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Can I Have Thicker Hair After Transplant? – Hair Loss Information by Dr. William Rassman

I am a young teenager who is not balding (yet.) I am worried about hairloss, because every male in my family is totally bald, except on the sides and back. I probably will have it by the time I turn 25 or 30(never asked anyone in my family when they started to lose hair, but I know my uncle started to lose hair at about 27 or 28.) But I have a question about my hair now. My hair has always had these various areas where there is really thin hair. They are like lines, not spots and seem very thin. I really don’t want to take pills or other applications to keep the hair I have, but am considering hair transplants when I do start to experience male pattern balding. If I do get hair transplants will there be an option to make my hair thicker? If not, will taking propecia after a hair transplant session make it thicker, or at least make the thin areas seem thicker? Please respond. Thank you for your time.

People use the word “thickness” to describe various contributors to ‘fullness’ that reflect very different aspects of hair; (a) the diameter of the hair shaft (i.e. the mass of the hair), (b) the density of the hair per square centimeter of scalp, (c) the character or wavy nature of the hair, (d) the color and contrast between hair and skin color (the lower the better). Propecia can improve the diameter of the hair shaft in a balding area, stop its eventual loss, or possibly make it regrow making the area thicker. Transplants can add donor hair (from the back) in between native hair (at the top or wherever the thinning area is) to increase the density of the hair in a particular area, also making it thicker. It is a little more complicated then this explanation, but not much. Doing both together (Propecia and Transplants), as you might imagine, will have an additive effect – that is, it will look even better. But doing both may not always be the right thing, if the anticipation of the results of Propecia alone may achieve the results without a hair transplsnt. Then you get the benefits without a surgery. That means that when you get evaluated by a doctor who can transplant your hair, you want a doctor with high integrity, one who will not recommend surgery if there is a reasonable possibility that Propecia alone will do the job.

As an aside, every male (and even some females) in my family also has some degree of hair loss, so I know where you are coming from. First and foremost, please get an assessment of miniaturization in order to detect when and if the genetic process started. A yearly check with a good doctor should show that to you. If and when you start balding, you may want to reconsider your decision not “to take pills or other applications to keep the hair I have.” Recent studies indicate that patients get the most improvement and are happiest when they keep the hair that they have, in addition to replacing what they have lost. As a surgeon I can tell you that nature does it a lot better than any doctor can – keeping what you’ve got is truly the best course of action overall.

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Treating Frontal Hair Loss – Hair Loss Information – Balding Blog

I have studied the norwood scale and have established that i am btween stages 2 and three – intial stages of rhair loss.

Reading through your articles , I have noted that propecia has limited results in treating hair loss towards the front of the head. are there any treatments which you have known to be effective in treating the front of the head?

many thanks

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Men who think that they are balding may actually just be undergoing a change from a childhood hairline into an adult hairline. Many people who think that they are balding don’t realize that the Norwood Class 2 pattern is normal. For some people, the early part of the Norwood 4 may not even be balding at all. Get a good doctor and get yourself checked out for miniaturization before you obsess into believing that you are going bald.

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Hair Transplants to Face – Hair Loss Information – Balding Blog

I am a 33yr old, health male, with no health problem. I am interested in getting facial hair augmentation. I am missing large clumps of hair which have never developed on my face, much like hair growth patterns seen I have seen in Asian men. I would like to complete the hair line from my sideburn to my chin and then up around to add to my mustache.

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It is possible that you have either a late onset beard that you understand may still yet develop. It is also possible that your genetic pattern has produced this facial hair distribution. What does your family look like? Are there relatives with this beard pattern? Is there Asian genetics in your family line? The dilemma here is to differentiate genetics (most probable cause) from other causes. Before embarking on such a path there are a number of steps that you need to get done. These steps are:

  1. Establish a relationship with a doctor where mutual trust is established. The doctor must feel comfortable with your goals and expectations and they must be realistic from the doctor’s point of view. You must understand all of the risks and downsides of such a procedure.
  2. Get testosterone and DHT blood tests to determine hormonal issues related to the facial patterns of hair distribution.
  3. Get an assessment of the status of your eventual hair loss with a close examination of your scalp under high-powered magnification.
  4. Get a second opinion from an endocrinologist to determine if exogenous DHT is available and/or advisable.

First, of course, I would start with #1, then work with the doctor you selected and extend to the rest of the list. If I was the doctor and agreed that this is a procedure I would be willing to perform, then I might start by extending your sideburns down the face and if that met your needs, I would consider another more aggressive step. I would love to engage you with further dialogue.

For examples of transplanted sideburns, please take a look at:

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Hair Regrowth After Waxing Scalp – Hair Loss Information – Balding Blog

I recently had a minor accident with hair removal wax. Well to make a long story short, it ended up in my hair on my scalp. It has been five weeks and the regrowth has been pretty sparse and not at all in some areas. I was wondering what the chances are that it will still grow back, and if not what I can do about it. thanks

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Wax only removes the hair shaft, not the entire root. Thus, your hair should grow back. It may take up to a few months for hair regrowth unless there is more to the story which I am not understanding.

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Hair Loss After Brow Lift – Hair Loss Information – Balding Blog

I really appreciate your informative and straight-forward approach to our hair concerns.

I have had a brow lift a little over a month ago. While the surgery was for the most part very successful, I was not prepared for the hair loss that preceeded it. I was told by the surgeon that my hairline would actually be lower afterwards. That was NOT the case.

The hair loss is along the incision line. It is more “loss” than just thinning. I was told not to worry that it would grow back.

My questions are:

1. What is the chances that the hair will return?
2. Would Propecia help?
3. About how long does the scalp normally stay numb?
4. How long should I wait to see regrowth before having hair restoration to correct it?
5. After hair restoration, how long will it be before I can do strenuous exercise and swim?

Thank you

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There is a good chance that some or all of the hair will return, but brow lift scars are often detectable due to some widening of the scar when the incision was done behind the hairline and hair loss risks when the incision is done in front of the hairline to lower it. Sometimes during the type of procedure you had, the blood flow to the hair follicles can be interrupted resulting in a temporary loss. Occasionally it is permanent, but in most cases you should be able to see some regrowth within 3-6 months. Most doctors will wait up to a year before giving up on seeing some growth return, and that is about the time you can consider a hair transplant surgeon to correct it if needed.

As for your other questions, if you had a hair restoration procedure, you would need to wait a week before resuming very strenuous exercise and you’d need to wait until the wound has completely healed before swimming. Propecia is a DHT blocker which prevents male pattern/genetic hair loss and it is not proven safe for women, so it will not help. The scalp numbness does not usually last more than a year (often weeks or month and is rarely permanent). Finally, time is really the most important commodity for you to evaluate your loss/regrowth. Wait for the regrowth and follow-up frequently with your surgeon.

Of interest, this complication is the most common reason women get hair transplantation (at least in our hair restoration practice), which does not reflect its incidence (of let’s say in 100 women with brow lifts), but it does tell you that it is not an uncommon problem.

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Ervamatin – Hair Loss Information – Balding Blog

I’ve been seeing lots of ads of Ervamatin. As a person who is not allowed to use finasteride due to liver problems, is it safe to use Ervamatin? It’s made by Amazon Health Care.

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I have done some extensive research on this herbal medication. I am not convinced about this drug until I see more concrete medical data. Finasteride was first discovered in South America in a plant extract by a group of primatives who normally ate large amounts of it in their diet. They had children that were hermaphrodites, as the pregnant mothers ate the extract in their daily diets at very high concentrations. I must warn you about herbal medications, because some of them can be toxic to your liver as well.

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Major Hair Loss After Stopping Propecia – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

I am 46 years old. My father and brother have extensive hairloss on top. I am blonde and have very fine hair. No hair loss on maternal side. About a year ago I noticed some thinning at the hairline after many years of very slight creeping at the temples…still a NW 1-2 with very good density and caliber. I became alarmed given the extent of loss of my younger brother whose loss started as a 20 yr. old.

After doing what I thought was sufficient research and an recommendation from my Dermatologist who had used Propecia very successfully for 7 years, I started on the drug in early March of this year. I noticed little difference in my hair other than very slow thinning in front and on top. At 6 months (Labor Day) loss of libido had become an issue and E.D. became a problem. Watery and loss of ejaculate also surfaced. I wasted no time and quit the drug cold turkey. The sexual sides resolved in a couple of weeks, but that was just the beginning. After a few weeks my hair began shedding like crazy from all parts of my scalp..front, top, back, sides, nape of neck, sideburns, eyebrows, arms and hands too! This has continued steadily and I have lost an enormous amount of hair in 4 months…probably 30-40% of total! I am very depressed, nearly paralyzed and suffering severe anxiety..can’t sleep and having trouble functioning in my professional career. My life is cascading downward rapidly.

I am afraid there has been some sort of androgen/dht backlash. My hair seems to have miniaturized all over my head in a few months. Remaining hair is very fine and wispy ..hard to manage. The falling hairs seem to be very fine and less pigmented as well. This was not nearly as evident until a couple of months ago. I feel like I have the hair of an 80 year old man all of the sudden.

I have experienced “burning scalp” symptoms where MPB would normally be evident. I am terrified by the speed in which things have occured. I have not done anything in terms of treatment for fear of more shedding. Can you please suggest a course of action. I have no one to turn to. There are no reputable hair restoration physicians up here in Oregon.

Propecia is often effective at slowing hair loss, however, once it is stopped your hair loss can appear to accelerate. Your hair loss plays ‘catch-up’ to get to the point where your balding would have been without having taken the drug in the first place. This therefore, may look like accelerated hair loss. If this happens, you may continue to lose whatever hair that had been saved by Propecia and then continue the loss at whatever rate would have been ‘programmed’ for you by your genetic code (assuming your have genetic hair loss). An important question to consider: ‘Could you have been at the beginning of a rapid hair loss period from genetic or medical causes?’ Your situation does sound more complicated than simple genetic hair loss and this means to me that you might need a full medical work-up looking for other causes of hair loss (including appropriate blood tests). Stress can add substantially to the rate of hair loss and you are clearly being heavily stressed now.

Men in their 40s often (40%) will have ED (Erection Dysfunction) and Viagra might be worth trying (you need a doctor’s prescription) for any sexual ED problems you might have. If you feel that you are the 1% of patients who get a decrease in your libido from Propecia, then you should probably not take the drug, but you need a good, caring doctor to evaluate you along the lines as I have discussed in this blog over and over again. Your strong words above say a lot to me. You are VERY concerned and you want to take charge of the process that is impacting your hair, so be smart about it and whatever you do, do it the right way, ‘partnering’ with a good doctor. We have an office in San Jose and Los Angeles and a trip to one of these offices may be in your best interest. If you see me in Los Angeles, there will be no charge for the visit.

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Hair is Thin After Highlighting – Hair Loss Information by Dr. William Rassman

I am a 47 year old woman who had slight graying hair. My hairdresser talked me into highlighting my hair. She used a volume 20 bleach and a toner. 24 hours later I had itching, burning and swelling and saw my allergist. He put me on prednisone for a week and cortisone lotions. A month later my hair feels like cotton as the strands of hair are thinner, breaking off at the crown and generally coming out at the root after washing/combing.

What if anything can I now do? Obviously, I will never again use chemicals on my hair.

You have likely had a chemical Alopecia (hair loss) with a skin reaction. I know exactly what you are going through (having had a spiral perm in the eighties with the same thing happen) and although it is likely all your hair will grow back just as it was, it will take time, especially if you wear your hair long. Avoiding harsh shampoos and conditioning your hair regularly may help the hair that is there, but little will help it grow faster which is what really needs to happen. Concealing options like hats, scarves, and Toppik are all options as well. If this condition persists past 6 months, I would recommend a follow-up visit to your doctor to determine if anything else is going on.

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Systemic Lupus Erythematosus and Hair Loss – Hair Loss Information – Balding Blog

Several years I had hair loss patch the size of Half dollar and my two end finger nails were lines and pecked. I was diagonosed as having alopecia areata. Treatment w/ cortisone shots did not help. in last year or so I developed more of these loss of hair and sometimes it itches. I had biopsy done and the results “the findings are suggestive of (but not diagonostic for) collagen vascular disease such as lupus erythemaous. The blood test shows that I’m negative for Lupus. What is the outlook in terms of medication, regrowth and outlook? Is there any thing to grow hair? will a transplant work?

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Sometime blood tests for SLE (Systemic Lupus Erythematosus) are not completely accurate. I recommended that you visit a rheumatologist to further your evaluation process. SLE is one of the many causes for hair loss. Hair can regrow if your cause is due to SLE or any reversible disease that arrests and then subsides. Some people will have lost their hair permanently, even if the disease goes away. Hair transplantation will not work if you have an active disease causing the hair loss, but if the disease is known and is not active, then a hair transplant will work, that is, unless it gets reactivated. Again, it is best to see a rheumatologist and a perhaps even a good dermatologist who focuses upon such problems.

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Hair Loss InformationZelnorm, Birth Control, Diet and Hair Loss in Teenage Female – Hair Loss Information – Balding Blog

i am 19 years old / female. when i was younger, in my middle teen years i had thick, thick hair, now its so thin. whenever i take a shower i lose so much hair its ridiculous. i’ve been using mousse for my hair for a long time. i started really using it when i was about 14-15 years old, but now i use it frequently in my hair but i never put in on my scalp. i always put it in the middle to the ends of my hair. i colored my hair once and that was when i was 15-16 yrs. old, and i’ve been smoking marijuana for about 2-3 years, but not every day. i also started two new pills, one is a birth control pill levora. i’ve been taking that for a year and the other the one is zelnorm. ive been taking that for 4 months now. my question is what could be the cause of this? my mother has noticed my hair loss, and i’m scared i could go bald at a young age. i’ve lost so much hair in the past year or two. could what i’m doing or taking be the cause or what????

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Birth control pill could potentially cause hair loss. However, Zelnorm does not directly cause hair loss. Zelnorm is for (Irritable Bowel Syndrome) IBS with constipation symptoms. Patients with IBS may have a nutrient deficiency leading to hair loss, so a focus upon your diet may be appropriate. There are many causes for female hair loss. I recommend that you visit your physician for blood work to rule out anemia and hypothyroidism, which could also potentially cause hair loss. The general causes for hair loss are hypothyroidism, alopecia areata, androgenic alopecia, repeatedly over plucking, eyebrows lifting, trichotillomania, stress, chemotherapy, radiation, eczema, seborrhea, scleroderma, lupus, hormonal imbalance, psoriasis, parasites, fungal, autoimmune disorders, poor diet, poor nutrients, burn, trauma, leprosy, and drugs. The common medications which may cause hair loss are beta-blocker, coumadin, oral contraceptive pill, antibiotics and chemo-medications.

Genetic hair loss starts in some women as early as 17-19 years of age. You need a complete examination for miniaturization to make the diagnosis, one way or the other. Get a good hair doctor, as that is critical for you to have a better understanding of what is happening to you.