I am 50 years old/F and have been taking Coumadin fo 8 years. I’ve had thin baby fine hair all my life and it’s been getting even thinner over the years. Last year I finally bought a wig. What effect does Coumadin have on hair loss?
Coumadin has hair loss as a known side effect. You need to have a hair diagnosis in hand as discussed on the many pages of this blog and then approach the problem with a good hair doctor.
how much “coverage and density” can a norwood 6 patient actually achieve? All your photos of men with 6 or 7 norwood, all have “comb over” type hair styles? How come u never show any pics of the back of the finished product(or crown)?
A person with a Norwood Class 6 pattern will have lost 50-60% of his natural hair. A person with a Class 7 pattern will have lost between 70-80% of his natural hair. If you move half of the permanent zone of an average man, the most you can yield would be about 15,000-20,000 hairs (or 7,500/10,000 grafts in a series of about 3-4 surgeries). That would mean the coverage mathematics, of let’s say 60% of the total area of originally hairy scalp, can only receive maximally 20,000 hairs in an area that originally had 60,000. This is at best 1/3rd of the original density. In actuality, one rarely ge’s out that much and more likely 12,000-15,000 hairs is maximal. In the person with a Class 7 pattern and 80% hair loss by count, the maximum overall density in the recipient area is 80/12 or 15% of the total original density. We usually weight it to the front so that there is a comb-back effect, moving more density to the place where the greatest impact will occur. We could weight it to the front and sides, with a good comb-over produced (front to back or side to side). Either approach works. The crown is often sacrificed with the lowest densities placed there favoring the front or the sides, as the case may be. So you are correct, the densities in the less favored areas are ‘covered’ with some type of comb-over.
I posted these photos a few months ago here, but it is worth displaying them again to show that the results of weighting the frontal hairline can be very good, even though the crown is not as dense. Patient ZU is in his mid 60’s and had multiple procedures totalling 6,036 follicular unit grafts transplanted. “Before” is on the left, “after” is on the right. Click the photos to enlarge.
You can see more of his before and after photos on the NHI site: Patient ZU
Hello Doc.
This blog is getting more useful everyday and of course warm applaud to Dr. Rassman . I’ve recieved a strip HT surgery, as you know that the sutures which were used to close the incision are left on for about 12 days post-op before removal. My enquiry is that during the removal process for my sutures, the nurse told me that my thin incision was closed in a zigzag way, something like this in shape \/\/\/\/ , now does that mean anything? and does it have any benefecial effects? Thanks & Thanks
Some doctors believe that zig-zag incisions are better, because they break the single line that may contribute to scar widening, as forces on the scar change accordingly. There is not a clear scientific paper presented that shows that this is true for the donor area scars, but neither is there a negative value to it unless you are going to have another transplant. The zig-zag scar makes the next strip excision more difficult.
Hi doctor , i have been taking propecia almost 8 months . I am 28 years old and do not have thinning anywehere but some receeding from the front sides. I was taking to slow down my receeding. Two weeks ago i decided to take two pill per day and i took it 5 days like that. And when i didnt see any difference i stop taking two pills and went back to one pill. Just two days after i went back to one pill .I started to realize that i have a pain on my upper back and shoulders and my shoulders started to move forward like a body builder. I stop taking propecia one week ago to see if it cleans whatever damage i had . Is it possible that something like this can happen in a short time. Now i have shoulder pain and upper back pain time to time during the day. Is the hormones has something to do with it.Thanks.
I have never heard about Propecia causing shoulder, back, and joint pain. I do not believe that blocking the conversion of testosterone to DHT will cause these muscular and joint problems. Have you been carrying some heavy loads or started new exercises which could cause your shoulder or back pain? Look for other causes for the problem, but get to see your doctor and do not treat yourself.
Hi Dr. Rassman,
What are your thoughts on Revivogen and Kevis? Revivogen seems to be pushed pretty hard as a “natural” DHT blocker that supposedly works well. I hear Kevis commercials on AM radio all the time. is there any validity to their claims?
thank you
Revivogen seems to make claims about ‘proven’ DHT blocking and ‘Doctor formulated’ natural ingredients. Kevis has minoxidil as an active ingredient. There is clear value to minoxidil, but you can buy this over the counter at substantially less money than with the Kevis formula and Revivogen has made claims that are not widely accepted although it has been around for years with some good reports by some consumers. I have made comments on non-FDA approved medications and claims about safety and effectiveness in the past (see Scalpmed and ViTrichol for examples).
Hello Dr.
I am a 40 year old male who has been taking Propecia for the last 6 years and up until early this year appeared to have great results.
The last 6 to 9 months have been a different story. I have noticed an acceleration of hair loss over this period. My doctor just switched me to Proscar this month to save money and see if that would have better results. He also had me take blood tests and saliva samples to test for illness or hormone imbalance. These tests should be back in a few weeks. Any idea why the Propecia has appeared to lost its effectiveness?
Propecia has only 7 years worth of documented value, although everyone expects that Propecia benefits will not last in the long term and the loss will resume. The hope is that the loss, when it restarts, will be slower over time. Studies show that the hair loss goes back to the ’start’ level at about 5 years (had you not taken it for these 5 years then the loss would be much greater). The value still maintains hair even if it is less effective over time, because for those who have stopped it, the loss became extreme when value had been seen. Some people think that a higher dose might help, but there is no definitive proof to that. Other drugs like Avodart may be more effective, but without safety and effectiveness certification from the FDA for hair loss, most doctors do not prescribe if ‘off label’ possibly because of potential legal problems (search for Avodart on this site for more information).
I am 66 / F and have been experiencing a brush or comb full of hair everytime I comb my hair. My mom who is 89 has pretty thin hair. What can I do? I watch the infomercials and hype and don’t want to be one of those gullible people besides I am not rich but don’t want thin hair. Would you also suggest short hair? Mine is pretty long.
Minoxidil / Rogaine for women works to some degree and is the only effective medication for women. Most women with female genetic hair loss use shorter hair and ‘puff’ the hair. Most good salons know how to cater to the elderly women who want their hair to be stronger. Light color (blonde/white) tends to make the hair look fuller (even streaking it), as low contrast between your skin and hair color takes less hair to appear full. Get a good hair doctor to assess your situation; use the physician search on ISHRS.org to find a doctor near you. It may not comfort you, but 50% of women over the age of 60 have hair thinning hair from genetic female hair loss and the generally effectiveness of hiding it from the male population reflects well on the hair stylists out there.
I have male pattern baldness (my doc says)…BUT I AM losing hair on sides too….does this happen in male pattern baldness….i mean….can hair loss on sides happed due to some other reason or it does happen in male pattern baldness…Thank You
There are many causes of hair loss. It is possible that you have a condition called Diffuse Unpatterned Alopecia (DUPA), which would cause hair loss on the sides. It is similar to the type of hair loss some women undergo. As this is a very significant finding in a man, please undergo a complete scalp examination to establish a metric for miniaturization. What those measurements will show for DUPA, is miniaturization on the back and sides of the head in addition to miniaturization on the front, top, and possibly crown area.
The treatment for this condition is about 50% effective, but because there are many causes of hair loss, please have yourself checked out before it goes too far.
Hello Dr. William Rassman firstly thank you very much for all your helps for who fight with mpb. I am 26 year male and I ve been on finasteride and minoxidil about 1 and half year but 8 months after started minoxidil I started to have sides around my heart unfortunately I could not find a heart doctor experienced about minoxidil in my country turkey. minoxidil works the best for me it is wonderful but it gives me heart pain although I begun to apply less and less of solution. I do not want to stop using it. so could you please help me with these sides and with any alternatives. thank you so much for all your helps again. best wishes
One of the side effect of Minoxidil can be chest pain, though it is rare. Minoxidil is a hypotensive agent, which means it can drop blood pressure, and with that drop it can potentially cause chest pain. This is the sign/symptom of too much medicine being absorbed into the body in too short a time-frame and you might consider stopping or reducing the amount of Minixidil you are using. You must see a cardiologist or your doctor to rule out other causes of chest pain, like coronary vascular disease (a real issue for you to rule out), muscular/joint pain, pulmonic pain or gastric reflux or gastritis or peptic ulcer disease. I believe Propecia may have a better effect than Minoxidil, without the low blood pressure or other side effects that we discussed here.
Is there any effective way to remove or reduce gray hair permanently? I tried 3 laser treatments & noticed very little change except a reduction in my wallet!
Where are you trying to remove the gray hair from? Generally, gray hair has less pigment cells and less pigment in the shafts so it will be more resistant to laser destruction.
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