Author: Dr. William Rassman

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Where’s the Double Blind Study on Equol or Procyanidin B-2? – Hair Loss Information by Dr. William Rassman

You say you are interested in research for new and improved hair loss treatment methods. Can I ask why no one has decided to do a serious, double blind study on Equol and MPB? Or even Procyanidin B-2? There is anectodal evidence these could help, as you admit. Why NO progress on ANYTHING in the US besides fin? Couldn’t an Equol pill make money if a study proved it worked for MPB instead of just hancuffing DHT? Why aren’t you leading the charge on some of this stuff, when you have access to the best research and best minds – and as you claim, a physician should CONSTANTLY seek better ways?

It is one thing to be a physician and another to be a researcher. It takes lots of money, time and logistic effort to conduct even a simple study, let alone a good, reputable study with many patients enrolled. While it is true that I am interested in research and science, I do not have the resources to take on such an endeavor. Perhaps you should pose this question to the drug companies and business entrepreneurs or find the funding to organize such effort.

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I Want a Scar Revision – Hair Loss Information – Balding Blog

I was wondering if you would do scar revision for my donor scar. I don’t think I had a very good doctor. What would the cost of a tricho closure be approximately? I have seen your photos and some look great, I can hardly tell there is a scar. Thanks!

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We are constantly researching to come up with better methods to manage the donor area for improving the donor scars. Scar formation has to do with several factors — the surgical technique is only one of them. One important factor that patients tend to forget is their different healing potentials. Not everyone is a good healer and some patients develop widened scars regardless of the meticulous methods that are used. We usually do a scar revision for our patients with no cost to them. For those patients who are referred from other centers, we charge a minimum fee including a trichophytic closure, but we need to evaluate you with regard to the size of the scar, know how many surgeries you had, and determine the looseness of your scalp before we can tell you if we think that we can help you. You may call the office for a quote on our minimum fee — 800-NEW-HAIR. It is possible that this could be done over a telephone consultation.

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Hair Loss InformationHead is Still Numb and Donor Area Still Hurts a Year and a Half After Surgery! – Hair Loss Information – Balding Blog

Dr R…You can publish. I paid for 1,600 grafts a year and a half ago [with a local doctor]. Horrible results! This is a photo the night after my surgery. My head is still numb on top & hurts in the back after a year and a half!!

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After a few weeks, any anesthesia (numbness) of the skin should abate unless it is in the back of the head and one of the major nerves was cut. It is not clear from your comment if the pain and numbness is in the top and back. The major nerve will control the back and top of the head. If you say you have had horrible results from the transplant, then confront the surgeon that did it and ask him/her for his/her opinion. Then get a second opinion (you can come see me in Los Angeles) to assess what grew or did not grow. Access to your preoperative and post operative pictures will be critical for me. As a smart consumer, you should know that you can get answers and you should pursue those answers. Hopefully, your doctor will respond to your concerns. Speaking with your doctor directly, is the first step you should always take.

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Baldness Calculator? – Hair Loss Information – Balding Blog

Hello!

I am 19 years old (going to be 20 in september).

I have a noticable receding hairline and I have now for 6-8 months or so. I am terrified of going bald!

I used a baldness calculator and it said I would be bald by my late 20’s. How reliable are these calculators?

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I don’t know of any publically available, reliable baldness calculator yet. The best way to determine what your final pattern of hair loss will be is to have your hair mapped out for miniaturization and see what areas are being impacted. In a young man, maybe only the frontal area is starting to bald and as you get older, the balding may progress more towards the back. Miniaturization studies will show that progression and if you start treating it with Propecia, you might find out that the problem will arrest or possibly reverse for a while. See a competent doctor and get your hair mapped as I’ve suggested.

As an aside, we have developed and submitted U.S. Patent applications for a type of baldness calculator. We are working on building it now, but it will take some time to get the right design and we will not manufacture it until we are satisfied with the iterations we work out.

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Root Stimulator – Hair Loss Information – Balding Blog

i have hairloss in my crown area and recently started using a root stimulator product and ive noticed small bumps in that area. could this be new hair emerging?

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I don’t know what you mean by “root stimulator” (it may be a marketing term, not a medical term), but new hair growth usually does not present like that. What is usually called hair growth, seen with available hair loss medications such as topical minoxidil (Rogaine) or oral finasteride (Propecia), is thickening of the miniaturized hair. The effects of these medications are to stop or slow down the rate of hair loss or sometimes to thicken the current (miniaturized) hair. Check this with your dermatologist if you see new bumps in your head.

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Bumped My Head 10 Days After Transplant – Hair Loss Information – Balding Blog

Hiya, I had hair transplant surgery on my temples about 10 days ago. Today I bumped my head on my left temple and it became slightly red. I wanna know if this is dangerous and would affect my hair transplants. Also some of my new hair fell out with the scabs about 8-9 days after surgery. Is it too soon for it too fall out?
Please help!!

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It would be unusual for loss of the root of the grafts at 10 days post transplant. We have published on this subject and found that the root of the transplanted graft stays in even if the top of graft came out at 10 days. What did your doctor say about it?

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I’m Confused About the Shedding from Hair Drugs – Hair Loss Information by Dr. William Rassman

i’ve heard people complain about “shedding” with Rogaine, Propecia, and Avodart (more with Avodart and Rogaine). I can see from what you have posted before how Rogaine may cause “shedding” (or loss of hair) as it speeds up the hair cycle, and may cause hairs to fall out to be replaced by new, by stimulating the hair cylce process. But how would Propecia or Avodart cause shedding? It seems like it would cause to stop, since only a hormonal inhibitor, not some hair regrowth stimulant. Are these people complaining of “shedding” really just experiencing hair loss from genetic hormonal factor (androgenic alopecia), and it just has not been long enough for their Propecia (6 months to 1 1/2 years) to really kick-in and cause regrowth?

Propecia (finasteride) and Avodart (dutasteride) may cause hair shedding in some, probably through the same mechanism. The exact mechanism for this hair shedding is not known, but the shedding induced by all different medications generally fall into the same pattern. As we’ve said before, this hair shedding is usually temporary and reversible within a few months and not as common as the readers of websites may think. In my practice, I rarely hear this complaint.

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Is Propecia Making My Hair Lighter in Color? – Balding Blog

Dear Dr. Rassman,

First of all, your website is very helpful and I commend you for offering your expertise.

My question is about a return to natural hair color while on Propecia. I am 28 years old with thinning hair, which has always been naturally thin but I am definitely balding recently. My hair is blonde but has darkened a bit over the years (a dirty blonde now). I have been on .5 mg propecia every day/every other day for 2 months now.

I noticed that much of the hair I lose is shorter, thinner, and a black color compared to the rest of my healthier hair strands. But recently since I started on propecia, the base of the hair falling out is a very light color, while dark towards the end. The lighter part at the root is about 2 cm or so and matches my more ‘natural’ hair color.

Is this an effect of Propecia? Does it mean that Propecia is having a positive effect returning my hair color/strength/thickness to it’s natural state? Why would thinner hairs be so dark in the first place?

Thanks for any answer you can give!

Miniaturized hair is lighter in color due to less melanin pigments present in each hair. Propecia can help thicken the miniaturized hair and by doing that make new hairs look darker. The light hair that you are losing may be the cycling miniaturized hair. Since you recently started taking Propecia, you may gain some of the original color back in the growing hair. Your miniaturized hair may continue to grow for a year or more and may eventually stop growing if Propecia can not keep it at bay. That is the reason most patients will see some return in color during the first year of taking the medication.




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Hair Loss InformationTransplanting Into a Neurosurgical Scar (with Photos) – Hair Loss Information – Balding Blog

This patient had an extensive neurosurgical procedure with a corresponding scar. Even when his hair was longer, the scar showed because he had frontal recession from genetic balding. We performed a hair transplant (one session of 1433 follicular units) and successfully treated both the scar and the frontal genetic recession. The “after” photos were taken just over 4 months after his procedure.

I have done this type of corrective surgery on many people. It is a life changing experience for these people, not having to face their deformities every day. Unfortunately, few neurosurgeons understand what modern hair transplants can do, not only for their patients, but for their own balding sons.

Click the photos to enlarge.

Before:

 

After (only 4.5 months):