Possible Triangular Alopecia
Balding Blog
by William Rassman, M.D.
23h ago
This young man sent these photos to me asking about this area of extreme thinning, which appears in the same place, even on the other side of his head. He said he had this same thin area when he was younger and it is also on the other side of the head, just less prominent.  This is often an inherited balding area called triangular alopecia, which is always found in this area. A simple hair transplant can permanently fix it if it is triangular alopecia. It could be alopecia areata, which is rarely in the same place on both sides of your head ..read more
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Typical strip surgery scar
Balding Blog
by William Rassman, M.D.
2d ago
I am often asked about what a typical strip scar would look like.  Not everyone heals this well.  This scar can be hidden even with a #2 cut or any reasonable long hair ..read more
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Lot’s of things wrong with this transplant
Balding Blog
by William Rassman, M.D.
5d ago
I saw this photo posted and decided to comment on it. There are many things wrong with this surgery, and as I don’t know the age of the patient nor the number of grafts he received, it is hard to complete my assessment; nevertheless, it is important for those of you who are considering a hair transplant to understand the difference between good and bad hair transplant techniques. The transplant donor area was unusually focused above the donor area, and that hair may be lost if this man develops an advanced balding pattern with age. The surgeon did not confine his surgery to the permanent ..read more
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How long does it take for finasteride to kick in?
Balding Blog
by William Rassman, M.D.
6d ago
Finasteride actually works fast (ignoring a shed) by at least slowing or stopping the hair loss within a week or two ..read more
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Finasteride for 1.5 years on 18 y/o male (photo)
Balding Blog
by William Rassman, M.D.
6d ago
Your hairline responded as I would expect in a young man under 25 with 1mg of finasteride daily.  ..read more
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Finasteride and muscle build-up
Balding Blog
by William Rassman, M.D.
1w ago
Will finasteride affect my strength performance at the gym and my ability to put on muscle? Finasteride should have no impact on your gym performance ..read more
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Genetics vs situation?
Balding Blog
by William Rassman, M.D.
1w ago
The man on the left uses great shampoos and conditioners, has a great diet, and takes hair loss medication, while the man on the right is Homeless.  It’s all in the genetics!  (Taken from a Facebook post). Hair loss is in your genes ..read more
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1.5 years minoxidil, finasteride and microneedling
Balding Blog
by William Rassman, M.D.
1w ago
I started minoxidil at 18, then added finasteride and then added microneedling. I got my hair back.  What should I do now? You can cut back on the microneedling to once a month. Keep up the other medication. It is likely that at 18, when you started this routine, you might have had good results from finasteride alone. 18-year-old men are generally very responsive to finasteride in the frontal hairline ..read more
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Day 11 after a hair transplant
Balding Blog
by William Rassman, M.D.
1w ago
I have now been able to remove all the scabs. I hope you didn’t pick them off. Picking at scabs too early can cause a loss of the graft. Picking also causes folliculitis. Proper washing of the recipient area is the solution to obtain a clean look after a hair transplant ..read more
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What if I microneedle using a 0.5mm depth?
Balding Blog
by William Rassman, M.D.
1w ago
The avascular part of the scalp averages 0.5mm thick, and below the epidermis of the scalp lies the upper reticular dermis. The hair follicles in the upper reticular dermis have stem cells nearby, usually above the sebaceous gland. Wounding this area is critical to getting a response to the healing cascade with microneedling that stimulates these stem cells. If you go down 0.5mm, you will not reach this area, and if you go down to 0.075, it will not induce the best result of the microneedling healing cascade ..read more
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