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Hello Dr. Rassman and Dr. Pak, Thank you for having this blog. I was wondering if Acell can grow (or re-grow) a new thumb, why can’t it grow (re-grow) a hair follicle? What if a 1mm punch was used to remove a section of the scalp and then the punched area was packed with Acell to see if a follicle will form?

I wish I had good news to report, but we know from our own studies using ACell powder and sheets in the wounds, that no significant amount of hair (less than 3%) was grown from the plucked hairs moved into the transplant area from the back of the head. I consider that this is not a supportable technique in our hands and I question the results of other doctors who report successful studies. This process is not rocket science that has technical barriers to entry that are for a doctor with my experience.

We were excited about the potential for ACell in hair transplantation following last year’s ISHRS meeting in Boston, but we haven’t been able to replicate anything close to the results from those original reports.

For those that want more information on ACell use in hair transplantation see these past posts:

• NHI ACell Update
• Why Are Some Doctors Already Claiming ACell Success?
• Follow-Up - Dr Cooley’s ISHRS ACell Presentation

I recently had loc extensions placed into my hair because my hair is very fine and soft and refuses to lock on its own. In the process of it one of the locs on the back of my head was done to tight and eventually came out pulling my own hair with it there is some what of a bald spot there and the hair growing is very very very fine thin and small. I recently shaved my head to get everything on the same level while the rest of my hair is growing at a normal rate this patch is still very slow is this permanent or will it grow back if not is there anything i can do to help it

Hair extensions can produce traction alopecia, leading to permanent hair loss. Since you just shaved your head, I hope that means you’re going to discontinue using extensions. At this point, you’ll just have to see what happens over the next few months.

If there is permanent loss from the tight pulling, you’ll know within a year or so. Hopefully it isn’t the case, though.

Hi Dr. Rassman
I was just wondering you said that SMP and FUE would work well together! So my question is would you do both SMP and FUE procedures on the same day or one first and then the other on another day? Or would it just be better to go through FUE procedures until getting good coverage then going for SMP so it will look more dense?

Sorry for so many questions: cause my goal is to get at least 4,000 grafts with FUE (even if it means 2 or 3 more procedures) and then get SMP done on top of that to give the illusion of a dense hair? Or should I go through SMP first and then FUE? Once again sorry for so many questions.

And thanks for keeping us all well informed and keep up the great work!!!!!!!!

Follicular unit extraction (FUE) and Scalp MicroPigmentation (SMP) can work very well together, but you can’t have the two procedures done on the same day. I generally recommend having the SMP and FUE procedures done 6 months apart.

Hi Dr. Rassman,

I’m a 18 year old male and my hair is really oily and I mean REALLY OILY I take a shower every night but once I wake up in the morning its already really greasy and it smells, this started 4 years ago when I started High School I went to a regular doctor about 2 years ago so he could check out my scalp but he said it was fine. I have used Paul Mitchell Tea Tree Oil Shampoo, Head & Shoulders Hair Endurance for Men, Selsun Blue and Suave Clarifying Shampoo in the past couple of years and have have little to no success, so I was wondering if you can help me with my “smelly hair syndrome” as they call it I will really appreciate the help.

Thank You for your time

It’s possible there’s some shampoo out there that might help, but I couldn’t specify which one help for your particular case. A good dermatologist might be able to help you.

There is a pretty good article on this “Smelly Hair Syndrome” available here.

Dr. Rassman, First of all, I really appreicate your great site. I learned a great deal from your answers. One of the most comforting answers was that some of your patients on propecia have retained their hair more than a decade. However, in other posts you mentioned that propecia does not work well in the front, especially for hairline. I am just curious that if patients seeing great result originally had loss limited to their crown or if Propecia actually maintained their front as well. If it has, did it completely prevent their hairline from receding also?

Another question is that do you see any particular trait in the ones with excellent result from propecia such as their lifestyle, diet or even their general personality(pessimistic, optismistic so on..)? Lastly, by rough estimate, talking about great result over a long-term, is it like only few of the total patients or is it actually some significant percent(like 30-50%)?

I apologize for these repetitive questions but just wanted to clear up if there’s any chance. Thank you very much in advance for your time and care for people from all over the world!

I don’t know that there have been specific studies, but (if I had to guess) less than 10% of patients who are on Propecia show benefit to their front hairline area, but even more rarely will they see regrowth there.

I’m not sure if I follow your question. If someone is just losing crown hair and takes Propecia, I wouldn’t consider the medication to necessarily be the cause of their hairline staying put. It could just be that their genetics limited their hair loss to the crown. There is no trait or lifestyle that predisposes someone for responding to the drug, though. It is just how their body reacts to it.

Propecia slows down the hair loss process and can reverse (in the first few years) hair loss in the crown, and it can also make enough of a significant visible difference by filling in behind the frontal hairline and in the top areas. But just keep in mind that Propecia does not COMPLETELY maintain or prevent hair loss. This is impossible.

Hello Dear Doctor

I deeply appreciate your efforts on this site helping people all over the world. I have two questions on my mind chasing me nowadays.

1-)I know you have given pretty information on this site about propecia (finasteride) and its stunting effects of growing taller, i’ ve read them all. In my case, i have finished 25 years(300 months) in life and started taking propecia. Do i need to worry propecia stunting my growth after this age, did you experience anything related to use of propecia and growing taller in your long career?

2-)Second, i went to see a derm 1 month later i started propecia. I told him about my medication and he sent me for a blood test. As i expected everything was normal. He told me that i can keep using minoxidil and shen min stuff, adviced me some dandruff shampoos but didn’t recommend me to use finasteride as it is working on hormones. Myself i want to give it a chance at least for 3 months. What is your suggestion on that?

You are already 25 years old. How much taller are you expecting to grow? I think it is safe to assume you will not likely grow any taller regardless of whether or not you took Propecia. Most men will stop growing by their late teens, maybe early 20s. You’re in the clear.

I can not give you a recommendation against what your doctor said. Propecia is a prescription medication, so you might want to seek a second opinion from another doctor if you do not like/or trust the recommendation given to you by your present doctor. I think that this is a reasonable thing to do.

Hey doctor,

please spread the word. If anyone is suffering hair loss due to a head injury please rub ginger on that area for a month and you will see results. Personal Experience guaranteed.

Rubbing ginger on your scalp might sound like an easy herbal remedy that wouldn’t hurt to try, but I doubt it’ll regrow hair. What kind of head injury did you have?

While I appreciate your dedication to spreading the word, the only guarantee someone will have if they do this is a ginger smell coming from their scalp.

Hi Dr.

Yesterday in a prank a friend of mine put duct tape in my hair and when I tried to take it out, I ripped out 7 or 8 hairs. I am very sensitive about my hair and would like to know if I should be concerned with these hairs not growing back.

Thank you for your support.

Nice friend. Chances are, those 7 or 8 hairs weren’t going to make a difference in your appearance anyway — unless you only had 10 hairs left.

No need to be concerned — the hair will grow back.