Category: Uncategorized

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Density of Hair Transplants

Hello, I just had a wonderful procedure. Their offices were clean, procedures were excellent, and the staff was very accommodating. In 2002 I had 800 grafts done by another group in San Francisco and then again I just did 3500 grafts. The follicles were transplanted throughout my scalp approximately 25 FU/CM2. I have a very nice NW2 hairline. Also, I had a very high number of 4-hair grafts. Over 400 of them! They excised a strip of 3500 grafts and got 3703!!!

Do most of your patients get about 25FU/cm2 and are happy with it? I think it will be ok but just need reassurance.

A normal person will have 1250 hairs or 600 two-hair follicular units. When converted to cm/square, that would extrapolate to 100 follicular units per square cm. If you received 25 follicular units in 1 cm, that would suggest that in one procedure, the doctor returned 25% of your normal density on the transplanted area. This is often not really the case, as some areas will have higher densities put in and other areas lower densities. For a person with average weight hair, olive skin, and brown hair, 50% densities overall should be more than enough to produce a full appearance. If you had a high number of four-hair grafts, then that might mean that your overall densities are higher than average. I generally target 25% density return on the first session, but at times I will go higher or lower depending upon other factors.

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Post Finasteride Syndrome question

I got a prescription of fin filled but it’s just sitting in my room. Been balding for a few years now but I still have a hairline that’s receded in the temples. I’m not scared so much as about the side effects but the stories I’ve heard/read about permanent side effects that last even after you stop using fin.

Post finasteride syndrome (PFS) is very rare. The best way to avoid it is if you are taking finasteride and have significant eD, then stop the medications before it goes on too long.

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Depleted donor area

The best way to treat an over-harvested donor area from FUE is with Scalp Microigmentation, something we do for patients who come to use from all over the world


2019-02-01 15:27:36Depleted donor area

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I Have Developed Lumps in My Donor Area 1 Month After My FUE

These lumps may be caused by buried grafts that were pushed under the skin of the donor area at the time the FUE was done. These, if they get infected or are painful, should be excised surgically. Here is an example of buried grafts that was removed after an FUE was incorrectly performed. If you look carefully at each lump, there are hairs and grafts inside the lumps.

ingrown or buried grafts

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Press Release – New Laser Cleared by FDA for Female Hair Loss

Snippet from the press release:

The United States Food and Drug Administration (FDA) has just cleared a new laser proven to regrow hair in women. The FDA ruling was based on a study performed by Dr. Grant Koher which showed that low level laser light, specifically with a precise wavelength, provides a medically significant treatment for women’s hair loss. Dr. Koher is the first physician to conduct a study resulting in 510k FDA clearance for a medical device for the treatment of female pattern baldness.

Dr. Koher conducted a three phased medical study to confirm that females with androgenetic alopecia, when exposed to scheduled applications of low level laser light, would have a reduction in hair loss and promotion in hair growth. This study was conducted over 18 months with 82 qualified participants. Each participant was scheduled to receive 52 treatments of 20 minute duration, over a period of 26 weeks. All study procedures included clinical protocol, clinical tracking, and clinical analysis approved by the Western Institutional Review Board (WIRB).

LaserRead the full PR — New Laser Cleared by Food and Drug Administration for the Treatment of Female Pattern Hair Loss

The study that is referenced was done by Dr. Koher in North Carolina, but I can’t find any information about it outside of this press release (not even on the doctor’s website). He apparently presented the study, “Effect of Laser Biostimulation In The Treatment of Female Pattern Hair Loss“, at last year’s ISHRS (International Society of Hair Restoration Surgery) meeting, but I can’t find any evidence that it was published anywhere.

Note that it is not FDA approved, but it is “cleared”. When the FDA clears something like this technology, it means that it is safe… not necessarily effective. For more information on 510(k) clearance, see here.

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Diagnosed with cancer and treated with chemotherapy, now have hair loss

I have been diagnsed with an aggressive large-cell non-Hodgkins lymphoma and received chemotherapy from June until September. My chemo included Adriamycin. I had two hair transplant procedure years ago and they have thinned. What should I do?

It might be worth trying minoxidil topically on the area where you lost hair. You will have to give it 8-12 months to see a benefit.


2017-05-02 09:26:28Diagnosed with cancer and treated with chemotherapy, now have hair loss

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Procapil, Nizoral, and DHT Blockers

Dear Dr:

First, I would like to say thanks for this web site of yours. you’re one of the few sources of hair loss info that i trust. keep up the good work.

my question: what, if anything, do you know about Procapil (www.procapil.com/index/html)? there is a brand of hair care products on the market called MiN New York (www.min.com) and they all contain several DHT-blocking ingredients — copper peptides, saw palmeto, etc. — and Procapil. any thoughts on this company and their products? also, i have read some info re: Nizoral and how it may help regrow hair as well as Rogaine. is this true?

Nizoral contains a drug used to treat a variety of fungal infections of the scalp. So many people think that it is the magic shampoo for hair loss. If it is, there is far more fungal infections than I ever thought amongst the population. Many ingredients like copper peptides and saw palmetto claim DHT blocking capability, but they are poorly documented at doing just that. If saw palmetto is a DHT blocker, it is a weak one. Copper peptides are not DHT blockers.

Procapil reports that it is a patented plant complex that repairs, nourishes and prolongs the hair cycles of the telogen phase of hair growth. There are claims as well that it is a DHT blocker. In my opinion, none of this is scientific or can be substantiated to meet my standards. Again, I warn every reader that this is a ‘Buyer Beware’ business and many people make good money on promotions that may not have good scientific data presented.

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Did Propecia Elevate My SGOT and SGPT (Liver) Levels?

Dear Dr. Rassman,

I am a 32 year old male with Norwood class 3.In December beginning I had started Propecia and continued with it for 7 weeks. I experienced no apparent side effects and in fact felt more energetic. There was no initial hair loss and at end of 3 weeks my hair felt fuller and it seemed that there was a decrease in hair loss ( lose fewer while combing/shampooing ).

During the 7th week a test revealed some of liver function indicators were elevated:

Value Range
A/G RATIO 1.29 1.2-2.0:1
SGOT(AST) 45.00 U/L 10 – 42
SGPT (ALT) 74.20 U/L 10.00 – 47.00

Subsequently, while still on Propecia, I also got these tested for

TESTOSTERONE 708.0 ng/dl 166 – 877 ng/dl
FREE TESTOSTERONE 4.88 pg/ml 4.25 – 30.37 ng/dl
DI-HYDRO 522.3 pg/ml 250 -990 ng/dl
TESTOSTERONE

A couple of years back testing for DHT had revealed that it was 3 times the upper limit. I was not treated for it.

I would really like to get back on to Propecia. Do you have any insights why SGOT/SGPT are elevated ( A few weeks before starting my Doctor had gotten me tested and LFT were normal then ) ? Could conversion of excessive DHT to Testosterone have caused such ? Would it be safe for me to restart Propecia ?

Regards

This is a question you need to ask your doctor. There are many possible factors that could be in play:

  1. To my knowledge, Propecia use will not impact liver function. If you have liver disease, you may have to reduce the dose of finasteride you are taking to take the disease into account.
  2. It can be a coincidence.
  3. It can be from alcohol use the night before.
  4. It can be from other drug use. Many drugs are metabolized by the liver and Propecia is not unique.
  5. It can be an insignificant temporary finding, but unlikely.
  6. It can be from an infection you are not aware of.
  7. The list goes on and on…

miniaturization study, not a lab test. I understand there are now genetic tests that can give you a “probability” score for androgenic alopecia, but sometimes even genetic testing does not really change the medical course of action.

One particular 18 year old patient I recently saw paid a few hundred dollars for genetic testing for androgenic alopecia at another medical group. The results were mailed to him and according to what he said, the doctor never followed up with him. He had no sign of balding, no hair loss, and no miniaturization. He had the test done because his grandfather was bald and he was afraid of going that same route. His results showed a “probability” of androgenic alopecia, but all it really did is tell him that he was carrying the gene for balding. Just carrying the gene does not mean that the gene will be expressed, as some men who carry the gene never go to clinical balding. The report given to him got him extremely worried and instead of following up with the medical group (who tried to sell him shampoos and lasers) he came to see me.

In my opinion, in this particular case the genetic test was a source of misery and misrepresentation. Sure, there may be a possibility that he may lose hair to some degree and have androgenic alopecia in his future, but I did not recommend any course of action (not even Propecia) for him, as he had absolutely no sign of balding or miniaturization.


2010-02-16 13:30:40Did Propecia Elevate My SGOT and SGPT (Liver) Levels?