Author: Dr. William Rassman

I am a 22-year-old male. I started Finasteride 4 months ago and recently noticed that most of my hair became wavy whereas they have always been straight. Is this normal with Finasteride?

I have seen a return to normal hair characteristics when Finasteride works on miniaturized hairs that are involved in the hair loss process. Did you have early hair loss there where Finasteride may have reversed it?

Do you know why some docs like Hasson/Wong/Rahal say they can do a 3500-4000 graft FUT procedure and charge per graft, while others say they’ll they’ll just take out a strip and transplant however many grafts they get, charging a flat rate and say that they can usually only get 2000 or so grafts in a single FUT session (assuming a second FUT session). There seem to be two camps of doctors: one aggressive, charging per graft and indicating a large number extracted from a strip, while others conservative, charging a flat rate and indicating they will probably only be able to get about 2000 at most depending on laxity.

I can’t speak for other doctors and why they do what they do. I have always charged per graft because that reflected the amount of work, the size of the staff needed and the value to the patient. Also, by estimating grafts yield, I can tell the patient what to expect and also address the donor supply that remains which can then be calculated into a Master Plan for the future balding of that surgery patient. I am big on long term strategic planning and that includes what future costs might be for my patients as the balding progresses.

Hello doctor,

My question is regarding weather and hairloss. I know in canada it gets really cold sometimes even -50, and i believe it effects my hair. I find my hair thinner and more brittle during winter and it becomes more straighter then usual (i have wavy air by the way and i would be a good candidate for a HT because i know i have frontal thinning but because of my wavy hair it covers the balding up) but during the summer it feels thicker and more brighter and wavier. I was just wondering if there are any studies showing weather and hair loss and texture or if its just a myth.

If it is just a myth then why am i experiencing all these hair characteristics during winter. I personally believe hair thins out during winter and becomes thicker during summer.

Thanks for your time. All the best.

There are no studies that I am aware of that look at a relationship between hair texture and weather. I think it is more of something we take as common sense that when the weather is cold and dry, our hairs and skin may be affected.

If your hair is dry in the winter months, then try using moisturizing shampoo. If your skin is dry and lips are chapped in the winter months (like many people) use moisturizing lotions and lip balm (Chapstick, for example). I don’t know if there is study that looks at dry skin and chapped lips in the winter/cold months, but I don’t think you need a study to prove that point either.

Scientifically, in cold months, the humidity in the air is much lower than warm summer months. That contributes to dry skin, chapped lips, and texture changes of your hair. There have been reports over the years from readers about thinning hair at different seasons, but I’ve got no medical reason for this.

Is there a way to check whether the hair loss is from chemical burns as opposed to a condition like alopecia?

If there is an event where a chemical burn could have happened, then the burn may limit some or all of the hair growth in the area where the burn happened. I generally say if hair has not grown in 8 months since the incident, then the chemical burn is permanent. Hair Transplants or Scalp Micropigmentation give solutions to this problem along with concealers like Toppik.

First, thank you Doctor for your years of good advice offered through your site and elsewhere. I am light skinned, 65 and have been on Finesteride for 10 years, had a FUE procedure with an outstanding surgeon in Thailand 9 years ago, and found that I was among the 5% who never shed (perhaps due to blood pressure on the high side?). The untransplanted region in the rear of the crown seems to have thinned over time, but not profoundly and I have considered the procedure a success, until now. Recently I believe that the right side of my frontal hairline may be undergoing some sort of change, where a patch of maybe 15mm by 10mm seems to have hair that is both thinning and maybe only 80mm long. The symmetrical area on the opposite side of the hairline is unchanged the hair long and as full as transplants typically are (i.e., not especially, but cosmetically impressive). Apart from any comments you might care to make concerning the possible cause, could there be reason to believe that this situation could recur even after an second FUE? Thanks so much.

You should send me some photos. I saw a man recently (https://baldingblog.com/2017/08/14/im-60-and-lost-my-forelock/) who developed an autoimmune disease of the scalp/hair. Photos will help me better understand your situation.

Hair transplants breed a new type of tourist in Turkey

In Turkey, revenue from popular procedures adds to country’s $7B medical tourism industry

By Nil Köksal, CBC News

“There is a new way to spot tourists in Turkey or in Iran, and it doesn’t rely on catching a glimpse of selfie sticks, maps or cameras slung around their necks.

Instead, look for the black terry cloth headbands and a telltale triangle of red spots on their scalps.” (hair transplant)

Doctors in Europe are feeling the pinch from competition from doctors in Istanbul Turkey and Iran who have set up hair transplant mills. This is similar to what the Russians did in the 1990s when setting up Cataract Mills for eye surgery. These are all FUE procedures and I doubt the ladies performing the FUE are all licensed doctors. It seems they are offering travel packages that cover air fare, hotel and the surgery for a 3 day stay. Of course, there is no guarantee of quality and there is no recourse if something goes wrong when these people return home after the surgery. Infections, if you get one, will have to be treated by a local doctor and if the procedure was not done right, the patient will not know for 8 months, which is the time that it takes for the hair to grow after a hair transplant. I suspect that the quality of the work ranges from good to poor, depending upon the clinic that is chosen. It is a bit of a gamble. Stay away from politics in either country or your stay may be longer than you planned.

my hair accidentally touched (clorox) while cleaning bathroom. it began to fall, and brake. my doctor said its a chemical burn and i need 2 months to feel progress. my hair from one area is broken and falling. i take tablets called (multihair). will my hair get well again?

If you just got bleach on your hair you’re likely going to be fine. It just takes time and patience, so follow your doctor’s advice and wait for the regrowth process.

Hi I’m a 21 yr. old male who is experiencing a form of chemical induced thinning and breakage. In August I had colored my hair and it had come out very dark. I frequently washed it and damaged it further, thinking it would fade the color. Needless to say once I started to notice some breakage I did everything I could do to condition my hair. The thinning was a very rapid affair, only taking a week. Since then there was no unusual hair loss. I was prescribed a topical steroid for redness in my scalp and I had some bad dandruff for about a month. Now I notice some new hairs coming in around the hairline and I still feel a diffuse thinning on top of my head kind of near my crown. It is hard to tell the new hairs from broken off hairs. Also I don’t see any kind of scarring. What advice can you give me to help my condition? Also what can I expect?

If you truly have hair thinning, you need a complete evaluation of your scalp and hair to determine if there is a genetic component to this process. It may not be due exclusively to the impact of the chemicals you used. If it was, then the chance is very good that most of your hair will grow back as long as no significant damage to your hair follicles and surrounding skin (which is probable). To determine if you have an underlying male balding pattern which may have exacerbated further hair loss by the chemicals which you have used, it is best getting a scalp and hair examination for miniaturization by a doctor that specializes in hair.