Category: Uncategorized

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How Could Someone Be a Norwood 6 But Still Look Like They Have a Full Head of Hair?

Dear Dr Rassman,

I was reading your blog the other day and was interested to see you comment that a person may have a norwood six balding pattern but still look like they have a full head of hair and also that a person who shows a Norwood 3 balding pattern would almost never advance to a norwood 6.

I am confused because in another post of yours you stated that thinning can begin in different areas at different ages. Can you clarify? I really would like to get an idea of what my final norwood pattern would be if bulk analysis can do that but now I’m not sure it can (?) what do you mean when you say that someone with NW3 thinning will rarely ever progress to a NW6?

If someone had slightly thinning temples and a thinner patch at the crown does this mean they are likely to be a higher NW pattern?

Many Thanks

Norwood 6Men in the process of losing their hair in a Norwood class 6 pattern may not be thinning uniformly. They may be losing more of the frontal hair faster, yet have the overall pattern of a class 6 that may or may not become complete. Some men who take finasteride will arrest much of the class 6 pattern thinning, especially in the top and crown of the head, but their frontal balding could actually be advanced.

I like to tell patients where they are going with their balding pattern, and where they are now during the evaluation.


2012-03-13 12:15:04How Could Someone Be a Norwood 6 But Still Look Like They Have a Full Head of Hair?

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What is wrong with my recipient area (photo)

You likely have an infection present with generalized redness and some pustule formation. Your doctor should drain one or more of the pustules, culture it and then place you on a targeted antibiotic.


2020-08-06 13:57:20What is wrong with my recipient area (photo)

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How Do I Know My Surgeon Has My Best Interests in Mind?

First of all, I’m a huge fan of your blog, it helped me a lot.

I visited a surgeon a year ago and he said he would do the surgery for me, but finally i did not have it done. I’m 24 and I haven’t noticed any hair loss for a year or so. I’m only balding in the front and it’s not too bad either.

I’m thinking of doing it now. But I read here that it’s usually not suggested to have it done at this age. Does usually mean that there are exceptions and occasionally you have patients at this age? How do I know my surgeon has my best interest? I actually do trust him. He is a member of ISHRS and seems very trustworthy. He said he usually doesn’t do it for young people, but that I have a lot of hair in the donor area and that since my hair is bright and curly, it’s easy to hide the balding.

We put together this post to help people like you to select a doctor: Selecting a Hair Transplant Doctor. You have to apply judgment in filtering out the variables discussed in this reference.

At 24 years old, you are at the marginal edge for doing hair transplants. Ask yourself — what is the rush? Is it bothering you enough to do something about it now or would waiting another year help you make the decision?

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What Should I Do After Propecia?

I’m 22 and have early frontal hair loss which I noticed 6 months ago and been on Propecia for 2 months now. I got a miniturization study done and the doc said I have it in the frontal area and a little on my mid anterior and he said it’s significant for my age (well in my opinion any thinning my age shouldn’t happen!). You always say Propecia works best for young men my age and we have a good chance of reversal and halt the hair loss but since men who start thinning my age are usually the baldest and have faster hair loss the others, how good in the long can Propecia work then? I know I’ll be fine for about 2-3 years but what then?

And it’s funny how weak MPB is in my family. Nobody except my father and mom’s brother had MPB but not until theirs 30s. My father is a NW5 at age 64 and my uncle is a NW3 with mid anterior thinning as well at age 40.

I have many male patients that first got great benefits from Propecia at your age, and now 10 years later they still have those benefits. I’m not sure how to answer your question — as I’ve said before, I can’t tell the future. Maybe there will be another drug available? Maybe your hair loss stops completely? Maybe you decide in 10 years that you hate hair and would rather shave your head? For now, stick with what is proven to work (Propecia).

There are patient results statistics for after 2 years and after 5 years on Propecia available here, and hopefully that will give you a little more peace of mind.


2008-09-18 10:48:06What Should I Do After Propecia?

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How do you tell if finasteride is impacting your brain?

I am about to get on fin but the one thing holding me back is I’m scared of suffering mental sides. How do you even know if you are suffering from them and not just… well… dumber?!? Makes me nervous cause of other things in my life. Curious if any fin users can add to this from their experience. Thanks!

People who have mental side effects generally don’t feel right. This is rare.


2019-05-19 10:22:52How do you tell if finasteride is impacting your brain?

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What’s the Average Number of Grafts That Can Be Transplanted in a Lifetime?

Many thanks doctors for providing help to all of us!! Your blog is very interesting.

How many grafts it is possible to extract from a caucasian male with an average donor supply over the course of his life? Does it make a difference whether it is a FUE or strip? 9,000?

Generally there are around 6,000 to 10,000, but it is depending on many factors, including race, ethnicity, scalp laxity, and hair density. We have transplanted as high as 10,000 grafts in a few of our patients over several surgeries. Others we max out at 6,000. Every patient is different.

The second part of your question was answered here — Can You Get More Grafts from Strip or FUE Over a Lifetime?

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How Effective is Rogaine Foam?

Hey doc, been using Propecia for 2 1/2 years its slowed things down a lot, just added Rogaine Foam last week. Just wondering if I can get a straight answer on the effectiveness of Rogaine Foam. The commercial says 85% of men see regrowth, ive heard other people say it only works for 50% of men and then I saw a post from you in your archive where you say it only works well for 15% of men. Well which one is it?

Rogaine FoamWe are prisoners of our words, so I will stick to what I said.

If you are in the 15% of good responders, then it moves you into the 100% category (playing with numbers, or course). Some people feel that the Rogaine Foam works better than standard liquid Rogaine drops, because it is easier to use and thus better for those who find the drops difficult to titrate. If there are 85% of men that see some growth, I’d estimate that maybe 15% of men see it work very well.


2011-07-15 06:27:42How Effective is Rogaine Foam?

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When hair disappears, are these hairs dead?

How does one know if a follicle has gone dormant, and can produce a new hair or is dead?

There is no way to tell other than the timing of its disappearance. Recent hair loss often has some active stem cells trying to find the ‘missing link’ to grow out a hair follicle. After years, these stem cells are thought to be inactive or possibly dead, but nobody knows for sure because we can get them to wake up so we assume the worst. If there is anything there, a small miniaturized hair left, medications might reverse it. Some people feel that microneedling might induce the recently hair that disappeared to come back. This is a microwounding process that causes the release of many kinases that can cause hair regeneration. When adding minoxidil to the process, results are even better. I referenced a review of mixroneedling here: https://baldingblog.com/review-of-microneedling-extensive-thorough-from-reddit/


2020-01-06 09:53:15When hair disappears, are these hairs dead?

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How Long Can I Skip Propecia for Without Problems?

I take propecia. It works. I’ve taken it for about 6 months. How long can I miss a dose? If I miss a day, I know it says just take one the next day. But will my hair fall out, and then the program just restart? Is there a site describing the way the drug works in your body, that would help me get this idea down? How much time can you miss?
Thanks.

Well, I wouldn’t suggest that you try to miss a dose. If you should miss a day, I doubt that it would produce measurable hair loss. Same goes for two skipped days… but 1 week starts to creep up on you and one month certainly will not be good. I have only seen 3 months of stopping Propecia where significant hair loss occurred. Don’t make it a regular habit of skipping days, though.


2008-12-22 08:26:59How Long Can I Skip Propecia for Without Problems?

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When Will Dr Rassman Retire?

Hello dr Rassman,

I think you are 68-69 years old.Does that mean that you are going to retire soon?If yes what will become of baldingblog?I hope you are going to be with us for another 5-10 years.

Dr RassmanMy grandparents lived well past their 90’s and longevity runs in the family… and since I love what I do, I suspect I will be doing this for a very long time. In fact, I am very involved with Dr. Pak in the engineering process of new hair transplant instruments and we will be testing a new FUE extractor and implanter in the next month!

Besides, even if I do eventually retire, I only need a computer and Internet for BaldingBlog, right? With respect to what you read on this site, Dr. Pak and I equally share contributing to the posts without the reader knowing who answered what. So even if I am gone for a long vacation, BaldingBlog will continue on. But in general, before any content is posted, both Dr Pak and I cross check and edit each other’s answers.

But just to make it clear, I am not planning on retiring yet.