Category: Uncategorized

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Do You Think Propecia Will Be Available Over the Counter?

Do you think Propecia will ever be available over the counter, without a prescription? Isn’t that the next logical step now that finasteride 1mg is for sale as a generic?

I mean Rogaine is readily available at most pharmacies and even in the supermarket, and many other OTC medications have much higher risks of side effects than Propecia does. Thoughts?

I doubt Propecia will be available over the counter. It is a medication that really needs to be prescribed by a physician. It is only meant for the treatment of a specific kind of hair loss (androgenic alopecia) and may not be good for some women. There are many medications that remain prescription only, even though a generic is available.

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Where do you put the hairline when you transplant an older man?

There is something called a normal hairline. Some doctors think that putting the hairline high, reflects the age of the patient. I, on the other hand, believe that the reason a person does a hair transplant is to get back his youthful look. There are many men who develop a mature hairlines so as a surgeon, that is what I build when I put back the hairline. Hairlines were defined in an article I wrote which you csn read here: https://newhair.com//pdf/2015/phenotype-article-published.pdf


2017-12-15 05:03:25Where do you put the hairline when you transplant an older man?

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Question about transplanted hairs vs normal hairs

Do transplanted hairs experience the same growth cycle (telogen to anagen) as native hairs? I’ve had two hair transplants several years ago and find that I occasionally shed transplanted hairs (marked by thicker, darker, healthier looking strands). Is this cause for concern and will they re-grow to the same thickness?
I believe that they have the same cycle although no one that I know of ever studied it. They usually are the same thickness as the donor hair


2017-12-27 17:32:43Question about transplanted hairs vs normal hairs

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Doctors can be ignorant about balding and its treatment

My uncles and father are doctors. Every one tells me that taking Finasteride is idiotic. They believe this because the drug ‘messes’ with hormones without very good reason. They believe that the only doctors that seem to think it’s “safe” are the doctors that stand to gain from prescribing it. What do I do?

Love to hear this. If you are old enough to make your own decisions, than do what your research tells you. Ignorance can’t be excused by education so even doctors don’t really understand the pain of balding and the value of both the drug and surgery treatments for balding.

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Rapid Hair Loss at 22

I’m a 22-year-old male who has experienced mass hair shed recently. It started in June and has lasted until now. Aside from seeing around 100 hairs in the shower regularly, and having my hair fall out easily when styling, I notice that it doesn’t have the same poof in the front that I usually style it with. I’ve also noticed that it is much flatter when wet, and more fluffy and light when its dry. Although the amount of hair shed is tapering down, my hair has not regained its natural shape. Hairs have fallen diffusely, but I’ve noticed it more on the top and front of my head. Every hair that falls is thick, and there’s been absolutely no temple recession. I’ve seen 1 GP, 1 derm on 2 different occasions with 2 months in between, and 1 hair transplant surgeon who have all definitely stated there is no miniaturization on my scalp and diagnosed me with Telogen Effluvium. I’ve been waiting for my hair to regain its density, although I know it is not back yet. My dad has a full head of hair at a NW2, my brother has a juvenile hairline at 28, my paternal grandpa had a NW 3 when he died at 85, and my maternal grandpa has a NW7 at the age of 90 (stated balding late 30’s). My questions is: how long until I am back to normal? You may be concerned with MPB in this situation, and so was I at first, but each diagnosis I was given stated that it is 100% not that.

In men, most of the time the hair loss it is genetic, not telogen effluvium. Men’s don’t have to show miniaturization. They still can shed from genetic hair loss. We don’t know why. Be prepared for the worst case. At 22, consider the drug Finasteride as an approach worth discussing with your doctor.


2018-06-22 08:56:53Rapid Hair Loss at 22

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Does a Hairline Shift When Closing a Strip Procedure?

Hi, doc. I’ve been researching hair-transplantation, and I have a question concerning F.U.T. (strip-harvesting): I understand, in this method, a strip is excised from the back of the scalp, the wound then closed. I wonder, then, is not the overall surface of the scalp reduced in this procedure? After two or three procedures, especially, (or even after one large session) — when, totally, a reasonably wide portion of the scalp has been removed, will not a patient’s hairline, in accordance, also be shifted?

That is, the front hairline would move back by the amount of scalp excised, or, more likely, the “rear hairline” (which ends at the back of the neck) must certainly be “moved upward.” At least, this is how I imagine it would be. Is my logic flawed? I’ve been trying to understand this in researching the procedure, but the point still evades me.

I understand a physician will take into consideration laxity of the scalp, so what I’m talking about might not be immediately noticed — I also hear doctors will try to cut out strips that are longer rather than wider, to reduce tension — but, ultimately (again, especially when a large number of grafts must be harvested), will not the hairlines (front and certainly rear) be affected? If not, why not? If so, is this effect permanent? The piece of scalp taken out can’t “regenerate,” can it (and, if it could, would it regenerate hair follicles, too)?

Sorry for this long question, but certainly I’d appreciate your taking the time to answer. Thank you very much.

P.S. Just one other question (a brief one): Can hair that’s already been transplanted to a new location be removed and successfully retransplanted in another area (e.g., back to front, then, later, if need be, north of that region)?

The hairline never shifts, but the scalp itself does stretch a little with each procedure so that the donor density reduces a bit. I’ve answered a similar question before.

Neither the front hairline nor the neck hair moves as a result of these excised areas. The only part of the scalp that is impacted is either the posterior scalp (which would be stretched) or in a small group of these patients, the redundancy of the scalp (scalp laxity) reduces. The scalp is attached to the galea and then to the skull. This keeps the movement from one area to another minimal, if at all. Scalp and follicles can’t regenerate.

As for your P.S. — Yes, we often move previously transplanted hair when the work is not good, but there are limitations to moving a great deal of transplanted hair. This is commonly done in repair procedures.

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Reader Doesn’t Think ACell Will Work

I don’t believe that A-Cell will work. Is there actually any proper evidence of this technology working anywhere? It seems to be just that guy with the finger which I am unsure whether has been exagerrated/fabricated. Other than this it feels like all hype.

Also, it seems like when you pluck these hairs, you have to take out so much of the hair that logically thinking I’m not even sure if they will grow back the same thickness (if at all). Now I know people will come back with how they wax their legs, chest, arms or even their head regularly and they always grow back, but I seriously doubt that when a normal person plucks/waxes, they are extracting the amount of tissue required to perform the A-Cell procedure.

In addition, Jerry Cooley states in his presentation on one slide: “you can see the thicker FUE grafts vs the thinner plucked hairs” – so this really isn’t what it is being hyped up to be?

This unfortunately to me feels like just another method of doing a standard hair transplant. Maybe it will infact become the common way as it appears to allow it to be done without any scaring at all, but right now it looks like you would actually be worse off using A-Cell method over current methods, as the hairs at the donor and recipient region will grow back thinner, that is if they grow back at all.

I don’t know of Dr Cooley’s reputation, but from watching his presentation this just doesn’t seem that impressive. The only way it might work is using beard hair that thinned out during the process and ended up like scalp hair, but even then if this worked perfectly is it really a cure? You can’t do whole units and can you control the direction?

Perhaps you are right, but in the spirit of scientific research we have to try. That is one reason why we are trying to conduct formal IRB approved clinical research. It will either prove or disprove the concept.

The hope is that the plucking approach will yield more hair than moving the hairs around with traditional transplantation. The fact is that not only us (NHI), but the entire hair transplant surgeon community needs to be able to replicate this technique to stand up to the test.


2010-12-10 09:08:40Reader Doesn’t Think ACell Will Work

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Does Body Hair Relate to MPB?

Hi Doc!

Does male body hair, like chest hair and/or back hair, have anything in common with MPB? In other words, have you ever seen a bald/balding person without this kind of male body hair? (assuming he is not shaved)

I also wonder if a maturing hairline should be as thick as a juvenile hairline, or if it is common that it is a little bit thinner at the very front of the hairline.

I would really appreciate your expertise on these matters.

It seems at times that the bald men have bodies covered in hair, somewhat like a gorilla, but it is simply not the case. There is no connection between body hair and the loss of head hair, except to state that those with lots of body hair probably have good testosterone production.

The maturing hairline is as thick as the juvenile hairline, as long as there is no genetic hair loss in the actual hairline (no miniaturization). Sometimes, the mature hairline is thinner (at least it seems that way to me as I look at my mature hairline), but that is just a feeling. No facts on that subject to back up my ‘feelings’.


2007-01-29 13:49:41Does Body Hair Relate to MPB?

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Recent Article Comparing Drug Results for Hair Loss

February 2, 2022

Relative Efficacy of Minoxidil and the 5-? Reductase Inhibitors in Androgenetic Alopecia Treatment of Male PatientsA Network Meta-analysis

Aditya K. Gupta, MD, PhD1,2; Maanasa Venkataraman, MSc1; Mesbah Talukder, PhD1; et alMary A. Bamimore, PhD1
Author Affiliations
JAMA Dermatol. Published online February 2, 2022. doi:10.1001/jamadermatol.2021.5743

Key PointsQuestion For male androgenetic alopecia, what is the relative efficacy of monotherapy with orally and topically administered minoxidil, dutasteride, and finasteride?

Findings In this network meta-analysis of 23 trials, the rank of efficacy across treatments and the relative efficacy for every possible pairwise comparison of treatments were determined for 4 end points (ie, change in total and terminal hair count after 24 and 48 weeks). The results of this meta-analysis indicate that 0.5 mg/d of oral dutasteride has the highest probability of being the most efficacious treatment, followed by these agents in decreasing order of efficacy: 5 mg/d of oral finasteride, 5 mg/d of oral minoxidil, 1 mg/d of oral finasteride, 5% topical minoxidil, 2% topical minoxidil, and 0.25 mg/d of oral minoxidil.

Meaning The findings of this meta-analysis contribute to the comparative effectiveness literature for AGA therapies with regard to the compared interventions.

Dr. Rassman’s Concern: Dutasteride has a half life of 5-6 weeks so daily dosing at 0.5mgs make little sense to me. Blood levels and other organ impact at this dose building up over time, have not been analyzed or published.

Dermatology News Wrote: Here are comments and an analysis of this article which our readers may find significant: https://www.mdedge.com/dermatology/article/251693/hair-nails/male-alopecia-agents-ranked-efficacy-meta-analysis