Author: Dr. William Rassman

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Can I Really Trust My Surgeon?

I recently had a hair transplant and I can tell that the grafted skin is clearly visible in only one particular area (I keep the hair extremely short). All other grafted areas are perfect. The difference is night and day. Can the surgeon tell if there will be a mark in one spot by inspecting the grafted areas during surgery? What causes one grafted area of skin to be visible and not all others? Could it be that the incision wasn’t deep enough…making the grafts not go in far enough and stand out a bit resulting in bumpy grafts? I hope you can answer because I am concerned about returning. I need to know if I can really trust the surgeon. Maybe I made him angry?

It is difficult to understand why you would have surgery without being able to trust him/her. Afterall, they are cutting you open. You really do need that trust. Furthermore, I cannot stress the importance that the relationship between a doctor and yourself should be a partnership and one of mutual respect. Your surgeon should be able to address any and all of your concerns before and after surgery without any reservations. I understand that it may not be a perfect world, but I would recommend that you speak with your surgeon first.

With respect to your particular situation, it is virtually impossible to know what was done and what the plan in your surgery was without examining you or asking your surgeon/and yourself the pre-operative plans and expectations. The ability to see the transplanted skin in the graft could be caused by many factors, including the deployment of minigrafts rather than follicular units, placing the grafts too deep or too superficial, angular placement that is inconsistent, inadequate trimming of the grafts when they were harvested, etc…

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Can I Make My Own Topical Finasteride?

I have finasteride 5mg pills. I crushed up the pill until it was very fine powder. I put it in an empty bottle of Minoxidil. I added 5ml of Minoxidil. Shook up the contents My intention is to shake up this mixture prior to applying and apply 1ML of this mixture a day via the Minox dropper. Thus this mixture should last 5 days Am i missing something here or is this sound?
The finasteride will not absorb into the skin and be effective the way you are using it. The real topical finasteride has a liposomal base that allows skin absorption. That is why you pay good money to a compounding pharmacist.


2019-11-05 10:17:16Can I Make My Own Topical Finasteride?

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Can I Prevent Hair Loss Following Giving Birth?

I am 25 years old, had a baby in 6 months ago, and since lost about 30 pounds. My scalp is also itchy. I know with pregnancy and weight loss you can lose hair. I am just wondering if it is reversible or what I can do to stop my hair from falling out before it is too late.

You must wait it out, at least a year. Hair loss often returns by then, especially if you are not breast feeding. There really isn’t any way I know of to prevent it, as there are many hormonal changes occurring that cause this telogen effluvium.


2013-06-18 18:09:00Can I Prevent Hair Loss Following Giving Birth?

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Can I make my own topical finasteride with alcohol?

Took fin orally and got bad sides, stopped and they went away quickly but hair loss is back lol. I’ve read studies about topical finasteride working to an extent and producing no side affects as DUT is only reduced 5% systemically. How to make it but without using minoxidil as the aqueous solution in the mix?

Mixing finasteride pills with alcohol will not give you anything worthwhile. The drug has to be mixed professionally with a liposomal compound that can allow it to go through the skin.


2020-07-16 08:27:58Can I make my own topical finasteride with alcohol?

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Can I Prevent Stress Hair Loss?

I am going through a divorce and heard that stress can cause hair loss but it will probably grow back when the stress subsides. Is this true? Is there anything that can be taken to prevent this?

Some people do lose hair all over the scalp due to extreme stress, but there’s no pill to take to treat or prevent this. Stress management is an art and a science. You should contact your family doctor if you believe that your stress is impacting you with hair loss.


2010-05-21 10:45:31Can I Prevent Stress Hair Loss?

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Can I Stop Taking Propecia and Continue with Minoxidil?

I am 21 with genetic hair loss.

I am taking propecia and minoxidil 12.5% + Azelaic Acid. If treatment works after, can I stop propecia and carry on with minoxidil 12.5% + Azelaic Acid?

As I’ve noted before, if you have any results from Propecia (finasteride 1mg) and stop taking it, you’ll see those results reverse. I’m not sure how long you’ve been using these medications, but I hope you talk to your prescribing physician before adjusting your treatments.

Even at the rather high 12.5% strength, minoxidil doesn’t maintain the benefits of Propecia (and vice versa). This is usually why I recommend starting with one medication and then adding another later, so you can get a better idea of which drug is giving you the best benefits. If you started both at the same time and decided to stop taking Propecia, you’re gambling that your visible results are just from minoxidil.


2013-03-12 12:49:10Can I Stop Taking Propecia and Continue with Minoxidil?

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Can I reverse my bad hair transplant?

I had a 1500 follicle FUE transplant about 8 years ago by a surgeon on Harley Street. I regret having it done now. I get the feeling that others can see the gap between the transplanted hair and behind it where my hair is thinning. Also the transplanted hair stands straight up which accentuates the difference between it and the rest of my hair. I don’t want to have another transplant as I feel that I will always be chasing the receding hair!

I went to see the surgery a couple of years ago about a reversal and they advised against it. However, I wondered if anyone had experience/knowledge of whether it was possible to have the transplanted hair removed?

I would want to see your hairline and get some good pictures of what you are looking like before rendering an opinion. I have fixed well over 1000 hairline patients. I find that the best way to fix it is to create camouflage that will take advantage of the poor grafts and fill it in with follicular units around and in front of the existing grafts (see here: https://baldingblog.com/actor-joe-penny-shows-off-his-repaired-hairline-with-photos/ ).

For those who need more, I add Scalp Micropigmentation (see here: https://scalpmicropigmentation.com/gallery/#!https://scalpmicropigmentation.com/wp-content/uploads/2016/04/new_hair_institute-scalp_micropigmentation-patient_photo-066b-smp-wm.jp here: https://baldingblog.com/repair-of-hairline-transplants-photos/. Also here is another fix: https://baldingblog.com/repair-of-hairline-transplants-photos/


2020-12-04 11:32:17Can I reverse my bad hair transplant?

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Can I Stop Being Bald Like My Father?

I am 24 years old and now have advanced my balding to include the front and the crown. I don’t want to be bald like my dad who is probably has a Class 6 pattern of balding. He said he got most of it when by the time he was 35. What if I started taking Propecia when I was 18, would that have preserved my hair?

That is a great question. Most advanced balding pattern patients have their pattern established in their 20s. Despite that almost 20 years that Propecia has been on the market, we really do not know if the progression could have been stopped had you taken the drug when you were 18. There would have had to be controlled clinical trials where one group who had advanced balding in their families were put on Propecia and the other group not. In that situation, we would know the answer to your question, but no such study has ever been done.

I suspect, however, that had you taken the medication when you were 18, you would have slowed down the progression of the balding and most of such young men in the 18 year old bracket, would not develop their final balding pattern for many years. i doubt that the final pattern would have been thwarted, but for such men, delaying into their 30s could give them the benefits for possibly another decade of so. We will probably never really know the answer, but for many men who I placed on finasteride (Propecia) I have seen the process slow, stop or occasionally reverse. Better to do it than not to take the drug if you are one of these 18 year old men. At 24, it can’t hurt and probably will help.

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Can I See a Trichologist to Diagnose Hair Loss?

Would trichologists be a good place to go to diagnose genetic hair loss. Consultation with examination is a bit expensive so I’d like your opinion on it. I’m seeing one in 2 days and what he plans to do is take some of my hair and examine it under the microscope. Would you have any idea on the effectiveness for diagnosis with this method vs the scalp mapping for miniaturization? I’m 26 asian male with a full head of hair (although not as thick or a lot compared to in HS)Is it still a good idea to see these specialist anyways even though Im not exhibiting any clear observational signs of balding (my diabetic father thinned and had bad hair loss at 46 and his younger brother balded in his teens…grandfather on both sides have hair although diabetic mother on father’s side has extremely thin hair pretty much balding)

I can not tell you what the trichologist will see or what he/she is looking for. Without miniaturization studies I do not believe that hair loss patterns for genetic hair loss can be anticipated. The miniaturization study is a microscopic examination of your scalp. If your trichologist is doing this, and knows what to look for, then you’re a step in the right direction.