Author: Dr. William Rassman

Posted on

I Had 4 Different Surgeons Give Me 4 Wildly Different Assessments of My Donor Area – Hair Loss Information – Balding Blog

Hello Doctor
I am having consultations with well respected surgeons in Europe. I’ve had two strip HTs in the past and i’m looking into another one. What astounds me is the very diverse opinions i’m getting regarding my donor area supply for another strip. One surgeon tells me it is depleted, another tells me it can yield no more than 1000 grafts, another one tells me i could have as much as 1300, the other one claims he can safely extract at least 2000 – 2200 grafts, and the last one claims i could have 800 grafts but it comes with risk.

I understand that the donor assessment is quite simple elasticity + density + strip size. Shouldn’t there be more or less unanimity on how much grafts can be extracted? How come i get such diverse opinions?

Block Quote

The answer is simple — there is no formal training that hair transplant doctors go through, so their experience and assessment can be highly variable (as well as their credentials).

Another possibility for the large graft range difference could be that some doctors are not equipped to do a 2200 graft case, and may only be able to do a 800 graft case (having less experienced staff or skills).

Out of curiosity, if you previously had two hair transplant surgeries and the results were satisfactory, why did you consult with four different doctors for your next procedure? My point being, if you were perfectly happy with the first surgeon and you trust him/her, wouldn’t you go back to the same surgeon?

Posted on

Prostaglandin D2 and Hair Loss – Hair Loss Information – Balding Blog

Dr,

Do you have any theories or ideas as to how prostogladin d2 (studies recently show bald men to have higher levels in the scalp) fits in with the factors which we know contribute to hair loss like genetics and DHT?

Is this something you discuss with your fellow professionals and do you think that this discovery of PGD2 will lead to less invasive ways to slow or stop hair loss any time soon?

I’m asking as somebody who can’t take propecia due to side effects who wishes there was another way!

Block Quote

Researchers have found that Prostaglandin D2 is present in bald scalp and not in a hairy scalp. The suggestion is that PGD2 is an inhibitor of hair growth in AGA and some researchers believe that the PGD2-GPR44 pathway is a potential target for treatment.

This is still in the research area and there is no drug that I am aware of that will be available clinically at this time. I’m always hopeful for new proven treatments, but whether this is one of them remains to be seen.

Posted on

Propecia and Clenbuterol – Hair Loss Information – Balding Blog

I’m about to start taking Propecia, but I’m currently taking fat burners called Clenbuterol

Will it be ok to take both at the same time?

Many thanks

Block Quote

I have not found anything that suggests a problem mixing these two drugs, but I know very little about clenbuterol other than its use in breathing disorders (chronic asthma) and as an enhancement drug for athletic competitors. You need to do your research and possibly speak with the doctor who is prescribing your Propecia.

Posted on

Can Norwood Class 3 Only Have Deep Corner Recession? – Hair Loss Information – Balding Blog

Dr. Rassmann:

Your site is an excellent resource. Thanks a bunch.

Is it possible to have a norwood three pattern with no frontal recession? In other words, can deep corner recession alone constitute a Norwood three?

Block Quote

Yes, deep recession in the corners with a normal central or low central hairline can co-exist when the forelock is persistent. This is actually quite common. The forelock is genetically coded differently than the frontal area in some families.

Posted on

I Take a Cut Proscar Tablet 6 Times a Week – Hair Loss Information – Balding Blog

Hi i’ve currently been taking Proscar 5mg tablets cut into quarters I take it 6 times a week and have a 1 day break (so im intaking 7.5mg per week) I’ve been on the drug for close to 4 months. firstly is this acceptable or should I be looking to take it every single day?

Also my main question, I have alot of vellus like hairs some grow to a centimetre or so some are eternally lingering around 1mm, small and blonde my plan with finasteride is to revert these hairs back to the terminal stage, I’ve noticed my remaining terminal hairs look stronger right now but im wondering the rough timescale of when I should see my vellus hairs growing in stronger, I know everybody responds differently but if you could ball park the average for me and maybe explain what I should see process wise (does anything change to let me know etc) if the medication is working for me. Many thanks!

Block Quote

This should be discussed with the doctor that prescribed you the medication. In general, the recommended treatment for male pattern baldness is 1mg finasteride per day. Many patients break up the 5mg finasteride pill into four pieces and take 1.25 mg per day with no issues. The half life of finasteride (Propecia) is about 4 hours, so after 24 hours almost all of the medication is out of your blood stream (even if you took a 5mg dose or 1mg dose or 1.25mg dose). Thus, the medication is meant to be taken daily (without skipping) so that you maintain a consistent level in your blood stream. It is not a cumulative dose over a week. You cannot take a 7mg pill once every seven days and expect it to work the same as taking 1mg daily for 7 days.

Finally, without an examination I really do not have any way to know if the medication is working for you. Ideally, one would have a measurement done before you started the medication (such as a photograph, miniaturization study, or bulk measurements) and compare this with a follow-up measurement. Otherwise it is just a subjective guess.

The Propecia timeline for results can be found here.

Posted on

My Plugs from the 1980s Look Ugly and I Don’t Want to Wear a Hairpiece Anymore to Hide Them – Hair Loss Information – Balding Blog

Iam 64 yrs old. I had transplants done in the early 80’s. Donor hairs from the back of my head to the front. In time the rest of my hair from the top fell out. The transplanted plugs looked ugly and I resorted to wearing a hair piece. I recently started to shave my head and I like it except for the scarring on the back of my head and the in front of my head where the plugs were inserted and hair grows. What can be done? The shaved look is really in style and I don’t want to go back to using a hair piece.

Block Quote

Your options are very limited, unfortunately. The plugs can possibly be removed, but you’ll still be left with scarring in that area and in the donor area at the back of your head.

Scalp Micropigmentation could be an option for covering the scars from old plugs. Many men with bad plugs and bad hair transplants have opted to shave their head and cover the scar with SMP, giving them the appearance of a closely cropped hairstyle. Each case is unique, but I doubt you’d be able to completely remove scalp scarring.

Posted on

In the News – Hair Loss Myths (Slideshow) – Hair Loss Information – Balding Blog

Hey doctors,

I found this slideshow of popular hair loss myths that Dr. Bernstein wrote that I thought you’d like.

Link: CBS News – Hey, Baldy: 10 Things You Need to Know about Hair Loss

Block Quote

We’ve covered practically every hair loss myth I can think of (most of which I’ve never heard before I started this site), but the slideshow mentions a few of my favorites — Genes for hair loss come from mom, hats make you go bald, and clogged pores cause hair loss.

There’s not much substance beyond 1 liners and stock photos, but CBS has the myths on their site at the link above.

Posted on

Could 20 Laser Treatments Cause Complete Regrowth? – Hair Loss Information – Balding Blog

What’s your take on this woman that had 1 laser treatment each week for 5 months and got all of her hair back? It’s very remarkable!!

Link: Health Watch: Hair Growing Treatments

Block Quote

I don’t believe it for a moment. I suspect that this lady had chemotherapy and lost her hair, then after a time, it grew back. I also suspect that doctor (?) or clinic involved in the process took the credit for what would have happened anyway.

Posted on

Hair Loss InformationBalding in the US Congress – Hair Loss Information – Balding Blog

CongressHi,

I just wanted to share with you our latest infographic: Bald Power

Feel free to give me a shout if you need an alternative sized version for you blog. Hope you like it!

Feedback appreciated.

Block Quote

I meant to post this a little while ago, but it slipped through the cracks. The graphic is quite large, so click the image at right to see the full size.

I haven’t looked at photos of Congress members for myself, but does your graphic account for thinning hair or strictly those that are bald? The infographic is nice if your numbers are right, but you spelled “United” wrong twice.

The presence of balding in the 5-8% range amongst members of the legislators (more men than women) is much less than the general population. In men, the balding rate (some degree of hair loss) is about 50% in men over 45, the age of most of our legislators. Except for Eisenhower, there has not been a bald president since before World War II.

I have written before that men with hair on the head have a better chance at getting elected than balding men. There is considerable prejudice against balding men in the population, and I’ve written about that here and here.

Posted on

Hair Loss InformationSex and Hair Loss? – Hair Loss Information – Balding Blog

Will having sex cause an increased rate of hair loss on men? And if so, is it better to have sex without ejaculating?

Block Quote

It is probably true that there is a relationship between testosterone and sexual appetite. There is also a relationship with testosterone and hair loss and if, for example, a man (who has the genes for androgenic alopecia) applied testosterone creams, he would increase his testosterone blood levels and probably have more hair loss due to the increased DHT. That is where this conversation ends.

Ejaculation (present or not) should not increase testosterone levels. There is no connection between ejaculation and hair loss. If you want to have sex without ejaculating… good luck!