Balding Blog – Page 1904

November 23, 2005

Hair Loss InformationFixing Plugs with Electrolysis – Hair Loss Information – Balding Blog

On your site, you write that removing grafts via electrolysis does only work on bigger grafts – what does this mean? How big are bigger grafts? I think my grafts have maximum 5 very thin hairs in it, many have 3 hairs or less. Would it be possible for you to treat 5-hair- grafts via electrolysis?

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I do not have the point of reference, but what I may have been referring to is that electrolysis of the hair has a 50% failure rate per hair. So when a larger graft is treated with electrolysis, the hairs are still present after one or two treatments. For large grafts, when the hair count in the graft is reduced, any skin cobblestonning (characteristic of the older grafts) may become more obvious. The modern approach could be to excise the entire frontal hairline since grafts in that location are most noticeable and bothersome. With fine hair and grafts that only have 4-5 hairs each (rather than the large plugs which may contain over 10 hairs), maybe less can be removed or treated with electrolysis. You can remove the hairs within the grafts with the FUE technique as well, with more certainty than electrolysis. I would need to see pictures to determine what is best. You can send pictures to the email address listed on the Contact page.

November 23, 2005

Hair Loss InformationSudden Hair Loss Years After Transplant – Hair Loss Information – Balding Blog

I have had 6 procedures. four smaller (elsewhere) and my last two (more substantial) with NHI. You performed my last procedure about 6 years ago. I started the restoration process early, so I never went through a noticeable hairloss phase. I have been on proscar for about 5 years and it halted my hairloss. Obviously, I still have a significant amount of hair. I normally kept my hair cut short, but recently I let it grow a bit longer and got a trendy razor cut hairstyle. I towel dry my hair and put a manipulator cream (bed head brand) to keep the style. I have never looked so good! Then one week before my next haircut I started to notice hairloss. From Oct. 13-Nov 12 I have lost all the hair behind and between my frontal-most grafts(about a half inch deep, from the front hairline and extending all the way across the front and into the corners. Is this normal? I’m beside myself. I have done everything through the years to combat my hairloss with unbelievable results and now this. It’s as if somebody just flipped a switch and Pow! Can proscar just stop working? I would appreciate any information(based on my brief description). I diligently keep track of my hair-the hairloss happened that quick. Also, I am now 41(a very young looking 41!!) I am on 3 medications. One is allegra D, the other is an acid reflux medication (both prescribed for allergies/cough) and finally, a cortiosteroid nose spray (nasonex). Can any of these be compromising the effects of the proscar? Thanks again.

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I am also alarmed. I will try to call you as I know you are not local to California. The corticosteroid nasal spray could cause this, if you are using it regularly and heavily. Loss of transplanted grafts after they have grown is very, very unusual. It could be caused by other medical conditions which you will have to get checked out. The Proscar should not be the problem.

As I think back about hair loss in transplanted grafts, they are rare. I have seen them in some men who have developed a type of senile alopecia where the donor area is thinning. If this was happening to you, your donor area should show signs of miniaturization and that would point to this diagnosis.

We need to talk and get you to a good doctor locally who can map out our scalp for miniaturization and attempt to clarify the cause for the hair loss.

November 23, 2005

Hair Loss InformationTidbits: Evolution of Hair Loss – Hair Loss Information – Balding Blog

A few times each month, I will post some random hair-related information, which I’m calling “tidbits”. I spend hours each day writing responses to questions I receive on this blog, so it is a nice change of pace. For example…

Evolution

In an doctors email group that I subscribe to, some comments were made which I would like to share, as they will have value in understanding the hair loss process from an evolutionary point of view. I want you to know that the comments made by this group of doctors are not intended to start a debate on evolution – we will not relive the famous Scopes/Monkey trial on this blog. It was stimulated by the question: “How long have humans experienced hair loss?”

One doctor suggested that genetic hair loss must go back millions of years. Neanderthal men had hair loss with varying degrees of balding. Humans (in the evolutionary tree) developed in a different line from chimpanzees about 5-6 million years ago. Chimps have crown loss, which progresses over time as the male chimps get older. The hair loss in macaques, also with a similar mechanism, suggests the process was present in our cousins at least 15 million years ago.

We know that monkeys have been around for millions of years longer than homo sapiens. Was the stump-tail macaque always bald? My memory does not work that far back, but one of the doctors believed that the bald characteristic of the stump-tail macaque may have been more recent (I guess he has a better memory than I do). No one today knows what Neanderthal man looked like, although on the time scale discussed above, he was alive just 30,000 years ago. He left a lot of cave paintings of animals but no detailed self-portraits of his manly appearance, certainly not one of a balding cave man.

The group of doctors who share this information do so to disseminate more knowledge to each other. We try to become not only better doctors by helping each other, but also more knowledgeable ones, trying to help our patients who suffer from the pain of hair loss.

November 23, 2005

Hair Loss InformationPimples in Transplanted Area – Hair Loss Information – Balding Blog

Dear Dr. Rassman

After going through your informative blog, i decided to publish my question seeking your good answer so others can benefit too. Am currently 8.5 weeks post HT surgery. Till now things seems to be fine except for one thing, infections from time to time that is, i get those deep pus filled pimples that develop right below the grafted area every now and then, which in part made me consider an oral anti-biotic called DURICEF. My question as follows, will my transplanted follicles survive in the presence of those so-called folliculitis? Is it advisable to leave the pimples un-touched when ever they form? Your Help is greatly appreciated

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Pimples in the recipient area are not uncommon in some people. When the transplant is done and the hair sheds, there are two things that could be left behind as the body works through the healing process. The first is that remnants of the actual hair shafts might stay buried under the skin. These would form a foreign body reaction and could manifest themselves with pimples. The more likely cause is the remnants of the sebaceous glands which survive and grow while the hair has not yet started to grow. These glands secrete sebum, which accumulate under the skin and cause pimples of varying sizes. They can be very annoying and become infected, on occasion. The best way to treat them is to have frequent soaks so that the skin softens and your pimples will work their way out with the sebum (or hair shafts). To stop infection (if they occur) a good bacteriostatic antibiotic usually works. I have my preferences, and your doctor will have his/hers.

November 22, 2005

Hair Loss InformationSteroid Creams and Hair Loss in Women – Hair Loss Information – Balding Blog

Hello Dr. Rassman

I have a major problem. I am 39 y.o. black female. I see a dermatologist for severe psoriasis in the palm of my hands and my feet. I have had this problem now for more than five years. I was not diagnosed with psoriasis until jan of this year. I saw podiatrists, dermatologists, allergist and no one diagnosed me with this condition. These doctors could not tell me what was wrong with me, they gave different diagnosis and treated me for latex allergy fungus, no sweat gland, vitamin b12 injection, prednisone, lamasil, and none of these treatments worked. I finally gave up and changed doctors and my primary sent me to a dermatologist in the Tampa Bay area. He took his time and treated me with different medications like clobetasol, propionate cream, different ointment combinations, and different creams such as salex, naftin, etc, etc. He did a biopsy on my foot, because at this time the psoriasis was creeping up my legs. That’s when I was finally diagnosed with this problem. I was placed on soriatane with the lowest dosage and then he increased it. I could see a difference in a few months. My labs were monitored monthly and I knew of some of the side effects and the problems that goes along with taking this med, but I was happy. I was in the process of taking soriatane qod until all the pills were finished. While I was in JA on vacation, the hair dresser noticed a bald spot on my scalp the size of a 1/4. It was not there when I left the USA. I have been getting relaxers, weaves, braids and wearing wigs for many years and I also have a hair dresser. She has been taking care of my hair very well and I had no problems. My scalp was itching me very badly and my scalp was tough and leathery and very dark. My hair was breaking and falling out pretty badly. When I washed my hair the shower floor was covered with hair. I got very scared and when into a depression which sent my self esteem in a tail spin. I saw my dermatologist and he gave me a topical abt for scalp due to the itching. The problem still persist and I had a biopsy done on the spots that were bald. The results were neg for any disease process. He told me I was losing my hair due to braids and relaxers and tension on my scalp and I should look into having hair replacement done. That still did not tell me how I came to have bald spots that seem to pop up over night and losing almost half the amount of hair in the front and middle. The back is still thick and less hair loss is seen there and no bald spots but I continue to have an unbearable itch to my scalp. I have not started any kind of treatment as yet. Its about 2 1/2 months now. I have to wear wigs everyday now. I don’t go to the hairdresser any more. I don’t want anyone to see me without hair. I don’t know what to do anymore. I would like to know if the soriatane and other steroid creams could cause my hair to fall out and if it would ever grow back. Will this itching ever stop and will my scalp feel like scalp again? Please give me some hope. I am desperate. Thank you.

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I went to the internet to look up Soriatane, which is related to Accutane (known to cause hair loss). This drug does cause depression, amongst other things. One lawyer has a website where he warns people about this drug: Soriatane Overview at YourLawyer.com

Braids do cause hair loss, as does genetic propensities, and an entire class of most drugs have hair loss as a stated side effect. It sounds like your case is too complicated for me to just make a stab at your problem via the internet. Steroids are a cayuse of hair loss also and you must be careful with their use. Even creams with steroids in them will absorbe through the skin and they can impact your body’s cortisone balance if they are used regularly. This is too important of an issue to not have a good doctor meet with you in person to take charge of your problems, as evident by your desperate email.

November 22, 2005

Hair Loss InformationHair Transplant Before Face Lift? – Hair Loss Information – Balding Blog

I have a question about possible future hairloss. I have a list of procedures I want to have done and thought I knew the best ordering of them. I plan on having a hair transplant first, this so my hair has time to regrow. About 6 to 7 months later I would have a SMAS Facelift. However, I have been reading about the hairloss common to post face lifting and now I am perplexed. Bear in mind, my eyebrows are to be lifted with a method that doesn’t go near my hairline on top, however, it is the sides of my hairline, the temple region that has me stressed. A facelift will deal in that area and quite truthfully, I can’t afford to lose hair there. It is already thinned out considerably as it is. But, I need to have the facelift. So, is it possible to have a “temple” hair transplant? I don’t see any way around this. Help me by imparting your knowledge so I make an educated choice. I think I can proceed with the transplant on top, to be scheduled in early december, but what about the temples and future facelift?

Thanks so much for taking the time to answer my question and solve this.

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Generally, I like to do hair transplants after face lifts, because if there are any problems to the hair caused by the face lift or brow lift, they can be addressed at the time of the hair transplant. A good deal of my practice is this type of surgery. Clearly, the newer face lift procedures spare some, but not all of the problems. You can follow your facelift with a hair transplant after a few weeks to a few months. If there are hair problems following the facelift, they will be evident by month three.

November 22, 2005

Melancor – Hair Loss Information – Balding Blog

Hey Dr. Rassman;
Concerning the subject of graying hair…I have look at about everything the internet has to offer on what causes it, and how to stop it, even reverse it. I would like to hear your take on the subject if I may. Do you know anything about Melancor or is it another “snake oil”? And what’s up with gray chest hair?….mine is 3 times as long, seems twice as thick and curlier than my dark brown chest hair. Why is that so? What is taking place here?
Always thankful for you time!

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I know very little about Melancor, but based upon your question, I did research it. The claims appear to me as marketing hype without documented scientific evidence to back up claims of safety or effectiveness that satisfy my scientific mind. That concerns me. The substance is in a pill form and that concerns me even more. I would doubt that this passes FDA or FCC standards and without safety studies, I would not want to risk my health taking an unproven medication.

With regard to your long chest hairs, I can only tell you that this is exactly what I see on my hairy chest. At least there are two observant people watching their chest hair grow far too long for their particular likes.

November 22, 2005

After Care for Scar Revision – Hair Loss Information – Balding Blog

Everything seems very promising at this stage, two weeks after a scar revision procedure. I am wondering whether there is anything proactive that I can do to help minimize the presence of the new scar. (Besides avoiding exercise involving unexpected head-turning.) Such as:
– applying onion-based anti-scarring ointment; or
– not applying onion-based anti-scarring ointment;
– or using or not using some other topical thing.

Thanks for everything!

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I think that patience is a virtue and if the surgery was done well, that should suffice. Applications of any topical ointment may be pointless at this time. If hypertrophic scarring should occur, then you may need to take a look at it as it forms. Stretching of the scar will take time, as stretching usually starts to become evident at about 6 weeks. Keep in touch with your doctor if anything worries you.

November 22, 2005

Genetic Balding in Family History – Hair Loss Information – Balding Blog

Hello, Im a 16 year old male and i have been experiencing frightening thoughts of a receeding hair line. My hair is currently around 40cm long from the root. Not so long ago I looked in the mirror to notice that my hair was slightly more blonde amongst the corners from my temples up, and the hair seems thinner and smoother. Im probably guessing it is from wearing my hair tight in a bun. There is no form of genetic balding in my family. Is this a Form of balding that can be overcome?

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It sounds like you could have traction alopecia which occurs when one braids his/her hair tightly, causing continuous traction, which over time will cause permanent hair loss. The actual pattern of hair loss will be helpful to view so send me a photo and I can tell you from that (wrassman@newhair.com). Alternatively, receding hairlines in men as they mature is a normal part of the aging process, most notable between the ages of 18-29.

Please note that genetic balding may skip a generation or two, so it is possible that you have a genetic predisposition to lose your hair. I recommend that you see a doctor that specializes in hair, so that he can evaluate you in detail, looking for miniaturization to determine if there is any balding process going on.

November 22, 2005

Can Miniaturization Be Reversed? – Hair Loss Information by Dr. William Rassman

Dear Doctor,
If you have miniaturization developed in the past 6 months at a rapid pace is it possible to fully reverse it or maybe most part of it ? I Got onto propecia last month once my derm confirmed I have MPB. I am thinking of adding Minoxidil too to the regimen the logic being since the miniaturization/ slight halr loss too has been in the past 6 months Minox might help steer those hair follicles slipping away into complete dormancy. Is my thinking right ? or will propecia and something like a 2% nizoral shampoo be enough to do the job/revive thoseminiaturized follicles ?. My miniaturization is mostly on the top and my hairline is intact. My hairloss history is about 7 months. I am late 20s. Also What is the ideal times a week you should wash hair for a male who has a desk job from 9-5 and works out 4 days a week. ?
I will appreciate your feedback.

In my opinion, I would hold off on the minoxidil and stick to the Propecia for the first 8 months. If the hair loss is as you have defined, then there is a high possibility that it will reverse because it seems to work best for short term genetic hair loss. If you take other drugs like minoxidil and make too many changes at once, then you will never know which one worked best and you’ll be ‘hooked’ on both of them for years. Play your bet out and try the 8 months of Propecia first.

As for washing your hair, I’ll just quote what I said in an earlier blog entry: “Frequent shampooing does not hurt, but aggressive massaging during shampooing and rough brushing will cause fragile hair to break easily.”

To conclude, yes miniaturization can be reversed. The more advanced the balding you have and the longer time you have had it, the less likely will be reversal of the balding process. But the resuls with Propecia (in particular) have at times been very powerful and I have seen a few men who I would have never guessed would reverse, reverse it nevertheless.

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