Author: Dr. William Rassman

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Hair Loss InformationLoss of Neck Hair – Hair Loss Information – Balding Blog

This man has a not-uncommon finding that shows the difference between scalp hair and neck hair. I always tell my patients that neck hair is not permanent, and even at 30 years old, this person’s neck hair is already disappearing. Too many surgeons use neck hair for a hair transplant with the idea that it is finer hair and makes for a better frontal hairline. But as you can see from the picture below, had neck hair been used for the front of his transplant, it would be falling out already. Even worse, neck incisions tend to produce wide scars. If this patient had recieved a hair transplant using his neck hair, he would have been deformed and would probably regret that he ever had done anything to begin with.

The key to good transplants is that every transplant stands on its own, and that no transplant can be seen as a person ages, loses more hair, or changes his hair style restricting his freedom. Please click the photo below to enlarge.


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I Have OCD And Didn’t Wash My Hair For a Long Time – Hair Loss Information – Balding Blog

I am a 20yr old male who didnt consistantly wash my hair from the age of 14-18 because of suffering OCD. Its hard to estimate but its possible I went a month without washing my hair in that 4 yr period. Although I did take a shower everyday and even sometimes twice, so my hair did get wet daily.

I was wondering if its true sebum buildup causes hairloss? IF so is this hairloss permenent or should we assume once the problem is corrected, any loss would grow back.

I also have oily scalp which makes me assume, I might have had sebum buildup.

Is the sebum builup story about causing hairlos true or false?? Please respond as your response will really relieve my worries and anxiety, since I do suffer a few mental problems and have been worrying about this for some time. Also if the sebum buildup applys to my case, would a dermatologist be able detect that by observing my scalp??

Thanks

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Sebum buildup does not cause hair loss. What may happen is that if you brush or comb you hair and the hair is stuck to your scalp, you may pull it out. Wash with a good shampoo and use a conditioner as well to prevent pulling the hair out.

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Severe Dandruff So Itchy My Head Bleeds – Hair Loss Information – Balding Blog

i have a lot dandruff,and it’s so bad that i itch so much and some times it bleeds and have clogs on certain areas of head…and..secondly…sems like right side of my head has less hair than left…and losing hair too.

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It sounds like you scratch it a lot. If that is that case, of course it will eventually bleed. Stop scratching it and use a good dandruff shampoo. If you are concerned about less hair on one side than the other, see a good dermatologist. It sounds to me that you are pulling hair from the scratching and if you keep doing that, you will eventually make the thinning you are seeing, permanent hair loss.

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I Have Thick Hair, But Not As Thick As 10 Years Ago – Hair Loss Information – Balding Blog

Hi Dr. Rassman, I am a 43 year old musician and I am very lucky to have thick shoulder length hair. However, although still thick, it is certainly not as thick as it was 10 years ago, and I am beginning to notice some slight thinning at the crown and although my hairline is still low, some very slight thinning there too. My question is, should I use Rogaine preventatively? Is it better to start Rogaine at the very beginning of what might be a problem? Will I see benefits from Rogaine if my hair is still thick? Or at 43, have I likely escaped a serious hair loss problem and just take some vitamins or something? Thank you so much for your help.

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To me, thinning hair either represents a change in hair thickness (possibly aging) — something we see when a baby becomes a young child, and then often when a young man takes the turn into puberty -or localized miniaturization in the areas where you notice the hair being not quite as thick as it previously was. To make that diagnosis, as I have said before, you need to get your hair mapped out for miniaturization and then the microscopic analysis will be clear as to what you are seeing with your eyes. In men, miniaturization is best treated with finasteride (Propecia), not Rogaine (minoxidil) as the drug of first choice. I now have an office in Newport Beach, and since you indicated that you are in Orange County, why not get your hair mapped out and find out that is happening to you?

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Is Miniaturization Mapping Like a Scalp Biopsy? – Hair Loss Information by Dr. William Rassman

Hello, Dr. Rassman…

Thank you fot the informative blog! I know you keep referring to “getting your hair mapped for miniaturization”. What is involved in this? Is it like a scalp biopsy? Also…what is the typical cost for this procedure? I am male, 37 years old, and i am noticing a lot of hairs in the drain, and a some recession in the temples. I plan on being in L.A. in September, can I come to your office to get “mapped”? Thanks.

I will be happy to see you in September — just call or email to setup an appointment. Mapping of the scalp does not require any surgery and is nothing like a biopsy. What we do is take photographs of the hair at the hair level, then count those hairs in the field of view that are miniaturized, compared to those that are normal. Each part of the head can be mapped accordingly. Miniaturization mapping is free, and is part of the consultation process.

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Taking Avodart and Propecia At the Same Time? – Hair Loss Information by Dr. William Rassman

Hey Doctor,

Thanks for continuing to answer all my questions. I had a consultation with you about 4-5 months ago.

I have been on Propecia for about 7 years now…and it seems to be less effective than it was before. I am losing more hair, especially within the past 3 or 4 months. I have read your comments on Avodart…and it seems for some people, Avodart is more effective than Propecia, especially when Propecia stops losing its effect.

If I want to try Avodart out for a little while (I know it’s not FDA approved), would you continue taking Propecia at the same time?

Thanks again.

If you take Avodart, there is no point to using Propecia. Be careful about dosing, unless you are under the care of a good doctor.


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Patients After Hair Transplantation (with Photos) – Hair Loss Information – Balding Blog

What will I look like within a week or two after a Hair Transplant?

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Here’s a collection of recent patients. Please note that the amount of redness is different for each person, and all of these patients had these photos taken pretty soon after surgery (between 3-10 days, as noted below). Click the photos to enlarge.

This first patient is 10 days since he had 2150 grafts. He has white skin and dark hair and wants to keep his hair pulled back. He would do better to hide the transplants by combing it forward, but this is his choice, of course. What you are looking at is a new beard from the transplanted hair which is about 1/8th inches long, just below the hair that he had prior to the transplant. The transplanted hairs were placed between his longer hair.




The second patient has 1661 grafts and had no cover at all. This is his bare skin on the 7th post operative day. Good washing and small surgical wounds are the key to fast recovery of hair transplants almost immediately after surgery. Most people who are bald worry about detection of the transplant. By about two seeks, the faint pink glow will not show. If his skin color was anything but ‘very light’ not even the pink appearance would show.




The third patient had 1794 grafts and is 3 days after his hair transplant procedure. He had short hair in the front and the transplanted hairs was placed between his short hairs. He did form very small crust that did not immediately wash off in the first day, as is often the case.




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Steroid Use with Propecia Makes Hair Loss Worse? – Hair Loss Information – Balding Blog

Dr. Rassman

I have recently read an article stating that the combination of steriod use and propecia can enhance hair loss rther than protect it and that they should not be used together. Is this true?

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Many steroid users want to protect their hair from loss and steroids are known to increase the hormones and byproduct DHT that promote hair loss. There are more body builders using steroids with hair loss than those who work out but do not use steroids. Many body builders ask me if Propecia will help them keep their hair. The best thing to do is stop taking steroids, but using Propecia can not hurt. There is logic that any DHT block will help and Propecia (finasteride) can accomplish this in theory. The key question to ask is: Will the negative impact of steroids on my hair be offset by the positive impact of a good DHT blocker like finasteride? The answer here is a theoretical, “probably”.