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What is Considered the Frontal Hair (Since Meds Don’t Work Well There)?

I hear a lot about how Finasteride and Minoxidil do not work well in reversing frontal hair loss, how far back is the hair considered frontal hair. To rephrase the question, by what Norwood are you considered to have no frontal hair? Also, even if Finasteride wont reverse frontal hair loss, will it at least help me keep the hair in my hairline and at best help thicken it up?

Norwood 4AThe area that balds in the Norwood Class 4A is the frontal area (see art at right). Finasteride might slow the loss down in the front, but rarely reverses the hair loss in that pattern. Minoxidil might regrow hair in that area, but it would be extremely rare.

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What is Confusing About The Dr Gho Patient Diary on Hair Regeneration?

Dear Dr. Rassman,

you stated in a previous post that the pictures of the Dr. Gho patient is “confusing”. Could you be more elaborate on this topic? Why do you say so? In your previous post concerning Dr. Gho you stated that a follow up video would be nice. Aren’t these photographs followup documentation. It clearly shows regrowth. I used photoshop to lay the before and after images over each other. It is definately the same hair region displaying how the follicles are regrowing from the extraction sites. Why do you still consider this deceptive?

Regards

For those that missed it, the original post is here.

Has anyone ever stopped and considered that maybe the regeneration you are seeing is just regular hairs (missed FUEs) growing back? I mean, what about the photos of the recipient site? Did anyone count the number or percentage of transplanted hairs that actually GREW?

If 1000 hairs were harvested, 700 of the transplanted hairs grew in the new location and 300 hairs regrew in the harvested donor area, would you consider this regrowth or hair multiplication or hair stem cell transplantation? Of course not! But you can take pictures of the donor area and show regrowth, and take pictures of the transplanted area and also show growth. The observer could think, “Wow! This is regeneration!” — but the observer would be mistaken. To show regeneration, duplication, cloning, stem cell transplant regeneration, or an outcome that showed splitting of the hairs, you must account for ALL the hairs that were taken out and ALL the hairs that grew back (not just a sample section). Otherwise, it is just hairs that grew back after being plucked.

Basic high school science teaches us about conservation of energy or mass in the universe. Many have tried to invent the perpetual engine or create gold from lead with no success. If Dr. Gho really figured out a way to clone hair, then he will be famous. If you would like to believe in it, that is your prerogative… but simply looking at someone’s diary or posts on the Internet is not a way to validate or document science.

The method and presentation of Dr. Gho’s study has serious issues and it does and (will) confuse many readers. A credible review by a third party should be something that Dr. Gho should want to do, if he is legitimate.

P.S. I understand that you’re very excited for my answer to your question, but sending a dozen emails and blog comments demanding that I answer right away is unnecessary.

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What is Chronic Telogen Effluvium?

hi there! What does chronic telogen effluvium mean? I have ulcerative colitis, and it seems like every time I get sick, about two months later my hair falls out. then after about six months it stops. Then when i get sick again, it will start to fall out again. is this chronic effluvium and will it last forever, or does chronic mean that the hair will always be falling out?

The exact mechanism of this is unclear, but what you are describing does seem to be chronic telogen effluvium. The hair is pushed into a resting phase (telogen) by the activation of your autoimmune system with the ulcerative colitis. You may try 2% Rogaine (minoxidil) for 8 months and see if you can push the hair out of the resting cycle. The good news is that the hair is sill there and probably alive (resting), but the bad news is that treatment results are generally unpredictable.

For more information on TE, see Telogen Effluvium by Elizabeth CW Hughes, MD.

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What Is Body Dysmorphic Disorder?

My doctor told me that I was body dysmorphic. I looked it up and got upset with my doctor. It suggested to me that he thought I was crazy.

There is a psychological condition know as “Body Dysmorphic Disorder” which cosmetic surgeons of all kinds (i.e. not just hair surgeons) have come to be familiar with. It is characterized by a feeling that one is deformed or very odd looking in some way when in fact one’s appearance is normal. Manifestations can range widely, from believing that one’s nose is malformed (anyone famous come to mind?), to perceptions of imperfection in one’s hairline. These patients have a preoccupation with their appearance that borders on obsession, and they often have multiple cosmetic surgeries to address the “problem”, often moving from surgeon to surgeon. Since the “deformity” is really a problem with self-perception, and not with the body itself, surgery rarely cures and often exacerbates and reinforces the individual’s feeling of deformity. The key to diagnosis is the dramatic disconnect between a normal appearance and the patient’s exaggerated feeling of being defective. A normal patient usually looks to improve their normal appearance, and they do not believe it is a deformity.

Some people (like Jimmy Durante and W.C. Fields – very old movie stars) played up their huge and pock marked nose deformities and exploited them for profit as part of their persona. This is not Body Dysmorphic Disorder, but just simple good business exploitation of a body part, similar to what Marilyn Monroe or Brigitte Bardot did to another extreme.

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What is Activance with Rhodanide?

Dr Rassman,

What are your thoughts on the following hair loss treatment? Is it another scam?

Activance

I don’t know if it’s a scam, but I guess it depends on what you’re using it for. This Activance product claims to treat hair health, but I don’t see anything here that would make it treat hair loss. Strengthening and thickening hair isn’t anything extraordinary, as many hair treatments can do this.

I didn’t know what rhodanide was, so I had to do a little Googling. Rhodanide is also known as thiocyanate, which isn’t a common hair loss treatment outside of guinea pigs. The US distributor of rhodanide says that there is some study (which one?) from 1997 that showed this ingredient regrew hair in 80% of participants in a trial. No real information is given other than that.

I’ll let you draw your own conclusions, but if you want to try the product and report back, please feel free.

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What is a Flowbee?

what is a flowbee? Does it help keep the hair healthy?

According to Wikipedia:

The Flowbee is a vacuum-powered device made for cutting hair invented by San Diego carpenter Rick Hunt in the late 1980s. The product was touted as being capable of performing “hundreds of precision layered haircuts” and was frequently displayed on late-night television infomercials.

It does nothing for hair health — it is simply a way of cutting your hair evenly at home. Their official site is at Flowbee.com.


2007-04-02 13:26:15What is a Flowbee?

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What Info Can Be Gathered from Fallen Hairs Found in the Bath?

Hi.

May I ask, is there anything to be gathered from the quality of hairs I find in the bath after washing my hair?

I have always noticed quite a lot of hair floating on the top of the bath. My mum has the same problem and we both have thick, coarse hair. There’s about 100 hairs after every bath, but it has been like that for as long as I can remember. Some of the hairs in the bath are thinner/finer than others. Does this support the idea that my hair is miniaturizing?

100-150 hairs lost each day is considered normal, but if they’re all coming out in the bath at once that might be a little much. Do you wear a hat all day and trap in the hairs that would normally fall out during the hair cycling process?

If you are concerned about hair loss, please see a doctor. I cannot possibly diagnose or understand your hair loss issue from 100 thin hairs in the bath water. The only info you can gather is that hair is falling out, either from genetic loss or just normal hair cycling.

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What If You Have Unavoidable Hair Loss from Chemo After You Have SMP?

Dr(s),
Regarding the use of SMP for creating a thicker look in those with existing, thin transplants and limited remaining donor hair….are you still creating simulated follicle “dots” or are you “painting” the whole scalp. If the latter is required for reasonable cosmetic difference, it seems like a really poor choice in terms of any unavoidable future hair loss (say, chemotherapy induced, etc).

The way we do SMP (scalp micropigmentation) is by creating individual “dots” that mimic a shaved scalp and an end view of the follicles. We don’t “paint” the scalp.

If you should lose your hair from chemotherapy or further hair loss should develop, it should not matter because SMP can be performed over the entire scalp. In some men, shaving the head is a good option and allows you to exploit the shaved look that SMP offers. If a man lost his crown hair, we do not just put the pigment over the bald crown, because that would look strange (it would look like a person shaved the crown and left the rest of the hair long). For women who keep their hair longer, if they go through chemotherapy but the recovery only has a partial return of their hair leaving it thin, then we may consider doing SMP to make it appear thicker in the areas where thinning is a problem.

Since there is definitely a limitation of SMP (mainly the life-long shaving of your scalp in men who want that look) we are highly selective on the clients we choose for this. There must be maturity and a clear understanding of the limitations of the process. For those who have had chemotherapy, SMP may be an option to make the hair appear thicker, but the decision to undertake this process must be clearly understood. There are more details on the SMP process: here.

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What If There Was an Unlimited Donor Supply?

If an unlimited supply of donor hair were available, could transplant surgeons give a patient the 200 hairs per cm squared that the average human head has or would a new tool smaller than the .5mm tool im aware need to be created to achieve this look?

I suppose you can achieve 200+ hairs per cm squared (which is about the average for a non balding Caucasian male), but I find most people who are obsessive with hair per square centimeter don’t understand the full story and are mislead by all the discussion groups on the Internet.

You can have 100 hair per cm squared and still look like someone with 200 hairs per cm squared, as this is not a numbers game. Furthermore, hair transplant is NOT about the numbers and density. It is about the art of creating a natural looking hairline with minimal number of hairs you harvest.

With respect to graft survival, there may be some issues of the grafts surviving such close packing in ONE surgery. Now 200 hairs in a square centimeter is possible with multiple surgeries to the same area… but again, numbers do not translate to how it looks overall.

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What if Prince William Had a Hair Transplant?

Is it possible for Prince William to have a hair transplant, and reach his father’s level of baldness ? Having a similar pattern of baldness I felt sorry for Prince William during his wedding. I believe his hair loss made him less attractive. In fact, my sister even said that Prince Harry is more attractive now. I can say the credit goes to the fullness of hair. Would a frontal coverage for that type of hair loss would be good in the long run. How would you apply a master plan toward a case like this ?

Prince WilliamBased on pictures alone, Prince William would likely be a great candidate for a hair transplant. We have treated many men with even more hair loss than he shows.

Here’s an open letter to the royal:

    Dear Prince William,

    It would be an honor if you would consider having NHI establish a Master Plan for your hair loss. If a hair transplant surgery could meet your goals, please consider us when choosing your doctors.

    Thank you and best regards!