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Can NHI Help Balding African American Men? – Hair Loss Information by Dr. William Rassman

Hey, I came in last summer for a consultation and I had a miniaturization test. The doctor confirmed that I was probably a class 2-3 on the Norwood scale. At the time he prescribed finasteride, which I have taken daily ever since. It’s been about a year now, and although my hair loss may have slowed down, it certainly hasn’t stopped. My hairline is a little suspect at this point, and I’m nervous that if I wait much longer people will really start to notice I’m “losing it.” I am biracial, with relatively coarse hair, and I’ve been able to get away with styling it so that no one can tell, however I think I’d like to solve the problem while I still have a relatively large amount of hair on my head. I’ve heard that there are doctors who specialize in treating African American hair loss patients. I’m wondering if this is true, or is NHI capable of generating the same results? Also, I’ve heard that micro-grafting is the least noticeable transplant procedure, do you perform this procedure at NHI?

Thanks for your help.

We are as experienced with African hair types as any medical group anywhere. We also stand by all of our results. You should be seen yearly, so I would hope to see you again.

The most natural way to transplant hair is with individual follicular units, as these are the natural groupings of hair in your scalp. A micrograft is not the same as a follicular unit and you need to be aware that the gold standard for hair transplantation in any race is follicular unit transplantation (FUT). Propecia (finasteride) is probably working for you, as it is slowing down what would probably be more dramatic hair loss. You are welcome to come back and have one of us take a look and further answer any questions you have.

Balding Forum - Hair Loss Discussion

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Use of DermMatch for Managing Thinning Hair in Women (with Photos) – Hair Loss Information – Balding Blog

This patient has classic female patterned balding with hair loss behind the frontal 1/2 inch. The thinning is worse in the frontal area and is more manageable in the top and back, but still thin and see-through. I have given this patient DermMatch, which is a cosmetic powder that colors the scalp and sticks to hairs to make them thicker. The contrast between hair and scalp is lessened with this product and when combined with good styling, products like this (see also, Toppik) can work to make the transparency of the hair less so. The photos below show how big of a difference a topical camouflage can make.

The photo on the left is before, on the right is after DermMatch. Click photos to enlarge.

 

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Hair Loss InformationHair Transplant Tools – Choi Implanter vs Carousel – Hair Loss Information – Balding Blog

I have sent this question to this blog several times, however have had no response. I understand you have extremely high volumes of email, but i feel i might of had no reply due to the question its self as it may be considered that i am being purposely insulting. My question is as follows. The carousel i think is an extremely well designed implanter. And i imagine its results are alo very good, however i have seen in one of your replies to a question about the choi implanter were you said, ‘The Choi implanter is just a surgical tool. It makes some aspects of the transplant easier to perform, especially for those people who did not develop the difficult placing skills with the more traditional transplant tools used throughout the world.”

This to me seems a contradiction when the carousel is also an automated surgical tool, which also makes some of the transplant easier to do. I admit that the carousel could be considered to be better in the sense that it may harvest the hairs better, however its still like the choi implanter. One could say the carousel is a better evolved version of the choi implanter. The carousel and the choi implanter do the same job in almost exactly the same way. Please will you reply as i would find an explanation really interesting. Thanks.

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CaouselPractically speaking, the Carousel and Choi implanter are similar in that both make a recipient site directly into intact skin and then place a follicular unit into such sites. Mechanically speaking, the way they place the follicular unit in the site is different. The main limitation of the Choi implanter is that you have to load one follicular unit at a time, make the site with the implanter, place the FU in the site and load it back again before you can continue. For the Choi, a single hair graft is pulled into the instrument by a hair (being backed in). The advantage of the Carousel implanter is that it holds 100 follicular units, making the process smoother. The discussion is moot, however, because the Carousel is not currently on the market and can not therefore be used by any surgeon.

Note: The image to the right is of the Carousel implanter.

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Dissecting Cellulitis of the Scalp – Hair Loss Information – Balding Blog

I am a family medicine resident finishing up my last year. I unfortunately have a condition which I discovered doing my own research called Dissecting Cellulitis of the Scalp. It is horrible!!! This is a rare condition that usually affects black men in their 20’s. It is a very painful, cosmetically disfiguring disease that I have dealt with for about 4 years now. I have tried all of the antibiotics and medical treatment that you can think of and have seen many dermatologists that in my opinion, are not really aware of how tough this is to treat. I have read some studies that state that Laser therapy has been used with some success and others that state that complete scalp excision is successful. Of course, I don’t want my whole scalp taken off, but I am willing to try Laser therapy if it really has good results. At this point, I am really ready to try anything. If you are familiar with this or can even refer me to someone who is, I would really appreciate it.

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This is a rare condition and as you said it is very difficult to treat. Before going as far as having surgical excision of your scalp, I found a case study in which they had success in treating recalcitrant dissecting cellulitis with Nd:YAG laser. The study was published in Dermatologic Surgery in August 2004, Volume 30 Issue 8, and was written by Eric C. Parlette MD, Nathan Kroeger, EVictor Ross MD — Laser Treatment of Recalcitrant Folliculitis Decalvans.

Unfortunately, I can’t post the text here and the publisher charges a fee to view the text, but it may be worth looking into. Good luck.

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Hair Loss InformationI Had Several Hair Transplants – Will Testosterone Therapy Cause Hair Loss? – Hair Loss Information – Balding Blog

I am a 53 yr old male who is considering have testosterone therapy. I have male pattern baldness and had several hair transplants,including one in your office in Fort Lee, NJ and one from your colleague in Fort Lee, NJ My hair looks fine now and have had no significant hair loss for years. Will low doses of testosterone cause me to have hair loss?

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As we all know, testosterone is converted to DHT, which is the main culprit in male pattern hair loss. There is always a risk, maybe low, that testosterone will cause hair loss since. It may help knowing if there is miniaturization in the remaining hair along the edge where the transplants were placed. Miniaturized hair may be affected by testosterone and DHT.

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Topical Finasteride Research – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,

As I scour the internet for information about new developments in the treatment for balding, just thought the readers might be interested that it appears some effort is being put into
researching/developing a topical version of finasteride to treat hair loss:

PubMed – Development of liposomal systems of Finasteride for topical applications: design, characterization, and in vitro evaluation.

Take care.

Seems like interesting research. Thanks for bringing it to our attention. The next step, with regard to the hair restoration field, would be to determine if it is equal to or better than oral finasteride in the treatment of hair loss. Clearly more work is being done for the formulation, as that is not finalized yet.

Balding Forum - Hair Loss Discussion

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If Hair Loss Is Not From Environmental Factors, Why Does Hair Only Fall Out On Top? – Hair Loss Information by Dr. William Rassman

My question is that when men are bald why is it usually only on the top of the head? it seems as though environmental factors should be considered as a cause. Sun, wearing hats, showering etc.

Now i understand that most causes seem to be genetic but it just makes me very curious why it would not be the whole head.

The sun, wearing hats, showering, etc. will not impact hair loss. It is all in the genetics. If I knew the answer to why genetic hair loss only impacted the top of the head (not counting diseases like alopecia universalis), I could be a rich man. Unfortunately, the answer is not known.

Balding Forum - Hair Loss Discussion

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Hypothyroidism and Hair Loss – Hair Loss Information by Dr. William Rassman

Good day doctor, I was reading a short article about hypothyroidism, and I was left with a few lingering thoughts. Perhaps you might be able to answer my questions:

a) Would you say that hair loss due to hypothyroidism is a common or a rare incidence among those who suffer from hair loss?
b) Or, among the various symptoms of hypothyroidism, is hair loss a common or rare occurrence?

I understand that there may not be good statistics to answer these questions, but perhaps you might be able to shed some light, based on your experience.

Hair loss is one of many symptoms of hypothyroidism, but the frequency of it is not reported. Patients suffering from hypothyroidism usually have other symptoms along with hair loss, including weight gain, cold intolerance, fatigue, weakness, constipation, and depression. The diagnosis of hypothyroidism is made through blood testing for the level of T4 (the main thyroid hormone) and TSH (thyroid stimulating hormone).

Most of the patients in our practice suffer from male pattern baldness (MPB). Patients concerned about hair loss should have a miniaturization study to determine if the pattern is consistent with MPB or if there is an underlying medical condition causing the hair loss.

Balding Forum - Hair Loss Discussion

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Hair Loss InformationDo You Have An Opinion on Individual Doctors? – Hair Loss Information – Balding Blog

Do you have any insight on Dr. [name removed]? As in do you think hes skilled and ethical? Please would like your advice

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Over and over again I am asked such questions. I just can not answer them, because I could be at legal risk if I thought badly about a particular doctor and voice my opinion over the internet… and there are many doctors in this field who I might not speak highly about.

There are some websites that claim to be consumer advocates and give such information to potential shoppers. Some of them provide a service and some do not. It is important for the readers to understand that many of these websites charge doctors a fair amount of money for an endorsement. That may not mean that if a doctor is not endorsed on the website, he/she is not a good doctor; it means that they do not want to pay thousands of dollars a year for such endorsements.

This is a buyer beware market, a theme I proclaim over and over again. In this blog, I tell consumers how to find a good doctor and I do not charge for any of that advice. So why do I add content to this blog day and after day addressing such questions as how to select a hair transplant doctor? The answer is that this is part of an overall philosophy I have to educate the public and to let the public know that there are many good doctors out there who perform quality hair transplants. Today’s modern hair transplant creates results which are indistinguishable from a person who never had a hair transplant and is blessed with a good head of hair. At our Open House events every month, many of our patients come in to help me illustrate that very point. I stress ethics in the field, tell the consumer how to hold a doctor responsible for their work and warn the consumer that this is a buyer beware market and the burden is on them, as a buyer, to do his/her research to get a quality job done.

For more information on doctors — what to avoid, how to find a good one, what some don’t want you to know — see:

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Hair Loss InformationAfter Taking Propecia for 2 Years, Suddenly I’m Shedding – Hair Loss Information – Balding Blog

Hi,
Love your site. I am a 37 yr old male and I’ve been on propecia for about 2 yrs (with very little shedding). I’ve recently started shedding quite a bit, almost like the propecia stopped working. Is this normal??? Please help!!!!

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Propecia (finasteride) does not cure hair loss. When your genetics ‘push’, then Propecia becomes less effective. Please note that I said less effective. If you were to stop the drug, then you would be on a wild ride to hair loss. As I am not your doctor, it is difficult for me to tell you what I would do. I might consider Avodart (dutasteride) under certain situations, but if I did, the dose would be high and sexual side effects may become evident. Sterility may be a price, as it has been reported (with reversal not clear). The Master Plan may include a hair transplant, but that would depend on many factors. You need to have a good relationship with your doctor.