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Dear Dr. Rassman: Had the 2nd of my three procedures today. Almost like a sculpture, it really now has started to take shape. Sure, I’ve looked at photos and seen real live guys at your Open House shows who’ve had this process, but there’s nothing like having SMP done to your own challenged head.

Once again, Kudos to the technicians who worker harder than stainless steal and have the patients of angels and Dr. Pak who stepped in mid-way and said: “Now it’s time to mail down your front hairline” which he did with the precision of a rocket shop landing on the moon.

But I do have one regret… which I expressed to your staff openly: “Where were you guys 40 years ago when I first coulda used this?

Dr. Rassman’s comment: This man started his hair transplant process too many years ago. He is now in his 60s and shaved his head for the procedure. He will eventually allow his hair to grow on top of the SMP. This type of comment occurs almost every day in our office. Scalp MicroPigmentation is one of the most satisfying procedures we have ever offered.

I read an article a while back that said resaerchers had found that acne was actually caused by a bacteria or fungal infection within the pores not an internal cause as previously thought.

Could it be, with Hair loss that resaerchers are only focusing on internal causes such as the DHT and actually overlooking other external causes like some kind of Fungal Folliculitis of the scalp that eats away at the folicles? Where does the DHT come from and why can’s we stop it?

Anything is possible, but the explanation you offered has not come to the forefront. I would not be surprised if there were other mediators for hair loss that make hair loss show up in one person and not another. We are not well informed enough to go there just yet.

This is what we know (taken from an article by Dr. David Whiting, a widely acknowledged leading researcher/dermatologist): “Testosterone and dihydrotestosterone can circulate systemically to follicles, or be manufactured locally in the follicle from circulating weak androgens (dehydroepiandro-sterone and androstenediol) via complex enzyme-mediated processes involving specific dehydrogenase and reductase enzyme pathways. All of these enzyme reactions are dependent upon specific pyridine cofactors. It is clear that reductase, dehydrogenase, and probably aromatase enzymes are of major importance in hair growth as they mediate the complex interchange of sex hormones implicated in anagen activity.”

That is the biochemistry of DHT (dihydrotestosterone).

This is an inherited form of hair loss that is often on both sides impacting the temple peak area and is easily fixed with hair transplant (the only solution)

The hair is a rapidly growing organ, possibly among the fastest of body well (outside the intestine). Cancers are also fast growing so when the cancer is treated with Chemotherapy, the treatment targets fast growing cells. That is why many people who get this get stomach and intestinal side effects. Hair loss occurs in the same way. We have written about the Cold Cap to prevent hair loss with chemotherapy and it is an important tool, review posts here: https://baldingblog.com/?s=cold+cap&x=0&y=0 and you can review the many posts on the subject.

Some people only partially regrow their hair if they lost it. This may be caused by permanent changes in the life of the hair follicle which is frequently limited anyway. When a hair follicle reaches the end of its life (from genetic balding or even old age), the cells undergo apoptosis (cell death). The Chemotherapy may damage the hair cycle clock limiting how many cycles the hair goes through. We know that hair goes through aging in all of us and we often see changes of hair character (from a coarser hair to a finer hair) or graying (as we lose the pigment cells that give our hair color.

Interesting article. I don’t understand the metabolic pathway suggested in the article. I will research this.

Hi doctor Is it normal for the left side of your hair line to be higher and thinner than the right? Also besides genes what are some physical activities than can cause hair loss?

Hair loss, when it occurs, is often not symmetrical. If you’re seeing the left side of the hairline creep higher than the right, there’s nothing unusual about it.

There are no activities that should cause hair loss. Unless you count pulling on your hair as an activity, but I think you mean something like sports or hobbies. You need a good examination to determine if your hair loss is genetic and then map out the status of your hair loss (see Mapping Your Own Scalp for Miniaturization).

I posted a while back asking if anybody had any anecdotes for taking smaller doses to alleviate sides. Well I bit the bullet and bought a pill cutter last Thursday and from then until Monday took 0.5mg fin every day. It was by the Monday that I woke up with proper morning wood for the first time in weeks and had the horn all day. At this point I noticed more hair in my hands than normal after washing, so went back to 1mg Monday night.

You should probably stay on the half dose as it is 80% as effective as the full dose.