Author: Dr. William Rassman

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21 Years Old and Anti-DHT Drugs Don’t Work for My Hair Loss!

im 21 and have had MPB for quite a few years i tried propecia 1st for a long long time and it did not work, basically with procecia its a low dosage for anti DHT and what was happening was I was still losing hair at the rate i was losing before. i took it for about a year. then tried avodart for 8 months and that damaged my hair even more i think because the Anti DHT dosage is higher.. anyways bottom line is, you have any idea why these anti DHT products arent working? or why my body wont take them? it seems the higher the dose,the worst the situation gets… not sure where to go from here, any suggestions doctor? thank you

You need a good doctor to work with you! Propecia (finasteride 1mg) and Avodart (dutasteride 0.5mg) are prescription items so you must already have a doctor, right? These DHT blockers do not always work at noticeable levels if your genetics are moving very fast.

The way I manage it is to get a baseline by mapping out your scalp for miniaturization and then look what happened over time by analyzing again in a year. This way, I know what is happening and can put a number on it. You need to have a Master Plan with a doctor who cares about you and is competent to manage you.

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2011 ISHRS Meeting Review, Part 4 – Surgical Techniques

ISHRS 2011

Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.

This is part 4. More to come…

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Which is better: FUE or FUT (strip)?

    I (Dr. Rassman) moderated a panel of 6 doctors to debate the merits of follicular unit extraction (FUE) over the more traditional strip harvesting transplant procedure (FUT). I started the sessions showing a case of what I called “follicular holocaust”. It was a case of 6840 FUE grafts performed over two sessions. I showed that the failure was not only on the growth of the grafts, but also on the destruction of the donor area. In all recipient sites and donor sites, there was a loss of 26,000 hairs and a massive failure of the FUE procedure.

    The debate followed this foreboding case study with the following insights:

  1. FUE is gaining popularity and seems to be demanded more and more by prospective patients. The graphs showed that the number of FUE procedures will surpass the number of FUT procedures in the next few years.
  2. FUE is safe in the hands of good doctors. The group all agreed on this because they were amongst the best doctors offering FUE. My only comment is that I can’t imagine any doctor putting themselves in the “bad doctor” category as shown in my presentation of “follicular holocaust”.
  3. FUE graft damage is being reduced with building experience resulting in better growth.
  4. Dr. Bradley Wolf demonstrated a patient who had 1000 grafts on each side of his head (total 2000 grafts) after 7 months of growth. The two sides seemed to be about equal. The patient reported no significant pain with either procedure (done one day apart) and the scars in both sides healed with minimal scarring.
  5. Dr. Suddleson argued that FUT supplied as many grafts as are needed, while FUE was more limiting in a single session. He argued that many of the advocates of FUE routinely offered FUT to their patients and that the FUT was the gold standard by which FUE would be compared. He generated a laugh when he pointed out that at least one doctor promoting FUE on the panel had reported his excellent results on the FUT strip based procedures.


 
FUE and ethnicity

    I’m often asked if there a difference in FUE patient candidates based upon ethnicity. This question was raised and answered by a doctor from India who showed that there are clear differences in the Indian population based upon skin types and some geographical areas of India where the skin is much thicker than others with thinner skin. He believes that these differences clearly can impact the difficulties of FUE and the results of transplanted graft growth.

    Also of note — it seems that the incidence of balding in the Indian population of India is much higher (62%) in men between the ages of 21-61 years old, than in the Caucasian population from comparable studies done in other countries. The use of finasteride was found to be in the 1% range for these men, while the use of various snake oils seemed to dominate the treatments of many Indian men.

 
I’ve got much more to post, so check back next week for topics on finasteride, the Artas® FUE robot system, and minoxidil.

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2011 ISHRS Meeting Review, Part 6 – Finasteride

ISHRS 2011

Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.

This is part 6. More to come…

***

 
Does finasteride induce mood and other psychiatric changes?

    A case report and literature review showed a connection between finasteride and mood changes. In one case presented, a patient suffered from severe disabling mood changes on finasteride, which ceased within a week after stopping the medication. After a short time period he restarted finasteride, and the mood changes returned within a few days. Other cases were reviewed with similar problems. There is little doubt that in some patients, mood changes and other psychiatric problems appeared with the use of finasteride.

    I believe that these case reports are the exception to what we commonly see and that finasteride is generally safe, but if a patient feels that they have changes in their personality or mood since the drug was started or if a family member sees changes in their mental state, they should meet with their doctor to discuss the appropriateness of their continued use of the drug.

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Balding Blog – 2008 – Hair Loss Information

Hello Dr.
I am 21 years old and i have been using Rogain and Propecia for a long time( about a year). Unfortunately I have not had a positive result from these medicines. I lost hair since I was 15. I am norwood 1 or 2. I have heard about an oil called Rejuvenating Oil including oils from plants such as:

Olea Europaea (Olive) Fruit Oil, Sesamum Indicum (Sesame) Seed Oil, Arachis Hypogaea (Peanut) Oil, Prunus Amygdalus Dulcis (Sweet Almond) Oil, Simmondsia Chinensis (Jojoba) Seed Oil, Juglans Regia (Walnut) Seed Oil, BHT, Cananga Odorata Flower Oil, Lavandula Angustifolia (Lavender) Oil, Gardenia Florida Oil, Geranium Maculatum Oil, and also chemicals such as: Chlorphenesin, Amyl Cinnamal, Benzyl Alcohol, Benzyl Benzoate, Benzyl Salicylate, Citral, Citronellol, Coumarin, Eugenol, Farnesol, Geraniol, Hydroxycitronellal, Isoeugenol, Limonene, Linalool

Are these oils really helpful ?

Block Quote

Olive oilNo, the oils probably do not help with your hair loss. Of course, you’re welcome to try the product out for yourself, but I don’t see anything in that list that will cause your hair to regrow.

My question to you is why did you use Rogaine (minoxidil) and Propecia (finasteride) when you classify yourself as a Norwood 1? Plus, I’m not sure what you’re looking for as far as results that have lead you to believe there was no positive result. Are you expecting complete regrowth, or do you know that just seeing the hair loss halt is also considered a positive benefit? As you can see, after reading your email I’m left with more questions than answers. There is something wrong with your logic, and unfortunately without an exam and better medical history, there isn’t much I can offer you.

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Balding Blog – 2014 – Hair Loss Information

We’re taking a few days off for the New Year holiday.

2015 marks the 10th year of Baldingblog with over 12,363 posts to date!
A special thanks goes out to all readers of this site with never ending hair loss questions.

We’ll be back in 2015!!!

Happy New Year

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I am 20 years old, can I now have a hair transplant?

The answer is no, you cannot have a hair transplant. I also always perform bulk measurements with an instrument called HAIR CHECK which is a good way to determine just how much thinning you have that you cannot see. Once this test is done and you have gone a year, I often repeat the test as it gives an excellent measurement on what happened to your hair over the year. If it got better and some of the thinning reversed, maybe you won’t need a transplant and that is the goal that you should look to do. Of course, a good doctor is critical to this course.

20 year old want HT

 


2017-10-10 19:29:25I am 20 years old, can I now have a hair transplant?

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Balding Blog – 2015 – Hair Loss Information

http://www.pressreleaserocket.net/the-aesthetic-surgery-journal-publishes-groundbreaking-study-on-nape-hair-for-fue-hair-transplantation/328237/

Taking neck hair, which is often finer than scalp hair, has problems with it. These problems include:

(1) more prominent scarring occurs in the neck and the neck area is very visible so such scars will be detectable as punctate scars

(2) neck hair is often not permanent hair as scalp hair is, so if one transplants the frontal hairline with these finer hairs, they may disappear with age.

This is a warning to those who see this press release. They must know the risks associated with a neck hair donor area.

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I am 21 and just got an FUE to the frontal 2cm of my hairline and my crown. Should I transplant everything else now?

This is a terrible question as it reflects a doctor who is not ethical and a patient who is naive. A 21 year old might have early crown hair loss and frontal hairline loss along the hairline (Called a Norwood Class 3 Vertex pattern) which is not uncommon in a young man under 23 years old. Most of these men can stop their hair loss on the drug finasteride, but of course the doctor can’t make money that way, so this poor fellow had a hair transplant and will be destined to continue having hair transplants until is final balding pattern is evident (about 26 years old). If he does not have the donor density for this, he will look freaky as he runs out of hair chasing possibly the impossible. Ethical doctors are in the business so if you are under 25 and have hair loss, see on of the ethical doctor who does not rush you into surgery to pay for his new car.

Norwood Class 3

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Balding Blog – 2007 – Hair Loss Information

Happy New Year
We’re taking a couple days off for the New Year celebration, but will be back on Wednesday, January 2nd with more hair loss questions and answers!

2007 was a very good year for BaldingBlog, as the site saw substantial growth in visitor traffic and number of questions answered. I’m pleased that I was able to help so many this year. I believe we published somewhere around 1700-1800 posts in the past 12 months! It’ll be hard to top 2007, but here’s to a great 2008!

Happy New Year!