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There’s trouble brewing over stem cells in Texas, and it raises a big question for the future of medicine. How should we regulate treatments that use cells taken from a patient’s own body?

If the cells are grown in culture, then the US Food and Drug Administration (FDA) views them as “drugs”, which must undergo a lengthy approval process. That has enraged clients of a company in Houston called Celltex, who argue that the government has no business telling them what they can and can’t do with their own body parts.

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Read the rest — Whose stem cells are they anyway?

It seems like nearly every day I am asked, “When will we have stem cells to grow our hair?” The author of the above editorial published in New Scientist earlier this month wonders about regulating our own cells. Unfortunately, the FDA says that if cells are grown in cultures, they will be treated as drugs which must undergo a lengthy approval process, possibly costing us far more in time and money than we can afford. This impacts cancer treatments as much as the search for the “hair holly grail” from which we can extract stem cells.

There are arguments raised that simple transplants are the practice of medicine and therefore not under FDA control. There seems to be some direction to this controversy. “Strict drug-style regulations” seem appropriate for extensively manipulated cells. What that means is still unclear, but the questions are the start of agreements on differentiating the practice of medicine from FDA safeguards for drugs.

So this is what I tell my patients — Any solution for hair regeneration will most likely go through some regulatory process which will slow down the availability of any “cure” coming out of stem cell research. Don’t hold your breath!

Tags: stem cells, fda, treatment, hairloss, hair loss


I am trying to find a product that will help grow my hair back a little faster after chemo therapy. Is there any product that you can recomend to use to help?

I meet a lady that used some amino acid and her hair grew really fast

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I don’t know of any commercially available product that accelerates the return of hair after chemotherapy. We have written about cold cap therapy before, but that is something that is used during chemotherapy to maintain the hair, not to regrow it faster after the chemo treatments are complete.

I realize this information doesn’t help you if you’ve already lost hair, but it is the only chemotherapy-related hair loss treatment I am familiar with. At this point, just being patient for the hair to regrow is likely going to be the best course of action.

Tags: chemotherapy, hairloss, hair loss


Is there any possibility for laser removal of a shoulder tattoo to have an impact on hair follicles? I had a transplant done and continued laser removal one month after it. I wanted to know if the laser might bounce somehow from the shoulder skin to the transplanted area or if there are some other ways that the laser might do harm to the transplanted follicles.

I’ve asked this question to four different tattoo removal experts and they all say no way in a million years could it have any impact. So i guess it only has effect on the skin where the tattoo is and don’t really go anywhere from that. When you have put over $15,000 into two surgeries you become pretty stressed about the outcome.

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I am by no means an expert in laser tattoo removal, but I don’t see how a targeted laser to remove pigment on your shoulder could cause any impact to your scalp hair (transplanted or otherwise). I wouldn’t be concerned.

Tags: tattoo, hairloss, hair loss, laser tattoo removal


I have started worrying about losing my hair. Until recently I hadn’t worried about losing my hair since my temples receded slightly as a young man. I had no reason to believe I was losing my hair. Since I have started worrying (triggered off by the fact that I am about to turn 33 and feel that as a hairy bodied man, I must start losing my hair soon) I have started to spot signs of losing hair.

I have looked at the hairs from the top of my head and they seem to be finer than the hairs at the back of my head. However, I have no way of knowing whether this was always the case. The hair seems a little thinner in the temples and doesn’t seem as thick overall as it used to but I am aware that hair naturally thins over your life and this isn’t necessarily MPB.

Basically this has become a problem for me because I can’t stop worrying about it and constantly check my hair, look for information on the internet, and stress out. If you saw me you would think that I was worrying about nothing – I have a full head of hair at 33 and as such am unlikely to go completely bald, if at all. Also, balding in older men is often part of the aging process so I am effectively worrying about getting old. Am I just being neurotic?

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If you’re not actually seeing any hair loss, but THINK your hair MIGHT be getting thinner up top, the only thing I’d recommend doing is getting your hair bulk analyzed with the HairCheck instrument. Beyond that, stressing out and worrying about maybe losing your hair might actually cause hair loss due to the stress. I hope I didn’t stress you out more by saying that!

There’s no point in being anxious about possibly losing your hair, especially since you’re in your 30s and aren’t seeing loss by now. Most men that are destined to lose hair due to their genetics will start to see the process starting in their 20s.

Tags: hairloss, hair loss, hair bulk


I have dramatic hair loss these last three months. Also on sides and behind the head on the neck (not in donor area). Also having too much dandruff and also losing hair on the temple.

Can dupa cause so much dandruff? Can hair loss on sides be caused by aggressive MPB? Can any chemical or toxin cause DUPA by consuming it once? Thanks for answers!

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Diffuse unpatterned alopecia (DUPA) is unrelated to dandruff. Male pattern baldness (MPB) does not include hair loss on the sides of the head. I don’t know that you even have DUPA. There is nothing I can tell you other than what you told me. You need to see a good doctor to give us an opportunity to make a diagnosis.

Tags: hairloss, hair loss, dupa, dandruff


I am experiencing hair loss in the crown of my head the size of a quarter. I am an african american woman. When I keep my hair braided with no chemicals, the hair grows back, so I know that it has the ability to grow. When I put a relaxer on my hair, I experience itching from within in only one area, then a month or so later the hair will fall out, but it only comes out in the same area. Could I be just allergic and sensitive in only one section of my hair. What do you recommend?

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Yes, an allergy would be highly probable. It might also be a chemical burn. I have no suggestions other than speak with your stylist or your dermatologist.

Tags: allergy, chemical burn, hairloss, hair loss, relaxer


Dr. Rassman, hi again.

I’m a long-time follower and fan of your blog. Besides enjoying the quality of the information you share, I really admire your realistic and down-to-earth approach when making comments about new treatments and current research. Some people consider your view to be pessimistic but I find it downright sincere. Thanks for the great job.

My question today refers to something I find in your comments quite often: the idea that even if someone has been on Propecia for quite a while, he will eventually lose the battle against hair loss. Now, assuming my understanding is correct, Propecia will keep DHT levels low for as long as the patient takes it, correct? If that’s a fact, why do we eventually “lose the battle”? Is it because the % of DHT that is not blocked by Propecia is enough to eventually affect the hair we retain or is it because besides DHT, there are other root causes still unknown to us?

Thanks a lot, Dr. Rassman!

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Propecia generally impacts only 70% of the DHT by a process called competitive inhibition. This means that the drug competes with DHT at its receptor site. We really do not know much more about this competitive process, but we know that some people get great responses from the drug at the 1mg dose, while others do not. I think that the sensitivity of the receptors varies as the genetic process advances.

I have discussed apoptosis in the past, which is cell death, and this hits the hair follicles at the end of their lives. The drugs can not give back the life that the process takes away. Take a look at the various posts in the past that discuss apoptosis here.

Tags: propecia, finasteride, hairloss, hair loss, apoptosis


Hello Doctor,

I’m a 20 year-old male with what I consider to be a high hairline (7cms from brow ridge to hairline). I know it falls between the male average of 6-8cms, but I have rather effeminate features that cause it to look disproportionate.

I recently talked to a highly regarded hair transplant specialist in my area to inquire about lowering my hairline with a hair transplant. He told me that my hairline was fine, and if I did go through with a transplant it would look fake and I would be very unhappy with it. Is this true? Or is it just because of the risk of further balding later in life?

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Decisions like this are made between the doctor and the patient. As for whether any surgery would look fake, I suppose that depends on the skill of the surgeon. But if your doctor is recommending you not have a procedure, I’d defer to him. If you want a second opinion, I am unable to give you one over the internet.

I am generally averse to doing any hair transplant or hairline lowering process on someone who might be balding in their future. At 20 years old, it probably wouldn’t be in your best interest.

Tags: hairline, hairline lowering


Hello Doctor,

My question is: Ive been taking proscar 2.5 mg for a while with good results, after some time i felt that it wasnt working that good anymore. Regardless, one day i visited a local hair surgeon and after a brief talk about surgery the discussion moved on to hair medications, which he told me that i should switch to avodart (which he’s taking as well) so i did.

The first few weeks was awesome, after that i am experiencing major shedding which continued for the past 2 months (i’ve been on it for 2 1/2 months) so i dont know whether to switch back to finasteride or wait to see what happens with the avodart?

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Honestly, you need to ask your doctor. This is a prescription medication that I did not prescribe to you. I can’t tell you whether you should switch between medications. Sorry.

avodart, dutasteride, finasteride, propecia, hairloss, hair loss


Hi Doctor Rassman,

I’ve been trying to make sense of all the internet literature that states that “Board Certified” by ABHRS is not technically certification by medical standards. What would be the difference if ABMS were to include ABHRS? Would that keep incompetency to a minimum or make me safer?

Other statements made by AHLA such as, “the AHLC uses remarkably outdated information that is dangerous so avoid them etc.” It’s hard for me, to get a real confident feeling, not knowing how to determine whether I’m safe in my decision.

Thank you very much for your time and professional opinion

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Hair transplant surgery is NOT technically certified by medical standards. In the United States there are 24 approved medical specialty boards that are overseen by the American Board of Medical Specialties (ABMS), a not-for-profit organization. Certification by an ABMS Member Board has long been considered the gold standard in physician credentialing. To be ABMS board certified means that the physician has undergone formal educational and clinical training at a medical institution after earning their medical degree, and has successfully passed a level of competence via written or practical or oral examinations. I (Dr. Rassman) am ABMS Board Certified in General Surgery and my colleague Dr. Jae Pak is ABMS Board Certified in Emergency Medicine.

Hair transplant surgery is not a part of the ABMS so there can not be any physicians that are board certified as a hair transplant surgeon. This is mainly because there is no formal training or credentialing in hair transplant surgery. There is no standard curriculum. There is no oversight or direct review of the quality of the work being done. Unfortunately, there is no ABMS sanctioned facility to enroll and learn hair transplant surgery. To date, the only way to learn how to perform hair transplant surgery is to read a book, attend a seminar, or become an apprentice to a private practice hair transplant surgeon. Even ABMS board certified plastic surgeons do not receive training in hair transplant surgery as part of their formal training.

In the mid-1990s the American Board of Hair Restoration Surgery (ABHRS) was formed by a group of hair transplant surgeons to create an organization that could independently certify hair transplant surgeons. But the ABHRS does not monitor doctor’s training quality and once the testing process is complete, they do not have any authority to enforce any form of discipline. In states like California, doctors are not allowed to call themselves “Board Certified” if the only certification they have is from the ABHRS or other non-ABMS approved boards. They must qualify which board they are claiming.

Tags: hair transplant, surgery, board certified, medical board, hairloss, hair loss


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