Author: Dr. William Rassman

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Hair Loss InformationCloning Hair in the Future – Hair Loss Information – Balding Blog

hey doc, thanks for answering my previous question.
Now I gotta question about hair cloning. Lets say that this becomes possible in the next 10 years or so. Don’t you think that due to the ethical issues it will raise, this procedure might be introduced as a cosmetic procedure first before it is used as a body part/organ replacement option? Or maybe, 10 years from now, due to the desentisizing of society by mass media and the acceptance of change, this advancement of mankind may be welcomed with open arms.

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The FDA will take a very long time to approved any cloning issues. Add up to 5-10 years after the breakthroughs are in hand. My five year estimate is based on the drug cures that are expedited through the FDA when human lives may end before the ‘cures’ are processed, not something as unimportant as hair cloning. I say unimportant in terms of a comparison for saving or extending lives, or reducing pain and suffering. This is a count backward assessment, for one must now add a solid set of breakthrough to the calculation. At this time I have seen no such breakthroughs introduced into this industry.

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Hair Loss InformationScarring Alopecias in Women – Hair Loss Information – Balding Blog

Hi,
I’m a 30 year old African-American female with hair loss on the entire top of my head. I was diagnosed 9 years ago with scarring hair folliclelitis and since that time my hair loss has escalated. I’ve worn weaves, wigs and the hair piece that you have to use a special tape to wear it. I feel that by using these methods to cover up my hair loss, i’ve made it worse. I was interested in hair transplant but do not know if I would be a candidate. Can you please tell me?

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Weaves, wigs and the hair pieces cause hair loss. This is common in the African-American female community where balding (hidden by wigs) may be the norm in some communities. As you have already seen a dermatologist, I would suggest that you go back to that doctor. Scarring alopecias are a special case diagnosis which your doctor can put into perspective for you. Hair transplantation in a patient with active scarring alopecia do not go together. An alternative to a biopsy may be a test transplant of 10 grafts into the bald area. If they grow in 6-8 months, then the disease may be inactive and you may be a candidate for a hair transplant. Hair transplants for African hair tend to do very well provided that the skin in healthy.

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10 Months Since Chemo And Hair Has Still Not Fully Regrown – Hair Loss Information by Dr. William Rassman

My son who is 21 completed a 4 cycle chemo treatment in May 05. Today his hair is still very thin, fine and spots of balding. I have left a message today with his doctor for some advise when I saw your web page. Any suggestions? I know hair growth takes a while but it is going on 10 months now. Thanks!

Hair loss during and after chemotherapy is one of the most distressing side effects. Hair loss occurs because chemotherapy targets all living cells in the body including hair follicle cells. Simply put, chemotherapy is poison to all living cells. It is a medical balancing game where the cancer cells are killed before the chemotherapy kills you.

Hair follicle cells have three phases of growth:

  1. Growth phase (Anagen phase) which lasts anywhere from 2 to 6 years. This is the phase where your hair is actively growing at approximately 10cm per year. 85% of hair is at this phase at any given time.
  2. Transitional phase (Catagen phase) which lasts about 2 weeks. This is the phase where the hair follicle shrinks and prepares to enter the resting phase.
  3. Resting phase (Telogen phase) which lasts about 1- 2 months. This is the phase where hair does not grow but stays attached to the follicle. Some hairs are shed at this phase, but at the end the hair follicle re-enters the growth phase to start the cycle over again. 10-15% of hairs are at this phase at any given time.

During chemotherapy, hair in the growth phase is most affected due to the active nature of the hair follicle. Ideally, hair lost during chemotherapy should start to grow after 3 to 6 months. Unfortunately, new hair may grow thinner, slower, or with different texture or color.

Your son’s hair growth seems to be returing, but at a much slower rate than you have anticipated. This may be due to the 4 cycles of chemotherapy. This may also be due to the fact that your son’s body is recovering at a different rate than expected. It may just be a normal recovery pace for your son. Ultimately, if your son is healthy and is in remission, that is the most important priority. Neverthess, hair loss is certainly the most visible and distressing side effect of chemotherapy and a stigmata of cancer. There are a number of support groups and wigs available to chemotherapy patients, which are sometimes even covered by insurance companies. Finally, topical creams or Propecia would not be of benefit for hair loss from chemotherapy.

By Dr. Jae Pak and Dr. William Rassman

[Note: This blog entry has been answered by Dr. Jae Pak, who has been working with Dr. Rassman for the past 9 years developing new surgical instruments and hair transplant procedures.]

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Accutane Caused My Hair Loss — Will a Transplant Fix This? – Hair Loss Information by Dr. William Rassman

First, let me tell you how wonderful and informational your website is. Never have I seen such an informative site that so clearly tells a customer what they might be getting themselves into if they undergo such a surgery. You should be commended!

Here is my situation…

When I was 22 years old (I’m 31 now), I took the Acne drug Accutane to clear up a moderate problem with Acne. My little brother took it and had no permanent side effects, so I figured it was safe enough. One of the rare side effects listed on the container of the drug is hair loss. Well, as you can imagine, I experienced this side effect. Within 3 weeks of taking the drug, the hair on front part of my head, the “juvenile” hairline, started to rapidly fallout to the point where it was clogging the shower everday. I didn’t realize how bad it was and kept taking the drug for a couple more weeks. After it became apparent that the hair was falling out and not growing back, I stopped taking the drug. The hairloss stopped within a couple of days of stopping the medication. I went to several dermatologists complaining of this because the hair never grew back! They all told me I was crazy and that I had plenty of hair and that they saw nothing wrong. Basically, they were defending their drug!

So to make a long story short, it never grew back but I still have plenty of hair left and have not lost any more hair since. So I do not have the typical male pattern baldness (at least not yet) but would like to fix the minor loss and restore it back to the way it was. I am concerned about the success of the procedure due to the fact that the Accutane changed my skin such that occassionally, the skin in the area where I experienced the Telogen Effluviam is dry. I am in Miami Beach now, so the humidity keeps it pretty healthy, but I am hoping that if I go through this procedure that there is not something else that might cause the newly transplanted hair to not grow there. For example, what if the Accutane changed the skin such that the blood flow is lessened there and hence, the transplanted hair would experience the same event?

I see this as the only risk for me right now and would like your comment on it. If I come in for an evaluation and it is determined that this should not be a problem, I will do the procedure without looking back.

Please advise.

Accutane may have had the side effect you describe. It is difficult to say that it only caused your frontal hair loss, as I would have expected a more diffuse hair loss pattern. It may have been just coincidence, but either way you should be evaluated by a good hair transplant surgeon to map out your hair loss pattern for miniaturization and then develop a Master Plan to ascertain what and when you can address this surgically with a hair transplant. At 22, the mapping I am talking about is critical, for if you do not know what you might look like when you are 30, 40, and 50, then starting before that evidence is in may not be in your best interest. Generally, I can see the pattern emerging on most men by the time that they are 25 with good mapping performed.

By Dr. Jae Pak

[Note: This blog entry has been answered by Dr. Jae Pak, who has been working with Dr. Rassman for the past 9 years developing new surgical instruments and hair transplant procedures.]

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Can I Eliminate The Greasy Feel After Rogaine Use? – Hair Loss Information by Dr. William Rassman

I have been using Rogaine unsuccessfully for a number of years. One problem I have with it is that I only apply it after taking a shower and never do a second daily application. The reason for this is that unless I dry it with a hair dryer the Rogaine always makes my scalp look greasy.

Is the hair dryer detrimental to the Rogaine working? What can I do to eliminate the greasiness?

To get real value from it, you must use it twice daily. Change to Rogaine for Women, as it has an alcohol base which is not oily.

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Norwood Class 4 at Age 20 – Hair Loss Information by Dr. William Rassman

Hello,
Well i am a 20 yr old guy. I started losing my hair since i was 16. By now i am a Class 4 patient with receded hairline from the front and at the top of the head. Many people have told me that hair transplant is not safe for a 20 yr old male. Is it true? ANd does it have any side effects. Kindly let me know on that.
Regards

At the young age of 20, you are experiencing accelerated hair loss. Your final pattern may be reflected in your family, so probe the entire history of hair loss amongst the men from both your mother’s and father’s sides. Having a hair transplant at this early age may lead to further hair loss, called shock loss, from the trauma of surgery itself. Thus, the net benefit of hair transplantion may outweight the hair loss experienced from shock loss and most (not all) 20 year olds are asked to wait for more time to pass. We can not determine the true pattern of your hair loss until you’re later in age. Hopefully, you have been using Propecia since the beginning of the balding process and this finding reflects a failure of the drug. If not, it is prudent to go on Propecia for now and wait for a response (in about a year). The drug can stabilize or reverse the hair loss in someone of your age. If you bond with a doctor and have been on the Propecia for a year or so, then you can discuss a hair transplant. Going forward along the surgery route requires that you develop a Master Plan for your future hair loss management taking your worst case scenario and balancing it with the worst case ‘donor’ hair availability (that is what is meant as a Master Plan for your hair loss).

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Taking 1.25mg of Finasteride Daily – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

I have been taking finasteride for 1 month. I have quartered proscar tablets. Given that the doses are therefore 1.25 mg of finasteride each I have been taking the pills for fours days straight and then taking one day off. This way I receive 5 mg in my body over five days just like with propecia. Can this skipping a dose have an effect of the drug’s effectiveness? Also, I plan on switching to the regular 1 mg dose of propecia every day once my 30 tablet proscar supply finishes (so roughly five months). I assumed the transition will be smoother with my current dose technique then if I was taking 1.25 every day and then switched to 1 mg per day. My main reason for skipping the 5th 1.25 mg dose is to reduce the chances of side effects. After two weeks of use I experienced some tenderness in one of my breasts but thankfully that passed after one week and I feel perfectly fine now. My worry is that an increased amount of finasteride in my body would increase the chances of such effects returning. Any thoughts you can give in regards to my concerns would be appreciated.

Thank you.

You need to have it on board every day. Don’t worry about side effects if you do not experience any now at the dose you are taking. The breast pain is a rare side effect (1 in 300 patients), so if it has passed, just count your blessings.

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Hair Loss InformationI Have Diffuse Thinning and Am Unhappy With Your Last Answer – Hair Loss Information – Balding Blog

Hey Doc, I have posted before and you replied, but I was very unhappy with your posted answer so I though I would rephrase my question. I am a 22 year old male who has thinning the kind you see in old women. Its pretty thin, and when i shower or go in the pool you can clearly see my scalp, its embarassing. Is DHT the chemical responsible for my balding. PLEASE dont tell me to see a doctor and leave it at that. I have Truly DIFFUSE UNPATTERNED alopecia. Hypothetically speaking, if you were my doctor, and you determined this what would you tell me to do short, SHORT of a hair transplant. Is Rogaine more effective than Propecia or Avodart for my kind of balding? Does Rogain work well in Women? Thanks for the help, your website kicks ass and has really helped me.

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Male hair loss presenting as Diffuse Unpatterned Alopecia (DUPA) is different from male pattern hair loss. If you have a diffuse pattern hair loss, that would include in what we call the donor area, which is the area in the occipital and bitemporal areas (the fringe around your head and sides), then you need to be evaluated first with blood work to rule out hypothyroidism, anemia, hormone imbalance, autoimmune disease, etc. Possibly, a dermatologist can biopsy your head if you have inflammatory disease on your scalp which can cause diffuse pattern hair loss. The process we call DUPA, when there is no metabolic or autoimmune problem indentified, may respond to Propecia (about 50% of men will get a partial reversal in my experience).