Author: Dr. William Rassman

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HairDX Announces Finasteride Test for Women

Snippet from the press release:

Genetics research and a clinical study are today bringing significant news to women experiencing hair loss. A new breakthrough test can now help doctors determine if a woman is likely to benefit from anti-androgen therapies.

Genetic dermatology research and development innovator DermaGenoma, Inc. today announces the HairDX Genetic Test for Female Androgen Sensitivity. The test offers a new genetic screening for women suffering from or at risk of androgenetic alopecia (AGA), and is making its debut to physicians at the International Society of Hair Restoration Surgery’s 18th Annual Scientific Meeting in Boston.

The HairDX Genetic Test for Female Androgen Sensitivity (to be available through dermatologists at a suggested price of $399) examines genetic and epigenetic (genetic control mechanism) variations in a woman’s androgen receptor gene. This analysis will assess her androgen sensitivity to determine if her hair loss has an androgenic origin.

Read the full press release — Breakthrough Genetic Discovery Helps Dermatologists Prescribe Effective Treatment For Female Hair Loss

Women have few options when it comes to treating genetic hair loss, and this new HairDX test seems to point out which women might respond to finasteride and which will not. I heard the announcement at the ISHRS meeting in Boston, but it’s important to note that finasteride is not FDA approved or recommended for treating female hair loss. The drug can pose a serious risk to those women that are pregnant or can become pregnant.

We previously mentioned the HairDX pilot study about finasteride response in women here.

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Hair used to sew facial wounds

https://www.medscape.com/viewarticle/885777?src=WNL_trdalrt_171017_MSCPEDIT&uac=209383MV&jobid=1458470&faf=1

Here is an interesting article that discusses the use of hair as a suture that is easily available on the person’s own head. You can use the hair if you find yourself in the woods needing suturing but don’t forget cleanliness and sterile conditions

 

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Haircheck for Hair Bulk Analysis

One of the things I enjoy about the annual ISHRS meeting is that I am introduced to new products. Sometimes the products can be half-baked or without merit, but every now and then something catches my eye and piques my interest. So at the recent ISHRS meeting in Boston, I was shown a refined instrument called Haircheck that was presented to measure hair bulk… and I was quite impressed.

Over the past 18 years, I have assessed the thinning process with video magnification using a patented device where I could see the hair shafts, visually compare them and measure the density of the donor hair. Now with this Haircheck device, I can actually measure the bulk of the hair in the impacted areas and compare it not only to the permanent hair, but also to previous measurements made during past visits.

When you undergo balding, one thing always occurs — the impacted hair loses its bulk (the hair shaft diameter becomes thinner and thinner over time). Eventually this thinning leads to balding. The use of drugs like finasteride seems to reduce the miniaturization (thinning) process, and if there is a positive impact on hair bulk by blocking DHT, it will clearly show up in these studies. For those patients who continuously ask about saw palmetto or other supposed hair loss treatments, the value could clearly be defined with this technology.

I fully recommend to every person that believes they’re losing hair to get a Haircheck examination in an office near them. I’m not sure which other clinics offer it, but we will be offering this service to our patients who believe that their hair is thinning. If you’d like to setup an appointment for a consultation, please call 800-NEW-HAIR or 310-553-9113.

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Haircut After Hair Transplant

When is it OK to have a haircut after a transplant, especially for the transplant area? Thanks.

After a couple of weeks you should be able to get a regular haircut. Don’t expect that the transplanted hair will grow out in less than 5 months.


2007-10-10 08:34:21Haircut After Hair Transplant

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Hairline advancement Surgery for men is a NoNo!

If the person has never had diffuse hair loss (like me). I suspect if it was in my genes, the so-called “diffuse thinning”, I would already have it and as you can see my head is full of hair, I’m merely a “receeder” not a “diffuse thinner”, Could the forehead reduction surgery ON ITS OWN cause diffuse hair loss?

As a general rule, I believe that forehead advancement surgery in men puts them at risk of balding and showing the scarring and making it look unnatural if that should happen. IF a man had a Bill Clinton hairline or a Ronald Reagan hairline, and they were over 45 with a normal HAIRCHECK test, I would not have a problem with a hairline advancement surgery on them.


2020-09-15 12:43:53Hairline advancement Surgery for men is a NoNo!

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HairDX Showed I Had Only a 30% Chance of Propecia Response

Dr Rassman, If you had a male patient who was 43 years old and is only approaching a Norwood 2A pattern, showed to have the balding gene based upon the HairDX testing and showed to have only a 30% chance to respond to Propecia based upon the HairDX, would you still advise the patient still continue taking Propecia. Also has father who is a NW7 and started balding at 18.

Secondly, would he still be a good candidate for a hair transplant to thicken the hairline even if he may not respond well to Propecia? My doctor advised me to continue taking the Propecia. Would you do the same?

I am not your doctor and you need to discuss your treatment option with the doctor who ordered the HairDX test. Is a 30% chance a worthwhile investment for you to take a pill a day? You can discuss your risks and benefits with your doctor.

I would not know if you would be a good candidate for hair transplant surgery because I do not know what you want or what your goals and expectations are, as I have not examined you. If you indeed have a Norwood class 2A pattern of “balding”, I would doubt that you are a candidate for a hair transplant at your age, but I would have to see you (or at least see some good pictures) before drawing any conclusions.

Hair transplantation is an elective cosmetic surgery. If want to lower or thicken your hairline and change your look that is your prerogative, but your response to Propecia and your candidacy for surgery are not related. The hair transplant surgeon’s job is to guide you, give you realistic expectations, and an overall Master Plan.


2013-10-13 14:45:05HairDX Showed I Had Only a 30% Chance of Propecia Response

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I Had a Hairline Advancement and It Looks Unnatural, What Can I Do? (Photo)

A typical female hairline is rounded and the leading edge should have a no-hairline hairline. This means that the transition zone should be built between your forehead and your thicker hairline so that there is no beginning of the hairline that looks like a ‘line’. Your picture on the left should be compared with a hair transplanted no-hairline hairline on the right below. Note the rounded soft nature of the hairline on the right which was completely transplanted, including the temple peaks and an advancement of the middle hairline about one inch, while the photo on the left is straight enough to draw a line connecting the hairs. I would build a transition zone with hair transplants to soften the abrupt hairline that is shown.

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HairDX Genetic Hair Loss Test System

Just wondering if you could speak about the HairDX test and whether it is useful to use for men who want to know how severe their future hairloss will be.

HairDXMy knowledge of HairDX is limited to what I can find on the Internet (not much outside of their official website and official press releases). Assuming HairDX works and does give you an accurate genetic testing profile, why would you want to spend $149 when you can get a free consultation with a doctor? I guess some people just don’t want to meet with a doctor at any cost. Furthermore, I personally base my medical and surgical recommendations on a physical examination, history, and a miniaturization study. I would have a hard time recommending surgery or medication (Propecia) for men who show no signs of balding, but do have a positive genetic test.

It is nevertheless an interesting test from a marketing and consumer perspective and as more genes are identified that contribute to the hair loss process (MPB), then this approach may help us find better treatments and possible cures for genetic hair loss.

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HairGenesis

Dear Dr. Rassman,
I’ve been taking propecia since I first noticed my hairloss, at age 20. Now I’m almost 24, and while I’ve retained some hair in the vertex, there’s been substantially more loss in the front/temple areas. Transplants are probably not a financially plausible option for me presently, so I’ve weighed other solutions (mostly vitamin/herbal supplements), bearing in mind the advice published in your blog. The website for “hairgenesis” touts an FDA-regulated published study supporting it’s claims: Is this information credible, or is it merely a marketing ploy? What other information should I look for when considering treatments other than propecia and surgery?

Thank you in advance for considering my question.

I do not like the Hair Genesis site, because it is very heavy on claims that appear unsubstantiated. As I have no experience with it, I can not tell you what I do not know or have not learned, but when there are so many claims and reflections on FDA ‘endorsements’, I would doubt their credibility. The field of homeopathic and herbal medications is generally unregulated, but it is not proper or ethical to claim FDA ‘endorsements’ like this company seems to have done. To my knowlege, only minoxidil and Propecia have been FDA approved for safe and effective hair loss treatment and there is good scientific evidence that minoxidil and Propecia works. When it comes to natural and herbal medications, there are many harmful natural and herbal medications. Arsenic, of example, is a natural medication that has been used in historical medicine for the treatment of syphilis, but I would not use it for prevention of syphilis nor for any human use as it is a well known poison, so ‘natural’ does not imply safety. The message here is BUYER BEWARE, and remember that just because claims are posted on a website, it does not imply true safety or effectiveness.


2005-11-21 13:40:42HairGenesis

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HairCheck vs Miniaturization Mapping

Hello Doctor Rassman,

first of all thanks for your website and for all the precious information!

I have a question related to the haircheck methodology (re. a post on Aug. 8, 2011). Is the haircheck methodology related to miniaturization or is it a different methodology? I.e., would haircheck reveal an early stage of miniaturization, which would not be usually seen with the traditional magnifying camera that you and Dr. Pak use when visiting patients? I ask this because, when doctor Pak visited me in San Jose 2 months ago, he said that at 30y I don’t have any sign of miniaturization, but I still have the “impression” that the hair on the top of my hair has lost volume over the last year. Maybe just a little paranoia :-)?

Keep up the great work!

Best regards

I discussed your case with Dr Pak and he remembers you well. You have absolutely no sign of balding. There was less than 10% of miniaturized hairs all over your scalp. There was no balding pattern identifiable. If you would like, you can send us a photo and permission for us to post it. You are 30 years old with a Norwood 2 hairline.

You are one of those people who had so much hair when you were younger, that you probably never saw the skin on your scalp. As you aged, you probably had some thinning (not balding), and when your hair was cut short and you were under bright lights, the whites of your scalp could be seen. It was the perfect storm.

The bulk measurement can be used to assess the VOLUME of hair at certain areas (top or crown) of your scalp and make a relative comparison of that value to the measurement from the back (donor) area of your scalp. This test cannot be done if you have lots of product (gel, mouse, pomade, hair spray) on your hair, as it will add to the bulk, nor can it be done if you have very short hair, because we need to grab a section of your hair in each area of the scalp. The bulk measurement is like counting the number of hairs in a certain area (density) and multiplying it by the cross section area of each hairs.

The miniaturization mapping measurement can be used to assess the condition and distribution of miniaturized hairs around certain areas of your scalp. The proportion of miniaturized hairs to non-miniaturized hairs can be compared to your own donor hair to see if there a pattern to the miniaturization (thinning). In your particular case, you had absolutely no miniaturization all over your scalp.

By the way, thank you for the bottle of wine!


2011-08-11 17:37:59HairCheck vs Miniaturization Mapping