Category: Uncategorized

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Woman with Thinning Hair – She Wants to Know What to Do

This is exactly the type of hair loss I have, but I also have extreme total hairline recession and miniaturization. I first noticed the loss of nape hair, and thereafter loss of density and complete recession of every area of the hairline. I have miniaturization throughout my entire scalp, but the emphasis seems to be on the hairline and top of my head (especially that front area like this photo). I have tried Spironolactone 200mg, Cyproterone acetate 50mg, Diane35 birth control, 0.5mg Dutasteride, 5% topical Minoxidil, 2.5mg oral Minoxidil, microneedling, topical Estrogen, topical anti-androgens (RU58841, Darolutamide), every manner of oral supplement, iron infusions, sulfasalazine, and setipiprant. The list is endless. Nothing has stopped my hair loss or miniaturization. I have been diagnosed with hypogonadotropic hypogonadism as of 2015, but the hormone replacement therapy I am on addresses this issue. I have no other hormonal or autoimmune issues. I was diagnosed with androgenetic alopecia via scalp biopsy. It has been through my own research that I have come to understand that my hair loss is classed as retrograde with diffuse female pattern loss, or diffuse unpatterned alopecia. I frequent hair loss forums where a few others have this pattern, and we have all been non-responders to all treatments. I believe that there must be something more to this pattern than what we currently know.

You clearly have a difficult problem. There is a cosmetic treatment for thinning and hair loss for women; it is called Scalp Micropigmenmtation. This may be something worth considering to address what you look like. However, it will not fix the underlying problem.


2018-08-15 08:35:46Woman with Thinning Hair – She Wants to Know What to Do

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I Got a Haircut 18 Days After My Transplant and I Felt Pain

I’m 18 days post op and i just got a hair cut today. I asked the lady cutting my hair to be gently when she combed my hair, but for some reason she didn’t pay much attention to my request. She rubbing up against my recipient site several times, i definitely felt some pain. While i know grafts are generally anchored after 9 days because of your joint study with Dr. Bernstein, but is it possible my grafts were damaged internally?

You may still have some tenderness, but I do not think you have anything to worry about that far out from your surgery. Shame on your stylist for not listening to you!


2011-12-13 11:56:53I Got a Haircut 18 Days After My Transplant and I Felt Pain

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Women Using Rogaine Foam for Men?

I recently bought Rogaine Foam for men, because I wanted foam. When I got it home and thouroughly read it, it said not for women. I can’t find foam for women. My question is, is there any health side effects from the active ingred.and can women use the foam for men. My beautician told me she heard about good results with the foam.

Thank you.

Rogaine FoamIf you are a woman losing hair, you can use Rogaine Foam (even though it says “for men”). In fact, I generally inform my female patients that they can use the “for men” brand. The only difference I have found is the “blue” vs “pink” color in the packaging and the concentration of the minoxidil. The “for men” stuff is usually 5% and the “for women” is 2%, though women can use the 5%.

The higher the concentration, the more of a potential for unwanted facial hair growth in some women. That being said, if you are a women that wants to use Rogaine Foam, that doesn’t mean the foam will guarantee you wake up with a moustache and beard. Just something you should watch for.


2008-09-12 09:28:03Women Using Rogaine Foam for Men?

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I had a beard transplant 5 days ago. I am concerned that my herpes is acting up on my recipient scabbing area?

At 5 days, you have far too many crusts on your beard. What you are seeing is probably the crusting not the Herpes. You should nevertheless start taking your acyclovir because wounds like this tend to bring on the Herpes, possibly in the recipient wounds themselves.Many doctors would have put you on the acyclovir just for having a beard and mustache hair transplant. You need proper washing of your crusts to get them off. See your doctor as you shouldn’t look like this at 5 days, it is poor post-operative management.


2020-08-23 16:07:21I had a beard transplant 5 days ago. I am concerned that my herpes is acting up on my recipient scabbing area?

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Worst Case Progression from Propecia-Only?

From your practice, what is the worst progression of balding that you have seen with someone taking only Propecia and not anything else like Minoxidil? Like what Norwood was he before and after and how long was he taking it and how old was he?

I routinely prescribe finasteride for all balding men, so progression is not evident as the process slows down considerably. In the days when Propecia was not available, the balding process was very evident in a matter of a few years, but now when Propecia is used, I just have not seen the radical changes in balding patterns.

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I had a forehead reduction surgery and thinned out the side hairline (Photo)

Sometimes when a woman has a forehead reduction surgery, or even a face lift, they could develop thinning of the hair on the corners and/or the sides of the hairline. If this is a recent surgery, I would wait a full eight months to see if the hair comes back. Shock loss in women is often reversible on its own. If it does not get better in a year, this area can then be transplanted to make it thick again.


2017-08-09 08:37:23I had a forehead reduction surgery and thinned out the side hairline (Photo)

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Would Propecia Prevent a Teenager from Growing Facial Hair?

Hello Doctor. I was wondering as Propecia affects male hormones, would taking the medication when you are 18 prevent anything such as facial hair growing and other changes that happen as you grow older?

DHT is partly responsible for growing beard hair and blocking DHT might slow it down. For boys younger than 18, it is not recommended.

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I have a scar from my hair transplant (photo)

I have a scar from my hair transplant, why did it happen, did my doctor do something wrong and what can I do about it? (photo)

You had a strip surgery and clearly scarred worse than many people do. I had three surgeries in the same place and have no significant visible scar. It is not that I had a better surgeon, I just healed better than you did. I am sure your surgeon did the surgery right. The best way to deal with the scar is to have scalp micropigmentation which covers up the scar nicely. Your picture is on the left, a worst case scar is shown on the right before and after scalp micropigmentation (https://scalpmicropigmentation.com/). There is hope!


2020-07-13 08:17:32I have a scar from my hair transplant (photo)

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Xanax and Hair Loss?

I am a 33 year old male and am convinced that I am losing my hair at the front of my head. I have thick hair, but it is certainly thinner, i.e. I seem to have less hairs per square cm. I can also see my scalp at the front, which I could not around 1 year ago. When I comb my hair, or wash it I notice hair in my hands or in the comb. I would say that the number of hairs is around 5 or 6. This is also something pretty new to me. What I would like to know is, am i going bald and how can I determine the rate? Also I take Xanax in small doses and what like to know if this has an effect. Would Rogaine help for frontal hair loss?Finally, how long should I wait before I have a hair transplant. I don’t want to go bald before I do. Thanks.

Xanax can cause hair loss, but I would think that if you are thinner in the frontal area, then you may be having genetic male patterned hair loss. As I have said many times in this blog, a diagnosis includes an examination for miniaturization, which would be evaluated throughout the head to determine what your genetic pattern might be. At 33 years old, your pattern should be evident when your scalp hair is mapped out. I am ingorning your 6 hairs per day loss as that is low and probably a wrong estimate, but the thinning of the hair in the front is more of a concern for me. If you have male pattern balding, the hair in the front will be heavily miniaturized and will show up nicely on magnification imaging. If that is the correct assessment, then Propecia may help slow or stop the hair loss.