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Shock Loss – Hair Loss Information by Dr. William Rassman

Here’s 2 related shock loss questions…

I have been on propecia for 12 months. I had a transplant at the frontal hairline 2 months ago. Since the transplant I have noticed thinning in behind the grafts and complete baldness at the graft area. My doctor tells he this is shock loss but the hair will re grow due to the fact I am on propecia. Is this true? Also, how long can shock loss occure after surgery?

Is it possible that native hair (in the recipient region) can go into shockloss well after the HT procedure, say 6 months or a year?

As a general rule, shock loss with a man on Propecia has a high possibility of reversal. Shock loss usually occurs in the first 3-4 months after a transplant and reverses in 5-7 months. Hair loss after that time may be from other causes, including acceleration of the genetic process. Time will tell you what your fate is. I would need to see your progress over time if you want more opinions from me. Take good pictures and keep a good library of your progress.

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Frontal Hair Loss – Hair Loss Information – Balding Blog

I have a receding hair line, similar to my fathers’. As of right now if i were to lift my bangs up, the two ends of my forehead are pretty far back(much like the shape of an M from a top p.o.v.)How can i grow this hair back before it’s too late? And will i ever loose the thin hair that is slightly covering this hairline?

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Assuming that you are older than 24/25 and you have genetic balding, then it would be reasonable to assume that you will probably not get your frontal hair back with anything short of a hair transplant. Take a look at this celebrity with a similar sounding problem to yours. We performed a hair transplant on Steve Hartman, a CBS sports correspondent with his own radio sport show every day in Southern California. He had a single hair transplant session of 1,895 grafts to accomplish his goal of restoring the hairline (see Steve Hartman feature for photos and details). You should also be on Propecia, a drug that can stop, slow down, and on rare occasions can regrow hair.

I’ve written previously about Steve Hartman on this blog. For more info, please see: Where Are the Celebrity Transplant Photos?

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Dermatix – Hair Loss Information – Balding Blog

Had a FUT procedure (not with you) and since i noticed the big deal about the donor scar i started worrying which made me try to avoid any strenuous activities. I bought some scar reduction product called DERMATIX which claimed to smooth raised surfaces and reduce redness associated with scarring. Ever heard about it? its also mentioned that it musn’t be used until the wound is completely healed,so how long does i take donor scar to be healed?

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Dermatix is a transparent, self-drying silicone gel with claimed advantages over other silicone formulations that are used by some people to smooth or soften scars and as a result, reduce itching. It is reported to be FDA approved in the US and Europe (it has a CE mark). It appears to be recommended for the prevention of hypertrophic and keloid scars, possibly in their treatment as well. Hypertrophic and keloid scars are your body’s reaction to wound healing, so I would be doubtful that it would prevent these scars, but frankly I am a skeptic, so take what I say here with a perverbial ‘grain of salt’. Some people use sheets of silicone to try to soften such scars when they occur, and that might work.

For most hair transplant donor scars, it is usually not hypertrophic or keloid scars, but rather widened scars, and here I would really doubt that Dermatix would prevent the widening of the donor scars. It is the widened donor scars that cause much of the internet comments about scars, not the hypertrophic or keloid problem. From your question, it sounds like you are more concerned about prevention. In that case, the best solution for a future surgery is to have a good surgeon use a ‘fascial’ closure to minimize the donor scar for traditional strip harvesting (second surgeries do run a higher risk of scarring of 5-10%), or consider having a Follicular Unit Extraction (FUE) procedure, where the surgery does not produce a linear scar (see our FUE page for details).

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Scalp Testosterone? – Hair Loss Information by Dr. William Rassman

Dr Rassman

Can you please tell me the role of scalp testosterone (not serum) in hair loss/growth?
Thank you

The scalp does not make testosterone, but it does metabolize it with the enzyme 5alpha-reductase, the same enzyme that Propecia (finasteride) blocks. During the metabolism of testosterone in the scalp, 5alpha-androstane-3beta-17beta-diol appears to be formed and the formation of androstanediol (a steroid byproduct created by the hair apparatus in the metabolic process) has some effect on the functioning of the sebaceous glands, as well as (possibly) accelerating the hair loss. It probably impacts the sweating and the sebum production. We really do not know this for sure so I would consider what I said here as an intellectual logical exercise (taken from what I read which incidates that much of this information is based upon experimental work from in-vitro research studies).

On a practical level, I think that you may be thinking about the length of time it takes to block DHT production. The answer here may be in the duration of action of the particular DHT blocker you are using. Propecia has a 5 hour half life, Avodart has a half life in months and other claimed DHT blockers do not have a clearly defined life of action. It is better off sticking with known drugs that are fully researched by standards established by such bodies as the FDA.

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Hair Loss InformationRecapeen, FUE Plus & Lasers for Hair Loss? – Hair Loss Information – Balding Blog

As creators of the FUE method, I presume you know what the FUE Plus method is? There is a clinic in my country that claims to have been able to boost the traditional FUE method by using a smaller tools when inserting the transplanted hair. (1) They claim that the increase in density is miraculously high, but still the improvement is impressive. Do you know more about this? (2) A new hairloss treatment called Recapeen, has been realeased. The “engine” in this package claims to be the unique pollen extract the substance is full of. Comments? And finally, 3) What is the strongest reason why to spend money on a hairtransplant rather then a laser treatment?

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I looked at the site referred to in your question. There is not enough information for me to judge what FUE plus is. When I purchase a bottle of shampoo and the company comes up with a new version of the shampoo they may add the term ‘plus’ to the name. The detergent market for washing clothes, made the most popular product in the early 1900s. That product was ‘Tide’. Then as they were improving the product, sales did not rise fast enough, so they came up with New Tide. The adjective NEW turned out to be the most popular advertising word in capitalistic history. Everyone came up with a product and then made up a NEW version of that product. I, knowing this, called my company the New Hair Institute and purchased the phone number 800-NEW-HAIR before anyone else thought of it. I was, at the time, an old fashioned marketing person, so NEW did it for me. The modern iteration of this is the term PLUS. I guess, if you did not invent FUE, then the best way to grab onto market presence is to invent FUE Plus, or at least the name. I respect the marketing brain that thought of it. The choice of doctors, of course, should have little to do with PLUS or NEW, but rather who you can trust to do the FUE on your head. Experience and judgments are critical to this choice and you sound (at times) like you are making such choices.

I did look at Recapeen and see that this miracle cure is listed with many other such potions and lotions on the respective websites. If Recapeen worked so well, one might ask why other products are listed there? I call it good marketing and diversification of strategies. Spread out well, and more people will get some part of the message. What are you really looking for?

I agree with you that hair transplants should be obsolete if these miracles worked, but then again, first I would want to see the studies and the scientific evidence that it works, because I am a cautious buyer. Every day that you chase the magical cure for balding is another day that you will continue to lose hair and progress further down the pattern of hair loss buried in your genetic cards.

With regard to laser treatments click here Low Laser Light Therapy for Hair Loss for more details.

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Hair Loss InformationIs One Hair Type Better Than Another? – Hair Loss Information – Balding Blog

Why does hair vary so much with people? Does coarse hair or kinky hair have an advantage over fine hair?

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I remember a television piece done by CBS News’ 60 Minutes where they tracked what was claimed to be one of the original 12 tribes of Israel deep into the African continent through genetic testing on the Y Chromosome. In the few thousand years since the migration, the physical characteristics of the African became evident in these people with bigger lips, a wider nose, and kinky hair. I think that thermal regulation has a lot to do with the kinky hair, which allowed better cooling as a person chased an animal in the savannas of Africa during the hunt. Wide nasal passages allowed better air movement for breathing as well. The scalp is a major releaser of heat by preventing overheating in the summer, especially when heat generation adds to climatic conditions. On the other side, we know that when the French invaded Russia in Napoleon times, the winter killed more Frenchman than the battles. We also know that the bald men died during the retreat at a much higher rate than those with a full head of hair. Conservation of our body heat in the cold is another function of hair. In your question, you suggest that there is a better hair type; but better for what? Those with thin hair that sticks to a sweaty scalp may insulate better than a person with kinky hair, but not with coarse hair that lies flat. Also, there are no kinky-haired people outside of the original African population, indicating that kinky hair had an evolutionary advantage, so it evolved as the people adapted better to their geography and climate. If everyone originated out of the middle east, then we should look to our cousins there to see where we may have started from. This could be interesting topics of conversation for those of us who believe that one type of hair/person is better than another. When we put esthetics into the formulae for your question, then culture and vanity act as modifiers that go well beyond the influences of climate. Thanks for the insightful question. I always enjoy the wide variety of questions posed in this blog.

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Hair Loss InformationDutasteride (Avodart) Risks – Hair Loss Information – Balding Blog

My husband is 33 years old and is losing his hair, he also suffers with body dysmorphic disorder and is desperate to do something about his hair loss. He has already tried many different lotions and potions to try and halt the hair loss because we can not afford for him to have a hair transplant. The problem that I need advice about is Dutagen (Dutasteride soft gel capsules) he has purchased a 6 month supply of this drug from the internet but I noticed the warnings about dangers to pregnant women and the risks to male foetuses. The problem is I am 7 months pregnant with our second son and I have great concerns about my husband taking this drug knowing that there are risks to our unborn son. We also plan to have more children in the future and I am extremely worried about the risks to me and my baby now and for any unknown problems that may arise in the future regarding having more children. What information is available to me to put my mind at rest about my husband taking this drug while I am pregnant and future fertility considerations associated with taking this drug?

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Dutasteride is a known DHT blocker. I am not familiar with this drug’s concentration in the sperm and how much of it could cross into the baby. If it follows the experience with Propecia, it should be safe in this regard, but without first hand knowledge, I can not tell you the answer to this question for sure. There is a theoretical problem if it did cross the placenta and into a baby’s body, it might affect the baby’s sexual development as the drug has a very long half life. You might ask your husband to use a condom until the baby is born.

Soft Gelatin Capsules, because of the possibility of absorption of dutasteride through the skin of people who handle this drug and the potential risk of a fetal anomaly to a male fetus in a pregnant woman who absorbs any amounts of this drug, could impact gonadal development. This is a risk that is not well defined for this drug. For this reason, women should use caution whenever handling Dutagen Soft Gelatin Capsules. Your physician should inform you and your husband that the ejaculate volume might be decreased during treatment so that for women wanting to get pregnant, this might also pose risks, particularly for the fetus if the sperm contains the drug and the drug last months inside the sperm (and possibly inside the fetus).

The known side effect of a decrease in sperm volume (with Propecia and Avodart) does not appear to interfere with normal sexual function in most men, but in clinical trials, impotence and decreased libido, considered by the investigator to be drug-related, occurred in a small number of patients treated with this drug. I hope that your husband’s body dysmorphia is being managed by a good physician.

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Hair Loss InformationIs My Hair Loss Normal? – Hair Loss Information – Balding Blog

Hi, i been taking propecia for a month and 1 week, this last 2 week i notice that i lose over 150 a day ( Each morring i lose around 50 hair on my pillow and around 80 in the shower). It been going on over 2 week.
Will this stop and Is this normal for taking propecia? if yes how long will this hair lost last? Do propecia cause initial hair lost?

thanks

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A typical person does lose 100-150 hairs per day. If what you see more recently reflects a change in your norm, you may be experiencing an acceleration of your hair loss. The relationship with your taking Propecia may be circumstantial and I would believe that the two are not related, but you can stop taking the drug and see what happens. The drug is out of your system usually in a day or two. If it stops the loss, then maybe there is a connection, but I have never seen that connection in others. If the loss continues, then I would go right back on the Propecia because that is the best hope for you.

There are some doctors who believe that some shedding after starting Propecia or Avodart is due to an acceleration of the hair cycling. See my previous posting on this subject here.

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My Chin & Goatee Transplants are Red – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,
First of all please let me thank you upon your excellent work (as i overheard from sources). Am 25 year old and had a HT procedure of about 1600 grafts by strip method 4-5 weeks ago for increasing my facial hair density around the chin and goatee region and due to the fact that i live in the middle east i didn’t have the chance to perform it with you,otherwise things would have been different. Without any exaggeration am now having cruel restless nights with lots of suffering. I have two major problems or should i call them concerns, first is that the recipient areas are exhibiting significant redness (even after more than 4 weeks post-op). Add to this a long battle with infections, second is that after going through many forums, i’ve found that infinitely many people are depressed about their donor area linear scars as the scars tend to stretch and looks ugly which restrict them from having their heads shaved or get a simple buzzcut. Is there anything i can do about the redness of the transplanted areas? Sorry for elaboration but you are saving a man’s life Dr. Rassman

I am assuming that you had only the chin and goatee region hair transplanted. With that assumption, 1600 grafts seems a bit high. If larger than one hair grafts were used, I can imagine a great deal of reaction to them. including skin changes like puckering of the skin. If you look at typical beard hair, these hairs rarely are more than one hair per grouping so if you had more, then there are wound issues in healing which might point to problems. Without seeing you myself or knowing what you had, I can not be certain. Infections are rare indeed, but if you are having them they are most likely the results of cysts at this early stage where sebaceous glands from the transplanted hair are producing sebum below the skin and becoming reactive cysts. There are usually best treated with soaks at least twice daily and meticulous hygiene. Antibiotics may have value but good cultures should be done prior to starting antibiotics in the event that you have a bad organism causing the infections.

We have spent a great deal of time discussing scars in previous blogs.