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Hello. i’m 23 and had a 2000 graft procedure in new york on july 1st 2005. its been about 6 months and some weeks and i havent seen the dramatic results i thought i was suppose to see. I asked the doctor and he says its early and everyone is different, just wait and be patient. What do you think? I “feel” some hairs growing in different spots but not everywhere, and i have some slight cobblestoning, does that go away?
Thanks so much

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I always tell my patients to wait a full 8 months before judging what the results look like. At 8 months, 80-90% of the transplants should have grown and much of them at styling length of 2 inches or so.

Be patient and wait it out. Significant changes will probably be evident in the next few months.


Hi i recently sent you a question about waxing. [see Hair Regrowth After Waxing Scalp]

For some reason the waxed area appears worse. I am worried that I may have developed folliculitis on my scalp as a result. My entire scalp itches. It would be helpful if you could give me some information about folliculitis as well as the differences if any between folliculitis and folliculitis decalvans. Also it would be helpful if you could tell me what to do to contain the hair loss to only the waxed area basically prevent it from spreading.

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Folliculitis is a condition where the hair follicles get infected because of bacterial invasion, often secondary to some irritation or wound of the skin. Folliculitis can spread from one hair follicle to another by touching or scratching it, making it worse. It is a fairly common condition.

Folliculitis Decalvans is a rare condition affecting mainly the scalp leading to scarring alopecia. The cause of the condition is still unknown, abnormal host response to Staphylococcus aureus (a bacterial infection) has been postulated. Folliculitis Decalvans causes scarring with hair loss (alopecia). There are areas of “corn stalking” (grouped hairs arising within the area of alopecia), redness (erythema), crusting, and pustules. Due to severe scarring, permanent hair loss occurs in the involved sites.

As you may be aware, this is a diagnosis not for the amateur. Get a good dermatologist to take care of you, starting off with a proper diagnosis. Appropriate antibiotics will be recommended by the doctor, if indicated.


i need your opinion concerning the placement technique of DHI Greece group.

i had a transplant with famous doctor in Australia, he is very good in FUE (body & head) but the placement is not good & transplant hair nature is changed. i think his way with washing hair not before one week of tranplantation is not good for hair, i need your opinion for that.

i think you are the best doctor in this field but i have 2 problems to proceed with you:
1- getting the VISA, my application was introduced from 18 months & there is no answer. i know this is not your fault, but this is the situation
2- i am Norwood 5 to 6, i prefer to use BODY HAIR & untill now you do not proceed with this option

finally thank you for this valuable website, i know everydetails of hair transplatation & made me have standard for quality procedure

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Thank you for the faith that you expressed in my skills. To answer the first part of your email about DHI, please take a look at FUE / FIT — Minimally Invasive Hair Transplants.

It sounds like although you did your research, the “Buyer Beware” axiom still failed even after considerable research. If you are a Class 6 pattern balding patient,l the best and probably only real good source of donor hair is from the back and sides of your head and you need to exploit this first before you consider body hair transplants (most people never need them). You have clearly recognized that the art of placement is critical to the final result, which is something that many people do not differentiate from medical clinic to medical clinic. As the inventor of the Follicular Unit Extraction (FUE) technique, I know that it is not always the best procedure for those who are extensively bald. I personally think that you must focus upon the quality of the transplanted hair, and body hair does not have that same quality or quantity as head and scalp hair. Performing body hair transplants will produce a poor quality hair transplant (when compared to a good transplant with scalp hair), which may be what you are observing and blaming on your shampoo and washing technique.

Please send photographs to the address on the Contact page as a starting point of a dialogue.


My maternal grandfather was bald and my father, who’s almost 60, has substantial thinning around his crown and a receded hairline. I just turned 27, and I don’t seem to have much if any thinning. The temples of my hairline have receded an inch or so in the last couple of years but everything else seems to be in place.

How long can my luck hold out? I have plenty of friends my age who have already lost substantial hair but I have not even though I’m certain I’ll lose substantial hair because of genetic inheritance.

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As a general rule, you may follow your family pattern not only with balding but with the onset date. When did your dad start balding? You can have your scalp mapped out for miniaturization to see if you have early signs of genetic hair loss, but if you do not see it, I would not even go that far.


Hey. I’m 20 years old and I have also had a further back hairline, but only on the side. it looked fine. A year ago i asked my doctor about it because it was a little thin on the right side and he prescribe propecia. Well i had been taking propecia for about 8 months every other day, when all of the sudden my hair was coming out like 15 hairs at a time. when i ran my fingers through my hair tons came out. I lost about an inch and a half on my hairline in 2 to 3 months. My hairline was fine before but it was just thin on the right side. It crazy its bother me alot. So i quit taking the propecia a little less then a month ago. I mean i cant even grow facial hair. so it feels weird that im losing my hair. PLease help. Could this be temporary?

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Dealing with someone like you over the internet is very difficult or almost impossible. As I have said many times on this blog, you first need a working diagnosis. Getting your hair and scalp mapped out of miniaturization should at the least establish a proper diagnosis. Having someone with my experience, for example, is critical in making the judgments you need. Questions that stand out for me include:

  1. Are you going through accelerated hair loss?
  2. Do you have other causes of hair loss?

I would want to go through an extensive history on your overall health and the family tree in terms of balding, hair growth (when and where), etc. Get a good doctor and do not treat yourself. It has been said that “A person who treats himself, has a fool for a doctor”.


Hi Dr. Rassman,
I started using Rogaine almost 2 months ago. My hair was getting very thin and each year I had less hair. Before using Rogaine, I never saw a hair in my shower drain, but somehow I was losing hair. After using Rogaine, my hair loss did not get worse in the first 2-3 weeks, but now, after almost 2 months of using Rogaine, I noticed a lot of hair in my shower drain every day. what shoud I do now? should stop using it? or should continue? I use twice a day, a little more than 1ml of 5% Rogaine.
Thank You

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Shedding of hair may occur shortly after starting Rogaine. I would suggest that you ride out this phase considering the short period of time.


I’ve had Laser treatments to remove the hair on my back and reduce the hair on my chest. I now have very little hair on my back and less on my chest.

Recently I’ve had a CATSCAN. My lymph nodes are irregular and I’m having a biopsy. I’ve been told I may have to do chemo.

I’m aware I can lose much of my hair during these treatments. I realize this is usually temporary. Will this have an effect in reversing any changes made by the Laser on my back and chest?


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If the laser succeeded and the hair on the back and chest has been gone for more than a year or two, then the chemotherapy should not impact any regrowth of the body hair that has been removed. The reason I am saying this, is that laser hair removal (when it succeeds) kills the ‘root’ of the hair so that it will not regrow. As you probably know, the laser is about 50% effective at killing each hair, so after one treatment 50% of the hair will return within a few months of the treatment. With each successive treatment 50% of the treated hair dies, so after the second treatment 25% returns, and after the third is 12.5%, then 6%, then 3%, and so on. This assumes that modern hair lasers are used.

Your head hair (if you lose it with chemotherapy) has not been killed off, but rather a chemically induced telogen process will have been precipitated. Chemotherapeutic agents go after the faster growing cells of the body (cancers, hair, certain blood cells, sometimes intestinal cells) and that is the common thread that produces the side effects you may experience with such agents (anemia and white blood cell depletion, bleeding from depleted platelets, diarrhea and nausea from intestinal cell impact). The telogen process from chemotherapy is in the hair follicle and it usually reverses in a few months after the chemo stops. The drugs used vary and not all people lose their hair with some of the chemotherapy agents. Some of the newer chemotherapy agents are more targeted at the cancer and some of these other fast growing cells may not be impacted.


Dear Dr. Rassman

I am 33 and suffered from depression and anxiety attacks over a period of years and took numerous antidepressants including Zoloft and Surmontil. In addition I took sedatives such as Xanax and Temesta. During that time I did not notice any hairloss, even though I experienced a huge amount of stress. I am on the way to recovery now and stopped taking the antidepressants over 6 months ago and am weaning myself off the Xanax. For the last 6 months I have been experiencing mild hair loss, especially noticeable on the front hairline. Gaps are appearing in the hairline, which was normally full. I wash my hair about 4 times a week and comb my hair when washing it. In total I notice about 20-30 hairs on my hands and comb every time, which I never did before. I have no family history on either side of baldness. I have the following questions:

1) Is it possible that I could be experience temporary hair loss as a result of a history of using antidepressants and huge stress, and am having something of a delayed reaction? If so when can I expect hair to start growing back, if at all?

2) Does hair generally become thinner and recede in any case with age?

3) How can the loss of 50-100 hairs a day be normal? It seems like such a huge amount. Even given that new hairs are growing, that is around 30,000 hairs a year.

Thanks for any advice.

Kind Regards

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Stress and antidepressent medications can cause hair loss. In some people, the hair shafts become finer (rather than coarser) and develop less densities of the hairs themselves with age. Most people lose about 100 hairs per day and they grow back about the same number of hairs each day.


Does hair age?

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Of course hair shows the effect of aging and it will often change as we get older. Look at the huge crop of large diameter hairs in the ponytail of a twenty two year old women and think of the meager, thin hair of some 80 year old women. Hair often gets smaller in diameter and fewer in number as we age.

The process of getting finer shafts (or lower densities of the hair) with age occurs insidiously over many years, starting in some people in their early 20s (male and female) and progressively becoming more frequent with each decade. We just notice the changes when we look at an isolated 80 year old in a nursing home and we think ‘Old’. The medical profession calls this type of thinning ‘senile alopecia’ (doctors have to use some Latin to create a medical mystique to it). Most people will notice that their adult hair changes in character as their age advances. This change in character may be from wavy to straight, or from thick gorilla hair to a see through appearance where the scalp can be seen in reasonably bright light (htat may never have been the case in that same person when they were 20). I would suspect that the thinning of hair densities occurs in fully 1/3rd of the adult population (male and female) at some time during their lifetime and I see this process in some men who are in their early 20s, which we now call ‘diffuse unpatterned alopecia’, yet another abuse of the latin language of olden days.

By Drs. Jim Arnold and William Rassman


Dr. Rassman,
I am 23, and have had diffuse thinning for the past three years. I am currently taking propecia and minox and have been for 15 months. During that period, I have not noticed any significant regrowth, but the appearence of my hair has seemed to maintain to some degree. I am also a law student and in December I had my first set of finals. During that time, I can honestly say that I was more stressed then I have ever been in my life. Since december, I have noticed that my hair has appeared to thin significantly.It used to be thin only in the back, now I can see a thinning pattern in the front. Additionally, in the month since finals ended my libido and sex drive have significantly increased. I do not know whether that increase is due to my lack of stress, however I am speculating that the propecia has stopped working for me. I was wonding if these are typical effects if it does stop working; i.e increased thinning and greater sex drive or perhaps I can attribute both the my level of stress and current lack there of. Any help would be greatly appreciated. If propecia has stopped working for me, then I really don’t know what else I could do

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Stress impacts everything in our lives. Your hair loss and thinning is certainly (assuming you have genetic hair loss) being made worse by stress. Propecia sounds like it has slowed or stopped the present hair loss, but as male genetic hair loss is a progressive process, it is only a matter of time until you notice more thinning/recession. The sex drive issue relates to many things. Men can find sex to be a good outlet for frustration and hiding from problems. Propecia can initially cause an increased sex drive due to the increase in testosterone levels, but the sex drive of a man your age should already be high, so perhaps your body is just learning to deal with the stress better. Could it be that your normal sex drive is what you are now experiencing?

With regard to your thinning and possible genetic hair loss, you should get your hair mapped out for miniaturization to determine if the hair loss is genetic and to what degree it is progressing. You need a Master Plan for your future hair loss. As you are in Los Angeles, I would be pleased to see you myself at no charge in my LA office. If you are interested, please call my office at 800-NEW-HAIR to set up a free consultation with me.


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