blog

Hi Dr. Rassman, I just have a few questions. Basically, I’m 24 years old and I have had (from what I can tell) diffuse pattern thinning on the top of my head. This has progressed for the past 3-4 years now as the hairs are becoming gradually more and more miniaturized. However, it wasn’t particularly noticeable until about a year ago. At this point (as it began to bother me) I went to my doctor and upon his recommendation I obtained some Propecia.

Anyways, after the first week I had some side effects (erectile ones) and it was recommended to me that I should take a half dose. I did this for about 10 months, and from what I can tell, the half dose didn’t seem to have much effect on slowing down the miniaturization (although, who knows it may have). Finally, about a month a half ago I got up the nerve to try the full dose everyday. The great news is I am not having any side effects. However, a friend of mine told me about a study (which I also looked up online) in which it was shown that there really isn’t much of a different in potency between the 1mg and .5mg dose. This makes me apprehensive about whether the full dose will make a difference.

So my first question is, do you think I should take Propecia for another year on the full dose before I make conclusions?

As for my second question, does Propecia have a propensity to work less/more/the same on people with a patterned diffuse hair loss in your experience?

My third question is related to my family genetics. I have two uncles who are bald. Both of them thinned out around their mid-30s and had the typical norwood-scale baldness pattern with a bald spot in the back that gradually got bigger until they finally started fully balding on the front and crown around 40. I don’t have this. Does that mean anything of significance, other than the fact that I probably have this issue from their genetics?

My final question is, I met soccer star David Beckham at a dinner a little over a year ago and he had what appeared to be the same kind of diffuse hair loss I have now at the time. Since I watch a lot of soccer, I couldn’t help but notice recently that his hair is significantly better than it was when I met him. I took another look at some pictures on the internet and its almost like he completely grew his hair back. How is this possible? Have you heard anything about what he did? I know you have been asked this before, but I figured I would ask again since I know for a fact that he was thinning at the time.

Sorry for such a long email. Any comments you can make would be greatly appreciated! Cheers

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David Beckham

From what I recall, the difference is not that big between half dose (0.5mg finasteride) and full dose (1mg finasteride) of Propecia. I believe half dose is about 70 to 80% as effective as the full dose. In your particular case, I cannot really say if the problem is dose related, but as you do not have side effects from the drug now at full dose, I do not see any reason for you to cut back to half a dose. I’m not your prescribing physician, so discuss this with him/her. Remember, Propecia is not a cure for balding. Some patients will have some hair growth in the first year or two. Some patients will have no further hair loss. Some patients will continue to have hair loss. In the end, all of these patients taking the drug will continue to lose hair to some degree, albeit at a SLOWER rate than if you were not taking Propecia. You see it may not be a cure, but it slows the hair loss down.
Propecia works for angrogenic alopecia (genetic male pattern balding). You self-describe your hair loss as “diffuse”, but I have a hard time believing you actually have diffuse hair loss. Diffuse hair loss would mean the back of your head is thinning as well. If you actually have diffuse hair loss (even in the donor area), then Propecia would likely not work for you. I would see a doctor for a diagnosis and a miniaturization study to document what you are treating.
Male pattern hair loss is genetic, but if you have it, you have it. It doesn’t really matter if your uncle, cousin, grandfather, father, or brother is bald because it is very difficult to associate a predictive inheritance pattern.
I didn’t think David Beckman was thinning or balding from the many pictures I reviewed of him asked by various readers. It is possible that there is a difference in lighting or hair products or perhaps even medication. I really have no way to know. Your definition of diffuse hair loss is peculiar to me though, and perhaps we are not on the same page here. I would love to examine you if that is possible.

September 8, 2009

Miniaturization Mapping for Female Hair Loss? – Hair Loss Information – Balding Blog

Hi. Good afternoon! I have been experiencing hair loss every six months for the last two years. There is a history of hair loss in my family on both sides. I need to find out if I’m experiencing female pattern baldness. Would miniaturization mapping of my scalp tell me if I have AGA (female pattern baldness)? I’m tired of not knowing what’s causing my hair loss/shedding.

Also, do you have a location in Newport Beach?

(Female, 32 years old)

Have a good day!

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I routinely map out the hair for miniaturization when I see a patient (male or female) and it will tell me much about the health of your hair.

We will be doing consultations in Newport Beach starting in October. If you’d like to setup an appointment, call our office at 800-NEW-HAIR. If you’d like to have an appointment before October, our Los Angeles office is only about an hour away from Newport (with good traffic).

September 8, 2009

Any Guess As to Why DHT Blocking Drugs Don’t Help as Much in the Hairline? – Hair Loss Information by Dr. William Rassman

Hi Doctors,

Thanks for all the great insight and help. Recently, you’ve had a few posts about frontal hair loss. My question relates to medical (non-surgical) options for treatment and why drugs only seem to be effective for the back/crown of the head. I realize that today’s most effective medicines, Rogaine and Propecia, only are scientifically proven to work in the back/crown of the head. However here is where I get caught up:

If DHT is one of the primary causes of MBP and these drugs, specifically Propecia, block DHT, why then are benefits not typically seen in the front? Likewise, why is Rogaine only medically proven to be effective in the back?

I realize that science doesn’t yet have the exact answer, but given your vast experience and exposure, could you venture a guess as to why these drugs do not affect frontal hair loss the way they affect back/crown loss? In your experience, do users of these drugs see a benefit in frontal loss as well?

Many thanks!

The impact of Propecia on the frontal hairline has not been impressive, but it clearly slows down loss in the frontal area. This is the results of observation on thousands of people. The same applies to the crown where both Propecia and Rogaine seem to have value. But everyone is different and responds differently to medication.

I do not know why there is less hair regrowth on the front than the crown with Propecia and I do not want to make a fool of myself for guessing.

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September 8, 2009

How Much Time Does a Hair Take to Cycle? – Hair Loss Information by Dr. William Rassman

Hi Doc,

Just wondering about the hair cycle.

In a normal situation (ie with no MPB) how much time would you expect for a hair to go from when it falls out through to when the hair is back to its previous length (lets say 5cm?)

And when you say ‘the time it takes to notice a difference in amount of hair’ do you mean when the hair has returned to the length of all other hair on your head or just when it has cracked the surface? (because different people notice different things – some might look very closely to the scalp and see hairs breaking through whereas others may not be as observant.)

And finally, have you got any super close up pictures of what hairs look like when they are coming through. (I am 16 weeks into proscar (large amount of shedding from weeks 2 – 10) and am seeing an abundance of hairs coming through at my hairline and temples and I want to tell if they are miniaturised or not)

And as an interesting side note i read somewhere on your site that everybody has miniaturised hairs on there hairline even if they are not balding, at about week 12 I noticed my miniaturised hairline hairs begininning to grow and then are now getting to normal length when they had sat at about 2-3cm for months and months and are now 5cm+.

Sorry for so much writing, very excited about my progress!

I am pleased you are seeing some positive results with finasteride and are excited about where things are headed. It generally takes about 6 to 12 months to see the difference after starting the medication. With respect to hair cycles, our hairs are constantly cycling with about 90% of them growing (anagen phase) and 10% shedding/resting (telogen/catagen). The entire cycle varies with people, sex, and age. The cycle can be as long as 7 years, but normally averages about 2-3 years. The growing phase lasts several years and the shedding/resting phase lasts a few weeks to months. This is why it takes several months to notice any changes in hair after starting finasteride.

I am not sure what difference it would make to see macro photos of hairs as they grow through the scalp, but I’ll see what I can come up with.

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September 8, 2009

Platelet Derived Hair Growth Factor – Hair Loss Information by Dr. William Rassman

I was wondering about the Platelet Derived Hair Growth Factor. The cost, availability, & how long the new hair growth last. Thanks

I believe much of this is still experimentation and I am learning more as the articles get published. We can wait for the answers as to whether it is better… and if so, how much better? I don’t have the answers at this time.

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September 7, 2009

Labor Day 2009 – Hair Loss Information by Dr. William Rassman

Today is Labor Day (the first Monday in September) in the US, so our office is closed for a long weekend. As such, we’re not blogging today, but we shall be back with more hair loss Q&A first thing tomorrow.

In just about 4 and a half years, there are over 7500 posts here on BaldingBlog, and I’m sure there are many articles you’ve never read. I know there’s a ton of content here… so to keep things interesting, we’ve added a random post option. Maybe you’ll find something interesting, perhaps even something hilarious.

Check it out — Random Post

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September 4, 2009

Why Don’t More Men Get Their Hair Back? – Hair Loss Information – Balding Blog

I was talking to a 40 year old patient the other day who reported that he connected up with an old high school friend via Facebook who commented that he hadn’t changed in the 20 years since they last met. We started to talk about what he might’ve looked like with a Norwood Class 4 pattern hair loss had he not gotten his hairline restored, and then he wondered why any man would let himself go bald when the techniques are available to allow you to look your best.

I came to the following conclusions:

Fear. Men are fearful of change of any type, particularly when it comes to their looks. Or perhaps it is the fear of surgery itself. What if something goes wrong? What if I’m worse off than before? What if the surgery hurts? These are huge concern and researching the doctor will likely alleviate some of that. It’s completely natural to have these fears, as you’re putting a lot of trust in someone you barely know. Build a relationship with the doctor beforehand, meet patients, know what you’re getting into and what to expect.
Finances. Money is a problem, particularly in these trying economic times, but if you consider that this is a once-in-a-lifetime investment, it really is quite minimal. And you need to consider how much your confidence is worth. Some men are fine with their hair loss, and others simply don’t feel complete without their hair. And that takes me to point #3…
Control. Having surgery is an admission that their vanity is in control, not them. That’s one way to look at it, anyway. I look at it as someone taking charge of their life and wanting to be the best they can. Confidence goes a long way in life, and if you’re not feeling 100% confident some people will pick up on that.

Considering the changes in what a patient looks like, the naturalness of the results today, and the need to cling on to our youth, everyone should be lining up to get surgery, right? Interestingly, the ISHRS has just released some statistics about hair transplant surgeries and it turns out that there was a 26% increase since 2006, so maybe the fear factor is shrinking and more men are actually addressing their physical appearance.

Come visit us at one of the Open House events that we hold every month and meet men who have had hair transplants. If they hadn’t told you, you’d likely never know that they had hair restoration. Most important, they are normal, youthful focused men, even those in their 70s who come to these events.

September 4, 2009

Female Hair Transplant Without a Line Scar? – Hair Loss Information – Balding Blog

Hi I am a 20 yr old female wondering about a hairline transplant. A previous question on your site about evening out a widows peak was the most similar to my request. I have had a high hairline on the sides for several years and a recent year on medications has now thinned out the hair on either side near the temple. I have always hated my hairline which is ill suited to my face shape and want to at least fill in the hairline around my temples. I am assuming hair grafts would be the correct procedure and want to know more about them.

HAving watched documentation of several female hairline transplants I wonder : Is the donor area for the grafts always left with a long scar? (example had one across the back of her head) CAn this be done without any scarring or difference to the doner area? and (of course) what would be the cost for this procedure?

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There are 2 techniques for hair transplantation — the strip method (with the linear scar) and FUE (where you are left with small punctuate scars in the donor area). There’s no surgical procedure without some level of scarring, though trying to minimize the scarring is the best we can do. Everyone scars differently, and closure techniques for the strip method have resulted in extremely thin linear scars, and the length of the scar depends on the amount of grafts required. Costs also depend on how many grafts are needed, with FUE fees being higher due to the more time-intensive nature of the procedure. You can learn more about FUE at the following pages: