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I Don’t Know If My Hair Loss is Genetics or Chemical Burn from Relaxers

Dear Dr. Rassman,
I am 28 yrs old have been suffering from hair loss since I was about 22 years of age. I am about a norwood 3 right now. I had chemically relaxed my hair once when I was 18 and a second time when I was about 21, while suffering a minor burn from my second treatment. I have taken the hair DX test and I have been told that I have a moderate predisposition to male pattern baldness. Can my hair loss be due to a combination of both factors?

If it were solely due to the chemical relaxers, would I have lost my hair when the injury occurred and wouldn’t my hair loss be more diffuse? If it is due to the insult by chemical straightening, would the hair/hair follicles show the same progression of hair loss as if it were male pattern baldness? I can’t change the past, but I would just like to know if my chemical relaxer treatments have led to this.

Thank You

You have a complex story and it would likely require a complex examination. Without seeing you and examining you, I can not tell you the cause of your hair loss or what you can do about it. The HairDX test can tell you if you’ve got the genetic markers, but it won’t tell you if or when you’ll see those genes expressed.

See a good hair transplant doctor who cares about your welfare and then you will know more than you know now.


2011-12-22 11:39:38I Don’t Know If My Hair Loss is Genetics or Chemical Burn from Relaxers

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I Feel Tingling on My Scalp and I Think I’ll End Up a Norwood Class 6

Hi Dr Rassman

Im a 18-year old boy having male patterned hairloss. I started balding when i was 16 and am a full norwood 3. Since the last year a have felt some tingling feeling when i run my hand trough my head,all of it except on the sides. I dont feel pain nor do i have some disease of what i know but just the tingling feeling. Its like i know what my hairloss pattern will be a (norwood 6) wich i can tell from the feeling.I have looked trough the internet to see if anyone has experienced the same thing and interestingly alot of people have. I was wondering if you heard about this? And if you have please tell

Tingling on the scalp does not mean you will lose hair. While people who are balding may experience these symptoms, people who are NOT balding also experience these symptoms (they just don’t write about on the Internet hair groups). You may consider dandruff, head lice, scabies, or other conditions (not related to hair loss). Or you may having nothing at all! I really can’t say what you are experiencing, but you may want to see a doctor if the problem persists.

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I had 2000 grafts one year ago, can I repeat it now?

The average Caucasian has 6,000-7,000 hair grafts, the average Asian or African has 80% of those numbers, so you can do it again with some to spare. It is not uncommon to repeat the surgery a second time for more density.


2017-08-08 08:46:30I had 2000 grafts one year ago, can I repeat it now?

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World Anti-Doping Agency to Remove Finasteride from Prohibited List!

The World Anti-Doping Agency (and subsequently the US Anti-Doping Agency) will be removing finasteride from its list of banned substances at the start of 2009. I can’t find any news items about this yet in the media, but according to the WADA website, the updated prohibited list won’t be made available until October 1.

So how do I know early? Well, I was forwarded a letter dated a few days ago, written by the USADA legal affairs director that states in part, “USADA has confirmed today that as of January 1, 2009, finasteride, the substance for which your client tested positive, is being removed from the WADA Prohibited List.”

Some background on the World Anti-Doping Agency from Wikipedia — “The WADA is an independent foundation created through a collective initiative led by the International Olympic Committee (IOC). It was set up on November 10, 1999 in Lausanne, Switzerland to coordinate the fight against drugs in sport.” The WADA had placed finasteride on the list of banned substances in 2005, because it was being abused by some as a way to mask steroids in urine testing. Meanwhile, the ban was punishing those balding athletes that wanted to take control of their hair loss problems. I’m glad they’ve come to their senses about this.

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I Had a Procedure with You in 1994, But Wasn’t Satisfied

Dear Dr. Rassman:

I don’t know whether or not you’d be interested in this message. Nevertheless, I would be interested in your reaction to it …

I was a patient (age 34 at the time) of yours in August of ’94. You transplanted about 2,000 grafts from the back of my scalp to the top of my head. My overall reaction was that the density wasn’t near enough. And there was no way I could afford a second trip through the mill.

While I thought the newly transplanted hairs themselves looked okay, I concluded that your procedure fell far short of my expectation. To be blunt, my head resembled a coconut. So I ended up going to a company that provides rather costly “hair systems” (the gentle term for wigs). They look great – full and natural. It’s an ongoing “expense” that’s become a part of my life. But I thought of you the other day.

The idea of finally just shaving my head and being done with the high cost of masking my hair loss crossed my mind again. So when I took another good look at the white scar that traverses the back of my head from ear to ear, I dropped the shaven head idea.

Maybe when head tattoos are commonplace, I’ll put one right over the scar; a picture of a “bald eagle” or something.

Your reaction to this would be appreciated.
Thank you, sir.

Thank you for contacting me. I had the opportunity to review your photographs and your medical record. Hair loss is a progressive process and it is clear that the communication between us failed. I care about my patients meeting their expectations (first being sure that these expectations are realistic) and following up with a good Master Plan to follow the hair loss over time. I did this in 1994 as well. A single hair transplant procedure of 2000 grafts may have filled in some of your thinning, but it was not enough to cover the complete hair loss pattern that probably evolved. As hair loss is a progressive process and your pictures showed that you were in the process of losing hair at the time of the transplant, clearly you were a moving target. I must have failed to explain that process to you. Drugs like Propecia (finasteride) were not around in 1994, so unfortunately, in those days, I worked with a handicap watching helplessly as people lost their valuable hair over time. As you may know by experience, hair transplants (without the protective effects of drugs like Propecia) can accelerate the hair loss and even produce shock loss, which means that the hair loss process probably accelerated.

I can suggest that you arrange a visit with me and let’s discuss your present status and your goals. There have been many advances in managing scars if that is your main focus today. Nevertheless, I do care and the best I can do is offer my advice and reconnect with you again after all of this time. My office can be reached at 800-NEW-HAIR. Please do give us a call so that my staff will be able to get your next visit arranged.


2007-09-24 15:33:51I Had a Procedure with You in 1994, But Wasn’t Satisfied

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Would Hair Regrow in a Scalp Scar?

(female) I’d had a bald spot since birth, possibly a birthmark and possibly a scar from my extraction. At 20 I had an stapled excision. Now I’m curious, Is hair meant to grow in the area where the staples were, or will there always be a bald line? Is there anything I can do to improve my chances?

The general concept you should understand is that if you have a scar where hair previously existed, regrowth in that area more than likely won’t occur on its own (though it can depend on how the closure method was done). However, transplanting hair into the scar should see growth just as it would if we put it on the frontal hairline area or on the tip of your nose. I’ve performed hair transplants procedures into scarred areas from head trauma, but I’m not sure how big of a bald spot you’re talking about and whether it’d even be worth having a transplant to fix it.


2010-03-18 09:36:35Would Hair Regrow in a Scalp Scar?

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I have a Class 6 pattern of balding and I’m 26.

Should I get FUE or FUT?

That depends upon your donor densities and your donor hair mass. The higher these two are, the easier is the FUE choice. If your donor hair mass is low and the donor density is under average, the FUT may be a superior procedure. The problem is that today’s doctors are not trained in FUT, so they always recommend FUE. Find the right doctor to help you with that decision. I am always there to help, and I do both types of procedures.

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Would You Use Body Hair if There Was No Donor Supply Left?

If you have no donor supply left would it be possible to use body hair to help with density. I understand your positions on BHT having read your posts on the topic, however is that something you would ever consider?

There are few indications for body hair transplants (BHT). From what I have seen, the results are quite variable. It might be a waste of your money doing it, especially if it did not meet your objectives. I occasionally refer patients who are committed to body hair, but I do not do them myself.