Author: Dr. William Rassman

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How Much Weight Do You Need to Lose Rapidly to Trigger Shock Hair Loss? Can It Recover?

I weighed around 85-86kg before this, and now, two weeks and two days later from the initial depression episode starting, ended two days ago, I weigh around 80-81kg apparently according to the scales. I am concerned, thats alot of weight to lose in such a short time.

It is different with different people, but 15 pounds per months could trigger hair loss with the genes for balding on board. When the genes kick in, it rarely reverses.


2020-06-04 18:40:12How Much Weight Do You Need to Lose Rapidly to Trigger Shock Hair Loss? Can It Recover?

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How much would a quality transplant cost in the US?

So I’m thinking of putting aside around $500-1000 enough assuming my hair doesn’t improve on the big 3. Hoping to get a procedure done by the summer of 2021. Really worried about quality and pretty risk adverse. At about a Norwood 3 now

The average hair transplant in my office practice runs $6,700. OF course, the range runs between $3000-$20,000 depending upon many factors. The reason I tell patients to establish a Personalized Master Plan for their hair loss is to be able to understand what it takes to keep their hair in place, from a good medication routine established by a credible doctor to a hair transplant if you should need it. Starting off early with hair transplants at the age of 25, might mean a smaller type of surgery with proper medical preparation early-on.


2020-02-09 11:14:43How much would a quality transplant cost in the US?

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How risky is trying fin?

I got a prescription of fin filled but it’s just sitting in my room. Been balding for a few years now but I still have a hairline that’s receded in the temples. I’m not scared so much as about the side effects but the stories I’ve heard/read about permanent side effects that last even after you stop using fin.
You can always stop it but don’t talk yourself into side effect because it is 100% for those who do.


2021-01-04 13:24:01How risky is trying fin?

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How Often Should I Map My Own Scalp?

Dr. Rassman,

Thank you for answering my last question. I have one more for you, if you do not mind.

I mapped my own scalp for miniaturization per your instructions, and found it a very useful tutorial, though I took a nod from a recent entry and snipped a few bits of hair from my head instead. I compared 5 locks of hair from all around my head (temples, forehead, crown, donor area) using my donor area as a control, and to be perfectly honest I could not see a difference in the hair shaft width between any of the samples. Unfortunately I do not have equipment to give hard numbers, but my hair does not seem any less pigmented or thinner in any of the areas compared to my donor zone. I examined it under a magnifying glass, but have access to a microscope if that is insufficient.

I’ve also visited a dermatologist. He did not have the equipment to map my scalp but he said I was a NW2 and was fine.

That said, how often do you suggest this process be repeated? Every three months? Six months? Yearly? Is there a certain age after which you can just stop as there is unlikely to be further progression?

I am 26 with no known male-pattern baldness in my family; both grandparents died with Norwood 2 patterns, and none of my uncles have any hints of balding.

Thanks!

I am assuming that the mapping showed no significant miniaturization. If that is the case, once a year mapping or more frequent mapping may have value if you think that the problem may be appearing or getting worse. The mapping exercise is best when comparing:

  1. The hair in the back of the scalp (donor area) with hair elsewhere on your head, or
  2. Hair within various local areas with hair-by-hair comparisons where the miniaturization shows up well

As for age, some men will lose hair in their teens, some in their 20s and 30s… it can even happen in the 40s and beyond (though it’s less likely). You might be one of the lucky ones and not have any hair loss problems, but I really have no way to tell at this point (and without at least an exam).

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How Quickly Could Catch-Up Hair Loss Start If I Quit Finasteride?

What is the minimum amount of time someone can use finasteride and then stop and see “catch up loss”? I am 35 and have very minor hair loss and I am afraid if I start, and get sides, et, or am not comfortable with the pill, and can’t tough them out, that my hairloss will accelerate much faster than it was previously. What would you consider an appropriate amount of time to use the drug, quit, and get catch up loss?

Also, what do the shed hairs say about my MPB or loss? Is there a difference if I am shedding long/thick hairs vs wispy ones? In normal shedding and accelerated/catch up shedding, should a “bulb” be attached?

Thanks!

Catch up hair loss takes about 1 to 3 months after stopping Propecia. Hair loss will accelerate to “catch up” to the point where you would have been if you never had taken Propecia in the first place. You will NOT have more hair loss than if you’d never taken Propecia.

The bulb at the end can be normal and isn’t a concern. I’m not sure what you’re seeing as far as the long/thick hairs, but you might just be describing normal hair cycling.

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How Rare Are Permanent Side Effects from Propecia/Finasteride?

The science papers suggest that the sexual side effect (the focus of most men on this site) are less than 2% and are reversible if stopped early. The nocebo effect is much higher as young men bring on their sexual side effects by obsessing over taking the drug, and reading forums that suggest that this is a common occurrence. The greatest concern of most young men is the condition called Post Finasteride Syndrome which if real, may reflect a 1% risk at most. There is controversy over the existence of this condition within the medical community, but it is nevertheless important for any man considering this drug


2020-03-23 15:54:06How Rare Are Permanent Side Effects from Propecia/Finasteride?

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How “reliable” is a hair transplant?

They say you can get a transplant once you’ve stabilized your hairloss with Fin – but how reliable is it actually? I’m not sure how accurate this is, but I often read that Fin doesn’t really halt your hairloss, it slowns it down a lot but your hairline is still receding. And who’s to say that you get you a transplant and, 3 years later, Fin starts losing effectiveness and you end up looking even worse before? Do you just have to gamble on this, or am I missing something? Or is the transplant a commitment in the sense that you’ll eventually need more to “recorrect” everything?

What are you realistically getting in the long term with a hair transplant?

I have been doing hair transplants for 28 years and started the trend with small follicular units used for the hair transplants. Many of my patients from 28 years ago, come and visit me and a few came back for more hair transplants as they continued to lose hair. In good hands, hair transplants work and in 99% of people, the results are permanent. That is good and bad because if it is done well, you will look good, but it is done poorly, you will always look freaky.


2019-03-27 09:42:45How “reliable” is a hair transplant?

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How stem cells make hair, teeth, glands and other organs (Schematic Diagram)

It should be clear from this schematic that to make a single hair, requires the use of epithelial stem cells with a lot of coaxing (click to enlarge).

Functional ectodermal organ regeneration as the next generation of organ replacement therapy, Etsuko Ikeda, Miho Ogawa, Makoto Takeo, Takashi Tsuji Published:06 March 2019https://doi.org/10.1098/rsob.190010

Author’s Conclusion about Hair: “Because hair follicle stem cells are the only adult stem cells possessing organ-inductive potential that can be transplanted autogenously, the first human clinical trial of organ regenerative therapy will undoubtedly investigate hair follicle regeneration. The regeneration of hair follicles using our organ germ method is now being investigated in a pre-clinical study to cure patients suffering from androgenic alopecia, with an aim of conducting clinical trials in 2020. This hair follicle regenerative therapy will be a milestone in organ regenerative therapies and will lead to the development of material and responsive infrastructure to realize organ regenerative medicine. Applying knowledge of hair follicle regeneration and expertise obtained from clinical trials to other organ germs or organoids will enable the regeneration of other organs from pluripotent and tissue stem cells in combination with organoid technologies in the next few decades.”


2019-05-19 10:39:39How stem cells make hair, teeth, glands and other organs (Schematic Diagram)

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How Should I Treat My Recipient Area Immediately After A Hair Transplant

Any hair transplant should be treated the same with regard to the recipient area, but if the donor area has open wounds (FUE), it requires daily washing with soap and water. Within 3 days of surgery, you can resume full activities, heavy exercises if you wish. The recipient area requires daily washes as well to keep the recipient area free of crusts. I generally recommend the use of a sponge and supply our patients with a surgical sponge to fill with soapy water (we supply the shampoo) and press on the recipient area daily in a rolling motion, never rubbing it. By repeating this daily, all crusts can be washed off without any fear of losing grafts from day one forward. If any crust are present, use a Q tip and dip it into soapy water or shampoo and roll it on the crusts and that will lift them off without dislodging them, but never rub them, just roll the Q tip on the recipient crust. I like to see no evidence of any crusting in the recipient area and the crusts from the donor area gone in the first day with daily washing and stay that way. Here is an example of the way is should look like in 12 days with before and after pictures:

https://baldingblog.com/2007/12/14/12-days-after-hair-transplant-with-photos/

The following is an example of one of the worst crusting I have seen in a picture:

https://baldingblog.com/2015/06/04/fue-from-turkey-help/

The problem with this type of crusting, the grafts get pulled out as the crusts come off. We wrote about this in a medical journal here:

https://baldingblog.com/wp-content/uploads/pdf/mp-2006-graft-anchoring.pdf

The key is good washing starting from day one.

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How Snake Oil Got Its Reputation

Snippet from the article:

These days, “snake oil” is synonymous with quackery, the phoniest of phony medicines. A “snake oil salesman” promises you the world, takes your money, and is long gone by the time you realize the product in your hands is completely worthless.

But get this: The original snake oil actually worked. Save this one for the next cocktail party; it will blow your friends’ minds.

Read the full story — How Snake Oil Got a Bad Rap (Hint: It Wasn’t The Snakes’ Fault)

I had thought “snake oil” was synonymous with “medical scam” in most of the world, but I still get emails from people in various parts of Asia that truly believe snake oil will cure what ails you and want to know where to buy it. Sorry, snake oil doesn’t regrow hair.