Dr. William Rassman – Page 985

August 23, 2012

How Is it Even Possible for Finasteride to Worsen or Accelerate a Receding Hairline? – Hair Loss Information – Balding Blog

Some claim that finasteride has, overtime, worsened and accelerated their receding hairlines. Is this medically possible? Or is what they’re seeing just a result of aggressive MPB that hasn’t responded to the drug?

Thanks!

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I do not know why finasteride would worsen hair loss. It is a drug treatment that slows down hair loss. Finasteride does not work well on frontal hairlines, but this does not mean it makes it worse. Perhaps in the process of slowing down the top/crown area drastically with not much effect on the front hairline, the overall perception may seem as if the front is worsening faster. I really do not know, though. This is just my speculation.

August 23, 2012

If a Man Gets Castrated While Losing Hair, Does the Loss Just Stop Immediately? – Hair Loss Information – Balding Blog

Doctor Rassman and Pak

I have a question about castration. Does castration only stop hairloss if a person were to be castrated before puberty(hence before male pattern baldness starts), or does it also stop hairloss once hairloss has started as well? for example lets say there is a 30 year old with active hairloss, he gets castrated, does the loss stop, or will it still continue regardless of the castration?

Im not thinking about castration lol, just want to know for knowledge purposes

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My educated guess is that once the hair loss starts you cannot completely stop the process even with castration for the hair that is scheduled to be lost (i.e. apoptosis). I could be way off base, though. I’m not going to suggest castration to prove it one way or the other.

August 22, 2012

Is Having 3600 Grafts Transplanted in One Procedure Safe? – Hair Loss Information – Balding Blog

Hi Drs. Rassman and Pak:

I was concerned about the recent story you posted today (8/9/12) of the guy who had a 3,000 graft transplant that failed. I consulted a very reputable transplant doctor in La Jolla (who will remain unnamed) who was/is prepared to transplant 3,600 FUs in one session on me because I have good scalp laxity and a good donor supply (I’m 54 by the way and never had any hair loss until about age 45 or so).

But now I am worried. Is this safe to do (3,600) in one procedure? Don’t you usually limit your procedures to about 2,000 grafts at a time, give or take (that’s all you did for Jon Gosselin on the TV show that was broadcast)?

Incidentally, and I don’t know if this is important, but I am one of those anti-Propecia people. I want hair, but not at the cost of taking Propecia. Never took it and never will. I’m not trying to stir that pot again, so don’t get me wrong, and I know many people disagree with me and that is fine. But I have made the decision never to take Propecia, ever. It’s just a horrible drug, in my opinion. If other people want to take it, that’s their business, it’s their funeral as far as I’m concerned and I couldn’t care less. Another way of looking at it is it’s none of my business.

So again, is 3,600 FUs all at once over the top, crazy? Risky? You know what the great British entrepreneur, Freddie Laker (of the now defunct Laker Airways fame),once said, “The only way to get ahead in life is to take a little risk and have a little luck.” I think that is very true. True with hair transplants too.

Thanks for the great blog.

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We have performed as many as 5400 grafts in one surgery at NHI. That particular patient had an unusually high donor hair density and very loose scalp laxity. In general, a 3600 graft procedure is considered a high number, but along with this high number of grafts comes the price of a longer and/or higher scar. As I’ve written on this site before, I’ve had three strip surgeries totaling 2200 grafts and have a barely detectable scar. If your laxity allows it and your donor supply is good, the 3600 grafts in one surgery might be achievable.

I hope you can realize that every person is unique, and their goals and needs are highly individualized. Some people may not care and want one large surgery to be done with the process. Some people choose to have the procedure in stages (multiple procedures over time). This is why choosing your doctor and having them explain all these options is critical.

I often get emails from patients who are price shopping and care only about the monetary cost involved. They miss the point that cosmetic surgery / hair transplant surgery is not like buying a car where you get the same vehicle at a variety of dealerships.

August 22, 2012

FUE Without Shaving the Donor Area for African Americans? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I want to thank you for developing the new FUE technique that does not require shaving the donor area. I am wondering if this technique has been tried and tested on African Americans given the curly nature of their hair. When I came for my FUE, I actually had to keep indoors and avoid contact with the general public.

I would certainly consider this technique for future transplants if it works for African Americans.

Thanks

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I have not tested or tried the long hair FUE procedure (mini FUE, mFUE) on the kinky hair character of African-Americans. I do not see any barriers for the technique itself as we have been doing this type of surgery (FUE) on African-Americans for many years.

The difficulties of performing FUE on kinky hair should be the same with the hair long or short. In general, FUE on kinky hair is difficult for the obvious reason that the hair turns into a ‘screw’ shape below the scalp skin.

August 22, 2012

I Was Diagnosed with Telogen Effluvium a Year Ago, But My Hair is Still Falling Out – Hair Loss Information – Balding Blog

Hello

I am a 30 year old woman and I have been experiencing hair thinning especially in the front. I did a hormonal test a couple of years back and it came ok. Last year a dermatologist in Atlanta did a Hair and I was diagnosed with TE. He did nothing but to prescribe vitamins. My hair loss has not stopped. What shall I do? can you suggest a doctor or a treatment?

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You should perhaps consider seeing another doctor for a second opinion, though I don’t have any personal recommendations in the Atlanta area.

In general, there is no definitive cure for women’s hair loss once other medical causes have been ruled out (anemia, thyroid conditions, etc). If you do have telogen effluvium, hair generally grows back after about one year.

August 22, 2012

Should I Bother with Medication If I’m Only Experiencing Corner Recession? – Hair Loss Information – Balding Blog

Dr. Rassmann:

My corners appear to be receding, but I don’t seem to have hair loss anywhere else.

I know you’ve said that Propecia and Rogaine’s effectiveness is limited to the crown and the top area of the scalp. But I don’t seem have any miniaturization in those areas.

Should I even bother exploring treatment with Rogaine or Propecia if I’m experiencing only corner recession?

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The best results from these medications are seen in the crown / top, but there are definitely cases with visible regrowth in the hairline. I wouldn’t suggest that it is likely for most men to see that type of result, though. In other words, it’s rare for decent hairline regrowth to be seen… but not impossible.

August 21, 2012

Do Actors Get Their Hairlines Transplanted Back to Juvenile Levels? – Hair Loss Information – Balding Blog

Is it common for actors coming to you and your contemporaries to ask to have their juvenile hairline back? Do you do agree with this procedure and can it be made to look natural? (I’m assuming a movie star would need a completely natural look).

Thanks!

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Many men want their juvenile hairlines back. They do not have to be actors. The relevant point is whether they are mentally and psychologically prepared to have a juvenile hairline for the rest of their lives. There have been actors that requested this, but so do some men of many different professions.

If you are 21 years old with early balding, you would not know where your hair loss will end up, but I understand that such a young man would remember very well where his hairline may have been just a few years before. For this and other reasons, most of the time I advise against putting back the juvenile hairline. But there are patients that insist and are fully accepting to the permanence of a juvenile hairline.

If I am comfortable that the patient will not develop an advanced hair loss pattern (higher than a Norwood Class 5) and I’ve estimated that the donor supply is adequate to follow the worst case pattern that the patient might develop (my opinion), I would consider creating a juvenile hairline on the patient. It’s really a case by case scenario, though.

August 21, 2012

I’m 17 Years Old And Wonder If My Hairline Will Get Worse (with Photo) – Hair Loss Information – Balding Blog

Hi Doc,

I am 17 and I have been very anxious recently about a receding hairline and I am wondering if it will get any worse.

I have what appears to be a NW2 hairline with very fine thin hairs around the corners of the hairline which have receded. My hair is already very thin and fine and when I was younger the corner of my hairline where blonde as opposed to my dark brown hair which I’m unsure if that has any significance. Thanks.

Is there a chance I am not balding or will I see more hair loss in the future?

Link: Photo

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It is clear from the picture, your age, and your concern that you need to see a good doctor to help you. At 17 years old with what appears to be a Norwood Class 3 balding pattern, it is a concern to me as well. It’s possible you won’t lose more hair, but there’s no way for me to know that just based on a hairline photo. You need to have an examination.

Since you indicated you’re in the UK, Dr. Bessam Farjo has offices in London and Manchester and I would suggest that you contact him, as he is local. You should also get a parent involved.

August 21, 2012

Does Early Success with Propecia Give Any Indication on the Future? – Hair Loss Information – Balding Blog

Doc,

Thanks for the great blog.

I started taking Propecia about 7 months ago at age 21 and have had great results. I’ve had some regrowth even at my hairline.

Is early success any indication of future effectiveness/longevity? I’m trying to gauge how much time I can expect Propecia to hold off baldness. Have you found any sort of correlation with your patients?

Thank you.

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It appears that people who had a good response to finasteride early do get better long term results. Like I’ve said before, I’ve had patients on this medication for over a decade with continued great results. I won’t be able to know what kind of time frame of success you’ll have, though.

If you’ve had regrowth at the hairline, that is fairly rare, but exciting!

August 21, 2012

Would a Doctor Prescribe Finasteride to Maintain a NW1 Hairline? – Balding Blog

Dr. Rassman,

It seems there are a lot of young men frequenting your site, myself included, that are concerned about hair loss.

My questions is how much recession from a juvenile hair line must occur before hair loss can be diagnosed and a treatment can be issued.

Would a responsible doctor issue finasteride to maintain a Norwood 1 hairline?

Finasteride does not usually bring back frontal hairlines and I do not prescribe it to men who are not balding. Norwood 1 or 2 patterns are not considered balding.