Dr. William Rassman – Page 1628

May 8, 2007

Chances of Nerve Damage from Strip Excision? – Hair Loss Information by Dr. William Rassman

Haemorrhage, vascular and nerve damage is a risk of strip excision?? can we see some of these implications in patients? what are the chances of this to happen?

I can reflect on these from only experience in my practice:

Bleeding after surgery — I sometimes see some wound ooze beyond a day after a surgery (I would guess 1 in 300 patients). I handle this with a simple pressure dressing over the donor wound. Bleeding is never a problem beyond a day in the recipient area.
Bleeding significantly during a surgery (by “significantly”, I mean enough to impact blood pressure – more than a few ounces of blood) — Risk for this is close to zero. Every patient bleeds during the surgery as the scalp is very vascular (might lose a few ounces of blood), but it should not be meaningful bleeding that risks anything. Bleeding may be a problem if a patient is on anticoagulants, Aspirin, or if they might have a clotting/bleeding disorder that stops blood from coagulating (this last one should be known by taking a good history from a patient for hemophilia).
Vascular damage — There is no risk of direct vascular damage in a normal person unless the patient has had many scalp reduction procedures or many hair transplant procedures, or the surgeon does not have experience in doing this type of surgery.
Nerve damage — There are two types of nerve damage that may follow a hair transplant. The fine cutaneous nerves are cut in almost everyone both in the recipient area and the donor area. This might leave some numbness above the wound and this usually disappears in days or weeks. The second type of nerve injury occurs when and if the surgeon accidentally cut a major nerve (’greater or lesser’ occipital nerves). This is a surgical error in technique when it occurs. In my practice, I have never seen it in a surgery I have done, but I have seen this injury in patients who came to me from other doctors who may not have been skilled surgeons in the first place.

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May 8, 2007

I’ve Lost Leg Hair – Hair Loss Information by Dr. William Rassman

(male)
I have lost all of the hair on the outside of my legs from the knee down. I do not have any medical conditions that should affect this. Thank you

I do not know enough about you — like your age, for starters. If you know you have nothing wrong with you, then what value can I have? I think you need to link with a good doctor and then let him/her tell you that you have no medical conditions, and/or possibly identify something that is wrong.

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May 8, 2007

No Hair Where Mole Was Removed from Scalp – Hair Loss Information by Dr. William Rassman

When I was about 16 years old I had a mole surgically removed from the back of my head because it was growing larger and the doctor said it could become cancerous. I am angry about this because I don’t know if it was necessary at the time or not. Anyway I am 22 now and no hair has grown in that spot since. I don’t under stand why but lately it has consumed me and I am extremely depressed and obsessed with it. Am I able to get a hair transplant and make the hair grow back? Also will I be loosing one bald spot and creating another one at the donor area if I can have a transplant?

Scars from removal of growths or just lacerations are common in the scalp. It depends upon the surgical technique and possibly more important is the general direction of the wound. Linear scars that run front to back tend to scar more than those that run side to side, but everything in the scalp can scar. With a good hair transplant surgeon, a decision can be made how best to address the scar. Some of these scars can be fixed with a simple surgical excision of the scar and proper closure techniques, while others may be fixed best with a small hair transplant (always works). See an expert.

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May 8, 2007

Propecia and Cancer – Hair Loss Information by Dr. William Rassman

My question concerns Propecia and Melanoma/other cancers. I’m a 28 year old male with moderate MPB. 2 years ago I was taking Propecia with positive results. After about 8 months on the drug I was diagnosed with a Stage 1 Melanoma. The biopsy showed no sun damage and I have no family history of the disease. I immediately made several life changes (diet etc.) including stopping Propecia. After lots of cancer research post diagnosis I noticed the correlation with hormone change/imbalance and cancer development (fertility drugs, pregnancy etc.). Studies also show that men that develop prostate cancer while taking dutastaride develop a more aggressive form of the cancer. My question is, what do you think the odds are that Propecia had a hand in the development of my cancer and have you ever heard of this before? Also, do you think it would be safe for me to start taking the drug again?
Thanks for your time

There is no evidence that Propecia (finasteride) impacts any cancer other than prostate cancer. The studies on finasteride (5mg daily use over 7 years) showed that men that took it (over placebo group) has a decreased risk of cancer by 25%. The statement of more malignant cancers has not been born out with follow-ups on these patients, as reports show that those patients that were thought to have a more aggressive cancer lived just as long as the other group of men. I do not believe that there is any connection between Propecia and your melanoma and would not hesitate to recommend it to one of my patients with your history, but if it worried you, then you can elect not to take it.

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May 8, 2007

Someone Told Me About a Home Remedy for Treating Head Fungus – Balding Blog

My sister-in-law has a one year old daughter. She was born with a head full of hair and she combed her hair everyday like she was supposed to and greased it. She used rubber bands to put braids on her hair and now all of a sudden at the top of the child’s head her hair has come out in big hunks, but just in that one section. So we took her to the doctor and he said it was a head fungus. It looks like big puss bumps and then they bust open by themselves and the puss and blood come out of them. The doctor gave her two types of medication for the fungus and a hair shampoo and he told us to grease her hair with vaseline everyday. But I was told by someone that I could mix Monostat Seven and vitamin E oil together to help it and it would make her hair grow back healthy and even thicker this time. Is this true or do you all have any other suggestions that you could tell me. She now has to wear hats everyday with her hair all down and vaseline on her scalp daily. Please help us if you can.

Treatment of scalp fungus could take a long time and even after treating it, you need to wait a few months for the hair follicles to generate new hair. My recommendation to you is to stick to the recommendation and treatment plan of your dermatologist.

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May 7, 2007

Hair Loss InformationLack of Sleep Causing My Hair Loss? – Hair Loss Information – Balding Blog

Dear dr.
i am 19, and sleep only four hours a night. this has gone on for years. i also have a lot of stress. a friend told me this is why my widdows peak hairline is so drasticly receding, is this true?!

would sleeping more and stressing less do any good?!!!! Thank you soo much for your time doctor.

Block Quote

Some people get along just fine on 3-4 hours of sleep a night, and while that might be stressful for some, others (like me) get along on little sleep without stress.

Stress can cause hair loss. A maturing hairline also occurs in people between 19-29 years old. Look at the photos in Maturation of a Hairline — Moving From Juvenile to Mature and you will see the different between a balding and a maturing hairline. See a doctor and make sure that he/she gets your scalp mapped out for miniaturization to see just how far back the change in your scalp is occurring. If you are balding, then stress reduction and probably Propecia is a reasonable alternative.

May 7, 2007

Is Propecia Less Effective After Prolonged Use? – Hair Loss Information by Dr. William Rassman

Dear Doctor
I have been using proscar tablets(5mg)instead of propecia,quartering the 5mg tablet & taking 1/4 tablet a day.This has worked 4 many years but now it has lost it’s effectivness & I am shedding hair rapidly. I have found many articles on the net were doctors suggest that patients increacse the dose to 2.5 mg to stop shedding & the risk of side efects will rise only slightly. What do u think ? Please respond,I am really depressed. Avodart is not available in Australia & regain liquid burnt my scalp & the foam isn’t available in Australia either.
Thanks in Advance.

You need to speak with your own doctor about this. I can not advise you over the internet. Generally, some people will go into accelerated hair loss in cycles and that may look like Propecia is not as effective, but it probably means that your balding process is more active than before. As far as Avodart (dutasteride), the studies on this medication are not available at this time. Experimental work is presently going on in Korea under the US FDA guidelines that may eventually answer your questions.

May 7, 2007

Parachute Therapie for Hair Loss? – Hair Loss Information by Dr. William Rassman

I just wanted to know that there is a product in Indian market by MARICO – called Parachute Therapie ,its a reputed company but I want to know if the reasons for Hair Loss mentioned and treatment is genuine??? you can consult parachutetherapie.com

Thanks a lot…I am really troubled with Hair Loss

That’s an attractive website with no real information on it, so I can not tell you what it means or if it contains anything of its value. What I did learn was that it is a 45 day oil treatment. The site says, “Parachute Therapie’s Natural Root Activising Alpha Proteins are a unique combination of various ingredients that are researched and proven.” Really, this tells me nothing.

When I read your question, I immediately thought of jumping out of an airplane…

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May 7, 2007

Perform a Skin Test Before Trying Hair Products? – Hair Loss Information by Dr. William Rassman

Hi Doc,
when we buy new hair products for our hair, like shampoo, conditioner, etc, is it necessary to do a skin test? This is because some products may be sensitive to a person’s scalp?

Yes, that may be a good idea, but most commercial products are designed to by hypoallergenic (low sensitivity for a reaction). It is generally safe to use almost any known brand on the market today.

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May 7, 2007

Touch-Up Hair Transplants – Hair Loss Information by Dr. William Rassman

What are your thoughts on “touch up” transplants? I am currently 27 yrs old and have had thinning in my front forelock since I was 18. When I was 24 I started Propecia and although it has progressed (from the size of a dime to a quarter) It has been slow.. This makes me think that my problem could be solved with 800 or so grafts. The rest of my head has good thickness. I realize you’re going to recomend a “master plan” and “hair mapping”, but if you could include your thoughts on touch up’s. It would be appreciated. Most importantly on what criteria you would recomend them, if any.

thank you.

It is impossible for me to tell you about your hair loss and treatment plans from a simple blog posting. You seem to know about the importance of a Master Plan and miniaturization mapping and with any transplant work that you are considering, anticipating the future direction of the hair loss is critical to balance things like:

Supply/demand of donor hair use
The rate of hair loss for following your progressive hair loss over time
Budgeting appropriately to follow-through with what you start

If you are concerned about your hair loss, your next step is to see a good, honest hair transplant doctor. If you saying that you already had a hair transplant or two or three, and this is a touch-up (meaning another small hair transplant procedure) you should ask your doctor how many more of these are needed to make sure that you know where it will all end sometime.

Sometimes patients come to me with a preconceived number of grafts they need. Often times these numbers do not match their expectations and the real needs to achieve the goals. Everyone’s needs and the criteria for choosing the numbers of grafts are different based on hair color, skin color, hair texture, head shape, etc, etc. See Patient’s Guide — How Many Grafts Will I Need?

I do not understand what you mean by a “touch up” transplant. You should either have a hair transplant to meet your goals or you should not have a transplant at all. There are some patients who may come back a year later for more fullness or address other areas and as there may be a risk of shock loss, you need to prepare a worst case scenario. You may see this as a “touch up”, but as you can see, it is related to the goals and expectations of a hair transplant program.

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