Author: Dr. William Rassman

Fantastic results from just finasteride and microneedling for one year.

Nice improvement of the corner hairline

Thanks for lifting your eyebrows and allowing your forehead to show the creases. 1.5 months is too early to see results but there are small hairs on the left side which appear stronger than they were in the before picture so this is a hopeful sign.

Hi Doctor,

A lot of questions on here about initial shedding after a transplant, but my question is regarding transplanted hairs shedding years later, due to the natural hair growth process.

I noticed my transplanted areas have become thinner over the past couple of months. It has been almost 4 years since my surgery. It is well known that the hair growth cycle for hair is between 3-4 years, then they shed to make room for new hair. I was wondering since all transplanted hairs are relatively growing at the same rate or time period, should we expect periods of thinness every 3-4 years when these hairs are ready to shed again? In other words going through a shed similar to your first initial shed before the hairs started growing again. I hope my question makes sense.

Transplanted hair is permanent for most people. In the recipient area, the surrounding non-transplanted hairs may not be permanent and you will continue to lose those hairs. Years after a hair transplant you may be noticing the non-transplanted hairs falling. This is assuming there was non-transplanted hairs mixed in with the transplanted hairs.

If your hairs were transplanted on a completely bald area of your scalp and you are noticing shedding, this is not considered normal. It may regrow if you are experiencing telogen effluvium, which is a temporary hair loss that can occur at any time… or you could be one of those rare people who lose transplanted hair. I always look at the permanent zone when someone asks me about hair loss in the recipient area, in case they are losing donor area hair. Whatever happens to the donor area will happen to the recipient area. For example — in elderly folks, there is a condition called senile alopecia which reflects thinning of the hair throughout the head, including the donor area.

In a very rare instance, you may actually be experiencing permanent transplanted hair loss which I have seen possibly a dozen times in my 20+ years in practice. I don’t remember a cause of this to ever have been pinpointed in most of those patients and I wonder if I should be biopsying them when I see that problem, looking for diseases like diffuse alopecia areata.

https://pubmed.ncbi.nlm.nih.gov/33878855/

Conclusions: Based on our results, the combination of arginine and zinc tested in our study could represent a good therapeutic option for the treatment of AGA and TE and it might represent a valid alternative to finasteride.

2021-04-24 01:53:422021-04-23 08:56:27Zinc and Argenine for AGA and TE

It is unusual for 30 year old men to reverse hair loss on finasteride alone. This man may have experienced a late onset hairline recession which would more likely reverse.

The pictures show nice filling in hair behind the hairline. It may still get better in the next year if you keep it up.

Have you seen first sign of improvement on Finasteride after one year?

This is not uncommon. Sometimes just slowing the hair loss is hard to notice, but if, while taking finasteride, your biological hair loss activity slows down, then the finasteride may become more effective. This might explain why you see improvement appearing at one year after starting the drug. This drug, in sensitive men, can give reversal of hair loss especially in the young men under 25 or even 30. It works better in the crown than on the frontal areas.

i had 1200 graphs put in one week ago. after reading your blog, i wish i had done them with you. i was planning on another 1500 or so in my next procedure and i will come see you first for sure. so you will be seeing me about 12 weeks from now. unfortunately, today i was getting into my car and hit my head on inside part of my car door. ( again i am one week post op) i hit it relatively hard…when i reached to see if there was bleeding( i hit in the area of my recepient site) it was bleeding. I did not stop bleeding for about 35 minutes. Did i likely dislodge new transplanted graphs as well? The cut is about 2 inches long, not very wide not too deep. After one week am i likely to have dislodged graphs? i did not see any follicles, but you never know? your opinion?

It is difficult to answer your question without examining you in person (you’re in Los Angeles — we’re in Los Angeles). That being said, the hair grafts are generally considered permanent after the first couple of days. It is very, very difficult to dislodge a graft after they get set-up and I have seen people get lacerations of the scalp from accidents at about 1 week and when I examined them, all of the grafts were intact and in place (unless they were inside the laceration itself). If you did not see any grafts, you probably did not do any significant damage. However if you have a cut on your head, you will get an inevitable scar and hair may not grow on the scar.

If you do decide to make an appointment to have your injury looked at, please mention this blog entry to me (or to Dr. Pak, who is a contributing editor to this blog).

This is a very good result from taking finasteride for 1.5 years and adding minoxidil one year ago

2020-10-13 02:45:312020-09-26 04:48:401.5 years on minoxidil & finasteride (photo)