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Hi Dr Rassman,

just wondering if the person in the mature hair line example ever got a hair transplant? And would you have pictures of it? Is he of asian decent? I have thinning hair similar to him. How do you determine if his hairline won’t recede further than the red line so future hair transplants wont be needed?

Maturation of a Hairline — Moving From Juvenile to Mature

This was a consultation patient of Asian descent that allowed me to use his photos for the purpose of educating on the blog. He only came in once and never had a hair transplant (at least, not with us). Miniaturization mapping may help to determine a future loss pattern.

I have blood dht levels of 4. My tsh is 2.71 I have been having severe hair loss for about a year. My hair which was once very thick is now thin and falling out. My testosterone is 33, estrogen 24 and progesterone is .5. Do any of these numbers tell you a possible reason for my hair loss? Does the dht level of 4 mean low levels of dht on the follicles also and if not, how can I test for dht on follicle? Please give me some insight and suggestions. I am a 53 yr old female.Thank you!

I would have to know the normal values for the lab you used. Female hair loss is a very difficult evaluation, and doing it without you in front of me will not be valuable. I do not read lab tests without the patient involved in the process.

A few days ago there was a post on your blog, the question was asking the effectiveness of finasteride in the time of a year, at the end of the first paragraph of your responce you talk about how effective it is in men at a young age unless they are headed for NW3 by age 23. Why is it different for men of that extreme case and what can they expect from taking finasteride? Is it pointless for them?

If there was confusion, allow me to clarify. Propecia should work better in men who are actively balding and have progressive miniaturization of their hair. The thicker the hair shafts are in the miniaturization process, the better the Propecia will work. People who have ‘twigs’ for hair (those at the end of the miniaturization process in the affected areas) or those who have completely lost their hair in the impacted pattern, are unlikely to get regrowth or thickening of the hair shafts, which is probably the way Propecia works anyway.

This drug may not work as well if you are heading to a Norwood Class 6 or 7 with existing balding areas, particularly if the miniaturization process is nearing the end of its process. For the very young man in his early 20s, advanced balding patterns are indications of an aggressive balding process and the drug may be less effective than those with mild (Class 3) balding patterns. If you lost all your hair in a Class 6 or 7 pattern or have been a Class 3 for years with little change, for example, Propecia probably will not be much benefit, because the hair is long since gone. Moreover, for reasons unknown, Propecia is reported to work best in the top/crown areas, not over the frontal areas.

How many more grafts can you gain if you add FUE. Say i had three strips for 6000 grafts and i’m stripped out. how many on average more grafts can a person get with FUE? One doctor said between 1000 and 2000. Does this sound accurate? thank you

Your laxity might be good after three strip surgeries, but some patients might find the donor area to be tight. The higher the density at the time of the follicular unit extraction (FUE) harvest, the greater the yield will be. For an FUE, the remaining density will reflect your depletion of 6000 grafts from the original permanent zone. For those men with a high original density, there could be many more grafts available… and for those with an average or below average density, the different yield could be significant. If I examined you, I might be able to give you an educated guess, but there is no general answer to your question. A graft estimate of between 1000-2000 grafts is possible, but an examination is critical to the estimating process.

Hey doc,
I know you’re not a fan of the various hair loss treatment lasers and I found this video that backs up your opinion. I thought you’d be interested in seeing it.

Thanks for sending this in. The video appears to have been produced by Feller Medical, and the basic argument it makes is that the laser doesn’t penetrate the skin, therefore it can’t possibly do what is claimed.

I’ve embedded the video here for all to see:

Hi, I have a question regarding colostrum supplements and hair loss. Colostrum supplements are supposedly rich in IGF-1 which I understand is implicated somehow in mpb.

My question is whether taking these supplements would trigger or accelerate hair loss, or have any negative effect on hair loss in general.

Reports on the internet forums are, as expected, mixed. Some say colostrum supplements helps their hair, others say it causes acceleration of loss. I can’t say definitively one way or the other, but I doubt that there would be any impact of this supplement on triggering or accelerating hair loss.

Hello doctor, I have been wondering about this and have found no answer. When the juvenile hairline matures, what happens to the characteristic of the hair on the juvenile hairline as this happens, does it miniaturise? Does it all go at once or one hair at a time? You suggested these hairs go through aptosis but during this process would these hairs become weaker every cycle?

Thank you

I have not seen miniaturization in those undergoing the shift from a juvenile to mature hairline as a rule. It just falls out without miniaturization, but this is not an all or nothing statement as miniaturization could occur.

Dr Rassman,

What do you make of this article: Jon Gosselin Is Totally Losing His Hair… AGAIN

and I’m sorry, but the second photo is a bit alarming, it really puts me off ever getting a hair transplant!

Jon was only transplanted in the frontal hairline area extending back about 2-3 inches, not elsewhere. He was told that a second procedure would likely be necessary and that he should follow the Master Plan we setup for him. His heavy smoking, the stress in his life, and his genetics are not really helping the rest of this head behind the transplants. So it is completely unfair for that blog site to write, “Good thing he didn’t have to pay for it since at this point, he’d probably demand a refund.” On the contrary, his hair transplants look great. It’s the non-transplanted hair and the progressive nature of hair loss that doesn’t look so hot. Plus, harsh lighting from paparazzi cameras can be unflattering to any hair.

If he is not taking Propecia at this time, then I think that only the hair transplants will remain over the long term. One needs a Master Plan in managing their hair loss or disaster could be the course. The good part is that the man Jon sees in the mirror every morning has hair. Only the camera shows what else is happening to his head. If he cares, then he should review the Master Plan I put together for him and assay his status.

Snippet from the article:

An Alameda County, Calif., jury late last month returned a $50 million verdict in a class action that sought relief for Californians who’d bought Avacor, a hair-loss remedy that was marketed as an all-natural, clinically tested product.

Attorneys fees have yet to be decided, said L. Timothy Fisher, of Walnut Creek, Calif., firm Bramson, Plutzik, Mahler & Birkhaeuser. New York lawyer Scott Bursor and New York firm Faruqi & Faruqi also represented the plaintiffs. There were about 150,000 purchases of Avacor in California during the class period, but since some were reorders, the exact size of the class is unclear, Fisher said.

Read the full article at Law.com

Remember this story the next time you see some new miracle “all natural” hair loss treatment that proclaims to do everything you could ever hope or dream of. There are people out there looking to prey on you, and it is up to you to become wise to their actions so you can stop lining their pockets while they crush your dreams.

It appears that Avacor is still on the market, but it is probably unrelated to the product that was sued into oblivion. The Avacor brand was purchased earlier this year, according to this press release I found. The news of this $50 million judgment can’t be too good for their PR efforts now, though.

As I sit in my CHU, aka containerized housing unit, everyday in the lovely country of Iraq I pay special and close attention to my hair since I have not much else to do at nights but read and finish up work, which I get enough during the regular working hours. I suppose the only reason I pay such close attention is one of two reasons;

First, since losing my hair at a young age I have always noticed it and it has bothered me enough that I can easily say that not a day goes by that I do not have at least a brief thought about it. Secondly, and the reason for writing, is I have recently had my second surgery about three months ago at NHI and I am at the phase of not much results noticeable yet but I remain faithful as this is not the first time and I tell myself not to judge anything this early everyday. I have noticed some of donors have started to grow but I am not concerned so much on the results of the second surgery as I am being patient about it.

My main concern is the first transplant, or more specifically, the texture of the hairs from the first transplant. I noticed early on in the first surgery that many of the hairs have a wiry, crinkled like textured that is near impossible to manage and very noticeable different from the natives hairs around it. I have read plenty on the internet, to include on this blog, about transplanted hair texture change and most say it is a temporary change caused by reasons not fully understood during the healing process of the transplanted follicle. I have stuck it out with the fact that it is only temporary but now well over a year into the first surgery I am starting to wonder if this texture change is really temporary or just how the hair is now. Or maybe I once again am not being patient enough and must still wait it out. I do want add that this is not just a few hairs, it is notable portion of the transplanted hairs. Is this a reality I must accept or should I continue to stick it out see what is in store?

Changes in hair character to curly and occasionally (rarely) to kinky does occur. I tell those that are affected that they should wait to see how it grows in after one hair cycle (about 3 years) has passed. Patience is a virtue, waiting is the hardest part, etc, etc. I know it is easier said than done while waiting for your transplanted hairs to grow, but try to focus anywhere other than your hair.

When you are in Los Angeles again, please get to me personally and I will go into your hair examination myself. Best of luck to you in Iraq.