Author: Dr. William Rassman

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Does Very Fine Hair Mean I’m More Susceptible to Hair Loss?

hey dr. william.

I’m a 20 year old male who have chanced upon your blog only yesterday and i must say that i’ve learnt pretty much and benefited as far as i could from it. I became less paranoid upon reading on archives speaking of victims losing hundreds and even thousands of hair daily or over a few days. Currently, my problem has persisted over 6 months, well to my friends, this might seem over-reacting and a self-proclaimed problem. But i do have a few burning highlights and concerns as follow:

  1. my hair is naturally very fine for a male counterpart, does that make me more susceptible to hair loss expecially i’m only starting to keep my hair long?
  2. i have yet focus so much on my hair loss more than 7 months ago but only when i started to grow more hair, am i overreacting? i see a little bunch of hair -of about 10-15 each time i finish showering and about 10 after i dry my hair and maybe 5 after combing my hair. Are these considered normal?
  3. last but not the least of paramount importance would be, do i have to lose alot of hair to become bald, or another way of asking would be, if i do not have bunches and bunches of hair dropping, does that mean that i’m safe from balding? I’m safe from genetics influences as far as my paternal great grand father.

Note: i do have oil scalp, contributing to oily hair. What do you suggest dr. william?

I really appreciate your effort and time in giving my message a serious thought and god knows how many have you saved! Keep on going dr. william and i’m looking forward to your reply?:)

  1. Fine hair or very fine hair or long hair have nothing to do with balding. If you are balding it is highly likely that it is your genetics.
  2. You are focusing way too much on your hair. You can lose 100 even 200 hairs EACH DAY. Losing 10 to 15 is lower than normal daily hair loss.
  3. You are born with 100,000 hairs on the average, and you can lose about half that and still not look bald.

You should see a good doctor and develop a Master Plan for yourself. In that, you need to have your hair mapped out for miniaturization. It may even be that you are not genetically losing hair — wouldn’t that be nice to know?

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Does Wind Cause Hair Loss?

My question relates to wind exposure. I’ve read on this blog (and elsewhere) that there is no correlation between exposure to high wind gusts and hair loss.

However, I’ve also read here that most of the hairs shed daily “blow out in the wind,” and from showering, styling, etc.

I live in Chicago where I have been exposed to wind gusts in excess of 30 mph. Can this cause hair loss or would I only be losing what was already bound to be lost?

Thanks Doc!

wind
Wind does not cause hair loss other than the fact it may blow away falling hair. Hair loss in men in most cases is due to genetic male pattern balding. Hair loss occurs in a pattern (thus the term). If your theory of the windy city (Chicago) is true, you would see more bald men and women in Chicago. I don’t believe Donald Trump is from Chicago.

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Does Transplanted Crown Hair Grow Slower Than Other Scalp Areas?

Hello Dr. Rassman. I got a ht done just under 6 months ago and i’ve noticed that the crown has shown little to no growth while the top front half of my head has shown a significant amount of growth. Could it possibly be the crown is the last place that sees the new hair growth?? the difference between the front and crown is very drastic and looks as if no hair was even transplanted in the crown. Im on week 25 so should the new hair in the crown have grown by now or is still too early? also, i still have those little red dots on my crown area but nowhere else on my scalp.

thanks in advance

Little red dots on your recipient area may reflect folliculitis and this can, on occasion, kill the transplants if not treated in a timely manner. You need to discuss this with your surgeon as he/she has a vested interest in your outcome.

I have often seen differences in the rate of growth from front to back or right to left. I would not worry a great deal if this is a rate dependent variable, unless you do not see the results you expect by the 8th month. I would expect some growth in most patients by now, but again, see your surgeon and discuss your concerns.

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Does Transplanted Hair Grow Like “Real” Hair?

Hi, I was wondering if the hair you add on is real hair, does it grow normally just like normal hair does? How long will the surgery take? How expensive is it? Accroding to your pictures, I’m at stage two of baldness, I’m currently using procerin, but the hair still falls, not as much though, I know the problem will continue and eventually I’ll go bald. I want to add on about an inch of hair down to my forehead all the way to the corners. I want to know what’s the cost of the surgery, your response will be greatly appreciated.

A hair transplant takes hair from the back of your head and moves it to where you need it (hairline, top, or crown). So yes, it grows just like normal hair, because it is normal hair. Pricing varies per doctor, and procedure length is measured in hours (depends on how many grafts you need transplanted). Our pricing can be found here — NHI – Fees and Financing.

Your brief description of hair loss is alarming because you state you have a Norwood class 2 hair pattern. What you may perceive as a hair loss problem may be that you are transitioning to a mature hairline, which is not a sign of balding.

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Does Toppik Work On My African Hair?

I am a African American woman and i was chemical burn by relaxer about 7 yeas ago. I do not know how and if you can help me with me living in the Caribbean. I was thinking of getting toppik but will that work on my African hair? please help

Yes. I know many African American men who came into our office to get a consult with us and when they are using Toppik, it seems to work well. I don’t see why it wouldn’t work in the same way for women. Give it a try!

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Does Thicker Diameter Hair Delay the Balding Process?

Dear Dr. Rassman
For a quite a lot of time I had been looking for information regarding hair diameter and its relation with hair loss (I know hair diameter can be used for diagnosis), my question is if thicker hair producing follicles need more time of exposure to dht to give the appearence of hair loss. In other words is thicker hair a a delayer/protective factor for baldness?

People with coarse hair may not show the reduction of hair shaft thickness that those with fine hair would, but DHT will impact the hair equally (regardless of hair character) once the genetic pattern is expressed.

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Doesn’t the Scalp Still Shine with SMP?

Hey Dr Rassman. i hope your day is treating you well. As i am a frequent reader of this ever informative blog of yours a few questions have sparked my interest over the last week. It is in regard to the new micro pigmentation service NHI is offering. Now in the past i have noticed you were quite the skeptic about this type of procedure. I recall reading a few comments made by yourself which made me think they were: wouldn’t the scalp still shine? The lack of a ”sandpaper feel due to there being no actual stubble on the scalp and hair is 3 dimensional a tattoo is not.

However I was doing some thinking and this came to mind. If a patient were to come and request to have as many grafts that their doner supply would allow then have the tattooing procedure done in between those grafts and also had the scar camouflaged in the back of the scalp wouldn’t it be nearly impossible to tell the persons head of hair from a non balding person ? It would eliminate all of those issues i previously mentioned. Like for those individuals with high donor densities if someone had 10,000 grafts placed on their scalp then had the micro pigmentation procedure done i would think they would be able to get close to their juvenile hairline back and they would also be able to grow their hair out to probably a number 1 clipper with out it looking to odd. What are your thoughts on this ?

as I presently support the shaved head look but my hairloss is progressing i like the look i would just like more coverage. I have been on finasteride for 3 years when i first started it i was 20 and an early norwood three now my hair is really thin through out the top half of my scalp. I totally anticipate being completely bald by the time im 25 whether im on the medication or not.

HeadlubeYour scalp can shine with the oil that your scalp produces, so scalp micropigmentation (SMP) patients often use matting products available at cosmetic stores. There’s various brands of shine control lotions for the scalp, including HeadLube.

SMP has a use with some negatives and some positives. There is a natural symbiosis between hair transplants and SMP in some individuals. SMP is far less expensive than hair transplants, but you can not have it both ways (SMP in part with a limited hair transplant) unless the Master Plan takes into account what is happening to you now and later. There is a balance between SMP and hair transplants, but I can not give you an opinion over the internet.

It sounds like you need a Master Plan (I know I talk about that a lot), because you are changing with regard to your hair loss. Whatever you do, it should fit into the life plan; if you do go really bald, you’ll want to have a plan for what you’ll look like in the future if you make decisions about today’s problem. Come see me.

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Can I get balding from Paternal Grandfather and Uncles?

My paternal grandfather went bald in his 40-50s, one of my uncles in their late 30s and the other one in his 40s. My dad on the other hand was a NW 7 by 32. A lot of people here say mpb comes from your maternal side but that doesnt always seem to be the case(my maternal grandfather went bald in his 60s). Im currently a NW2 maybe less idk, which isnt bad I wanted to know if there are any high chances i keep my hair until at least my 30s because i dont really mind being bald after than that but being bald so early sucks.

Your uncles and grandparents just tell you if the balding genes are in your family line. Then you have to determine who you might take after.


2020-03-18 09:15:31Can I get balding from Paternal Grandfather and Uncles?

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Doing Hair Transplant Surgery On A Teenager Is Not Good Standard Of Care

Source: NY Post: “Teenagers are fighting the “recession.”
The battle against baldness is sprouting to new heights as boys as young as 16 flock to surgeons for hair transplants, doctors and patients told The Post.

teen

These young men have a high return rate for their hair when put on Propecia. Propecia is an elective medication and like all drugs, it has it’s side effects. The side effects are well publicized in the Internet balding forums and hotly debated. The reality is that Propecia works and the side effect only affects 1 to 2 % of men.

Doing a hair transplant commits a young man for a life time of hair transplants without giving him the opportunity to reverse or stabilize the hair loss. Doing surgery at an early stage can often accelerate the genetic balding in young men. The overall profession does not look kindly on hair transplant surgeries on teenagers. The only exception may be if the teenager is completely bald (Norwood 6/7) and understand the full implication and limitation of a hair transplant surgery.


2015-09-05 23:02:02Doing Hair Transplant Surgery On A Teenager Is Not Good Standard Of Care

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Donald Trump and Hair Transplants

What is the story on Donald Trump’s hair? He looks like he is trying to hide something?

Donald TrumpAs I understand it, Donald Trump was a victim of the old hair transplant process starting in the 1980s. The quality of the work most probably resulted in the pluggy look, and he possibly had scalp reductions (which were popular in those days). Between the two, he might have little donor hair left. There may be significant scarring as well if he had many procedures in the ‘old days’. He apparently found the solution to cover up his hair loss problem, with a creative hair styling that he is now well known for. He knows that his hair is the subject of much focus and with people who just love to talk or make their living hosting entertainment shows. That is the price of today’s celebrity.

What he has done is to exploit a ‘comb-forward’ style, maximizing what hair he has to cover what he wants to hide. Like the comb-over, it layers hair from one part of the scalp to another (comb-forward means that the hair is kept long and combed to the front). I call this the ‘Trump style comb-forward’ in my private office practice, because of his celebrity status. This style uses what many people with frontal balding exploit (see the Norwood Class 3 or 4 pattern balding). The less hair that is lost and the more hair that remains, the more effective is the result of styling to hide thinning or balding in the frontal area. When taken to extreme, whether it is the comb-over or the comb-forward, the appearance does not look good.

When any reasonable amount of hair is transplanted in the Class 3 or 4 balding pattern (those with natural Norwood Class frontal balding patterns), a comb-forward can work even better so restoring all of the missing density is not needed. Nobody ever knew that CBS News sports reporter Steve Hartman was balding and he perfected the combing to the front and side enough to hide his thinning hairline. This canopy comb-forward was very effective for him (a common combing style for many men), but he was slowly losing the battle to preserve his look. Many men tell me that they spend more and more time dealing with their hair, not only in the mornings, but throughout the day as well. One man who comes to mind told me that his comb was like his Mont-blanc pen, always needed wherever he went and he carried hair spray with him to touch up the styling in bathroom breaks that he had to take quite often. Steve’s hair, on the other hand, was very cooperative with a strong character that easily laid down the way he wanted it to. Rather than waiting too long and risking an unnatural appearance, Steve decided to take the bull by the horns and had one transplant procedure (see pictures). Steve went for natural fullness as he did not want to maintain any illusion at all, so we put as much hair as we could safely move in just one transplant session. The point between where Steve came from and a really bad comb-over (the kind that everyone sees on TV or at the airport), is a slow, insidious process — so slow in fact, that the person who is doing it never notices the advancing balding nor the progressive failure of the grooming style. I always wonder why family members do not comment on the failure of this styling process, but maybe they are just not saying anything early enough and now are embarrassed to say anything at all so late in the process.

Some men with bad comb-overs deny their evolving look, putting a mental block on the unnatural appearance they evolved, and others just stop going out into the public arena. Hats and wigs solve the problem for some, a type of cover-up that does not work for everyone and I have seen a few take it to extreme levels, creating a bouffant style with hair that is one or two feet long and combed into a circlular pattern, layered hair by hair to mimic what the person thinks is normal.

I have been asked many times why the rich and famous who can afford the best doctors don’t just get the best surgical hair restoration money can buy. Ignorance is part of the answer. I believe that many men with the old deforming hair transplants find themselves in a difficult situation. They may not know that they were going down that road when the process initially started. When they found out, they may have come to the conclusion that it was too late to do something about it. With luck, men in this predicament may find some solution that they learn to live with when it works (comb overs, hats, wigs, scalp coloring agents, and the like) or they may find their way to a good hair transplant surgeon who can fix the problem.

With today’s modern Follicular Unit Transplant and Follicular Unit Extraction (FUE) techniques, some amazing work can be done. With FUE in particular, it is virtually for all practical purposes scar-less and the procedure is minimally invasive. Not everyone can be brought back to “normal” if too much of the hair has been squandered, or if scarring has gone too far. If Mr. Trump had old type plugs, he can have that hair redistributed so that the big bad plugs are no longer present. Any hair that is moved can be put to better esthetic use in other scalp locations under the guidance of an artistic hair restoration surgeon (see Dean’s Story for an example of this).

Had Mr. Trump been a patient of ours, I could never have written anything about him because patient privacy is central to the way doctors operate their business today. I hope that by writing this piece in answer to your question, I have not offended him in any way.