Hair Loss InformationHair Diameter Thicker Near Middle, Rather than Near the Bulb – Hair Loss Information – Balding Blog

I have read that hair diameter is thickest near the bulb and thinnest as it reaches the tip. Recently I have seen some fallen hairs with the diameter thickest at the center and thinner as it reaches the bulb and tip. Is this indicative of hair loss?

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The hair shaft should be uniform in its thickness through its entire length when the hair is shed during the normal growth phase that all hairs go through. If there is active miniaturization that radically sets in, then that could explain what you see in some of the hairs that you observed. In the miniaturized hair, the hair probably grows slower than in the normal state, so a hair that you are looking at (lets say one inch long) might have taken some time to find its way out (more than the normal 1/2 inch of growth per month). The best indication of hair loss is to assess the degree of miniaturization that is present throughout the scalp, particularly the areas that are thinning. I hope that this helps.

Any Way to Tell How Many Transplant Hairs Actually Will Yield Growing Hair? – Hair Loss Information by Dr. William Rassman

IS there a correlation between how well transplanted hairs “took” at first, and the eventual yield?

The reason I ask is, I’m about 4+ months out from a 1,200 FUE session and I have seen little/no evidence of growth yet. But, I remember in the first couple weeks after my procedure, I felt and saw a whole lot of hairs as nubs, and they grew a little before falling out. If the hairs held at first, and even grew, can that be an assurance (or at least almost an assurance) that everything was done properly and they’re going to come back and grow for real? or is it still possible to end up with poor yield even if the hair looked real good at first?

At 4 months, I would not have expected much hair to be there. Between the 4-5 month, you should see hair growth and by the 7-8th month you should be in the combable hair stage. By the 12th month, expect over 95% of the grafts to have grown.

It is rare to have no graft growth if your surgery was performed by a doctor with an experienced team. A complete failure of the transplant in the hands of such a team is very rare. Those hairs that appear to grow in the first 2-3 weeks after the surgery (those short hairs that feel like a beard) are really just being shed and contrary to what you see, they are not growing. These hairs sometimes remain in the head and are not shed in the first month, but most times they do not grow either. Any residual hairs that look beard-like will almost all shed by the time the actual transplanted hair grows.

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Is Weight a Contributing Factor to Female Hair Loss? – Hair Loss Information by Dr. William Rassman

hello! i’m a 21 year old female student that has been experiencing hair loss for a couple years now. my stress levels varies, but i doubt that is the reason why i’m shedding. my mom believes that i’m lacking the correct amount of vitamins and what nots. i eat regularly, but i’m 5′4” and only 102 lbs. do you think my weight is a contributing factor? also, what kind of supplements should i consider? rogaine would be my very last resort, so any advice is greatly apprecaited. thank you.

If you are malnourished, then this is a cause of hair loss along with a variety of medical conditions that require a good doctor to exclude in a diagnostic workup. Diseases like thyroid disease can cause weight loss and hair loss. Focusing upon dietary supplements is the wrong focus. You need to know if you are healthy first, and if you are malnourished second. Taking some natural supplements will delay what you need to do. The best students are those who understand and learn about their body. It is a temple, so treat it with respect.

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Patches of Hair Loss from Medication? – Hair Loss Information by Dr. William Rassman

I am 31 years old, and I have noticed patches of my hair have been falling out in certain areas. Friends have noticed as well, especially right at the front of my forehead. I have been on birth control for several years ortho novum 777, and recently changed to a new pill this month called (low estrogen), due to medicine I am taking for seizures(Topamax) What can I take to help this? I don’t want my hair falling out. Please help me

Some of the medications you are taking can cause hair loss, but patches of hair loss on one side of your head indicate either an infection problem (like ringworm) or a condition called alopecia areata. You need to see a specialist for this. It is not for me (over the internet) to diagnose your problem, but it does need a competent medical expert.

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Skin Cancer on the Scalp – Hair Loss Information by Dr. William Rassman

In an earlier post, you commented that Toppik can cause skin cancer. Did I read that wrong?

Yes, you read it wrong. Toppik can hide a skin cancer, because it is like a make-up that covers what it is put on. If the scalp is tan, then a tan Toppik would be used to cover the scalp, thereby hiding a skin abnormality like the skin cancer seen here:

I actually picked up this cancer by giving this man a hair wash in the office so I would get off the Toppik and get a good examination of this scalp. He had noticed this spot when his comb got caught on it. It often bleed, but he did not think much about it because he assumed it was from his comb. Wounds that do not heal like this must be examined by an expert to rule out a skin cancer. I found this tumor and was concerned that it was a malignant melanoma (see below), but after excision biopsy was done, it turned out (fortunately) to be a Basal Cell type. The excision alone should cure this particular cancer.

Skin cancers come in three varieties:

  1. Basal cell cancers are the most common and they frequently ‘crater’ and elevate. These tumors are most often the result of direct sun damage and they rarely metastasize and they are slow growing. They will, however, locally invade the surrounding structures.
  2. Squamous cell cancers are the second most frequent cancer and they will invade beyond the confines of the tumor, even spreading to other parts of the body. They can kill.
  3. Malignant melanomas are skin cancers most dreaded by everyone. They often have a black, elevated surface with a spreading out of the tumor like an octopus or an amoeba. Once they invade below the very superficial surface component and break through into the lower structures of the skin (about 1-2 mm below the surface), they can and often spread through the body and they can be deadly.

Hair Loss InformationHow to Tell if You’ve Found the Right Hair Transplant Doctor – Hair Loss Information – Balding Blog

What is the difference between doctors and the various medical groups performing hair transplants. There appears to be a great deal of competition and as I go between groups, I get confused and overwhelmed.

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If you were looking for a good family doctor or plastic surgeon, you would most likely use certain criteria for selecting one over the other. Fundamentally, you would look for a well credentialed, caring, competent doctor who you like and feel comfortable with. Be sure that the doctor values you as a patient by spending time with you and discussing your agenda freely. Ask yourself if the doctor listened to what you were saying or lectured you about his/her ideas. That doctor must be trustworthy to take on your welfare or your family’s welfare, and not only must you believe in his/her skills, but you should also like him/her as a person. Although the various family doctors and plastic surgeons use physician’s assistants or nurse practitioners to help them manage patient’s needs, the doctor is always ultimately the person in charge, the one whose skills you will eventually depend upon. As most doctors practice in groups, you should feel comfortable with the doctors who work with your doctor in the group that you selected, as sometimes your doctor may be on vacation or off-call when you need him/her the most.

You should expect that physician extenders should be educated as physician extenders (nurses or certified physician assistants, not salesmen). Hair transplantation differs from standard family practice and cosmetic surgery procedures in that there is a team approach to performing surgery. Doing refined follicular unit transplantation takes a team of 3-6 people working together for hours, so the doctor’s team is as important as the doctor is. An old cliché says that a chain is only as strong as its weakest link, so the skills of the doctor as one link of that chain can easily be offset by inexperienced technicians in the surgical team or sloppy processes that are not put together carefully and not focused on the many detailed nuances that produce quality hair transplants. You should feel confidence in the doctor and the team and you should feel ‘integrity’ and trust in soul of that doctor.

In my hair restoration practice, I add many elements to build confidence and establish trust. I have an open practice, where new, potential patients can meet completed hair transplanted patients one-on-one. This offers the opportunity for new patients to probe the process and see up front what they will be getting if we perform the surgery. I focus heavily on patient education, not only by providing copies of some of the important medical articles I have written, but also in spending time with each potential patient (doctor and patient in a private room without a salesman). Then after the visit, I provide a detailed letter summarizing what I learned about the patient’s objectives, and a written Master Plan for what I think will happen to that patient. Fees are openly discussed by the doctor and quotes for surgical fees are put into writing. By far, most of our patients do not have surgery and can be spared surgery with appropriate medications.

NHI is unique in that we have a fully accredited surgical center where all of our surgeries are performed, ensuring safety for patients to the highest national standard. Our surgical center is audited regularly for following hospital quality processes and procedure. Very few (if any) hair transplant facilities adhere to such rigorous standards. Why is that important? Well, it is the patient’s assurance that our sense of quality is judged against the best healthcare facilities in the nation. When you select a medical group for your hair transplant procedure, you should not only know the facility, the staff competence, and longevity of that staff, but also the history of the doctor. Has the doctor been disciplined before the medical board for infractions in any form of conduct? What does the public and his colleagues think about the doctor (available through internet sources)? What is the doctor’s malpractice record? Have you met or spoken to his/her former patients, and if so, what do they tell you about their research prior to taking on this doctor as their doctor-of-choice?

I always tell my patients (and have written on this blog many times before) that there is good news and bad news for the hair transplant patient — simply put, hair transplants are absolutely permanent. Getting it done right the first time is far easier that trying to fix what might not be fixable if it is done wrong. By following this selection process, finding a good doctor should not be difficult. There are many good doctors out there, just be careful not to end up in the wrong place.

I’ve Worn a Hair System for 14 Years – Hair Loss Information – Balding Blog

I am a 55 year old, white male with normal crown baldness. I have been wearing a hair system for the last 14 years. Could hair transplantation work for me and what would be the estimated cost?

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See Patient ZU for a good example of a man that wore a hair system for 30 years. He was transplanted and has a wonderful result. The costs depends upon how bald you are. Send me photographs and I will give you some starting points and an estimate.

For more photos of Patient ZU, please click here.

14 Year Old with Bald Spots – Hair Loss Information by Dr. William Rassman

I am 14 years of age. I don’t know how many bald spots I have, but when my hair is wet, I notice quite a lot, especially on the spots where I gel my hair. When I gel my hair, I do notice hairs in the comb. You said it should grow back, but I’ve been waiting 6 months to a year, and no signs of regrowth. How long should it take? Is this normal?

Oh, yeah. 1 more thing. My cousin hit me with a baseball bat, and then there was a bump where I got hit. After my mom put some green oil (it’s an Asian thing, not sure what it’s called). Now there’s a bald spot there. Will it grow back?

These bald spots need to be evaluated by a good dermatologist. A fungal infection is the most common cause of such spots and there are other medical conditions that need to be evaluated as well. You don’t want to be your own doctor here.

The traumatic baseball bat type of injury has been know to produce temporary hair loss at the point of impact. It should grow back in under 6 months.

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A Second Hair Transplant Surgery – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman;

Second Surgery.
How long should one wait for a second hair transplant procedure? I’ve read some articles of men who have had a second surgery only six months after the first and a third only within six months after the second. Is this correct? I had my first surgery 7 months ago and I’m still seeing new little hairs coming up where there were no hairs before. I had to look at my 2 days post op pictures to realize that these are transplanted hairs. So if I’m still getting new hairs coming in after 7 months how can a Doctor suggest to a patient to get a second procedure after only 6 months?

Again thank you for your honesty and for answering our questions.

Kind Regards.

You are absolutely correct. I generally tell my patients that 8 months is the minimum waiting time between hair transplant procedures, because as you suggested, more hair is still growing in until that time. By 8 months, you can generally expect 80-90% of the growth and by 1 year, 95+% of the growth.

There is usually a big difference between the first procedure and the second procedure. In the first procedure, the doctor will make most of the decisions with the patient’s guidance. In the follow-up surgery, the patient makes most of the decisions, because now the patient understands that value of the new hair, particularly with regard to hair and graft distribution.

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Pinker Scalp Pigment Under White Hairs in 18 Year Old – Hair Loss Information by Dr. William Rassman

I’m 18, and last year i started getting a spot of white hairs on my head. The skin on this spot is pinker then the rest of my skelp. Also I think the white hairs are falling out in this area. Is their anything that i can to to help thinkin this area?

These are genetic pigmentation spots that occur in some people. These areas are also subject to genetic balding if the rest of the hair has pattern balding (in some people), so I would make the same suggestions I always make — get your hair mapped out for miniaturization and find out if you are really losing hair in the white spot area, as well as other areas around your head.