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Medications That Prohibit You From Getting a Hair Transplant?

i am on coumadin. is hair transplant possible?

Coumadin (warfarin) is an anticoagulant, also known as a blood thinner. Blood thinners are on the top of the list of medications which must be addressed in a patient who is about to have a hair transplant. I have done transplants on people who are on such medications, but take many steps in the process to assure safety. Generally, one can cut back on the Coumadin and then step it up on the day of transplants. Your general health is really the issue and the reason you are on these medications may allow you to stop them for a week or so. The answer therefore is an individualized answer depending upon the patient, his/her medical condition causing the use of such a medication, and the general state of the patient’s health.

I take a thorough patient history and review all medications that a patient is taking prior to performing a hair transplant.


2008-06-16 09:30:04Medications That Prohibit You From Getting a Hair Transplant?

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Medications and Hair Loss. Can You Beat the Hair Loss with Medications for Years?

Thank you, Dr. Rassman. I know I am definitely thinning. Especially after shaving my hair. In certain lighting it looked like I had no hair in my corners and I could see straight through to the scalp. I have been using minoxidil with a bunch of hair sprouting along the hairline. And a great change in density. I did have a question for you though, how long would minoxidil keep my hairline? And if I start on finasteride, how long would that keep my hairline. I am being optimistic but I am hoping it extends my current density for the next decade if I use both together. I am also very hopeful that there will be better alternatives in the next decade, or quite possibly a cure.

I also would rather not consult my doctor as I know it is very obvious I am experiencing hair loss. I mean, I will have to when I go for finasteride. But I am someone who participates in homeopathy up to a point. So I would rather not alter my hormones unless it is my last resort.

Combining both minoxidil and finasteride will give you the best opportunity to hold on to your hair. I always tell my patients to look at hair loss as a ‘tug of war’, with treatment on one side and the hair loss process on the other side. As long as the pull from the medications is stronger than the genetic pull, you win. When the pull reverses, hair loss is the consequence.


2018-06-19 10:16:31Medications and Hair Loss. Can You Beat the Hair Loss with Medications for Years?

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Medications for Diffuse Unpatterned Alopecia

Hello. I am 24 year old male, who believes I am suffering from diffuse unpatterned alopecia. My hair is thinning evenly over the top and the side of my head to from the classic horseshoe pattern of a Norwood class VII. I have been taking Propecia since January and i do not believe its working as the thinning has progressed. My dermatologist did not seem to concerned and told me to continue taking it for the full year before asking for any other options. Are there any other effective options available? I have read about Avodart and minoxidil, or the possibily of a chemical imbalance, but I do not know if they are effective for this condition.

I believe that DUPA can be reversed with Propecia. I see this in about half of the patients who are taking it. For those like you, it may be worthwhile, after trying Propecia for a year, to consider Avodart, but I have said many things about this drug which you should review.

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Medicated Shampoo and Hair Loss?

Hello Doctor

I know many people with hair loss that use ketoconazole 2% shampoo times a week, thinking it fights seb derm. Others use salycylic acid shampoos 4 – 5 times a week thinking it thickens the hair shaft

My question is: Could overusing active medicated shampoos for long periods, contrary to official recommendations lead to permanent hair loss?

Thank you

I don’t think shampoos will cause permanent hair loss per se, but you should not be using medications of any sort in ways they are not prescribed or recommended.

Ketoconazole shampoo (also known as Nizoral, among other names) does work in treating seborrhoeic dermatitis, but you should follow your doctor’s recommendation for dosing.


2011-07-04 07:56:07Medicated Shampoo and Hair Loss?

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Medical Causes of Miniaturized Hair?

in regards to low testosterone and low lh question that was answered…..

Are other medical causes that would contribute to hair miniaturization other than DHT/aga?

Male pattern baldness is not the only cause of miniaturization, which could be seen in many other conditions, such as Diffuse Unpatterned Alopecia (DUPA). Most of the cases of miniaturization are chronic conditions with gradual thinning of the hair. In more acute balding conditions, such as stress related hair loss, fungal infections, or alopecia areata, you may not see any miniaturization.


2006-12-07 10:35:05Medical Causes of Miniaturized Hair?

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Mechanism of Male Pattern Balding?

Can you explain more in detail the actual mechanism of MPB? I know that some hair follicles are sensitive to DHT and somehow the DHT causes miniaturization, but how does this actually work? Also, any wisdom on why some hairs develop later in life even where there were no (or not visible?) follicles. Like pubic hair and hairs on the chest and back as men age?

I am not going to write a book to answer your question but here is a quick summary: People who have the genes for hair loss, when exposed to DHT (normal for men to have this) trigger the process called Apoptosis (the progression of cell death) for hair follicles carrying the genes. DHT works directly on the growth center in the impacted hairs. Drugs like finasteride or dutasteride block this process so it slows down the effects of the DHT and the balding that occurs.

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Measuring the Mature Hairline

I know you explained how to measure the mature hairline with the wrinkled brow but you didn’t say how exactly. Do I need to put a ruler in the middle of my forehead and measure that way (this way it shows my corners are 2 inches receded) or can I put in highest corner of my temple and measure downwards if I do it that way I get 1 1/2 inches but my hairline is only 0.4inches away which is good. I believe I’m on a NW2.

Also around my temples I have a chunk of short hairs but there thickness is pretty much the same like other hairs. My hair is kinda longish you know. But what worries me that they will fall off and then my corners will be quite big. Is this all normal?

I’m almost 22 years old and my temples started to recede slowly since late 17s but in the past year just jumped up fast.

A maturing hairline is a generalization of how a young male will have a slight recession of his hairline in his teenage years or early 20’s. If you follow this “rule” (it is actually my rule) then there are three elements of it. A mature male hairline exists when:

  1. the middle of the hairline is about 1/2-2/3 inches above the highest crease of the furrowed brow
  2. the shape of the hairline is convex
  3. the sides of the hairline will rise about 1.5 – 2 times higher than the middle of the mature hairline

If you continue to recede beyond this area then there may be a genetic component of androgenic alopecia. This presence of genetic causation can be seen by mapping out the hair for miniaturization and looking for miniaturized hair substantially behind the leading edge of the mature hairline. And not to confuse anyone, but even though I call it a “rule”, there really is no specific rule to this. You cannot go by an exact set of measurements, such as 0.4 inches. If you are worried about this matter, I would see a doctor for a good microscopic examination (miniaturization study) of your hair to determine if there is a pattern developing.


2008-07-23 15:03:44Measuring the Mature Hairline

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Measuring Hair Bulk After a Year on Finasteride

Doctors, I’m confused as to what Haircheck is and how it’s different from the miniaturization mapping. Can I get some more info please?

I’m going to try to clarify the usefulness of this tool as best I can. I saw a patient (we’ll call him John) that came to see me after I started him on Propecia a year ago. At the time I prescribed Propecia, I noticed he had miniaturization to 50% in the top of his head. I measured this when I used the video microscope, but there was no see-through appearance as his hair had a good weight to it so with the naked eye and I did not see miniaturization, nevertheless, the hair looked normal but with the microscope. It was clear that he had early balding when measured by the HAIRCHECK instrument. The HAIRCHECK instrument measures hair bulk and puts an actual number to it. From a visual appearance, there was no sign of balding on John (just like a year ago). The main reason for taking the test at the office on this visit (as with the last one) was that John saw hair on the pillow case indicating that he was losing hair. The HAIRCHECK device confirmed his concern that he was losing hair.

The measurement of hair in the mid-head (between the ears) at, 17 cm just above the glabella (just above the nose), was measured for hair bulk and compared with hair from the donor area, just above the occipital notch, in the back of the head. The measurements of the hair on the back of his head should reflect his normal hair bulk. If the area between the ears had the same bulk as the back of his head, I would tell him he did not need Propecia and was not balding. But last year we saw a reduction in hair bulk determined with the HAIRCHECK instrument in the top of his head indicating that he was balding. One year ago, John has a measurement showing that he had lost 45% of the hair on the top of his head. On today’s visit John had a bulk measurement of the hair at the exact same location (in the middle of his head) and a bulk measurement indicated that on this visit, John had a hair loss now of 55% of the hair on the top of his hea (between the ears), a clear sign of more hair loss and a progressive process.

When he comes back in a year, if his number may drop further because hair loss is progressive. Fortunately, many men stop their hair loss with the drug finasteride (Propecia). Let’s assume that in 1 year it drops to 35% of the bulk, and in three years it drops to 25% of his hair bulk when compared with the back of his head. If this becomes his case, then the idea of the Master Plan that I have been pushing for many years is just what should he needs, as this plan will define a path for him to take. At some point, his hair loss will become obvious to him. My job is to follow the progression of his hair loss and build a plan for him on what to do. There are many options, but I will not write a book on it for this blog post.

I hope that this blog post gets the message across that everyone needs a Master Plan for his hair loss and it must be with a good doctor, one that can be trusted to always act in the best interests of the patients.