Dr. William Rassman – Page 1567

October 2, 2007

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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October 2, 2007

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:

Is it common for hair not in the donor site or the recipient site to shed so much?

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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October 2, 2007

The Best Procedure for a 22 Year Old That Wants His Hairline Back? – Hair Loss Information by Dr. William Rassman

hello, i am a 22 year old male who has had hairloss for about 3/4 years now, a year ago after noticing quite bad thinning i started using regaine and procerin combined, my hair thickened slightly but not much so 3 weeks ago i swapped the procerin for finpecia (generic finasteride) i now have lots of hairs in my hairline but they seem to stay the same length, realising that these medications don’t re grow hair in the receding hairline area i have been considering some form of surgery, baffled by the procedures and sites recommending certain types only i was wondering if you could tell me what the best procedure is for a young man who just wants to fill in his hairline slightly and maybe help thicken the front as well?

regards

I do not quite know what you are asking. If you are considering a hair transplant procedure, you need to see a hair transplant doctor for a good physical examination and his/her evaluation. Generally, hair transplants in a 22 year old man is approached with great caution for two key reasons –

You may have further balding in the future
A surgical procedure like this may accelerate the balding process

A good Master Plan must be created to account for your hair loss worst case scenario so that whatever is done today, will continue to look good as you get older. The best hair transplant procedures use follicular unit grafts by experienced teams.

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October 1, 2007

Hair Loss InformationWhat Dosage of Beta Blockers Triggers Hair Loss? – Hair Loss Information – Balding Blog

Dear Dr. Rassman, I’ve read on your blog that beta blockers can accelerate hair loss in men with MPB. Is there a specific amount (on average) of this medication that usually triggers balding? For example, someone taking beta blockers for high blood pressure would probably take a higher dosage than someone taking it for performance anxiety. I take it for performance anxiety. Are the people who take a higher dosage for blood pressure the people who usually see hairloss as a result?

Also, do certain types of beta blockers cause more hair loss than other types?

Thanks!

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There is no particular dose of beta blockers that would cause more hair loss. More importantly, you may be confused by my prior posts. Many drugs can cause your ot lose hair, but medication is the LAST thing on the list of other, more common causes of hair loss. Medications (including beta blockers) do not cause androgenic alopecia (AGA) or male pattern balding (MPB).

You should not start or stop or change any medication regimen without consulting your doctor.

October 1, 2007

Herbal Shampoo and Rogaine for Women – Hair Loss Information – Balding Blog

my mother takes rogaine. i have found a herbal shampoo system that is supposed to enhance hair growth.

the ingredients are: cetearyl alcohol, dimethicone PEG-8, meadowfoamate, cocamidopropyl, pg-dimethiconol, lecithin, borago officinalis seed oil, caprylic/capric triglyceride, retinyl palmitate, tocopheryl acetate, ascorbyl palmitate, phosphatidyl choline, panthenol, glycerin, phopholipids, niacin, sodium riboflavin phosphate, calcium pantothenate, pyridoxine hcl, carbomer, papain, hydrolyzed algae extract, biotin, salvia officinalis(sage) leaf extract, ezuisetum hiemale extract, juniperus communis fruit extract, hypercium perforatum extract, arctium lappa root extract, symphytum officinale extract, m humulus lupulus(hops) extract, uirtica dioica(nettle) extract, thymus vulgaris extract, serenoa serrulata fruit extract, yucca schidigera extract, glycyrrhiz glabra extract, rosmarinus officinalis leag extract hydrolytzed wheat protein, benzyl nicotinate, guar hydroxypropytrimonium chloride, citric acid, hydroxyethylcellulose, safflower, sessssssssame seed oil, stearamidopropyl dimethylamine, quaternium-80, methylchloroisothiazolinone, methylisothiazolinone, butylene glycol, menthol, mentha piperita.

can she use this with the rogaine?

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Yes, I don’t see why not.

October 1, 2007

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

I washed my hair one day after pulling out braids. I went to my personal hairdresser to get my hair redone only to be told “Honey you know you have a bald patch” then she proceeded to rub it with her finger. It was as smooth as could be. It now has a few strains of hair and i have bought things specifically described for hair loss near to the neck. It itches a the bottom of the spot. Just tell me what exactly to do please cause it really bugs me out.

You describe a condition known as traction alopecia, where hair follicles are permanently damaged with constant traction (in your case braids). That area may never grow hair back. You need to see a hair specialist (a good hair transplant surgeon may help), but you should wait for 6 months to see if it does grows back.

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October 1, 2007

How Long For Grafts to Take Hold After a Hair Transplant? – Hair Loss Information by Dr. William Rassman

I have a question after the procedure of a hair transplant.

How many days does it take for the bulb/graft to take and settle? So even if the scabs and hair fallout it won’t be a problem.

THANK YOU FOR YOUR TIME

Dr. Bernstein and I wrote an article in the February 2006 issue of Dermatologic Surgery that essentially says that when the ’scabs’ come off, the grafts are anchored. That can take 3-14 days and is determined by the aggressiveness of your washing process. The abstract of the article is available here — Graft anchoring in hair transplantation.

In an ideal world, the grafts are relatively permanent after the first 48 hours unless you actually work them out. In the real world, I would generally say about a week (just to be safe). If you are determined enough, I am sure you can get a tweezer and pick them out, though I’m sure you are trying to avoid doing.

October 1, 2007

Management of Progressive Balding – Balding Blog

Dear Dr Rassman,

Your blog entry of 17 July 2007 includes before and after pictures of a man with a receding hairline who has been transplanted on. I am curious what his Norwood classification was before he had the corrective transplants. Is balding in this particular pattern common? Am I right in assuming that most men with this kind of hair loss will need more transplants later on as the balding progresses?

His before photo is on the left; after photo on the right. Click the photos below to enlarge. For more photos, see Results After a Single Session.

This patient has a Norwood Class 3 balding pattern, and yes, it is quite common. He is over 50 years old, so I would not expect his pattern to advance much at all. If he was 25 years old he could lose hair behind the transplants, which may require another procedure, but taking Propecia (finasteride 1mg) may help to prevent that. I don’t like surprises and nor do my patients, which is why miniaturization mapping and a good Master Plan in the hands of a caring, experienced and focused doctor go together hand in hand.

September 28, 2007

Hair Loss InformationI’m Considering Laser Chest Hair Removal – But What If I Want to Use Chest Hair for BHT? – Hair Loss Information – Balding Blog

I’m 30 and a Norwood Class 2. My dad is almost a Norwood class 6 and I have a feeling I’m heading in that direction. I am considering laser removal of chest hair but am having second thoughts wondering if body hair transplant will someday become more successful. (I have read your postings on BHT so far and understand that the results have been limited). Do you see a more promising future for BHT? And thank you maintaing such an informative site. Glad to have fumbled upon it.

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I do not endorse body hair transplantation (BHT), because it is not the standard of care in hair transplant surgery. Body hair does not grow the same length or texture as scalp hair. Furthermore, the growth cycle of body hair is much slower and different than scalp hair. The growth phase for the hairs is much shorter from body hair and the sleep (Telogen) cycle is longer. If a doctor transplanted 100 hairs, then as many as 40-60% of them will be in sleep mode reducing the total number of hairs that grow at any one time. These are some of the reasons why I do not recommend body hair transplant to my patients. I am sure that there are doctors and patients who claim benefits and success with body hair transplants, but I am not one of them. If you are a Class 2 at 30 years old, you most probably will not become a Class 6 as your father is, but if you map out your scalp for miniaturization and show miniaturized hairs in the Class 6 pattern, then you might follow your father’s class. Mapping is good for that reason, to give your reassurance one way or the other. To answer your question though, I don’t see a more promising future for BHT. The hairs on your body are different from the hairs on your scalp.

September 28, 2007

Hair Loss InformationI’m 18 and Want a Lower Hairline – Hair Loss Information – Balding Blog

I have a naturally high forehead. I want to lower it somehoe but I am only 18 and no one seems to want to deal with me. WHat can I do??

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Generally hair transplants for 18 year old males are approached with caution since they have further balding and a hair transplant may accelerate the balding process. For women, hairline lowering with a hair transplant is well proven with great results, even at the age of 18, because the worry about balding (male pattern balding) is not a factor in females. You should start with a miniaturization study of your scalp to see if you have early signs of balding. After all the risks and benefits of surgery are presented to you, it may be a consideration.