Author: Dr. William Rassman

I at 22 years old and had one hair transplant procedure with 3300 grafts in the first 2/3ds inch for my Class 2 balding pattern. Now my hairline is clearly not normal looking and runs like a straight line across my brow. What can I do to fix the problem.

A 22 year old with a Norwood Class 2 pattern (see image at right) should never have been transplanted. I am assuming that you understand that in many young men, the Class 2 pattern is a movement from a juvenile to a mature hairline. I am also assuming that the surgeon put your hairline against the upper crease in your furrowed brow and if I am right, you may have limited your options to fix it.

What you need is a thinner hairline, one that is irregular. I would want to know if you are balding behind the area that was transplanted and if so, what did the miniaturization study show (get one if you did not have one done). If you have had a successful transplant of that number of grafts in that narrow a space, you will appear more dense in the front if you are thinning behind it. You need to know all of the options and build a good Master Plan with a good doctor. Ask your doctor what he had on his mind when he built that hairline for you. More surgery may or may not be one of your choices.

Hey doc, well this isnt really a question, but a comment on an observation i made. I’ve read your posts on how smoking may cause hair loss,which kind of intrigued me a little. I recently started smoking again after 8 months of quitting, and the hair on my left hand got introduced to a lot of smoke about 5-6 times daily. Today,after a week of smoking, I’ve noticed that the hairs on my left hand fingers and back of my hand have either shortened, or have disappeared. What makes me believe that smoking has caused it, is that the hair on my right hand fingers are just as they used to be. It doesn’t seem to be a possibility that the cigarette smoke ‘burnt’ my hair off because if that was the case the the back of my hand wouldn’t have lost hair, and smoke from a cigarette isn’t hot enough to be able to do that anyways.

I know the mechanism behind your statement on smoking and hair loss is related to the blood flow, but there may be another way on how smoking damages hair. It’s a toxic emission and has caused the hair to die off. Something I would now try to keep my head hair away from, and it’s now made me think of qutting again! I know that body hair is different from head hair, but who knows, and I’m not willing to risk my already dying head hair!

I don’t have much to add to your comments, so I’ll just say that your statement alone expresses the unknowns and your observations stand on their own. Smoking is harmful in many ways.

This is my second time deployed to iraq, and my last time over here I started experiencing this problem with my head. It was only one spot, and then eventually after all the puss was released it went bald. Now my second time over here and it has come back with vengance. There are now three spots on my head, and the one just seems to be spreading more and more each week. Please help me because the doctors over here dont know anything.

Pus? It sound like an infection. I would see a doctor and take care of the infection. Tell the doctors that you may have folliculitis and need a culture of one of the “boils” to determine the diagnosis. Sometimes hair loss can be permanent from scarring after an infection, but if you take care of the infection early enough permanent hair loss can be prevented. If the hair loss is permanent, you can always have a small hair transplant procedure to cover up the scar. It generally takes over a year to assess if the hair will grow back.