About     Contact     Archives     Videos     Events     Hair Transplant

Hi Doctor,

I know everyone is genetically different in their balding patterns, speed, etc. but how long does it generally take for miniaturization to turn a healthy hair folicle into one that can’t grow any hair? Weeks? Months? Thanks!

You are right — everyone is different. The hair you see on top of your head reflects about 1/2 inch per month of growth. Miniaturization can take months or possibly even years to appear.

Hi Dr. Rassman,

If Finasteride has a half-life of only 5 hours, how can it be so effective at stopping hair loss? If we take 1 mg or 1.25 mg of it, it would be pretty much out of our system before the end of the day. Does only a small amount of it prevent DHT from being created? Is it’s efficacy only dependent on a miniscule amount being present? Why is taking 2 doses per day not more effective than 1? And also, what are your current thoughts on what time of day to take it?

Just because a drug’s half life is 5 or 6 hours does not mean you need to take the medication according to its half life. Although half of the drug is out of the blood stream in 5-6 hours, some of the drug remains in the tissues for as long (possibly) as a week or so. Doubling the dose was not shown to be effective for better response in the original tests for Propecia.

In addition, the drug has been tested at different intervals and different doses, with trials determining that taking it once daily was just as beneficial as twice a day for treating hair loss. The best time to take Propecia is when you can remember to take it on a consistent basis.

Is it true that human hair has a predetermined number of cycles? If someone experiences TE or chronic TE are they using those cycles prematurely and causing their hair to thin earlier than it would have?

It is true that life of a hair determines the number of hair cycles you will have. I was bald in the crown by the time I was 45, so my hair there died… and then I had transplants to correct it.

If your hair cycle (from telogen to anagen) is 3 years and you have 10 cycles genetically programmed for that hair, then that hair will die at the age of 30. Although I am making this example sound simple, it is certainly not that simple… but male pattern baldness does probably follow that rule. I do not believe that telogen effluvium changes the hair cycle’s length, but just the telogen phase of that cycle.

Is it a coincidence or not that both my father and my grandfather (his father) went bald, or is it because of the similarities? My father has an overbite (his top jaw is more in front of his bottom jaw), as did his father. My grandfather and father went bald at about the same age, which was their early 20’s, although my father said he noticed hair loss at around the age of 18-19.

My brother who does not share this bite similarity is now 26 has his hair, but has an asymmetric pattern which has been this way since his late teens, and has maybe matured/receded more since then, but he has a healthy head of hair.

I guess my main question is: since I also have this overbite like my 2 bald family members, does this put me at more of a risk of balding because I have a facial feature more like them, or is balding simply not relateable whatsoever to minor facial similarities. I guess my concern is inheriting genetics.

Thanks.

I wouldn’t expect facial features and hair loss to have relation. You can get tested for the balding genes with HairDX and that will give you an idea if you are carrying the gene for balding. It won’t tell you if that gene will express itself (or to what degree, or when)… but it’s something to go on if you’re concerned.

Can hair thickening conditioners/ shampoos give false readings when performing hair check or miniaturization mapping?

Yes. Be sure to mention this to your doctor if you’re having bulk measurement or mapping done.

Doctor, love the blog, lots of useful information. I was hoping you could give a little career advice. What would you say to the students in medical school interested in getting into the field of hair transplantation? Would this not be a wise decision with companies such as histogen/replicell potentially achieving positive results using non-invasive techniques?

For a medical student thinking of a specialty to choose, I would not recommend hair transplant surgery. Not because it is not a great field, but mainly because there is no formal hair transplant surgery training or residency that would give you the requisite skills you should have. There is no consistency in the field of hair transplantation. I do believe the community of hair transplant doctors is improving and striving for consistency and it has greatly improved in the last decade. In fact, there is a board certification for hair transplant doctors, but it isn’t recognized by the American Board of Medical Specialties (ABMS).

If you still would like to pursue the hair transplant field, I would pursue a ABMS approved residency program of your interest. First get basic training in some official specialty like dermatology, and then get a fellowship under some well recognized expert in the hair transplant field who will take you under his wing.

Hello Doctor,
I have undergone HT 2 weeks back with 2 sessions of a total of 5000 grafts done. Till date, I don’t see a single transplanted hair being fallen out. Instead, I see them growing in length. Is this something to be worried?

I’m wondering why would you worry if you are seeing something positive like growth? You must have had a great donor density to get out 5,000 grafts in two sessions.

In general, most people see what appears to be graft growth in the first 2-3 weeks (it is actually the hair in the graft being pushed out of the scalp). As this is actually the shedding process of the hair which is going into telogen, most of the transplanted hairs will fall out in one month. Either way, follow up with your doctor as he/she can better assess your post operative course and progress.

Snippet from the article:

Allergan Inc. has moved its eyelash treatment into the second clinical stage of testing as a therapy for baldness and expects to see data by the middle of next year, Chief Executive Officer David Pyott said.

The product, Latisse, was approved in 2008 to aid in eyelash growth, and generated $82 million last year for the Irvine, California-based company. Allergan is currently testing Latisse for men and women against placebo. U.S. regulators generally require three stages of trials before approval.

Read the full story — Botox-Maker Allergan Tests Eyelash Lengthener for Baldness

I know the cost for Latisse as it is right now would be pretty steep for use on the scalp, since it is packaged in small quantities for use in eyelash growth. If this proves successful in treating scalp hair loss, I’m sure that will change. We’re still a way off from that, though.

Hi i have a somthing weird going on here. i started propecia in year 2001 because i had a receding hairline and my crown was very thin. After a year on the drug i stopped using it because it was too expensive and i only saw a little change. on month 3 without propecia my hair was very bad but i gave up and didnt care.

in 2009 my wife asked me “have you got a hair transplant or something?” i looked in the mirror and i could actually see there was something going on, but i just thought i had a good hair day. my hair just keep on growing and my hair seem better and better. what is going on? my hairline has moved a whole inch down from before propecia, and my hair is getting thicker and i dont have hair loss in temples anymore. you cant really see i have hairloss anymore. everybody thinks i got a transplant or wearing a toupee, but im not. How can this happen?

I have never heard a story like that before, so I can not comment on it. What you’re describing is highly unusual. Do you have pictures to compare where you were and where you are now?

Is there any way whatsoever to determine whether a person will at some point in their lives suffer from male pattern baldness, and if so, would this not eliminate the problem of transplanting people too young (say if they have a naturally high/ uneven hairline etc)

There is a test called HairDX that will tell you if you have the gene (70% accurate), but it won’t tell you when that gene will be expressed… or if it will be expressed at all. So on a predictive basis, the answer is unfortunately no. But if you want to know if you are balding (possibly just a little) then you should see a doctor who is experienced in hair analysis for miniaturization and hair bulk, which this will tell you if the balding process has started in you.

Many young men with a balding dad or uncle or brother are expecting hair loss to happen to them, and these are the patients I can help by telling them what, if anything, is going on in their head. If you have an average hair thickness, you might not see thinning until the hair loss is at 50% of the original density. Coarser haired men will often not detect loss even at 60-70% of their original density and blond men may not detect hair loss or thinning to 80-90% of the hair due to the low contrast between hair and skin color.