Category: Physician training

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Southwest Florida Doctor Recommendation? – Hair Loss Information – Balding Blog

I’m 36, female, and have been losing hair for 8 years. My hair has always been fine and thin, and I inherited my father’s “receding” hairline. Now to be losing hair on top of this is awful. I’m new to the are and seriously considering transplants. I just saw a dermatologist who took a biopsy and said it’s female pattern hairloss, use Rogaine, there’s no other hope. I want to see a real professional who is caring, sympathetic, and willing to work with me to discover the best option of treatment. Can you recommend someone in southwest Florida please? Thanks

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Ask your dermatologist to recommend a doctor in your area. A direct referral is always the best way to go. Dr. Bernard Nesbaum is a hair transplant doctor in Florida who has considerable experience with women and he is a dermatologist. You might want to check with him. You can get the doctors in Florida by looking at ISHRS.org.

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Where Does the Hair Loss Gene Come From? – Hair Loss Information by Dr. William Rassman

I am 23 years years old and have been losing hair since a litte before I turned 20, but only in the form of a receding hair line. Aside from my fairly quickly receding hair line, the rest of my head, including the crown, remains covered with thick hair. Would taking Propecia be a waste of time at this point since it supposedly does not help in the temple region? Should I just wait until I start losing hair on the top and crown of my head before I start taking it? Is there anything I can do to slow the progession of the receding hair line? Also does the hair loss gene come soley from one of your grandfathers, or is the state of your hair a result of a variety of genes from one side of your family? I ask this because one of my grandfathers died with a full of head hair in his late 70’s and one was completely bald in his thirties. Given that I am experiencing hair loss at such an early age it is obvious that I am taking after the side with the balding grandfather. Does this mean that I’m undoubtedly destined to suffer complete hair loss if I do not take action? Thank you.

If you are losing hair now, you should start Propecia now. The longer you wait, the worse the genetic toll will become if you are prone to it. You will not bald any further than your genetic pattern, but alas, no one knows the genetic pattern of anybody until you finish balding. A good doctor can do some estimating based upon the degree of small hair (miniaturized hair) in the areas that to your naked eye look normal. Many times what you see is not what is really there.

We can inherit it from anyone in either side of the family, male or female. The gene can skip generations, so sometimes people can not identify a balding person in their family. If you take after one of your family members in pattern and age of loss, it is more possible that you may be like him. There is no way to determine that final pattern, as I said above, but you can control it if you treat it with Propecia early and then get transplants to return what was lost. Between the two, people are often able to control what they look like.

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Hair Loss, Lasers, Drugs and Transplants – Hair Loss Information – Balding Blog

I am undergoing a hair loss treatment. This treatment involves lasers, basically a helmet that shines light on my head to deter DHT. I am somewhat skeptical, but it was the only option that was within my price range at the moment. I am 20 years old; my hair loss is not substantial. I am thinning on the top of my head and the most severe areas are in my hairline and the back of my head. I took this treatment to prevent my hair from thinning anymore. The thinning is not very obvious but I can tell it is still progressing. I wanted to know if transplanting hair from my own head would leave an area in the back of my head that hair will not grow on anymore. I also wanted to know if there are ways of getting transplants from other donors. Lastly, I want to know how much these treatments would cost and how effective the treatment I’m receiving is.

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There is anecdotal evidence in Europe that hair lasers (Low Level Light Therapy / LLLT) increases hair growth. I’ve written about LLLT previously, here. Thinning of the hair in young men often starts off insidiously and gets slowly worse. At the beginning, you might actually lose 50% or more of your hair before you notice it. If you are a platinum blonde, you could lose 85% of your hair before it becomes noticable. The key is to make the diagnosis early and get on the only good, FDA approved DHT blocker that is out there: Propecia. This drug is the best and possibly the only real hope at this point to slow down, stop or reverse the hair loss. In young men, I have seen some wonderful reversals of hair loss. Transplants in a 20 year old without noticable hair loss is NOT something you should pursue at this time. When the donor area is harvested for hair transplants (the back of the head) it does not produce a bald area as you suggested in your question.

Laser treatments can be obtained from those who sell those services. We have a laser in our Los Angeles office, but do not sell the service at this time. I am told that the company that provides the service charges about $3000/year for treatment. Propecia costs range from $55/month to as high as $120/month depending upon the pharmacy you purchase it from. We sell it in our office at $53/month (very close to our cost). Transplants are sold by the graft. These surgical procedure generally cost a few thousand dollars per surgery, but they do last your lifetime. The more transplanted grafts you buy, the higher the fee.

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Doctor Recommendation in Turkey? – Hair Loss Information – Balding Blog

Hello doctor. I was wondering if you knew any good doctors in Turkey. I live in turkey and it would cost me alot to travel to the united states. I was wondering if you knew any doctors with a good clinic and staff..

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It is important to read as much as you can about hair transplantation. Know the different types of techniques and know what the standard of care should be. Our website, www.newhair.com, has a tremendous amount of educational material for you to review. Then look up the list of doctors in Turkey on the International Society of Hair Restoration Surgery. I do not have any personal recommendations for Turkey, but ISHRS is a good place to check. See if any of the doctors have websites that detail the type of procedures they do. You’ll want to find a doctor that at the minimum does ‘state of the art, follicular unit transplantation’, and has their staff use microscopes for graft dissection. See if they post patient photos of their results or allow you to meet their patients to show examples of their work. After you have narrowed down your list, make consult appointments with the doctors, try and see their patient results in person, tour their facility, ask questions, and get as many recommendations that you can. Find a doctor that you feel comfortable with, and one that gives you the best plan for your hair loss treatment. If you have access to a digital camera and would like me to also give you a diagnosis, email them to me and I will review them.

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Hair Loss InformationHair Transplantation in Filipino Man – Hair Loss Information – Balding Blog

I am a filipino male with brownish black hair that is semi thick in nature. My hairline is receeding and would like to have the FUT procedure done. but before this takes place, have you done this procedure on clients that fit my description, and if so, may i see pictures of them? may i also call them if possible. as far as medication goes, do i need to take propecia, rogaine or any other prescription? because i rather not. my next question is time off work. because i am self employed and serve clients face to face i can not afford to take more than 5 days off from work. is there way to discreetly hide my surgery as it heals? my last question is i enjoy having my hair cut very short, is possible to do that without showing that i have had hair transplant surgery? do you have pictures of your clients like this?

thank you

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What you have is typical for our practice. Our website has many, many patient pictures of what you are talking about in our Before and After Photo Galleries. Our monthly open house events allow you to meet former patients and see the results for yourself. You do not have to rely solely on photographs when you get to meet the patients in person. In addition, an open house allows you to see a surgery, talk with the patient having the procedure, and see how he looks immediately after surgery. We also invite patients who have had surgery during the previous week to stop by, but I can not guarantee that they would have the same hair characteristics as you.

The use of medications relates to the natural hair that you are losing. Medications may be necessary to hold on to hair that is genetically not going to last, but medication is not needed for the hair that is transplanted. I strongly recommend that my patients use Propecia, to maintain their existing hair.

You can return to work fairly fast. I have performed FUT surgery on a number of celebrities who have appeared on television within days or even hours of their surgery. I have had a few people run a marathon within 5-7 days of the surgery. Going back to work is easy, but the question relates to just how bald you are and if you care if someone notices that you had a hair transplant. For the very bald man, this can be an issue, yet for those not very bald, they can be undetectable within a day or two. There can be a little redness in the recipient area for the first few days and if you allow your hair to grow a little longer than usual, it will hide the donor area nicely. If you do schedule a surgery, you may want to shoot for a Friday, taking the following week off, then you will have nine full days before your next work day. As far as wearing your hair short after the healing is completed, that will be up to you. FUT surgery will leave a thin scar in the donor area, the length of which is determined by the number of grafts you need, your hair density, and scalp laxity.

My advice is to visit us at an open house event and get comfortable with what we do. Review our website, where hundreds of patients are shown, and get the book I wrote, The Patient’s Guide to Hair Restoration, which is probably the most comprehensive book ever written in this field.

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Hair Loss InformationLosing Hair Grafts After Transplant – Hair Loss Information – Balding Blog

Hi, Dr. Rassman, I hope that this email finds you well. I had my surgery in June and have lost about 9 grafts (4 in the last 3 weeks or so). I didn’t lose this many last time. Should I be at all concerned?

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Nice to hear from you. I would doubt that you lost any hair grafts. After 5-10 days, once the scab is off, most of the grafts actually can not come out even if pulled on. What you may have lost was the remnant of the graft and the hair shaft. The growth center will remain and will grow its hair in 4-5 months. If you are at all concerned, call my office at 800-NEW-HAIR and make an appointment to come in. I will be happy to take a look at your early results.

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Hair Loss InformationGraft Quality From Different Areas of Scalp – Hair Loss Information – Balding Blog

I am a 48 year old male who has had 3 procedures: 800,800, 2000. I was told that by the 1st doctor that the same donor area would be used over again for the 2nd procedure. For the 3rd procedure I went to another Doctor who told me that the quality of the grafts is better if they used another location. slightly higher than the first. I would like at least one more procedure and would like to know if I need another donor area or can one of the old areas work as well. Also is there any benifit to having a hair analysis done. Thank you for your time.

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Some doctors take the hair from the high neck rather than the mid posterior scalp. This view is misguided because using the high neck has problems, including:

  1. it is not permanent hair
  2. it tends to scar
  3. it does not tolerate much taken from it without severe scarring that is difficult or impossible to cover up

I always take the donor area from the middle of the donor area (the 3 1/2 inch high band around the side and back of the head) as that is where the best hair is. I call this area the sweet spot, because it is highly productive for good quality hair. I continue to harvest the same area, at the same scar in subsequent surgeries, when they are needed. This gives me the ability to reduce any scarring, if it should occur. Since you are in my area, I would be pleased to give you another opinion, at no charge, and I will analyze your hair at the same time.

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Transplanting Someone Else’s Hair to Your Head – Hair Loss Information – Balding Blog

If one can transplant the face of another person, why can’t we transplant the hair from another person? Please read US plans first face transplant on BBC News for details about the face transplant.

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You are referring to the face transplants that have been recently approved by the FDA. The answer is that a face transplant is like a cadaver kidney transplant. Some genetic matching helps, but anti-rejection drugs are essential. The issue is best exemplified by the old adage “Does the punishment fit the crime?” One can easily transplant most people’s own hair (an autotransplant) so that rejection of the hair is never an issue. If you transplant someone else’s hair, then you would have to use anti-rejection drugs to stop the body from rejecting the hair organs from the other person. These drugs are dangerous and in themselves have great risks associated with them. In the very deformed people, the benefits outweigh the risk. As your own hair is easier to use, there is little need or demand for transplanting someone else’s hair to your head. The few that are very, very bald, or those who have run out of donor hair after receiving far too many old type hair transplant procedures, are left without a solution for today’s focused world.

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Hair Loss InformationDoes Azelaic Acid Stop Hair Loss? – Hair Loss Information – Balding Blog

Does Azelaic acid in Xandrox block DHT? Will it will inhibit virtually all synthesis of DHT in the scalp at the follicle level as claimed by some [people? It has been said that it will not bind with the 5 alpha reductase enzymes (Propecia binds with type 2, 5-alpha reductase.), but it will inhibit the synthesis of all of the hormones in the 17-hydroxy group, which would include testosterone, DHT and androstenediol, the most potent of the androgens. Can you clarify this for me?

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I reached out to my colleagues and Drs. Shaprio and Cooley responded with one of the better answers given to me. The focus of the quoted study was on in-vitro (in the laboratory) studies and there are no invivo (in patients) studies. The finding in the laboratory is interesting, but it is a big jump to answering it for people like you who seem to research things in great depth. I would warn most of my readers that there is a long stretch to findings in the laboratory and responses in patients. we have seen cancers killed in the laboratory and no impact on patients. Certainly safety issues are pre-eminent and drive much of what I recommend for my patients.

“I think Dr Lee is referring to this old in vitro data. I’m skeptical azelaic acid is a good in vivo topical 5AR inhibitor and even if it is”, as Dr. Shapiro said, “there’s still the systemic DHT that must be addressed. I doubt that azelaic acid does much for hair growth. ”

Read the citation summarized below from British Journal of Dermatology, 1988 Nov;119(5):627-32.

Inhibition of 5 alpha-reductase activity in human skin by zinc and azelaic acid, by Stamatiadis D, Bulteau-Portois MC, Mowszowicz I., Laboratoire de Biochimie B, Hopital Necker-Enfants-Malades, Paris, France.

The effects of zinc sulphate and azelaic acid on 5 alpha-reductase activity in human skin were studied using an in vitro assay with 1,2[3H]-testosterone as substrate. When added at concentrations of 3 or 9 mmol/l, zinc was a potent inhibitor of 5 alpha-reductase activity. At high concentrations, zinc could completely inhibit the enzyme activity. Azelaic acid was also a potent inhibitor of 5 alpha-reductase; inhibition was detectable at concentrations as low as 0.2 mmol/l and was complete at 3 mmol/l. An additive effect of the two inhibitors was observed. Vitamin B6 potentiated the inhibitory effect of zinc, but not of azelaic acid, suggesting that two different mechanisms are involved. When the three substances were added together at very low concentrations which had been shown to be ineffective alone, 90% inhibition of 5 alpha-reductase activity was obtained. If this inhibition is confirmed in vivo, zinc sulphate combined with azelaic acid could be an effective agent in the treatment of androgen related pathology of human skin.

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Desperate for Hair that Looks Real – Hair Loss Information – Balding Blog

I’ve been losing my hair since i was 19 and now i’m 23. I’m pretty much at a strong norwood 3. I tried alot of things, but nothing has helped. My mom’s dad was bald and the rest of his family too. Basically don’t know what to do. I’ve read that i’m too young to get a transplant and have not made a move on it. Im also afraid to get one cause of the scars. I really don’t know what to do. It has pretty much ruined my life. I use to have girlfriends all the time now have not had one since 20. Pretty much so desperate i would sell my mustang just to pay for a transplant but i don’t know if i should if results don’t look real and if there is scars involved.

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First, be careful with statements like “I would sell my mustang just to pay for a transplant,” because many unscrupulous people will take your money and sell you hair. Realistic expectations, reasonable predictions based upon a good solid examination of your hair and hair loss distribution with good microscopic examination of the scalp, a good doctor with great integrity and lots of good experience, and some comparative shopping will tell you much about what you can do. Read my book, available online in PDF format here, or get one sent to you free. Visit my offices if you are in California. Natural results with a hair transplant are not difficult to obtain, but first you must know where you stand and what your long term ‘Master Plan’ should be before you jump to a hair transplant.

I know that if you do not feel good about yourself, if you do not have the self-esteem you want, then having a normal life becomes more difficult. A hair transplant may or may not solve these problems. The main reason we generally discourage men of your age in getting a hair transplant is that (1) you may not be able to determine when the hair loss will stop, (2) you may not be mature enough to understand both the financial and social remifications of the transplant process, and (3) you may not be able to get the realistic expectations that fit with your hair metrics (hair density, contrast in colors, character of the hair, laxity of the scalp, etc..). In effect, will you have enough hair supply to follow your hair loss to meet your expectations? Get a good doctor and develop a Master Plan with him/her. Then and only then, can you deal with the decision of “Should I or shouldn’t I?”