Author: Dr. William Rassman

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Hair Loss InformationIn the News – Alopecia Totalis Sufferer Called Names By Coward on the Street – Hair Loss Information – Balding Blog

Snippet from the article:

TV presenter Gail Porter has tweeted her shock after a man accosted her on a London street, calling her “baldy.”

The Scottish personality has alopecia which has left her suffering from severe hair loss and she has spent years campaigning to increase awareness of the condition.

Porter tweeted to describe the incident which she said left her in tears near her London home

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Read the rest — Man calls Gail Porter ‘baldy’ in alopecia abuse incident

Most of us in the US are probably not familiar with Ms. Porter, but she is a former pin-up model and currently a television presenter in the UK that has campaigned for alopecia awareness since her hair began falling out after discovering she had alopecia totalis in 2005. I suppose the silver lining of this incident is that it brought her story back into the news, thus hopefully raising further awareness.

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Hair Loss InformationI Hate My Cowlick So Much That I Don’t Want to Live Anymore – Hair Loss Information – Balding Blog

i don’t keep my hair long and when i have it short i have this horrible cow lick in the front of my head. it starts in the middle of my head and swings around to the side. it’s quite horrendous. i need to know if it can be reset to look like the rest of my hair. if not i don’t want to live. i am at my whits end and it has hindered my confidence to the point i don’t have a life. please help.

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If you are thinking about ending your life over a perfectly normal hairline with a cowlick, you need to see a psychiatrist or seek some other type of help immediately. Your email is distinctly a cry for help. Making a cowlick disappear is easy, but does not appear to be the real issue here.

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Hair Loss InformationIs Avodart Off-Limits for Treating Hair Loss Until it is FDA Approved for Such Use? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I’ve been on Propecia and Rogaine for 3 years and have been delighted with the results……up until now. Propecia and Rogaine thickened the hair all over my scalp and slowed the regression of my hairline. Unfortunately, it’s becoming apparent that my crown is now thinning, an area that had been strong prior to treatment.

I’m 28 now, and, if possible, I’d like to keep my crown hair for another few years, what are my options?

1) Would upping propecia dosage ever be advisable for a 28 year old?
2) Should I consider Avodart off-limits until it is FDA approved for hair loss?
3) What would you do if you were in this situation?

I’ve a check up with the doctor (who I’m very happy with) that originally prescribed the treatment in a couple of weeks, and will pose the same questions to him. However, your opinion is really important to me, and will help inform any decisions I may have to make. All the best

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Upping the dose of Propecia (finasteride) usually does not work in your situation. Rogaine (minoxidil) is fairly effective in the crown and worth trying. Avodart (dutasteride) is an option and some doctors will prescribe it, however, the long term risks of sterility are there (probably remote), and the side effects are more frequent than on Propecia.

Try the minoxidil and give it at least 6 months. Then reassess your situation.

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Hair Loss InformationBaking Soda in Shampoo to Increase Hair Thickness? – Hair Loss Information – Balding Blog

Hello Doctor

Many internet sources claim that adding baking soda to your shampoo increases hair thickness. Would you say it worth a try? Could be any dangerous?

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I don’t like the idea of using baking soda on your hair and scalp to make your hair appear thicker, but I don’t think it will hurt. There are volumizing shampoos and conditioners that are safe and proven effective, and that’s what I would personally stick with.

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Hair Loss InformationMy Doctor Prescribed Me Avodart and I Don’t Care About Side Effects – Hair Loss Information – Balding Blog

Good afternoon Doctor. To make a long story short just want to say I am a 28 year old male with early hair loss, and my derma gave me an rx for the drug avodart to stop hair loss. He didn’t give finasteride as he said its weak, and avodart is better. he told me about all the side affects of both drugs such as erection problems, gyno, low sperm count with avodart, etc. and basically said its my decision to pick which one, propecia or avodart so I choose the more effective one. I honestly do not care about the side affects, I’m single and I could care less if I have erection problems from avodart. My hair is more important than sex lol.

But anyways my question is that does avodart from clinical experience and studies does it work on hair loss better, or its about the same as propecia? The reason I’m asking is because avodart is more expensive, so if it the same as propecia might as well take the cheaper one. My dermatologist said it blocks type 2 5AR way better than propecia, and that the type 1 blocking ability of it will do nothing for hair loss as type is negligible and not proven to cause hair loss. From your practice, are the patients that take this drug doing better than the ones on propecia?

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My first choice for a drug treatment is always finasteride (Propecia) and in the generic form it costs about $3/month. So yes, while Propecia is probably the cheaper option, it is also the only oral drug approved at this time by the FDA for the treating genetic hair loss (the other is topical minoxidil).

There haven’t been a ton of studies comparing the two for treating hair loss, but the one study that stands out in my mind is from late 2006, where 416 men were studied over 24 weeks. The results showed dutasteride was more potent and resulted in a superior hair growth count based on photos. But that is just one study over six months time, published nearly seven years ago.

One does not have to give up their sex life, nor does one have to take crazy risks with this decision. The incidence of sexual side effects from finasteride is 1 to 2%. Avodart (dutasteride) might work better in some men, but the side effect risk is much higher. I would criticize your doctor’s view on these two drug choices, and will point out that you are welcome to get another doctor’s opinion. Some doctors who do not specialize in these areas may not have all the information.

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Hair Loss Information3 Months After My FUE Procedure, I Still Have Hairs That Didn’t Shed but Refuse to Grow – Hair Loss Information – Balding Blog

Dr. Rassman,

I am almost 3 months post surgery (FUE) having had about 2300 grafts with a skilled and well respected surgeon.

I have a number of transplanted hairs in the front of my scalp that have not shed nor have they grown. I scrub them, and nothing. They remain. I have a few rogue hairs that did start to grow (very few, maybe 5-10) without having fallen out post op, but moreso, a couple hundred perhaps, that are just like beard stubble, and wont fall out nor are they growing.

Can you shed (no pun intended) some light as to what may be going on, what the effect of this may be, either negative or positive, and contribute any other thoughts to this as I am not panicking, but as the weeks roll by, I am growing more and more concerned.

As an aside, at nearly 11 weeks, there is no other new growth yet beginning, which I understand is not abnormal.

Thanks again

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This can be all normal for the course. Hairs that remain are leftover from the old grafts and they can be identified by a slight pull with tweezers. They will come out or you can just leave them alone. I see this on occasion after a hair transplant.

With regard to the growth, wait it out. Don’t panic — if a good surgeon did it, then the results will be apparent starting at 5-6 months.

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Hair Loss InformationI’m Still Losing Hair Even Though I’ve Had Good Results from Propecia – Hair Loss Information – Balding Blog

Doctor, how are you. I have been on propecia for 2 years, with fairly good results. hair is about the same, but my question is why do I still shed alot of hairs. I just want your opinion on this from your experiences with propecia and hair restoration field. I mean I know your suppose to shed up to 150 hairs a day, but I feel like I shed more. The hair still looks the same, but why is the shedding so much?

The amount of hair I shed I should be slick bald now, but still have a full head of hair with a bit of thinning like it was 2 years ago when I started propecia. when I wake up theres like 20 hairs on pillow, when I shower I shed so much, when I comb I shed so much, and its been like this even before starting propecia, but still have hair.

are there people that shed more and its still normal? I shed thin weak hairs, to thick hairs, and hair still looks same. As I said with the amount I shed I should be slick bald

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We still cycle hair and the thin, weak hairs will eventually be lost. Propecia delays the long term hair loss, but it does not stop it completely. If you have not had your hair bulk analyzed, you should have it done. A baseline of hair bulk will tell you over time what is really happening to you.

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Hair Loss InformationI Hate My Widow’s Peak and Want to Straighten My Hairline – Hair Loss Information – Balding Blog

My hair is not falling out, it is just straight across with a very prominent widow’s peak like Andy Garcia (the actor) had when he was younger. I hate this hairline and it’s been like that since I was younger. I would like filled in, to make it look better in the front.

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The widow’s peak is desired by many people and generally thought of as a sexy hairline. Many great actors have had them and their appearance has propelled them in show business. Andy Garcia’s widow’s peak is a look that some transplant patients have specifically requested when having their hairline restored.

Your desire to do this depends upon your age because you must be sure that what you do is what you really want. Hair transplants are for life and hair transplants in the very front are absolutely permanent (as they are everywhere).

Men at 18 years old do not know if they may bald as they get older, so you might look very abnormal with these holes filled in as the hair around it goes through genetic balding. If you are 45 years old and without balding, then this may be a reasonable request. If you are under 30 years old, we need to meet and I need to examine you for changes that indicate future balding possibilities ( miniaturization mapping).

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What Can I Do About Poor Hair Growth of My 7 Month Old Son? – Hair Loss Information – Balding Blog

I want to ask about the baby’s hair. I had a baby boy, his hair slightly at birth, even in the crown of the region virtually no hair or bald. But I put aloe vera on a regular basis to grow hair on the crown. But overall not too much hair.

My baby boy is now seven months old and has never cut his hair. I want to ask is, whether the baby’s hair will grow thicker if shaved off? And what if the hair was shaved off, whether the hair would grow up to be more violent?

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Shaving the head does not make hair grow faster, so do not do that. Also, aloe vera isn’t going to grow his hair.

The hair will change over the next year or so. I would not worry about it, as some babies look bald and some are very hairy. By 18 months, you should see a full head of hair on your son. Baby hair is very fine and will not develop its normal thickness for some years.

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Hair Loss InformationCan a Younger Patient Have SMP First, Then Have a Hair Transplant Years Later If Hair Loss Progresses? – Hair Loss Information – Balding Blog

Hey Doc,

Regarding the order of SMP and a HT (either FUE or Strip) – is an order of procedures preferred or needed? Specifically, if a younger candidate with the beginnings of thinning hair wanted to get SMP first to “fill in” some thin spots while anticipating the need of a HT procedure down the road, would the ink from the SMP hurt the recipient area? Thanks so much!

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There is no real anatomical risk to the Scalp MicroPigmentation (SMP); however, there is something that we call the Master Plan that you need to discuss with your doctor, which includes planning for SMP and hair transplants.

If you want us to be your doctor, please contact my office at 800-NEW-HAIR and send me some good photos. I will be happy to offer you a free consultation and keep your photos confidential.