I have scalp psoriasis and consequent thinning patches. Would using Rogaine aggravate the psoriasis?
Rogaine (minoxidil) can cause skin irritation and may aggravate your psoriasis. You might try it and see. The worst case is that you make the psoriasis worse for a few days. Many people with psoriasis have to experiment on how to manage the disease. It behaves differently in different people.
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I have gone to a number of doctors and asked, as you have advised, to map my scalp for Miniaturization. They do not know what I am talking about? What should I do? Are you the only one who does this? How important is it?
There are a series of hair metrics (measurements) that any good doctor must do for a proper analysis of your scalp. First, if the doctor waves his/her hand over your head and says that you have a fine hair density, run for the hills. Good metrics require scientific measurement and the science of densitometry as I have defined it in scientific publications (such as this article from 1993 which discusses densitometry) .
If you step back for a moment, you will see that if you do not know just how much hair you have and the value of each hair, then you do not know much about the way your hair (or lack thereof) will meet your needs as you replace it. Metaphorically, think about a house, where half of the house has been eaten by termites and you need to replace the wood that is not any good. Then you want to add a room on at the same time. It would be crazy to try to do this job without assessing just how much wood is rotten (miniaturized hairs), how much wood is available from the lumber yard (assuming that you have a limited amount of wood/hair from the donor area), and how much area you intend to build up from scratch (the balding area which needs to be restored). If you can not measure any of these factors, you can not determine your needs, which must be matched against supply. It is not very complicated when you know what you are doing.
It would be absurd for a doctor to tell you that measurements are not important in determining early balding (miniaturization). It would be as if he/she is saying that the pending termite damage is irrelevant, and to just wait until the house caves in. Crazy? If you do not know if your wood supply is in 2×2’s, or 4×4’s then you do not really know the value of the essential replacement resources you have. If you have miniaturized hairs in the donor area, then you might have a disease which will contradict a hair transplant, but without measurements you can not say. If the termites have invaded the wood supply (miniaturized hairs in the donor area which is a disease in men and a common finding in women with genetic hair loss), then you can not build a house (trusses and all) with 2×2 studs alone (damaged or otherwise inadequate in quantity), you need wood beams and 18 on center 4×4 studs to support a wall properly. Likewise, you can not put in single hairs or damaged hairs into the transplant to do what god’s follicular units are doing for you now like when you were young.
So, to conclude, a doctor adds very little value to your Master Plan to help you determine what you must do over time, when the doctor does not use measurements to determine:
This is not about the doctor making money doing hair transplants to all balding men, but rather using a full arsenal of treatments available to you, determining the value of those treatments over time and using his/her skills to your overall benefit. You have must a real clinical scientist / caring physician on your team who puts your benefit and goals above all else.
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I am a 42 year old male with thinning hair both at the front & crown area of my head. Without entertaining hair transplants, what do you recommend to improve the appearance of my hair? What is the best Thickening agent/shampoo out there? Are there any products that actually work in your opinion? I used minoxidol years ago but gave it up quickly.
Thanks
There are many thickening agents/shampoos on the market and people respond differently to each depending upon texture, shaft thickness, the wave in the hair, and other factors. I generally tell people to buy a series of such products and then test what works best, or ask a hair stylist who works with such products daily and get a recommendation from them. Minoxidil does not impact the texture or shaft thickness from above the skin as thickening agents/shampoo will.
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Hi DR. RASSMAN
About two months ago..I used procede to thicken my hair. I used the patch test on my arm but the results were a horror. I used the solution on election day night. It started to burn my head and it was so intense that I ran for a cold shower followed by placing my head in the refrigerator. When the burning stopped I washed and rinsed my hair out and went to bed. The next morning I found my hair on my pillow in clumps. Prioe to this experience i had hair but it was thinning. I used monoxidil and had success for five years. I guess that I just wanted more hair. I went to a hair system which was bonded to my scalp but I could not stand the glue so I use the hair piece with a tape that comes off with alcohol. I find that I can look OK. The piece and the other systems are close to 4,000 bucks. I wasn’t a candidate for a transplant these last months since I had burning from that procede. I think a hair system is OK but needs a daily washing…I have no odor. I miss my hair and am thinking about a transplant in the future. Also my hair is growing strange..more like spikes. I wish that Procede was off the market but it still exists. This ordeal was such a bad experience that I dream of it. Hoping to also use my body hair.Sorry if this is a look message. But this experience I wanted to share with others .
It sounds like you had some allergic reaction to something in ProCede. I am certain that this type of reaction can occur with any topical therapy. The more ’stuff’ that is in the formulation, the higher the likelihood that this diagnosis may be correct. It doesn’t sound like you’re eager to use it again, but my best advice would be to stay away from this treatment, for the next reaction may be worse.
Hair systems (the nice term for a wig) will run a risk of further damage to your hair. I would strongly recommend that you get a good examination by a competent doctor to establish a baseline as to where you are now (with respect to miniaturization) and over time repeat the examination. You need a working relationship with a competent doctor.
Is hair transplantation an art form? Does one doctor really get better results than another? If it is only technicians putting grafts into holes in a head, how is it worth the money that you doctors charge?
Hair transplantation is a discipline that includes a sense of artistic balance, a sense of meticulous organizational skills, good judgments, and lots of experience. I know this because I see too many hair transplants that reflect failures of these elements. For example:
I can go on an on here, but to see what I am talking about, visit my website. There are over 200 patients with before and after photographs on the site and copies of much of what I have written and published is in the medical literature. Yes, hair transplantation is expensive, but would you want people to immediately say, “Nice hair transplant”? No one should even know.
Hi,
First I would like to thank you for providing this site, it has help me a great deal. Here is my question. I am a 31 year old female suffering from hair loss, and as of yet I do not know the definite cause. My question is concerning all that I have read about the possibility of vitamin deficiency causing hair loss in women. My doctor runs routine bloodwork every year, and for approximately the past 10 years I have had low iron, low B12, and my last set of tests, last year, did show that I also have an overactive thyroid. Throughout this time I have never taken the supplements that were advised by my doctor, I am now regretting that, and have since started. Now to the question, with being low in iron and b12 for so long cause miniaturization? I have miniaturization hairs throught my entire head, and very thin on the crown, and this is why I am questioning the effects of vitamins and hair loss. From what I have read miniaturization and thinning at the crown usually indicates AGA, however I did read once that low iron could mimic AGA with miniaturization. And I am hoping that this hair loss that I have is from low vitamins for a long period of time, and not AGA.
Thank you so much in advance.
Yes, low iron and B12 can cause hair loss. Get a good doctor to take charge of you, as that is the best approach to the problem.
Do REAL versions of generic Proscar/Propecia exist? I see them at online pharmacies but I’m not sure I should trust in them.
Legal generic versions of Propecia and Proscar do not exist. In countries that do not recognize the US and International patent systems, generic versions are produced, but then you do not know if they work or if they are even real. A patient who recently came back from India brought back some Indian Viagra, which he said did not work for him, although the American version did clearly work. It is easy to see if Viagra works, but on the other hand, Propecia is harder to tell if it is working. The old rule, “Buyer Beware”, still prevails!
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Dr Rassman
Can you please tell me if its know whether mega doses of nutritional supplements (other than Vitamin A) can contribute to hair loss?
Thank you
This is a very broad question and one that this blog gets asked often. Unfortunately, since nutritional supplements are not regulated by the FDA, there is often very little information in the medical literature regarding side effects and/or scientific studies about how/if they work. You are correct that Vitamin A toxicity is known to cause hair loss so you should avoid doses greater than 50,000 IU. It would also be a good idea to avoid anything which alters your metabolism (thyroid is often a buzzword there) or your hormone levels. Some high protein diets have noted hair loss as a side effect, too. In the final analysis, it is just not possible to know without a specific analysis of a particular nutritional supplement.
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I understand that miniaturization is the first step for most people to begin understanding hair problems. But this procedure seems very exclusive as I have not often seen this on the internet for searches in my area.
I live in montreal Canada and I don’t even know who to look for to consult: Hair Doctor? Hair Specialist? Hair Consultant? I do not know the name of the profession so finding someone to help me is difficult.
What am I looking for exactly? And do you know if this procedure is availible for my area?
Visualizing instruments that magnify the detailed microscopic view of hair follicles, allow the viewer to estimate the miniaturization of all of the hair as compared to the healthy hairs in the field of view. The term ‘miniaturized hairs’ have been around for decades and they are the hallmark of genetic balding. I (Rassman) invented a practical instrument which I called the “Densitometer’ and patented it in the early 1990s so that every doctor could do the analysis. The tool was eventually sold by Radio Shack as a hand microscope for about $12/U.S. There are hair transplant surgeons in Canada, several good ones actually, and you should look for just that, a “hair transplant surgeon” who looks for the health of the hair and makes projection of the long term hair loss pattern with this hand held instrument. If the donor area has significant miniaturization, then the patient may have a poor outcome from a transplant. Now, my $12 hand held instrument is hooked up to video monitors and computerized for about $6,000. Still, although I use the video versions of it that are commercial (I paid about $5000 for mine), I still use the $12 hand version for measurement.
Choose a doctor who does hair transplantation exclusively (not on the side) and who has a good reputation among their patients. Often these people will call themselves a “hair doctor” but it is okay to question someone about their practice if you are unsure. “Hair Specialist” or “Hair Consultant” is likely to be a non-medical professional (in North America), usually knowledgeable about the procedure but not medically trained. I suggest you check their website, visit the doctor’s office and ask to meet many of his/her patients. At our offices in Los Angeles and San Jose, we hold open house events every month, which allow prospective patients to meet actual completed transplant patients, for we always say, what you see is what you are going to get. I personally like photographs, but photographs have the limitation of showing you what the photographer wants you to see. When you actually meet patients you can trust your eyes. Our upcoming Open House event schedule is available on our site. Also, go to the ISHRS site to find a listing of doctors who focus in this specialty and in your area.
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I cut my bangs too short in the front and now I have a bald spot. what do I do to cover it up besides a hat? HELP
The good news is your hair will grow back, the bad news is that it will take time. Other than a hat, I often suggest color-matched Toppik to help cover areas with hair loss where the scalp shows. Honestly, though, if you have a good sense of humor, that is the best way to cope. You might also try a professional hair stylist to avoid the problem in the future.
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