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The Hair Loss Consultation

Hi, I believe I asked a question some months back but you only responded by asking me to come in for a consultation. So, let me try to get into specifics before considering coming in. I have been undergoing some stress lately and noticed thinning of my vertex. My hairline is completely unchanged… same as it has been since high school. I am also underweight for my height. Male, 28 years old 6’2″ 160-165 lbs. I have been underweight for the last 4-5 years. My average weight was 180 lbs in the past but have been eating less due to shortage of time and decreased appetite from work, plus I exercise 5-6 days a week. Also, my protein intake has fallen drastically.

I am contemplating whether I am experiencing MPB or Telogen Effluvium. Few months back I noticed a lot more shedding from the vertex area, mostly in the shower. I would pull at my hair and more than 4-5 strands would come out at a time and would not stop until I have pulled out an average of 10-15 strands. This happened every morning in the shower. It has somewhat slowed down, but now I am seeing some hairs come out that underwent miniaturization. Maybe I am experiencing a combo of both Telogen Effluvium and MPB. But has there been cases where men only experience balding in the vertex only?

My father is balding at the age of 59 (typical horseshoe). My mother’s side shows no signs of hairloss from anyone. He informed me that he experienced loss in the front first. If I inherited his baldness, would I follow his pattern?

Detailed feedback would be appreciated. Is consultation by appt only?

Yes, consultations are by appointment only. Your case, like many, are not as cut-and-dry as you’d like it to be, so it would be difficult to just make random assumptions about your hair loss without an exam. I’m not trying to “rope” you into coming in, but I’m also not trying to steer you in the wrong direction. This does require an exam, which can and should be done locally. When I see a patient for the first time (let’s say you, for example), I would plan on spending an hour with you, which gives me time to:

  • Get to know you
  • Listen to the problem you will be defining
  • Examine your scalp and hair in detail
  • Discuss a ‘plan of attack’ based upon a Master Plan we would setup to manage your hair loss problem

MPB can be limited to only the vertex (crown), or it may start in the front and progress backward. Genetic hair loss generally occurs in patterns (see Norwood Chart). Telogen effluvium, on the other hand, would be diffuse and not only limited to a patterned area.

If you’d like to setup a free consultation, you can either call my office at 800-NEW-HAIR or fill out the form on my site to Request Additional Info and someone from my staff will get in contact with you.


2007-12-20 09:55:05The Hair Loss Consultation

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The Hair Around My Ears Doesn’t Grow As Long As the Rest of My Hair

Hello,

I hope all is well today. I was curious as to why hair around ones ear and lower hairline (the rim around sideburns/ ears to bottom back part of head / even up to temples) only grows a certain length. I guess I just assumed this hair would keep growing for years and be as long as ones hair on top. I am not experiencing MPB or anything, I was just curious. Seems as though even no matter how long my hair on top and mid sides gets these hairs around the hairline perimeter only grow so long, maybe just a few inches.

Thanks

Hair that grows in different parts of the scalp and neck vary from each other based upon your genetic programming. We are all different, so what applies to one person may not apply to another. For example, neck hair does not grow long like scalp hair in most people and it may even be different in texture.

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The Great American Dream Vote Winner Update (Video)

College student Russ Jowell’s dream was to have a head of hair again, and as the winner of ABC TV’s “The Great American Dream Vote”, his dream was granted by the New Hair Institute in the form of hair transplantation surgery.

I sat down to speak with him the day after his surgery so he could tell the viewing audience what it’s like to win all that money, the car, and the rest of the amazing prizes. Plus, find out what his hair transplant surgery experience was like and how his life has changed since the show. Look at him and see if you can tell that he had a hair transplant the day before.

For more about the show, click here.

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The FDA Has Been Wrong in the Past

I hear you say any Propecia side effects are gone within a few days or weeks at most. But what about other drugs that the FDA has recalled because of permanent side effects? Those drugs presumably had half lives, and the literature indicated that side effects would go away soon after stopping those drugs. Maybe the same scenario goes for Propecia.

You have an agenda in your question. God does not reside at the FDA, which means that their activities are less than perfect, and yes, they’ve made mistakes in the past. We can only tell you what we believe we know. Finasteride has been on the market for over a dozen years now. If you can’t find the research and proof to be credible by now, I don’t know what more I can do to help.

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The FDA Ain’t Perfect

I rely on your blog as an authority in Hair Transplant information as well as hair loss information, but I don’t understand why you guys have absolutely no faith in any treatments that are not backed by the FDA. You have lots of people on here claiming that they are getting results from other treatments and you just waive those off with, “well the FDA hasn’t said anything about Nioxin so I doubt have any real benefits” or Regenix or Nizoral.

If we wanted the advice of the FDA we could manage to find their website, but then again they are the federal body that told us Rezulin and Vioxx were okay.

So my question really is why be so close minded to alternative treatments other than lasers, minoxidil and finasteride. We get that those have been approved by the FDA, but why not look more closely at the alternative treatments that have not been approved or even looked at by the FDA, instead of just non-chalantly poo-pooing anyone on here you seems to have good results from them.

Anyways, great blog regardless. Thanks for all of your contributions.

FDAI’ve never told anyone to flat out “do not use that product” unless I knew it to be harmful to them. Most of these products are a waste of time and money, and when I’m asked about my opinions I’m going to provide them. There is no regulation on many of the products I’m asked about, and countless companies will take advantage of the balding public’s desire for hair growth. In fact, I’ve often told people that write in with positive experiences with a non-FDA approved hair treatment that I’m glad they’re getting good results and to continue using it as they see fit. However, as a medical doctor I’m not going to recommend possible garbage to thousands of people that visit my site daily. I will, however, recommend proven treatments that have been tested and shown to be safe.

Yes, the FDA isn’t perfect. I’ve addressed that topic many times. But until something better comes along, it’s what we have. I’d certainly trust the FDA before I’d trust most messages posted by anonymous people on internet boards just eager to tell you all about the latest new hair loss cure that they happen to be selling if you click their affiliate link. I mean, the last time I looked, the FDA didn’t have links to buy the products they approve… but I can’t say the same thing for those people that spam web boards. Oh, and for the record — I think the hair lasers are also a scam and I’ve been highly critical of them (they’re not FDA approved, just cleared for safety).

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The Dangers of Medical Tourism: What It Is and How It Can Impact You

The following post is by UK-based physician Dr. Bessam Farjo:


Written by:
Dr Bessam Farjo, United Kingdom
Dr Bessam Farjo
United Kingdom

I recently came across a poll on newbeauty.com, which reveals that one in four Americans would consider having surgery if it wasn’t so costly. With this in mind, it’s not surprising that people seek a lower cost option and consequently consider having surgery in a country where it’s cheaper. While the discounted price tag may be very appealing, there are some important things to bear in mind when it comes to having surgery abroad.

The same website outlines some of the dangers associated with medical tourism. It describes how it can be difficult to check if a foreign physician’s credentials are genuine, suggesting that the International Society for Aesthetic Plastic Surgery is a good place to start. It also flags up that you may not be covered by your travel insurance if something goes wrong in another country. Another issue concerns recovery, which can sometimes take longer than expected after surgery and there can also be a danger of clotting if travelling by plane.

Similar considerations apply to our own field of hair transplant surgery. The website of the International Society of Hair Restoration Surgery provides a list of members as a reference not necessarily recommending anyone in particular. It is down to the individual patient to do their due diligence whether online or in person.

There are clinics that try to take advantage of potential patients who consider surgery at home too. We’ve seen a growing number of men come to us after opting for surgery via an offer on a discount website such as Groupon or KGB deals. These ‘deals’ are usually limited to 1,000 grafts which is only around 2,000 – 2,500 hairs. To anyone with a significant amount of hair loss this would be nowhere near enough to provide a suitable result.

The small print in these offers often dictates that only one discount is available per person, meaning that anyone requiring further treatment would have to pay the full cost or more likely, above the odds.

There certainly are some serious dangers involved with having surgery both abroad and at home and I would strongly recommend considering these should patients be tempted by low-cost surgery options. As always, I must stress the importance of thorough planning and research when contemplating any type of surgery, make your decisions based on what’s right for you, not on the price it costs.

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Learn more about the author of this article, Dr. Bessam Farjo, on his BaldingBlog profile or at his website.

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Dr. William Rassman’s Comments:

    I can speak to having surgery in the United States, Canada or Europe. The issue of recourse comes up. What recourse do you have if the doctor misrepresented himself (or herself)? Or if there is medical malpractice involved in the delivery of the surgery? Or if the “doctor” really isn’t a doctor?

    I know the laws in California are made to protect the patient at all times, and California lawyers are waiting enthusiastically to represent those who are harmed. The legal recourse in many foreign countries may not be there, which means that if you become a victim of the surgeon, there is little you can do about it. This, to me, is a good reason to have the surgeries in the United States, Canada or European countries that have strict laws that control doctors’ licenses and the way they use their licenses.

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The Damage Produced by Sun Exposure (with Photos)

This is a 70+ year old man who had blonde hair in is youth. He was a lifeguard for 15 years and constantly got sun burned. The price he paid for this sun exposure is monthly visits to his dermatologist with many, many skin cancers. Notice that his hair loss could not be worse, with hair not only in the front and top, but also the sides to just behind the ears. I suggested that he was not a candidate for hair transplants. You can see the many scars resulting for removal of his skin cancer. The message to take from this is to stay out of the sun and certainly be careful that you don’t get sun burned!

Click the photos to enlarge.

 

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The Corners of My Hairline Are About 2 Inches High

Good afternoon Doctor! I just want to thank you for this site.

Im an 18 year old boy, and since i was around 17 my hairline changed into what it now is today. However I’m not sure where to class ito n the norwood scale. The frontal hairline is, like you say in the normal place, exactly half an inch above the furrowed brow, however my concern is asscociated with the corners of the hairline. From the highest wrinkle, if i place a tape measure to the furthest point of the corner of the hairline it measures around 2 inches.

My question is with a corner reccession like this, could i still be placed in the Norwood 2 section? Because if you look at the stage 2 of the Norwood scale, the measurements found on this site for the mature hairline don’t appear to fit with it. The front of the hairline and the corners appear to have a far greater gap than the ‘norm’ of 1 – 1.5 inches…..

And just as a last question, if i start on Propecia at this age, is there a chance i could keep this hairline for the rest of my life? I hope i’ve been clear in what i’m saying. THanks alot and i look forward to your reply.

I’d stop trying to categorize yourself into a particular Norwood class. Perhaps you are a class 2 or class 3, but I really do not know (photos might help). Are you measuring at an angle? Assuming you’re seeing 2 inches when measuring perfectly vertical from the brow to the corner, it sounds like it’s past the Norwood class 2 level. But it seems more like things are changing and evolving as you are maturing. You’re 18 years old, and a maturing hairline is definitely not uncommon at that age. The real issue is finding out if you are actually balding or not.

Before thinking about Propecia or putting yourself into a category, go see a doctor and get your scalp mapped out for miniaturization. If you are indeed thinning, Propecia may be an option to halt further loss.

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The clinic is offering me 6000 FUE grafts, what do you think?

As the doctor who pioneered the FUE, I can tell you with authority that 6000 FUE grafts will deplete your donor area and produce a see-through donor area. This is not a fixable situation as once the hair is moved, it will not regrow there. What is the doctor’s plan other than to get your money? What happens if you continue to bald over time, what then? Have you thought through this process?? If you are under 25, then you are about to make a terrible mistake.