Category: Uncategorized

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What happens to DHT with age?

Been balding since 2014. The type of balding I have is related to DHT. What happened to my scalp from 2014 to now? Did my body produce more DHT? Or am I producing the same amounts of DHT as before, but something that used to use DHT is lowered? If it increased, then theoretically, fin and all should have no negative effect on me, and I should be like pre 2014.

DHT often goes down slowly with age because it is the product of testosterone metabolism and the older you get the less testosterone you produce, hence less DHT. Balding works off of a genetic clock, so you don’t need a rise in DHT to allow the clock to kick in when the time comes (genetically speaking). Get professional advice from a good hair doctor.

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Higher Sex Drive from Finasteride Leading to Increased Masturbation

Dear Dr. Rassman,
I am taking finasteride for my hair and it’s working well on me. I am 23 years old. But my problem is i am having higher sex drive than before and also having increased number of masterbation. What can i do? My question is does increase in sex drive and thus increasing the number of masterbation affect the effectiveness of finasteride? If testosterone is increased by finasteride, does it affect the effectiveness of testosterone? My last question is people say masterbation is related with hair loss. If it were true then now in the world every healthy mature married men would be bald, isn’t it Dr.?

It is true that Propecia (finasteride 1mg) can cause an increase in your sex drive, but just as I always caution men who have a decrease in sex drive, do not be so quick to blame the drug. Young men in their early 20’s naturally have a high sex drive. It is normal to masturbate.

Does masturbation cause hair loss? No!!! Once again… masturbation does not cause hair loss! Your hair loss is likely caused by your genetics.


2008-10-03 11:38:16Higher Sex Drive from Finasteride Leading to Increased Masturbation

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What if Prince William Had a Hair Transplant?

Is it possible for Prince William to have a hair transplant, and reach his father’s level of baldness ? Having a similar pattern of baldness I felt sorry for Prince William during his wedding. I believe his hair loss made him less attractive. In fact, my sister even said that Prince Harry is more attractive now. I can say the credit goes to the fullness of hair. Would a frontal coverage for that type of hair loss would be good in the long run. How would you apply a master plan toward a case like this ?

Prince WilliamBased on pictures alone, Prince William would likely be a great candidate for a hair transplant. We have treated many men with even more hair loss than he shows.

Here’s an open letter to the royal:

    Dear Prince William,

    It would be an honor if you would consider having NHI establish a Master Plan for your hair loss. If a hair transplant surgery could meet your goals, please consider us when choosing your doctors.

    Thank you and best regards!

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Hormones after 18 months on finasteride & dutasteride

Added dutasteride after 6 months on finasteride. It’s total 18 months now.

Bloodwork results :

Testosterone Total – 584 (249 – 836)

Testosterone Free – 19.2 (8.8 – 27)

Estradiol E2 – 13 (11.6 – 41.2)

DHT – 389.2 (250 – 990)

DHT is still in normal range. I thought combination of fin and dut would crush DHT to undetectable levels.

Hair is still the same(no regrowth though).

Why are my hormone levels all normal?

You are having a normal response. That is the reason I don’t get blood tests as it has nothing really to do with the impact of finasteride that you can expect to see.

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What Is Happening to My Face?!

In the past year or so I’ve slowly lost my facial hair. First it started with a small patch then grew bigger. My wife looked up what could this be from and came to he conclusion ring worm. But at the time I had no round red ring on my face. Interesting though the very next morning I woke up to a very obvious red ring on my face. I bought lotriman and applied to my face as more then recommended. Then my skin was dry and red and then the baldness spread to my neck. I started seeing a dermatologist at this point 8 months ago and she prescribed cortisone cream and cortisone shots. Nothing and spread to other side of face. I’m not seeing her anymore and I don’t know what to do. It is very embarressing! Now on the opposite side of my face I have another suspicious red round mark with itching and dryness. Please help! Any, Any thoughts on why this is happening to my face?

You need to see a dermatologist. As you hopefully know, dermatology is a specialty and the doctors trained in this field are more familiar with this type of presentation than I am. Emailing a surgical doctor 3000 miles from you, unfortunately, is not in your best interests.

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How Can I Be Assured That Treatment Will Work For Me?

I am 23 years of age and have a bald area in the front portion of my head. Many doctors who i have consulted told me that i have class 4 hair loss and can’t be treated by drugs. This may be true somehow because my hair started falling out from the age of 17 and i didn’t take a treatment then. Can you assure me that if i get treatment now, my problem will get resolved?

“In this world nothing can be said to be certain, except death and taxes.” – Benjamin Franklin

I can stop here with the answer, but if you’re not satisfied please read on:

I can not assure you that a medication will work for your hair loss. In fact, no one can assure you that any drug treatment will work. You stated that you were seen by “many doctors”, which I assume included an examination, and were still told that your hair loss couldn’t be treated with medication, yet you wrote to ask for my opinion. I suspect what the doctors were saying in ‘doctor speak’ is that Propecia usually does not regrow frontal hair so a Class 4A balding pattern (where all of the hair in the front is gone), I suspect the hair will not regrow. In a 23 year old (without seeing pictures of your balding) I would assume that there is still some hair in the frontal distribution and that what hair is there is miniaturized. Miniaturized hair will often respond to Propecia to some degree in a young man, even if it is in the frontal area. Unless you try, you will not know.

I suppose I should be flattered to be thought of as a hair loss authority to give you assurance on a medication. If your scalp has been examined for miniaturization and you have a diagnosis of Male Pattern Baldness (MPB), medication such as finasteride (Propecia) may work, but there are no guarantees.

If you need another medical opinion, feel free to make an appointment with me.


2006-03-28 09:05:38How Can I Be Assured That Treatment Will Work For Me?

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What is the difference between hairline advancement vs hair transplant lowering surgery?

Hairline lowering procedures come in two types (1) a hairline advancement surgery (a good surgery for women but generally not men) and (2) a hairline lowering hair transplant surgery. When women have corner recession as many men do, then a hairline advancement surgery is not as good as a hair transplant lowering surgery. As this surgery could leave a scar in the front of the hairline, men who recede shouldn’t have it because their hairline could go back and leave the scar exposed requiring a hair transplant to cover it. Be careful, as some surgeon promote what they know not what may be good for you. Here are some examples of a hair transplant hairline lowering surgery:

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How Can Shock Loss Be Avoided If You Transplant Into a Thinning Area?

Doctor, I just watched a video of a transplant and I don’t see how you avoid shock loss or at least loss to hairs in the recipient area when filling in a thinning area as opposed to a bald area. Propecia or not, that’s a lot of trauma. There has to be some TE going on there. Maybe you have techniques that can minimize it but I have to believe you can’t avoid it. And you’re going to lose some nearby hair after a procedure.

Again I’m talking about a thinning area not bald. Maybe 30% or more of original hair left. You say it doesn’t happen much anymore because of Propecia, From what I just watched just doesn’t seem possible to me. it would certainly seem it would accelerate loss to any hairs that are miniaturized or about to be.

I speak from my experience over 23 years. In the days before Propecia, when we did a hair transplant, almost every patient developed some degree of shock loss. It was so common that I always told the patient to expect it, and that if it happened (which it usually did) we might have to do another transplant just to address the shock loss. I often increased the number of grafts just to address this possibility.

When Propecia came on the market and many patients who eventually asked to have a transplant after the drug failed to meet their expectations, I noticed quickly that the shock loss problem was far less frequent that on those patients not on the drug. Although I never reported this in a medical journal publication, it was not just my own experience, but the experience of many other doctors as well.

Hair loss following a hair transplant procedure is most often in the hairs that are miniaturized, or at the end of their normal life span. These hairs, I suspect, are far more sensitive to the trauma of the anesthetics and/or the surgery. The use of finasteride (Propecia) is not foolproof for preventing shock loss, but it is darn good.

As we don’t really see the hair loss and/or miniaturized hairs in the parts of the scalp that doesn’t look like there is balding present, even since I have been performing bulk analysis of the hair, I know now with absolute certainty what I suspected for many years — in many men, 50% of the hair that may be in a miniaturized state to some degree is where the shock loss occurs. I call this clinical observation by a questioning mind, like mine.

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What is the role of the surgeon in a hair transplant?

Because the actual work takes often many people, the work load is distributed to technicians; however, the doctor must do the following: (1) give the anesthetic, (2) do all of the surgical planning including the design and distribution of the grafts, (3) make determinations on the size of the strip (if a strip surgery is one) or the instruments that are appropriate if FUE is done, (4) Perform the strip surgery or the FUE which includes the extraction of either the strip or the FUE coring component, (5) Orchestrate the individual’s roles, control quality of graft management among the staff who prepare the grafts and may insert them into sites made by the surgeon (site making must be done by the surgeon)?


2019-03-27 09:48:23What is the role of the surgeon in a hair transplant?

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How do I remove scabs from a Hair Transplant?

Use a surgical sponge without soap, then dip it into a shampoo solution and make a lot of suds. With the sponge full of soapy shampoo, roll if back to forward on the grafts. Press on the sponge. Little squirts will come from the holes in the sponge and take off all scabs. Repeat it until it is clean. If any scabs remain, then get a Q-tip, dip it into the shampoo water and roll in over residual crusts over and over again until takes off the last of the scabs. Repeat this daily to keep the scabs off. You will look clean of scabs if you follow this routine. Read my article on graft anchoring here: https://newhair.com/wp-content/uploads/2018/11/mp-2006-graft-anchoring.pdf

This is what you should look like:


2021-10-10 10:01:34How do I remove scabs from a Hair Transplant?