Author: Dr. William Rassman

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Hair Loss InformationHandfuls of Hair Come Out a Few Months After Giving Birth – Hair Loss Information – Balding Blog

I am 26 years old, and I recently gave birth to my 2nd child (4 months old), and noticed a significant increase in hair loss. We are talking handfuls come out in the shower, or even just brushing my hair. In addition, my scalp has become incredibly itchy. Is it the stress? Are they related? What is causing it?

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Some women complain of hair loss after child birth. It may be due to hormonal changes your body goes through, but it is not well understood. There is no cure for this phenomenon, but the hair grows back usually after about one year.

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Another Hair Transplant Failure, This Time with Photos – Hair Loss Information – Balding Blog

We’ve written about hair transplant failures before (here and here), but this time we have some photos that we’ve been given permission to share.

This patient had 1000 grafts placed into the frontal area 10 years ago (not with us). Around 95% of the grafts have failed to grow either initially or since the surgery. In looking for a cause of the failure, I found that the donor area was taken from neck hair, not scalp hair. The incision high in the neck from a strip surgery healed better than most neck incisions, but below the incision the hair is significantly thinner than the area above it (see photos below).

The cause of the failure of the grafts could be from:

  1. The use of neck hair in the recipient area. It is well known that neck hair is not permanent and as this patient has thinning of the neck hair today (10 years after his transplant was done), it is possible that aptosis (cell death) was induced from the neck hair transplant.
  2. A failure of the quality control in the hair transplant process.
  3. A failure of the technique at the time of surgery.

Click the photos to enlarge.

 

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How Bad Would a Thin Strip Scar Really Look If I Shaved My Head? – Hair Loss Information – Balding Blog

Hello, thank you Dr. Rassman and Dr. Pak, for maintaining this fantastic site.

You’ve explained that once transplant surgery has been performed, a patient cannot shave his head without scarring (either a FUT line or FUE dots) being visible.

My question is: If someone had a thin scar from FUT, would it really look so terrible if they shaved their head in the future (if Finasteride’s effectiveness waned and hair cloning treatments fail to emerge, and they become an advanced Norwood 6/7)?

Obviously, there are pictures of strip scars online, but it’s difficult to imagine what they would look like on a shaved head. Do you know of any patients who have done this?

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You can look at how bad strip scars may look on our ScalpMicropigment.com website (see some of the before photos of scalp scars). Unless you shave your head, even the wider scar is not visible with long hair. My scar, after three strip surgeries, can barely be seen; however, if I decided to shave my head, everyone would see the 1-2mm scar I have. Now unless you are wanting to completely shave your head, you should not have to worry about the strip scar.

In general, you can keep your hair cut as short with a number 2 to 3 guard on hair clippers without the scar being noticeable in most cases.

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Hair Loss InformationBill Gates Criticizes That More Money is Spent on Balding Cures than Polio and Malaria Vaccines – Hair Loss Information – Balding Blog

Mr Rassman,

I have a question for you regarding Bill Gates. He’s always on TV talking about how there is less money being put into polio and malaria research than there is to balding cures. He criticizes this. I think more money should go to hair loss than polio and malaria combined. Hair loss causes so much grief and difficulty for men. I think he just doesn’t understand it and might change his tune if he were bald. What do you think?

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We wrote about Bill Gates’ quote years ago here.

I am in the business of hair restoration, and even I agree that polio and malaria treatments are more important than curing balding. Hair loss, while it causes grief and stress to men and women, is not a disease, but rather a heritable pattern of hair loss. It does not cause death like polio and malaria. Some may not agree with me, but hair loss is not a disease.

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I Saw Amazing Finasteride and Minoxidil Regrowth Photos, So Will My Hair Look Like That? – Hair Loss Information – Balding Blog

Hi doctor!

I was researching before and after pics for finasteride results when I stumbled on this link from Dr. Bernsteins website.

According to his site these are all patients who took finasteride or minoxidil or both ONLY. No surgical procedures on these patients. And I must say the results are pretty thumping good! I am 22 and recently was prescribed about a month ago for early hairloss. At this point i seem to be heading towards a Norwood 3 with a persistent forelock (as of now) no major recession or erosion of the hairline just many shorter hairs in the front that “appear” The same thickness but just aren’t getting as long as my “long hair”. My coarse dark hair however does look incredibly thin when wet but when dry it’s extremely thick appearing. I get compliments on how much hair I have. So there is no noticeable balding or thinning happening to the outside world yet.

My question is why do you say in many posts that finasteride and minoxidil do not work in the frontal scalp and hairline?

According to these patients almost EVERY person of all age ranges seem to have gotten a good bit of positive results from the medications alone including crown AND frontal regrowth. I only ask because I am hopeful that finasteride will produce similar results for me and if nothing else maintain what I have. I currently have no thinning in crown, that’s actually my thickest area of my hair.

I am 22 and given where I currently stand would you say that finasteride has a good chance of working for me? About what percentage of men see NO RESULTS from finasteride and continue to thin At the same pace? I am worried that I will be one of the patients that see no response from it :(

Thanks for your time and your informative site!

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The photos you saw on Dr. Bernstein’s site are amazing, and I have seen results like this for myself on occasion at my office. But regrowth at the front is rare (probably under 5%) compared to the results that are more common in the top/crown.

The photos show what is possible, but you have to remember that everyone will react differently to medication. Dr. Bernstein was not implying guaranteed results, but just showing some examples of positive growth. Medication might regrow your hairline, but you shouldn’t expect it to.

I have no way to know if finasteride will work for you, but you can have a HairDX finasteride response test done if you’re curious. If anything, I would expect to arrest your hair loss to give you more time with hair. If it regrows, that’s the icing on the cake.

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My Husband Took Propecia for 8 Years and Now We Want to Get Pregnant – Hair Loss Information – Balding Blog

My husband has taken Propecia for hair loss for 8 years and I am concerned about his sperm count because we want to get pregnant. How long does it take to leave the body? Is there a danger to the fetus? Does it cause fertility problems? I am very concerned and wish he never took this drug.

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In general, men can continue to take Propecia while trying to conceive. This is safe and there should not be a danger to the fetus. However, in my practice I generally advise men to stop taking Propecia for the two week mid-cycle so that there can be no question as to the safety issue and to put the patient’s mind at ease. Propecia is out of the blood stream within 24 hours and out of the tissue in a few days.

The most important part to this is to talk with your doctor and discuss these concerns with them.

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Hair Loss InformationWhat’s the Average Number of Grafts That Can Be Transplanted in a Lifetime? – Hair Loss Information – Balding Blog

Many thanks doctors for providing help to all of us!! Your blog is very interesting.

How many grafts it is possible to extract from a caucasian male with an average donor supply over the course of his life? Does it make a difference whether it is a FUE or strip? 9,000?

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Generally there are around 6,000 to 10,000, but it is depending on many factors, including race, ethnicity, scalp laxity, and hair density. We have transplanted as high as 10,000 grafts in a few of our patients over several surgeries. Others we max out at 6,000. Every patient is different.

The second part of your question was answered here — Can You Get More Grafts from Strip or FUE Over a Lifetime?

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Hair Loss InformationWhat Can I Do About a Scar On My Forehead? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,
I am still waiting to do my first surgery with you in the LA office. An off-topic question today:

I have a 0.7cm scar in my forehead that resulted from a home accident by opening a door. Do you know of good doctors, laser surgery or other means, in the Los Angeles area who can remove such a scar?

I am thinking to do it along with my first strip surgery on a trip to California. All the best doctor.

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There is no such product that exists that removes scars. Some scars can be modified in the hands of a good plastic surgeon. There may be ways to minimize the appearance of scars, but this is very specialized to the individual and the type of scar.

We will look at you when you come in and we’ll be able to give you an opinion then.

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Not Hair Loss News – Egg Yolks Can Be Dangerous to Your Health? – Hair Loss Information – Balding Blog

Snippet from the non-hair-loss article:

Researchers who have long argued that egg-yolk consumption contributes to cardiovascular disease have now published a study showing that lifelong consumption of egg yolks is correlated to development of carotid artery plaques and therefore should be avoided by anyone at risk for cardiovascular disease.

Dr J David Spence (Robarts Research Institute, London, ON) publish the results of a study of 1262 consecutive patients attending vascular prevention clinics in Canada online August 1, 2012 in Atherosclerosis. All of the subjects had baseline measurement of total carotid plaque area by ultrasound and filled out questionnaires about their diet and lifestyle, including medications they take, smoking, and the number of egg yolks they’ve eaten per week times the number of years they’ve kept that dietary pattern (egg-yolk years).

The results show that carotid plaque area increased linearly with age after age 40 and increased exponentially with both pack-years of smoking and egg-yolk years.

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Egg yolkRead the rest — Debate Over Dangers of Egg-Yolk Consumption Continues With New Study

The article goes on to point out that the egg industry says the study was poorly done by a longtime critic of the industry, and they cite a small study that disputes the findings. So while this could potentially be important health news, I guess it depends on who you believe.

Still, this might be something to keep this in mind what you eat eggs. I personally only like the eggs if there is a yolk in it, so I guess that stops another bit of goodness from my healthy diet.

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Hair Loss InformationI Had Brain Surgery and Want to Fill in the Scar, But I Also Have Early Balding – Hair Loss Information – Balding Blog

I have a scar from a previous brain surgery. I went to hair transplant surgeon and he estimated that it would take about 300 to 400 grafts to adequately cover the scar.

However, I am 18, and I’m already experiencing balding. My dad (and most of my male relatives on his side) are diffuse NW6s, so I’ll probably be heading in that direction. Furthermore, I have straight black hair and brown skin, with a lower-than-average density.

Would it be smart to put off the filling in of the scar?

Basically, I don’t want to unnecessarily deplete my donor supply.

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At NHI, we have good experience in addressing brain surgery / craniotomy scars with hair transplants. In general, patients usually need more than one surgery to be adequately satisfied, so be prepared.

If you are balding to a Norwood class 5 or 6 it may not be advisable to fill in the scar unless you plan on having a full hair transplant surgery and have adequate supplies of donor hair.