Taking away the Lion’s mane in the Donald, would be like castration for him as he wouldn’t be able to function but he has a good looking skull shape for a balding man.

from WRassman,M.D. BaldingBlog https://ift.tt/2ZgxHQF

This is nice to see, however, it doesn’t take into account a few very important factors:

1- Your hair thickness (fine hair has 1/4 the value of coarse hair) so the calculations are different based upon hair thickness

2- Your hair density in the donor area: We are all different with different hair densities. The density reflects the donor bank so if you take out say 3000 grafts, and you only have 3000 to donate, then you have used up your reserve. A good doctor will tell you how much hair you have in your donor bank and as you use it, how much remains.

3- What can you expect in the future as hair loss is progressive. Today, for example, you have some frontal loss and you transplant it with 2000 grafts. In a few years maybe you have more frontal recession behind the area that was transplanted and you also develop some early crown loss. If you transplant these two areas, then maybe in time, the crown loss will become more and wider, what do you do then? Did you leave enough hair in the donor bank to manage future hair loss?

The hair transplant conundrum is not so simple as a graft calculator can easily solve. A good doctor who has experience, will address this for you and give you a realistic assessment of your short term and long term needs. I always tell my patients don’t think a year out, because balding is a lifetime problem.

HOW MANY GRAFTS Do You Need? Try this 30 Second GRAFT CALCULATOR! from tressless

from WRassman,M.D. BaldingBlog https://ift.tt/2HmM7Z8

I’m 18 and I’ve had diffuse thinning for the past 3 years. Yes it sucks but it’s slow and still have decent amount of hair. I’ve noticed for the past 3 years that when ever I get a hair cut, my hair is easy to pull out. Same with sides and my back. Is this DUPA? I’m really worried because I hope it isn’t. I took pictures with the flash and it’s still thick. Also when my sides grow out, I try pulling on it and it doesn’t come our. WTF.

I am the doctor who defined DUPA and it is rare. You need to have a microscopic examination of your donor area if you want DUPA eliminated as a diagnostic possibility. Most hair transplanted doctors offer this.

from WRassman,M.D. BaldingBlog https://ift.tt/2P8K15t

I just got my first box of finasteride 1 mg today.  I wanted to get minoxidil 5% as well, but I need a prescription for that where I live.  However, my dermatologist said the action of finasteride and minoxidil isn’t synergic, and that I won’t get better results by adding topical minoxidil to oral finasteride. That’s the opposite of everything I’ve heard so far. Men do combine oral finasteride and topical minoxidil 5% exactly to get better results, don’t they?

I don’t agree with your dermatologist. These two medications have different modes of action so taking them in combination, especially for the crown, is more effective.

from WRassman,M.D. BaldingBlog https://ift.tt/2PbyCSy

They say you can get a transplant once you’ve stabilized your hairloss with Fin – but how reliable is it actually? I’m not sure how accurate this is, but I often read that Fin doesn’t really halt your hairloss, it slowns it down a lot but your hairline is still receding. And who’s to say that you get you a transplant and, 3 years later, Fin starts losing effectiveness and you end up looking even worse before? Do you just have to gamble on this, or am I missing something? Or is the transplant a commitment in the sense that you’ll eventually need more to “recorrect” everything?

What are you realistically getting in the long term with a hair transplant?

I have been doing hair transplants for 28 years and started the trend with small follicular units used for the hair transplants. Many of my patients from 28 years ago, come and visit me and a few came back for more hair transplants as they continued to lose hair. In good hands, hair transplants work and in 99% of people, the results are permanent. That is good and bad because if it is done well, you will look good, but it is done poorly, you will always look freaky.

from WRassman,M.D. BaldingBlog https://ift.tt/2NnpHuU

It takes about a year to get any reasonable results from either minoxidil or finasteride. Stick to it if you go that way

from WRassman,M.D. BaldingBlog https://ift.tt/30l3Tn6

Nice early results. It shows the impact of finasteride and minoxidil used in combination. The impact on the crown is clearly better than on the front, but both are better. It is unusual to see results in just 3 months but because he kept his hair short, the new hair impacted by the finasteride and the minoxidil showed better. If his hair was longer, then he may not have seen the value as quickly because only the hair close to the scalp was helped by the finasteride and the minoxidil.

from WRassman,M.D. BaldingBlog http://bit.ly/33OwLGE

I have been on Fin 1mg for last six months. I have started observing that my Hair, Armpit Hair, Pubic Hair and Facial Hair have started thinning and the density & growth has reduced. Could this be related to Fin ? I checked with my dermatologist. I was told that it was unlikely. Does anyone had a similar experiences ?

Some people do report a reduction of body hair when on finasteride. It is a known, but rare, side effect

from WRassman,M.D. BaldingBlog http://bit.ly/2KHyC8u

I didn’t post this in the other thread mainly because I have a weird bald spot that I’m hoping someone will help me identify.

A few years ago I went to a hair salon to get my hair curled and somehow the hairdresser burned off some some strands of my hair (one in the front and one in the middle). I only noticed it weeks later when the one in the front was just standing out up in the air (it looked weird lol). Around the same time I realized I had a weird bald spot in my scalp. Until this day I’m not sure if it was caused by the blow dryer/curling iron the hairdresser used or if it happened naturally. I still have this bald spot. And I’m saying “the hairdresser used” because I don’t curl or flat iron or blow dryer my hair at all. That was a rare thing and I did it for an event. So now I don’t know if this is part of the alopecia or if somehow the hair root was burned and that’s why it’s not growing back. Does anyone recognize what this is?

Also I feel like my hairline is receding but I do notice some baby hairs growing at the same time. The middle part of my hair is significantly thinning over the past couple of years. Is this androgenic alopecia? And is the bald spot related to this? Should I start treatment and do I have keep doing it for the rest of my life (cue panic mode).

I attached pictures from different distances. Please excuse the dandruff and the frizz (trust me, I’m trying to get ride of it). Thank you so much for your help!

If this is new, you should see a dermatologist who will perform dermoscopy on your to find out if you have any disease in this area. You might have had a partial burn to the scalp that could cause it, but the loss is uniform

from WRassman,M.D. BaldingBlog http://bit.ly/31PPmjz

Hey Doc- I had a quick question. Have you seen any patients have hair loss worsened by Fin? I took fin from roman for maybe a week and had such extreme shedding immediately that I stopped. Shedding continued for 8 weeks or so and stopped but I went from a NW2 to a NW4 in that time. Do you think this will grow back? I tried Min, but the sides were bad for me and made it extremely uncomfortable. Thanks! 

I have heard about shedding, but I haven’t seen it myself in my patient population so it must be rare. I gather that those who have it should stay on the medication as their is a delayed response but the response usually does happen in a couple of months.

from WRassman,M.D. BaldingBlog http://bit.ly/2ZfvVPw

This finding at your age suggests that you may have significantly more balding as you get older.  See a doctor and build a Master Plan with that doctor that accounts for the short and long term changes that you are undergoing.  Your frontal hairline needs to be examined closely by an expert.

from WRassman,M.D. BaldingBlog http://bit.ly/2HexwPn

I can’t comment about Europe, but we are the best traditional Scalp Micropigmentation  in California here: https://scalpmicropigmentation.com/ . I just published an article about a Scalp Micropigmentation breakthrough with a new system which we just started using and are the first in North America to have it:

“We introduced a new needleless microjet injector that uses laser pulse energy to inject tattoo pigments for Scalp Micropigmentation (SMP) directly through the skin without a needle”. It also has the advantage of a one-pass use, which means that when the pigments are deposited, it is permanent and doesn’t have to be repeated.

It has the advantage of an almost painless experience, eliminating the need for anesthesia.that has no needles and does not require anesthesia. Right now, there is not much availability of this technology but I am sure it will change soon. We are offering it to a limited number of people.

from WRassman,M.D. BaldingBlog http://bit.ly/30ddSuL

My best alternative for my hair loss is to get a Hair Transplant. However I have read various news from the internet and I came down to these conclusions:

1. It is permanent however you would need to get another hair transplant in the future if you want more density.

2. My hair transplant doctor says you do not need to take any medications, treatments. For my case, and that is exactly what I want to do but alot of internet topics suggested to take minoxidil, rogain, finasteraide, proprecia, prp to keep the existing hair for the rest of your life if you do not want to lose anymore hair.

3. I wear toppik and have 1 picture of my current hair.

4. I would consider a hair transplant if all I had to do was 1, and no medications were required. Is it possible or are you in a endless cycle of multiple transplants and a lifetime supply of treatments.

You discussed endless cycles but at 20, the reality is that repeated hair transplants every year until your balding becomes stable is a awful endless cycle, see here: https://newhair.com/baldingblog/22-year-old-received-a-hair-transplant-of-2800-grafts-from-reddit/

from WRassman,M.D. BaldingBlog http://bit.ly/2KOs72K

The costs for a hair transplant are usually priced per graft and the costs range from $4-10/graft depending upon the doctor, the location, and the reputation of the doctor for consistency and predictability. I always ask patients: Would you try to find the least expensive brain or heart surgeon? The hair you have on your head that the surgeon transplants can be seen by everyone. You MUST meet some of the doctor’s patients to see the quality of the work your surgeon does routinely. My patients have been coming to monthly Open House events months for 27 years just to help prospective patients learn about the process.

from WRassman,M.D. BaldingBlog http://bit.ly/2Mjwq9t

This patient’s recipient area became infected and has this been my patient, I would have drained these infected cysts and place the patient upon antibiotics. I would have cultured the cysts to be sure that the antibiotic I would use is the correct antibiotics. If this infection is not treated quickly., the infection could kill the transplants.

from WRassman,M.D. BaldingBlog http://bit.ly/2KFuciJ

This spider is also called the Brown Recluse Spider. It often hides in boxes that you store away the the basement. This bite can cause you to lose an arm or leg. The picture shows what the bite looked like and what the spider looks like. My wife saw the spider land on me one day (she has a photographic memory and acute vision) and tried to tell me before I wiped it off of my arm.  Too late, the spider bit me and in a day my arm swelled but I did not get the necrosis shown on the picture on the left so I did not need surgical excision of the bite venom. This is a dangerous bite, but other than swelling and a fever, I did OK but it caused pain for about 3 days and it took a week for the swelling to go away.  Some people have been known to die or lose an arm or leg from such a spider bit. This happened to me in Los Angeles, California but the spider is wide spread in the United States. The patient in the photo shows that a surgeon removed the area of the bite because the skin died (necrosis) and this surgery was needed.

from WRassman,M.D. BaldingBlog http://bit.ly/2KAN56g

So I’ve been to dermatologist and started using fin and minoxidil. He used some camera to see whether I have hair follicles on my temples and it turns out that I have a lot (basically I could go back by 0.5-1 norwood if I grew them out). From what I understood my dermatologist seemed to suggest that there is hope in regrowing this hair. But I’m not sure whether I understood his words correctly. It’s said a lot that fin is going to let you “preserve what you already have at the moment”. And that minox works on scalp only. But I’ve been instructed to use fin, dermaroll once a day and use minox on both crown (which has very little loss) and temples. Does it mean I’m trying to regrow hair on my temples this way? Most articles mention that hair regrowth on the temples is unlikely as hair follicles are probably already dead (unless you lost your hair just recently). In my case I’ve lost hair on my temples quite within 4-5 years mark but most of the follicles seem to still be there. Does it mean I can expect regrowth?

A proper examination of the hair for balding is (1) the use of a video or hand microscope, (2) the use of a HAIRCHECK instrument which will measure the actual hair bulk in different parts of the scalp, and (3) see a good doctor who specializes in this field. With all of that done, you can be confident that you have done everything you need to do to make a proper diagnosis and commence treatment. Hair may or may not regrow with drugs like minoxidil and finasteride.

from WRassman,M.D. BaldingBlog http://bit.ly/2YT3EmL

Yes, if your pony tail pulls tightly on your hair, then you could develop ‘traction alopecia’ common in both men and women who wear pony tails.

from WRassman,M.D. BaldingBlog http://bit.ly/2N0Q9u5

So Im 26 now. My hairline is good, and I have no visible balding, but I noticed (since im growing my hair long) that I would lose more strands of hair in the shower than norm. In fact my first dermotologist just looked at my hair and told me Im not balding. Decided to get a second opinion, went to a very qualified dermo, had a scalp biopsy, and it turned out to be aga, and she told me I was lucky to have discovered so early, due to the fact I have no visible balding, or recessed hairline. Basically, caught it before any visible damage was done. I was prescribed finasteride, as well as a 7% minoxidil liquid.

My question is, with how little hair loss I have, would I be fine to just take the finasteride daily and ignore the minoxidil? I find the application of minoxidil extremely annoying and uncomfortable, especially since I have shoulder length hair now. 

I would recommend that you get a HAIRCHECK test to find out if you are actually balding (losing hair). If you’re not losing hair by this test, starting on a drug for life based on a biopsy alone make no sense to me. See here: https://newhair.com/baldingblog/24-year-old-male-receding-hairline-no-change-hair-loss-past-year-haircheck-test/

from WRassman,M.D. BaldingBlog http://bit.ly/2YWqqcH

I started finasteride about one year ago (1mg finasteride daily + topical minoxidil). It’s worked pretty well with minimal to no sides.

I had a previous stint w/ fin a couple years ago so I was mentally prepared for the testicular pain that hits you in the first few weeks when i re-upped, but I don’t rly remember it even happening when I started on Keeps though.

However about a week ago I started feeling sharp jolts pain in my nuts (more specifically general scrotum / maybe epididymus?) after I’d by lying down about to get up or just at random times throughout the day. Also has kind of come to feel like I have some tension down there like someone’s got a vice grip on my scrot basically all the time (maybe like a 2 or 3/10 in terms of being noticeable or painful). The jolts are more like a 7 and sometimes even make me flinch once or twice a day.

Pain in the testicles could be from the drug finasteride or it could be from other causes that are anatomic in nature. See your family doctor for an examination.

from WRassman,M.D. BaldingBlog http://bit.ly/2YPNQkE