Author: Dr. William Rassman

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Hair Transplant for Patient with Diffuse Patterned Alopecia (DPA)? – Hair Loss Information – Balding Blog

Hi, i am almost 20 years old and have seen a few derms regarding my hair loss, it looks like a have DPA, strong hair on frontal tuft, sides and back, my thinning hair is blonde and on the remaining areas of my scalp. i am on propecia, but would like to know your opinion on what surgical advice you could give me. I know its best to wait as long as possible but when would be the appropiate time to schedule a surgery? also, do you recommend FUE for patients with DPA?
thanks so much

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I would need to examine you myself and perform a miniaturization study to determine what you actual diagnosis is. I can not offer you surgical advice without understanding the diagnosis, where your hair loss is at the moment, and more about your overall history (including family history). In other words, each patient is different, so I really can’t give you a clear cut time without an exam.

As you indicated that you’re in Southern California, I invite you to call 800-NEW-HAIR to setup a free consultation in my Los Angeles office.

For those curious about DPA, I’ve written about it before:

Diffuse Patterned Alopecia (DPA) is an androgenetic alopecia characterized by diffuse thinning in the front, top, and vertex of the scalp in conjunction with a stable permanent zone. Diffuse Patterned Alopecia is usually associated with the persistence of the frontal hairline represented by the hairline position of the Norwood Class II or Class III patient.

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I’m Unhappy with the Growth of My Facial Hair – Hair Loss Information – Balding Blog

Dr. Rassman,

I am 25 years old, and my beard only grows on my neck and under my chin. Only a few stray hairs appear on the cheeks and face. The beard growth is of low-medium density, but with very thick hairs (the hair on my head is also thick.) I also have a moustace that grows under my nose and above the lip, but it abrputly stops and does not continue at all past the lower lip. In short, I have a beard only under my chin (not on the chin) to the base of the neck, and only above the upper lip.

What could cause this?

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Different patterns of hair growth in the scalp and facial hair are usually inherited. There are some dermatological disorders that can cause patchy hair loss in those areas, such as alopecia areata, but it does not seem to be the case in the way you describe yours. If there is no one else with this pattern in your family, I’d suggest seeing a hair specialist/dermatologist to rule out other causes of hair loss. If you are diagnosed to have a genetic pattern of hair loss in those areas, you may be a candidate to restore your facial hair with hair transplantation.

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All of The Falling Hairs Are the Same Length – Hair Loss Information – Balding Blog

Thank you for making yourself accessable on the blog Dr. Rassman.

I’m having a peculiar issue with my hair. I shaved my head completely bald apx. 3 months ago to achieve a good baseline to monitor any future potential regrowth. My hair over my entire
head is generally about 1.5 inches long now. When I do see hairs that fall out in the shower or on my pillow they are strangely without question the same uniformed length(being about 1/4 inch long). Why is this so? or how can this be? They are always the same length, being much shorter than the majority of the other hairs on my head that are not falling out. They are however, no less thicker or thinner in diameter than the other hairs. Thanks for your time again.

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We lose 100-150 hairs per day normally as the hair cycles. Considering that you cut the hair to equal lengths, then the ‘old’ normal hair that is shed will have the same length as the ‘new’ hair that is not shed.

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Areas All Over Face and Scalp are Smooth — And It is Spreading! – Hair Loss Information by Dr. William Rassman

Dear sir, I am 46 yrs old and recently have had blotching hair loss on face and scalp. it is baby smooth and it seems to be speading in different areas. can you please explain? thank you

With such a brief description it is impossible to offer any help or try to explain what is going on. Atypical hair loss has many differential diagnoses (such as alopecia areata) . You need to see a good physician for a full medical work up to explore medical causes of hair loss. In some cases hair loss can be a sign for medical problems.

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Hair Loss from Breastfeeding? – Hair Loss Information by Dr. William Rassman

I have been on Errin Tablets 28’s for 2 months now and am noticing hair lost not only am I losing my hair but my 2.5 month old baby as well. Can this be because I am breastfeeding him? How long does this contraceptive take to get out of my system?

BreastfeedingHair loss is reported in users of oral birth control pills (with norethindrone and ethinyl estradiol), like Errin tablets. Breastfeeding does cause a woman to lose weight and even hair as well.

Many, many years ago, I was a dairy farmer and milked up to 120 cows per day. The milking process caused significant weight loss in the cows, but provided that the diet was healthy, side health effects from milking the cows was kept minimal. Clearly any breastfeeding, like the milking cow, can cause hair loss. See iVillage – Weight loss and hair loss with breast-feeding.

I mean no disrespect when comparing breastfeeding women and milking cows — I obviously have no first-hand breastfeeding experience, so this is the best comparison I can make when trying to pull from personal observations.

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If Propecia Works Best for Recent Hair Loss, What Is Considered “Recent”? – Hair Loss Information by Dr. William Rassman

Propecia reportedly works best regrowing recent hairloss, but what is considered recent? Hair lost the last 6 months? The last year? Longer?

Propecia (finasteride 1mg) works best for men who are actively losing hair. If you are totally bald, it will not regrow hair. Propecia works best if you have many miniaturized hairs, if you are under 30 years old, and if the hair loss has occurred over less than 2 years (this does not necessarily mean that it won’t work with more chronic hair loss, though). I often write about getting a miniaturization study to document a starting point, particularly before you get on a drug to treat your loss.

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Norwood Class 3 Hair Loss in Women – Hair Loss Information – Balding Blog

Norwood Class 3Male pattern balding is thought to only affect males and rare indeed is the female with this type of balding, according to popular belief. Yet, I have seen some relatively young females (in their twenties at most) with a hairline resembling a Norwood Class 3. What is this about? Perhaps I should buy myself a set of spectacles, or is it really true that females may develop male pattern balding to a certain degree?

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Many women get a very thin corner that develops over time. The hair is miniaturized, but most often not lost. It grows slowly and rarely bothers the women. It has been suggested that women with this corner thinning, may have some form of genetic balding like the Class 3 males with corner recession.

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In What Case Is Avodart Better than Propecia? – Hair Loss Information by Dr. William Rassman

Hi Doc,

In what situation do you think that Avodart may be better than propecia. For users of propecia who have been on it for more than 5 years and its effectiveness diminishing do you think that switching to avodart is ok? Obviously if propecia was still working then there would be no need to switch but what if propecia results were fading?

I am just speculating here, as I don’t have the definitive answer to your question. Avodart (dutasteride) may be more powerful that Propecia (finasteride) in treating hair loss at higher doses than are usually used (2.5mgs/day rather than0.5mgs/day), but it almost certainly has more side effects as well including significantly reduced sperm counts. The best dosing is unknown in the use of Avodart as a hair loss treatment and until the manufacturere comes up with a recommendation that the FDA will accept with regard to effectiveness and safety, the drug must be assumed not be be safe for young men who wish to have children. It is quite possible that many doctors are overdosing the medication at this point as the known half life of the drug is 5+ weeks. If/when the FDA approves this medication, more information will be available.

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Post-Op Questions After Hair Transplant 6 Weeks Ago – Hair Loss Information by Dr. William Rassman

I recently had a hair transplant (approx 6 weeks ago). The doctor cut 5 strips and transplanted into the vertex and front hairline, leaving the top of the head alone.

Since then I have noticed a lot of shedding (counting about 50-60 hairs in the shower as opposed to the typical 10 before). I realize there will be shedding after a procedure, however, I notice considerable thinning directly on the top of my head. A lot of the hairs that are shedding are long and thick.

I have 2 questions:

  1. Is it common for hair not in the donor site or the recipient site to shed so much?
  2. How much longer is this going to keep going on for?

Assuming you are male, then you may be experiencing shock loss, as it seems to relate to your recent hair transplant. Shock loss in young men often does not reverse. Were you taking finasteride (Propecia) which tends to protect against shock loss? Most importantly, I think these questions should be addressed to your doctor who performed your surgery and/or these things should have been explained to you in advance. At the very least, they should’ve been written out in your pre and post operative hand out.

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