2017-09-19 05:30:452017-09-19 05:30:45The hair in the back of the head is not growing well after my FUE (photo)
Tightness in the Donor Area a Week After Hair Transplant
Hi,
Before writing to you i tried finding a similar case to my problem but i couldn’t. i have asked my doctor this question but i wanted another opinion to make sure that everything is going well. My question is that i have had my transplant (strip method) done a week ago, and i am feeling tightness in the donor area , where it feels a lot tighter to turn my neck and look at the left side than turning my neck to the right side, is this a normal feeling or should it feel equally tight on both sides? and if it is normal, how long will it take to be moving my neck normally and freely?
It is normal for the area behind the head (where the strip was taken) to feel tight. It may actually feel tighter than it is. When I (Dr. Rassman) had transplants, it felt tight in the donor area, but in a few weeks, it felt less tight and more mobile. Bending the head and turning it may be an indication of tightness, but in a few weeks, it should substantially lessen.
2009-08-11 10:33:382009-08-07 09:35:36Tightness in the Donor Area a Week After Hair Transplant
Hair Darkening taking Finasteride, Is This a Good Sign?
Yes, it is a good sign because miniaturized hairs don’t have the pigments that normal hair has. When the miniaturization is reversing, many people get some return of their original color.
2020-03-06 04:00:572020-03-06 09:42:36Hair Darkening taking Finasteride, Is This a Good Sign?
Tongkat Ali and Finasteride
Hi Doc,
Thank you for this site, it is a source of valuable info for a lot of people including me. Keep up the good work.My question is, can tongkat ali affect the effectiveness of finasteride (Proscar) in stopping hair loss? I read that tongkat ali is a natural testosterone enhancer and can benefit the person using it with stronger libido, sexual performance enhancer, and can promote good physical well being. Will it make the finasteride less effective? According to some research it has not found any baldness side effect for people using tongkat ali. Thank you and more power to your work.
I’ve got no experience with this herbal, also known as eurycoma longifolia, so I turned to the internet for some info. According to this page, tongkat ali requires DHT to boost the libido, and finasteride blocks DHT. Therefore, you should not take both at the same time if you want the tongkat ali to work and if what I read on that site is actually true.
I don’t know if it’ll make finasteride less effective, but it seems that the finasteride would make the tongkat ali ineffective.
2009-09-10 10:33:152009-09-04 11:49:23Tongkat Ali and Finasteride
Hair Graft And Incision Counting During A Hair Transplant Procedure
Hi Dr.Rassman,
I’d be very grateful if you could reply to the following questions:1. How do the technicians slivering the donor strip record the Follicular Units. Is this done as a running total on a sheet of paper for type 1, 2, 3 units? Is the total of these units then recorded?
2. How do the placers, placing the Follicular Units record the Incisions created. Is this similar to Q.1 above.
3. Is it true that each incision site created can only contain ONE Follicular Unit graft? Otherwise, more than one would be compressed, traumatized and die??
4.If the Incision count is LESS than the Grafts extracted from the donor strip, what would that indicate.
5. What would increase a hair transplant procedure between 2 patients having the same amount of grafts transplanted and the same number of medical staff in attendance? For example, if one of the patients had blond hair, would it be more difficult to see such grafts under a stereomicroscope?
I often get these type of questions asked in different ways. It is a very good question that also can be seen as a trust between doctor and patient. In other words, how do you know if you are receiving the number of grafts agreed up on (which relates to how much you paid for).
It is also a great question merely from purely a technical point of view of how one keeps track of thousands of grafts and incisions on one’s head.
I cannot speak for all the hair transplant doctors in the world as there is no standardization on how one keeps track of grafts. I will try to explain your question from a general perspective as well as what I personally have been doing in my practice for the last 23+ years.
1. Our staff keeps track of each graft dissected on a paper as they cut about 25 to 50 grafts at a time. They record and sort out single hair to multiple hair grafts individually as they dissect the grafts. A team leader then double checks the numbers as the day progress and add up the total number of grafts on a master sheet. Finally when all the grafts are dissected, another accounting in made on a computer Excel spread sheet. Usually we double check numbers with another staff individually adding up the numbers separately.
2. The placers do not keep track of the grafts being placed. Instead the doctor keeps track of how many incisions were made. If there was 1000 grafts cut, the doctor makes 1000 incisions and the placers have to find individual incisions to place the grafts. It sounds tedious and difficult but that is why the experience of a good staff and the reputation of a medical practice is important. This is one of the critical steps in the hair transplant surgery where this task need to be completed as fast and most efficiently as possible to accomplish a successful surgery. Longer this takes, your hair grafts may not grow to its full potential as it is kept out of your body and handled by an inexperienced staff trying to find the incision.
3. One incision usually has one graft. Sometimes where there is an over abundance of single grafts, the doctor instructs the staff to place two single hair grafts in one incision (or one single hair and one double hair grafts in the incision). If the staff is experienced there should be no issue with compression (we call it “piggybacking”) and trauma to the grafts. If the staff is inexperienced they may inadvertently place on graft on top of one another and cause trauma and poor growth. If the doctor is planning on “doubling” grafts he appropriately makes less incisions than the grafts that are being cut. He also makes the incision differently with a different needle to indicate to the staff where the double grafts should go. This a very subtle thing that has huge implications and requires a very well trained staff.
4. If the incision count is less than the grafts extracted, then more incisions have to be made. Or if the grafts are less than the incisions made then more grafts have to be harvested or you have to leave the incisions empty. Another subtle thing that takes coordination between staff and doctor.
5. Every patient is different even when the same number of grafts are planned (even with same colored hairs). In general curly hair and white hair is more challenging. Some patients have different textured scalp which cause the grafts to “pop” out and not stay in its place.
Topamax, Low-Ogestrel, and Female Hair Loss
I have been taking Topamax sprinkle capsules for my migraines for almost a year (onyl 45 mg per day). After the first few months on the drug, I noticed more hair on the floor in my bathroom and that it was falling out when I ran my fingers through it. In November of this year, I switched my birth control pills to Low Ogestrel,a low dosage monophasic pill so as to keep my hormone levels more stable and keep headaches at bay. After doing this, I noticed an increase in my hair loss. Now, in the shower, there is hair everywhere. Hair on my pillow, and hair on my clothes. I’ve noticed that my hair looks thin at my widows peak and on the sides of my head. It’s frightening. I got off the Topamax two weeks ago and the hair loss has continued. I am going off the birth control this month to see if that stops it.
Just wondering if you’ve ever heard of these drugs causing hair loss? Perhaps the combo of the two has wreaked havoc on my body for some reason? My doctors keep saying “It’s possible, but uncommon.” I’ve had all my bloodwork done and every checked out ok.. I just want this to stop. If it is the pills, how long before it will stop?
Thanks for any help!
Hair loss is associated with each and every one of the medications you use. I am sorry to report this to you, but these things have a cost in side effects and finding the balance can be difficult. Some people may be more sensitive than others. It may take months to see any regrowth after stopping or switching the medications. When medications are used in combination, it makes identifying the problem medication(s) more difficult.
2006-02-20 13:29:022006-02-20 12:43:47Topamax, Low-Ogestrel, and Female Hair Loss
Hair Lasers
I have seen ads all over the newspapers on hair lasers. What is the deal on them?
When you probe what these devices actually do, you often hear either unjustified claims (which are not legal from an FDA or FCC point of view) or that “studies are being done†and naming prominent people involved in these studies (as if to justify their premature endorsements). We never hear about the final results of negative studies! Reports from prominent doctors in my community tell me that they have seen a very high disappointed group of early adopters who participate in these modalities, but then again, my community of doctors are not experts in these lasers and they may have been negative from the start, not keeping an open mind. Some doctors, on the other hand, have become enthusiastic about them, but most of their observations are based upon subjective observations. A small number of people report some gain from the lasers and some segments of the European medical community seem to be enthusiastic for its value.
I personally believe that the literature I read does suggest that there is some stimulation to the vasculature of the scalp and that this impacts hair regrowth, but if so, then the question should become “, Growth? By How Much?â€. I really think we should wait for final results on hair growth with good scientific trials before the medical community endorses this modality. I am supportive, however, of all uses of this modality on an experimental basis. What concerns me is if a doctor focuses upon money-making add-ons with any less than proven value defined scientifically like questionable creams and potions (like having a large display of hair conditioners, shampoos, “scalp cleaners,†etc as a focus on their medical practice that claim to make the hair grow), then the objectivity of the doctor as a consumer advocate will be questionable when it comes to these modalities. Sorry to be such a curmudgeon, but I will have to wait until I see some convincing proof of value before endorsing such approaches for saving my patient’s hair.
Topical minoxiidl plus Finasteride (low dose) photo
The photos show a very early response in just 2 months. Most young men are in a rush to see the response to medications, but the real good results, if they occur, will come about well after 6 months.
Hair Loss After Hysterectomy
I’ve recently had a total hysterectomy at age 24. I’ve noticed that my hair has stopped growing. Is this something permanent or can something be done about it?
Stress and shock loss is something that we have discussed before in many posts in this blog. Almost any kind of stress can precipitate hair loss in some people. Women seem to be more impacted by stressful surgeries like hysterectomies, while men are more stressed by business, financial, or family problems rather than by surgeries. Any major surgery can cause shock loss and it is not limited to the scalp surgery. This is called telogen effluvium and is similar to what women experience after delivery of a baby.
2007-07-31 13:32:442007-07-31 13:32:47Hair Loss After Hysterectomy