I have seen a few patients who have responded better to finasteride at a higher dose, suggesting that that particular individual just needed a higher dose. If you understand Bell Curves, the 1mg dose determined as the ideal dose by Merck in their original studies used a Bell Curve to make that determination. We can sit on either side of that Bell Curve as we find the ideal dose of finasteride for us.
[If you have any questions, you can reach me at williamrassman33@gmail.com]
Can you get fungus on your head from wearing a hat all the time for too long that results in your hair falling out?
A fungus spreads from person to person. A hat worn by a person with a fungus could transmit the fungus as the hat is shared with another. Fungal infections love warm, moist environments and if you sweat from the hat that is carrying a fungus, you may get it. Depending on the fungus, hair loss could result. These are all longshots, but they are possibilities.
2008-08-21 11:35:362008-08-20 15:01:05Can a Hat Cause Hair Loss and Fungus?
Can a hairline mature unevenly? My hairline hasn’t been totally straight since I was about 14. Every man in my family is sort of Norwood 1.5 or 2, my dad is 60 with Norwood 2 but he is thinning a bit. Nobody except my maternal grandfather has ever gone bald. I’ve really freaked out about my hairline since I noticed it at the beginning of this year. It’s changed very slightly since I was about 14, however it has remained unchanged for about a year. It’s about a norwood 1.5. My forelock is still where it’s always been, which makes my temples look far more receded than they are. One temple seems to be a bit higher than the other, just slightly. Is it possible that the front of my hairline will mature too, making it look less dramatic? Or will this stay the same? I don’t really think it’s MPB, but I’ve had a lot of grief over it. I’d love not to worry about it anymore. I’m 18 by the way!
Yes, hairline maturation can be asymmetrical but eventually it evens out if you give it time.
2020-11-12 03:32:132020-11-04 08:36:14Can a hair line mature unevenly?
Hello,
when a graft comes out.. in the first few days.. if it is saved.. can it be put back in the scalp…?Thank you
Most likely not, because there will be a delay between the graft coming out and being put back into the scalp. Exposure to the air will kill the graft and that occurs in under a minute.
2008-08-20 08:35:202008-08-19 11:29:27Can a Graft Be Put Back into the Scalp If It Comes Out?
I am interested in using a dermaroller to enhance topical absorption. How long can the needles be before there is a risk of damaging the follicle and the surrounding vasculature?
We do not use or have experience with a dermaroller. I had one on my desk to play around with, but it never got use on the scalp, so I am the wrong person to ask about this one. I wrote about that years ago. It still looks painful.
In general, anything with a sharp point or a needle that you use on yourself (or others) should be sterile and used with caution. If there are readers out there that use this product, I’d be curious to know what you think about it.
Many of you hopefully know (or at least have read) about the Norwood Classifications for male pattern baldness. I wrote the question in the title of this post, because there is no such thing as a Class 8 patient. Norwood Class 7 is the highest balding pattern defined, but I want to discuss a patient that has an extremely advanced Class 7, so to get my point across I’ve defined the Class 8 term here. He has white skin and black hair with a very, very fine hair character. I had great trepidations when he came to me three years ago to get a transplant, because he had no good quality hair and the worst color contrast possible. One thing running in his favor was a donor density 25% higher than normal. He’s had three procedures with me over the years. First one was 3908 grafts, then 3177 grafts, then 1525 grafts… for a total of 8610 grafts, and as the density dropped with each procedure, the yield also dropped. Of interest, his scar was minimal and the rest of the donor fringe area maintained its height to reflect the dropping density of the fringe hair with each successive hair transplant. He is tickled over the results and could not be happier. The fine hair is see-through, but he loves to comb it and keep it styled.
Click the photos below to enlarge.
Before:
After 8610 grafts:
A few weeks ago he came in and we tried an experiment. We applied concealers (Toppik) to try to manage the see-through hair. The results of this experiment can be seen in 3rd set of photos below. What we concluded was that the concealers made him appear too thick and if he dyed his hair a light brown and then used Toppik, his overall look might be better. His eyebrows are light brown, so that would fit.
After 8610 grafts (and Toppik):
This is a very important piece for BaldingBlog and the first time this patient has agreed to show his results on the Internet. In my opinion, this is one of the best “miracles” we have pulled off in this practice. It took courage for him (see his before picture) to trust me to make this happen and I was honored with his faith in me. With good doctor/patient communication, almost anything is possible. This man is soft spoken and often comes to our open house events to speak with patients and show off his results in person.
Here’s the side-by-side of his before and after (8610 grafts over 3 hair transplant procedures and Toppik), and you can see the results are just amazing!
Hi,
I’ve been having some pretty severe anxiety over potential hair loss over the past few months. I went to my primary care doctor, barber, and mother who have told me that I just have fine, blonde hair and a high forehead. I specifically asked if there was any receding or balding, and each said no. Hoping to get closure,n I went to a dermatologist that I randomly found on the internet. This dermatologist has only been in practice for two years, so I’m a little skeptical when he said I had early hair loss by running his fingers through my hair a few times.That’s where this blog comes in. I feel you’re a pretty trustworthy source of information, and hopefully you can help. My primary doctor actually did bloodwork, specifically DHT and testosterone, and they came back fine. This dermatologist almost disregarded the blood test and said he saw things as a dermatologist that no other doctor would see. Now I’m not sure what to think. So I have to questions.
1. Can a blood test determine genetic hair loss?
2. Is it possible that I just have fine, light hair? It’s darker and a bit thicker around the sides, but my maternal grandfather has the same hairline and fine hair as I do, just looks a but thinner as his is gray.
It may also be of note that this dermatologist said I had mild hair loss, and then was somewhat eager to prescribe Propecia. He also assured me that once on Propecia, it would not stop working and I would be fine and keep what I had for the rest of my life.
Sorry for the long inquiry, but hopefully you can set me straight. Thank you in advance.
A blood test can determine a “probability” for genetic hair loss based upon your carrying of the gene, but carrying it does not mean that it will be expressed. More importantly, any good doctor can tell you if you have genetic hair loss without a blood test by simply mapping out your hair for miniaturization, which shows genetic effects well before the naked eye will show it.
Yes, it is just possible to have fine, light hair or just a high forehead that may look like hair loss. In any case this seems to bother you. If you want to find out more, see a hair transplant doctor who can see your hair under a microscope to see evidence of some pattern of balding.
2010-07-07 10:52:352010-07-06 12:04:53Can a Blood Test Determine Genetic Hair Loss?
Calling Men ‘Bald’ Counts as Sexual Harassment, UK Tribunal Rules – Bloomberg
Rassman Opinion: I believe that the context of the use ‘Bald” is the main issue. If it is used as part of other derogatory smears, then it may be clearly used as part of some ‘harassment’. Many men use the ‘balding’ term as part of their conversations with me and I likewise, will use it in a medical or social context as part of my work and would not consider it sexual harassment when I ask a man for his family balding history. Men use it as well, often in conversation without mal-intent.
My question is, how many grafts can the average Caucasian person get from their donor via FUE? I don’t mean in one session; I mean in total over their lifetime. I saw different answers in different blog posts, some said at the very least 6,000, others said about 7,000, and yet others said that most people would become depleted after 5,000.
Hi Doc,
I found this article about caffeine and hair loss. It seems a little silly to me. Care to comment? Once again thanks for all of your work.
This article is referring to the research that was done in Germany and recently published in International Journal of Dermatology. In this study, researchers removed some hair follicles from balding patients. They have cultured the hair follicles and then exposed them to testosterone and/or caffeine. The growth of the hair follicles has shown to be increased after being exposed to caffeine, so the investigators suggested that caffeine may have a protective mechanism against testosterone effects on hair growth.
Does it mean that you should double the amount of coffee you take every day to prevent your hair loss?
The answer is “absolutely not“.
Although interesting, this basic study was done in the lab and not in the human body. There are several factors involved in the process of hair loss that can not necessarily be contemplated in cell culture. In order to reach the conclusion to use caffeine as a medication for hair loss, several other studies should be done. Efficient levels of caffeine should be determined in animal studies in an appropriate hair loss model (topical, as well as systemic). Safety of caffeine at those concentrations should be determined with toxicology examinations. After these phases, and if it is proven to be both efficient and safe in animals, the product should pass different phases in human trials, like any other medication. The human part of the study usually takes years before it could be approved for human use.
