Balding Blog – Page 1400

October 15, 2008

Bald Spots After a Buzz Cut – Hair Loss Information by Dr. William Rassman

Hello
male/20/GA/caucasian
i have very thick hair and rich hair. but about two months ago i got a buzz cut (my hair at that time must have been about three inches or more). the barber did it very quickly though. there was no blood or irritation at the time. however when my hair started growing back a few weeks later i noticed a few irregular small patches and patterns on my scalp, on which there was no hair. i don’t see any scar marks either, it’s just that after the haircut i have not seen hair there after that haircut. do you think hair will regrow in those patches eventually?

If you have patches of bald areas after the close clipping and your scalp was not damaged by your stylist (you would’ve felt it), these patches may have just been revealed by the clipping, not caused by it. You should see a doctor for a diagnosis or send me photos, and maybe I can help (reference this post when sending).

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October 14, 2008

Hair Loss InformationIf I Had Minimal Yield from FUE Procedures, Do I Have Alopecia Areata? – Hair Loss Information – Balding Blog

In the post linked — Hair Cloning and Hair Transplant Failures — you discuss “transplant failure”. Does this mean total failure or just poor yield? I am a male, late twenties that has been mapped for miniaturization and found to have Diffuse Patterned Alopecia.

Would minimal yield from two (2) FUE surgeries suggest to you that the patient is in fact actually suffering from diffuse alopecia areata? Or do you believe FUE is unpredictable? I realize you cannot make a personal diagnosis over the Internet, but I would like your initial thoughts to point me in the right direction because I am running out of donor hair and patience with two failed doctors.

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You’re right in that I cannot make a personal diagnosis over the Internet. You report Diffuse Patterned Alopecia which does not define what you have. I am assuming that you do not have the diffuse form of alopecia areata which is an autoimmune disease (very rare in young men) and if you had it, it would certainly kill off hair transplants if they were done. To make a diagnosis of alopecia areata, you would need several skin biopsies and an expert dermatopathologist to read the tissue when it was prepared. Have you gone through this? If not, this might be your next step before jumping to the conclusion that you had FUE failure for technical reasons.

I would love to see your results with a good photo or two, a set of slides from biopsies of your skin and then I can give you an opinion. What I meant in that post you referenced is a total or partial failure. Failures with FUE are often partial failures, where so many of the grafts were transected (having many amputated hairs) that the yield will be less than what has been transplanted.

In regard to follicular unit extraction (FUE), in my opinion, it is a procedure that is quite variable in the hands of doctors with different skill sets. Most of the failures with FUE, are probably related to the skill of the surgeon. I couldn’t tell you if you’re experiencing alopecia areata just based on the failure of FUE by your doctor. I recently wrote a new FUE guide that I hope you’ll read — Introduction to Follicular Unit Extraction Techniques.

October 14, 2008

Hair Loss InformationIn the News – Other Takes on the Hair Loss Gene Findings – Hair Loss Information – Balding Blog

I’ve been reading more of the news items about yesterday’s publication of the two studies in Nature Genetics, and pulled some key quotes from various news sites that are worth highlighting.

From the BBC —

“Analysis of DNA from 5,000 volunteers with and without male-pattern baldness found two stretches of the genome linked with the condition.”

“One was the androgen receptor gene and has already been linked to male-pattern baldness. The other region is on chromosome 20 and is nowhere near any known gene.”

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We’ve long known that genes were responsible for hair loss, but now they’ve finally been identified.

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From the Scotsman —

“Until now, the only known genetic link with male baldness was on the female chromosome, meaning it could be passed down to men from their mother’s father.”

“Dr Richards said so far they had only identified a cause of hair loss.”

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In other words, the cure isn’t here and this is still the very early stage, so don’t cancel your hair transplant just yet.

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From the Wall Street Journal —

But dermatologists say that looking at hair shafts under a microscope can spot shrinkage years before it’s apparent. “We can pick it up when kids are teenagers,” says Robert Bernstein, founder of Bernstein Medical Center for Hair Restoration, a treatment clinic in New York. He agrees that medication can slow hair loss only if it isn’t too advanced. Once an area is devoid of hair, only a transplant can restore it.

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This is what I’ve been talking about all along — mapping your scalp for miniaturization.

October 14, 2008

Picked Off Scabs 4 Days After FUE – Hair Loss Information by Dr. William Rassman

I was wondering if after having a FOX procedure if you pick off the scabs from the donor area will this cause more significant scarring. I took off a scab 4 days from my procedure and it looks like it left a dimpled hole. I wonder if this will heal?

It is never a good idea to pick at a wound, as it creates the opportunity for infection. If you have eschar/crusts at the donor site from the FUE procedure (which is usually the case) you can wash them off with a good shampoo and a surgical brush. I don’t know what the dimpled hole is without seeing it, but hopefully it healed up for you.

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October 14, 2008

Hair Loss Information » I Kept Nizoral on My Scalp for 20 Hours! – Balding Blog

Dr Rassman

Due to a series of very unfortunate events , i had to have my scalp covered with very poorly rinsed nizoral 2% for over 20 hours (believe it or not , water supply was interrupted a few seconds after i started rinsing and a few minutes later i had to rush to the hospital ) . I rinsed my head thorouughly 20 hours later but i feel it itching like crazy .My question is : Should i be afraid of any hair damage , temporary or more serious ?

I would appreciate a reply as im overly stressed

I do not know the answer to that question, but I assume by the time you read this answer, if your hair is still present and looks healthy, then there will probably be no long term side effect of what happened. You might want to contact the makers of Nizoral to find out what they’ve learned about keeping ketoconazole (the active ingredient in the Nizoral shampoo) in your hair for extended periods of time.

October 14, 2008

How Do I Know I Got All the Grafts I Was Charged For? – Balding Blog

Dear Dr. Rassman,

Excellent blog. It’s great to be able to find straight forward information on hair loss which isn’t over hyped (like much hair info on the web) and isn’t afraid to point out pitfalls.

I’ve consulted with a Clinic who offer a technique which appears to be an advancement of FUE . They suggested I need one session and have 2,000 follicles transplanted on the day.

From looking at the photo of me today, aged 31, does it look like I need 2,000 transplanted? (I know a photo isn’t sufficient for you to diagnose and you could easily guess 15% too high or too low from looking at it) Also, how am I to know that I wasn’t charged for 2,000 while 1,500 are transplanted?

As I’ve found your blog useful I’m sure others have too and I’m more than happy for you to publish the photos attached.

Thanks in advance

Firstly, thanks for sending and allowing me to publish your photos. Even if I know the clinic you mention, it would be unprofessional of me to give a comment. The graft recommendation of 2000 grafts appears reasonable based upon the photos you sent and projecting the building of a mature hair line which is lower than the high exposed forelock the photo shows. Viewing the hairline proposed by the doctor would give me a better way to determine the appropriateness of the estimate.

In the end, it is still a “buyer beware” market. You really need to do your research, meet with the doctor, and meet with patients from the clinic to judge the results — don’t just settle for seeing photos of results. Most important, you need to be comfortable with your ultimate decision to trust the doctor performing your surgery. Yes… its a hard process. Speaking with patients who have had the work done there before you came on the scene, will tell you much about the doctor. Speaking with the patient that has had the work done by that clinic should get you the inside scoop. I remember a clinic that offered potential clients a list of over 1,000 satisfied customers, but when I personally called the first 20 on the list, 100% of them told me of horror stories about their experiences with that clinic. The trust issue sometime is relatively easy to flush out from former patients.

If you trust the doctor, you shouldn’t have to worry if you indeed got the grafts you were promised. And yes, there are clinics that can deceive you on the number of grafts you received. We developed count sheets and for FUE we even recorded the amount of damage to the hairs in the follicular units, but damage from the FUE technique is now virtually eliminated with our new breakthrough (but we still keep a written track record of what we do every time, even with FUE². Ask the clinic you ultimately decide to have surgery with, to show you their count sheet paperwork, not only for your own surgery (as this is something you should have in your possession when you leave the surgery), but also in other patients (with the name blanked out so you can verify they actually even make count sheets and record their damaged grafts). If the clinic will not give it to you, or they do not exist, then I would probe the situation more.

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October 14, 2008

Happy Be Bald and Be Free Day! – Hair Loss Information by Dr. William Rassman

I was sent this fluff piece that really doesn’t dig into anything other than reminding me that today is “Be Bald and Be Free” day. The article from the Examiner is about professional golfers that are losing their hair, and the writer states:

Looking at mug shots in the PGA Tour media guide, I count 21 baldies – not including a surgically enhanced Woods – among 311 players listed in the publication.

That’s only 7 percent, compared to the 40-to-50 percent of the male population who are bald or balding. (Estimates vary, depending on age parameters, definition of baldness and what studies you believe. However, I did learn in my research that castration is the only cure for baldness and neither masturbation nor wearing hats causes hair loss.)

Tiger Woods had a hair transplant? He wears a hat so often, as many golfers do, that I never noticed.

But back to the Be Bald and Be Free day — Holiday Insights says, “Bald and Free Day honors those of us with a beautiful, shiny top. You don’t have to be bald to celebrate this day. But, it helps. People who are married to, or related to a bald headed person can celebrate with the honoree.”

I’m enjoying a big slice of Be Bald and Be Free Day cake and our Be Bald and Be Free flag is proudly presented in our office, in honor of those fallen follicles. Sorry, I got carried away.

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October 14, 2008

Does a Juvenile Hairline at 29 Years Old Indicate That I Won’t Bald? – Hair Loss Information by Dr. William Rassman

I am a 29 year old male who still has his jeuvenile hairline and low, thick, full hair. I have heard that men who retain their jeuvenile hairlines by 30 years old rarily ever go bald early, if ever. My father kept his jeuvenile hairline and has only lost a very small amount of hair in recent years since he has been in his fifties. I have noticed other older men who have a complete full head of hair sometimes have a jeuvenile hairline. So is there any truth to this? Is a jeuvenile hairline at 29 a good sign?

A juvenile hairline at the age of 29 without evidence of balding says that there is a good possibility that you may never bald (at least not in the front)… but to be sure, get your hair mapped out for miniaturization, which would show any signs of balding at your age.

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October 13, 2008

Hair Loss InformationIn the News – Tracking Down the Hair Loss Genes – Hair Loss Information – Balding Blog

Two articles just published in Nature Genetics may explain why some men lose their hair, while others do not. One of the articles shows the complexity of the gene, where the baldness gene not only has more than one site, but it also is on more than one chromosome. There is a link between balding, heart disease, and other metabolic abnormalities as well.

The published journal articles themselves are not online yet (not sure if they will be freely available by the publisher), but there are a few summaries in the news that I found, linked below. Read the news items:

October 13, 2008

Tinea Capitis / Ringworm Scars (with Photos) – Balding Blog

I had Tinea Capitis as a child and i would pick them off of my scalp leaving these scar spots. I was wondering how much it would cost to fill in most of the “bald spots” also if i get them filled in would it be possible for me to cut my hair and the hair that was transplanted will regrow?

Iam 19years old Male, You have permission to use my pictures if needed.

First, thank you for allowing me to publish your photos. This is an extraordinary case, and one that is ideal for follicular unit extraction (FUE), where we can re-arrange the hairs from one place to another.

What I’m wondering, though, is whether you’re going to experience male pattern baldness. There is a genetic test that will tell you if you carry the balding gene, and it would be worth getting tested. If you do not have genetic MPB, then I would perform FUE all over your head, redistributing the hair from one place next to the balding areas, one at a time. If you are carrying the balding gene, then we would have to rethink the strategy. Cost might become an issue, as there is a great deal of cumulative balding, and although the fees are generally charged per graft (group of hairs), I could work with you on pricing due to the unique nature of the case.

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