Author: Dr. William Rassman

If you keep plucking the grafts and sooner or later the hair will not return. In those grafts that you pluck you will eventually kills these hairs. We call this traction alopecia but it may take quite a few pluckings to kill these hairs.

Is there a way to predict if you are going to respond or not? Like are there any patterns of hair loss that Finasteride significantly does not work for?

Not everyone responds to finasteride. You may not be a responder; however, if you are going to take it, stay on a regular routine and do it for at least a full year. Privately, I have been told that a new test will soon be available that will tell who will and who will not respond to this drug.

I had 4,400 grafts done, and I am terribly scarred with cobblestoning of my skin. I have a heavily scarred recipient and donor area. Can this be reversed?

Unfortunately, the answer here is no. Reversing 4,400 grafts would be an enormous challenge, and it would take far longer to try to reverse it than having it done in the first place. Scalp Micropigmentation may be your only option, but I would have to see you to understand the deformities you are asking about. We have performed Scalp MicroPigmentation in many people with similar problems as you have described, and it works very well (see here: https://scalpmicropigmentation.com/scar-covering/)

There are a number of ways to fix this problem. Since I was the first doctor to perform large sessions of small grafts, I must have fixed hundreds of such patients. The first way to address this is to remove the pluggy grafts provided that there are not too many of them. If they take up the entire frontal area, then it is best to have another hair transplant and overwhelm the pluggy grafts creating a new nature hairline. These pugs can be s source of donor hair as well, as the surgeon can take hair using FUE techniques from the plubs to thin them out. These hairs can be relocated to soften and normalize the look. Longer hair works better than shorter hair once this process is complete. Here is a patient that had terrible plugs and how I fixed fixed it with a series of photos and linkes for you to follow: https://baldingblog.com/2005/10/07/repairing-pluggy-transplant-with-photos/

According to Google Search: “The amino acids present in rice water, in particular, help in the regeneration of hair and aid faster growth of your hair. Also, rice water contains vitamins B, C, and E, which further help in hair growth (7). The best way to use rice water to grow hair is to rinse your hair with it after a wash.Oct 25, 2017″. Instructions follow in this link on how to use Rice Water: https://www.google.com/search?q=rice+water+and+hair+growth&oq=rice+water+and+hair+growth&aqs=chrome.0.69i59j0l5.5077j0j7&sourceid=chrome&ie=UTF-8

Look at the picture and you decide!

Dr Rassman,

I am on Minoxidil 5% topical for more than 8 months now, and beginning to see modest yet much appreciated results. I love massages. I remember reading years ago that scalp massages can damage hair in early anagen phase. Would I be putting my newly growing hair at risk if I indulge? For the purposes of your answer, please assume a massage once a month by a skilled masseur applying reasonable amount of pressure.

Where did you read that scalp massage can damage anagen hairs? The only thing I remember writing was a quip about a very vigorous head massage that could potentially cause hair loss in miniaturized hairs — but not damage hairs that are in anagen (growth).

If you must indulge in scalp massage, go for it! If you are scared you’ll lose the hair, then don’t get the scalp massage.