Author: Dr. William Rassman

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Getting Concerned After No Results on Propecia for 7 Months

Hello Doctor
I am in my mid 7th month of using Propecia everyday (alone without anything else), and am starting to get concerned. As I understand it, you need to wait 9-12 months to see any effect from the treatment, and thats where I need clarification.

  1. Would I notice worst symptoms (loss of hair bulk/mass) before it got better? My hair was diffuse beforehand but still covered my head. Now, the rear crown of my head is very close to being bald. (Please see images..I sent them to your email) Frontal has remained basically the same. I now keep my hair very short, so I dont know if there was shedding (and it just wasnt apparent for this reason.) But I havent noticed ANY hairs falling out….instead the hair just seems to be getting thinner and thinner.
  2. At this point, I am trying to determine whether to use Rogaine on top of Propecia as a last ditch effort. I know that would make it hard to determine WHICH product is helping my hair (which is why I have been holding out on that), but my big concern is that if I let things continue to progress at this rate than I won’t have any hair in the crown for Rogaine to even “thicken”…What is your take on that.
  3. The only reversal/progress I THINK I have found is a few disperse black hairs that have spouted up in areas that I believe were bald before (in my frontal region). This could very well be my imagination, but I am wondering if that is a sign that things are picking up..or if some people just gain a few of these random hairs and nothing else.
  4. In considering that I started taking Propecia 7 months ago….does Propecia work to try and maintain THAT base level hair (with ups and downs in the process). Or does it work to maintain baselevel from the 6-12 month mark when you guys say it typically starts to take effect….I am very confused at the “typical” experience I should expect for the 1-12 month term of treatment (with Propecia)
  5. I would be open to take that genetic test, but they dont list any NY doctors on the site…any suggestions for that?

Thanks for the help!

  1. Some report shedding, but it doesn’t seem extremely common. At 7 months, things shouldn’t necessarily be worse than before. The HairDX finasteride response test might be a good idea (see #5 below).
  2. Many men use both medications. I see no problem with that as long as you don’t mind the financial aspect of sticking to two medications for life.
  3. Not really sure what you mean. Random black hairs?
  4. Aside from regrowth, the goal of taking Propecia is to maintain your hair at the point of when you started taking it. Obviously, each person is different.
  5. The HairDX site has a list of clinics that offer their genetic tests, but if there’s no listings for New York, you should contact them to find out about local options. I’m sure they’re looking to have their tests available on the east coast.


2009-05-21 09:36:46Getting Concerned After No Results on Propecia for 7 Months

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Getting a hair transplant in your late 20s, what to know!

I’m getting an FUT procedure done next week. I’m excited and a little nervous. I’m 29. Still have some hair left on top of head. But my temples are completely bald. Can someone share their experience?

  • Was it worth the effort and money?

  • After how long did you see the results?

  • Any shock loss of existing hair? Did it come back?

  • Anything else I need to be aware of?

I believe that every man must develop a Master Plan when they start their hair loss, particularly when they start doing a hair transplant because hair loss is progressive and it may, depending upon your balding pattern, keep going if you inherited a Class 7 pattern (the most extreme pattern as this man did: https://baldingblog.com/norwood-class-7-pattern-patient-received-11000-grafts-plus-smp/ ). It is so important that the doctor that you bond with, cares about you and not the size of your bank account. In the example here, I donated the last half of his hair transplants at no charge in exchange for him helping me educate some of my patients, We both got a good deal and he kept his hair for his entire life. I also did his father and his brother and all of his balding friends.


2019-09-02 11:14:34Getting a hair transplant in your late 20s, what to know!

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Girl Told Me I’d Be Ugly Bald

I responded with, “If I go bald, then I’ll just have to deal with it and go on with life”. It felt so empowering to embrace the fact that I might be bald someday. If she thinks I’m ugly, then that leaves another 4 billion potential females who might find me attractive. This girl and I are just friends by the way and I don’t think she knows my hair is thinning.

Society has prejudices. This is well illustrated in two observations: (1) Since Eisenhower was president, no president has been elected that has been bald because society thinks that bald men can’t be trusted. Men’t Fitness magazine did a study that showed that society felt different about bald men vs hairy men. I think that is why our sexy movies stars have good hairlines. (2) I ran a talk radio show called The Inner Man for a year in Los Angeles. Although my focus was not hair issues but religion, sex or social issues, I remember one show where I talked about hair and societies attitudes about it. One man called in and he was the Vice President of Marketing and Sales for a Billion dollar company (he did not say who he was just what he did). He told me that he would never hire a bald man because bald people couldn’t be trusted. As a side note, he said he was completely bald but he was trustworthy, different than everyone else.

People who are superficial don’t look below the surface of most things (balding included). I am sure that your ‘girl’ friend would not abandon her friendship with you if you started losing hair. She would be very supportive.

 


2020-04-20 17:49:37Girl Told Me I’d Be Ugly Bald

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Gilbert’s Syndrome and Hair Loss

Hello, I was wondering if you could help me out in explaining my blood results.

I am a 20 years old male and it seems and i am experiencing hair loss. I have Gilbert’s syndrome and i was told that it may somehow benefit to hair loss but i am unsure how. I used to have low iron in my blood and i thought that it could be an issue however i have normal levels of iron in my blood now but im still losing hair.

My blood results showed that my testosterone levels are normal however my dht levels are 3 times above normal. I recently experienced some weight loss. Could it be that my liver condition adds to the dht increase? can the dht increase be temporary due to my weight loss? what can i possibly do to slow it down?

Thank you!

I do not believe Gilbert’s syndrome (a liver condition) has any relation to genetic androgenic hair loss. The two are not related.

Gilbert’s syndrome is a hereditary condition that relates has to do with how your body metabolizes bilirubin. I am not sure how it may relate to your DHT levels or if that even has any factor in androgenic hair loss. I would recommend you consult with your doctor or an endocrinologist.

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Getting Shock Loss on Sides of My Donor Scar

At 4 weeks post op i have significant shock loss on the donor area primarily just behind each ear where the loss is. Not so bad in middle but still some. Is it normal for more loss behind the ears and will it grow back?? Is that area more prone to shock loss than the middle of the back of the head.

Thanks

Sometimes the donor area can experience hair loss from the stress and/or tension from the surgery. Unlike the shock loss in the recipient area, the hair loss in the donor area should grow back in a few months to a year. I would follow up with your surgeon and have him/her further evaluate it.


2008-11-18 09:04:54Getting Shock Loss on Sides of My Donor Scar

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Getting a Lot of Scalp Pimples 6 Months After Hair Transplant

did second transplant 6 months ago.i seem to have alot of pimples and they are getting worse.is there any cure.tried with pills already but doesn’t work.thanks.age 27-sex male

Six months after a hair transplant should be enough time to end any cycle of pimples. I’m not sure what pills you might’ve taken to eliminate the scalp pimples, but I suggest you go back to your hair transplant surgeon and get yourself evaluated. You have a doctor, take him/her to task. Patient aftercare is important, and your doctor should be willing to answer your concerns.

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Gho Clinic Says Their FUE Allows the Donor Hair to Regrow?!

Dr. Rassman
i have stumbled upon a hair transplant clinic in Prague called the “GHO clinic” which offer a proprietary FUE in which apparently the donor hair will regrow (page here)

i don’t know how well the human body would repair a partially punched out hair follicle, i just want to ask if this procedure is actually hair multiplication available today or just someone trying to make his FUE look better than everyone else’s?

I just chaired the session at the annual ISHRS meeting in Amsterdam and had Dr. Coen Gho as one of the speakers. I had lost my voice, so I could not comment as the chair of that session, but considering that you asked me about him, I will use this as a forum to speak my opinion on what I heard.

Dr. Gho reported that he did 1500 patients with his “cloning” procedure. If I had to give a score to the material he presented using a 1-10 scale for scientific credibility, I’d score it a 1, with 1 being the lowest possible. His science was pathetic, with slides that were blurred and blackened out so that there was really nothing to see. He claimed that his FUE technique cut the follicular units in half longitudinally, and that the part that remained regrew hair, but there was no proof of this in any of the material he showed. He did not show any patient results and certainly was never reviewed by any credible agency or physician.

Partially divided follicles have been well studied by many prominent researchers. Despite their attempts, none succeed to create even an equal amount of hair (equal to the original divided follicular units). Dr. Kim (Korean researcher) had done some wonderful research on this very subject and failed to do what Dr. Gho claims. I believe that what I heard from Dr. Gho is marketing hype without any evidence of any hairs regrowing.

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Getting a minor transplant for minor hair loss

I noticed that something like this takes only 800 grafts and my hair is not even close to as bad as this persons so reasonably speaking is 500 grafts not a reasonable guess and there is a lot of hair present, so these drugs are the best option. That area would take more like 1500-2000 grafts depending upon the thickness (fine, medium or coarse) of the hair

There is a lot of hair present, so drugs are the best option. If you are compelled to do something, then get Scalp Micropigmentation (SMP) rather than a hair transplant and you will not have a visible balding crown. Our website shows the results we get from SMP: https://scalpmicropigmentation.com/gallery/thinning-hair/


2020-12-18 08:57:30Getting a minor transplant for minor hair loss

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Girls In Haiti Orphanage Are Losing Hair

There is a wonderful ministry called “Love a Child” which has an orphange in the country of Haiti. The owner/manager of the orphanage is struggling to help several of her African American orphan girls who are suddenly suffering from hair loss. She has pictures of the girls on her site at loveachild.com

From reading various information on your website and others it seems the only options are:
1. Stop tight hair braids (but it’s too late now)
2. Costly hair implants

Any suggestions or advice you might have to help these precious children would be greatly appreciated.

From the photos in the link you provided, it seems the girls on the site have traction alopecia from wearing tight hair braids for long periods of time. Unfortunately, traction alopecia is permanent and there are no good treatment options. Hair transplantation surgery may help, but it cannot replace all the hair that was lost as even with a hair transplant, the supply of hair may exceed the demand for hair in the balding area.

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Giving Myself Bald Spots

Hello. I am a 17 year old male that maybe hair transplantation is the answer to my problem. So heres what happaned. This was about 6-7 years ago when i was a young boy i used to pull on the front part of my hair. I know thta is one of the hair problems children face (Alopecia Trichotillomania), but i was doing that for a really short period of time. After about 2 weeks of pulling I had completely stopped pulling on my hair. After a long period of time most but not all of my hair grew back. Its been 6 to 7 years now and i have a few bald spots that have been bothering me ever since. I have one a little less than a dime, and my hairline isnt shaped right, and scattered mirco tin bald areas. Also, I would like to know from an estimate, how much it would cost for this procedure, and what is the difference betweeen FUE, FUT, and a hair transplant. I live in the los angeles area. I really want to fix my hair problem. Thank you.

Your first step should be to get a diagnosis. Small bald spots may reflect alopecia areata or ringworm and neither of these should be transplanted. There is no substitute for a diagnosis by a good doctor.

Assuming that you are a candidate for a hair transplant, it is difficult to estimate the cost of something that I have not seen. If you can send me pictures or give me some way to understand the size of the bald areas, maybe I can estimate the job. If it is small, use coins to tell me (e.g 3 dime size areas or one silver dollar size area). On that basis, I can estimate the job. Picking or pulling out the hair (trichotillomania) must be under absolute control or it will happen again. The picking must be solved before you transplant it. I can always tell if there is active picking going on in your head.

As you are in the Los Angeles area, pay me a visit and I will determine what the problem is, its scope, and what to do next.