Impact of Change In Appearance

A former patient came to my office last week complaining that the hair from the transplant last year did not grow. He wanted to discuss his options with me. When he came in, I pulled out his before pictures to be sure that both he and I would be talking about the presence or absence or change. As he looked at his before pictures, I asked him again to repeat the complaint. He repeated it despite looking at a before picture of himself — when he was a bald man. Then I gave him a mirror and asked him to look at the pictures from one year earlier, and then look back at the man in his mirror. I asked him if there was a difference.

He looked confused. When I probed his confusion, he told me that his wife was totally convinced that the hair did not grow. She reported to him that she had watched for his hair growth very closely and never saw the growth occur. He did admit that the man in the mirror was hairy and the man in the picture was bald. To help him through whatever problem he was having, I told him to think about planting grass seed or watching a child grow. The more closely you watch, the less change you see. Clearly, his wife had that problem and complained over the past year that the transplant was a waste of money. Then I suggested that he take home pictures of himself before the surgery to show to his wife, and see if her view changed. That seemed to solve the problem and he left very happy.

We see the same thing echoed by many men who are amazed that their hair transplant was never detected, even by them. In the workplace, the change occurs so slowly, that people who see you every day never notice any change. We quickly adjust to what we see before us, not the image we stored in our memories.

I always enjoy these return visits a year or so after the initial transplants were done, to be able to compare the image stored in the before photos to the ‘hairy’ person in front of me.


2005-07-05 07:03:36Impact of Change In Appearance

19 Year Old, Parent Told Him He Is Not Balding, but He Is According to Haircheck!

This is a 19 year old who has been told by everyone in the family that he is not balding. He has coarse hair and is as curly as it gets, so this could hide any balding from the naked eye. We performed a HAIRCHECK and he was right, he has lost 1/3rd of his hair volume in the crown. From these pictures, it is easy to see why no one believed him, but he knew and I confirmed it today. He elected to take finasteride to treat what he now knows is balding.

full head of hair full head of hair2

In the News – Actor Jackie Chan Shills for Poison Hair Loss Shampoo?

Snippet from the article:

Judging from billboards and television commercials in China, film star Jackie Chan has never met a product he wouldn’t endorse. Travel the country and you’ll see the Hong Kong native’s handsome visage hawking electric bikes, anti-virus software, even frozen dumplings.

But although the Chan name has translated to big bucks at the box office, not every product he touches turns to gold. In fact, when news broke last month that an anti- hair-loss shampoo he promoted allegedly contained carcinogens, Chinese cyberspace and media were buzzing about the “Jackie Chan curse.”

Read the full story at LA Times: If Jackie Chan says it’s good — well, get a second opinion

The article isn’t so much about the cancer-risk-increasing hair loss shampoo that actor and martial artist Jackie Chan was putting his stamp of approval on, but more about how he takes just about every paycheck to endorse products that he can get… and he has an unusually high rate of failure.

The shampoo is mentioned again later in the article, though: “Few know whether Chan actually uses the shampoo, called BaWang, which its manufacturer claims keeps hair roots strong and black. BaWang Group stock has tanked since the scandal broke, even though government regulators deemed the product safe.


2010-08-24 17:42:30In the News – Actor Jackie Chan Shills for Poison Hair Loss Shampoo?

2 Weeks After My 2800+ Graft Surgery, I Had Massive Shock Loss

hi, two weeks after a surgery with dr. rahal of 2846 grafts (888 1 hair, 1526 2-hairs, 429 3-hairs, and 3 4-hairs), i experienced a massive shock loss. it has been one month post surgery and i am very worried about even going to my original look, which at this point i would be happy with. i only take minoxidil, because of the side effects of finasteride.

do you see a lot of this shock loss from the pics as being temporary, because although i am thinning, i am not an entirely diffuse thinner, but lost everything. at this point would total of the 5239 hairs even be enough to fill in what i have lost? i should also note that the hairs that are remaining are ones from a previous surgery with ziering that was supposed to be around 2300 grafts, but i am not even entirely sure about his work.

thank you so much for your help and suggestions, greatly appreciated!

Click the photos to enlarge:

 

It is difficult to make many comments about your exact situation, because the before picture and the change in your hair length are confusing your situation. I will assume that you are young (under 30 years old). Were you afraid of possible side effects from finasteride, or did you actually experience them? Shock loss is common in young men after a hair transplant, unless the young man is protected with Propecia (finasteride). Prior to the appearance of this drug on the market, shock loss was a common problem for hair transplant surgeons. Since the use of finasteride, this type of report is relatively uncommon.

Shock loss usually appears in the first three months after a surgery, when it happens. I do not believe that the size (# of grafts) is related to the shock loss, as a hair transplant of any size can do it. Shock loss reflects your genetic timelines and often accelerates the timelines 1-3 years.


2013-04-17 12:58:082 Weeks After My 2800+ Graft Surgery, I Had Massive Shock Loss

In the News – Blood Type Can Make Men More Prone to Baldness?

Snippet from the article:

Going by the recent study on Alopecia by Chandigarh-based Plastic Surgeon Dr Tejinder Bhatti, it’s not just the “G” factor but the “A” factor that plays a major role in baldness. Dr. Bhatti has explained that the “G” factor – genes – do play an important role, but the “A” factor – A+ blood group, especially in males – makes one more prone to baldness. Dr Bhatti initiated the study in 2007 and completed it in December 2012.

Dr Bhatti opined that although patients blame water content or quality of their shampoo for baldness, but blood groups play an equally important role. A+ blood group people are unable to optimally absorb B vitamins, including Biotin, in their blood and therefore the thickness of the hair is quite low.

Read the rest — ‘A’ factor leading to baldness?

I’m not sure that I agree with this. It would be interesting to read it on a medical journal.

They kind of lost me once I read, “Dr Bhatti says that In male pattern baldness (MPB), in 80% cases the gene causing baldness comes from the mother’s side. So if your nana or mama are bald, there are 80% chances you too will be bald.” That actually just a myth and has never been proven.

20 year-old had a hair transplant and then lost a lot of hair

Hello I am 20 years-old and I had a hair transplant nine days ago. Today when I combed my hair I saw a lot of hairs I mean a lot. Is this normal? I mean there were not only hair from the recipient or donor area but from all over the head…plz help me is this shock loss or what? ps: my hair transplant was very small I had 500 grafts, 250 on the right temple 250 on the left

You should never have had a hair transplant at 20 years-old as that is, in my opinion, malpractice on the doctor’s part. He cared more about your money than you. A 20 year-old will certainly lose hair after a hair transplant. The key is to go on the drug Finasteride and see a lawyer. You can use me as an expert witness in this case.

 


2017-09-19 05:34:3820 year-old had a hair transplant and then lost a lot of hair

In the News – Do Redheads Have a Higher Skin Cancer Risk?

Snippet from the article:

The red in redheads’ hair is thought to put them at increased risk of the dangerous skin cancer melanoma, even if they don’t spend a lot of time in the sun, according to a new study.

Study co-author Dr. David Fisher and his research team first uncovered the apparent link between red hair pigment and melanoma last fall. That study used genetically altered mice that had been given a mutant gene that increased their risk of contracting the skin cancer.

Now the researchers are taking the next step: asking why the body’s creation of the red hair pigment — called pheomelanin — might prompt that risk.

Their new paper, published May 9 in the journal BioEssays, speculates that pheomelanin could increase skin cancer risk by leaving skin cells more vulnerable to DNA damage.

Read the rest — Red Hair Pigment Might Raise Melanoma Risk: Study

20 Years Old and Losing the Battle with Finasteride. What Should I Do?

Hello, I am not sure what to do now.

I am a 20-year-old male currently suffering with AGA. I have frontal and crown diffuse thinning. I was on (brand name) Finasteride for about a year, but my hair loss continued. I then switched to (brand name) Dutasteride. No sides and am currently on 1 gram a day rather than 0.5mg. Been on it for nearly 10 months.

All this, yet my hair continues to fall. I can’t use Minoxidil because I am required to look very tidy every day for work related matters. Minox causes a lot of dandruff and makes what’s left of my hair feel coarse and dry.

What can I do? I have been reading up on a famous hair transplant doctor and he mentions how he prescribed a very low dose of around 2.5 – 5mg of Loniten to his patients, and it apparently was very successful. I know of the dangers that come with this drug, though I am prepared to test the waters for a trial with a low dose of around 2mg. This is all I know of that can help. If you know anything else to help I would appreciate it!

You could use topical Minoxidil at night only after a shower, and then shower it off during the daytime. That is as effective as twice a day use. Oral Minoxidil as you suggest might also work, and in many countries it is the drug of choice.


2018-05-10 08:48:4220 Years Old and Losing the Battle with Finasteride. What Should I Do?

In the News – Full Face Transplant in the US

Snippet from the non-hair-loss article:

A Texas construction worker badly disfigured in a power line accident two years ago has received the nation’s first full face transplant at a Boston hospital.

More than 30 doctors, nurses and other staff at Brigham and Women’s Hospital led by plastic surgeon Dr. Bohdan Pomahac performed the 15-hour operation last week on 25-year-old Dallas Wiens of Fort Worth, Texas. He was listed in good condition at the hospital today.

The electrical accident in November 2008 left Wiens blind and without lips, a nose or eyebrows. In Boston, doctors transplanted an entire new face, including a nose, lips, skin and muscles and nerves that animate the skin and give sensation. The donor’s identity was not disclosed nor would the hospital say exactly when the surgery was done for privacy reasons.

Read the rest — Boston Hospital Performs Nation’s First Full Face Transplant

An amazing story of perseverance. The problem that this poor man has is monumental, as is the surgery and the recovery process. His attitude and drive make him unique. We all wonder how we would respond to such an injury, asking ourselves if we are fighters or quitters?

2011 ISHRS Meeting Review, Part 6 – Finasteride

ISHRS 2011

Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.

This is part 6. More to come…

***

 
Does finasteride induce mood and other psychiatric changes?

    A case report and literature review showed a connection between finasteride and mood changes. In one case presented, a patient suffered from severe disabling mood changes on finasteride, which ceased within a week after stopping the medication. After a short time period he restarted finasteride, and the mood changes returned within a few days. Other cases were reviewed with similar problems. There is little doubt that in some patients, mood changes and other psychiatric problems appeared with the use of finasteride.

    I believe that these case reports are the exception to what we commonly see and that finasteride is generally safe, but if a patient feels that they have changes in their personality or mood since the drug was started or if a family member sees changes in their mental state, they should meet with their doctor to discuss the appropriateness of their continued use of the drug.