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I’m considering to get a procedure done and was wondering if there are difference between FUE procedures or are they all about the same? What are some important questions to ask when deciding on a doctor besides ‘how long have you been doing this’?

FUEs vary between doctors because each doctor uses a different type of hand ‘punch’ and smaller ones (up to a limit), leave smaller, less detectable scars. The problem with FUE is that the number of grafts removed safely is absolutely related to the density of the hair in the back of the head. The higher the donor hair density, the more FUE grafts can be taken, while in a person with a low donor density (a typical Asian, Indian or middle easterner) might have a normal lower hair density than a typical Caucasian from Northern Europe. This rule also applied to the Hair Mass Index of the hair, the higher the index, the more FUE grafts can be safely removed. If a doctor takes too many hair grafts out, then you can get balding in the back and sides of your head from the FUE (see here: https://baldingblog.com/collection-victim-photos-internet-harvested-depleted-donor-areas/ ) which is something that the doctors don’t have to live with, you do. Worst, 90% of the people doing the FUEs in Turkey are not doctor so that certainly with an non-professional person doing your surgery may be VERY common in people receiving surgery in Turkey.

I was the person who pioneered the FUE in 2002 when I published the first paper and presented it at the first meeting all in the same month. I gave out 600 DVDs showing what an FUE looked like. Then, within a week, doctors from all over the world started doing it and doing it very poorly. My video was only 2 minutes long and it was not made to teach the doctors all of the nuances of the FUE. Even today, many doctors don’t understand it well. I, with my partner Dr. Pak, also invented the robot that does the FUE holding two patents for the technology. We licensed it to the company that made the ARTAS robot. Here is our original article that opened up the FUE business: https://newhair.com/wp-content/uploads/2018/11/mp-2002-fue.pdf

You must find a doctor who is skilled in the process and you can tell by asking to meet some of his patients and then look carefully at the donor area for the type of scarring that is evident (my link above shows it). Ask your doctor for his measurement of your original donor density and his assessment of how many grafts he believes you can support in your lifetime. Too many doctors take out too many grafts with FUE causing the problems I demonstrated above.

Good study; however, it was only the low intensity exercise group with a family history of AGA that saw an effect causing alopecia. The study was taken with participant cooperation and therefore required individual reporting, which has its limits. Thanks for following up and pointing me to this interesting study.

I am just 15 and i am male. About 3 years ago i got nits and bought some conditioner for it. My scalp reacted with it and i got dandruff. My peers teased me about my dandruff and i started frantically rubbing my hair to get rid of it. When i was 14 it turned into pulling hair from the very centre of my scalp. i didnt want to pull my hair and get bald but i had an urge and got satisfaction out of pulling. i have now got a small circle of baldness on my scalp and have managed to stop pulling from there but now im pulling from the back of my neck and behind my ears and it is thinning out there. I require help and advice and want to know:if i leave it will it grow back to normal?

This condition is called trichotillomania, which is an impulse disorder characterized by the urge of pulling out hair from scalp, eyelashes, eyebrows, beard, nose, pubic area, or any other area in the body. It is most often related to obsessive-compulsive disorders. Surgical treatments for hair restoration are usually not indicated, and the best treatment would be through psychotherapy and behavioral treatment. You should be seen and treated by a psychiatrist. If you can stop pulling hair, it will usually grow back in a few months with no further treatments, but if you have stopped pulling out your hair and the hair does not return, then transplants are a relatively fool proof way of handing it provided that you do not go back to pucking out the hair again and again.

Dr. Richard Shiell wrote the following about this disease: “By far the most common of patients with this disease are children of both sexes and as trichotillomania is an OCD, where stress seems to play a role, most of the kids just “grow out of it” with no lasting problems. Success rate very high (probably over 90 %)

Some do not grow out of it however and a small percentage of the females go on to be chronic pluckers. They associate the plucking with episodes of stress but I do not know if this has been verified scientifically. Most of the cases I see fall into this category and have plucked each hair so many times that the follicles in the patch cease to grow somewhere along the line. In other cases, not so long standing, the hair is short , vellus-like and snowy white in the plucked area. It is this group of women who acknowledge the plucking (past or present) and who are seeking help that you will have some success after transplantation. I cannot give you a figure for success as I have lost contact with all of these patients over the years. Psychologists tell me that medication will assist those members of this group who find it difficult to refrain from plucking.”

Been on Min (and Fin) for 7 months and have made some nice progress and got my hair to grow back on the crown and temples, but if I shave, is that like pressing the “restart” button? Do I have to wait another 7 months to gain what I have back?

No, shaving your head will not cause hair loss; however, miniaturized hairs which are not growing well, may not be growing when you let your hair grow back.

Dear Sir,

I moved into Hyderabad about an year back. They say that the water is hard here. I take bath with hot water daily, but not on scalp.

I had always had a dandruff problem and i applied nizoral, and the problem was in control. From about 7 months back, I am experiencing hair fall, about 15-20 strands each time I brush (even with a soft comb). There are dry scales on the hair. I have tried consulting doctors who say this may be due to psoraisis, and I am taking homeopathy medicines – psornium-200 daily, besides nizoral – 2 a week, 2 a week propysalic (a steroid having salicylic acid).

There is no signficant relief. Please advise if I should go for a trichoscan, if it helps.

I used to put coconut oil on my hair earlier, but not after moving to Hyderabad. Please advise…

If you are not washing your hair, you are probably building up considerable dead skin (what you are calling dandruff) and waxy debris. When you brush it, this debris may be anchored to the actual hair shafts. This will result in hair appearing in the brush — more hair than one might expect if you washed and used a hair conditioner for it. This would be the most likely cause of your hair loss. When you feel the ground shaking and see a herd of charging elephants coming your way, the first thing that should not come to your mind is an upcoming thunder storm.

Hi Dr. Rassman, I found this man’s photos with what looks to be a sharp NW2 or mature hairline at age 30, but he and others in the comments believe it will worsen and he’ll “get more bald without finasteride.” I’m asking because I’m 22 and can kind of see my hairline is starting to turn to this sharp shape. So if you had to guess without a haircheck test, what would you say? Mature hairline or MPB? Thanks

The balding pattern if each male is predetermined by genetics. The problem is second guessing it before it starts to become apparent. There is no guarantee that the picture of the man showed will eventually lead to balding. A good doctor building a Master Plan with him and using the tools of trichometry and the HAIRCHECK test might be able to tell before it becomes obvious. That is what I do.

I’m a 22 year old male and i have no medical problems that I know of so far, but i don’t have any hair on my legs. i am kind of ashamed to wear shorts and show my legs to others. is there anyway anyone can help me out?

It’s possible that when you get older some leg hair may appear, though if you haven’t developed it by 22 years old I would think the chances are pretty slim that it’ll start growing later. It is most likely genetics, though if you at one time had some hair on your legs it could be due to some underlying issue (diabetes or a thyroid condition) or even extremely tight fitting clothing.

If hair never grew on your legs at all, I’d look to your genes, in which case there is nothing that is 100% safe to do about this.