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Does Senator John Ensign have a transplant? Sen. Ensign was in the news recently due to an affair with a former staffer.

Here’s a frontal picture — Another view of the top of his head

I looked at the photos you sent along with some others I found on the web, and it appears that Nevada Senator John Ensign has a great natural head of hair. I really don’t know if he had a hair transplant, as the best hair transplants aren’t recognizable anyway. You only spot the bad ones and some people will notice when you’re visibly balding for years and then your hair regrows (this is particularly the case with those in the spotlight — celebrities, politicians, etc).

Also in my search, I found that many political gossip blogs are referring to Senator Ensign as “The Hair” or something similar, so his thick head of hair does not go unnoticed. There’s just something about politicians with great hair that seem to have the upper hand over the follicle-challenged politicians…

Is a hair transplant possible even if the person still has enough hair to pass as not being bald?

My main concern is that I am a local television personality and on camera everyday. I have been receding and thinning since I was 18 (Im 24 now)but through very strategic hairstyling I am able to cover it to some degree. However in the last year the balding process has been picking up and it is becoming harder to manage. From reading your past questions, I know you don’t advocate what one reader referred to as a “preventative transplant”, but looking decent and having hair can effect my job. What would you recommend in this case?

Thank you

You don’t have to be completely bald to have a hair transplant. I can’t say whether you’re a candidate without examining your hair (or lack thereof) first, but if you’re losing hair and require strategic styling to manage it, it might be worth a trip to LA to see me.

Los Angeles sports reporter Steve Hartman went right back on TV not long after his procedure and no one could tell he had a hair transplant, but he had natural cover for it. I have had two people I remember who were on national TV (primetime on their own specials) who had transplants. One person was on TV just one day after a hair transplant and the other was 6 days out from the transplant… and nobody could tell. Again, I would have to see you before I could give you my opinion on your ability to hide the transplant easily. Many of my patients do go out into the public (lawyers, judges, executives) and in select cases where they are not very bald, they can get away with a one day turn around.

Hi,

I had a hair transplant about 7 months ago and I really have not seen any major improvement. I had the transplant of the hair line. What has happened is that some of the transplanted hair never fell out and has continued to grow but I have seen no regrowth where the transplants shed.

Is this a failure or will it still grow.

My hairline is still a little red.

Thank you

At 7 months, you should see growth from the transplants. It sounds like it’s possible that your transplants grew in right away (seen in 5% of patients), but you may have experienced shock loss in the surrounding hair, leaving you no better off than before you started. As for redness, it should’ve subsided months ago. I don’t know enough about your procedure (number of grafts, hair type, technique used) or your skin type to be able to reflect on the persistent redness or if the transplant was a failure or not. I would discuss your concerns with the physician that performed the surgery and use the pre-operative photographs when you discuss this with him/her.

hi,
I have been taking saw palmetto for a year and I reckon it has helped not only my hair loose. but other problems such as depression,sexual desire this cant be a bad thing considering it has helped three things with one tablet. I know your goin to say it is not fda approved but how can it be so bad when I am feeling great again and able to tackle life without feeling suicidal and depressed. I reckon it is the greatest thing thats happened to me.

What you are reporting that you got out of saw palmetto are not known effects for the herb. It is mainly used as a prostate enlargement treatment, and I’ve never heard of it alleviating depression or suicidal tendencies. I don’t recommend saw palmetto to treat your hair loss, but it is harmless to my knowledge and if it works for you, certainly you are free to continue using it. Good luck.

Snippet from the article:

GREY hair may be unwelcome, but the processes that produce it are now better understood and could be protecting us from cancer.

Cells called melanocytes produce the pigments that colour hair and their numbers are kept topped up by stem cells. Hair goes grey when the number of stem cells in hair follicles declines. Now Emi Nishimura of Tokyo Medical and Dental University in Japan and colleagues have found what causes this decline in mice.

Read the rest at NewScientist - Grey hair may be protecting us from cancer

This is a long stretch from a prominent researcher. I will not celebrate my gray hair because of this article.

Hi,

Thank you for your great blog. I’m a head shaver, and currently I’m using Rogaine foam. I will shave, then shower, then use the foam. I was wondering if it’s ok to put moisturizer on my head before the Rogaine foam? Would that change the effectiveness? Thanks!

Probably not, but more chemicals on the scalp could potentially block the Rogaine Foam absorption. The application instructions for Rogaine say to apply it to a clean and dry scalp.

Dear Dr. Rassman,

recently you wrote on this blog about having advised several of your patients seeing a certain loss in efficacy of finasteride treatment to higher the dosage from the regular 1 mg per day to 2.5 mg (half a proscar). In older entries, however, you are strongly advising against that therapeutic “move”. Could you please explain why you seem to have changed your mind on this and what conditions you´d like to see fufilled before making such an increase in dosage!

Thank you so much!

There have been more and more complaints by some patients that over the long term, Propecia seems not to prevent the advancing balding patterns that they are experiencing. Because of the high interest in Avodart in some individuals who are not getting control of an advancing balding pattern (without its FDA clearance), there seems to be a consensus by some of the prominent doctors in the field that 2mg of Propecia (or 2.5 mg of generic finasteride — which is a half of a Proscar/generic finasteride pill) may be better in some of these individuals and worthy of a try. Please note that I’m not suggesting that people increase their dosage on their own without talking to their prescribing doctor.

As long as there are no negative side effects, I believe it is a better option than Avodart, which I am reluctant at prescribing until I get more comfortable with the FDA clinical trial that just completed. I will try to understand this better at the ISHRS meeting next month in Amsterdam, where the Avodart study will be discussed. Once I know more, I’ll post it here.

I have a question concerning thin hair. I am a 31 year old male. I have always had really fine hair. I dont appear to be going bald but there is a really thin spot on the back middle section of my head. When my hair is cut short it looks pretty thin back there. Someone told me this might be because this is where the occipital bone is. Is it common to have thinner hair around the occipital bone? Do you see this alot? Thank you very much.

No, I do not see this in isolation. You may be noticing thinning around the rim of the crown area on the back of the head (see image at right).

If you are indeed pointing to where the occipital bone is (see highlighted label on image below), that is the area where hair should be the thickest and fullest in most men who have genetic balding. That is why we call it the permanent zone. Right below this area is the neck and this can have a different genetic code, but there is no bone under that part of the scalp in the midline.

Image source: AARP

Doc, I am 19 and experiencing signifigant hair loss in my hairline/temple area. I have heard that the earlier one looses hair, the balder they will go, but no one on either side of my family has ever experienced extreme hair loss or anything past a norwood class A type Va (worst case)

Is it true that the earlier one starts balding the more hair they will lose, or do they just reach their pattern quicker?

The two points are not necessarily connected, but those that lose a lot of hair often start early in their 20s with the process. From a transplant perspective, a Norwood class 5A pattern is a good end stage pattern for most people who want full coverage, where a class 6 or 7 is often difficult to treat for full coverage. In someone with a Norwood class 6 or 7, the supply of donor hair will often not be enough to solve the need for a full replacement hair transplant. I have transplanted a sereis of Class 7 patients with upwards of 7000 grafts (as high as 9900 grafts in one patient) to get the coverage they wanted. These individuals were fortunate enough to have high density donor hair and good scalp laxity. It certainly took more than one session to reach this number of grafts. For the sake of convenience, the Norwood chart is shown here:

Hi Dr. Rassman or whomever receives this message,

I’m a 24 year old South Asian male and I’ve been taking finasteride daily for over a year now to combat my early hair loss. I’ve experienced good results with regrowth around my crown and an apparent freezing of any more thinning on the top of my head.

However, I’ve recently started taking Strattera (Atomoxetine)for my ADHD (I’ve always had it, but now its starting to interfere with my daily life). Is there any possibility that this could interfere with the effectiveness of the finasteride (I take Finpecia)? What about other ADHD drugs like Adderall or methylphenidate or even high amounts of caffeine?

Thanks for your time

There are many reports by individuals on the web that reflect hair loss in association with Strattera and Adderall. I would discuss these issues and concerns with your prescribing doctor.

If the hair loss problem is not related to DHT (which I believe is the case with these drug side effects), I would not expect DHT blockers such as finasteride to help… unless there is some genetic cause.