Author: Dr. William Rassman

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I Have Crown Balding, and the Area Is like a Circle 4 Inches in Diameter. I Have No Loss in the Front. (Photo)

The crown often takes more hair than other areas of a similar size because the swirl is present in the crown and the hair changes direction. The swirl draws the eye to the scalp. A 4-inch area will take anywhere between 2000-3000 grafts, depending upon the thickness of your hair shafts. More coarse hair requires less grafts when compared to fine hair.


2018-06-21 08:51:12I Have Crown Balding, and the Area Is like a Circle 4 Inches in Diameter. I Have No Loss in the Front. (Photo)

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CRISPER pigs could dotate organs to us

Using animals for organ donors have been tried for years, but cross species transplants have done very poorly over time. Now the use of CRISPER can tolerate organ donation much like Dolly the Sheep. Genetic material are used in pig cells in the early embryo and implanted in sows. The plan is to create pigs that have also been altered to make them more immunologically similar to people. In theory, this should mean transplanted organs are less prone to attack by a recipient’s immune system. This work is being done by Robin Weiss of University College London as reported in the New Scientist August 19, 2017 issue.

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Curis and Hair Loss

How long will you think CURIS take to be produced commercially? Also, does it have capability to grow hair on already balded areas?

This is a most interesting and exciting technology in its early stages. A great deal of work will be required to take this from the animal study into the human realm and it may not transport easily. What this does show is the many faces of the regrowth phenomenon in hair regeneration. Generally this process, under FDA regulation, will take years. To answer your question, I really do not know exactly how the medication works, but as I find out more, I will let the blog readers know. Thanks for pointing this out to me.

For those interested in learning more, please see Curis Presents Study Showing Stimulation of Hair Growth by Small Molecule Hedgehog Pathway Agonist.

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cut my dose of finasteride by half and the sexual side effects went away

I posted a while back asking if anybody had any anecdotes for taking smaller doses to alleviate sides. Well I bit the bullet and bought a pill cutter last Thursday and from then until Monday took 0.5mg fin every day. It was by the Monday that I woke up with proper morning wood for the first time in weeks and had the horn all day. At this point I noticed more hair in my hands than normal after washing, so went back to 1mg Monday night.

You should probably stay on the half dose as it is 80% as effective as the full dose.

 


2019-05-10 12:43:14cut my dose of finasteride by half and the sexual side effects went away

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Crown transplants and Swirl (photo)

The swirl area is always difficult because the hairs do not layer but rather draw one’s eye to the center of the vortex. The impacts of 4000 grafts depend upon the thickness of your hair shafts (fine, medium or coarse). The thicker the hair shafts, the better the coverage. I suspect that, looking at your result, your hair has a medium or medium-fine hair thickness. Please let me know if I am correct. The transplant was largely done in front of the swirl, but half of the upper swirl was included in the transplant. Note how difficult it is to get a tight swirl unless you put in more hair or have coarser hair. This is a nice result. Rarely does new hair appear from a hair transplant beyond 9 months. Congrats!

As an aside, look at my crown hair transplant, which was fine when it was done; however, when my hair thinned out with age, a see-through appearance showed my scalp. I had SMP done and the change was dramatic, see here; https://baldingblog.com/i-just-finished-my-smp-on-my-crown-area-today-see-before-and-after-photos/

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Curious About The Hairline My Transplant Doctor Gave Me

I recently had a hair transplant done and I was curious about the way my doctor had done it. I naturally have had a widow’s peak but it has receded some. The way the doctor put the graphs in was sort of also in a M shaped form just out to the sides. Will this restore my natural hairline?

I cannot answer your question without seeing a current photo and comparing it to what you looked like before you lost your hair. More importantly, you should have addressed this before the surgery to make sure that your doctor understood your goals and expectations.

The standard practice at NHI is for the physician to draw a hairline with an erasable marker prior to surgery and have the patient look at the general shape and position so that he/she can approve or modify what the doctor planned. Generally this take a few minutes as the patient has specific concerns and requests (such as adding a widow’s peak). In the end, both patient and doctor are on the same page in agreement before the surgery starts and we take good pictures to document what we had agreed to. After the hairs grow in, we can then go back to the drawing on the head and see if the hairline we had tried to produce, was actually produced.

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Cutis Verticals Gyrata (photo)

Cutis verticis gyrata describes a scalp condition with convoluted folds and deep furrows that resemble the surface of the brain. Cutis verticis gyrata is a progressive condition. It is mainly troublesome due to the cosmetic appearance. Rarely, it can be complicated by malignant melanoma developing within a melanocytic naevus. Cutis verticis gyrata occurs more commonly in males. The primary form of cutis verticis gyrata has a reported male-to-female ratio of 5:1. The incidence of cutis verticis gyrata may be reported as lower in women because longer hair may camouflage the condition (Ref: Dermnet NZ).

This is a cosmetic issue for those who have it. As you can see in this photo, styling the hair can be a problem.


2020-05-04 12:39:19Cutis Verticals Gyrata (photo)

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Cutting My Propecia Dose in Half Eliminated the Side Effects

Hi Dr,

I tried Propecia about 2 months ago and got sides (could not maintain full erection during sex after a week). I stopped for a month and have now take .5 propecia for the past 2 weeks with no problems. I am 25 and have a bald spot in the back forming with diffuse thinning down the middle of my scalp.

What do you advise as my plan of action for re-growth, would you recommend me to up the full dose soon? Rogaine? Have you seen good results with adults my age range?

thanks for you help

If half the dose of Propecia works, you will get about 80% of the value of the drug, on average. That may be enough to accomplish your goals. You can try increasing the dosage up over time, but I really don’t want to give dosing recommendations for someone that isn’t my patient. This is a prescription medication, so you should go over your options with your physician.

You can try adding Rogaine to your routine, which is sold over-the-counter.


2010-01-15 09:54:18Cutting My Propecia Dose in Half Eliminated the Side Effects

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Cutis Verticis Gyrata and Hair Loss

I have a condition that is called ‘cutis verticis gyrata’ where the scalp grows ridges or abnormal lines on the surface. I have had this condition for some time, but have never been concerned before because I have hair that covers the ridges in my head. I’m in the beginning stages of MPB, and have been taking propecia for about a month. I don’t know if my hair loss will ever be extensive enough to show the condition of my scalp, but it causes great concern because I do not want this to happen. I am 32 years old. Have you ever dealt with this issue before? I have read a little on the internet to try to see what people have done with this, but there is not much out there about it. I have read that it has been treated with scalp reduction, which sounds reasonable, but then what? Any ideas?

Cutis Verticis GyrataAfter receiving your email, I wrote to a group of well-respected doctors to inquire about experience in this area, and the general consensus was that this should not be treated surgically. Most of the doctors I wrote to were dermatologists who may have an aversion to scalp reductions in this situation. You need to be evaluated by a surgeon, perhaps a very specialized plastic surgeon who has experience doing this surgery in a patient with your diagnosis. Logically, scalp reductions should work, but I wouldn’t recommend that you be the first patient to attempt surgery to correct this condition.

If you are concerned about balding (which might make the appearance more detectable) then I strongly suggest a miniaturization study to see what degree of hair is at risk of falling out, followed up by a Master Plan. If I was your doctor, I would explore your options after you became my patient, but I simply cannot give you an in-depth answer as I have not examined your scalp or your hair.

Image from DermAtlas

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Cyproterone Acetate and DHT

Dr. Rassman,

I know this may sound like an odd question, but, would an antiandrogen such as Cyproterone Acetate reduce the levels of DHT in the male body? Would it preserve hair in a person with very little balding. I realize there are major side effects with this drug, but am still curious.

Thanks, and keep up the wonderful work, your blog is quite informative!

Anti-androgens in men can cause a chemical castration, so yes, I would say that the side effects are major. A castrated male has no sex drive and may lose facial and body hair. Cyproterone is not something I’d suggest fooling around with.

The direct answer to your question comes from Wikipedia: “Some in vitro studies have suggested that cyproterone or cyproterone acetate may have a slight inhibitory effect on 5-alpha-reductase, however no significant reduction in DHT production has been observed in vivo.”