Category: Uncategorized

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Transplanting Nape Hair at the Hairline to Soften the Look

A prominent HT doctor recommends using transplanted nape hair at the hair line to soften the look of the hair transplant and make it look more natural. This seems to make sense as often hair transplants look like the hair strands are too thick where transplanted and not natural. You mentioned that nape hair is not permament. Does this mean it might fall out over time and even if it does is it still worth it for the cosmetic effect in creating a more natural hairline?

I recently saw a patient in my office who asked me this same question and asked about the doctor. In case you are the same person, my answer was as you correctly state — nape of the neck hairs are not permanent. Some patients actually come to have hair transplants to the nape of the neck, as they are completely bald from below the ear level.

Thus, your nape of the neck hairs that are transplanted elsewhere may fall out over time and it is not worth the surgery. More importantly, even with the FUE technique there will be scarring that may show at the neck with white pale dots if the nape hair falls out over time. If you are considering this type of surgery I would ask that doctor if you can meet with a patient who has had it done to see what it looks like. When the donor area is from the nape of the neck with strip surgery, most of the time the scars are prominent and wide. Scars like these are not amenable to repairs and even with FUEs placed into them, they can not really look normal.

If you want a softer hairline, regular donor hair should be sufficient if done right with single follicles that are finer and grow naturally that way. If the staff and the doctor are good, they will pick out the smaller caliber single follicles for the very front.

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Hair Loss in Children

I just found an article on the subject of hair loss in children which may have interest to my readers. See yesterday’s question from the young girl with possible genetic hair loss. This article is a bit technical but it does address the problem.

Androgenetic Alopecia in Children: report of 20 cases by Tosti A, Iorizzo M, Piraccini BM.
Research performed at: Department of Dermatology, University of Bologna,
Via Massarenti 1, 40138 Bologna, Italy. tosti@med.unibo.it

SUMMARY: Androgenetic alopecia (AGA) is the most common type of hair loss in adults. Although there are differences in the age at onset, the disease starts after puberty when enough testosterone is available to be transformed into dihydrotestosterone. We report 20 prepubertal children with AGA, 12 girls and eight boys, age range 6-10 years, observed over the last 4 years. All had normal physical development. Clinical examination showed hair loss with thinning and widening of the central parting of the scalp, both in boys and girls. In eight cases frontal accentuation and breach of frontal hairline were also present. The clinical diagnosis was confirmed by pull test, trichogram and dermoscopy in all cases, and by scalp biopsy performed in six cases. There was a strong family history of AGA in all patients. The onset of AGA is not expected to be seen in prepubertal patients without abnormal androgen levels. A common feature observed in our series of children with AGA was a strong genetic predisposition to the disease. Although the pathogenesis remains speculative, endocrine evaluation and a strict follow-up are strongly recommended.

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Travel to California Is Too Expensive to See You!

Dear Dr Rassman,

I have read with huge interest your blog/articles and links. I have a hair-loss problem and live in the UK. I am convinced that your clinic and FUE techniques are the best solution to my problem. I believe I would score as a type 6 pattern and accordingly may need more than one session. Being based in UK and having to travel to California several times would make it cost-prohibitive for me, I believe even with your 5% travel discounts.

Most of the UK surgeons in this field seem to me to be much less experienced and professional with only a few of them offering FUE.

Do you have colleagues on the East Coast of the US and/or clinics you could recommend in eg. Florida where inexpensive flights from UK are frequent these days.

Kind regards

You may want to consult with Dr. Robert Bernstein in New York.


2006-06-02 07:06:55Travel to California Is Too Expensive to See You!

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Hair Loss Now with Excessive Monthly Bleeding in 33 Year Old Female

I had excessive bleeding and the doctors determined I have high estrogen. They put me on a birth control pill and it fixed the bleeding. I’m concerned because I had full luscious hair and now anyone can see through to my scalp. Please help me!

The birth control pills have been known to cause hair loss in some women. Speak with your doctor about the type of pill he has you on.


2018-09-24 06:22:39Hair Loss Now with Excessive Monthly Bleeding in 33 Year Old Female

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Triangular Alopecia (hoto)

I’ve had a bald spot on the side of my head for like 10 years and I’m only 16. How can I grow hair here? Please help

You have an inherited condition called Triangular Alopecia. A small hair transplant procedure will solve this permanently. Some people have it on both sides.

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Hair Loss When Using Lamisil

I had hair loss as well when using Lamisil, did your hair grow back? Can anybody respond back to me if their hair after these of Terbinafine. Thank you very much.

Stop using the Lamisil if it caused hair loss. You may have developed an allergic reaction to it.

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True or false statement about finasteride

  1. the longer you take fin the more chances side effects increases.
  2. Going off fin despite length of time (ie 2 months vs 2 years or vice versa) can lead to hormone crash. Fin makes your hairloss worse years after stating treatment
  3. Would love to know as these three kinda scare me. If it’s a fact please state why and the likelihood of it.

The ANSWERS to your questions are below:

  1. No body knows for sure, but there is a suggestion that the longer you stay on the medication with sexual side effects the greater the risk of the sexual side effects not leaving after you stop the finasteride. This is based on no valid information, more a feeling from experienced doctors who seem not to get long term post-finasteride syndrome.
  2. No such thing as a hormone crash from finasteride on or off and finasteride will not make your hair loss worse in the future after taking it for years
  3. Absolutely no, the longer you take finasteride, the longer you hold on to your hair.


2019-07-10 08:49:25True or false statement about finasteride

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Hair Pieces and Advancing Hair Loss

I live in Brasil, I’m 41 year old and my grade of baldness is 6 / 7. I use a hairpiece for 18 year and i want to get free of this, but i have a problem, because when i started using , i was able to avoid peolple noticing that was a hair piece, as was very natural and my baldness was class 2/3 and as i used to travel a lot i didn4t see people so frequently. My case i believe is needed a scalp reduction for a start, but i’m afraid of procedures go wrong and i cannot remove the hairpiece to much in advance. Please help me . I can travel to NHI if necesary but I can forward photos to a better evaluation of my case
Thanks

Your story of how one starts with a hair piece and then gets caught in a cycle of more and more dependence as the hair loss advances, is a common story. Many of our patients have been where you are now. The problem for advanced hair loss patterned people is the availability of supply. The basic point is to find out if there is enough donor hair, when combined with good styling, to produce the type of coverage you want or need. That depends upon many factors, of which the number of hairs available for transplants is only one of these factors:

  1. A better match of hair and skin color will work to your advantage, wavy hair and coarser hair also will work to your advantage if that is what you have. What is your skin and hair color?
  2. How loose is the skin in the back and sides of your scalp. For those who have loose skin, the availability of donor hair is generally higher.
  3. Is your hair wavy or straight?
  4. Is your hair coarse or fine?

Sending me a good set of pictures is important for me to establish a good baseline. Please answer the questions above for me in your responsive email. You can use the form or my email address on the Contact page.

In answer to your other point, the idea of using scalp reductions, I will just say that this procedure has fallen into a bad reputation and most good surgeons do not do them anymore. The problems are that there is severe scarring on many patients and thinning of the donor hair to such a degree that there is not enough donor hair to restore the frontal area. Although there are some patients that may do well with them, there are far too many risks for the average patient. I know about these risks because I had three scalp reductions in the early 90s and was left with scars and a return of my entire balding area. I eventually got transplants and had enough donor hair to fill in the crown defect. Best of all for me was that I had no frontal hairloss. Had I been a Class 6-7 balding pattern, I would have been in trouble. So in conclusion, cutting out the bald spot is a risky surgery with many things that could go wrong. The key to a good hair restoration procedure is low risk and a normal, hairy outcome in a reasonable time-frame.

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Two Class 7 patients treated with hair transplants and SMP

What is important to note, is that the top patient had wonderful medium weight hair and had a good shape and body to it while the bottom patient had super fine hair. We solve the see-through look with Scalp Micropigmentation

 


2020-09-02 13:39:19Two Class 7 patients treated with hair transplants and SMP

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Hair Spray and Hair Loss

Can hairspray damage hair follicles and lead to hair loss?

If you brush or comb through your hair after the hair spray dries, you may pull out hair. In men and women with varying forms of alopecia, the use of hair sprays can be dangerous with rough combing of the hair. Best to wash it out rather than brush it out. Rough brushing can be a cause of hair loss made worse with hair sprays. Otherwise, hair spray by itself doesn’t equal hair loss.


2008-10-01 11:50:15Hair Spray and Hair Loss