Author: Dr. William Rassman

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Hair Loss InformationHey Doc! – Hair Loss Information – Balding Blog

DoctorHello Doctor.
I notice that a lot of questions here start with “hey Doc,” or “Wassup Doc,” or something similar.

Does this bother you at all? I’m sure if I had spent years in education and training to get my M.D. and everyone kept referring to me as “Doc” rather than “Doctor”, i’d be slightly annoyed but maybe that’s because my ego is larger than yours. It seems only polite to refer to a professional such as yourself by your proper title, or at least, Mr. Rassman.

I also notice your hairline seems quite healthy. If you don’t mind me asking, are you on medications yourself or are you simply one of the lucky healthy-haired males?

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I really don’t have a doctor complex and many people get familiar with me and I don’t mind. As long as they aren’t calling me something vulgar…

My frontal hairline is natural, but the crown of my head is transplanted.

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Hair Loss InformationWhat Causes DUPA and Can Hair Be Restored? – Hair Loss Information – Balding Blog

If Diffuse Unpatterned Alopecia is not related to DHT, the main cause of hair loss, then what causes DUPA. So if DHT level’s are not related to Diffuse Unpatterned Alopica, then that means that there should be some hope of restoration since DHT is not the cause of DUPA.

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We do not know what causes DUPA. I have had some success with finasteride with patients having DUPA, but as it is not statistical and more anecdotal, I can not even recommend this approach with any real certainty of success.

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Hair Loss InformationBody Hair Transplant – A Case of 100% Failure – Hair Loss Information – Balding Blog

I saw a patient earlier this week who had a well known surgeon place hundreds of body hair grafts into a bald area of his scalp about two years ago. This surgeon is one who promotes his body hair transplant procedures quite heavily, particularly on various websites and hair loss forums. No, I won’t name names (do your research and you’ll probably figure it out). There was 100% failure for the body hair to grow. Yes, a complete disaster. As one might expect, this patient was quite angry because he spent $11,000 and had great hope for this procedure, as he was depleted of donor hair from the back of the scalp.

Those looking to use body hair to transplant into their scalps should strongly consider other options if they are available, as this is not the first time something like this has occurred. I’ve read various reports and have heard quite a bit about this level of growth failure before.

Respectfully, the patient has requested that his photos not be published here.

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Could Finasteride Be Affecting My Sperm? – Hair Loss Information – Balding Blog

Dear Doctor,
I have been taking Propecia for years. My wife and I are trying to have our first baby. She has gotten pregnant twice, however both have resulted in her getting a D & C. There have been problems with cell growth after conception in that an empty sac forms with nothing inside. Could finasteride be affecting the genetics of my sperm?

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There are many potential reasons why your wife may have trouble conceiving. There are two issues that are known with regard to sperm while taking Propecia —

  • Reduced semen volume is very common, but usually the presence of sperm is good.
  • A recent report in the medical literature suggests that Propecia may cause reduced sperm counts, so I would have your sperm tested for this.

I would think that Propecia is low on the list of many more common possibilities.

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I Have Hairy Shoulders, Back, and Chest – Will I Have MPB? – Hair Loss Information – Balding Blog

Hi Doc. I have a few questions regarding male pattern balding and hormones.

  1. I obviously have a lot of DHT as I am 22 and have hair on my shoulders, back and chest and had bad acne growing up. Does this mean that I will be more susceptible to MPB?
  2. I have a widows peak that I inherited from my father. He is in his 50’s and the only extent of balding happened before his mid twenties that resulted in a pronounced widows peak. Does this mean That I will probably follow his pattern? if I have more DHT that he does is there a greater chance that I will have more balding…or is your pattern of balding predetermined…regardless of the amount of DHT you have.
  3. I have noticed miniaturized hair falling out every once in a while, they are thin but still as long as the rest of the hair. Does this always mean MPB or does some hair naturally miniaturize. (could other scalp conditions cause this, such as dermatitis)

I appreciate any info you can offer regarding these questions. Excellent site, keep up the good work.

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  1. Having “lots” of DHT does not necessarily mean you will have MPB. You need to have the gene for MPB. Just having hairy shoulders, back, and chest does not necessarily mean you have “lots” of DHT either.
  2. You may or may not follow your father’s hair pattern. There is no way to tell for certain.
  3. Miniaturized hair does not necessarily mean you have MPB. Men with MPB have miniaturized hair in certain “patterns” — thus, the term male pattern baldness (MPB).

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Why Was I Born with a Bald Spot? – Hair Loss Information – Balding Blog

Hi,
I am a 28 year old woman that was born with a bald spot in the middle of the back of my head. Do you know what may have caused this? And do you know how I may be able to fix this? I never wear my hair down because of it and it’d be nice to. Thanks!

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I really couldn’t tell you why you have a bald spot on the back of your head. The bald spot may just be a birthmark or it could have been a result of trauma when you were a baby. I do not know. If you want to address or fix the bald spot, you can consider a hair transplant.

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Gastric Bypass Surgery Coming Up – What Can I Do to Keep My Hair? – Hair Loss Information – Balding Blog

(female) Hi. I am a pre-op for gastric bypass surgery. I understand that hair loss is a common effect of gastric bypass surgery. Is there anything that I can do now to get ready for this? I have thin hair to begin with. Is biotin helpful? Thanks.

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Hair loss and weight loss go hand in hand. Speak with a dietician to come up with the best balanced diet for you. You may suffer from hair loss as long as the weight loss continues, and as this is a consequence of the surgery there may be little for you to do once you focus on your best diet through professional help.

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Success Story – A Reader’s Hair Transplant Experience – Hair Loss Information – Balding Blog

I am writing this message as a way to convey my personal experience thus far with a hair transplant. I would like to offer hope to people considering this route. One caveat is that everyone is a different case-regarding donor supply, pain tolerance, how far along the Norwood scale, etc. Without naming physician-I will tell you of my experience. I researched for over 5 years who to go to and kept coming back to the surgeon I chose.

I had tremendous trepidation about whether I should do this-people would tell me I look fine but I knew I was kidding myself with my hairstylist working with me to cover my completely eroded hairline and front as well it made me a 4A on the Norwood scale. I was given 2 valium to relax me. We discussed the hairline that would be age appropriate for now and the future. Then we were ready to get started.

OK-here is the answer everyone wants to know- does it hurt?

Well I can tell you that I have a low pain tolerance and definitely dreaded the needles for the anesthesia and rightfully so-they did hurt especially the forehead-but the good news is you felt nothing after that. None of the cutting/suturing nor placement of grafts into the receptor sites. I was pleasantly surprised. Based on my personal experience the surgeon was able to place 2502 grafts. He even told me that he was sure I would be happy with the results something he refrains from saying. He knows that I am very particular and I believed him. It is all a waiting game. say 6 months to a year before you see real results at least this is what I have been told.

The surgeon used the latest technology-the tricophytic closure a double suture process-to assure a minimal scar provided you do as your told.

We are all adults and clearly must be responsible for our own welfare. Therefore if you follow exactly the direction for maintaining post op procedures I am sure it will minimize infection chances and limit scar size. You must treat these grafts as if they are fragile like glass-they can be destroyed accidentally and through not following directions. I am on day 5-one third of the way through the post op.

I myself am very sad to say that I had a violent reaction to the pain medication with Codeine. Between the antibiotics and the pain meds it really did a number on my stomach. I see that as the worst part for me. Amazing the procedure was easier than the recuperating time-I never would have guessed. I am just getting over this gas pain/vomiting caused by the medication. It was a tough couple of days.

Would I do it again?

Absolutely yes-the small/moderate pain you feel in the few days is nothing compared to a lifetime of happiness. The bottom line is I was unhappy with my appearance-depressed, self-conscious, lack of confidence you name it. Being a 46 year old male who has been told he looks like he is in his late thirties is Great-but for how long can I pull that off what with the way my hair was going south.

My advice is simple-do your research. check out hair transplant on youtube-they show actual surgeries-do not let that put you off. do not shop around for cheap. this is your future. my cost was $10,000 for 2500 grafts from a surgeon rated the top 100 in Manhattan. Do not go cheap-you will pay for it in the end.

Good Luck!

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The above letter is a response I received after posting Reader Encourages Others to Send In Their Success Stories.

The experiences outlined above are common and even the response to codeine is not atypical and can easily be managed. Codeine has an impact on the stomach as an irritant. I appreciate that you took the time to write this eloquent history to share with our readers!

Note to everyone out there, please keep sending in those success stories!

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Steak Accelerates Hair Loss? – Hair Loss Information – Balding Blog

I have seen certain studys that show hormone polluted meats such as mince meat and steak can accelerate MPB causing more hair loss. Is there any truth to this?

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SteakI found an article with a quote that suggested there was something to this: “If you look at Japan, male pattern baldness was almost unheard of prior to World War II. The Japanese diet is now far more fatty and Westernized, and Japanese men are going bald everywhere. It’s clear that a high-fat, meat-based diet raises testosterone levels, and that may adversely affect hair follicles. I’m not sure eating low-fat foods will stop hair loss, but it might slow it down.”

The above quote is attributed to Dr Michael Klaper, a vegan health advocate that focuses on the perceived dangers of consuming meat and dairy. The problem is, there is no modern science to back his hair loss claims up. While there are many suggestions that “we are what we eat” and that diet does influence the expression of genes, I am unaware of good statistical or scientific studies that accurately report balding prior to WWII in Japanese men or that meat contributes to hair loss.

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When Will My Donor Scar Not Be Visible? – Hair Loss Information – Balding Blog

I have had a recent HT in Nov 2007 and now having problems with haircuts. I have tried a number 2 shear and number 3 shear haircut with both showing the donor area scar for weeks. I was told that a number 2 was fine but obviously not. How long will this donor scar be visible for males that like to wear their hair shorter.

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I do not know how wide your scar is or where your donor scar is. You may have a wider than average scar. You may or may not be a candidate for a scar revision surgery if the scar is wide. You may have temporary telogen effluvium on your donor area that may make the scar more visible and if that is the case, it should reverse in 4-6 months. There are many variables that I cannot readily answer without examining you. You can send me photos of your scar with a ruler next to it so that I can appreciate the degree of scar widening (please reference this post when sending). You should see your surgeon who performed the hair transplant surgery and discuss your concerns with him/her.