Author: Dr. William Rassman

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Common Age for Female Hair Loss to Start?

Hi Dr. Rassman,
Searching the internet and various websites I always seem to hear/read about women who have severe diffuse hair loss and have developed female pattern baldness when they are around 20-years-old. Is this very common? Some information I’ve come across says it’s very very common while other says it rarely happens. Do you have any statistics on it?

I am not aware of statistics, but from my experience, women often follow the females in the family that have genetic balding in the time of onset and the pattern. There is a strong one-to-one link between mother and daughter in this condition and it is not infrequent to see it in your mother’s mother or aunts. Female genetic hair loss is not common in very young women, but in each decade, the frequency rises until menopause when almost 50% of women experience the problem. We see hair loss after pregnancy in many of these women as well.

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Comparing FUE and FUT from Reddit

I generally agree with this analysis; however, I believe that for men with an advanced balding pattern and a finer hair and particularly those with a lower than average donor density (which includes a lot of Asian men), the FUT is a superior procedure because it avoids the moth eaten appearance which is inevitable with FUE.

FUT versus FUE: Pros and Cons from tressless


2020-10-07 04:51:51Comparing FUE and FUT from Reddit

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Comparing Prices for Hair Transplants

I live in New York City and am looking into scheduling my second session of FUT this fall. I’m transsexual and need to finish rounding out my m-shaped hairline after having done my first session last year out of the country because it was done within a week of another surgery.

This time I’m looking to stay close to home and have been speaking to a surgeon recommended by a friend, Michael Beehner, located far upstate in Saratoga. I like him because he’s communicated in depth with me over email and has a decent amount of before and after photos of trans women. I don’t think all surgeons/technicians are good at creating natural looking hairlines and I also don’t think my hairline was drawn properly the first time so I want it reevaluated.

What makes me hesitant in scheduling is the four hour bus ride for someone who charges $5/graft. I’m wondering if anyone in the NYC area can give me a comparison to other doctors here. Bernstein’s office told me $7. Maxim seems the cheapest, although I’m not sure by how much: their website says $2.95, but I saw a blog post from last year where a woman was quoted $4. Basically, if I feel like I’m getting a deal for a top notch surgeon and team then I’d feel a lot better about making the trip.

Never buy based upon price! Always check out the quality of the doctor. If you get a doctor who discounts his prices because he isn’t good enough to compete on quality, then you could buy less quality with a lesser price. I know both Bernstein and Beehner and they are both first class doctors.


2019-11-22 15:39:19Comparing Prices for Hair Transplants

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Computers Causing Hair Loss?

Hi doctor I have three major concerns:

  1. I have been using Tricovivax (“Minoxidil 5%”) for about two months and I have noticed a massive rate of hair fall, shedding, and thinning. Even my family members are telling you are starting to have bald spots in your head.
  2. I am very concerned with thinning at the back of my head (donor) are and when my doctor mapped my hair for “Miniaturization” noticed that my donor area is thinning too; and he applied the “pull test” and noticed a large amount of hair being pull.
  3. Is setting long time at the computer screen during work will accelerate my hair loss since the computer screen emits radiation?

Thanks a lot doctor

I am pleased to hear that you have had a miniaturization study done. By your brief description, you may have a condition known as DUPA (diffuse unpatterned alopecia) or chronic telogen effluvium. Using drugs such as minoxidil or finasteride may not help in these cases. You need to follow-up with your doctor for options, diagnosis, and treatment. Sounds like he started off by taking the first correct steps.

Sitting at a computer screen will not cause hair loss.


2007-05-22 13:33:28Computers Causing Hair Loss?

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Complications of Mesotheray (Photo)

Multiple injections into the scalp caused multiple abscesses and hair loss. Make sure you get to see an experienced doctor and not some unskilled doctor who is in the hair filed in it to make a buck! You may pay more heavily than with money for terrible work.


2020-04-19 09:41:49Complications of Mesotheray (Photo)

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Compounding my own finasteride vs oral

I have no idea if compounding finasteride myself is the way to go and if it does anything. The only objectively sure thing is that I have experienced no side effects so far. But I also have no results in the 3 weeks since I started this self made drug and it is a real hassle making it myself.

Maybe with no results, what you did to make your own topical finasteride is not working. There is a reason that compounding pharmacies do this, they have expertise that you don’t have


2021-07-15 06:46:51Compounding my own finasteride vs oral

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Complications of minoxidil

Dr. Rassman in your practice have you ever had a patient with an adverse reaction to oral min? Thanks so much!

Yes, some people can’t tolerate this medication for one of many reasons, and the blood pressure effects can be disabling for a few people, with lightheaded and rapid heart beat. Here is a list of some of the side effects of minoxidil. Some of these side effects only relate to the topical application of minoxidil.

  • Fluid retention
  • Facial hair growth
  • Fast heartbeat
  • Hair shedding
  • Irritation
  • Nausea
  • Acne
  • Burning of scalp
  • Chest pain
  • Fainting
  • Headaches
  • Application site redness
  • Difficulty breathing
  • Hypertrichosis
  • Redness
  • Swelling of face
  • Breast tenderness
  • Burning
  • Low blood pressureReddened skin
  • Weight gain
  • Hair texture changes
  • Heart palpitations
  • Cardiac Tamponade (very rare with a lot of early signs of it but potentially deadly)
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Computer Imaging for Balding Patients

Dr. Rassman:
Do you use computer imaging with your patients, to manipulate a current patient picture into a “target goal” picture? I did not see any info about this on your website, but it certainly seems to me the best way to ensure both patient and doctor share the same vision. Thank you.

We have been offering open house events for 14 years so that prospective patients can see, first hand, what the actual results are from hair restoration surgery. The use of computer imaging is frequently misleading, just as photography can be, because it shows what the operator wants to show and does not take into account the real elements that make ‘coverage’ for hair replacement surgery. Things like hair thickness and hair character can not accurately be portrayed with computer imaging. The view can also be misleading. Frontal views, for example, are often better than top views for showing more fullness.

Setting patient expectations is at the core of what I do. I have written extensively on the artistic elements in the hair restoration process and published these observations in prestigious medical journals and text books. I do not believe that correct expectations can be set by the imaginary world created by computer images. As a side note, although many doctors do computer imaging, few will give the patient a picture of what they might look like from such imaging systems. The reason is simple: such a picture is like a contract, which can be used in court against the doctor if the result in that picture is not obtained. If the correlation between computer generated images poorly defines the differences between projected results and the actual results, then this tool does not set proper expectations for the bald buyer. It is clearly better when you examine a person up close, who has actually had a surgical hair restoration procedure and holds his ‘before’ picture for you to examine with his ‘after’ presence in person.

This computer imaging is vastly different for a nose job where a nose is altered in length, or taking out a bumb. A breast augmentation is also a simple computer image to demonstrate because size and location with support or poor support is easly altered on the computer as it would be in surgery. Most patients who show at the open house, will let you feel the thickness of their hair and then you can compare your thickness with theirs. In addition, the hair character (curly vs straight) will be evident. You can look from many views, even the worst view so that you absolutely know what will happen to you. What you see is going to be what you are going to get.

Hair is very different and that is why we rely on the open house format. I do not want to mislead anyone.

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Confusing Information on Propecia

IT is funny how you waffle and change your mind on what propecia can do. I don’t understand you sometimes ..you are confusing.. sometimes you say propecia will stop hair loss and sometimes you say it just slows it down. Take a look at your blog and it is all over on how you say one thing and then another.. please look at what you wrote many different people… you use stop and slow as if they mean the same thing… thanks

Propecia can stop hair loss, reverse hair loss and slow the hair loss process. It really depends upon the person, where they are in their hair loss process, and the expression status of the person’s genes (add to this a large group of unknowns that will become evident from researchers over time).

Sorry if I am confusing you. I write so much to handle each person’s agenda and what I write can be colored by the patient’s interpretation and the way I perceived the questions given me.


2005-11-17 12:08:56Confusing Information on Propecia