Can you tell something regarding the change in pH value when using shampoos? I am 20 yrs old and I am using a mild shampoo which I use 3 to 4 times a week. Will that change any pH value and affect me?
The pH value measures how acidic or alkaline a substance is, from 0 (most acidic) to 14 (most alkaline). The range of healthy skin and hair is 4.5 to 5.5. You should choose your shampoo by what makes your hair look great. The type of shampoo and frequency of use will not cause hair loss.
How many hairs (grafts) does a person have to transplant?
I assume that you are talking about the donor hair supply. The supply is calculated by using the most bald person you can find. Assuming normal density of his hair, a person with the Norwood Class 7 hair loss pattern (the worst case) will lose 70% of the total hair he was born with. This will leave him with a 3 inch by 14 inch wreath of hair around the back and sides of his head. Assuming 100,000 original hairs averaging 2 hairs per follicular unit, that would mean that such a person could theoretically move half of the permanent wreath of hair (15,000 hairs or 7,500 grafts). There are other factors involved such as the looseness of the scalp and healing factors. We have a number of patients with Class 6 and 7 hair loss patterns than have moved between 15,000-20,000 hairs. The ones with the very high numbers generally had higher densities of the hairs on the head. One patient comes to mind had a birth hair population of about 150,000 hairs. He had 50% more to work with and he took advantage of that supply with wonderful results.
Generally, that is a lot of hair to move and unless you are very, very bald and have a very ‘perfectionist’ view of your need for fullnesss, most people get away with moving less hair.
Hi, Dr. Rassman. I had a procedure done a few years ago in Texas with Dr. McClellan and I’m very happy with the results. My hair loss has been very slow, thankfully, in some part perhaps due to the fact that Dr. Bob put me on Propecia after my initial consultation. I took it up until about a year ago, and now my crown is thinning pretty badly (I know – it was stupid to stop). My question is this: I’ve read on other hairloss sites of guys buying Proscar and cutting them into fourths or fifths so that they are down to, or near, the 1 mg found in Propecia. Will this give you the same results? It is, after all, a cheaper route. Most of these guys get the Proscar from Canada or overseas, which makes me wonder about the authenticity of the drugs, but I guess that is another question altogether. Thanks, and this is a very helpful site.
I am glad that you are pleased with the results. Dr. Bob does excellent work! As to your question, Finasteride is marketed in two strengths: Proscar (5 mg for prostate problems) and Propecia (1 mg for hair loss). While you can get the same result if you were to exactly cut the Proscar tablet into fifths, it is sometimes difficult to cut the pill in equivalent doses. As a NHI patient, this is something you may want to discuss with us when you need a new prescription. Give us a call at 800-NEW-HAIR (800-639-4247) to set up a phone re-check. I do recommend that you only order prescription drugs from reputable suppliers.
I have followed your work for years, and believe me when the time comes, you are the one I will be going to. How come the crown continues to be so challenging? Most photos seem to show sparse coverage. I have taken proscar for several years, and my crown has filled in nicely. The front filled in a bit with rogaine but not at the density I would like. I am intrigued by the FOX and Mega sessions, but is the donor area so large that you gain hair in one area and lose it in the other? What happens in the large donor area?
Everyone is different. I try to imagine and plan for the worst case hair loss. Depending upon age and family history, I can often make a reasonable intellectual guess on what the worst case hair loss pattern will be. With Propecia, the worst case is usually ‘less’ worse. The crown is usually slower to bald for many people so Propecia works better because it is usually started before the crown goes bald enough to notice.
The size of the donor area is determined by the density of your donor hair, your scalp laxity and the size of the non-balding area. You are correct, that once you move most of the available donor hair, then there may not be enough hair available for future hair loss. If you have good scalp laxity and your density is high, then there could be enough hair to cover the entire head, even for the baldest of men. A good surgeon will make sure that the donor area is the appropriate size and take into consideration future balding and how the donor scar can be hidden by existing hair (if it should scar). I would have to see you to determine where you are in the balding process and where you might lose more hair. As you are in Los Angeles, a free visit to my office will help. We also hold monthly open houses, so you might want to come and see patients for yourself, watch a surgery and let us examine you all at the same time. In fact, our next open house even will be held next Thursday, July 7, at our LA office. Please see the NHI Events page for more details.
Does Cool Laser Therapy work?
The low laser energy therapy is relatively new in the United States. It has been used in Europe for some time. The evidence is anecdotal, but there is no real good objective science to prove value. Everyone wants to believe that it works. Products like the laser comb are available for around $600 and people seem to be willing to invest in such products in the hope that it will work. I have reviewed all of the cursory science from Europe, and possibly there is a suggestion that the increase in hair fullness may be in the order of 10%. If that happens, then it would be good, but the issue is ‘at what cost?’ I am going to participate in a well controlled assessment of this therapy shortly. If the company follows through with the study, it will put numbers to the value of laser treatment so people like you can determine its worth in your approach to hair loss. At this time, I can not endorse it, but I feel that there is no down side to its use except the money you invest.
Here’s two more eyebrow transplant-related emails I’ve received…
In 2002 I cut my eye brows off. But they grew back very thin some parts did even grow back, like the ends. Only the inner part would grow but not so thick. Anyway to date they are not growing at all. My hair line has also thinned out about an inch. I do not know what is going on but I am tired of drawing it on. Please help.
Eyebrows can be successfully transplanted, if the eyebrows you had have not returned after a couple of years. The eyebrow hair is taken from the scalp hair, and as such will have to be trimmed about three times a week and cut on an angle for hair shape. I posted a blog entry recently about this: Eyebrow Transplants. You need to be evaluated for the hairline loss. Read my responses addressing female hair loss, as they do apply to you.
I am considering eyebrow hair transplantation and I have many questions. Does having permanent makeup interfere with the procedure? Should it be removed first or will it cause scarring to the follicle? Also, does the transplant have to follow the original eyebrow hairline or will it grow in any follicle (if I wanted it slightly raised for a more youthful appearance for instance)? Do eyebrow transplants yield a high success rate? I noticed you listed some special summer prices but they were specified for the strip method. What is the cost for the FOX method. Finally, I live near Riverside Ca, zip code 92313, is there an office near me?
Permanent makeup is cosmetic tattooing and is permanent by its nature. It will not impact an eyebrow hair transplant. You should be evaluated first, before any surgery is considered. Eyebrows can be angled for more lift, but it is difficult to angle them for less lift. The success of eyebrow transplants are high. NHI’s summer fees have been reduced by 10% but the FUE approach has not been discounted and still is priced at about twice the price per hair/graft as a traditional strip method of transplantation. Our closest office to you would be in the Beverly Hills area.
Hi.DR.RASSMAN, I would like to know if type 1 DHT causes hairloss?? or is it just type 2..?? Please let me know when you get a chance… and do you think they will becoming out with anything better then propecia in the near future???
Propecia is a type 2 competitive inhibitor of DHT and Avodart is a competitive inhibitor of both Type 1 and Type 2 receptors. I think that is what you are asking. There is no clear evidence that blocking both Type 1 and type 2 receptors is better. What we do know is the Avodart does drop the DHT level in the blood stream more effectively than Finasteride (90% vs 75%). What this means is suggestive that it might work better in some people. But I must state clearly that safety and effectiveness is the mainstay of the FDA and until we have a handle on these two issues, I believe it is better to stick to Finasteride.
im 21, but have been going bald since sixteen. i hate it cause im so young and have no confidence. i used drugs to solve it but nothing happened. is a hair transplant the only answer? sick of seeing all these ways of growing hair back, as in using tablets
At 21, you are young to be balding, especially since this has been going on since you were 16. However, you are certainly not alone; see the Age postings in this blog for some of the other questions (and my responses) from men your age. I would suggest that first you have a complete physical to rule out any underlying medical conditions that could be causing the hair loss. Once that is done, your next step would be to see a doctor who specializes in hair loss. Be ready to discuss with them your medical history, what hair loss treatments you have tried and for how long, what effect they have had, and what is your family history of balding.
A hair transplant may be appropriate at your age if your future genetic balding pattern can be determined. A good, ethical hair transplant surgeon will be able to tell you whether surgery is an option, or if Propecia alone would be beneficial at this stage in your balding. Do not rush into surgery without a clear understanding of what your future balding pattern may be.
I am a 27 year old African American woman. A few months ago I saw some bald spots in the middle of my head. I thought it was the wigs and hair weave I used to wear, but later on the bald spots started to spread down to the front of my hair line. When my hair itches I used to bang my head with my hand so that I could stop the iching. I don’t know what to do with this situation. I want to cut my hair off and start all over re-growing my hair. What do you think is best for me to do?
If you have not yet seen a physician, I suggest that you get a thorough examination to rule out any underlying medical conditions, which could be causing the balding. The physician would also be able to determine how best to treat the itching.
I have recently began using the new lazer comb. It was given to me as a gift. I was curious if it has been effective in the hair loss fight? Any comments, advice, side effects would be greatly appreciated.
I have not read any impartial scientific papers that verify the effectiveness of laser combs. I tend to discount any reports that claim the combs work, if they are written by those who have a vested interest in the success of the laser comb industry. On the positive side, I have not read any papers that claim that is unsafe to use the laser comb. Since the comb was a gift, and you plan on using it as recommended, I see no reason for you not to try it. However, if you see any adverse reactions or have continuing balding, you may want to have a doctor examine you and see if there are any recommended and scientifically proven methods that may help you.
I’ve previously written about this in a previous blog entry, Hair Lasers.
