Category: Uncategorized

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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.

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Propecia and Frequent Urination

My question concerns an unreported side effect of Propecia that has never been discussed on this website…I really feel alone on this one and am really depressed about my circumstance. I am 17 years old and recently started taking propecia for my hairloss, but had to stop because it causes me to constantly unrinate and gives me a burning sensation down there (which cannot be tolerated). My doctor told me to stop taking the medicine because of this, but now I am at a loss for what to do to stop my hairloss. Have you ever heard of this and what do you suggest I do so that I don’t lose my hair? Thank you so much for your response.

The usual report with some older men on Propecia is that their frequent urination (particularly at night) will decrease. This occurs because the prostate will frequently shrink on Propecia (finasteride 1mg) and in older men, swollen prostates cause urination problems.

From what you are describing, I would think that you have some other problem. First, you can stop taking the Propecia and see if your urination problem goes away. I would be surprised if it did. If I am correct, I would look for Chlamydia and other forms of prostatitis. Go back to your doctor after you stop taking the drug for a week, particularly if the problem persists.

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What is the difference between a biopsy and a HAIRCHECK test?

A hair biopsy or rather a scalp biopsy takes a small piece of your scalp out with a knife or punch, and sends it off to pathology to view it under a high powered microscope after it has been prepared and stained. A HAIRCHECK instrument tests for the thickness of the hair in a defined area of the scalp. As this can be compared area by area, the differences always reflects loss of hair bulk or hair mass. The HAIRCHECK test is non-invasive while the biopsy is invasive

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Propecia and Shedding Phase

I am 23 years old. I would like to know if the shedding phase associated with Propecia is a real thing. I was on Propecia for 2 months when a shed began. I was losing about 3 times as much hair as usual. I read on some online forums that Propecia can have a “shedding phase” where you lose a bunch of hair but it then stops and grows back. So I stayed on Propecia for an additional 2 and half months after the shed began. During this time the shed never relinquished so I stopped Propecia. My hair loss returned to its baseline rate within a few days. When I talked to my dermatologist he had never had a patient experience this “shed.” Also, on the forums it appears that for many people the shed never actually stops. For these people it just continues to fall out. This led me to believe that maybe the Propecia is causing a chronic telogen effluvium that does not cease until the drug is discontinued, as can occur with other medicine. I was considering trying Propecia again. So my question is, have you ever actually seen someone go through this shedding phase and then it stopped and they experienced no more hairloss? I would like to know if I should have stayed on the drug longer or if I just simply did not respond to it appropriately.

There is no shedding of hair associated with Propecia. There is however, natural genetic hair loss that still persist even while taking Propecia. In other words, Propecia does not completely stop hair loss. Propecia does not cause more hair loss. Internet forums are a collection of opinions from its members. It does not necessarily mean it is a definitive source or the correct source of information. If you are seeking a personal medical information, please see a doctor.

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Diffuse Unpatterned Alopecia-DUPA

I have a Class 3 balding pattern (just corner loss) and I went to a hair transplant doctor who offered to perform 2000 grafts in the front to address the balding area. It seemed to me that I was thinning outside of my frontal balding area. The doctor who offered me the surgery never looked at my hair under a microscope. I am a 24 year old male and I purchased a hand microscope as you suggested on Amazon. When I looked at my donor area, this is what I saw in different parts of the donor area. How would you interpret the hand microscope pictures I have attached here?

This is clearly Diffuse Unpatterned Alpopecia (DUPA) which I originally wrote about in 1997 (see here: https://baldingblog.com/wp-content/uploads/pdf/mp-1997-evaluation.pdf). The view of your donor area shows very significant miniaturization of the donor area which means you are not a candidate for a hair transplant because it will fail. The hairs that get transplanted will look like these hairs and not have much bulk to them. The doctor who recommended 2000 grafts just wanted your money and probably never read about DUPA. You seem too smart for that doctor. The drug finasteride sometimes helps.

This is what my donor area looks like

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Propecia Benefits Won’t Last Forever?

Note: I believe these were from two different people, but the questions are related so I’ll answer them together…

Email #1

Now doc , i have a suggestion to make just like you do.You write “Every person will eventually lose the benefits of this drug, but the open question is when” – there is no proof for this , or you do have one ? Even if this statement is based on your experience , you are aware that this is not official and there is not way to be.The official one is that after 5 years only 10 % of the people lose some hair , and please attention – more of teh 50 % of the rest CONTINUED to improve even after this.So unless you can prove the opposite ,please flag those ones as “my opiniion ” or “may” or “might ” , but please do not make statements which are neither proven nor stuided in the medical literature – 10x

Email #2

Why do you recommend Propecia to people that come to you for hair transplants if the effect is only temporary? I just ask because you emphasize a master plan for long term benefits, and it seems like as soon as the drug stops working, the hair it saved will fall out and the patient will have that embarrassing pluggy look -bald head with transplanted hairs. Isn’t it setting up people for more misery to take a drug that temporarily grows their hair back, only for it to fail and then they experience going bald again?

Thanks for your time

Read the official study posted at Hairlosstalk.com and you can draw whatever conclusions you want from it. I believe that this drug has a forever component, but that does not mean that it will hold all of the initial benefits forever. Each person will react differently and I can’t give an exact timetable for when you’ll start to see thinning continuing (if ever). So yes, the medication does work “forever” as long as you continue taking, but the benefits may eventually appear to be less. It could be 5 years, it could be 20 years. The only facts at our hands are in the official Merck/FDA studies.

Propecia’s benefits aren’t quite temporary. It’s not just going to suddenly one day turn itself off 100%. The entire point of a Master Plan is to create a roadmap for a worst case scenario of hair loss so that nobody is taken by surprise if the progressive nature of MPB becomes more evident a decade after you start Propecia. With the modern hair transplantation, the “embarrassing pluggy look” you described shouldn’t occur.

Propecia is a miracle drug for many people, as it gets them some (or a lot) of their hair back… and it largely slows or stops the hair loss. Many of my patients swear by this medication. This is a type of medication in that if it grew hair back and stopped or slowed hair loss, them some benefit will probably last ‘forever’. Of course, you can test this by just stopping the drug and seeing what happens. Most people who saw substantial benefits and then stopped the medication saw hair loss, which suggests that the drug had some residual value. The alternative is that you can elect to take your natural balding process to its conclusion, reflecting your genetic makeup. Your choice, of course.

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Do all transplanted grafts shed after the surgery?

I know that theres a small chance that your grafts don’t shed at all, but thats not what I am talking about. I had my surgery done 2 months ago, most of my transplanted grafts shed until the 1 month mark, since then i have kept around 30-40% of the others and they grew like my other hair. Is this normal that not all shed, or should i expect them to also fall out in the next weeks?

It is common to lose all or some of the transplanted grafts between weeks 2-5. Many of the grafts that stick around will grow, similar to your native hair. I transplanted my cousin, and in just 4 months, he had a full head of hair. He told me that he never shed any grafts. Then I did another transplant on him to thicken up the previous transplant because his hair was “fine”. He didn’t shed grafts the second time either. I find that one in 30-50 patients, will not shed their grafts.

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Propecia Is Working in the Hairline, But Not on the Top of the Scalp

Thank you for listening. I have been taking Propecia for a little over 10 months now, and it seems as if it is having a strange effect. It seems that it has started to rebuild my hairline, which was receding somewhat with moderate miniaturization. Alas, it has not shown any results in the vertex/top of scalp. Have you heard of this before? I’m merely curious as to whether this is common. Thanks for your time.

What you are experiencing is not common, but it does happen. Hair loss varies in individuals and by location in the scalp. Experience has shown that the drug works best in areas where the hair loss is most recent. Is that what you are seeing?