Balding Blog

Hi Dr. Rassman,I have been to two dermatologists about my recent diffuse shedding which I believed to be telogen effluvium and they did very little to help because they said “you look like you have hair”. One dermatologist took some of the shed hairs and said he could not really tell if there was clubs on them because they were somewhat clubbed but had a tail too. When i look at them i can clearly see a white bulb at the end about twice the diameter of the hair but at the end of the bulb there is a very short hair like structure that is much thinner that the hair itself, the hair is very different from the ones i would say “pluck out”. So my question that I and my dermatologist was stumped on is whether they were telogen hairs because they had a tail at the end of the bulb.

Thank You

The telogen effluvium hair often has a white bulb and a mucus debris at the end so this could be the correct diagnosis. Also, the ‘hair pull test’ will show more than 10% of the hairs that are pulled, and will come out between the fingers that pull it. If you do this test, be gentle when the hair is pulled.

The history following the potential cure for balding is nicely put together here in the link supplied:

https://www.sixthtone.com/news/1004217/report-exposes-chinas-unlicensed-hair-transplant-industry

This is similar to many clinics in Turkey where almost 500 clinics have FUE surgery performed by minimally trained personal. I believe that these people can learn how to do it as they practice more and more on patients, but the problem is what happens when there is a side effect from anesthesia, or a cardiac arrhythmia? Then the patient has a risk of death, something that has been reported in countries from around the world. These ‘on-the-job’ trained people certainly can’t respond properly to any emergency. In the 16,000 surgeries we have done in our practice, we have seen such events almost every year, but we NEVER had a problem addressing the problem when it appeared because we are skilled in Emergency treatments and we are physicians who know this as a result of years of speciality training.

What is important to note, is that the top patient had wonderful medium weight hair and had a good shape and body to it while the bottom patient had super fine hair. We solve the see-through look with Scalp Micropigmentation

JAMA Internal Medicine study estimates that the number of deaths attributable to cigarette smoking for 12 smoking-related cancers and found that continued progress in reducing cancer mortality requires more comprehensive tobacco control (in other words, best if you stop smoking). These cancers include cancers of the: Lung, Esophagus, larynx, kidneys, liver and bile ducts, leukemia, mouth and pharynx, stomach, bladder, and uterine cervix.

The report I got said:

“A Turkish doctor called from Germany and said that approximately 16 clinics in Germany and the Netherlands where Turkish technicians perform hair transplants have been inspected by health authorities, and many of them have been temporarily closed; the equipment used was said to be not CE Compliant or nut sufficiently sterilized. Some technicians were also deported as they were on Visas that didn’t allow them to work.”

Another source echoed this story for France and Belgium. I have also been informed that many of the 5000 clinics in Turkey are shutting down for similar reasons and due to a doctor’s absence.

There are clear risks here, one technician moves to another patient because the team needs help, instruments are crossed between patients, there is clearly not surgeons for each of these patients. All of this can cause life threatening infections transferred from one patient to another. There is a real question of quality control, who does it. Are all technicians equal (some report that the technicians are hired and join the surgical teams that same week).

This would be outlawed in the US or most major Western countries.

This young man went to Turkey 3 months ago for a hair transplant because the fee was much lower than quotes near his home. He had a medium level balding crown and very small frontal corner recession. When he went to the clinic, the building was beautiful. He came in on the first day for the surgery evaluation and they suggested 4200 grafts. The next day he had the surgery and found the entire surgical crew unprofessional, ignoring him, laughing and chatting and not focusing on his surgery. He found out that many of them were hired recently, “just off the street” and they were being trained on his head. That day, he counted more than 20 patients having surgery at that facility. He knows that this was a terrible mistake and I am going to work with him after he gets to the 8 month postoperative date when he sees where he is. I am concerned about his donor site, which he believes has been damaged.

An Istanbul hair transplant clinic was raided by the police and all of the technicians were arrested. There was no doctor in the clinic. The technicians ran a clinic with 10 surgery rooms. There are hundreds of such clinics in Turkey. I am not sure why this particular one was selected.