Author: Dr. William Rassman

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Cough, Cough — The Cure for Baldness? – Hair Loss Information by Dr. William Rassman

A reader sent the link to this article from The Independent regarding Intercytex:

It should be interesting reading — though I must warn you that the UK-based website charges you to read the full text (it costs £1, which is around $1.85 US).

The article talks about the nonsense that is being propagated over the internet to drive the price of someone’s stock higher and higher. Although this company’s effort in hair cell research is credible, the P/R that they are doing does not do much for what I think of them. The Euro/Dollar indicates that this hype has driven the stock to almost $100 million in value. Maybe I should try that too, not a bad return for selling hype!

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Itchy Scalp After Transplants – Hair Loss Information by Dr. William Rassman

I am a 53 year old male who was blessed, until November 2004, with a mostly full, but fine head of hair. At Halloween, I put hair coloring in my hair for a costume, did not wash it out until the following Monday morning (the color came out when I slept and I did think about the chemicals still being there – when I read the can later, it said not to use on fine hair – I was extremely mad at myself). Anyway, I had six weeks of an itchy scalp and some hair loss with it.

This past summer, I had another 8 week bout with itchiness and even more hair loss- I started using tea tree oil shampoo and creme rinse, and Jason’s thin-to-thick shampoo and rinse, as well as putting jojoba oil with tea tree oil into my scalp at night. I visited two Chicago area doctors who told me itchiness was part of the active balding time and nothing was wrong with my scalp. I visited them after this bout ended, with loss that I now wanted to do something about. I decided to go to female doctor at the end of October 2005. Everything went fine until a couple of months ago, four months after the transplants. I started to notice hair coming in, but then the itchiness/sensitivity started. I thought that was just irritation from the new hairs, but then I started to worry that maybe this was not the case. Anyway, the hairs placed deeper in the middle front and the majority of the right side transplants came in, but the front middle (new V) and the front left side mostly did not. I am very unhappy about this, and I just hate this feeling of itchiness /sensitivity that is only on the left side this time. (two months and running-getting better) I was / am taking propecia three times a week, as I had a lowered libido with daily use. (Dr. told me to go to 3x a week) I was not using Rogaine until a week ago, where I started to use Scalpmed, another minoxidal product.

Do I possibly have some stress loss of new hairs? Should I go back to using Propecia more often? I can accept the more frequent use until the hairs come in, if they still can. I was told by an assistant than it will take 18 months for the complete result.

I am in great need of some guidance. Thank you

If you have a good doctor, you should be discussing these things with that doctor. You asked about itchiness and was told that it is caused by male pattern balding. That is not the case as there is no evidence that the two are connected directly unless it is the result of sunburns or other things that dry your scalp skin. You had transplants about 7 months ago. I generally tell patients that 80% of the results will be in by the 8th month and 95% should be in within a year. If one side grows slower than the other, that is ok, but if one side does not grow and the other side grows out well, then the technical people placing (different technicians placing the grafts into the different sides of the transplanted area) may have caused a problem that killed off hair. Less skilled technicians may damage the grafts when moving them around or take longer to place them and in the process of placing the grafts, they just dry them out (just 10-15 seconds exposure of these grafts to the air can kill them). Wait out the full 8 months first before thinking of the worst.

Taking Propecia three times a week makes no sense to me, because it is completely out of your body in a day. Taking 1/2 tablet of Propecia each day has about 80% of the benefits of taking a full tablet if you have a libido problem. Rogaine (which is minoxidil, also contained in ScalpMed) can dry the skin and make it itch and that is not commenting on the other additives in each of the commercial products containing minoxidil. Propecia will have no effect on the new hairs, nor will the minoxidil impact the hairs from the donor area. I think that you need to sit down with your doctor and get answers from your doctor, real answers and not be talking to his technicians. This is what a doctor/patient relationship is about.

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My 3 Year Old Is Losing Hair – Hair Loss Information by Dr. William Rassman

My little girl is three and her hair is falling out. When it does it looks and feels like a fur ball from a cat. When she was one she had milk indused anemia. She has been on iron drops since. Her iron levels are now normal, but she is still taking iron drops. Can this have any bearing with the hair loss? Could it be too much iron in her body? She was tested for thyroid, diabetes, and other tests that could cause hair loss – all normal. The way the hair started to fall out was on one side only and now has started to fall from the top of her head. One day at her day care, another girl pulled her hair and a clump of it was sent home to me in an envelope. She is very petite for her age. She is a very nervous little girl. I am a single mother, although she sees her father several times a week and he spends time with her on the weekends. Help me with some answers. Hair loss is not an issue in the family. My hair is red and very thick. With this info please help me?

You need to see a pediatric dermatologist, a specialty in itself. I wouldn’t know how to treat hair loss conditions in a 3 year old over the internet. Sorry.

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My Father Had Awful Transplants from a Dermatologist – Hair Loss Information by Dr. William Rassman

I have been on finasteride for 7 years. I have pretty much maintained my same density over this period. A little more thinning in the front. I am now 36. My father had many transplants from a doctor who is a dermatologist. Not from a doctor that specializes in transplants. His transplants are awful. What should my expectations be if I wanted to get off the drug and try transplants? I am fair-skinned with wavy auburn hair, and my individual follicles are thick, but not dense.

First, the old plugs can easily be fixed today. Look at the following links for articles and examples of good repair work which can and should be offered to your father:

The second part is that taking the drug Propecia is a different decision to having transplants. They can be complementary (see: Hair Transplant and Propecia Combination Results). As for expectations about transplants for yourself, meet with your doctor and have him/her develop a Master Plan with you, so that you have your needs addressed before the procedure.

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Patchy Hair Loss — Is It Fungus? – Hair Loss Information by Dr. William Rassman

I have had patchy hair loss for about 9 months or so, I went to a derm, he said it did not appear to be normal male loss, he gave me some shampoo and wanted me to come back in 2 month, I did, he did not see any improvememts, the bald spots still become very red, and burn. I just went to a new derm, he also said the hair loss doesn;t appear to me male pattern, he gave me some foam called olux and said it may be a fungal thing, he said if no new hair growth are seen in the bald patches in 4 week, he wants to do a scalp biopsy, what will this show? I really don’t understand, what things can it biopsy turn up, what conditions could make my hair fall out in patches, also the patches are on the top part of my scalp. thanks you and any info would be helpfull.. thanks again

To answer your question I would be giving you a course in dermatology. To answer your question about the scalp biopsy, I believe he is looking for fungal infections (it would show the actual fungus interacting with the skin), autoimmune diseases (it would show certain primative defensive cells attacking the hair follicles with reactive tissues around it), and the like. It sounds like he knows what he is doing, so stick with him.

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Wrinkles, Shock Loss – Hair Loss Information by Dr. William Rassman

Did you say that scalp excercises and massages actually CAUSE wrinkles in your forehead?

Also, Im not sure if you answered my question regarding hair follicles, but if you have a hair transplant and hairs fall out due to shock loss and dont grow back….does that mean that the follicle is actually destroyed or is it still intact, but just not producing hair anymore.

Thanks for your help

Sleeping BeautyMassages do not cause wrinkles in the forehead, nor will exercising the forehead muscles make that happen. You may be thinking about what I said when a person is trying to find out where their hairline was when they were youths. Wrinkling the forehead will produce a line at the top of the forehead muscles (frontalis muscle) and that line marks where a child’s hairline or a woman’s hairline starts.

‘Shock loss’ from a hair transplant may grow back if the hair is permanent hair (most women) or hair that is not at the end of its life cycle (such as an accident with a scalp wound in a non-balding man). When the balding process is at the end of the cycle for those hairs that fall out from shock loss, these hairs may not grow back. Miniaturized hairs which result from genetic balding are ‘weak’ hairs that will not live through a major stressful event.

When it does grow back in balding men, it is because the hairs that were lost are usually not at the end of their natural life cycle. If they grow back, then clearly there is life still left in them. Hair that does not return after shock loss in the male is for all practical purposes hair at the end of its ‘life’. With that said, I do not really believe that the hair is ‘dead’, but rather impacted by whatever the defect that causes male patterned genetic hair loss. Some day, hopefully in my lifetime, a medication will be produced that will take up all of the ’seeds of hair’ that I believe are still in the scalp, closing the defect so that the hair will start to grow… in a way much like the classic tale of Sleeping Beauty, I suppose.

Sometimes ’shock loss’ can be minimized by being on Propecia prior to having the hair transplant. Shock loss does not happen to all patients who undergo hair transplants, just some of them. Most people are quick to forget the robust nature of permanent hair which comes with the hair transplant process. Shock loss should be something that is explained to you before you get hair transplants. It is a part of the informed consent process and you need to know all of the risks involved when you undergo a hair transplant (or any surgical procedure).

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Hair Loss InformationHow Long Must Hair Be To Hide Donor Scar for 2500 Grafts? – Hair Loss Information – Balding Blog

hi dr Rassman, am considering having a megasession but am worried about the linear scar if I want to keep my hair short at the back. how long do you need to keep the hair at the back to hide the scar if I have 2500 grafts. is there anywhere on your website with pictures of the scar etc…

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I always tell people that there is always a scar present, the key is to keep the scar as small as possible. 95% of people will have a scar smaller than 1/8th of an inch wide. Assuming that there is a 1/8th of an inch scar, any reasonable length hair will cover it (even hair 1/4 inch in length). With the newer trichophytic incisions (shown here), hair can be forced to grow out of the scar so that in 95% of people, unless you shave the head, the scar will barely be visible. Using special scar reducing techniques, scars are now far smaller than they ever have been and if you are the unlucky 5%, there are ways to solve almost any scarring problem you might develop.

Today we use a deep fascia closure to reduce skin tension (the number one cause of stretching of a scar). Megasessions in the hands of experienced surgeons who practice with these techniques to control scarring is an important consideration when selecting a doctor. I have always assumed that any scarring problem in my patient is my problem and I will often fix the scar at no cost to the patient, if there is such an issue.

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Hair Coloring and Scar Visibility After Transplantation? – Hair Loss Information by Dr. William Rassman

Hi-
Over the past 3+ years, I’ve had 3 transplant surgeries and I’m tremendously happy with the results. Some years ago, I used to occasionally double process my hair blond (it’s dark brown naturally) and I liked the results. Is this still a possibiliy or is it to risky for my hair. Will it make the scars more visible? Needless to say, I wouldn’t want to damage my transplants in any way. Many thanks

Colored HairYour hair is your hair and a hair transplant, once done correctly, means you can dye it, cut it, perm it, spike it, etc. The beauty of a good hair transplant is that it is just like you never had lost your hair. As for the scars, I couldn’t tell you for sure, as there are a number of factors such as width/length of your scars (I am assuming you had strip procedures) and the length of your hair. However, I do not think the scar visibility will be an issue with processing your hair blonde, but the only way to know for sure is to try it once. Generally, the only time the scar has a chance of being seen is when the hair is cut way too short (like crew-cut length).

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I Don’t Like Having a Mature Hairline – Hair Loss Information by Dr. William Rassman

I am 23 and notice I have a mature hairline. its a 2 on the scale. I dont like my hairline though and would like to get the hair around my temples back. Is there any procedure that can fix this? If so please tell me

I have transplanted the juvenile hairline back in some men, but I do so only under certain conditions:

  1. There is no evidence of advanced balding either on examination or in the family line.
  2. I want to get to know the patient and he must be mature and able to understand the ‘worst case’ scenario that could happen (in your age the worst case thing is advanced balding).
  3. I look at the value of the various elements of hair quality, skin color, hair density, and overall donor supply characteristics and connect it with potential demand considerations.

I have clearly done this more than once, but in my present memory the only ones I have done under 25 years old were professional actors, television soap opera sexy men, or models whose livelihood depends upon that ‘youthful’ look.

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I Need My Hair To Be Colored… – Hair Loss Information by Dr. William Rassman

I dyed my hair blackey blue about a month ago and it is in quite a dry condition. However the colour is fading there are now brown patches(my natural colour) becuase each time I straigthen my hair (which has been reduced to about twice a week)strips the colour slightly. This upsets me as my hair looks a mess and I do not know what to do. I have a school prom in three weeks time and would love my hair to look nice for it. However I do not really want to dye my hair again as the damage done to it will be awful and I do not know whether it is worth taking the risk again as the starightners will probably just strip the colour. Please help! Also my hair is starting to snap and becoming thin! Please, please get back to me!I will be grateful forever! xx

Sounds like you need the help of a good hair stylist, not a doctor. Have fun at prom.