Hello Dr Rassmann,this blog is great.
Sir suppose a person has genetic hairloss for around last 3 years. If he also has abdominal pain for around last 6 months, so is it possible that his abdominal pain can increase/accelerate his genetic hairloss but without causing acute/chronic telogen effluvium?
I am not sure how you can make a correlation between abdominal pain and hair loss. Abdominal pain is not related to genetic hair loss or any other type of hair loss from my experience.
What are the possible negative consequences of accidentally double dosing Propecia? Taking Propecia every morning has been part of my morning routine for about a year now. The other day, I’m about to leave for work and blanked out on weather I had taken my Propecia pill before I got in the shower (my usual pattern), and so I took what might have been a second pill in one morning. Should I be worried, can I ruin the effectiveness of the drug that way? I’m a 30-year old male, been on propecia since May 2009.
Taking a double dose of Propecia will not harm you or your hair and you should not be worried. There are no negative consequences. For that matter missing one dose would not harm you or your hair either. We are all human and we make mistakes.
Also remember that many men take 5x the Propecia dose everyday for certain prostate problems with only a slight increase in side effects. In fact, research has shown that 5x the dose of Propecia prevents certain types of prostate cancer…. but taking more will not make your hair grow better (in case you were going to ask).
If at the 8 month mark I desire more density, would another operation be appropriate or should I wait until 1 year?
Since 95% of the growth (possibly not length but growth) occurs within the first 8 months, a second surgery can then be done if the desired goals are not met. By the 8th month, you will have a good idea what the value of the first transplant is.
2020-08-25 02:48:512020-08-24 11:18:50A second hair transplant, when to do it?
I’m a 22 year old male with androgenic alopecia and diffuse thinning. I’ve been balding since I was 18 years old.
Recently, I’ve been experiencing very rapid shedding all over my scalp (top of the scalp, donor area, and both sides of the head). I went to my dermatologist and had a scalp biopsy (4mm, punch) done to make sure it wasn’t alopecia areata. Turns out, it’s telogen effluvium due to various stressors. 12 days later, I got the stitches removed from the area.
BUT
The hair that is currently growing out and closely around the biopsy site are probably the thickest that they have been in YEARS.
I currently use a topical minoxidil 7%, finasteride 0.1% compound solution ((been using for 1 month), stopped taking finasteride tablets due to sides (used for 2 months)) and I use a microneedling pen (1mm, once per month). Although I’ve had very subtle hair regrowth on my hairline and slight thickening on my temples, the hair from the biopsy site feels and looks thicker than most of the hair on my scalp at the moment.
I’m aware that it may seem like an “illusion” due to my current TE condition, but it honestly feels much more thicker than before the initial shedding started. It almost nearly resembles the texture that it was from when I was a teenager.
If anyone is familiar with the biological components of hair loss and hair regrowth, I would love to hear from you about this matter.
Wounds sometime stimulate hair growth much like microneedling does
2021-01-18 02:37:182021-01-17 07:29:21A scalp biopsy with slightly surprising results…
I began to lose my hair in the frontal region of my head, shortly after beginning to take accutane. Is there any thing that will help?
Hair loss from Accutane is a known side effect. First you must weigh the options of stopping the Accutane. Your doctor should be able to help you make the right decision. The lost hair may return, so you need some time to observe what happens. If the hair does not come back within 8-12 months, then you might need a complete evaluation with a doctor like me, who specializes in hair loss.
I have previously discussed Accutane on my blog, which can be found below:
Just want to preface this by saying that I’m all for fighting hair loss in any way you want if it’s what you wanna do. I’m genuinely not here trying to sway anyone one way or the other. That’s why I’m not even gonna mention what I’m doing/not doing for my hair loss. Just wanted to comment on how some people in the hair loss community might have a bit of an unhealthy relationship towards balding and I think we all torture ourselves more then we need to.
I had to say that I had a very enlightening talk with my therapist and also spoke with some of the good people on the r/bald sub and it was quite enlightening for me. I’d realized that it was super unhealthy to obsess about image and my hair to the extent that I was doing it (in the back of my head at all times, sucking all joy out of my life at the worst moments)
realized that a key for me was to not catastrophiez hair loss more then it needed to be and to realize that even the one thing I was fearing most in the whole world (being bald) is not something that’s that bad.
If we wake up bald tomorrow our family will still love us, our friends will still be there, we will still enjoy every hobby, tv show, movie, video game, book, interest that we had prior. It will be an adjustment period sure, it’ll be weird to look in the mirror and you’ll have to relearn to like how look the same as when you had hair and also for a little while after our loved ones will have to get used to the new look. But then after a few months at most, life will go on just how it was before. Having that mentality of ‘whatever happens it’ll be ok’ is so important in this situation.
I think most people who lose hair young torture themselves much more then they need to by making the stakes in their head so high. If you think being bald is a death sentence then of course you are going to stress over it 24/7 and drive yourself mad. If you think balding is just a natural part of life that happens to many people, just like wrinkles or skin sagging or any other changes our body goes through over the course of our entire life. If you convince yourself that if it happens to you it won’t be a huge deal, then you will have a much healthier perspective and be much more comfortable, whether you decide to fight your hair loss or accept it. Bring down the stakes a little, it’ll be a weight off your shoulders:).
So yah I think this sub is great and that if you want to fight your hair loss then by all means, more power to you. I just think that some people on here could tone down the animosity and negativity regarding certain topics and I know that if people had a healthier perspective and relationship with their hair loss and overall body changes then they might be a lot happier and more calm with whatever they decided to do. Even the worse case scenario for us would be ok so we don’t need to be as terrified as we think.
Wanted to get this off my chest because I recognize a lot of myself in the people on here with how I see them stressing so much with this all or nothing mentality and making the stakes so high in their heads that they spiral into bouts of depression.
Again nothing wrong with taking finasteride or whatever other method if that’s what you want and you’ve balanced the sacrifice/reward in your head. Just want people to know that they should do this because it’s something they want that would bring them pleasure, not because they should feel like they absolutely have to or else their life will be over because that can lead to being in a bit of an unhealthy place mentally.
This is all, thanks to anyone who read this far, wish you the best
2019-12-13 02:25:522019-12-12 12:29:37A personal rant on Hair Loss from Reddit (12/12/19)
Dear Doctor:
I have thin patches in my eyebrows and want them treated, preferably by means of an eyebrow transplant. Dr Rassman is one of my three short-listed doctors and I have several questions, which I would be extremely grateful if they could be answered.
Many thanks in advance
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Questions re FUE/FUT, yield etc.
1. Does the doctor recommend FUE or FUT for the eyebrow and why?2. How does Dr Rassman avoid shock loss when implanting grafts amongst existing eyebrows?
3. How does he optimise yield of transplanted grafts?
4. What determines which follicles Dr Rassman selects for an eyebrow transplant?
5. What is unique about Dr Rassman’s approach for eyebrows as compared to similar leading transplant doctors?
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Questions re physical apperance of eyebrow6. What is to prevent the hair turning grey later on, with age etc.?
7. How can you properly trim eyebrow hairs if they are growing horizontally?-with a simple nail scissor this would not be possible.
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Questions re preparation for operation:8. How can you ensure the recipient area is in a healthy state to accept transplanted hairs? Should creams be used to ‘disinfect’ the area?
9. What factors would make an eyebrow transplant unsuitable for a patient?
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Side effects:10 . Can having an eyebrow transplant affect the muscles around the brow, leading to future risk of a descending brow?
11. Is it risky operating on an eyebrow from the perspective of harming arteries etc. close to the eye? Can this harm the eyes? Have any patients experienced this?
12. In what percentage of cases, is the patient dissatisfied with his results?
13. Many of Dr Rassman’s patients travel from abroad and so can only avail themselves of an online transplant prior to the op. Upon closer inspection on the day or the day before the operation it may transpire that the patient is not a ‘good’ candidate for a transplant. Does the doctor in these cases advise against going through with a transplant? How many times this year, for example, has the doctor turned down a patient on the day or the day before an operation?
14. What controls does the doctor put in place to measure the performance of the various technicians?
15. Does the doctor, have a feedback system with a standard feedback form for post-op patients?
Now that is some due diligence! Below are the answers to your questions.
For more information on eyebrow transplants see:
Do not hesitate to call my office @ 800-NEW-HAIR to setup a phone consultation with me if you’re not local.
2012-04-05 14:49:242012-04-05 12:10:29A Whole Lot of Eyebrow Transplant Questions
First of all I want to thank you for this great site.
In Dec. of 2006 I went to a T.P. doctor, mainly to get a prescription for propecia and to hear what he had to say about how good of a candidate I would be for a hair transplant. I found out at that time that he still used the mini & micro minigraft procedure, with magnification and backlighting.(no steroscopic microscope). In Dec. 2007 I was looking at his web site,and to his credit, is now doing follicular unit grafting using stereoscopic microscopes.
My question is this,how difficult is it for his staff to learn to use microscopes and to be cutting in follicular units instead of minigrafts? I guess what I really want to know is how much time should I give them, to learn the “new” procedure before I go back for another consultation?
Do you have any photos that show the difference between minigrafting and folicular unit graphing on the scalp?
Thanks again.
P.S. How much does a stereoscopic microscope cost? This doctor has been doing hair transplants for 14 years and is now just getting some.They must cost alot!
Cost for hair transplant at New Hair Institute… as low as $5 per graft.
Cost of microscope at a local scientific store… around $500.
Cost of a well done follicular unit hair transplant… priceless.
The difference between minigraft and follicular unit transplantation is small, but can be significant when you look closely at the growing hair. Minigrafts and micrografts transplant skin between the hair follicles and this skin can produce changes in the scalp at the point the hair exits the skin. There may be cobblestoning from the transplanted skin. Follicular unit transplantation only transplants the natural occurring units of hair as they exit the scalp and most of the skin edge is removed so that the point of exit of the hair is normal.
More importantly, the difference when using a microscope for dissection is that you do not waste good follicular units since you can see minute details (under the microscope).
For more details, read our published articles on the subject:
Hello,
After having a bald spot on the left side of my head for 28 years, I’d like to do something about it. The bald spot is circular in shape and 2cm in diameter, about 7cm directly above my left ear. The hair fell out when I was 2 and the bald spot has remained the same size for as long as I can remember. I am able to cover it with hair surrounding it, but it does take an emotional toll on me as I see it every day and I have to be very careful every month when having my haircut. I saw a dermatologist about a year ago who told me it’s triangular alopecia. He was not able to locate any hair follicles under the skin, and told me the chance of regrowth is slim to none, especially as there has been no hair there for 28 years. He suggested we first try cortisone injections which did not work, and then referred me to a specialist. I went to see a specialist and he recommended scalp reduction surgery given the small area and lack of hair follicles.
I’ve done some reading on scalp reduction surgery, on your blog and others. The risks seem to be significant (stretchback, slot scaring, hair angled incorrectly, etc.) and it’s clear you’re not a proponent. I’ve also been unable to find any success stories/testimonials online. I’m going to ask the specialist to share more information (# of surgeries he’s done, before/after photos, # of surgeries I’ll need, risks, type of incision, etc.), but before doing so I’m hoping to get your advice.
Given the small area (2cm in diameter) and being able to cover with existing hair, do you think this is a case for a successful scalp reduction surgery? If not, are there any alternatives you’d suggest (e.g., Rogaine, hair transplant)? Both my dad and grandpa have full heads of hair, so I’m not really worry about the hair on the left side of my head receding back to the site of the bald spot.
Thanks for your help!
You are correct in that I am not a proponent of scalp reduction surgery. This is because over the years I have never seen it work well. I’ve written about this type of procedure before here.
A scalp reduction could be very tempting to the surgeon and the patient, because it makes logical sense — just take out the bald spot — but the best you would get is maybe 50% improvement. Or you might get considerable scarring from this, depending on the location.
There are other options, such as a hair transplant using the follicular unit extraction (FUE) technique into the small area you described. This is a more predictable result, particularly for the small area.
The small scar can be treated with Scalp Micropigmentation (https://scalpmicropigmentation.com/scar-covering/) or a hair transplant. The least cost would be Scalp Micropigmentation
2018-09-26 06:10:592018-09-28 07:10:14Accident Two Years Ago and Lost a Spot on My Mustache (Photo)
