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Hi doctors. I’m a big fan of your work and this site. Thank you for what you do!!

I just saw this video by Dr Umar using beard hair taken with the FUE technique as the donor into the line scar from the strip technique. I know how you feel about body hair transplants and I agree that the results from using body hair on front/top of the scalp generally look unimpressive, but what about using body hair densely packed into the strip scar? Even if the hairs never get too long or have a different growth cycle, its just being used in the scar.

I have a scar and it doesn’t bother me, but if I have the option to essentially eliminate the appearance of the line I might consider something like this. I wanted to get your thoughts about using body hair for this and whether one could use hair from another part of the body for the same thing (why not chest hair for example). Check it out:

YouTube video

Thanks again

While I do have reservations about using body hair transplants, my biggest problem is when they’re used in the frontal hairline or top of the scalp. That being said, the use of beard hair to transplant into a linear scalp scar (from a hair transplant) is reasonable. The beard hair has a thicker hair shaft than most scalp hair and it would work well to fill in the scar.

I have used it on a limited basis, particularly when a plastic surgeon supplies me the beard skin after a facelift. The few cases I have done (one with FUE) have worked nicely.

As I mentioned in a past post, I cannot give an endorsement of Dr. Umar because I have not reviewed his work beyond what I’ve seen in YouTube videos. The video is impressive, though it is a bit long, so for those that don’t want to watch the whole thing just skip to about 2:30 to see how the linear scars disappeared.

Dear Doctor Rassman,

I read a recent post on your blog and it got me thinking.

-Propecia usually does work on the crown.
-Propecia usually doesn’t work on the hairline.
-Propecia blocks DHT.

Is there a posiibility that the genetics of frontal balding and crown balding are different?

-The baldness on the crown is more dependant on adrogens then frontal baldness.
-Maybe crown baldness is more of a result of the androgen receptor mutation then frontal baldness.

It’s just some random thoughts.

Genetics for front balding and crown balding are different, and there is a Norwood classification to describe the differences.

I suspect there are some differences in how the DHT affects the crown versus the front, but I do not think it has anything to do with mutations as you suggest. I think we have not completely solved all the mechanisms of why we bald, and I’m suspicious that much of the different rates of balding has to do with the length of duration of the balding process.

So far only DHT (dihydrotestosterone) is recognized as the hormone that relates to balding, but it does not mean it is the only hormone related to balding. I suspect there are other discoveries to be made.

Hi Doc,

I suffer constantly from razor bumps after shaving and just very sensitive skin in general. I get a very bad reaction if i shave more than once a wk. I was considering getting laser hair removal to permanently remove all stubble from my face. What is the success rate of this and have you come across anyone that has had this done with decent results. Thanks Doc.

I do not use the laser in my office, so I’m probably the wrong person to ask. I put in hair… I don’t remove it.

Removing facial (beard hair in men) with a laser can be time consuming and costly. I don’t know success rates off hand, but you can speak with a dermatologist experienced with using lasers for this purpose, or check with facial hair removal “specialists” online. I found one such site using Google that explains various methods, costs, and time involved — HairRemovalJournal.org.

I wish I could offer you more, but laser hair removal isn’t within my field of expertise.

Hey Drs at NHI,
I am currently on my sixth month of finasteride and have been applying rogaine for about a month and a half (once a day). I am a Norwood 3 at 18 years old (turning 19 very soon) and cannot tell if the drugs are working. I have however, noticed growth at the temple area of very small hairs (1/4cm - 3/4cmm). It is growing in asymmetrically though, I have more growing in on my right side than my left and I can see an “outline” of where my hair would be if I had a perfect hairline. I just want to know if it is a good sign? It does seem like my hairline is continuing to recede but I am wondering if it will eventually reverse, despite it being a frontal loss.

And just out of curiosity, Dr.Rassman could you tell me more about your son who had success with frontal regrowth? Like what balding pattern he was at and his age when he started using finasteride?

Thank you your blog is very insightful and has helped me in my high school years.

Asymmetrical hair loss is common with genetic balding when it occurs, and reversal of that loss can also be asymmetrical. I’d say any regrowth is a good sign, particularly at the temples.

I believe my son was in his mid-20s at the time he started on finasteride. He was thinning in a Norwood Class 3A pattern and the drug reversed all signs of miniaturization symmetrically.

How many years of MPB does one have to go through before considering an HT considering the following facts: I started to notice hair loss at age 17 and now am 20. I have been using Propecia for 2 years now and it has maintained most of my hair (temples and crown have thinned out a bit since then but nothing cosmetically significant). My father and my grandfather are both NW6 and my uncles are mostly NW5-6. I have been losing my hair for almost 4 years now, how much longer do I have to wait before I go for an HT?

It is not about how long you should wait, but rather it’s more about building a Master Plan with your doctor to address this concern. A good doctor will always work off a Master Plan that you and the physician will create. Your questions will then be answered, because you will have a customized plan to meet your exact problem and address the rate of your hair loss. As you were already prescribed Propecia, stick with it and hope the results continue to be positive.

I don’t know enough about your current hair loss, but hair transplant surgery at 20 years old is not usually recommended. There isn’t a real minimum age for having this procedure, but we generally don’t do these in men under 24 years old, because the hair loss pattern is not clearly defined.

You can read more in these past posts about hair transplants in the young man:

• I’m 21 Years Old and Had a Hair Transplant 10 Months Ago
• Youngest Person to Have a Hair Transplant?
• In the News - Dr Farjo’s Plea for Age Limits on Hair Transplants

Hello doctor. About 3-4 weeks ago, I was prescribed tretinoin gel(Vitamin A acid - mild gel 0.01%) for my facial acne. I haven’t noticed anything, but as I was browsing the balding blog entries, I noticed that someone in the past had brought up a question about acne medication causing hair loss.

My question is: does tretinoin gel(Vitamin A acid)cause hair loss if it is applied to the face/cheek region? My doctor did not go over the side effects and the box doesn’t mention anything about side effects. I was told to take one cream and night and another one at morning.

Thank you very much.

Hair loss is listed as a known common side effect of tretinoin (also known as Retin-A), but it is also used by some people in conjunction with minoxidil to grow hair.

Here’s what I wrote in a blog post a few years back — “Retin-A is applied to the skin and can produce burns to the skin. It is believed that a light burn will make the skin more able to absorb other medications (like minoxidil for hair loss), because increased vasculatiry is induced by the burn.”

So will it make you lose hair even if you apply it only to your face? I can’t say for sure, but it is a possibility.

When using Rogaine foam, I notice a heavy scaling throughout my scalp. Is this normal or should I discontinue its use? If so, what can I substitute for male pattern balness?

Thank you.

This sounds like a reaction to Rogaine (minoxidil). You might try the liquid Rogaine to see if it makes a difference, though it probably won’t. Scalp irritation is a known side effect of minoxidil for some people, and if it’s making your head scaly and uncomfortable you likely don’t want to continue using it.

As for substitutions, well, the only two FDA approved hair loss medications are minoxidil and Propecia (finasteride). So if minoxidil is giving you severe scalp irritation, you can talk to your doctor about Propecia, which is a once daily pill available by prescription only.

Hello,
I recently shaved (for the first time) and am experiencing pseudofolliculitis barbae. I was wondering if these razor bumps will somehow inhibit my hair growth or cause hair loss in the prospective future?

I thank you in advance for your generous time.

I doubt a bad shave will inhibit hair growth and your pseudofolliculitis barbae should resolve with time. Wait until it heals before you tackle it again. With the second shave of your life, be a bit more gentle and read up on proper shaving techniques.

I just saw this press release from Hair Club that said female hair loss is caused by DHT, and scalp massages are a “good way to prevent hair loss”. Is any of this correct? Here’s the press release (and thank you)

Press release

The part of the press release that you’re questioning says, “The most widespread hair loss among women is female pattern thinning, or Androgenetic Alopecia. This is a condition caused by a build-up of Dihydrotestosterone or DHT that eventually kills both the hair follicle and the hair itself.”

I can understand why you’d be skeptical. To my knowledge, there is no real connection between DHT and female hair loss, except in women with polycystic ovary syndrome (PCOS) or other virilizing conditions. DHT is linked to male pattern baldness (MPB), but that isn’t what the press release is about. If Hair Club has some new insight, I’d love to see the source.

As for scalp massage being a hair loss prevention technique, that is also not correct. I don’t know where that info came from, but I’d have to wonder if this was simply an overzealous PR agency that used common-yet-untrue myths to fill out a press release. So while rubbing your head won’t help you keep your hair, some of the other information in that press release is right — chemicals and tight braids can cause hair loss in women, along with hormones, stress, pregnancy, and disease.

Stuff like this is likely how false hair loss information gets propagated across the internet, resulting in hair loss sufferers buying into treatments that just aren’t valid. I just hope when folks do their research, they’ll be able to identify the truth from the sales pitches.

Hi doc,
First off, I’d like to say thanks for all you do on here. I had a hair transplant about three months ago and am starting to finally see a little growth. I recently have been developing a lot of pain in my prostate area and have been prescribed 500 mg of Ciprofloxacin twice a day for 14 days. My doc seems to think I have developed some form of bacterial prostatitis. In your opinion, will being on these antibiotics for such a long period of time have any permanent or negative effects on my future growth? Again, thanks for putting in the extra time for all of us hopeful hair farmers. It means a lot.

Chronic prostatitis can be a very serious problem and must be treated with supervision from your physician. Some doctors question the use of long term antibiotics if the infection has been successfully treated, but many people with chronic prostatitis have persistent pain that may not reflect an active infection. If your doctor is going to prescribe you ciprofloxacin (an antibiotic also known as Cipro), perhaps he has more experience with possible side effects than I would.

With all that said, I do not think that Cipro will affect your transplanted hair. I’ve read reports from people online that believe Cipro and hair loss are linked, but I’ve not found anything like that in medical literature and if there is a link it would be rare.