Category: Uncategorized

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Possible to Change the Angle of Hair Grafts?

Hey Dr. Rassman,

Appreciate all you do on the blog as well as answering my questions in the past. I had a less than desirable result from a HT procedure to say the least. Make a long story short, if I ever need to get one again, which I will since I have small gaps on my head still, I will be visiting your office before.

The grafts that did grow, which was on the low side, are coming in at all different angles and growing in different directions than both the other grafts and of my current hair. When I mentioned this to my doctor and the dissatisfaction of my results, he mentioned that it might be possible to change the angle of the grafts with a new tool? Is this possible to your knowledge? If not, is there anything I can do or this is just the way my grafts will grow forever? Also, do you ever have any open houses in the New York area?

Thanks so much.

It is unfortunate that your grafts were placed at poor angles and your results are questionable. Your story of a bad procedure result illustrates the fact that hair transplant is for LIFE and you should do your research of the doctors and see their work first hand before going ahead with the surgery.

There is no tool or technique that will change the direction of your hair. I suppose you can individually excise them one by one and try to re-implant them, but that could potentially cause more damage, trauma, scarring, and failure to grow. Plus why would you place more trust and risk a poor outcome from the same doctor who already put the hairs in the wrong angle? You are a brave man!

I don’t have offices on the east coast any more, but Dr. Bernstein does have open houses in his NY office.

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Density and Scalp Laxity

In an earlier entry, you were asked to talk about the ability to expand the lower donor scalp. Could you tell me more about why this is important.

The ability to move hair from the permanent zone around the side and back of the head to areas where it may be needed are dependent upon two factors, which are:

  • the density of the hair in the donor area. The normal density measures 1250 hairs per square inch. The more the density, the more is the movable hair
  • the number of square inches of scalp that can be moved depends upon the looseness of the scalp (something we call Scalp Laxity). The more square inches we can safely move, the more hair we can transplant

The ability to move more square inches of scalp with a strip excision also depends on the ability of the surgical team to place them safely into the area of need. Of course, it is important that the need for hair reflects the size of the bald area. For small bald areas, either less hair is needed or more density is needed. The ability for an experienced and skillful surgical team to place the highest density into the recipient area safely is core to the results that one can expect after a hair transplant. This varies between doctors offices and that is why the wide offerings are promoted on the internet. Some physician teams promote 5000 grafts in a single session in a fairly bald person, while other state that a lesser number is the only safe number. The safe number varies with the skills of the surgical team and nothing else.

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Post by Reader: Benadryl and Hair loss – from FDA reports

Hair loss is found among people who take Benadryl, especially for people who are female, 60+ old , have been taking the drug for < 1 month, also take medication Tylenol, and have Breast cancer female. This study is created by eHealthMe based on reports of 51,573 people who have side effects when taking Benadryl from FDA, and is updated regularly.

How to use this study: bring a copy to your health teams to ensure drug risks and benefits are fully discussed and understood.

Who is eHealthMe: we are a data analysis company who specializes in health care industry. Our original studies have been referenced on 500+ peer-reviewed medical publications, including The Lancet, Mayo Clinic Proceedings, and EANO. On eHealthMe, you can research drugs and monitor them (see testimonials). If you find eHealthMe useful, please help us to spread the words below or leave us a testimonial.

A Second Comment: WOW, I have been dealing with extreme hair loss for the last 3 years. I have a third of my hair. thyroid tests etc come back fine. Looked this up on a hunch. And see all these! I hope not too much of the hair loss is permanent but I am afraid that it is. Stopping nighttime benedryl immediately.

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A Dermatologist Just Looked at Me and Told Me I Had MPB. Is It That Easy to Make This Diagnosis?

Well, my dermatologist just looked at my hair and said I have androgenic alopecia. The thing which is troubling me is that she didn’t take any tests. And again, I don’t have a family history of hair loss. So I don’t know why I’m suffering from mbp.

See another doctor who specializes in hair loss. You can find them on the ISHRS.org website. I would look to find a local doctor from that site. You need a real examination and don’t need to live in fear.


2018-05-17 08:08:44A Dermatologist Just Looked at Me and Told Me I Had MPB. Is It That Easy to Make This Diagnosis?

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Prescription Holiday to Turn Side Effects Off?

Question re Propecia and Sperm Count. I take Flomax and Finasteride. Side effects are reduced libido and ejaculation. I noticed if I discontinue taking the pills, I regain libido and ejaculation volume in 3 – 4 days, although I had only been on these pills for three weeks. My question is, can I periodically take a “prescription holiday” and then resume medication after, say a week without risk of return of BPH? I.E. will the long term benefits of this prescription program remain in effect if I take periodic holidays?

I am not a urologist, but I suspect that when the “flow problem” has resolved, you might be able to stop if for a week, but I would first check with your prescribing doctor for a more definitive answer.

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DHT and High Cholesterol

I am a 36-year-old male noticing some hair loss. I thought it was related to having taken prohormones, but the slow hair loss has continued after more than a year off the prohormones. I am considering taking Avodart/dutasteride, but not just for the cosmetic hair loss. A concern I have is the relation between MPB to increased risk of heart disease. Thus, my two questions:

  1. Do you know of any connection between DHT and high cholesterol/heart disease? And if there is a connection, would DHT suppression also contribute a health benefit above and beyond the cosmetic issue of MPB?
  2. Do you have any suggestions for any OTC or prescription drugs/remedies that would work to help curb the aromatization of the increased testosterone from taking a DHT inhibitor?
  1. I do not believe that using DHT blockers like Propecia will have any effect on your cholesterol. We know that Propecia will reduce the risk of prostate cancer.
  2. With regard to your second question, I am not an expert on OTC medications that curb aromatization from increased testosterone.


2007-07-25 10:33:56DHT and High Cholesterol

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My previous FUT surgery failed, should I do FUE now? I am a female.

I think that you are focusing on the wrong issue. First, you want to make sure that you don’t have some condition that will kill off your hair like Frontal Fibrosing Alopecia or related entities. Assuming that you do not, and you said you were disappointed with the results of your last surgery as some of the grafts failed to grow, it may be likely that the problem was with the surgical team (including the surgeon who is captain of the ship). Both FUE and FUT in the hands of experienced and well disciplined surgeons and teams, work reliably. As a female, an FUT is a better option for two reasons (1) you don’t have to shave the back of your head and (2) you had on FUT before so the surgeon can work in the same place and if there is a scar there, the surgeon can remove it at the time of the next surgery. This time get the right surgeon to do the right job, with FUT or if you are willing to shave the back of your head, then FUE works well.


2019-05-10 08:35:08My previous FUT surgery failed, should I do FUE now? I am a female.

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Did Mel Gibson Have a Hair Transplant?

The value of posts such as this on the BaldingBlog are to show the difficulty in detecting modern hair transplants. In my day, when advertisements focused on blondes, the saying was, “Does she or doesn’t she? Only her hair dresser knows for sure.” This would be the case for people who have had hair transplants today. I might take that old ad and change it to ask, “Does he or doesn’t he have a hair transplant? Only his hair transplant surgeon would know for sure!”

This article about Mel Gibson’s possible hair transplant is about 6 or 7 weeks old now, but it is nonetheless interesting (at least to me).

The photo caption states that the below photo on the left is Mel from 2 years ago, and the photo on the right is from today (or July, when the article was published).

(photo: DailyMail.co.uk)

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Prolactinoma and Hair Loss?

Hi Dr Rassman,

Im looking for a bit of advice, i think i have been fooling myself into believing i was going bald genetically and that my hairloss was due to Seb Derm/Inflammation and Traction loss. I believe some of it has been caused by my scalp picking and itching, but i have noticed i am starting now to recede and have lost hair diffusely through the top and also on the sides of my head.

I have been diagnosed lately with a Prolactinoma and low Testosterone so dont know how much that could be affecting my loss if any ? if im just going bald DUPA what would be youre recommendation for halting and regrowth, and would it conflict with my Cabergoline im using to shrink my Pituatory Tumor ?

Thanks

You’ve got a lot going on. The excess production of the hormone prolactin can possibly cause hair loss, but I do not have a lot of experience in this area. I can’t give recommendations for you, as I don’t have enough information and you’re under the care of a doctor that you should be getting your info from. Cabergoline doesn’t list hair loss as a side effect, and I’ve written about a similar problem before here.

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Did Surgeries from My Fibrous Dysplasia Cause Hair Loss?

Dear Dr Rassman:

I’m a 27 year old who has long suffered from Fibrous Dysplasia (I’m not sure if you are familiar with this disease). Due to my ailment, I have incurred over 30 medical surgeries over my lifetime. My hair was thick up untl high school, and then it really began to thin. The only ancestors of mine that have been bald were only two of my great-grandfathers. I was wondering if all of the major surgery I have had would have caused my hair loss. Also, I have been on propecia since November of last year and am having some back surgery next week. Would the shock of surgery or the medications used cause my hair loss to increase? Also, because I may be missing a couple of days of propecia doses would this affect the progress of the drug in combating my hair loss?

I’m familiar with fibrous dysplasia (it is a very rare bone disease), but I do not know what surgery you have had or what medications you take. Your question is very general and it is not something I can give you an answer to in this format. You need to see a physician and have a complete history and examination.

In most cases, hair loss in men is caused by genetics. If you have an autoimmune disease like a form of a scarring alopecia, surgery done in these conditions can be dangerous and produce failures of the grafts and further scarring of the scalp. Any medical illness or surgery that is a stress to your body can cause hair loss (sometimes permanent). But to distinguish that from genetic causes is something that only a thorough examination with a physician can provide. You are looking for a cause and effect type of relationship and I really cannot help you with the limited information I have.