Category: Uncategorized

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Doesn’t the Scalp Still Shine with SMP?

Hey Dr Rassman. i hope your day is treating you well. As i am a frequent reader of this ever informative blog of yours a few questions have sparked my interest over the last week. It is in regard to the new micro pigmentation service NHI is offering. Now in the past i have noticed you were quite the skeptic about this type of procedure. I recall reading a few comments made by yourself which made me think they were: wouldn’t the scalp still shine? The lack of a ”sandpaper feel due to there being no actual stubble on the scalp and hair is 3 dimensional a tattoo is not.

However I was doing some thinking and this came to mind. If a patient were to come and request to have as many grafts that their doner supply would allow then have the tattooing procedure done in between those grafts and also had the scar camouflaged in the back of the scalp wouldn’t it be nearly impossible to tell the persons head of hair from a non balding person ? It would eliminate all of those issues i previously mentioned. Like for those individuals with high donor densities if someone had 10,000 grafts placed on their scalp then had the micro pigmentation procedure done i would think they would be able to get close to their juvenile hairline back and they would also be able to grow their hair out to probably a number 1 clipper with out it looking to odd. What are your thoughts on this ?

as I presently support the shaved head look but my hairloss is progressing i like the look i would just like more coverage. I have been on finasteride for 3 years when i first started it i was 20 and an early norwood three now my hair is really thin through out the top half of my scalp. I totally anticipate being completely bald by the time im 25 whether im on the medication or not.

HeadlubeYour scalp can shine with the oil that your scalp produces, so scalp micropigmentation (SMP) patients often use matting products available at cosmetic stores. There’s various brands of shine control lotions for the scalp, including HeadLube.

SMP has a use with some negatives and some positives. There is a natural symbiosis between hair transplants and SMP in some individuals. SMP is far less expensive than hair transplants, but you can not have it both ways (SMP in part with a limited hair transplant) unless the Master Plan takes into account what is happening to you now and later. There is a balance between SMP and hair transplants, but I can not give you an opinion over the internet.

It sounds like you need a Master Plan (I know I talk about that a lot), because you are changing with regard to your hair loss. Whatever you do, it should fit into the life plan; if you do go really bald, you’ll want to have a plan for what you’ll look like in the future if you make decisions about today’s problem. Come see me.

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Rogaine Foam Ruined My Hairline Within a Month — Should I Wait for It to Regrow?

Doctor..

Had slow diffuse thinning for years. Just turned 60 with what many thought was a full head of hair. Though i knew it was thinning. Thought I was years away from needing a transplant until switched to Rogaine foam which devastated my hairline within a month. Lost years in days. The company told me to stop using it. So the question is, should I consider a transplant now or wait to see if the hairline grows back? Read a lot about minoxidil shed hair grows back (though all I did was switch brands) and am on another brand now, but grow back at the hairline? I highly doubt it. What do you think?

Without an exam, this is a highly subjective question to answer. Moreover, we do not give medical recommendations on BaldingBlog.

Rogaine (minoxidil) can sometime cause initial shedding, but it should generally reverse over time (should wait at least 1 year). You may see the reversal in as early as 3 months.

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Donor grafts as high as 15,000, please discuss

In your assessment of my donor supply, you noted that I can bald to a Norwood 7 and still get hair. I’m not a NW7 but out of curiosity, I know different factors are involved, like head size and stuff but how many grafts would a Norwood 7 typically require for adequate coverage at an average transplant density? I know I’ve seen photos online from another doctor in California you’ve probably heard of or maybe even know (Dr. Umar), who specializes in the use of body hair grafts. Some of the Norwood 7’s he’s restored required over 15,000 grafts! One of the clients in particular, transplanted 9,000 grafts from just his beard alone! (how many follicles are even on a man’s face because he still was able to grow a beard, albeit just much less dense); the results were pretty impressive, regardless. Granted some of those clients requested really aggressive/ juvenile hairlines and had a lot of thin/single-haired grafts harvested from their back and legs which probably accounted for the need for a higher graft harvest

I wrote an article in the Journal of Plastic and Reconstructive Surgery in 2017 which discussed that almost anyone can get a full head of hair if they combine FUE with SMP. I didn’t discuss beard hair, but the use of beard hair significantly adds to the donor supply. I believe that body hair has much less value for two reasons (1) the hair is fine, and (2) the telogen cycle is long, which results in only half of the hairs growing at any one time while the other is in telogen phase.
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Running and Hair Loss

Is there any truth to the fact that running will help with Baldness? Since increase in blood circulation.

Also, what can i take to increase my blood circulation?

Where do these urban legends come from? No, there’s no truth to running as a treatment for hair loss. And before someone asks, running won’t make you lose hair either.

With respect to blood circulation, as long as you can feel the tips of your fingers and toes and it’s warm, I suspect you gave good blood circulation. Hair loss is not related to blood circulation — it is genetics.


2010-09-10 10:15:59Running and Hair Loss

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Dot Scarring from a Large FUE Procedure (with Photo)

I (Dr. Rassman) have had a total of 2200 grafts in three strip surgeries over the past 20 years, the last one being 6 months ago. If you were to look at my single linear scar, most people (even with a comb in their hand looking for it) can’t locate it. My strip scar is certainly far less significant than the mottled scars from follicular unit extraction (FUE) in this patient below. To be fair, if the patient had let his hair grow slightly longer, the scars would be less visible.

This is not my FUE patient, but I was told that he had 2500 grafts extracted in one session four years ago (and saw extremely poor growth). FUE scars like these are very common, and as most people get FUE procedures because they want the option of cutting their hair very short without a linear scar, many of them can’t do so when these dot scars are so detectable. Click the photo to enlarge:

 

I grant that some patients will have visible scarring from a traditional strip procedure, but now with Scalp Micropigmentation (SMP) the linear scars can be made undetectable. The same treatment can make these ugly FUE scars undetectable.

My point for this post is that scarring occurs with all types of surgery. Scarring should not be the motivator for the choice of FUE over strip surgery. Considering the cost differential between strip and FUE surgery, this is just part of the calculation each person must do in making the decision between strip and FUE surgeries.

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Saw Palmetto (Questions for a Reader)

Did it do anything for you? Did you get side effects (because it reportedly blocks 30% of DHT, half of what Finasteride is doing)? Is it an alternative treatment? After all, it doesn’t need to be prescribed by an MD, because it is over the counter, so bad side effects would be quite f***** up for something like that. Interestingly, people reported having side effects compared to Finasteride on this sub, which should pretty much unleash a big scandal because, as mentioned, it is an over the counter drug. I can’t figure out if these people actually got side effects or if they are nuts though.

Saw Palmetto is a very weak DHT blocker, and I don’t believe that anyone has had a reversal of hair loss on this drug.


2018-07-19 05:55:31Saw Palmetto (Questions for a Reader)

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Dr. Rassman talks about hairline and the good and bad about hairlines (video)

Dr. William Rassman discusses how to and how not to design a hairline. As a consumer, you must know what to expect and this short video covers what you need to know about what a hair transplant must look like so it is undetectable. Dr. Rassman pulled some photos from his files to show some of the things that have gone wrong with transplants performed by physicians or illegal technicians who don’t know the basics of the art and science of FUE or FUT. Be careful, as there are many illegal hair transplant clinics worldwide who care about making money and are not capable of focusing on natural results. here: https://youtu.be/qvr951TNlaM


2019-10-02 13:22:11Dr. Rassman talks about hairline and the good and bad about hairlines (video)

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Scalp DHT, Propecia, and Androcur

Dear Dr. Rassman,

Article at hairlosstalk.com includes the following statement of “Spironolactone effectively prevents DHT from attaching to the receptor sites on the hair follicles. As a result, the follicles no longer atrophy and can mature again to their normal size. And it does so without decreasing the circulating levels of DHT in the body.”

1. Is it sufficient just to block scalp DHT levels, or serum DHT reduction also necessary to combat MPB? If scalp DHT inhibition is sufficient for MPB, is serum DHT inhibition dangerous for the body as claimed by this doctor?

2. You’ve told in one of your comments that propecia is a anti-androgen, but the prospectus states that it does not have an anti-androgenic effect. Could you please clarify?

3. It’s mentioned that Androcur is the best against MPB. Is this the case?

Your reply will be much appreciated.

Finasteride needs to go through the blood stream to get to the hair follicles. When it gets to the hair follicle it then fixes to the tissue and blocks the DHT. Finasteride is not dangerous to the scalp.

Finasteride blocks DHT and when it does this, the testosterone levels often rise. If the body would not produce testosterone in response to a DHT block, then one would say it is anti-androgenic, but it is foolish talk like that because testosterone needs to be present to have DHT made by the body (DHT being a byproduct of testosterone).

Drugs like Androcur are good blockers of androgens and can produce major side effects on the male sex drive, something I would not recommend for patients with male patterned genetic balding.


2009-03-17 16:39:58Scalp DHT, Propecia, and Androcur

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Dreadlocks Causing Hair Loss in Woman?

I have a dear friend, young, beautiful girl (caucasian) who has come to believe that her really long dreadlocks – which she has been growing for 7 years…is causing perhaps permanent bald spots on her scalp. She is really beside herself about it, and wondered what she could do to be sure, and if so – to cure the problem.

Dreadlocks can produce traction alopecia (hair loss from constant pulling). The best thing for her to do is to get rid of them and then wait for recovery of the hair. After 7 years, the hair loss may be permanent, but until the pulling stops, you will not know one way or the other. Recovery from traction alopecia may take up to a year.