Category: Other

Dr. Rassman,

Thank you for maintaining this blog. It is very informative. Although you have made a number of posts about the use of platelet rich plasma (prp) as hair-loss treatment, I was wondering if you could maybe elaborate on some questions I had.

By way of background, I am a 27 year old male with thinning in the crown. I seem to be exhibiting the same pattern of hair loss as my father. (He lost hair in the crown, but has a strong hair line). I am currently using both propecia and rogaine (7 months).

I am considering having the prp treatment. I realize it is in the early stages, but from what I have read (1) it is safe and(2) does not have affect other treatements, such as propecia and rogaine.

Do you agree with these statements? Do you think it may be effecive? Is it safe? Will the use of prp in combination with other treatements (propecia and rogaine) affect that treatment? Will the use of prp affect a patient’s ability to get future procedures (i.e., a hair transplant)?

Thanks in advance.

I do not believe that a PRP (platelet rich plasma or protein rich plasma) treatment will impact a future hair transplant procedure. You can read about this therapy here. It should be a safe procedure, but I do not understand what is being done to you. Are you doing this yourself, is a doctor or someone else doing it for you, and what do you expect from this unproven technique with regard to returning your hair or stopping its loss?

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From the very tongue-in-cheek post at automotive blog, Jalopnik:

In China, hair-pulling is, counter-intuitively to Western conventional wisdom, a male-dominated sport. This makes Zhang Tingting the Danica Patrick of the strange competition of pulling cars with her hair.

See more photos — Chinese Woman Pulls Six Cars With Her Hair

This looks painful. But… um, congratulations?

What are your thoughts about Histogen? They were at ISHRS meeting and showed photos and data. They say 5 years.

You can read up on their progress in this article from a couple weeks ago at Biospace.com. Who knows where this will go? I certainly don’t have the answers. I would not wait for the breakthrough based upon where the company is in its research at this time. Maybe in a year we will know more and then be able to forecast to answer your question.

Dr. Rassman, Dr Pak

Hi, I’m a 23 year old Asian Male. I was wondering some areas on my face does not grow facial hair at all. For an Asian, I grow facial hair pretty fast and it’s thick (for instance, under the chin). But there are spots on my cheeks that don’t grow facial hair at all, which keeps me from growing a full and even looking facial hair. The spots are literally the smoothest skin on my face. Is this because of my genes? What can I do to grow a full even set of facial hair rather then only certain areas of my face? I appreciate any help or advice you can give me. Thank you

It is your genes. Asian men do not usually grow full thick facial hair (some can, but they generally have less facial and body hair than most). What you describe is normal. If you want a full beard you can consider a hair transplant procedure to the beard area, but I would suggest that you wait a few years and see what grows in first. Full beard growth occurs between the ages of 25-30. Many men have actually had transplants with great success.

At right, an image of the late Japanese-American actor Pat Morita (from the Karate Kid) sporting a goatee.

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This is a general health posting, unrelated to hair loss.

Snippet from the article:

Fish oils are so effective at helping protect against heart attacks, they should be taken daily by everyone, say doctors in a new review of the effects of omega-3 fatty acids.

The doctors say their review found that there is now “compelling” evidence that the omega-3 fatty acids in certain fish and other sources not only prevent cardiovascular disease, but may even help treat it.

The study, published in the Journal of the American College of Cardiology, reviewed data on four trials involving almost 40,000 participants that showed the benefits of omega-3 fatty acids in the prevention of cardiovascular disease, in treatment after heart attack and, most recently, in heart failure patients.

Read the rest of the article — Fish oil’s heart benefits overwhelming, say docs

Being bald is OK, but dying from heart disease should not be in your cards.

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Dr Rassman,

What’s your opinion on “Bo-Tax” — the proposed 10% tax on cosmetic surgeries that Congress is talking about?

TaxProf – Congress Considers “Botax” — 10% Tax on Plastic Surgery to Fund Health Care Reform

Thanks!

As a surgeon doing hair transplantation this would certainly impact the costs of such procedures to the patient. Taxes on cosmetic surgery are already in effect in Hawaii (4% last time I checked) and in New York (6% I believe). The U.S. government can’t seem to balance their budget and they are going to get everyone, every time they pass “go”. So I guess you could say that I’m not a fan of it.

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Hi,

I realize you’re dismissive of “conspiracy” type plots, that companies like Pfizer and Merck would buy off and suppress results from genetic and other advances in hair restoration in order to insure their profits from Propecia and Rogaine. But from your position, are there any indications that this really wouldn’t be the case? It seems like these companies could just buy out the labs that are developing hair regneration techniques, and just file away the results. After all, if people suffering hair loss can get a 1-2 visit multiplication procedure and be cured, that does mean the end of: Rogaine, Propecia, and traditional hair transplants. So, if you have any reassurances that this is just the stuff of silly theories, it would be great to hear that.

Thanks

Silly theory, indeed. If I was Merck or Pfizer or if there was a lab that has found the cure for hair loss, I would buy the company or the proprietary rights to market and sell it for as much as I can get. Then I will take my billions and buy out Bill Gates and Steve Jobs and pay for the U.S bailout with the leftover residuals. I love a good conspiracy theory, but if a drug company had a cure to hair loss, they could charge practically whatever they want and take over the entire market… and I don’t think a big pharma company (with investors to keep happy) would pass up that opportunity.

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Hey Doc, no surgeon would give an approximate number of grafts you may need so that I can calculate the costs of a hair transplant. I found various hair calculators on different web-sites. How good are these in answering that question for me?

There is a science called multi-variant analysis based upon our ability to take complex variables and put them together to get a better understanding of complexity. Estimating the number of hair grafts for a balding pattern is such a complex problem, as the variables include less than pristine numbers. The variables include:

1. Thickness of the hair shaft (fine, medium, or coarse)
2. Color of the hair (white, blond, red, brown, black)
3. Color of the skin (very light, various shades of olive, ruddy, pigmented from light to dark)
4. Character of the hair (wavy – straight)
5. Density of the donor hair
6. Degree of hair loss in the patterns under analysis
7. Size of the balding area
8. Size of the head
9. Looseness of the donor scalp (for strip surgery)
10. FOX biopsy status (for FUE)

To show the difficulty of the analysis, lets look at an example “average” head size, white skin, and black very fine hair. Let’s make our patient a Class 3A pattern (see diagram at right). With very fine hair, to fill in this area, it may take between 5000-6000 follicular units, but by just increasing the hair shaft thickness from fine to medium coarse, the same size area may only require about 2500 follicular units, substantially less than the same size area with very fine hair. Even with that said, the way the hair is distributed by the surgeon will dictate what the final results will look like. The calculators offered for estimating hair graft numbers clearly do not apply, because the multi-variant analysis is far too complex.

With that said, let take what the surgeon does as an art form and you are his canvas. Like a good artist, a good surgeon can get the best out of his working material… but unlike a canvas, what you get from a hair transplant surgeon is with you for the rest of your life. You will see it in the mirror every morning and your wife, children, or the business people you deal with will also see it. If they even look at your hair, your cover is blown and it may not be repairable. So just how many grafts do you need? So while these online calculators might be a fun marketing gimmick, the answers are clearly not calculable by a simple graft calculator.