Author: Dr. William Rassman

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Hair Density in Scars

How many hairs can you transplant into a square centimeter? I have a scar, and I want to fill it in. I am trying to find a doctor who can fill it in with just one surgery. Is this a reasonable question?

An excellent question! The calculation is one that is used in the industry as a benchmark measurement. The average person with 100,000 hairs on his head has 1250 hairs per square inch or 193 hairs per square centimeter.

But what is the number to use in determining the correct density for a hair transplant? Some doctors use high density numbers to define how good they are. However, there is a balancing act between maximizing density at the time of a transplant surgery and maximizing growth months later. Experienced doctors are the key.

The reasonable upper limit of density numbers from a transplant perspective is up to 120 hairs per square cm. This type of density, however, requires supple skin that still has elastic properties. Scars do not have this characteristic. Also scars have an abnormal blood supply when compared with normal skin. Much of the infrastructure and microcirculation in the vasculature is not present in scar, so transplanting very high densities may not produce good growth.

You need to be examined by a hair transplant expert, who has the experience to give you a reasonable answer to your specific need. While I understand that you would like to have this completed in one surgery, that may not be in your best interest. Only your doctor will be able to advise you.

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Hair Distribution in Class 7 pattern

The distribution of your hair in hair grafts in a Class 7 pattern is dependent upon (1) your donor density (available supply of graft without depleting the donor area, (2) your styling preferences, (3) the thickness of your donor hair (Hair mass of each shaft which is a measurable criteria) and (4) your pocketbook. A good doctor should be able to set up realistic expectations for you here. You must recognize that the bald area is three times the area of your entire donor area and that only a little over half of your donor area can contribute grafts to the bald area which means that a little over 1/5th of the hair is movable to cover an area 5 times the size. Anybody can figure out that the math doesn’t work, so how do you get good results when there is such a limitation? That is the ART that the doctor does the surgery with a good design and an understanding of what he has to work with and what he can and can not accomplish. The key is to communicate this information to you, the patient.


2020-12-03 07:02:44Hair Distribution in Class 7 pattern

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Hair Doctors in the UK Remind Me of Car Salesmen

Hello, I am a 29 year old male who’s suffering from hair loss. I’ve recently been to a few consultants’ regarding hair restoration surgery in UK. Unfortunately the surgeries and the surgeons seem to be inexperienced in which I didn’t feel confident enough to go through with the surgery. Also they came across as more of sales man trying to sell me a car rather than be a respectable surgeon. I would be most grateful if you could recommend me a good surgeon, I am willing to travel to the US to get the best surgeon.

Many Thanks

Be careful not to generalize. There are immoral doctors who employ aggressive sales tactics in the United States also. There are good doctors in the UK who have good reputations and are not of the ‘used car’ variety. If you are traveling from the United Kingdom and want a hair transplant surgery in the US, you can contact Dr. Robert Bernstein in New York, which is closer than my offices in California. Dr. Bernstein was my associate for many years at NHI. Or if you don’t mind the extra 5 or 6 hours of flying time, you are more than welcome to have your procedure done at my office. If you send me your picture (which will remain confidential), my office staff can set up a phone consultation.


2007-10-18 19:04:07Hair Doctors in the UK Remind Me of Car Salesmen

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When my hair dresser dyed my hair, gobs of hair fell out on the foil. Did I get a chemical burn?

I now have a few areas of white scalp which I can see coming from where the hair fell out. Will it grow back?

Dyes can be dangerous when they are improperly used and you most likely had a chemical burn from inappropriately used dyes which goes deep below the skin to kill the hair follicles in many instances. This is unfortunately common and these chemical burns most often cause permanent hair loss. Hair transplantation works if the burn is not too extensive. ?Scalp Micropigmentation also works in some situations (see here: https://scalpmicropigmentation.com/smp-for-women/


2017-02-10 10:28:00When my hair dresser dyed my hair, gobs of hair fell out on the foil. Did I get a chemical burn?

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Hair Dye

Hair dye, it’s long term use and potential adverse health affects, has received a lot of media coverage recently. Do you think that hair-dye should be avoided? Is there any such thing as a safe hair-dye?

Dyeing your hair is not as good as not-dyeing your hair. Many people point out that when they dye their hair they get more breakage. Anytime you apply chemicals to your hair you are changing what nature thinks is the best. Periodically, I hear of people who develop hair loss from dyeing their hair. I suspect that toxic chemicals or high doses of chemicals are being used that cause this hair loss. I am often surprised by the failure of such hair to return in the most extreme cases. There is no doubt in my mind that some people overdo their hair coloring, changing it frequently and in effect ‘abusing’ their hair. Anything done in excess is not good. With regard to long term use, be responsive to what you see. Take a break from the dyeing periodically, going back to your normal hair color to see if it makes your hair better. At least, this way you will know how far from normal you have migrated to.


2005-07-21 11:37:35Hair Dye

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Hair Falling Out When Towel Drying — Am I Being Paranoid?

I was wondering. When some of my hair falls out when I’m drying it with a towel, I notice some hair strands are thicker than others. Is that a sign of miniturization? Or am I just paranoid?

Hairs normally fall out at a rate of about 100/day, more when you wash your hair. The hairs that fall out as part of the normal hair cycle are usually normal thickness hairs, but if you lose a miniaturized hair, say goodbye to it, for it may not come back.


2008-09-10 16:41:39Hair Falling Out When Towel Drying — Am I Being Paranoid?

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Hair Falling Out — Lighter Color Near Bulb

I am a 21 (about to be 22) year old male and I am currently in between a NW 2 and 3 on the balding scale. I’ve been taking propecia for about 4 months with decent results.

My question is, when I examine hair that has fallen out of my head, it appears that the hair is lighter colored at the base of the hair (near the bulb) than up around the middle and tip. Is this a sign that the hair has thinned or is it normal for hair to be lighter near the base?

You did not state your hair color. In blonde, gray or white haired people, the bulb is lighter. In hair that is near the end of its life, the pigment changes may be lighter in color as is hair that is about to go into telogen. If you are worried about balding, then get your hair mapped out for miniaturization to determine what is actually going on in your hair.


2006-10-23 14:12:29Hair Falling Out — Lighter Color Near Bulb

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Hair Falls Out When Running My Hand Through It

I’ve noticed recently when I run my had through my hair that there will be a few single hairs on my hand. I don’t know if this is a sign of going bald or just natural? My older brother is bald, but started going bald when he was about 23 or 24, I’m 27 and this is the first I’ve noticed hair falling out. I don’t see hair falling out in clumps, but could this be an early sign of balding?

Hair loss in a 27 year old man may start the way you are telling me about. You need to get your hair examination and mapped for miniaturization and that will tell you if you have genetic balding in its early stage.


2007-03-15 15:46:15Hair Falls Out When Running My Hand Through It

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Hair Gel and Hair Loss

You responded to a post saying “good commercial” hair gel does not cause hair loss. Ok, what about cheap ones? And what is your conclusion based on, can you provide me with any studies supporting this position? How has this “myth” survived for so long, other than how most do in general – stated differently, what do proponents of this accusation base their claims on and why are they wrong?

Thanks in advance

OK, you got me on language and meanings. “Good and cheap” commercial hair gel should not cause hair loss. Otherwise they would be sued and go out of business or possibly go into a hair removal business. There is no medical study I am aware of to support my claim — it is just my opinion. I never knew there was a myth about gel and hair loss. I use gel everyday, as do millions of people.