Author: Dr. William Rassman

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A transplant at 21, now at 22 he has more hair loss and needs a MASTER PLAN (photos)

The circles show where the hair loss has progressed since his hair transplant. I tell 21 year old men who want a limited hair transplant to wait until at least they are 25 or they will be back every year as the hair loss progresses as shown in these photos with the circle just one year after his hair transplant at 21 (not done by me, of course). By the time he is 25, he might have a lot more balding present (you can see some crown loss now showing up) and if he had a hair transplant every year from the age of 21, he would use up his donor hair. With patchy hair transplants done every year, the doctor makes money and the patient slowly develops an abnormal look without a plan. That is why I stress the need for a MASTER PLAN for hair loss on EVERY balding male who is thinking about hair transplants. Imagine at age 36, he might look like this: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/


2019-10-17 13:23:17A transplant at 21, now at 22 he has more hair loss and needs a MASTER PLAN (photos)

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Hair and self-confidence

I’m balding since i’m 23 and since then i never stopped looking at my hair in the mirror every time or looking at older pictures and my eyes goes to my hairs. Or also when i’m outside looking at peoples hair and comparing to mine or telling that guy has beautiful hair why not me.. Even now i’m 31 and i still do it it’s been more than 8 years that i do that. Fin saved me and got my hairline from 3 years ago (where my hair loss wasn’t so obvious) So i’m less sensitive to that but i’m still looking at other hairs and also mine every day

Your story is typical. Most men who see hair loss recognize for the first time that they are aging and nobody likes that reality. One of my sons noticed that his soccer skills have precipitously fallen down in the past few years and as he was always #1 in scoring, he now plays second class to the younger guys. We all, sooner or later, will recognize that we are getting older, sometimes it’s the hair, sometimes it’s the body’s performance, sometimes it is in the death of a friend way before his time. From the many celebrities (actors and musicians) I have worked with over the years, I found that their hair was critical to their art. Getting their hair back with drugs or a hair transplant gave them peace of mind so that they can focus on the things that are really important once their hair situation is a thing that they don’t have to deal with in the present.


2021-05-18 07:07:51Hair and self-confidence

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Hair at Age 10, Blonde Hairs on Temples Are Gone Now at Age 20 (Photo)

You need to see an expert doctor like me, who can do a HAIR CHECK test (https://baldingblog.com/haircheck-test-how-it-is-done-video/) on you to determine if you are going to go bald. This is a lot of recession in someone 20 years of age. Who do you take after in your family line? Blondes are the BEST candidates for hair transplants, but at your age, I would be hesitant to recommend it. You should absolutely be on the drug finasteride if you want to keep your hair. I find that blondes are the best hair transplant candidates because of the low contrast between hair and skin color. If hair is important to you, you will look at my comments seriously.


2019-09-12 12:25:49Hair at Age 10, Blonde Hairs on Temples Are Gone Now at Age 20 (Photo)

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3000 FUE grafts 1 week with ago with cracks on my head, why? (photo)

What you are seeing is terrible post-operative care which has allowed thick crusts to form on your head and then crack. An FUE is treated just like a regular hair transplant with regard to the recipient area while the donor area has open wounds which require daily washing with soap and water. Within 3 days of surgery, you can resume full activities, heavy exercises if you wish.

The recipient area requires daily washes as well to keep the recipient area free of crusts. I generally recommend the use of a sponge and supply my patient with a surgical sponge to fill with soapy water and press on the recipient area daily. By repeating this daily, all crusts can be washed off without any fear of losing grafts. IF any crust are present, use a Q-Tip and dip it into soapy water and roll it on the crusts. That will lift them off without dislodging them but never rub them, just roll the Q-Tip on the recipient crust. I like to see no evidence of any crusting in the recipient area and the crusts from the donor area are gone in 7-10 days with daily washing.

I don’t like the idea of anyone removing grafts that have scabs on them. We have published a paper in a formal medical journal (https://newhair.com/wp-content/uploads/2018/11/mp-2006-graft-anchoring.pdf) that states when a person pulls off a scab (crust) from a recipient area in less than 12 days, the risk of losing the graft is very high. Put a shampoo on your head and let it sit for 10-15 minutes, then gently work the crusts with your fingers. This will take days to get the crust off but you will not disturb the grafts.

I am also disturbed that 3000 grafts were placed in the frontal 3 inch zone of your scalp. Keep in mind that most people have only a bout 7000 grafts in their donor area and if your original donor density was low, then that number could be 4000 or even less. IF your hair is fine, things get even worse. You can contact me for more details on how to evaluate your long term planning if you wish.


2020-09-15 09:22:333000 FUE grafts 1 week with ago with cracks on my head, why? (photo)

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Hair Around My Ears Just Falls Out from Touching It

Hi, I am 25 and male.

I have for the past year or so been losing my hair round on the sides of my head to the point that you can now see the scalp through it. The hair round my ears falls out even if I gently touch it and the thinning is worst just above and behind my ears to the point there is almost a bald spot above/behind both.

Although I am in early stages of MPB (between II and III vertex) could you please advise whether this is anything more than MPB – as pretty soon I won’t even be able to shave my head without looking slightly odd? Thanks

Hair loss around the ears is not from male pattern baldness (MPB), as that area of the scalp is considered the permanent fringe area. That doesn’t mean you do not have MPB, but it should not affect the hairs around your ears. It seems you need a diagnosis and I cannot provide that here.


2010-11-23 10:47:18Hair Around My Ears Just Falls Out from Touching It

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Hair and the Effects of Flat Irons

Hi I am 29 years old, male. Do flat irons cause permanent hair loss? My hair dresser started using a flat iron on my hair 3 years ago, since my hair was wavy, he showed me how I can make it straight. About 2 months after using it (usually once or twice a week) I noticed that my hair was drying out. I stopped, only to use it once in a while. Today I find that my hair is receding on the sides and my crown is thinning. Is this from the use of the flat iron? I’ve stopped using it for about 6 months now but I still find that my hair falls out everytime I wash and style it. I researching on the net about the side effects of flat irons but never found any concrete proof about the consequences of using them. I hope I didn’t ruin my hair for good! What can I do?

Let’s think logically about this. When hair has grown beyond the scalp, it is no longer a living tissue. Only the hair organ below the skin is living. Hair is made of compressed fibers and a shingle type of structure made up of shed skin cells called cutin. These shed skin cells are in effect the same ‘stuff’ that produces the scales we see in dandruff and may reflect higher turnover of the skin on our scalps. As these shed cells are compressed above the fibers in the hair shaft, they form a layered array just like the shingles on a roof would form to keep out the water. But below the skin, the hair organ puts lipoproetin layers into these scales of cutin that give the hair the character that you have. The presence of fat on the outside of the hair shaft is what brings out ‘luster’ in the hair. Once the hair exits the skin as it grows , it enters the hostile environment of air, wind, weather, heat, etc… and it no longer is subject to what your body can do for it. As the hair exits the surface of the skin, the sebaceous glands secret a waxy sebum that may find its way onto the hair shaft, giving some people an oily hair.

When you iron your hair with heat, you do change the character of the hair and change the configuration of the varying layers of compacted cutin and the fibers that make up the structure of your hair. Heat takes away the luster (shine) from hair, burns away the waxy covering, may denature the lipoproteins on the surface of the hair shaft and it is this that protects the hair from the environment. Heat may damage the core of the fibers inside the hair as well. High heat applications can damage the hair so that it cracks, breaks, and even become fragile, producing broken ends from hair that breaks too easily. Take a look at this illustration of an enlarged hair shaft here (illustrated by Norm Nason). Note the layering of the cutin shingles. Look at the center of the shaft and see the fibers that form the backbone and the strength of the hair shaft. When these fibers are broken, or the shingled cutin is removed, damaged or burned, a pealing process may begin which would reflect the damage to the foundation of the hair shaft, and it can become permanent. When the hair is damaged, then gentle handling is critical to maintain and hold it on your head. You can, of course, cut it off and new hair coming from below the skin which should not grow out damaged, will eventually replace the weak hair. The hair exiting the skin is normal and undamaged so you can and should expect that once you cut off the damaged hair, the new hair will grow to whatever your normal should be. Good cosmetology can hydrate the hair and it might bring back some of its luster and strength. For those of you interested in high powered microscopic views of the hair system below the skin, see here.

So, if you have hair loss or thinning of new hair, it is possibly a new problem, and you need to have your hair analyzed by a doctor like me.


2008-02-08 10:03:10Hair and the Effects of Flat Irons

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Hair Attachments for Women

My girlfriend and I don’t think that we have hair loss problems (at least not yet), but we would LOVE to have fuller hair so that we wouldn’t need to use hair extensions (which I assume all the celebs use because no one has hair like that!). Could transplants do this for us too?

Historical Perspective: It is important to understand that many of the accoutrements that adorn our bodies arose from earlier, less sophisticated times. The use of wigs date back to the Egyptians in the years between 4000-300 BC. They were used extensively by men and women. The Greeks were the first to popularize wigs and braids and that began the long torturous route to hair styles that cycled in popularity for the next few thousand years. In the middle ages (1200-1400 AD), single women showed their health and vitality by demonstrating full heads of hair, much of the hair manufactured from animals. Once married, only the husband could see the head uncovered, so it was the young single, female that had to appear healthy and capable of producing healthy children. Even back then, women were packaging themselves for the marriage process. As the populations started to concentrate more and more in the cities, the disease tuberculosis, took its toll. For the malnourished females whose heads were uncovered, their hair showed a window into their core health. Those women who were not sick but had the misfortune to have a fine hair, appeared sickly. So women with a thin head of hair wore a wig or used braids to increase the fullness of their hair, thus appearing healthier. Sexual attractiveness and a healthy appearance were inextricably linked early in our evolving society. Paintings since the late renaissance, showed women with abundant body fat and full heads of luxurious hair. As tuberculosis is blind to socioeconomic conditions, the successful artisans were engaged by wealthier clients to create the illusion of health with abundant hair and lots of braids. The concepts of portrait art, showed what the person wanted to look like, not what they actually looked like. As the hair became thicker, it hid signs of illness or malnutrition. Braids became common place and the use of wigs and other hair extensions remain part of our cultural heritage, as our question suggests.

No, hair transplantation should not be used to increase the fullness of a normal head of hair, but the use of hair extensions and other such devices comes with a hidden cost for some people. That cost can be progressive hair loss. When it happens, it is caused by the continuous pulling that these devices produce on the hair at the point where they are attached. If you weave your existing hair into the matting of the extension to hold it, then the constant pulling from the attachment can produce Traction Alopecia (hair loss from pulling) and it can be permanent if the process continues. I have seen women with patches of hair loss or hair thinning from these extensions. What they do to manage the proble, is put in more extensions around the thinning area. This successfully masks the thinning area while it damages the healthy area nearby. Eventually, these damaged areas become confluent. My advice to you is to respect your hair and watch carefully for any signs of Traction Alopecia. Make sure that you are not starting a cycle that worsens with time.

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The hair in the back of the head is not growing well after my FUE (photo)

You have possibly been over-harvested and have developed donor site depletion. If it does not get better, the only treatment that can make the back of the head look better is Scalp Micropigmentation (https://scalpmicropigmentation.com/scar-covering/#!)


2017-09-19 05:30:45The hair in the back of the head is not growing well after my FUE (photo)

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Hair Change After Chemotherapy

why does your hair change after chemotherapy. hair is a genetic code in your DNA so does that mean that it changes your DNA?

Hair has a very high metabolic rate just like the cancers you are treating with chemotherapy. These chemotherapeutic agents get to cells that have a high metabolic rate, which include: hair, elements of bone marrow, intestinal cells. So when you get chemotherapy, it gets to all of the fast growing cells. That is why people become anemic on chemotherapy, or get diarrhea from damage to the intestinal lining of the stomach and intestines, so I would expect that if the hair is not forced into its telogen cycle, the hair growing out would not be normal.


2008-09-15 15:11:29Hair Change After Chemotherapy