Dr. William Rassman – Page 1300

June 11, 2009

If Propecia Takes Months to Start Working, Why Did My Loss Stop After Only a Month? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I’ve now been on Propecia for a little over a month and a half and it appears that I’ve noticed a slow down in shedding since before I started taking it. I know that on average we lose 50/150 hairs a day and I’m positive that I don’t notice all of the hairs that I lose over the course of the day (that would be impossible), but I am almost certain I’m not losing 100 a day, and it appears I’m shedding much less than before.

Is it pretty common for Propecia to start working noticeably a month and a half into treatment? I’ve read that it takes three months at least for it to start slowing down hair loss. I still have a pretty full head of hair (with some thinning at the crown and slight recession in the front. Not seeing as much hair shedding has me feeling really good that Propecia might work really well for me. Thank you, Dr!

Many people will report a reduction in shedding within the first month of taking the drug. I don’t know the hows or whys of it, but the medication doesn’t work exactly the same for everyone. In your case, it sounds like you’re seeing a positive result in a short amount of time. That’s good news!

Paid advertisements (not an endorsement):

June 11, 2009

My Hairline Was Transplanted Too Straight – Balding Blog

Hi Dr Rasman – many thanks for the very appreciated blog.

2 years ago I underwent an aggressive hairline FUE procedure – 3,000 grafts all in the hairline with temple closure.

I’ve recently started shaving my head and, despite the white-dotted donor area, I feel much better about myself. I’d love to continue shaving my head – the problem is the recipient area. My recipient hairs, though not particularly dense, are much thicker than the natural hair behind them and begin with a very sudden, ‘flat’ line. The texture of the skin is bumpy and *may* form a small ridge at the start of the hairline; it’s difficult to tell whether it’s scarring, or just hair follicles pushing up the skin.

If I were to remove the grafts, is there any hope of restoring a natural-looking, albeit bald area where my current transplanted hairline is? If so, what sort of treatments would you suggest?

Thanks again for the site

Oh wow! 3000 grafts to the hairline and temples does sound very aggressive, if not impossible from my personal experience. The bumpy skin texture you describe can be scarring from your surgery and if it is scarring there really is no treatment for it. I am not implying you had a bad surgery, but hair transplant surgery is not reversible. Hair transplant surgery is permanent and you need to have a good foundation and understanding of what you are getting yourself into, as well as the long term complication and issues (such as scarring and shaving) before you regret the decision.

There are doctors who do 3000 grafts routinely in a small area of the frontal line and I have seen the work. The hairlines I have seen are straight and many times I doubt that the patient actually got the 3000 grafts they paid for, which makes me question the integrity of the doctor. These hairlines can be repaired by creating a good transition zone in front of the harsh tight hairline, but that assumes that the hairline was not placed too low in the first place. Often in some of these patients the hairline is too low, making a good repair very difficult. Each case is different and I would love to see you either in consultation or good digital photographs of your frontal hairline.

June 11, 2009

Where Is the Topical Finasteride? – Hair Loss Information by Dr. William Rassman

Hi
Great blog you have, really useful. I have a question about topical Finasteride. I take 1mg Finast and think it might be holding my hair loss + scientifically expect it probably should be, therefore very much don’t want to stop. However, I am convinced that I get sexual side effects whereby my penis is just not as full and pumped (flaccid and erect) when I take it. I’ve tried experiments of washing it out for 3 weeks and then going back on it and I’m pretty sure there is quite a marked difference.

This has left me in a dilema and I was very glad to see a recent Indian paper in which they’d compared topical Finasteride with oral for a few months and found that, though the effect took longer to come on, it seemed as strong after 6 months.

Do you know how far away we are from topical Finasteride being available? Whether there is any other data on efficacy? Whether there is any data on whether systemic absorption occurs? And whether one has to apply it for long periods which would make it problematic to use? Many thanks for any light you can shed!

I’m not sure which Indian paper you’re referring to, but to my knowledge topical finasteride doesn’t have proven value. It would require special formulations for topical use and some drug company would have to push it through the FDA before it was determined safe and effective. Some doctors sell it online and armchair chemists on hair loss forums have their own tips on how to make your own, but I’ve not read any formal studies that show topical finasteride works the same as the oral finasteride. I’ve written about this before.

Paid advertisements (not an endorsement):

June 10, 2009

FUE2 vs FIT – Hair Loss Information – Balding Blog

I’m 32 years old with near norwood 4 loss and am still confused over both these techniques. There were two previous posts that you replied stating that both procedures are identical but according to Dr. Coles website he claims that FIT is much better than FUE.

My personal search has led me to either pursue your new FUEÂ² or Dr. Coles but I’m at a standstill and not sure which path would be better. IF both procedures are the same then the only criteria left for me in my decision would be $ cost per graft. My last question would be how much you charge per graft for a shaved head for a FUEÂ² procedure? Thank you!

Block Quote

Follicular unit extraction (FUE) is the core terminology that I used to define the surgery when it was first published and is the recognized term worldwide. Could there be marketing hype used here? I would think so (my opinion). The tools have been overblown and unless the technique is substantially different, an FIT is an FUE. The FUEÂ² is different from the FUE in the basic technique deployed, because it uses a dissecting technique with high pressure fluid to assist in the extraction.

Our fees for FUE are as follows:

$10/graft for procedures done by Dr. Pak
$15/graft for those done by me (Dr. Rassman)

Some doctors charge more if the head hair is not allowed to be clipped close (shaved), though our fees are the same. At the moment though, by not allowing us to clip the hair, the total number of grafts available will be less.

June 10, 2009

Receding Hairline Corners – Is It Just a Mature Hairline? (with Photos) – Hair Loss Information – Balding Blog

Dear Mr Rassman,

First of all thank you for your very informative and helpful site.

I am 30 years old and lately I started worrying about my temples. I have a feeling that I have rececing temples and want to take action in case this is the case. Unfortunately I do not have old photos taken from the right angle to compare. Could you please tell me what you think and my Norwood class according to the attached photos. I do not have any balding or thinning on top.

By the way, you can use my photos on your blog if you please.

Kind regards

Block Quote

Click the photos to enlarge:

First of all, thanks for allowing me to publish these. What I believe you’re talking about are the corners of the hairline, not the temples. The temples are below the corners (above the ear) and those look fine in the photos you provided. People seem to get the temples and corners confused all the time when labeling them.

It appears that your hairline is now convex in shape and the central area does meet the side areas, suggesting that the maturing hairline is locking into place. If there is no miniaturization present, I would do nothing other than observe your hairline yearly. This is a Norwood Class I or II.

June 10, 2009

Does Sensitive Skin Mean Sensitive to DHT? – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman.

I have a theory, can the type of skin (texture, etc) determine if a person will go bald? Sensitive skin equals sensitive to DHT? For example a Caucasian male can freckle easy and have allergies easily.

Thanks.

I suggest that you scrap that theory. I assume by “sensitive to DHT” you’re equating it to mean genetic hair loss. What is below the skin and what is above the skin (what it looks like) are very different things.

Paid advertisements (not an endorsement):

June 10, 2009

Folliculitis and Hair Loss in the Crown – Balding Blog

I have folliculitis which has caused hairloss at the crown. Will minoxidil regrow this hair? If it does, will the hair be lost once application has stopped or will the hair continue to survive on its own as my dermatologist says I have no MPB only the folliculitis.

There is a condition called folliculitis decalvans, which is an autoimmune disease that often reflects extensive hair loss. First, one would have to make a diagnosis (something I can not do without seeing you myself). If it is just a small patch from the infection of a few hair follicles that caused hair to fall out and does not reflect an underlying disease, then it might regrow. Minoxidil may help. I can’t say much more without knowing much more about you, what it looks like, and more of your history with the folliculitis. There’s a lot of info and photos of folliculitis decalvans here.

Paid advertisements (not an endorsement):

June 10, 2009

Prilosec (Omeprazole) and Hair Loss – Hair Loss Information by Dr. William Rassman

I too am taking omeprazole and finding that my hair is thinning severely. I want to weigh in on this because I see other comments to this effect on your site and others. I think you should not be too hasty to dismiss the connection.

On researching this, I did find references to a rare connection between Prilosec (omeprazole) and hair loss. As I’ve explained before, it is difficult to conclude whether omeprazole is the cause of your hair loss, as hair loss is quite common due to genetics. Hair loss reported from the medication is in less than 1% of cases. See eMedTV for more.

Paid advertisements (not an endorsement):

June 10, 2009

Some Months My Transplanted Hair Looks Thick – Hair Loss Information by Dr. William Rassman

I had a hair transplant nearly two years ago now. every 6 months or so it looks thick and occasionally some months it doesnt. Now becuase the transplant to place maybe as the rest of my hair was at a resting phase, could the hair transplant section and the rest of the hair always be at a different rate of growth as in resting phase. I was wondering whether this was the reason for certain months it looking thick and more hair and other months lacking as much hair. Also as the transplant section isnt as dense and compact could it be that when some hairs fall out in order to be replaced it just isnt as thick?

Thanks NHI TEAM

The general hair cycling is somewhat random when we look at it. I can not imagine why your hair looks better sometimes than other times. We’ve all heard of a “bad hair day,” so maybe that is what you are talking about. Are you doing anything different with your hair during the periods in question?

Paid advertisements (not an endorsement):

June 9, 2009

Propecia Isn’t Stopping My Hairline from Going NW1 to NW2! – Hair Loss Information by Dr. William Rassman

Hi Doc,
I started propecia 5 months ago for a receding hairline. My hairline appears to still be a norwood 1, but it is closing in on the second one very quickly. I don’t think the propecia has helped at all. I don’t even think the recession is slowing down. Is there any way the propecia could help from here on in, even if it hasn’t even slowed down the hair loss in 5 months?

Propecia (finasteride) will not stop the appearance of a mature hairline, as that is what it sounds like you’re describing to me. You should send me photos and I will give you a more definitive answer. Mature hairlines are convex in shape, while juvenile hairlines are concave.

Paid advertisements (not an endorsement):