Author: Dr. William Rassman

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Discolored Recipient Area Months After Hair Transplant – Hair Loss Information by Dr. William Rassman

It has been 3 months since my hair restoration surgery of 1600 grafts in my hairline. I am experiencing a prolonged purplish discoloration in certain areas of my recipient site. I can even visualize the line that was drawn for my new hairline although none of the new hairs have grown in. I am a Fitzpatrick type 4 skin type. It seems like the discoloration IS fading but slowly. Is this normal? Will it continue to fade? What can I do to speed up the process? I greatly appreciate your input and expertise. Thank you

Discoloration rarely lasts months as you report, but as you report it is fading and I would expect it to do so. Ask your hair transplant doctor about it. Good luck.

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HVT Dietary Supplement Claims to Stop Hair Loss and Restore Thinning Hair – Hair Loss Information by Dr. William Rassman

Have you heard anything about “HVT” from New Health Products in Brewster, NY. Their propaganda reads like many dietary supplement products: stop hair loss, thicken hair, regrow hair. Most of their “so called” testimonials primarily mention “fuzz”. I have used other products before that have given me more fuzz, but the fuzz never matured to “typical adult scalp hair.”

I did search your archives. I could not find anything using your search. Using a google search brought me to your blog in the first place. It found one message asking about HVT in the middle of a thread for a different product and the HVT question did not seem to get answered. (The person should have probably asked the question separately.)

http://www.new-healthproducts.com/hvt.html

Some of the vitamins and minerals that are used in this product are things that I take daily (like folic acid), but I do not see any evidence that this has any value for treating hair loss or regrowing hair. You are right to call it propaganda. A lot of hype without proof.

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Libido and Propecia — Is it a Gradual Problem? – Hair Loss Information by Dr. William Rassman

I recently read that propecia can cause a VERY gradual decrease in libido over an extended period of time in some people , to the point to where its almost not even noticeable, eventually resulting in very low libido. Is there any truth in this? I would hate to take propecia for 8 months or a year with good results and then have to discontinue use due to loss of sex drive.

I really don’t know the answer to your question. We change as we age, so it might be impossible to distinguish the slow onset of libido problems from Propecia from what you may normally experience without it. My experience with libido problems relate to many factors. If we exclude the physical issues with ED, we can talk about the partner issue, which may come into play as well. For example, when some people have marriage problems, they may lose their sex drive. If the relationship problem comes on a year after starting Propecia, it is easy to blame the drug.

My general advice to a patient would be the following:

  1. If you have libido problem, try going off the Propecia for a week or two. If it is induced by the Propecia, it should reverse.
  2. You can always reduce the dose to half a pill (1/2mg instead of 1mg). A half a pill is still about 80% effective as a full pill and certainly has less side effects.

I think that you should not worry about what might happen in a year, just because someone else may have experienced it. That person is not you. Each person reacts differently to various medications. The benefits of taking it and knowing that it is working on your hair is better than what might happen down the road.

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Using 0.25mg Finasteride to Lessen Side Effects – Hair Loss Information by Dr. William Rassman

Hello Dr, I have used propecia in the past with a loss of libido and erection problems.So for the past year i have been using Revivogen. Revivogen has stopped further hairloss for me but has not given me any regrowth. So four months ago i decided to use rogaine, But rogaine gave me bad water retention and facial swelling so i stopped using it one week ago. I am planning to go and see my doctor tomorrow to get a prescription for propecia again. I plan to use 0.25 daily. I have heard that using this low dose has a low side effect rate. Do you think that adding propecia to my regimen of revivogen will give me some good regrowth? I have a feeling that these two products will work very well together.Thanks

Your guess is as good as mine with regard to Revivogen and Propecia (finasteride 1mg) when used together. I’ve written about Revivogen in the past (see Revivogen vs Propecia).

There are reports that 0.25mg of finasteride has only about 25% the effects of 1mg, but it still has some benefit… and your chances of side effects are likely less.

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Hair Loss InformationPlucking Out My Old Hair Plugs – Hair Loss Information – Balding Blog

I had one procedure done around 10 years ago. I was young, and like many, I jumped without doing too much research. I’m glad that I stopped at the one procedure. Now I’m looking for a way to reverse the whole thing. The scar is hard enough to keep hidden, but the hair plugs are even harder to deal with. Is there any way to get rid of the transplanted hair besides shaving it or tweazing it? Tweazing the 600 grafts takes too long, and like a beard, they grow back a few hours later after shaving them. I thought about lazer hair removal, but I’m worried that it will permanantely damage the dormant follicles, and with just my luck, they’ll find a cure a week later!

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I really do not know your specific problem and the extent of the “pluggy” appearance to give you a personalized opinion. However, it may be almost impossible to completely undo old (or new) hair transplants, because a hair transplant is permanent. It goes to stress the importance of good research and being able to see the results of patients from the doctor as well as the medical group you are having the surgery with. Even 10 years ago, the pluggy transplants were not standard care.

You can try laser hair removal, but you may be left with scarring if the old grafts were the large plugs. Large plugs often leave a cobblestoned skin and depigmentation where the plugs were. Sometimes, these can be cored out, but an experienced hair surgeon needs to evaluate you for this option. Otherwise you can attempt another hair transplant to disguise the old plugs.

For more information on repairing old hair plugs, please see:

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Does Propecia Reduce Body Odor? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,
I am a 32 year old male currently on Propecia for the past 6-7months. I know this might sound a little strange but my wife and I have noticed that ever since the first month of taking Propecia I have had significantly less body odor (particularly in the armpits). I still sweat a lot in sports (and sex) but I rarely require the use of a deodorant like I used to. Have you heard of such a side effect in your experience? I am pretty sure I am not imagining this and it was also confirmed by my wife (who is blessed by a rather well developed olfactory system!). I have not changed my diet or anything else in my life over the past few months that might trigger this. Not that I am complaining about it but apart from this rather beneficial side effect I seem to be perfectly normal!

Thanks for your help.

Interesting. I have not heard about a decrease in body odor from Propecia (finasteride 1mg), but if that is what happened, it sure does sound like a benefit.

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Math Problem — Making a Class 7 Look Like He Has No Hair Loss – Hair Loss Information by Dr. William Rassman

This is a follow-up to last week’s How Many Grafts to Give Dick Vitale Hair Like Brad Pitt?

Doctor by saying you would need 40000 hairs to give mr Vitale the coverage mr Pitt has, do you mean that 40000 hair could produce the coverage but not the density? Cause otherwise the numbers don’t add up. A head like mr Pitt’s has at least 100.000 hairs right? Now, assuming that Vitale has kept about 10.000 hair at the back of his head : 40.000 + 10000 = 50000

What am i calculating wrong?

We at NHI have produced wonderful, full-looking heads of hair with a total of 50% of the original density. If Brad Pitt would allow me to pull out every other hair behind his hairline, I don’t believe that you would be able to tell that he lost 50% of his density. One doctor actually did this on a human volunteer and found (using good photography) that in this white male with black hair, observers and photographs could not tell the difference. The contrast of the black hair against white skin is what makes this most interesting.

This is an important observation, because if 50% is the amount of the original density a white male with black hair needs to appear full, then a white male with light brown hair may only need 20-30% of his original density, and a white male with blond hair may only need 10-20% of his original density to look full. The color contrast also extends to dark skinned people who have matching hair colors and they may behave just like the blond hair white skinned man I discussed above.

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Minoxidil and the Sun – Hair Loss Information by Dr. William Rassman

Hello Doctor,

I am a 24 year old Caucasian male. Since my early twenties I started noticing a little hair loss. Now it has gotten to the point that I find hairs everywhere. I work on a computer all day and I constantly find new hairs with what seem to be roots attached to them on my keyboard, up to 50 a day. And that is just on my keyboard… I can’t imagine what happens when I shower or go running outside.

Also my scalp is terribly itchy all the time. I have spoken to my doctor about my premature hair loss and the itchiness and he told me the only thing that works is Minoxidil 5%. I have been using that for about 3 months now and I do not notice any improvement. Also I live in a very sunny part of the world and I read somewhere that coming in contact with sun a lot when you have Minoxidil applied isn’t very good. Is this true?

The thing that gets me most is that my father now 65 has a head full of hair, and also my mother’s father still had a head full of hair when he was 80. Only one person in the entire family has hair loss problems and that is one of my father’s brothers. And that only started when he was 45. I must say I am quite a hairy person (back, chest, legs ect) and I live a stress free life as far as I can tell.

What could be causing my hairs to fall out so early in my life? Is it all in my genes or is there something else at play? Also what would you suggest? Keep using Minoxidil or maybe start using something like Propecia?

Minoxidil can cause irritation to the scalp making it itchy, but there should be no impact of sun exposure for a person who uses minoxidil as directed. The hair loss gene (or genes) can come from either the paternal or maternal side of the family and can even skip generations, so although it might not be immediately apparent, your genetics may still be in play with regard to the hair loss you see.

I can’t suggest prescription medications like Propecia without knowing whether you have genetic hair loss. Minoxidil is an over-the-counter medication, so if you use as directed you should be fine. Many men have experienced substantial benefits from Propecia, but you should first get your hair mapped out for miniaturization to find out if you have male patterned baldness (MPB).

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Numbness Months After Hair Transplant – Hair Loss Information by Dr. William Rassman

I am still feeling numbness over the area of my surgery 2 months after the procedure. Is that normal?

I assume you mean numbness in the donor area (back of the head). Your doctor should check for numbness over the distribution of the major occipital nerves if the numbness is very wide. Most people who feel some numbness are experiencing the cut cutaneous nerves just above the incision. These should not extend more than an inch and they should return in time. Best to check with the doctor who performed your surgery.

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Diffuse Hair Loss – Hair Loss Information – Balding Blog

(female) Dear Drs,

I was told that I most likely am suffering from Diffuse Areata, the thing that directed my doctor to this diagnosis is diffuse all over hair loss, brow and lash shed and short tapered hairs shedding out. I can find nothing on the subject, nothing on the net and my doctor admitted he did not understand the disorder.

Could you provide me with information regarding the diffuse form leaving no bald spots but diffuse loss all over the head. What is the general prognosis etc?

Thanks for your help

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First, I want to tell you that clinical medical science is a descriptive science in many situation. This is important because what we see is what we are reporting when we diagnose diffuse alopecia areata. What doctors are saying is that there is a diffuse form of the disease that mimics classic alopecia areata, except that it is found all over the head. Some doctors question if this is the same disease, but because it looks like the same entity when the skin is biopsied as localized alopecia areata, the conclusion is that the diffuse variant is different in ways that are not understood. Most people believe that it is an autoimmune disease and we see evidence in what we call chronic and diffuse alopecia areata of the microscopic changes seen in autoimmune diseases.

Second, I can point you to some sites of interest so that you can learn more (but hopefully not confuse you):