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i have scar on my scalp. can i do hair transplant on my newly 1 month scar??

I don’t know what your scar is from, the placement of it, or even the size of it. You never know, you may have some hair grow back around the scar. Many people will show redness at the scar which fades over weeks and months. I generally advise patients to wait at least 6 months when the redness is also minimal. Sometimes up to a year.

Last week I wrote about the ACell presentation at the recent International Society for Hair Restoration Surgery (ISHRS) meeting that may have opened the possibility for a patient’s hair to be multiplied in his or her own scalp. ACell’s MatriStem has had some early success with growing hairs that were plucked and then placed into recipient sites on the patient’s scalp, and although this is a major breakthrough, significant work remains before this becomes a practical hair loss treatment.

For those that missed my post from last week, here is a little background –

ACell, Inc. has developed and refined an Extracellular Matrix (ECM), a natural biological material derived from porcine (pig) tissue. When ACell’s MatriStem product is placed into a surgical site or wound, it is reabsorbed and replaced with new, more supple tissue, rather than a firm scar. The ECM stimulates the body’s own cells to form new tissue specific to that site. When applied to hairs plucked from elsewhere on the body, this is called “auto-cloning”, as new hairs are derived from the process.

We are currently studying the use of ACell for scalp hair multiplication (auto-cloning) as well as the facilitation of wound healing in follicular unit transplantation procedures. For those individuals interested in auto-cloning, we will be happy to see you in the office for a more in-depth discussion of the opportunity. Details will not be discussed over the phone but will be covered by the doctor during your consultation.

People interested in working with us in a study can participate at no cost, but because of the newness of the process, we will be selective as to which patients we accept. A limited number of patients who are not selected for a study may be eligible to obtain this procedure as well for a special fee. We will also be using ACell in the donor area of on our traditional strip surgery patients to promote better wound healing at no additional cost. Please call my office at 310-553-9113 to set up an appointment for a qualifying examination.

Dear Dr. Rassman
During my full time obsession with male pattern baldness, I have observed the hairline of quite a lot of people. I came to notice that some people have hairlines that give the impression that they wont never recede, e.g.: Maradona; Colin Farrel.

These people with this particular hairline appear to be immune to baldness (at least frontal). My brother happens to be a case, when he was a child he had a fuzzy and very low inserted hairline that matured into that particular pattern. My question is could be hair distribution be associated with baldness?

You are doing exactly what Dr. O’Tar Norwood did many years back when he came up with his Norwood classification. You’re observing hairlines.

The pictures you see in the Norwood chart is NOT a scale of hair loss progression, but rather it is observations of how men’s hair can be classified. The thing is, not ALL men go bald. It is roughly estimated that only 50% of men will have some degree of balding. Of those 50%, only a small percentage (around 8% of total male population) will go completely bald. The other 50% will have a full head of hair (maybe like your brother).

So to answer your question more pointedly, hairline placement in youth isn’t an indicator of future hair loss plans.

Hello Doctor,

I am a male in my late 20’s and had a question regarding the relation between your hairline and whether or not you will go bald like your father. Looking at past photos of my father when he was in his early 20’s I have his hairline rather than my mother’s. However, I seem to have more hair (pretty full head with just a little loss around temple area) than my father did when he was in his late 20’s. My father is now in his late 60’s and has just a little on top (basically bald). My mom is in her late 50’s and has very thick full head hair.

Is it possible to inherit the same hairline as your father but not go bald like him?

Thanks for your help.

Hair loss is genetic, but it does not always follow your father’s pattern either in the hairline or elsewhere on your scalp. It is just that in general your father’s hairline/recession is a good reference point, as may be your grandfather on both sides of the family and possibly your uncles as well. But as you are finding out, it is not always the case. Anything is possible.

If you’re fine with your current hair situation, keep your fingers crossed that it doesn’t progress… or talk to a physician about medication to slow it down.

I’m a 17 year old kid who had alopecia areata starting at 15 years old. I shaved my head (all the way to the skin, shaving cream and all) and did this for 2 years. Recently i stopped and my hair has grown again (YAY!) Its back to normal but for the past month, my hair has started falling again. Can alopecia areata come back again? Or is it another problem? and if please what will be a solution for it!

Thank you very much!

There is no cure for alopecia areata, and as such, it can regress and then come right back. If it comes back again, another such experience it is not predicable. Alopecia areata is a lifelong condition. Please the see National Alopecia Areata Foundation site for much, much more information on this condition.

Dr Rassman and co.,

Firstly, wonderful job on the blog. The content is balanced, informative and insightful to my research - big props! I am early and my research and considering coming to one of your seminars, as I am located close to your San Jose office.

I was hoping you could first give me some perspective. I believe I am around a stage 2 and wanted to get a confirmation on this. My hair line is almost identical to Joel McHale’s pictured here: photo

I am planning on going the FUE route and I am wondering about how many grafts it would take a patient, such as the one in the picture, to have a better hairline upfront.

Thank you in advance.

The photo you linked to of actor Joel McHale (from the shows “Community” and “The Soup”) might show what appears to be a Norwood class 2 or 3, but we’ve written in the past about his possible hair transplant. Without a close look at his hairline, I can not tell for sure what class he’s at now.

Without seeing you or at least seeing good pictures, I can not give you an opinion about your individual case. Graft needs depend on more than just looking at the size of a bald area. We need to also consider hair character, skin contrast, etc.

I also generally do not advise surgery on Norwood 2 patients or younger patients unless they fully understand they will never have a full hair density they desire. Plus, they need to understand that they may continue to lose hair in the future. In fact, hair transplants may precipitate more hair loss as a direct result of surgery itself.

Hi, I’d like to start by thanking you for your blog. I’ve been reading since for around 4 months since I first suspected I may be balding. I’m 20 years old and have long, thin hair. Because it is thin and I have always had a fringe I fear it is more noticable. My father is bald and my brother has also always had thin hair, but he doesn’t seem to be suffering any loss despite being 2 years older than me.

I have been on Finpecia for just over a week and have noticed significant thinning of my hairline above my forehead. I was wondering if it was normal for it to accelerate so quickly after starting to take the pills? Is it normal for my ’shedding period’ to commence this quickly? Also, I know it probably varies from person to person but I was wondering if you could give me any idea as to how much hair I should expect to lose during this period? Do people actually lose ALL their hair during this period?

Thank you.

Let’s say you were visiting Los Angeles and when you arrived, it started raining and kept doing so for nearly a week straight. You might then conclude that L.A. is a rainy city. Of course, Los Angeles generally gets around 15 inches of rain per year, so you really can not tell anything by looking at just a week of weather. The same analogy applies for your hair loss experience.

Your issue is not normal and I highly doubt it is related to a medication, as you have been on it only ONE week! If anything, it’s possible that you’re just paying more attention to your frontal hairline and are noticing what was always there (or not there).

Snippet from the article:

According to Spanish researchers, screenings for urinary symptoms in men with androgenetic alopecia (AGA, more commonly known as male-pattern baldness) could help with earlier identification of those who could benefit from treatment to prevent benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Their rationale: Men with male-pattern baldness have higher than normal levels of 5-alpha-reductase, the chemical that converts the male hormone testosterone into dihydrotestosterone, the active form of male hormone within the prostate.

Male-pattern baldness, which accounts for almost all hair loss in men, results from a genetic malfunction that causes hair follicles to become more susceptible and shrink in the presence of dihydrotestosterone. Over time, the affected hair follicles stop producing hair. The chemical 5-alpha-reductase also plays a key role in the development of BPH. When testosterone is converted to the more potent dihydrotestosterone by 5-alpha-reductase, it can cause the prostate to enlarge, eventually leading to BPH and LUTS.

Read the full story — Male-Pattern Baldness and BPH: What’s the Connection?

In case you don’t want to read the whole thing, here’s a quick two sentence summary: If you’ve got genetic hair loss, you should get screened for prostate problems. The researchers found that in the 30 men they examined, all of them had larger prostates than the control group of men without hair loss.

(female)
I have always had yearly autumn hair shedding but since I had chemo 2 years ago this has stopped, do you have any ideas why this might be? Thanks.

Sorry, I’m not familiar with a possible reason for what you’re experiencing.

Just so I’m clear, you’re saying that your hair grew back after chemotherapy, but the seasonal shedding you normally experienced in the past has stopped, right? Have you talked with your oncologist about this?

Hello, I have been on propecia for 20 months, never missed a dose. My hair line is intact but hair has continued to thin all over. My presentation is very much that of DUPA in my opinion. My eyebrows, facial hair and body hair have all thinned since the start of this medication. If I titrate down to 1mg propecia every other day will I see facial hair come back as it once was? If I completely stop propecia what can I expect? I don’t feel I have gained much from it approaching the two year mark. I am 35 with no past medical history. Mother is extremely thin, dad is now going bald in the crown. What should I do? Thanks

I think you might not be on the right track, as you seem confused about what is going on with your body. I highly recommend that you see a physician or follow up with your doctor who prescribed the drug for you.

Propecia is the brand name of a drug called finasteride in 1mg strength, so I do not understand what you mean by when you ask about titrating it. Propecia doesn’t treat diffuse unpatterned alopecia (DUPA)… nor does it cause it. Also, Propecia shouldn’t impact body hair or beard hair.

If you completely stop the medication, you’ll see any benefits disappear in what we refer to as “catch-up” hair loss. Your hair loss would catch-up to the pattern it would be at if you’d never taken the medication. If you haven’t gained much visually from the regrowth side of things, it’s possible the medication just kept your loss from progressing. Again, talk to your doctor.