Category: Uncategorized

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Is My Dermatologist Denying My Hair Loss for Some Reason?

Hi Docs,
I’m a white Caucasian man who turned 27 in April. I have been balding for 6 years now. I have no more doubt about that because my frontal hairline receded about 1 inch maybe more (depending on how I pull my hair back more or less) and I have got miniaturized hair on the temples. I would like to know why the dermatologist (head of a dermatology department) keeps denying my baldness and if I am really balding or not.

Well, at the very beginning, I didn’t notice anything. I used to go to the hairdresser once a month. But, at the age of 24 (about 3 years ago) I could see my scalp through my hair witch obviously began thinning. And my hair’s colour wasn’t the same anymore (much clearer than before).

So, one day I decided to have my hair cut very short. That day I realized that my hairline was receding. I could see the temples that I have never had and never seen before. According to the pictures, I’m receding since the age of 21 or 22. At the age of 21 I had a full head of hair and no temples, at the age of 22, I had temples, at the age of 24 I reached the first stage of baldness and now I’m at least at the first or maybe second stage of baldness at only 27.

Well, I can assume that I’m balding and having a similar evolution as my father had (maybe a little slower) except that he started a little earlier. At the age of 18-19, my father reached the first stage of the Norwood-Hamilton scale, at the age of 27, he was at the second stage maybe a little more (almost third), at the age of 32, he was at least NWD 3, by the time he turned 37 he reached the fourth stage and now, he is a 50 years old man and he’s almost 5 (almost bald)!

In my family, my father is the only “real” bald man. My grand father (my dad’s father) is only Norwood 2 at the age of 75, my uncles (my dad’s brothers) are Norwood 1 at 47 and Norwood 2 at 52 and my mother’s father is only Norwood 1 or 1.5 at the age of 68. I have to say also that when I was a kid I had a similar implantation (very low and with no temples at all), the same hair quality (very thick) and the same hair colour (dark) as my mothers’. Now, I keep my hair long and I only cut a little of length when it’s too long and I’m hiding the temples with my hair from the middle of the head.

I have already seen the dermatologist several times and he always denied the truth by saying “You’re not balding.” or “You have got only temples.” or “You have a lot of hair” or “You have got no hair loss.” etc. The last time I have seen the dermatologist (April of 2013) he told me that I had a “very young” implantation and I had no kind of baldness and he asked me how my mother’s brothers were but she has got only sisters !

So, I would like to know if it is possible that the dermatologist is denying my baldness or maybe is not seeing it. Am I really balding or not? (My hairline receded about 1 inch or more in only 6 years. That is what I call the second stage, maybe it is still a first stage).

Thanks for reading. I wish you could answer to my question.

I don’t know what purpose it would serve for your dermatologist to deny your hair loss if you actually had genetic loss. In situations like this, I would that you get another opinion. You can send me some good quality photographs with your eyebrows lifted high so that the wrinkles of your forehead show, and then I can give you the feedback you want and apparently need. Second opinions are always a good idea if you lack the confidence in the opinions you are given.

You would need to call my office at (310) 553-9113 or (800) NEW-HAIR to set up a formal phone or in-person consultation for this. Personal / individual consultations are not given via email or this site.

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I Had 5000 Grafts, Will My Donor Area Regrow? (Photos)

No, your donor area is depleted. I don’t believe that 99% of people who get 5000 FUE grafts can support that number without getting a see-through donor area. Your residual donor density is probably too low for reasonable coverage. Scalp Micropigmentation works well for managing the APPEARANCE of this problem (See: https://scalpmicropigmentation.com/)


2019-02-14 06:27:36I Had 5000 Grafts, Will My Donor Area Regrow? (Photos)

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Is Norwood Class 1 a Mature Hairline?

Hello, Dr. Rassman, I have a couple questions for you about hairlines. You see, I’m a little confused…

I am a 24-year-old Caucasian male with no outward signs of pattern baldness, even though it does run on both sides of my family. I was looking at pictures of myself the other day from when I was about 12, and noticed in one picture of me with a crew cut, that I at one time had a very rounded hairline, like that of a female. This got me thinking (and a little worried), since my hairline today looks like that of the guy in the first picture on the Norwood scale. It’s not the hairline I had when I was 12, but it’s not a “mature hairline” either. I did the brow measurements and my hairline is still very much in the juvenile position, albeit more square in shape and rising slightly at the corners, just like the guy in the picture.

So I’m curious, is it possible for the first Norwood illustration to be the mature hairline in some cases? My hairline has been like this since I was about 18 or 19-years-old and hasn’t moved an inch since then.

Thank you for your help on the matter.

Norwood 1I’d say that yes, a Norwood Class 1 (see art at right) and a mature hairline are basically the same. The hairline you saw at 12 years old is your childhood hairline and it is completely normal for your hairline to mature to some degree a dozen years later. You can not tell at your age for sure, but with a good mapping of your scalp and measurements looking for miniaturization in the corners, you might just see where your hair loss is going, if anywhere.

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6 month old Hair transplant and disappointed (photo)

You have to give it a couple of more months as more hair may yet grow and the hair that is growing will grow longer. If it doesn’t get better than see your surgeon and he/she should make it right as any good surgeon would as long as trust is there.


2021-01-21 16:16:466 month old Hair transplant and disappointed (photo)

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Is Scarring Common at the Recipient Sites?

Thank you for the time and effort you put into answering all of our questions. My question regards scarring. I have heard some people say that scar tissue forms where the hairs are implanted during a transplant, and that this can result in bumps or raised spots on the hairline. Is this true? If so, is it common? If not, why don’t scars form where the hairs are implanted? After all, a wound of sorts must be made to implant the hair, so how would do you prevent hundreds or thousands of scars from forming after a hair transplant?

With the technique we pioneered, we do two things that minimize recipient site scarring —

  1. We make very small wounds in the skin, essentially slits that approximate the size of the grafts. These heal very fast.
  2. When preparing the grafts for implantation, we cut off the skin disk at the skin level. To minimize the skin disk, we remove the top layer of the graft skin from the surface of the graft. This prevents the skin from surviving the transplant which could, in some individuals, produce the bump seen in recipient areas. The same process is done with grafts taken from strip surgery.

When doctors use grafts that have a larger surface area than what I described above, the bumps you referenced get more prominent. We have seen from the old days when plugs were done and the graft sizes ranged from 3-5 mm across, the skin always was deformed. Clearly the more skin that survives at the top of the graft, the more detectable will be the existence of the transplanted graft.

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6 months on finasteride and minoxidil (photo)

This is another great result on a person who appears sensitive to both minoxidil and finasteride. Reversal is more common when hair loss was in the past couple of years.

 


2020-07-06 17:59:316 months on finasteride and minoxidil (photo)

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Is the Hair Transplant Industry Getting Oversaturated?

Hello Dr. Rassman,

I’m a pre-medical student, applying to medical school next year, and ever since discovering sites like ‘hair transplant network’ and doing independent research, I’ve decided I have a great interest in entering the hair transplant field. However, I recently read an abstract you published in 2003 regarding the status of the transplant market for both the consumer and the physician, and it lead me to believe that by the time I get out of medical school and residency, hair transplants may be an over saturated commodity? I may have interpreted the results of your work a tad harshly, but I was wondering if you had any advice for someone in my situation? Do you think there will still be potential for a successful, innovative private practice, or would it be akin to opening a laser clinic on Rodeo in 2009 -aka you’ve missed the cusp of the wave and it’s too late to break in now? I realize that you can’t predict the future, but I’d appreciate any advice or insight you can give me. Thank you very much.

I think that the issue is classic capitalism (supply and demand). With today’s economics, hair transplantation is not a necessity so there are clearly more providers than patients, but who knows 10 years down the road. The miracles I see daily in my practice will be better understood by the balding population and will, almost certainly, cause an upswing in patients seeking this service, but who know if the physicians skilled in the art will multiply faster than the demand for services. Ask our economists, who seem to know the answers to everything in our present economic climate.

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Is There a Way to Determine If You Will Eventually Have MPB at Some Point?

Is there any way whatsoever to determine whether a person will at some point in their lives suffer from male pattern baldness, and if so, would this not eliminate the problem of transplanting people too young (say if they have a naturally high/ uneven hairline etc)

There is a test called HairDX that will tell you if you have the gene (70% accurate), but it won’t tell you when that gene will be expressed… or if it will be expressed at all. So on a predictive basis, the answer is unfortunately no. But if you want to know if you are balding (possibly just a little) then you should see a doctor who is experienced in hair analysis for miniaturization and hair bulk, which this will tell you if the balding process has started in you.

Many young men with a balding dad or uncle or brother are expecting hair loss to happen to them, and these are the patients I can help by telling them what, if anything, is going on in their head. If you have an average hair thickness, you might not see thinning until the hair loss is at 50% of the original density. Coarser haired men will often not detect loss even at 60-70% of their original density and blond men may not detect hair loss or thinning to 80-90% of the hair due to the low contrast between hair and skin color.


2011-09-11 10:03:01Is There a Way to Determine If You Will Eventually Have MPB at Some Point?

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7 months finasteride, minoxidil and microneedling

As promised I am entering in the 7 months with complete photos took each month.

Routine:

  1. finasteride 1mg every morning when i wake up

  2. minoxidil twice a day

  3. zinc + D vitamin 3 months cure After dinner

  4. cafein + kératin 3 months cure After dinner for better absorption

  5. microneedling once every 2 weeks at 0.5 to 0.75mm with 16 needle dermapen . If i go more than 0.75mm = bleeding which i do not want

  6. 15mn head massage twice a month

  7. t gel shampoo once a week max.

  8. essentiel oil shampoo that i have made (Cedar + ginger oil)

Amazing! This is strongly the work of microneedling plus help from everything else.