Category: Uncategorized

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Hair Loss, Lasers, Drugs and Transplants

I am undergoing a hair loss treatment. This treatment involves lasers, basically a helmet that shines light on my head to deter DHT. I am somewhat skeptical, but it was the only option that was within my price range at the moment. I am 20 years old; my hair loss is not substantial. I am thinning on the top of my head and the most severe areas are in my hairline and the back of my head. I took this treatment to prevent my hair from thinning anymore. The thinning is not very obvious but I can tell it is still progressing. I wanted to know if transplanting hair from my own head would leave an area in the back of my head that hair will not grow on anymore. I also wanted to know if there are ways of getting transplants from other donors. Lastly, I want to know how much these treatments would cost and how effective the treatment I’m receiving is.

There is anecdotal evidence in Europe that hair lasers (Low Level Light Therapy / LLLT) increases hair growth. I’ve written about LLLT previously, here. Thinning of the hair in young men often starts off insidiously and gets slowly worse. At the beginning, you might actually lose 50% or more of your hair before you notice it. If you are a platinum blonde, you could lose 85% of your hair before it becomes noticable. The key is to make the diagnosis early and get on the only good, FDA approved DHT blocker that is out there: Propecia. This drug is the best and possibly the only real hope at this point to slow down, stop or reverse the hair loss. In young men, I have seen some wonderful reversals of hair loss. Transplants in a 20 year old without noticable hair loss is NOT something you should pursue at this time. When the donor area is harvested for hair transplants (the back of the head) it does not produce a bald area as you suggested in your question.

Laser treatments can be obtained from those who sell those services. We have a laser in our Los Angeles office, but do not sell the service at this time. I am told that the company that provides the service charges about $3000/year for treatment. Propecia costs range from $55/month to as high as $120/month depending upon the pharmacy you purchase it from. We sell it in our office at $53/month (very close to our cost). Transplants are sold by the graft. These surgical procedure generally cost a few thousand dollars per surgery, but they do last your lifetime. The more transplanted grafts you buy, the higher the fee.

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Treating Norwood “A” Patterns

Hi Dr Rassman,
my question is the following : How often do you see people with Norwood “A”-pattern hair loss that reach Norwood 7 (or 6) AND how difficult is a 5a pattern to treat with transplants (can they get full coverage). Seeing that you now offer SMP. Because I’m a Norwood 5a patient who recently had a FUE hair transplant with Dr. Pak in your Los Angeles office it’s was about 1,200 grafts and I have to tell you it was the best decision that I’ve could’ve made!! I’m thinking of having another FUE procedure, so I was thinking of having the FUE & SMP done together to get more density.

I would really appreciated if you could let me know what you think about my question.

Thanks for everything you do and keeping us informed. Oh and 1 million thanks for a great job and keeping up the great work!!!

I am pleased that you are pleased with Dr. Pak’s work!

The Class 5A pattern does not evolve into a Class 6 or 7 pattern. The original chart by Dr. O’Tar Norwood showed that the patterns defined in the diagrams are the end stage, particularly the “A” series. I like to work on the “A” pattern patients, because there is usually enough hair to give them whatever they want (that is, unless their original density is very low).

Scalp micro-pigmentation (SMP) with follicular unit extraction (FUE) is a great combination treatment where you can achieve the dense look with SMP and a natural real hair line in the front with the FUE.

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Why Does Hair Loss Start at the Temples or the Crown? (from Reddit)

Genetics dictate where the hair loss starts. No one understands why, but it is “observational”. It often starts at the hairline and in the crown then spreads from there according to your inherited pattern. Look at your family’s pattern (mother and father’s side) to see what might happen to you.

Why does hair loss start at the temples or the crown? from tressless


2018-09-14 09:29:02Why Does Hair Loss Start at the Temples or the Crown? (from Reddit)

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Trichotillomania and microneeding

Some people see regrowth from microneedling coupled with finesteride. If somebody’s hair loss is not entirely related to dht then would just microneedling have a better chance of working then for somebody who has dht related loss? For example some women experience this trichotillomania related hair loss issue and they most likely don’t have dht related loss. Do you think it’s worth a shot to try only microneedling? I already started but I wanted to know what you think.

At the end stage, trichotillomania causes traction alopecia and it is usually permanent. IF the person still has growth potential, all they need to do is to stop picking on the scalp and then wait for 6 months, when the hair will usually grow back. Adding microneedling to this might accelerate the growth of hair that is not ‘dead’ but will come back normally after 6 or so months

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Tugging on Hair to Stimulate Growth, Applying Garlic to Nurish the Hair Root

i have evidence that there are methods to reverse hair loss without paying money for chemicals like minoxidil or for surgery. however, because these methods are completely natural and can’t really be bought or sold, there is resistance to publish this information or no incentive to pay for clinical tests to produce results that they work.

examples include:
1) topical application of garlic, onion and olive oil to the scalp to nurish and clean the hair root;
2) using store bought saw palmetto to block dth;
3) stimulating hair by tugging on it gently, etc.

over a duration of 2 months results can be seen because dormant follicles begin sprouting hair again.

How did you unlock these secrets that medical professionals have been hiding for years?! Let’s dissect this…

  1. Garlic can create a unique pheromone, so tell us in another email if it helps with the ladies. It sounds like you’re making a pizza.
  2. Saw palmetto has been shown to slow hair loss in some men, but it is not consistent. Dosages are not controlled by the FDA (it is an herbal), so you never really know what you purchased.
  3. Pulling on the hair in the same place causes hair loss (traction alopecia) in some people depending how often and how hard you pull in it. Any advice on how to pull on your hair? I hope nobody is takes that seriously, because tugging on your hair won’t reverse hair loss.

Congratulations, I have given your message to thousands of readers. Hope it helps someone.


2009-07-10 09:02:49Tugging on Hair to Stimulate Growth, Applying Garlic to Nurish the Hair Root

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Hair Regrowth After Waxing Scalp, Part 2

Hi i recently sent you a question about waxing. [see Hair Regrowth After Waxing Scalp]

For some reason the waxed area appears worse. I am worried that I may have developed folliculitis on my scalp as a result. My entire scalp itches. It would be helpful if you could give me some information about folliculitis as well as the differences if any between folliculitis and folliculitis decalvans. Also it would be helpful if you could tell me what to do to contain the hair loss to only the waxed area basically prevent it from spreading.

Folliculitis is a condition where the hair follicles get infected because of bacterial invasion, often secondary to some irritation or wound of the skin. Folliculitis can spread from one hair follicle to another by touching or scratching it, making it worse. It is a fairly common condition.

Folliculitis Decalvans is a rare condition affecting mainly the scalp leading to scarring alopecia. The cause of the condition is still unknown, abnormal host response to Staphylococcus aureus (a bacterial infection) has been postulated. Folliculitis Decalvans causes scarring with hair loss (alopecia). There are areas of “corn stalking” (grouped hairs arising within the area of alopecia), redness (erythema), crusting, and pustules. Due to severe scarring, permanent hair loss occurs in the involved sites.

As you may be aware, this is a diagnosis not for the amateur. Get a good dermatologist to take care of you, starting off with a proper diagnosis. Appropriate antibiotics will be recommended by the doctor, if indicated.

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Two pictures of my hairline are 5 years apart, what is happening to me? (photo)

The two pictures are when I was 13 years old and I’m and 18 girl. My hairline shape is changing. Should I be worried about this?

The 18 year old picture needs better quality, but it does look like the shape is changing. This is not uncommon. I studied children from the age of 5 (both boys and girls) and saw rounded hairlines if preadolescent children change in both boys and girls as they got well into their teens. The rounded hairline when you were 13, has flattened out now and that is very common and normal. If you think that you are losing hair, then see a hair doctor.

juvenile hairline2evolved hairline 18


2017-10-10 19:27:12Two pictures of my hairline are 5 years apart, what is happening to me? (photo)

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Hair Thickening, Thinning, and Thickening Again from Minoxidil

Doctor

Just read a recent post regarding someone who notices his hair thickens and thins and thickens again. I’ve noticed that for years and just assumed it was from Rogaine. That it was either synch shedding which happened after first using the drug and just continued through the years or that at times realized I’ve been missing areas and after reapplying those areas came back. But again that was Rogaine not Propecia which the previous post was on. Wonder if other minox users noticed this.

After reading your reply made me wonder if TE tends to reoccur in people. It would make sense if it is in response to a stress. People who have physical ailments in response to stress tend to have the same physical responses repeat throughout their life. I wouldn’t be surprised if some people are predisposed to TE under stress. Just as some develop IBS that comes and goes.. acid reflux.. back pain.. IF TE happened once it will probably happen again under stress.

Thanks for your comments. I’m posting this to hopefully get other readers to share their experience with back and forth shedding from minoxidil, as you describe.

To put this all together, a good relationship with a doctor is a good idea. Yes, telogen effluvium can reoccur in some people. See eMedicine for more info.

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Unethical Hair Transplant Doctor Transplanting Hair On Patient Who Did Not Need The Surgery

This is a note I sent to a patient I saw today.

You have had previous hair transplants done by a Los Angeles doctor who has since lost his license. You received 3400 grafts in the front of your head. You were very frightened about the prospect of being bald at that age of 23. Now you are 31 years old and started Propecia 4 months ago. You want to know the status of your balding situation.

Today’s we used the HAIRCHECK instrument on your head. Measurements indicated that you hair bulk in the frontal 3 inches of your scalp exceeds the hair bulk of the donor area by 30%. Comparing the crown and the back of your head, the measurements were comparable.
This tells me two things:
  1. You are not presently balding
  2. Your hair transplant done years ago was done on a young man that probably was not balding but driven to have a hair transplant out of fear of balding. Frankly, you were taken advantage of for the money. I am ashamed that doctors in this field would take advantage of your youth and naivety.You agreed with me that in hindsight, you were driven by fear, not balding
The good news is that you should stop the Propecia and if you are ever concerned again about balding (which I believe will be unlikely for your future), please come back and let me retest you with the HAIRCHECK instrument.
As a side note: I would agree to (1) help him file a complaint with the medical board if the doctor was still licensed in California and (2) I would put him in touch with a lawyer to facilitate a malpractice action against the doctor and act as an expert witness on his behalf.