Author: Dr. William Rassman

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Analysis of My Donor Area

I have about 90 cm2 of baldness and about 200 cm2 of possible donor area. When I counted 1 cm2 of donor 3 times, I got 110,113 hairs and 123 follicular units per 1 cm2. I was wondering if the ones with red arrow are still the same follicular unit even though the hairs are spaced out compared to one with green arrow.

You are pointing out the follicular units that have more than one hair. Sometimes they exit the same pore and sometimes it appears to exit next to the main pore. The count of 110,113 hairs is about the average hair count in a Caucasian male and the number of follicular units are about 50,000 or 2.2 hairs per follicular unit on average. Clearly, some of the Follicular units have higher hair counts and others may just have a single hair. If you look at the leading edge of a normal hairline, you will see all single hair follicular units transitioning into more hairs per follicular unit as you move away from the leading edge. You were very astute in your analysis. The next step is to calculate the size of the balding area you are thinking about transplanting. That is just the beginning of the next analysis where multivariate analysis comes into play. The other variables that must be considered are (a) hair thickness, (b) character of your hair (wavy or straight), (c) the thickness of the hair shafts (fine, medium or coarse) and last and most important is where you are heading with your existing balding (based upon HAIRCHECK analysis, family history, your age, if you are going to treat the progressive nature of balding, and your long term medical plan with regard to going forward management).


2019-02-14 06:54:32Analysis of My Donor Area

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Analyzing the Results of the HairMax Laser Comb

I have added a link to some of the before and after pics of people who have apparently used the lasercomb.

What do you think?

https://www.lasercomb.net/beforeafter.htm

Thanks again Dr! I’m addicted to your site now!!!

Ah, the HairMax LaserComb by Lexington International. It’s worth noting that lasercomb.net and hairmax.com both go to the exact same site, so the link you sent is the official site of this product. The page you sent (linked above) has 2 groups of photographs, each with multiple before/after sets. The 1st group is apparently patient results, and the 2nd group is of clinical trial macro photos.

So let’s start with the first group of photos — the patient results. I looked carefully at these, and there is a real question in my mind as to what I am seeing. A few of these pictures have longer hair that is possibly responsible for the changes that I can see. I wanted to get an enlarged version of the photos to see the details that would tell me what I was looking at, but they are not available on the site. The first before/after set in the group are a good example to start with. There is a suggestion that the scalp has coloring to it (Dermatch or something similar), but as I can’t enlarge the photos, I can’t try to determine what it might be. Could the difference be lighting or combing style? I don’t know, honestly. Many of the photographs suggest styling differences. In no case was there any significant change in the hair coverage, though. Either the person had plenty of hair when they started or there was not enough hair when they finished treatment.

Moving on to the 2nd group of pictures, the clinical trial macro photos —

We analyzed two sets of the before/after high-powered magnification photos, which also includes the data that they based their research upon. The actual hair counts as they did them are well presented and can be seen by magnifying the circular areas of hair density assessments. Each hair grouping was identified, numbered, and the authors put the actual count on each follicular unit as they made the measurement. They did not separate or identify those hairs that were miniaturized. Because all of the information is present in the material presented on their website, it was easy for us to repeat their measurements and to ascertain if their numbers corresponded to an independent assessment.

Here’s a breakdown of what I found in the macro photos that Hairmax presents on their LaserComb site.

Macro Photo Set 1 – Before picture:

  • HairMax’s hair count: 107
  • My hair count: 115
  • Of these hairs, 12 were miniaturized

Macro Photo Set 1 – After picture:

  • HairMax’s hair count: 148
  • My hair count: 128
  • Of these hairs, 10 were miniaturized

See the image on the LaserComb site

Statistically, the percent difference between the before and after photos (according to my count) is insignificant. Therefore, in the first set of photos the LaserComb made no real difference.

In the second sequential set of photos, I discovered that the after photo actually had less hair than the before photo —

Macro Photo Set 2 – Before picture:

  • HairMax’s hair count: 147
  • My hair count: 161
  • Of these hairs, 12 were miniaturized

Macro Photo Set 2 – After picture:

  • HairMax’s hair count: 184
  • My hair count: 159
  • Of these hairs, 10 were miniaturized

See the image on the LaserComb site

Yes, I actually counted three fewer hairs after the LaserComb was used. My measurements of the data on their official site do not support the findings they offer.

I am comfortable saying that I am one of the world’s experts in hair densitometry. I can prove this as I am the inventor of this technology and hold the U.S. Patent on the instruments used by HairMax (or Lexington International) to demonstrate their findings (see: USPTO.gov). With that being said, I reviewed our findings and agree with our counts. I believe that HairMax’s photos do not show any objective evidence of hair growth on the first two sets of data and that the numbers that they derived do not correspond to the assessments made by us. Lots of good hype if you’re into it.

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Anatomy of a hair

For those of you who perform microneedling, you want to reach the area between the gland and the skin which is between 1 – 1.5 mm from the skin edge

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Announcing Follicular Unit Extraction Enhanced!

 

We have made a significant breakthrough in the way to perform Follicular Unit Extraction (FUE) and we have put a substantial effort into giving our readership some practical basis to understand how to evaluate the significance of our breakthrough technology and the FUE process in general. There have been recent claims about FUE that I frankly can’t believe which are now appearing on various websites around the world. Considering that I literally pioneered the FUE field, I believe that I am an authority worth listening to. I have not spoken up about this before, but there is no time like the present to address my concerns publicly.

Please see our latest FUE writings at newhair.com/fue.

Also, we just announced a huge fee discount on our FUE breakthrough, which we’re calling FUE2 — or Follicular Unit Extraction Enhanced. See newhair.com/fue2 for more on that.

 

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Anemia and Hair Loss

I started researching on the web what I can do to prevent additional hair loss and ways to restore hair loss and found your website.

I was wondering if you could answer a question for me. Here’s a little history – I have had a medical condition which involved being on non-inflammatory steroids (prednisone) for 4 years and have had 3 surgeries. During each surgery I have noticed that my hair had gotten thinner. I also have a problem with being anemic due to the result of my prior medical problem and surgeries. I am supposed to be cured now, however, I have hair loss which is visible on the top of my head (easily to see my scalp). I’m only 34 years old and am very discouraged. Can my hair loss be restored by taking vitamins and/or iron pills? If not, what would I be facing to restore it? Can it even be restored at this point? Help!

You need to be examined to be sure that there is no other medical problem that is producing hair loss at this time. Anemia is just one of the causes of hair loss. Generally, vitamins and / or iron pills will have no effect. I am not sure if you are a man or woman from this question and this would be an important factor for men with hair loss that is genetic and precipitated by a medical condition will usually not get the hair back. You need to make an appointment with a competent doctor, who is familiar with hair loss.

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Angry Reader Points Out — Lamisil Does Cause Hair Loss!

A Google search brought me to the question and your answer from a man who was experiencing dramatic hair loss following a two month usage of Lamasil. Your reply discounted Lamasil from being a cause, citing the drug’s use for infections that in and of the condition cause hair loss.

I am sorry to tell you I find your reply specious. Look, the drug insert slip detailing the side effects CLEARLY states that hair loss is a DIRECT side effect of terbinafine hydrochloride usage. You can bet the drug company would give much not to have to include it, or any other in a list of side effects, but after 33 years of patient use, I’m fairly certain that it’s had substantiation. Hair loss is a real unpleasant and tremendously visable side effect, and tons of money is spent by men and women to counter baldness. No drug company wants to have to tell users “this could happen to you”.

Now, I am a 45 year old woman prescribed and dutifully taking on schedule terbinafine hydrochloride aka Lamasil. I have had HUGE, by the handfuls, hair loss. I am in perfect health, substantiated by my age 45 health screening, except for normal stress, the effects of aging, and toenail fungus.

Please note: I received the prescription of Lamasil for TOENAIL fungus, not fingernail fungus, not ringworm or anything else that would cause hair loss, and hair loss is NOT a result of toenail fungus, doctor. So, when you post a sincere and concerned question (which unsurprisingly you did NOT answer) with a reply disdaining and discounting the legitimacy of the issue with an answer that supports an obvious agenda on your part, you discredit yourself and your profession.

AND I still need to know if MY hair will regrow. That guy was almost certainly loosing his hair from the Lamasil. Drugs are special, doctor, and many are needful, but those side effects ARE real.

Many drugs can cause hair loss, but my position has always been to explore other, more common causes of hair loss before blaming the drug. More importantly you need to discuss starting or stopping any medication with your physician.

Lamisil is often used in the treatment of fungal diseases of the skin, such as ringworm or toe fungus. If left untreated, some fungal diseases of the scalp by itself can also cause hair loss. I stand corrected with your reference to the drug insert warning of hair loss as a complication, but many times, just because a person is on a drug that has hair loss as a known side effect, it does not mean that it is THE cause of the hair loss. Diagnosis is just not that simple.

If you believe the drug you are taking is causing your hair loss, please address these issues with the prescribing doctor. There’s a disclaimer at the bottom of every page of this site that can be summarized to say, “This site is intended to educate the public on hair loss topics and should not be used for the purpose of medical diagnosis or treatment recommendation.” Please remember that I am not your doctor.


2007-11-27 14:33:09Angry Reader Points Out — Lamisil Does Cause Hair Loss!

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Anemic Teen Girl Losing Hair

i am an 18 year old girl and for about 6 months my hair has been falling out-particularly in the shower. it used to be fairly thick and now has become so much thinner. The doctors have said i am anemic- with very low ferritin in my blood. i am on iron pills and have been for two months. how long should it take to restore these levels and thus stop my hair loss? i have no problems with thyroid and no genetic history of premature balding if balding at all. what else could you suggest and is it worth buying any hair loss products? please help!

Iron deficiency in one of the medical conditions that could lead to hair loss or could accelerate hair loss due to other causes. Its treatment is not always easy and it may take a few months. You need to be checked with blood work periodically to assure that you are heading in the right direction with your treatment. When the iron deficiency is treated, your lost hair may re-grow within a few months.


2007-04-02 11:33:29Anemic Teen Girl Losing Hair

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Angle of Hair Growth (Photo)

The angle of the hair growth is determined by the surgeon who creates the recipient sites. The direction of the recipient sites, which is made with a needle, has an angle that will eventually dictate the final hair growth direction. I can’t tell from these photos the direction apart from the curl to your hair. I would have to look closely at the angle that the hair exits the skin to determine if the angle is correct. I have seen many hair surgeons create the hairline like the wheels of a bicycle spoke, circular from a mid-point in the center of the head. When it is done this way and the hair is straight, it is impossible to make it normal looking.

 


2018-09-14 09:44:32Angle of Hair Growth (Photo)

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Anger appearing on finasteride

Started taking fin around a week ago, and I feel like I’ve been getting really mad and annoyed very easily. Has anyone else experienced this?

If you think that the drug is causing this, try stopping it for two week and see if things go back to normal. There have been reports of changes in mental states in people taking this drug, although rare.


2020-08-08 09:53:04Anger appearing on finasteride

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Another case of DUPA

Diffuse Unpatterned Alopecia (DUPA) hits the donor area (back of the head) as it does everywhere else on the head. Men with DUPA should not have a hair transplant. The arrows point to only three normal terminal hairs in this patient’s donor area within the field of view. All of the other hairs are in some degree of miniaturization.