Author: Dr. William Rassman

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How Does a Doctor Get FUE Training? – Hair Loss Information by Dr. William Rassman

I see that many HT docs are offering FUEs and claiming how great they are. Where did they learn this and how can the consumer know what we’re getting is really quality work and not just a publicity scam?

It is best to ask to see the doctor’s patients and meet them directly. Do not accept photographs alone, for they may not be what they appear to be. FUE is becoming the ‘hip’ thing to offer patients to start to build a practice. It takes about 8 months from the time of the surgery until the results are known. For the dishonest doctor, that could become the ‘funding’ for a new venture and claims of expertise are easily made throughout newspaper ads and internet websites. Training is almost impossible to obtain unless you have a large hair transplant practice and are willing to practice on a dozen or so FUE grafts on every patient you perform a strip surgery upon. That is how I learned how to do them, 1-2 at a time per patient over 9 years. The main difference between me and others is that today’s self proclaimed expert can reference the standard I set and published. For me it was more complex than that, because I never knew it was really possible to obtain consistency until I had been doing it for years. The question you did not ask is about claims of success are measured. Self-proclaimed success in harvesting is clearly dependent upon ’self reporting’ without audits. Trust is everything and integrity is at the core of the surgeons being. I can not advise upon this point for the buyer has responsibilities to research it heavily (please see The Truth About Cheap Hair Transplants for more info). As I always end these types of comments, let the buyer beware.

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Moved to New Country and Hair Is Falling Out – Hair Loss Information by Dr. William Rassman

Hi Dr.Rassman,
I been bothered by this problem for almost a year now and couldn’t find way of solving it .I been reding magzines and testimonials about this but need more explaination. I come from the Philippines but residing here in Dubai, U.A.E because i am working here now.I am here for 2 1/2 years now in Dubai.Back in the Philippines i have a healthy hair means shinny and bouncing but my nightmare came to me when I am here now in Dubai my healthy hair becomes lifeless, dull,dry,and i experience hairloss too plus my sclap is very itchy to been trying different medication about it but i don’t seem to see the results.

Admittedly, as a person I easily gets depressed and one year back i did experienced a total depression due to some personal problems. I also heard some stories that one reason of hairloss hair in dubai is the water and the harsh weather of this country .Also, I am quiet afraid of the reality that my mom had a thin hair and i suspect i may have hereditary hair loss.But , I am only 24 to experience such problem, that is why i am consulting you this problem because i really want to know the mean reason of my problem if you could elaborate some of the theory you may have for this; and also could you give a solutions or advise on what should i do .

Thank you very much and I would really appreciate everything if you will send me a reply on my e-mail as soon as possible.

I do not have an answer to your problem. Your depression should be addressed, but being away from home surely adds stress to your life and stress can change the character of hair in some people.

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Propecia and Body Hair (with Photos of Hair Transplant) – Hair Loss Information by Dr. William Rassman

This patient had a very nice result from one hair transplant procedure. An interesting item to me was that he reported that when he started to take Propecia, the hair from his chest and back (which was very heavy) returned to his barely hairy 18 year old body’s hairless appearance. In addition, he also reported a reduction of nose and ear hair. So this patient shows not only the benefits of a good hair transplant, but also a rare but good side effect of Propecia (I have rarely seen been made aware of this loss of body hair). I only have photos of his head, as I didn’t think people needed to see photos of the inside of his nose or ears (and so I didn’t take any).

The first set shows his before photos. Click the images to enlarge.

And this set shows his results after one hair transplant procedure of 2,073 grafts.

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Hair Loss InformationNext Line of Cures for Balding – Hair Loss Information – Balding Blog

What can we expect in the next line of cures for balding if cloning, as you suggest, is not going to appear in the next couple of years?

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There are many new approaches for the treatment of male genetic balding that fall below the radar. I tell my patients that there are a few hundred steps to growing and cycling hair in the human body. What we know appears to be very little with regard to the identification of each of these steps and in understanding how each step may or may not be dependent upon each other. There are drugs coming out that will address the hair loss problem, possibly better than Propecia, but it will take time to determine how these drugs work, as many of them were/are discovered by accident rather than by taking a model of the drug that fits into the defective pathway for balding. Once the drug is screened for toxicity in desktop or animal model, the predictability of these drugs in addressing the hair loss problem needs to be identified. Safety and effectiveness (a term I throw around a great deal when I am asked about potions and lotions offered to cure balding) must meet a stringent FDA standard, just to protect the public. I tried to research the drug pipeline to give my readers something to ‘cut their teeth on’, that might give them hope. I have outlined a couple of important articles that will shed light on either the potential of a new drug just recently hitting a press release, or an insight into the risk factors for dealing with new drugs to give the readership of this blog some insights into the scope of the problems and opportunities before us.

Safety determination is no simple job. Even with the most stringent testing for the toxic effects of a new drug cleared from animal testing, the risks take years to define. Unfortunately, the following linked article showed the risks all too soon for the 6 young people who became victims of the drug testing process. The point I want to make here is that you do not want this type of outcome from taking a drug, potion or lotion on any product that is not well tested and through thorough human trials run to strict standards. See: Parexel in hot water over drug trial scare

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Hair Loss After Stitches in My Scalp – Hair Loss Information – Balding Blog

Hey,
I’m 18 years and of african descent. My problem is that I’ve noticed that whenever I get my hair cut (down to the skin) the hair on the right-forward side of my head grows slower than the left. I have noticed signs of possible hair loss in future but nothing like this, hardly even a horseshoe pattern.

Also quite recently I was involved in an accident and got stitches on the boarder of my scalp (this was after I noticed thinning). I want to ask if this affects possible hairgrowth in the area. Thanks.

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It is not unusual to have hair loss around the scar for a distance of a mm or two. Most of the hair around the scar should grow back within a year but there may be a small area around the scar that will not grow hair. Sometimes, people who are genetically prone to hair loss may find that a bad cut or accident on the head could start the process off and without any balding present, the sutures can produce some hair loss. It may just appear as thinning or it could advance to general hair loss. If the scar is too big and unacceptable to you, hair transplants into the scar can help, but the diagnostic mapping of your head is critical for you to define just what is going on.

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5% Minoxidil for Women? – Balding Blog

Hello,
I am a 26 year old female and have been using 2% female minoxidil for a little over 6 months. I wanted to ask if it was safe for a woman to use the Men’s Strength 5%. Please advice.

You should use products as directed on the FDA approved label. 5% minoxidil is not available for women, but they are formulated for men. The women’s formulations are mostly water/alcohol based which makes it easier to style your hair. Most men’s preparations are oil based. You can use the woman’s alcohol base in the morning and the men’s 5% oil base at night. Some drug stores will make up the 5% alcohol base on prescription. Ask your pharmacist. Also, please see this article on HairLossTalk.com.




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Balding Forum - Hair Loss Discussion

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I Want My Plugs Removed and Not Replaced – Hair Loss Information by Dr. William Rassman

Dr. Rassman:

I have approximately 110 plugs (from the late 1970’s) that were placed in the frontal hairline where your hair is receding according to your picture. Can the plugs be removed and not replaced without leaving obvious scars?

If not what is a viable alternative?

Yes, the plugs can be removed. There is no way that they will not leave some scarring. Each person is different with different skin types and skin textures that reflect light differently and produce different degrees of scarring. Plugs done in the 1970’s tend to have a great deal of skin taken with the hair. These skin discs will stand out because the flat nature of them with the associated scars, when placed into a smooth, rounded bald scalp, will reflect light such that the difference becomes very obvious. When you add the ‘plugs’ of pencil size hair in the normal scalp, attention is drawn to that area. Many times, if the plugs are lined up, they can be excised as a block, or they can be removed one by one. To determine the best approach, there is no substitute for a personal consultation to make the judgments that reflect your situation.

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I Want To Undo My Hair Transplants – Hair Loss Information by Dr. William Rassman

I had a transplant procedure a few years ago and now have some grafts along the front of my hairline, an entire bald back (Norwood Class 7) and a raised scar in the back of my head where the transplated hair was taken from. I went back to the original doctor once, and he took out some of the grafts, but there is still pitting in the front and I need to wear a hair system to cover it up. How I hate that rug, I can not express enough. How do I go back to square one? Is that realistic? Am I trapped into having more transplants that I can not afford?

You asked about the skin deformity of the frontal hairline and about how realistic it would be that the small pits could be abolished. I think that it is unlikely that it can be completely taken away, but it would not be unreasonable to remove the present hair. Risks of scarring further is a real consideration as the smooth surface skin of a bald Class 7 patient will easily show any deformity by the glare of the light. The balding skin is atrophic, which means that it lost its normal texture, where small pores exist and the sebaceous glands wax the scalp. The normal skin is clearly different than the tissue paper thin skin of an advanced balding man. When something is done to an atrophic skin, it will never go back to its pre-surgical appearance. Some people ask about dermabrasion to smooth out the skin and I feel that this procedure would likely create more skin abnormalities and I would not recommend it, even though other doctors often do this.

As your goals are unclear and the amount of normal skin and hair is an unknown for me, I am assuming that you are a full, well established Norwood Class 7 patient, but I would suggest that you let your hair grow out a bit under the hair system so that a doctor can make a determination about your condition and patterned hair loss. To accomplish this goal, you will need to have your hair system converted to clips and away from the glues or tape you are probably using for the moment.

To remove the hair in the frontal hairline, an FUE procedure to remove the hairs in the frontal hairline is worth considering. To treat the scar in the donor area, you can either attempt to remove it with a surgical excision or fill in the scar with FUE grafts.

You can visit me for an extensive exam, or even send photographs as appropriate to improve our communication. Please do let your hair grow out under the hair piece after you convert to clips. Please also do not rule out a proper and complete transplant to get your original goals back as a consideration, but it would be a good idea to see patients at an upcoming open house event to make such an assessment. Whatever you do, take your time here to make an informed decision, something clearly you did not do when you started.

Balding Forum - Hair Loss Discussion

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So Many Products, So Little Results – Hair Loss Information by Dr. William Rassman

Hello. I’ve been experiencing hair loss since the age of 17, I am 20 now. Being in the National Guard and full-time in college, it’s a given I’m under alot of stress. I first noticed my hair started receding at the temples. I began using Rogaine 5% with some success as well as Procerin tablets. Some of the hair began to grow back. I stopped using both products in September of 2005 until December 2005. In December, my hair started to fall out in mass amounts in the shower. I began to use a solution called “Nutrifolica” and Procerin again. Since then, the temples have recovered, but I now have a very distinct patch of scalp showing almost dead center down the the top of my head. It starts from my part in the back, straight forward. It’s weird because the “crown” isn’t really receding (yet, I guess). But it’s fading all the while I’m applying Nutrifolica and taking Procerin twice a day, and using Rogaine after the shower. Oh, and I also tried the Nisim system to no avail. It seems there’s something new on the TV every week on infomercials but it costs $90 for a month supply. That adds up quick.

What are my options? (if any). I’m just completing my freshman year of college and have multiple to go, I’d like to keep my self-esteem in tact, I’m very conscious about my hair.

VacuumYou sound like a bright young man, so I must ask why you are not being smart when it comes to your hair problem? You are selling yourself ‘things’ that you see on TV which are promoted to cure problems with hair loss where the promoters are all profiting from the ‘buy’. Ask a fertilizer salesman what will make your flowers grow, and he will show you his fertilizer products. Ask a vacuum salesmen why you have allergies, and he will tell you that dust in your house is causing it, because the vacuum cleaner you are using is missing the allergens. But what you need to know in the second case is: Are your really allergic to dust? If not, then the $500 vacuum cleaner that this fellow is selling will only serve to make your $500 more foolish and reinforce the idea that maybe you were taken to the cleaners.

I always tell my patients on this blog to first find out if your are losing your hair to genetic balding by seeing an expert who can make a firm diagnosis by mapping out your scalp for miniaturization to determine what is happening to your scalp and hair. If you do have genetic balding, there is a wonderful treatment that really works in young men called Propecia. You could approach this scientifically and know what is happening or you can call that fertilizer salesman for some potion or lotion that will meet his needs and take some of your hard-earned cash.

Balding Forum - Hair Loss Discussion

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