Author: Dr. William Rassman

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If I Have a Transplant Now, Would That Mean Future Treatments Wouldn’t Work? – Hair Loss Information – Balding Blog

Have had a thinning hairline for the past few years (I’m 27). I take propecia and rogaine to slow it down, but lately it has been getting a bit more noticeable.

I am considering getting a hair transplant, I have a question regarding future treatment though. Lets say I get a hair transplant now and eventually a topical or injectable solution comes out to reverse hairloss. Would there be a conflict between the transplanted follicles, and the follicles in the same area that are miniaturized/dormant that are now being revitalized? Would getting a hair transplant mean I couldn’t use those future treatments?

Thanks.

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We always advocate having a Master Plan made, which means you need a consultation with a doctor.

I do not know the future of hair restoration technology, but a hair transplant surgery would not be a contraindication to any future developments. That is, unless you end up with a bad hair transplant surgery… so choose your doctor wisely.

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Hair Loss InformationFUE Failures Continue to Happen – Hair Loss Information – Balding Blog

Last week, I met with a patient who had two follicular unit extraction (FUE) procedures at a clinic, but came to see me to find out why his grafts hadn’t grown in. After an examination, I’d estimate that 90% of the grafts did not grow. The patient told me that his surgeon thinks there might be a problem with his skin, but I told him the real problem was the doctor couldn’t deliver what he was supposed to give him with a good survival.

In another conversation on the same day, I called one of the most prominent hair transplant surgeons in North America about another issue. Our conversation drifted to FUE failures, and he named three doctors who are FUE promoters whose patients have been in his office because of high failure rates. I know about these same three doctors. There are no secrets to the community of skilled and honorable surgeons of who are the unreliable doctors; however, I can not come out with their names publicly here or I would be the subject of a slander lawsuit. I can only be vague, which I know isn’t always the most helpful, but I needed to post something.

I’m disappointed that I can’t name names, because I know that many patients will be harmed by those less-than-honorable doctors. All I can do is continue to post about what you should do to become a more knowledgeable shopper — research the doctor you choose, ask to meet with his/her patients so you can see the results in person, and remember that this is a surgery that will be with you for the rest of your life (for better or worse).

See this post for more about FUE failures.

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Hair Loss InformationIf I Can’t Maintain the Minoxidil Schedule of Twice Daily, Is It Worth Using At All? – Hair Loss Information – Balding Blog

Hi Doc,

I am already on Finasteride 1 mg. I had bought Minoxidil for application on temple region. Since i am not able to maintain the medication schedule (twice a day forever till one wants to maintain hair), i discontinued after applying for 5 – 7 days. I plan to apply it whenever my busy schedule permits me (maybe once / twice a week during weekends).

Do you think there would be any benefits in doing so OR would i be doing more harm than good (like accelerated hair-loss for the first few days while applying Minoxidil)? Thanks.

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A couple things that should be pointed out —
1. Minoxidil is indicated for top/crown hair loss. It really does not work all that well for frontal hairline or temple areas.
2. Minoxidil is recommended for use twice a day everyday for several months before you see some improvement.

If you know the two facts above, you can make an educated and informed decision about whether random applications to an area that the medication isn’t intended to regrow hair in will be beneficial for you or not.

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Hair Loss InformationMy Scalp Burned and Felt Numb After Getting Highlights, And Now It’s Much Thinner! – Hair Loss Information – Balding Blog

(female)
I have been getting my thick hair dyed for 20 years. I usually go every month. I have been using an Aveda salon where they use products with high ammonia content. I have been noticing the last few months that my hair is no longer thick.

I feel I did not realize this because I have a different style that is has very choppy layers and just naturally makes it look thinner. So, the last 3 times she put a toner on the highlights (bleach over bleach process) my scalped burned and felt numb. The times before this happened also, and I told her about it. I did not see any redness to my scalp. It just felt numb for more than a week and then it itched. I have seen my hair on my pillow and in the filter after a shower. It is noticeably thinner now and I am very distressed and worried that this is a PERMANENT loss, with having sustained death to the hair follicles.

Please help!!! My sister lives in LA and I could come to see you. What do you recommend?

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The use of hair dyes have risks and can impact hair permanently, which is why you must go to a reputable hair stylist to hopefully avoid the types of damage that these chemicals can induce. You are welcome to visit us for an opinion.

In general, it may take a full year before you can tell if the damage was permanent.

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Do Hair Transplant Surgeons Take Shock Loss Into Account? – Hair Loss Information – Balding Blog

I wanted to comment and say you have a really informative website and I enjoy reading the blogs on here and your advice to people. I try to come here as much as I can and get advice with my hair loss situation.

My question is regarding thinning hair and transplants. When a surgeon places grafts into a thinning area, does he take into consideration there might be shock loss present and places more grafts into that area to fill it in, even though the patient is on propecia and lets say he’s 30 yrs of age? Or, does he expect the patient to come back for future surgeries to fill in the thinning area due to shock loss?

My other question is regarding working out and losing hair. I mostly run to stay in shape and stay away from the heavy lifting. I have read on this website, that working out with either weights or running doesn’t increase hair loss. However, I have read some comments from posters also on here that it has made them lose hair, and I have heard from other people at the gym where I live that they noticed hair loss while working out, without steroids of course, or while taking creatine (supplement). So, Which is the truth?

Thank you for helping me.

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When transplanting hair into a young man (under 30 years old), shock hair loss should be at the top of the discussion points, particularly if the young man does not take finasteride. Of course, the same is true for patients older than 30. Where the cut off is for risk of shock hair loss without finasteride on board, I am not quite sure… but I know it happens even to a 40 year old and an occasional 50 year old. Being on finasteride, having a small number of grafts (no mega sessions), and not having any accelerated thinning definitely is a good indicator. In the end it is really about each patient on a case by case basis. There is no set rule. Thus relationship with a doctor is very important.

Transplanting into thinning hair follows the same rules as above, but there is not the introduction of mechanical shock into thinning, miniaturized hair, which is more susceptible for hair loss than normal hair that is not miniaturized.

As for exercise and heavy lifting, as long as you stay away from anabolic steroids, I do not believe there is risk with protein concoctions. Hair loss has been reported in rare cases while taking creatine, but I can’t say for sure if there is truth to it.

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Does Minoxidil Need to Be Rubbed Into the Scalp? – Hair Loss Information – Balding Blog

Doc.. does minoxidil have to be rubbed into the scalp to be effective. I feel like my hair is soaking it up when I do that.

Also my hair looks much worse with it. Even if I use it just at night and wash it out. It seems to effect the texture. If i go a few days without it my hair returns to normal looking much better. I guess that’s the trade off. Wish I never started it.

Thanks.

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Minoxidil is for use on the scalp, not the hair. Unfortunately, much of it is wasted on the hair because of the applicators and their limitations. There almost seems to be a conspiracy to design the applicators to be wasteful and more profitable for the suppliers selling the products. Maybe one day, a better applicator will come along.

Minoxidil is also known as Rogaine, and there is a video on Rogaine.com, showing you how to apply the foam. The same application instructions apply to the liquid version, though the foam likely involves less of a mess.

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Hair Loss InformationI Used Doo Gro And Felt a Burning On My Scalp – Hair Loss Information – Balding Blog

The left side or my hairline is thinning and so is the middle. Im only 20 years old (male) and balding doesnt happen this early in my family. This happened REALLY SUDDEN (I keep a grade one haircut most of the time so I would noticed).

I have been using a product called Doo Gro and it burned the back of my head and gave me weird headaches. I stopped but started using it again and one day I felt a tingle/burning in my left temple where I applied the product. I plan on stop using it for good if I see improvements. Could this have triggered MPB to start early?

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I couldn’t tell you if this kickstarted your genes. This is an over the counter product, but if the problem persists I’d see a dermatologist. I don’t know anything about it from personal experience, but if the product is causing burning sensations on your scalp and even headaches… I’d stop using it immediately.

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Propecia Was Great for Years, But After Switching to a Generic I Saw My Hair Loss Start Again – Hair Loss Information – Balding Blog

I’m 33 years old and have been using Propecia for about 5-6 years with great results. my hair on top of the head regrew almost completely. three months ago in order to save costs, instead of using Propecia, I started dividing a generic Finasteride 5mg into 4 pieces and take a quarter daily. Ever since then ive started noticing that im losing hair again. this may or may not be related to Finasteride and could be down to the fact that the drug itself may have stopped working for me.

Ive introduced Minoxidil Foam Extra Strength twice daily and will use Nizoral 2% 3 times a week but I’m a little anxious about this and wanted you opinion. do you think i should go back to Propecia or perhaps take 2.5mg daily of Finasteride, or alternatively start taking Avodart?

Many thanks for your help

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As you know, the medication in Propecia and the 5mg generic are the same, just different dosages. Cutting the 5mg pill shouldn’t produce anything different from the 1mg name brand pill. I guess you could go back to trying the name brand Propecia to see if that makes any difference, but I would be surprised if it did.

Many men use minoxidil and finasteride at the same time, and I suppose you can add Nizoral to your regimen. One thing that I should point out about using a bunch of daily treatments is the financial commitment you’ll need to make to continue these for life.

As for whether you should take Avodart (dutasteride) or increase your finasteride dosage, that is something you’ll need to talk to your prescribing doctor about.

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Does a Higher Concentration of Minoxidil Provide Faster Results? – Hair Loss Information – Balding Blog

I’m 24 years old male and have hair loss both at the front of my head and the crown. I’m starting to use rogaine foam in combination with propecia. I’ve heard that using minoxidil in higher concentrations (10%) makes you see better results faster. Is this true?

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Perhaps it’s possible that high concentrations of minoxidil will bring about faster results (I’m not sure), but nothing occurs overnight in this business as the timeline often goes into months. In other words, don’t expect a miracle. I don’t recall seeing any studies comparing the speed of regrowth for the 10% vs 5%.

Higher concentrations of minoxidil will produce more side effects, so read the instructions carefully.

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Hair Loss InformationMusician Lindsey Buckingham’s Hairline – Hair Loss Information – Balding Blog

Lindsey BuckinghamHello Dr. Rassman,
With Fleetwood Mac starting up on a new world tour this year, I was just wondering if you could shed some light on guitarist Lindsey Buckingham’s hairline. It is without a doubt much higher than when he was younger, but its perfectly straight across the temples. Hair transplant or genetics?

Photo

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His hairline did move up, but it’s difficult to tell for sure if there was work done based on the small photo you linked to. I did a Google Image Search and found some larger photos that appear to show a natural hairline. Maybe he has some styling at the corners to change the hairline’s appearance.

There’s a larger version of the above photo here.