Author: Dr. William Rassman

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Common Age for Female Hair Loss to Start? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,
Searching the internet and various websites I always seem to hear/read about women who have severe diffuse hair loss and have developed female pattern baldness when they are around 20-years-old. Is this very common? Some information I’ve come across says it’s very very common while other says it rarely happens. Do you have any statistics on it?

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I am not aware of statistics, but from my experience, women often follow the females in the family that have genetic balding in the time of onset and the pattern. There is a strong one-to-one link between mother and daughter in this condition and it is not infrequent to see it in your mother’s mother or aunts. Female genetic hair loss is not common in very young women, but in each decade, the frequency rises until menopause when almost 50% of women experience the problem. We see hair loss after pregnancy in many of these women as well.

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2 Weeks After Hair Transplant, The Density Looks Better on One Side! – Hair Loss Information – Balding Blog

I recently underwent a 1700 FUT procedure in the temples with a very respected surgeon. I followed all post-op instructions. A day after the surgery I noticed that the incisions on the left side temple looked closer than the right and I could see more hair coming from them. It is now 13 days post op and all scabs are gone. It seems that the hairs are more dense on the left side of my head than right.

My question is if the density of the hair I see that was transplanted is indicative of the final density I will see? If the right side looked less dense a day after surgery and looks less dense 13 days after surgery does that mean it will likely be less dense in the final result or can small hairs be transplanted below the skin hence not being seen until they grow out?

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What you see is what you will probably get. Ask you doctor about it — maybe he did it intentionally as part of a plan he had for you.

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I Think My Hair Loss Is Too Aggressive to Be MPB! – Hair Loss Information by Dr. William Rassman

I would like to get your opinion on why I am experiencing relatively sudden thinning. I am 19 years old. I can’t pinpoint the exact time that my hair started getting thinner, but I can say that my hair was completely full a little under a year ago, because of my driver’s license photo.

I have a feeling the hair loss is far too aggressive to be male pattern baldness, because I have had no signs up until recently. I don’t recall before a couple of months ago. In fact I have never seen hair fall out of my scalp or seen actual “hairloss” but i’m sure people rarely do.

I would like to know if you think this hair loss is temporary (based on the photographs) and if you think this is possibly permanent or even male pattern baldness. I have no history of the disease, my grandfathers on both sides died with a full head of hair. So did the grandmothers!

Male pattern baldness (MPB) does not always require a doctor to assess. Look at your hair loss pattern (use two mirrors). Is it thinning mostly at the top, but you still have good hair on the back and sides? If so, chances are you have MPB. We recommend a miniaturization mapping of your scalp hair and you can make the diagnosis that way. You can see how to do this yourself — here. By the way, MPB is not a “disease”. It is a genetic trait that you inherited from one of your parents. It may skip generations so you may not see it in your immediate family tree.

Finally, the aggressive nature as you describe does not surprise me, as men who lose considerable amounts of hair with an advanced balding pattern usually have a more rapid course of hair loss, often starting in their very early 20s. That may not be your case, but don’t fool around with it as there is a good medication (finasteride) to take if you are unfortunately balding. See your doctor and get a correct diagnosis and ask about options.

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I Trust My Transplant Doctor, But I Think I Had Shock Loss – Hair Loss Information by Dr. William Rassman

Firstly, I would like to thank you for your input on the website; I’m a daily reader. I have read your previous posts regarding preventative transplants. I am in my late 20’s and essentially had a first transplant done 1.5 years ago in what was pretty much a preventative measure. The transplant definitely had the impact of which you speak, namely causing native hairs to fall out, replacing miniaturized hairs with a lesser number of transplanted hairs. My transplant was only done in the front portion of the scalp, not touching the crown. I was not taking Propecia before the surgery, although there is doubt as to whether or not that would have prevented the shedding. Either way, I now am being told the following from my doctor, whom I trust and with whom I’ve developed a very good relationship:

  • The procedure was not wasteful as if we had waited 1-2 years, there would have been less hair to camouflage the procedure.
  • You did lose some pre-existing miniaturized hairs, but gained permanent, terminal hairs that give much more of a cosmetic fullness than miniaturized hairs.
  • It is disappointing that you did not get the full potential cosmetic fullness because of miniaturized hair loss so the relative change wasn’t as great as you had hoped. But if you had waited there would have been less hair to camouflage what we were doing, and you would have been perceived as having more hair loss going into the procedures.
  • For now you can go on Propecia for 6 months to help maintain hair and perhaps beef it up somewhat. Then you may have a 2nd and 3rd procedure at some point for the frontal half of the scalp to get the density you can get with transplants. You can also do a second procedure at any time, and I know you will feel that much better when that second session is in and growing.

My questions at this point are the following: Should I do another transplant now or should I wait longer? I’m told that 70% of the hair in that area now is transplanted hair and that I wouldn’t really get much if any shock loss from the next one as there are very few miniaturized hairs between the transplanted hair. Should I take Propecia before going to another transplant and if so for how long or does it not matter because there will not be anymore shock loss?

Thank you for your answer. I have had a great experience with my doctor so far and trust him to the fullest. I simply post as an educational measure for myself and for all other readers as I think this is a topic of great interest to younger men in the initial stages of hair loss.

I am a bit critical of your doctor for not using Propecia prior to your first surgery, as this probably would have prevented much of the hair loss you experienced. Propecia (finasteride) is very important in young men having transplants to protect against shock loss. Anytime after 8 months you can follow up with another procedure. Best this time to be on Propecia before hand.

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Hair Loss InformationWhy Is Dr Farjo Balding? – Hair Loss Information – Balding Blog

Not to be rude but I can’t help but ask, before i ask a more detailed question; why Dr. Farjo, a contributing writer appears to be having serious balding problem.

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Look at this another way — should a plastic surgeon make a statement by not having a boob job or a face lift? My former associate, Dr. Robert Bernstein, was asked about his balding on national TV (he has a class 6/7 balding pattern) and simply put, his hair loss does not bother him. Like Dr. Bernstein, there are many men who look handsome with a short haircut and some advanced balding pattern. Decisions on having a hair transplant reflect upon personal choices. I’ve written about this before here and here (and probably elsewhere).

I know a man with a broken nose who never had it fixed. He came to see me for a hair transplant and he said his nose was not a priority for him and the cost of a repair exceeded his budget. He obviously felt different about his hair. As to the cause, I am sure Dr. Farjo’s balding reflects genetic pattern balding like most men.

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Online Doctor Consultation and Propecia Purchasing – Hair Loss Information – Balding Blog

Hello Dr,

I have been following your blog for a while now and am definite that I am beginning to suffer MPB.I am 20,and my dad and brothers were all 16/17 when they started balding. They have all followed a pattern of continued receding from the front hairline untill it reached all over. My temples and frontal hairline however resemble a normal mature hairline. It is the hairs on top and mainly in my crown which when they fall out are noticably and quite a bit thinner than the rest of my hair, which otherwise is probably thicker than average! The crown also looks and feels thinner. MPB has appeared in most men on both sides of the family (just one uncle has escaped it), my genetics are against me!

Although I want to get the situation controlled, I cannot bring myself to go to the doctor, the embarassment is too much. Especially here in the UK it seems trying to beat hairloss has a lot of stigma and embarassment attached to it. Even my parents think I am ridiculous thinking that I am thinning (they think I am ok seeing as i don’t have the same pattern as father and brothers)…obviously not having read what I have here about minaturization and not necessarily following an identical pattern.

I came across this website and wondered what you thought. It claims to give a consultation with an online doctor and then to allow you to purchase propecia online if they authorise it. I wondered if you think this all looks genuine, as I am considering doing it, It does seem so!

The beginnings of MPB is ruling my life but I can’t face the embarassment of a doctor considering friends and family think I am being stupid, also there doesnt seem to be much knowledge on the subject here or specialised doctors/clinics.

Thankyou.

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I do not generally condone strictly online consultations, but would not be against it if you can take Propecia to prevent the family hair loss problem following you into adulthood. Nothing compares to a one-on-one patient to doctor relationship. I don’t know if that site is genuine or if prescribing medication like that is legal in the UK. There is nothing wrong with being bald and there should be no embarrassment to request medications to stop the hair loss. I would do your research and find a doctor in your area and have a confidential consultation and examination.

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Can I Quit Rogaine After a Couple Months And Switch to Propecia? – Hair Loss Information – Balding Blog

Dr. Rassman,

I’m a 25 year old male that noticed a few months ago that i was starting to thin on the crown of my head. I started using rogaine foam. About a month or so into using the foam I read about Propecia, and vistited my doctor who said that he thinks Propecia would work the best for me. My question is; since I’ve only been using Rogaine for two and a half months, do you think I’d be okay quitting the foam and just using Propecia (which I’ve been on for the last month)? I haven’t noticed any improvements with the rogaine yet(which makes sense to me since the package says it could take many months to start seeing results). I’m just wondering if I can quit the foam without losing hair. I figure I should be okay since I haven’t seen improvements yet.

Thanks so much, doctor. I appreciate your blog very much.

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I would hope (though I am not sure) that you did not build minoxidil dependence on the miniaturized hairs. For men of your age, Propecia is a better choice.

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Growth After Eyebrow Transplants – Hair Loss Information by Dr. William Rassman

I heard many excellent reviews about your work on Hair/eyebrow transplant, I wish to ask you a few question regarding a procedure. do you do eyebrow restoration? how often do you perform this procedure?. how much would it cost? I enclosed several photograph regarding the area, the scar is about 6cm long and 1/3 cm wide.

I done a procedure with another company back in June 27th, but they only put in 30 (as supposed to 100-150 recommended by most doctors). It’s almost 3 months since [my transplant], I already begin to see 10 follicle grow out. when do you think I can do a 2nd procedure? beside Rogain, is there any medication I can do to speed up the growth? I heard follicile transplanted to eyebrow usually grow faster then those transplanted to scalp? What’s the reason beside the difference?

Since scalp hair is different than eyebrow hair, what do you usually do to make the result look more natural? Thanks for your info!!

It sounds like you were given far too few grafts. Generally it takes 300-400 grafts to complete an eyebrow transplant. We charge about $3000 for eyebrows, but if I do it, it will be $4000 as my fee is higher. Dr. Pak is my associate and he is terrific and his work is impeccable. I would consider another transplant after 6-8 months. By that time all of the eyebrow hair will have grown in. Eyebrow transplants are with scalp hair and grow at about the same time as if it were transplanted into the scalp. In other words, it does not grow faster than when it is put into your hairline.

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In the News – Hair Makes the Employee? – Hair Loss Information by Dr. William Rassman

Snippet from the article:

In my 30years of experience, I have seen several economic situations, each one uniquely different but all the same. No matter the differences, one issue remained the same. If you wanted to endure, you needed to possess every attribute desired by your employer and prospective employer.

One constant is, how you look is as important as what you know. It’s as important to look youthful as it is to look experienced. Unfortunately looking older does not pay off, most of the time you are not perceived as experienced it’s simply perceived as old.

Read the full text at Examiner.com

The article goes on to talk about how important hair is, in that it adds confidence to the prospective employee. I’ve written about this before (and there was an LA Times article about it), but it’s good to get someone else writing about it from time to time. So do you agree or disagree that hair makes the man?

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