Balding Blog

Dr. Rassman,

Long time no chat. Used to browse here everyday, but took some time off.

Question. I was walking in an apartment complex about two weeks ago, turned the corner, and walked into an air conditioner that was clearly too low with my head. I was fiddling with a bag in my hands, my keys, and some other things so I wasn’t looking up. Plus, I was a wearing a baseball cap, although not a typical baseball cap. More like one of those touristy ones that might say “Universal Studios” or “Los Angeles” on it. Not as thick. Also, I have a ponytail and I wear my hat above the ponytail, so it might hang a bit low. Anyhow, I didn’t see the AC as I turned the corner and smacked/walked into the part where the bottom meets the side and hit the top of my head in one particular spot. I took off my hat and checked for blood. Couldn’t find any, and was relieved. However, when I got to a bathroom, I checked again with a paper towel and blotched a little bit of blood — not too much — on the paper towel. Although there could have been more because I do have pretty thick hair in the spot. The spot where I was hit developed into a raised, red bruise about the size of a quarter. I used a handheld mirror to check the bruise. It looked pretty good actually. Couldn’t even spot any open skin amongst my hair. At most, it looked like a shallow scrape with no definite sides. It was pretty red though. I thought I lucked out. That the hat I was wearing actually absorbed some or a lot of the blow.

I kept looking at the sore for a few days, and was resolved to the fact that I lucked out. Then a few days later I checked again with my hand and noticed a raised scab had formed. It was hard to see amongst the hair, even under light and with a handheld mirror. The scab looked white to me, but my brother said it was dark. Not sure if he saw it well. A scab must mean that the scrape was a bit more than I originally thought right? I didn’t wash my hair as much as usual for about the next two week, which brings us to today, but with working out and using the sauna, my hair became pretty itchy sometimes. So I had to wash, using my usual natural oil shampoo, and massaged with the palms of my hand, something I usually do on the top. Further, it seems the hair on my head protects my scalp from the shower water, which is interesting.

So where am I going? Apparently my scab fell off a few days ago because it wasn’t where it was. My hair in the general area looked pretty dandruffy, although it was the scab and remnants. I’m wondering if I should be worried about a permanent scar and damage to the hair follicles? I’ve read that scar tissue does not contain hair follicles. I checked my hair tonight pretty good and I can’t find a scar, but it’s hard to be certain with my back to the mirror and using a handheld mirror to look over my head. I still think I lucked out because of my pretty thick hair and the hat, but I’m still a bit paranoid. Also, I’m wondering if the hair in the area of the bruise is particularly fragile to being pulled out by a comb or fingers or whatever? What do you think? Give me an honest answer. Not an answer that would make me a client. 😉

So to summarize… you hit your head, which caused a bruise, followed by a scab. After the scab came off, you became worried that it would leave a scar and hair wouldn’t grow in that area again. You can’t see a scar, you don’t have a bald spot in the injury area, but you’re paranoid. You don’t wash your hair for weeks and now your scalp itches. Is that about it?

My honest answer is that it would terrify me if you were my client. By all accounts it’ll be fine. You can’t see a scar so I’m not sure what you’re worried about. Not everyone will see hair loss surrounding a scalp injury. It sounds like you’re borderline OCD about this.

just got a hair transplant in the UK. Met the doctors on the day due to distance to clinic. i was informed my crown couldn’t be transplanted to which was difference to our email correspondence. After a short chat the dr., he drew what would be my new hair line in pen on my forehead. I asked for it to be lower in the temples to give the youthful look and they assured me they would transplant hairs to the very bottom of the drawn line which would achieve this. I took their advice after being assured it would be to the bottom of the line and went ahead with the procedure, it was straight forward and they were very professional – lasted around 4 1/2 hours. After the procedure i wasn’t shown the results by the team but had to check myself in the bathroom on the way out. My head was rather bloody and slightly swollen so it was hard to judge at this point. it has now been 4 days and things have settled but I am worried that the hairline doesn’t come down far enough at the temples and that it is noticeably squint from the front.

I also took short video during the procedure and have since noted that the hairline drawn for me before the procedure is not the same as the one used during the procedure which is slightly above the former. I have contacted the clinic on two separate occasions to ask for photos taken which they responded to but have ignored both my questions about the number of hairs/grafts actually used on the day. They have informed me it was roughly 2800 hairs, can anyone guess if this looks right from the photo provided. not sure how to add more than one for the changing hairline drawn.

Any thoughts would be appreciated.

This doesn’t sound like a good experience. we make it a point to make the experience fantastic confirmed by all of our patients comment on Yelp and Realself. We treat every patient like royalty and complete dedication to the patient’s needs. Communication is key, of course. Your complaints are reflective of poor communications on the physician side, but the transplant looks ok. 2800 hairs, maybe, but most doctors don’t count hairs but grafts. I would imagine that you had 1400 grafts. The hairline looks ok also. After it has grown out, if you don’t like the hairline you are given or anything is wrong, it can be improved to meet your needs. Good luck.

I get watery semen every time I take 320mg SP extract. I reproduced this issue a dozen times. Doesn’t that suggest it blocks DHT significantly?

I have never recommended Saw Palmetto, so I have no personal experience with it other than what I read. It does sound like a DHT blocking effect.

I just tanned my head haha.

Tanning works like anything that changes the contrast between hair and skin color. The darker your skin with dark hair, the less the contrast between hair and skin color. I often recommend that men with very white skin get a tan. Dying it blonde works even better for the white guys, maybe not for darker haired men. SMP also changes the contrast between hair and skin color, see here: https://scalpmicropigmentation.com/

Hi Dr Rassman

Im a 18-year old boy having male patterned hairloss. I started balding when i was 16 and am a full norwood 3. Since the last year a have felt some tingling feeling when i run my hand trough my head,all of it except on the sides. I dont feel pain nor do i have some disease of what i know but just the tingling feeling. Its like i know what my hairloss pattern will be a (norwood 6) wich i can tell from the feeling.I have looked trough the internet to see if anyone has experienced the same thing and interestingly alot of people have. I was wondering if you heard about this? And if you have please tell

Tingling on the scalp does not mean you will lose hair. While people who are balding may experience these symptoms, people who are NOT balding also experience these symptoms (they just don’t write about on the Internet hair groups). You may consider dandruff, head lice, scabies, or other conditions (not related to hair loss). Or you may having nothing at all! I really can’t say what you are experiencing, but you may want to see a doctor if the problem persists.

Cardiac complication of pericardial effusion have been reported at the 5mg dose. It is a rare finding but it can be fatal. When I prescribe oral minoxidil, I never go above 2.5mg for a daily dose.

Im a 20 year old male, and Ive noticed about 3 months ago ive started to shed my hair along my frontal hairline as well as my scalp. The thinning is gradual, but I can tell that the more I mess with it, touch it, shampoo or comb it it gets much worse. My concern isnt going going bald, my concern is that I feel terrible pains when I do in fact lose hair. It feels as if someone is yanking on my head. Also, afterwards my hair feels very oily, and has a smell to it. Is this normal shedding? Im concerned this isnt male pattern baldness Im being faced with. Thanks in advance for your time, dedication and help.

I’m not making light of your pain, but it sounds like you are overly obsessed with your hair. The pain you feel may be from the emotional roller coaster that you are riding. Do you have someone close that you can talk with? You should try to get some emotional counseling.

Many men experience pain when they lose control over their lives or their health. Hair has been known to reflect such a loss of control. One patient told me, “I have control over everything in my life, what I do, how I feel, how much to work out, who I am friendly with and who become my friends. When it comes to my hair, I know that I have no control over it.”