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Hello,
Just a quick question about the 2011 Alaska meeting. You spoke briefly about Minoxidil and spironolactone used together by a doctor in Thailand with good results. Can you elaborate on this?

Thanks a lot

Not much more info than is already all over the web separately on each medication. The study in Thailand was with systemic minoxidil, which is clearly not suggested for treating hair loss.

Can a bulk analysis predict how bald a man suffering hair loss only in the ‘receding’ pattern will end up? For me, I’m almost 100% sure I haven’t lost any density or thickness behind the hairline so how would a bulk analysis predict where my recession will progress to?

Yes and no.

The hair that is going to be lost has a biological clock with a trigger point that starts the balding process. Let’s say that someone will become a Norwood class 5 pattern balding man and that the leading edge of his frontal hairline started at 18, the remaining part of the front started at 24, and his crown started to thin at the age of 22. That means that the predicted pattern will not show until the bulk starts to reduce in those ‘triggered areas’.

When the thinning starts, the bulk measurements are clearly impacted earlier than the eye can detect, so that is the “yes” part of the answer to your question. The “no” part may reflect the crown status at the age of 20, which will not show thinning (in this scenario) until he is 22.

I am a 46 year-old male and a loyal reader of your blog. Based upon the positive results you have seen with Propecia, I decided to try it, after consulting with a hair-loss surgeon. I have taken 4 pills thus far. I was more than willing to tolerate the side effects reported by Merck if it meant stopping my hair loss. However, I have began to experience possible side effects not reported by Merck, including difficulty sleeping, mental fogginess, breaking out in sweats, along with the more common side effects of decreased energy and drive.

After experiencing these, I began doing some research and ran across sites you may be familiar with, such as Propeciahelp, on which users complain of side effects such as these along with others (e.g., hypogonadism) even after stopping the drug. There are various reports that the drug alters the brain (e.g., mood and thinking) by affecting neurosteroids and can permanently alter the neuroendocrine system.

Obviously, I am freaked out about this and will probably stop taking the drug. I would like to know your opinion on the reports of these side effects, the possibility of permanent alterations of various bodily systems with use of this drug, and your opinion on websites such as these (Propeciahelp) in general. Thank you for your trusted advice.

Suggestions can produce side effects (see “placebo effect” and “power of suggestion”). Your gonads will not shrink in a few days. It is possible (albeit very remote) that there are brain effects, but you should discuss this with your physician and that is why a doctor’s prescription is required for this drug in the United States and many countries. Have an open line of communication with your doctor. If you’re unable to sleep and you think it is related to the drug, talk to your doctor about stopping it.

While forums can be helpful, one must remember that many times they are full of unverified claims and feed into irrational fears. I’ve written about this before here.

Hi, thank you for providing your blog as a source of information. I’m a 40 y.o. male and recently had an appointment for a transplant to correct some mild thinning in the frontal and temple area… approximately 800 grafts. I was literally minutes from the procedure when the doctor learned that I was diagnosed with Wolf Parkinson White syndrome as a teen and informed me that he would not continue with the transplant. From a providers perspective, is this the consensus of the industry as a whole or are there still transplant options available to me? Thanks in advance

There is no contraindication to an outpatient surgery (such as a hair transplant procedure) for patients with WPW. Moreover, if you were diagnosed with WPW in your teenage years, I would assume you have had it treated with ablation. If you were not treated with ablation, I would think you should be followed by a cardiologist.

For somebody with a tight scalp is a FUE procedure really the only hair transplant option?

If you have a tight scalp, you can “work” your scalp with an exercise program for 30 minutes per day for 3 months. Most people will succeed in getting more laxity with these exercises. We made a video of this here.

Snippet from the article:

Famously bald Seinfeld star Jason Alexander, 52, showed up to the 27th Annual C.S.A. Artios Awards in Beverly Hills Monday with a full head of hair.

Source: Balding Jason Alexander Debuts Full Head of Hair

Actor Jason Alexander (George Costanza from Seinfeld) recently acknowledged that it was a hair piece he wore to this event. We see that the result looks good and some might even say he looks younger.

One has to wonder if he considered going the permanent route with a hair transplant… or whether he would even be a good candidate for one. It’s possible that he could get good results if his hair thickness was not fine, if his hair density was at least average, and if he would be committed to following through to the completion of the process.

There’s a tremendous amount of upkeep involved with hair pieces, and since he’s well known for his bald appearance, perhaps he wanted to just go for temporary shock value by appearing with a full head of hair.

I’m sorry, but I can’t believe that the following picture on your website is true. There’s no way a class 7 can have so much donor hair and have results like this.

Patient ZU

It’s absolutely true. This was a patient model of ours for many years, coming to every open house event in my office each month to show off his wonderful result in person for anyone that wanted to take a look. He had above average donor density that allowed for the amount of grafts we were able to get. So yes, there is a way… because this patient is for real. We don’t play tricks with photos of patient results.

His sons followed in dad’s footsteps and they are transplant patients as well. We showed one of the sons here.

As rogaine is intended for hair regrowth and not to combat hair loss, can it be effective on regrowing hair lost from anything other than male pattern baldness, i.e. traction alopecia, or even a mature hairline?

I wouldn’t expect Rogaine (minoxidil) to regrow either frontal hairlines or hair loss caused by traction alopecia. It’s possible that it could cause hair growth in areas where there wasn’t significant hair previously, though.