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Hello Dr Rassman, I was wondering how you can tell if new hair is growing. I had Telogen Effluvium starting in october or so and it has stopped and i can only see new growth right at my frontal hair line. I am also using retin A and it gets applied around there so im not sure if it is the retin a regrowing the hair or my hair is growing everywhere. IN SHORT: Is it possible to see new hair growth mid scalp amongst long hair.

Also, Im unclear about when people say hair may not regrow from TE. Is this only if the people were going to bald within the next few years, in other words will hair always grow back from TE so long as you have no predisposition to genetic balding .

With telogen effluvium (TE) you will likely regrow the hair, but in some people it may not always grow back to the full thickness you once had. In your case though, you stated that you are seeing new hair growth. So there you go! If you want to see it under a video microscope, these new hairs show up well. Logically if you are seeing short hair growing amongst long hair that would be new hair growing, right? There is no big secret to seeing hairs grow.

With respect to Retin A, I doubt that is causing the hair growth, as it is an irritant.

The total donor hair supply usually reflects 25% of your total hair count which is the capacity of the donor area for available hair. This post elaborates on how this is measured: https://baldingblog.com/how-do-you-determine-your-donor-density/. Assuming that the typical Caucasian has 110,000 hairs and 50,000 Follicular Units on his scalp, the number of grafts available are most likely between 50-65% of the Follicular units can be moved in a person with a hair thickness that is average (60 microns thick). If your hair is finer than that, the number of grafts plummets.

According to what I read regarding Male pattern Baldness It is a problem of Hair Follicles being sensitive to DHT rather than excessive DHT.

1. What does this really mean?

2. How did I develop this condition?

3. Is there any way to reverse this sensitivity?

4. If not then why aren’t researchers and scientists working on it?

5. Why is it so that DHT gets attached to my scalp follicles more than other parts of my body like my face?

6. Does DHT lead to bone growth?

Note: I’m losing hair and I have a receding hairline and I’m thinning on the top. I still don’t have a proper beard.

DHT is a trigger in people who have the genes for balding. Each hair on your head has a life cycle (usually 3 years) and it sheds and regrows over and over again, unless, it has a limit genetically set on how many cycles you get. Some men (in the balding areas) have limits on these cycles, so when that limit is hit, the hairs miniaturize and eventually fall out. Finasteride slows this process down and is the ONLY medication available that is known to work.

Dear Dr.,

If you can’t accurately measure the growth rate of your hair transplants (as posted in a previous blog post), how do you determine if a transplant was successful considering that no quantitative data is available (i.e. 95% growth)…?…

Also, since you’ve been doing this so long, what is your opinion on whether people are too vain? You must see lots of interesting information regarding this since you are in a unique position as a hair transplant surgeon.

Success is determined by your ability to achieve your goals provided that you have had realistic expectations of it. A good doctor will tell you if it meets his/her expectations. I have had patients who felt that they had their expectations met and I did not, so in those very, very few patients I usually just do another hair transplant at my cost.

We are all vain, but we do not like to admit it. I can fill hundreds of pages of stories on vanity, but I’ll save them for another time. I don’t believe people are too vain, but some people see vanity as a problem, and that is where I disagree. There is nothing wrong with wanting to look as good as you feel (or hope to feel).

About two years ago I noticed thinning at the front of my scalp and corners, now I still have thin hair at the front but what really bothers me is that there are two dime sized patches of hair that is not completely bald but much much thinner. will this progress? and should I expect more thinning in the future?

I often get these questions emailed to me. Actually I get these questions asked alot! I just want to make it clear that I am not a fortune teller nor can I diagnosis hair loss over the Internet. If your hair loss bothers you, see a doctor. You can always search the Internet but you’ll end up with mixed messages or information. I can tell you in general the most common cause of men’s hair loss is genetic and it is known as male pattern balding (MPB). If you have MPB and would like to do something about it, there are medications (Rogaine or Propecia) and hair transplant surgery. There is also Scalp Micropigmentation (see scalpmicropigmentation.com). When people describe circular dime sized or quarter sized bald patches, it makes me think of alopecia areata (AA), an autoimmune disease that requires a doctor to make the diagnosis. There is no cure for AA, it has a different cause than male pattern balding and if hair is transplanted in to these ‘dime sized areas’ it will not grow unlike male pattern balding where good results from a transplant can be expected.

I am a female who has been using minoxidil for 1 month. I have a lot of minituarized hairs and I’d like to know how Minoxidil would work on these short hairs. Will Minoxidil work by pushing out these minituarized hairs and allowing new and stronger hairs to come out? OR Will Minoxidil allow these short hairs to remain and stimulate them to grow stronger and thicker?

Minoxidil doesn’t replace existing hairs but it produces new hairs when it works that grow out of the scalp. New hair growth is a known side effect of this drug which was originally produced for high blood pressure. There are also suggestions that it may reverse miniatutrization of existing hairs.

How good does the donor area have to be to achieve that amount of coverage with the amount of hair loss he started with taken into account? Does the patient have to have a very dense donor area or would just an “average donor” area be enough?

An average donor area will work fine. A medium hair shaft or thicker hair shafts produce more fullness per graft than a fine hair this is important. It is not unusual for a fine haired person to have a second hair transplant to get more fullness

That is the ultimate question. When a person goes bald, the hairs disappear, but many experts believe that below the skin in these men, at least for a number of months or years, the stem cells for hair growth are still there. We like to call that dormant, but they may have died off. Nobody knows!