Category: Uncategorized

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Your take on hair systems?

I was wondering if you have an opinion on hair systems, or if you ever recommend them to patients with advanced balding? I know that most people prefer to keep their natural hair, but I feel like people with very advanced balding (NW5+) would look much better if they just wore fake hair rather than try to stretch out their limited donor supply over their entire scalp. I’ve noticed that people who try to get a transplant as a nw6/7 almost inevitably have to choose between a sky-high hairline, a giant bald spot surrounded by a ring of hair, or just very thin hair all over.

Different strokes for different folks. Hair systems work and work well; however they are very expensive (see here: https://baldingblog.com/why-not-a-hair-system-instead-of-a-hair-transplant/) and once your on them, you are hooked on them because the attachment mechanisms cause permanent hair loss and makes the balding worse. Even from a cost perspective, a hair transplant is generally less expensive unless you are a Class 7 man. In that case, a hair system is like putting on a hat, but you have to wear it all of the time and over time they start to smell and fall apart, requiring washing and replacement frequently. Also, unless you can afford the best like Donald Trump has, your system may be detectable to almost everyone. Nobody likes that.


2021-04-05 06:48:47Your take on hair systems?

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I Have Red Hair — My Dad’s Family Has Red Hair, My Mom’s Family Line Is Balding

Hi

I have red hair and it comes from my father’s side of the family only. The men on this side of the family have their hair but the men on my mom’s side (who do not have the red hair gene)all suffer from MPB.

My hair is starting to form into Norwood Scale 2: is it possible I could go bald too even though the red hair gene comes from my dad’s side?

Thank you for your help.

The color of you hair, along with other physical characteristics you inherited, are carried in different genes than the ones associated with MPB. The genetic predisposition for balding is inherited from either your father’s and mother’s sides, with more weight on your maternal lineage (48% for father’s side vs 52% for mom). There is a possibility that you may develop MPB. You need to be examined by an expert, someone who will map out your scalp hair for miniaturization to determine if you will be losing your hair. If you are in the early stages of hair loss, then you need a Master Plan to determine how to proceed with your hair loss treatments.


2008-02-15 14:34:48I Have Red Hair — My Dad’s Family Has Red Hair, My Mom’s Family Line Is Balding

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I have water retention from Minoxidil

Have any of you guys found a successful dosage that doesn’t give you puffy face, fat belly etc while still being effective for hair growth?

If you are getting these side effects, either the dose is too high or you should not be on this drug. Speak with your doctor

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Dutasteride dosing with a long hair life?

I just started Dutasteride. What’s this about the half-life allowing you to take it less often than fin?

The half life for dutasteride is 6 days (this is in the blood), but the tissue life (at the hair follicle itself) lasts much longer-possibly weeks or even a month. Less frequent dosing is ok, in my humble opinion.


2020-02-07 08:49:14Dutasteride dosing with a long hair life?

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I Met with a Doctor That Immediately Told Me I Needed Three FUE Procedures for $45,000

Hi Doctor,

I am 26 and have been losing my hair at the centre, back and recently at the front.

I consulted this week with a doctor in Dubai and he classified my hair loss as pattern 4 class 5 (Hair characteristics are color:black, quality: wavy,thickness is average and density is average). He told me i would have to undergo the FUE procedure. His treatment recommendations were 2 sessions of 3000 hair follicular units at the center and back, another 3000 at the front. The total cost of it being 45,000 usd with a 3 month gap in between these surgeries.

What puzzled me the most is that he just had a look and told me that i would have to undergo this surgery. My concerns are that the price quoted is too expensive for me and i want to know if there are any good doctors out here in Dubai who could do this for a lesser cost. I would greatly appreciate your opinion on this. Thank you.

Nuts
More examples of nuts

This is nuts! By just looking at you, he knows your hair density? My opinion is that no doctor can do 9000 grafts total in 3 sessions over a period of 6 months without really examining you, knowing your density, scalp laxity (for strip surgery), etc. And to add insult to potential injury, recommending it blindly every three months on the schedule outlined above is either the work of God, or possibly a doctor who has a streak of larceny (small or large) in him. Maybe I am just overreacting, knowing that I have a human type of limitations.

In other words, I’d seriously think about what this doctor is trying to sell you, and whether it is even possible for him to do what he is suggesting with any consistent quality. You wouldn’t want to pay for something and only get a small percentage of hairs actually taking and growing, leaving the other grafts too damaged to be of any good. Maybe Dubai does not have laws that protect consumers (nevermind, they do), but I would be suspicious, at the very least.

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I Read Online About Propecia Side Effects and Now I’m Freaked Out!

I am seriously considering taking propecia, I did a bit of research online and came across a few sites that really freaked me out, askthepatient.com propeciasideeffects.com. which report serious side effects and by some people they have not gone away. what do you say about all this, I would really like to take the drug but I am a bit freaked??? please answer me

Propecia (finasteride) has side effects that I know of, as follows:

  1. Increased libido in some men (usually older), because testosterone levels go up by about 15%.
  2. Decreased libido in about 1-2% of men, Also, erectile dysfunction is included in this group.
  3. Decreased in prostate cancer. Many people, like me, feel that this may be the magic bullet for prevention of this disease.
  4. Breast nodules in far less than 1% of men taking Propecia.

As the half life of this drug is 5 hours, it will be out of your system in a couple of days after stopping it. If you get any of these side effects, they will go away. Although I do hear some reports of other ‘not feeling well’ side effects, these may well be psychosomatic. If you need it, try it, for there is nothing to lose. If you do decide to try it, then you should give it a fair opportunity to benefit you by taking it for a full 8-12 months.


2006-09-18 09:28:24I Read Online About Propecia Side Effects and Now I’m Freaked Out!

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I Started Losing Hair Before I Hit Puberty!

dear doctor,

PLEASE HELP ME!
i am a 16 year old male teen. the hair on the top of my head has been thinning since age 9-10, and i fear that at the rate i will not have hair on the top of my head by this time next year. this has been 6 long years that have been devastating to my self-confidence and i dont know if i can deal with being bald at age 16.

i did plenty of research on my dilemma, and i didnt find any record of a case that is similar to mine. i have been to a doctor, and have been tested for things such as thyroid, but it always come out negative. my doctors dont really seem to care much to help me. they tell me its just hereditary, but i dont understand how it could be. i started losing my hair before i hit puberty, and also my my whole family still has there hair. even my grandma and grandpa who are in his 70’s have nearly all there hair.

at age 12 i was told to start using rogaine, but stopped because i know that there is something else wrong that is not being found. every day i wake up and look in the mirror to see that i have lost more hair. it getting harder and harder to hide it from my friends. and everywhere i go im constantly reminded of it because my hair shows up everywhere like in my sink, or on my desk at school.

anyway, please please please answer me back. you’ll be the one person in the world that cares enough to truly help me find out the problem and hopefully the answer. thank you for listening.

I wish I could offer you some solid advice or anything of substance, but you really need to be examined, as your case is quite unusual. I couldn’t do you any justice by just guessing at your problem via the web. As you indicated in your email that you’re located in New Jersey, try to arrange a visit with Dr. Robert Bernstein (with offices in Fort Lee, NJ and Manhattan, NY). He can examine you and offer suggestions.


2008-06-10 12:07:31I Started Losing Hair Before I Hit Puberty!

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I Switched From Finasteride to Dutasteride And Now Have Shedding All Over the Scalp

Hello Dr. Rassman. First, a huge thank you for this great site. It is an island of real medical information amidst the sea of misinformation of hais loss.

I have a question I believe has not been asked before. Can the switch from finasteride to dutasteride cause catch up loss?

After 4 years on 1.25mg of finasteride, 3 months ago I added 2.5g of avodart daily for two months, lowering the dosage to 0,5g daily after that. I mantained finasteride for the first month of avodart and stopped taking it since about two months ago.

As of now I am experiencing massive shedding all over the scalp (including the sides and donor area), with the characteristic white bulb of a telogen effluvium. Could this shedding be catch up loss from not taking finasteride, causing permanent damage, or does avodart “picks up” that protection and is just normal shedding from switching medication? Is it reasonable to expect my hair to grow back? I discussed this with my doctor, but he simply does not have your knowledge. I returned with my daily 1,25 of finasteride a few days ago, just in case, and will maintain a low dose of avodart for extra dht suppression.

Thanks for your time!

Changing many factors makes an analysis extremely difficult. I haven’t heard of a switch between medications causing catch-up loss, but I’m not sure why you were taking both medications and changing doses so much. Did your doctor prescribe this method?

Since you’re going back to your finasteride routine that worked for you before, I’d give it some time to see what happens. I’m not sure why you experienced a massive shed, and it’s particularly troubling that it occurred in the back and sides of your scalp. If your doctor isn’t knowledgeable about treating hair loss, you should try to find one that does. You should have your scalp examined and baselines measured so that you can know for sure what any treatment is doing (good or bad).

I said this many times, and it may not be something you want to hear, but in the end your genetic predisposition will win out. It is really not about total DHT suppression.


2013-03-04 15:35:59I Switched From Finasteride to Dutasteride And Now Have Shedding All Over the Scalp

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I Think My Hair Loss Is Too Aggressive to Be MPB!

I would like to get your opinion on why I am experiencing relatively sudden thinning. I am 19 years old. I can’t pinpoint the exact time that my hair started getting thinner, but I can say that my hair was completely full a little under a year ago, because of my driver’s license photo.

I have a feeling the hair loss is far too aggressive to be male pattern baldness, because I have had no signs up until recently. I don’t recall before a couple of months ago. In fact I have never seen hair fall out of my scalp or seen actual “hairloss” but i’m sure people rarely do.

I would like to know if you think this hair loss is temporary (based on the photographs) and if you think this is possibly permanent or even male pattern baldness. I have no history of the disease, my grandfathers on both sides died with a full head of hair. So did the grandmothers!

Male pattern baldness (MPB) does not always require a doctor to assess. Look at your hair loss pattern (use two mirrors). Is it thinning mostly at the top, but you still have good hair on the back and sides? If so, chances are you have MPB. We recommend a miniaturization mapping of your scalp hair and you can make the diagnosis that way. You can see how to do this yourself — here. By the way, MPB is not a “disease”. It is a genetic trait that you inherited from one of your parents. It may skip generations so you may not see it in your immediate family tree.

Finally, the aggressive nature as you describe does not surprise me, as men who lose considerable amounts of hair with an advanced balding pattern usually have a more rapid course of hair loss, often starting in their very early 20s. That may not be your case, but don’t fool around with it as there is a good medication (finasteride) to take if you are unfortunately balding. See your doctor and get a correct diagnosis and ask about options.

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I Use Rogaine Foam in the Morning and Liquid in the Evening, But See a Lot of Shedding

Hi Dr. Rassman,

Firstly, thank you for your awesome blog, it’s a brilliant resource for hair loss sufferers.

About 2 months ago I started using liquid rogaine in the evening instead of foam (I still use foam in the mornings). I did this because my hair is relatively long and I felt that the foam was just going on my hair rather than my scalp. My hair has been shedding like crazy recently and I’m wondering if this could be due to the switch to liquid in the evenings?

I’m hoping that now more minoxidil is reaching my scalp it’s causing miniaturized hairs to fall out rather than the balding process accelerating. What do you think, could my theory have any credibility?

PS. I have been on proscar split in 1/4s for over a year.

Many thanks in advance.

I suppose it’s possible that you could have an allergy to something in the liquid that isn’t in the foam, but the active ingredient in both versions of Rogaine is 5% minoxidil. Some people notice increased shedding in the first couple of months, so continue using it and see what happens over time.

You should be managed by a competent, experienced hair doctor who uses the HairCheck device to accurately measure your hair bulk to see if you are losing hair. Once baseline measurements are made with this instrument, you can repeat it in a year to see what, if anything, changed.