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I have had 5 hair transplants. All were done by way of the strip method and I am very pleased with the ultimate outcome. However, the linear scar from my 4th surgery is horrible. It is very wide and red. The scars from my prior surgeries and the one subsequent surgery look fine. Because of concerns about elasticity issues, between the 4th and 5th HT I did scalp exercises to improve the donor elasticity which I found on Youtube. My Doctor said that the elasticity between my 4th and 5th surgeries was greatly improved and attributed it to these exercises. With this improvement, I am considering a scar revision with the hopes that the scar from my 4th surgery can turn out like the one from my 5th surgery. Is this realistic?

Lastly, in general would you recommend a plastic surgeon for the scar revision or a hair transplant Doctor? I traveled some distance to have my last hair transplant and don’t plan on making this trip again for a scar revision so I would look for local Doctor to do this procedure.
Thank you for your time

Scar revisions in the hands of an experienced surgeon that deals with hair transplant scar issues on a regular basis is generally better than a plastic surgeon for this type of work. Experience is everything in this process. I don’t know what is realistic to expect, as each case is unique and I haven’t seen you.

If you want to find a doctor in your area, I’d suggest using the physician search at ISHRS.org.

I have been taking proscar for hair loss for about 12 years and recently read a disturbing article in Mens Health regarding side effects. Has new long term evidence emerged that shows greater risks? Can stopping the use of Proscar actually bring on side effects?

We are being overwhelmed with negative information that is out of proportion to the reality of the actual numbers of side effect and the statistics that go with that information. Are you willing to take the chance on reversing the hair benefits that stopping the medication will bring about? Any benefits, even reduced prostate problems, will reverse if you stop the medication.

Hi there,
Im 8 weeks post op…I had 4200 grafts done…Everything went well and i seem to have had no problems at all really other than my head feels like i have sunburn…It only stings for a few second if i touch it,other than that its not sore….Just wanted to see if thats normal? Would greatly appreciate your advice on this…Thanks

At 8 weeks after your hair transplant, you should feel normal without pain. I suggest that you see your surgeon and get his opinion.

This 41 year old man saw himself in a TV spot and then panicked as he never realized that he had a huge bald spot in his crown. 15 months ago, he had 1870 grafts into his crown and the results are shown in the photo below. He also had a very small scar from the donor strip measuring 1-2 mm wide, a photo of which I’ve also included.

Click the photos below to enlarge:

After (1 procedure of 1870 grafts):

Before:

Dr Rassman,

I’m a Caucasian 27-year-old male with zero known family history of MPB. However, I’ve lost some hair on the front of my head, and crown miniaturization was detected — meaning that down the road, I could have a serious (Norwood 6?) pattern. I started taking Propecia and hope it can hold onto my hair for 5+ years.

That said, I already need a transplant. (A “conservative” well-regarded doctor recommended 1400 FUT.) I understand the need for a Master Plan and to not run out of donor hair too early. However, it’s very important to me to not be viewed as balding as a young man (I’m single and haven’t firmly established a career.)

I have fair skin and dark brown hair. Luckily, I’m blessed with wavy hair, donor density 2.3, that people commonly describe as coarse and thick. So, I’m wondering, how big of a transplant could I do now for the front of my head, and still leave enough donor hair for future loss? Could I transplant 2000-2500 grafts without worry? I imagine other patients might be in a similar situation to me.

Thanks so much.

Everyone is different. A 2.3 density suggests you have more hair in the donor area than many people, and with coarse hair you may be able to cover an extensive pattern. But for those with fine hair, it may not be enough to cover a class 6 or 7 balding pattern. I have many patients who have had more that 6500 grafts and most of them get quite depleted. A few of these patients have gone to 10,000+ grafts like this man, and although he could have passed the 10,000 graft number, he got realistically what he needed.

My 21 year old son has been experiencing heavy body hair loss since summer 2011. He took propecia for 13 months stopping in February 2011 due to sexual side effects. He still has significant sexual dysfunction,anxiety, panic attacks and depression. Loss of body hair has been reported to the FDA as a side effect of the drug. This is absolutely devastating for him.

Some people experience side effects from the drug that range from sexual to mood changes. Based on my clinical experience, I am of the belief that side effects disappear upon stopping the drug. There may be other things happening to him that your son’s doctor should assess. I hope he’s seen his prescribing doctor for a follow-up after stopping the medication.

I have recently been diagnosed with hypothyroidism, and I have started eltroxin. I have also been suffering from FPB since the last 8-9 years. Is eltroxin likely to cause a TE to people who is predisposed, like me? When is this hair loss noticed, and can it be prolonged? Can anything be done to contain it?

There is an association between taking Eltroxin (levothyroxine) and hair loss, particularly in the first few months of taking it. You need to take this complication up with your doctor. It’s worth noting that hypothyroidism itself can cause hair loss, too.

How are you, Dr. Rassman?

I don’t get it. A a firm believer in Charles Darwin’s theories about evolution and natural selection, I would have thought that those unfortunate souls who bear the gene that causes baldness would be an extinct breed. The overwhelming majority of women I’ve met find balding or bald men unattractive. Yet, the baldness gene hasn’t been removed from the human gene pool. How come this gene has made it?

Women and homosexuals find bald men sexually unattractive. Nobody chooses to sleep with a baldie over a hottie with a thick head of hair. Still, 50 percent of the male population has some degree of hair loss. Why does everyone find bald men that hideous?

I realize that my questions might be beyond the scope of this blog and that nobody really knows for sure. Nevertheless, I’d love to hear your thoughts about this.

We think of balding in terms of known times of recorded civilization. I wrote about this very question a few years back — Evolutionary Reason for Hair Loss?.

As humans grew their brains, intelligence and brain power came into play as an important factor for female mate choices. In the early years of humans, the disease tuberculosis was common, and men who had TB would become sickly. Women could often judge the long term health of their prospective mate by looking at the hair. Even though genetic balding was also present, women assumed that men who were bald (I suspect class 6 or class 7 pattern bald) would not make good mates because they would not live long enough to provide for them and their children. Those balding men with TB would die, so women assumed there was a connection between the two. Choosing a non-balding man with a full head of hair gave a woman some assurance that the man was healthy.

In modern Western society, TB is not common. Today’s balding men in Western societies are generally healthy. The genetics of balding may not negatively impact a woman’s choice if the man was smart, successful, and wealthy. I suspect that a class 6 or 7 bald, healthy, and successful man might be preferred over a poorer, full-haired man today. Ask if a sickly man lost his hair, would he be chosen by a good looking woman searching for a husband to produce a family today? The answer might lay in his bank account.

Besides all that, I’m sure there are plenty of people out there that would disagree with the idea that “nobody chooses to sleep with” a balding man.

Snippet from the article:

Here’s a reason to get your flu shot that you probably haven’t considered: infection with H1N1 may trigger baldness in a small number of people.

A new report from Japan suggests a link between alopecia areata, a condition in which patches of hair fall out, and swine flu (H1N1). The researchers report that seven patients experienced hair loss one to four months after developing the illness.

Read the rest — H1N1 May Cause Baldness

Apparently 7 patients with H1N1 (swine flu) saw hair loss, and although this is an extremely small number of patients to make a link, it’s worth exploring further. The exact cause of alopecia areata remains unknown, so finding even casual links could possibly lead to new information and perhaps even treatments.

Is it true that women that shave their legs all the time eventually will have less and less hair growing on their legs? What I’m getting at is, as a 23 year old man that shaves his head daily, if I decide in a few years to grow my hair out again am I going to run the risk of going bald from all the shaving? I’ve been shaving my head completely bald since I was a teenager and have no hair loss in my immediate family that I know of. And before I started shaving my head, I had no visible loss. I just want to know if I’m hurting my hair by shaving it off every morning.

Thanks!!!

These are old wives tales and have no truth to them. A similar myth is also shaving the head will make the hairs grow out thicker or fuller. False!