Author: Dr. William Rassman

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My Dermatologist Said That Telogen Hair is Supposed to be Miniaturized – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,
I went to see a dermatologist today about my diffuse hair loss, and I asked him if the thinner hairs that are falling out now (as opposed to the thicker hairs that fell out before) necessarily pinpointed miniaturization. He said that a telogen hair is supposed to be miniaturized compared with a anagen hair. Now, I’ve done quite a bit of research on this topic, and I’ve never heard that a telogen hair was supposed to be miniaturized. Can you give some insight into why he might say this? Thanks so much!

I agree with you. Telogen hairs, when they fall out, are normal width. I have no idea why your dermatologist would say otherwise.

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Wellman Tricologic Tablets – Hair Loss Information by Dr. William Rassman

Hello NHI team,
I have recentaly bought Wellman tricologic tablets, are for helping to maintain healthy hair follicles and existing hair growth. The tablets utilises Keratone, a combination of ligans, amino-acids, PABA(para-aminobenzoic acid) and pantothenic acid for the maintenance of natural hair colour. Here is some of what the tablets contain and this is what the box says and their website:

KeratoneTM includes;
• Standardised Lignan Extract – lignans (including the special compound Secoisolariciresionol Diglucoside) have been shown to help to naturally balance the conversion of testosterone to Dihydrotestosterone (DHT) which is implicated in the male hair growth cycle.
• N-acetyl-cysteine – this amino acid supports hair growth, and hair shaft diameter for fuller hair.
• L-cystine – this amino acid dimer of cystine is integral to disulphide bonding in the keratin of the hair, supporting its strength.
• L-methionine – an essential amino acid that must be provided from the diet and participates in a wide range of hair related biochemical reactions.
• L-lysine – as essential amino acid.
• Choline – a constituent of lecithin in cell membranes. A lack of choline can influence hair growth and hair pigmentation
• Inositol – a constituent of lecithin in cell membranes and a growth factor for rapidly dividing hair cells. A lack of inositol can influence hair growth and skin health

Silicon – Silicon is the third most abundant trace element of the human body and is important in the structure of hair.
Iodine – Iodine plays a role in metabolism and required for hair growth to proceed at optimal levels.
Antioxidant vitamins C, E and Beta-carotene – help to protect against the damaging effects of free radicals, which can lead to premature ageing. Vitamin C is also essential in forming the connective tissue of the skin while Vitamin E may help support skin repair. Beta-carotene provides a source of vitamin A, which helps support scalp oil production and skin health.
B-vitamin complex – Essential in the health and growth of rapidly dividing cells such as those present in the hair follicle

Recognising the concerns many men have about hair growth and hair condition, Wellman Tricologic® has been developed by leading scientists. Each specialist formula tablet provides 29 bio-active ingredients including essential vitamins, minerals and nutrients designed to nourish hair by maintaining healthy hair follicle metabolism.

My question is, what are your views on these tablets and how effective would they be. Would they be good if used with propecia/avodart. What is your opinion. Please, please reply. Thank you NHI team.

Wellman TricologicThe list of ingredients excluded the kitchen sink, but I doubt that adding it would help with genetic hair loss. If there were deficiencies in diet in any of these areas, it would impact your overall health, of which your hair is clearly an important element. The problem with many of these ingredients is that the scientific connection between their availability to your body and hair loss or hair regrowth is just not there.

For those interested, a list of how much of each supplement is available here. This product appears to only be sold in the UK and/or European markets.

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Dandruff Is From Increased Sebum, Right? – Hair Loss Information by Dr. William Rassman

Okay I read when you said that dandruff cannot cause hair loss, but I also read that dandruff is related to an increase in the amount of sebum on the scalp, which presmuably is caused by increased testosterone? All this together seems like dandruff is a sign of pending hair loss…

Sebum is an oily secretion of the sebaceous gland which helps to preserve the flexibility of the hair and to protect it from the environment (source: MedicineNet.com). It is NOT “presumably” caused by increased testosterone. The human body is much too complicated to make these cause and effect correlations. In the end, what are you really asking me? Are your asking me if your hair loss is caused by dandruff or if people with dandruff have hair loss?

The most common cause of hair loss in men is due to genetic balding. You can thank your mother or father, not your dandruff. People with hair and people who are balding all can have dandruff.

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Do You Survey Your Patients About Their Family Hair Loss History? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

First off thank you for taking the time to answer all of our questions.

My question is, do you think that the severity of hair loss depends on the number of genes for hair loss that someone has? In other words, do you think that someone whose father has perfect hair with a mothers side with hair loss will not begin to lose their hair until mid age. Whereas someone with a bald father and balding mothers side of the family will lose at an early age? I ask this because I made the observation on people I know. It seems to me that men who lose their hair in their early 20s almost always have a balding father. Anyone I know with a father with flawless hair and a balding maternal grandfather and uncles seems to begin losing at mid age (if ever).

Do you survey your patients? In other words, do you ask them what their family history of hair loss has been?

Yes, I always ask patients about their balding family history. I have not noted what you have, so I can not comment on it directly. There is no detectable connection that I have observed between balding fathers and the age their sons start balding. When both sides of the family have balding, the frequency of balding in sons does increase.

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Is Hair Always the Same Thickness All Over the Scalp? – Hair Loss Information by Dr. William Rassman

I recently pulled out a few hairs at the front hairline and noticed some were thinner than others.I did the same at the back of my head where the hair meets the neck and found the same thing. Are there different thickness hairs all over your head or is this miniturization? I dont understand as i thought the hair that meets the neck could not be lost?? Is it normal to have some thinner hairs all the way round the head where the hairline starts??
Thanks for a great site, your help is much appreciated!

Generally, if there is no miniaturization (no balding) present, most hair on your scalp will have the same thickness except for:

  1. the very front of the hairline
  2. the nape of the neck
  3. the temple prominences on the front-side of the scalp

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L-Carnitine and Hair Growth – Hair Loss Information by Dr. William Rassman

hello dr rassman,
first thank you for your help. i found this on some hair loss forum.

L-carnitine-L-tartrate promotes human hair growth in vitro

Source: Experimental Dermatology, Nov 2007

Thank you for sending this. This is an interesting read. It is important to recognize that things that work outside the body do not necessarily work inside the body. Pinpointing these stimulants has value in ongoing research.

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My Hair Grows Differently After Brow and Face Lift – Hair Loss Information by Dr. William Rassman

If I may piggy-back on the previous inquiry regarding loss of sensitivity of the scalp and hair loss. 3 weeks ago I underwent a brow and face lift and now the top and sides of my head are totally numb. I also cannot get my hair to lay the way it did previously…it’s like it’s developed a totaly new growth pattern and new cowlicks that make the hair impossible to manage… My surgeon says it may take 3-4 months for the feeling to come back. he can’t comment on my hair except to be patient. Is this sort of development to be expected? What should I do?

Your doctor is probably correct. You must wait this process out. If it does not get better, then be sure to speak with your doctor further. Brow lifts can cause changes in hair growth because of scarring and the pull on the existing hair, reduction of thickness of the hair shaft caused by blood supply problems, and the inducement of genetic changes that may be programmed and not ‘expressed’ without the brow lift. There are probably other factors, but I do not believe that anyone knows them all.

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New Hair Institute Los Angeles Office is Moving – Hair Loss Information by Dr. William Rassman

MovingToday is the last day in our Pico Blvd office in Los Angeles. We’re moving to a beautiful and completely remodeled office space in a medical building in Century City (just a few blocks down the road). Starting April 28, 2008, our NHI Los Angeles office will be:

2080 Century Park East, Suite 607
Los Angeles, CA 90067

Our first Open House in the new office will be next Saturday, May 3rd from noon-2pm. If you’re able to attend, I welcome you to stop by to see the new place — and of course, to meet with patients, have a free consultation with myself or Dr. Pak, and to see a live hair transplant surgery.

Anyway, I’ll post some photos of our new place once things get settled. In the meantime, things have been busy with the move (anyone that has moved to a new home in the past can surely attest to that — and moving an office is just like moving a home, except with more computers and surgical equipment), but I’ll make a point to have the blog updated in the same frequency as you’ve come to expect!

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Short Hair Syndrome? – Hair Loss Information – Balding Blog

I’m writing on behalf of my mother in law, a 59 year old african american woman. Her hair never seems to grow and she hasn’t gotten a haircut in a long, long while. Can I get your thoughts on “Short Hair Syndrome”? This sounds like what my she is dealing with, but I can’t find any further info on it. Is it even real? The site is http://www.lisaakbari.com/SHS.html

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From a medical point of view, or as a physician involved in hair loss for over 15 years, I do not recall ever hearing or reading about “Short Hair Syndrome”… but I can logically give you an explanation for it, assuming the the examination of the hair and scalp is normal and there are no medical problems lingering behind the scene.

First, I will assume that she has no miniaturization going on throughout the scalp. If she does, then short hairs will come about when the hair miniaturizes so that a diagnosis needs to be established. With respect to your mother-in-law whose hair is not growing much, she may have a very short anagen phase (growth phase) of the hair cycle. A short growth phase could produce healthy, but short hairs. Of course, she should see a dermatologist or her primary care physician to see if there are medical issues that are causing such problems.