I appreciate your helpfulness! Keep in mind a lot of this is performed on rodents and in vitro. However in 2015 there was a study on females that supplemented with fish oil and saw a significant positive impact with a sample size of 100+ if I recall correctly.
https://pubmed.ncbi.nlm.nih.gov/25573272/
I have quite a few more but they are quite dense in information but if you’re interested I can show you.
https://pubmed.ncbi.nlm.nih.gov/22440736/
https://pubmed.ncbi.nlm.nih.gov/14668211/
Hi Dr,
I’m a patient of Dr. Pak who came to the office in March. For the past year or so, I have been using a combo of OTC Nizoral and T-gel to combat an itchy scalp. I alternate between the two each day.
However, I can no longer find Nizoral anywhere — it’s gone from Amazon, drugstore.com and any physical pharmacy I’ve gone to. Any idea what happened? I can’t find any substantiated reason for the disappearance online. Also, in the absence of Nizoral, do you have a suggested replacement I could put in my routine?
Many thanks.
I haven’t followed the sales or availability of Nizoral (ketoconazole) shampoo. I’ve had a few readers ask about it, but I’ve not been able to find any news. I have no suggestion on a replacement shampoo. Have you contacted the manufacturer?
So I’ll open it up to the readers — have you read anything about why Nizoral has disappeared from shelves?
Firstly your site has done wonders to increase my knowledge. However, I first noticed losing my hair at the age of 27 in the crown. I am now 37 and the loss has increased dramatically all over, so much so that I am receding into my bald crown. My hair grows unevenly but now only hair on the top grows but at different lengths and rate. My receding hairline is now moving into the middle of my head which is now very thin. Miniturisation is throughout. I thought that this process would have slowed into my late thirties. Should this be the case or is this a very long balding process? In fact it has sped up over the last 18 months, Is this normal? Been on propecia 4 1/2 months with little effect. In my situation will propecia have some impact at all? Thank you very much
First of all, I would expect that you should see slowing of the balding process about now. The full value of Propecia takes a full year or so. We use general rules about balding and although most men slow down their balding process in their 30s, some don’t follow the doctor’s rules. Hair loss is a progressive process in most men, but fortunately it slows down to a ‘crawl’ by the time most men reach their 40s. You should be followed by a good doctor with yearly miniaturization studies. At the least, it will give you a good metric as to how you are doing. Good photography will also help define what is happening to you. You need to have a good dialog with a doctor who can work you through the process you are going through.
Did you invent/discover the strip method for hair transplants??
No, I did not invent the strip method in hair transplantation. I do not believe there was an official inventor of it. The surgical crowd moved somewhat together in the evolution of the strip, which was a neat solution to harvesting that became obvious.
When I was learning about the state-of-the-art donor harvesting, I saw some doctors use a large drill and attached from end to end the holes that were used to harvest the plugs. This caused an irregular wound of connected holes that were sewn together. Any reasonably good surgeon could have figured out that an irregular, sloppy wound would be better created by a controlled strip, and that is what the surgeons were evolving towards. So you see, there isn’t always an inventor.
I remember that there were few doing strips when I started doing hair transplants in 1991. Dr. Paul Straub demonstrated the method to me back then. I immediately went to the strip for harvesting, having never used a large drill as others were doing. A few doctors were already using this method, but the art at that time was still about establishing large grafts, not small ones. When I started doing the surgery, I began with small grafts… and made them smaller and smaller, which required more and more of them to get the amount of hair that would make a difference. This refined the look of the hair transplant as we know it today.
2011-02-18 15:02:232011-02-17 10:13:25Who Invented the Strip Method?
If I was to get a hair transplant but my hairloss progressed to the point I had to shave my head how visible would the scarring be at the back? Would I have visible white dots on the back of my head or do they fade
Scarring from FUE is inevitable; however, the amount of scar may not be enough to see it or make the donor area see-through. The scarring that you can see or the see-through donor area is the result of too many FUE grafts being harvested. If you think about the average donor supply having 12,000 follicular units (grafts in a surgical sense), then if you remove only 3000 of them, you are only removing 25% of the total donor supply. In a medium weight hair, that can be tolerated provided that the punch size used is not too large. But if you extract 6,000 FUE with FUE, then the numbers reduce by 50% and problems may arise, especially if your hair is fine in character.
i am 25 and i was just starting to loose hair(have a small bald spot in ‘U’ shape at the crown and can be covered easily) . My doc confirmed it as pattern baldness and asked me to use finasteride and minoxidil 5%. i dont want to get bald at any age. So,instead of loosing hair after 10 years or whenever hair loss beats propecia and getting hair transplant,why not let the hair loose now and get a HT,so that i can save the money on drugs for years. My doc said thats stupid.whats your opinion?
I think it is a bad idea to wait for all your hair to fall out and then have hair transplant. First, it may not all fall out. Second, you will become balder when you are younger and the medication may delay this for years. You have a limited amount of permanent hair that can be used for hair transplantation. The cost of the drug is much, much less than a hair transplant.
You don’t have to take my word for it — if anyone wants to give their 2 cents, please leave a comment below to let this writer know what you would do in his shoes.
2008-02-18 12:32:052008-02-13 10:35:35Why Bother With Taking Medication? Shouldn’t I Just Go Bald Enough for a Hair Transplant?
2020-04-06 14:06:172020-04-19 15:45:03How many grafts needed for my crown? (photo)
Dear Dr. Rassman
I hope you can help explain something to me regarding the treatment of hair loss with PRP. I was considering have a treatment of PRP + Acell but then read that one of the growth factors in PRP is TGF-B1 which has been claimed to be something that actually causes hair follicle death. Could you please explain to me how this growth factor supposedly helps when introduced to the scalp in PRP treatments? Is it somehow changed? or do the doctors using PRP not see it as harmful?
Thank you in advance for you answer and insight.
Regards
The use of platelet-rich plasma therapy (PRP) is a good way for a doctor to make money and probably not harm his patient. It’s the buzz du jour and is an excuse for some doctors to sell something extra. I’ve yet to see any satisfactory study that shows using PRP in a hair transplant has any value.
The NY Times wrote about PRP earlier this year — Does Platelet-Rich Plasma Therapy Really Work?.
2011-07-25 10:45:582011-07-22 13:50:42Why Do Doctors Think PRP is Helpful?
Good day Dr Rassman. Im about to start Dutasteride/avodart.. my question is. what type of Dosage would you recommend, could 0.5= a pill a day do the trick??? thanks in advance i really appreciate it
The dose for dutasteride for treating hair loss is not well understood, because the drug has a half life of 5 weeks. The long half life suggests that once a month dose would work, but the doctors who are using it tell me that 0.5mg per day is the right dose. This is the problem with this drug, as nobody knows the correct dose. When the FDA study in Korea is complete, we should have an idea how the dose response relationship works.
2007-05-10 11:36:422007-05-10 11:36:43How Much Dutasteride Should I Take?
I don’t know that I can really answer that. The human body does very well to adjust to small changes like what Finasteride does. We know, for example, that testosterone levels often rise with Finasteride, which is a body response to the drug. My son got an increased sex drive from his higher level of testosterone when he went on Finasteride.
