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Hair can cover scars nicely as shown with your results taking advantage of a good beard transplant. Congrats!

About a year ago I started getting some scalp problems, primarily an itch. I would scratch the itch so hard I would develop some raw areas on the scalp that would scab over. Yet I continued to scratch and pick at the scabs until I noticed patches of bald areas on the top of my head where I had been scratching and picking. Will these areas grow back hair in time? Have I damaged the roots to the point no hair will re-grow in these areas? It looks horrible. Thanks.

You are clearly developing traction alopecia and these areas may stay bald. This is an obsessive/compulsive disorder and you should see your family doctor about his/her recommendations for treatment.

The study was released by the Britich Medical Journal which reported that the association of finasteride and Erectile Dysfunction when used for Benigh Proetatic Hypertrophy stated: “Our findings should be reassuring that the risk of erectile dysfunction is not higher for men who are prescribed finasteride or dutasteride for BPH or finasteride 1 mg for alopecia. Clinicians should be aware that the longer a man has BPH, the higher his risk for developing erectile dysfunction,” Katrina Wilcox Hagberg of the Boston Collaborative Drug Surveillance Program at Boston University School of Public Health, told Reuters Health by email.

The same was suggested in men who used the drug for hair loss, which they said “Similarly, in the cohort of men with alopecia (n=12,346), the risk of ED was not increased for users of finasteride compared with unexposed men with alopecia (IRR, 1.03; OR, 0.95).”.

What this says is that these drugs do not cause Erectile dysfunction. I am not sure that I believe this as some of the patients who I ahve treated have reported real one-on-one relationships between ED, libido and the drug finasteride, and when they stopped it, the symptoms always went away.

Here is the article which you can read for yourself. https://www.medscape.com/viewarticle/869443?nlid=109620_1001&src=WNL_mdplsfeat_161004_mscpedit_urol&uac=90007MX&spon=15&impID=1209180&faf=1

If your hair is fine, the part looks more see-through than when your hair is coarse. It does not mean that something is wrong unless you believe you are losing hair. I always tell people that when I was young, the grown-ups would rub my short hair for luck when they saw me. They did this because my hair was coarse and there was no see-through to the scalp. If I asked you, I’l bet nobody ever did that for you and you agreed, that means that your hair is fine and fine hair never looks very full and the scalp is often seen through the hair.

Do you ever increase density to an area in anticipation that there will be some shock loss?

Maybe I”m off but if technicians are doing most of the procedure I would think the rate of transection would be high. I don’t know what kind of training they’ve had. I assume just in house training. Obviously they’re needed considering the number of grafts but it’s a concern of mine.

No one can predict shock hair loss from surgery precisely. As a general rule the younger you are (early 20’s) with active (noticeable) hair loss in the preceding months would be very concerning for shock hair loss. If one is in their 30’s and 40’s with no significant change in their hair status in the last several years the chances of shock hair loss will be less. This is further improved by being on Propecia / finasteride.

If one were to go ahead with a hair transplant surgery, we take all the above in to account and balance out the risks (shock hair loss) versus the benefit of (new hair growth).

We do overlap the “risky” areas where there may be future hair loss with additional hair. This is not necessarily anticipating shock hair loss but rather anticipating further natural genetic hair loss. So that as you age the transplants would naturally blend in with natural thinning. This is basically part of the global MASTER PLAN that we always talk about at New Hair Institute.

With respect to the technicians who assist with surgery, they are the ones responsible for dissecting the grafts and inserting the grafts. This is their MAIN job. They do their work better than any surgeon – which is painstakingly dissecting and separating each individual hair follicles under a microscope. It is a very detail oriented work that require years of practice. The transection rate under a good technicians’ hands are very low. Most of the technicians at New Hair Institute have more than 10 to 15 years of experience trained personally by Dr. Rassman.

Hi doc, in your experience, is finasteride less successful for people who are lifting weights in the gym? Currently on 3mg/week for almost 2 months and still lose some hair.

I don’t see going to the gym as reducing the impact of finasteride