Month: October 2005

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Penis Dysfunction from Propecia? – Hair Loss Information by Dr. William Rassman

Hi doctor how are you, Thanks for your time. I have been using propecia almost 5 1/2 months and so far nothing has been happening positive way and there is some thinning .i have pattern 2 to 3 going for 3 soon. I am 28 years old. I have been seening this beatufil girl almost 3 months we are so into each other and last night we been together firt time but i had a major erection problem.Everything went so bad… i cant explain wierd feeling. This never happened in my life. It did feel really bad.Aspecial because it happened with her but i was wondering if i stop taking propecia this kind of side effect will be gone and how long after stopping the medication i can expect to get back to normal if it is caused by propecia. I know you cant have all the answer but according to your knowledge, could you suggest something else to keep up love life and control hair receding problem. Sincerly.

A poor erection may come from many causes. If you stop taking Propecia, the drug will be out of your system in just a day or two. If there is a relationship between this drug and your erectile problem, then it should disappear within a week. More men get an increased sex drive than a decreased sex drive. However, in your case it does not sound like you are having a sex drive problem, which is more frequently an observation with Propecia than an erection problem is. First, stress is probably the single most important cause of erectile problems in young men. Just the anxiety of performing well, in many men, can make erections a problem. In older men, what we call erectile dysfunction, is more common. This is easy to understand when you think back on your 16 year old penis, which may have had spontaneous erections as many as 5-20 times an hour. No man in his 20’s experiences that type of problem and as you age, your penis function changes and you may experience perfomance challenging symptoms. I would say that 20% of men in the 20’s, 30% in their 30’s, 40% in their 40’s and 50% or more above the age of 50 would complain about their penis function. Therefore, I would conclude that it is not a disease, but a fact of life; as the male penis ages, so does the man’s production of male horomones that drive it and the blood vessels that make the erection a reality. For most of the men without anxiety problems, those who take medications that impact penis or libido function, those with diabetes, or those with vascular disease, drugs that enhance performance of the penis are useful.

The initial benefits of Propecia usually take between 8-12 months, so it is important to be patient.

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First Steps to Hair Transplantation – Hair Loss Information – Balding Blog

I would like more information on hair transplantation. I am 20 years old and am already haveing a noticable amount of hair loss and receeding hair line. I want to soon rid this problem for good. Hope you can help.

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When a young man starts to lose hair, I perform a complete medical evaluation of the hair and scalp, trying to predict the final hair loss pattern. Sometimes predicting the pattern is not possible until you reach your mid-20s. Good medical treatments, such as Propecia, are important in the management of hair loss. The drug Propecia can slow down the hair loss, and even reversal may occur. Hair transplants in a 20 year old are rarely done. Get a good doctor to manage the problem and diagnose where you are going before you jump into the hair transplant process.

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Where Does the Hair Loss Gene Come From? – Hair Loss Information by Dr. William Rassman

I am 23 years years old and have been losing hair since a litte before I turned 20, but only in the form of a receding hair line. Aside from my fairly quickly receding hair line, the rest of my head, including the crown, remains covered with thick hair. Would taking Propecia be a waste of time at this point since it supposedly does not help in the temple region? Should I just wait until I start losing hair on the top and crown of my head before I start taking it? Is there anything I can do to slow the progession of the receding hair line? Also does the hair loss gene come soley from one of your grandfathers, or is the state of your hair a result of a variety of genes from one side of your family? I ask this because one of my grandfathers died with a full of head hair in his late 70’s and one was completely bald in his thirties. Given that I am experiencing hair loss at such an early age it is obvious that I am taking after the side with the balding grandfather. Does this mean that I’m undoubtedly destined to suffer complete hair loss if I do not take action? Thank you.

If you are losing hair now, you should start Propecia now. The longer you wait, the worse the genetic toll will become if you are prone to it. You will not bald any further than your genetic pattern, but alas, no one knows the genetic pattern of anybody until you finish balding. A good doctor can do some estimating based upon the degree of small hair (miniaturized hair) in the areas that to your naked eye look normal. Many times what you see is not what is really there.

We can inherit it from anyone in either side of the family, male or female. The gene can skip generations, so sometimes people can not identify a balding person in their family. If you take after one of your family members in pattern and age of loss, it is more possible that you may be like him. There is no way to determine that final pattern, as I said above, but you can control it if you treat it with Propecia early and then get transplants to return what was lost. Between the two, people are often able to control what they look like.

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Female Hair Loss – What To Do? – Hair Loss Information by Dr. William Rassman

i am a 47 year old female experiencing hair loss. My mother has thinning hair at 73.

My history… Back in my early 20’s I experienced hair loss after moving far from home and leaving my parents…. Hair grew back after a while. Started thinning in early 40’s…would shed quite a bit and then it would seem to thicken back up. 2004, went through bad divorce and began experiencing thinning more rapidly…. after a year it got a little better.. I am under alot of stress and it has started thinning rapidly.

I went for consultation to hair transplant facility and had committed to transplant in another city where their was a surgical facility but after doing some reading and research I backed out. I don’t know what to do. I think I should locate a doctor who specializes in hair loss to see if some of this is from stress or other medical condition. I have been on bioidential progesterone treatment for 5 months…don’t know if that could be part of it…

My question is ….should I seek medical attention 1st to rule out any medical cause… I feel I’m the only woman who’s going through this.. I appreciate your input.

I am under the impression that the person you visited who recommended a hair transplant was not a doctor. If so, then it sounds like the hair transplant recommendation was only a salesperson wanting to make a sale, and they may not have had your best interest at heart. You need to see a doctor, a good doctor. A dermatologist is often the best and hopeffully you will find one that is knowledgeable about hair loss in women. What you are describing is female genetic hair loss which is the cause in 70% of females with hair loss. The medications you are taking may be contributing to the loss. A hair transplant for you, without understanding the process, is absolutely the wrong thing to do.

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Hair Loss InformationTestosterone Causing Female Hair Loss? – Hair Loss Information – Balding Blog

I have noticed this last year that my hair has receded DRASTICALLY.I am a 47 year old woman and have been taking hormone replacement for the last 8 years…Could the testosterone that I take monthly play a part in the hair loss because the testosterone makes hair grow in other places…several other places. I am so shocked and embarresed by my hair loss….the only place that it is recedeing is at the hairline on both sides and it is so so noticeable…please advise me as to ANYTHING that I could possible do to stop this or correct it. I am in a very desperate need for some help.I am a healthy, active, and am told a attractive woman and I run 2 Communictation’s business that demand that I deal with the public & I can’t stand this. I have plenty of hair everywhere else. Please advise me. I will await a reply from you. I am sending some picturs that were taking about 6 months ago…it wasn’t as bad then but it is now.
Thank You

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Testosterone is a known cause for female hair loss in women with a genetic predisposition to genetic balding. Testosterone is broken down to DHT, and DHT is the other male hormone that promotes genetic hair loss in those patients. You also sound stressed, and stress in these predisposed people adds to the hair loss problem. I always tell men that there are 4 causes of male pattern loss: (1) genetics, (2) male hormones, (3) stress and (4) time. If you are genetically predisposed, you have then all four of these. The use of DHT blockers may have value, but this medication is not cleared for safety by the FDA for use in women. Effectiveness is still an open issue here. Other causes of hair loss include: crash diets, tight ponytails/braids/weaves/extension (more common in African young girls), thyroid disorders, pregnancy, going on or off birth control and even a surgical procedure of any time which may include a general anesthesia. Get a knowledgeable doctor and talk to him/her about this answer.

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Avodart for Androgenic Alopecia? – Hair Loss Information – Balding Blog

Dr Rassman

Do you know for certain if GSK has dropped the idea of continuing Avodart studies for androgenic alopecia?

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I can not speak for Glaxo Smith Kline, a pharmacuetical company, as to their official or unofficial plans for the drug Avodart. They manufacture Avodart for prostate disease as the most powerful and most effective DHT blocker. In theory, it should work better than Propecia, but without a committment by this drug company to bring it to market as a hair loss drug, the FDA will not allow it to be sold for hair loss.

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Hair Loss InformationFUE Harvesting Limit? – Hair Loss Information – Balding Blog

What is the approximate limit for FUE harvesting, e.g. at what point does taking out individual grafts one at a time start to noticeably thin the hair in the back?

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The answer here varies with the many attributes of hair that include:

  1. density
  2. hair thickness
  3. hair character / texture
  4. hair color and contrast to skin

You can use possibly 90% of the donor hair if your characteristics from the above are good. If they aren’t, the actual number may be well below 50% of the donor hair before you start to look noticeably thin. We have had a few patients who have had as many as 25,000 hairs taken from the donor area without any detectability. These were fairly bald men or those who were perfectionist. I recently saw one of these men and even though the original donor density was reduced by significantly more than 50%, the donor area looked good, even under close inspection.

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Diabetic Taking Minoxidil – Hair Loss Information by Dr. William Rassman

I am 30year old man having diabetic problem. I have heavy hair loss problem and I would like to take minoxidil..shall i take minoxidil directly.. Will it cause any problem for my blood sugar level.

How about minoxidil? pl, advise me… Is minoxidil is the only solution for regrwoth of the hair? Is there any other pills we can go along with minoxidil to strenthen the hair..

All diabetics should speak with their doctor about the use of any new medication. Minoxidil was originally manufactured for the treatment of high blood pressure in the 1960s. Some people report drops in blood pressure using it for a short time after its use. In a diabetic with vascular or heart disease, such effects can be dangerous.

Propecia, on the other hand, blocks DHT and should have no impact on a diabetic. It also works more reliably than minoxidil, but requires a doctor’s prescription. Don’t be your own doctor. If you are a diabetic, I would guess that you already have a good doctor, so please use him/her.

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Hair Loss InformationRepairing Pluggy Transplant (with Photos) – Hair Loss Information – Balding Blog

around 1989 at the age of 20 I had a hair transplant , had approx 12 grafts put into each of my temporal areas as I was beginning to notice some receding. These were the old style plugs, my hair has now receded beyond these, so now I pluck hairs from the plugs to prevent the doll hair look. The problem is that the plugs are noticeable, they are hypopigmented, they are relatively smooth and level. What do you recommend? I would prefer to avoid any more transplants. Is there any procedure to give me a more natural appearance? Would dermabrasion work? Could the Relume laser restore the pigmentation? Any and all info would be greatly appreciated. Thank you.

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I have written extensively on the issue of repairs and published these writings in a prestigious peer reviewed journal. This publication has become the standard for repair techniques in the field.

What you asked is important to people like you and others. Generally, there are many approaches to the problem. First of all, most people in your situation have lost trust, so trusting another doctor to do surgery on your is often the most difficult step. Even patients who come to me because of my reputation or due to referrals from other repair patients I have helped, come with an ingrained mistrust. There is a reason for the old cliché, “once burned, twice shy.”

With that said, the other problems that you must face are how much time it will take to fix the problem, how many procedures, and how much it will cost. A reasonable goal should be to complete the process in one to three surgical procedures, depending upon how bad the problem is. The third and most important issue that must be considered is the end result – what is the likelihood that the problem will be fixed and gone? To address your questions, I would start by giving you an example of a recent patient I did. This is his second surgery and I would expect that it will be his last with a certainty factor of nearly 100%.

You also have a special problem, with the ‘plugs’ placed in the temples. These are best treated with removal. There are many ways to remove them, but the key is to make sure that the removal process does not leave you with bad scars that are as bad as the plugs.

This patient I am about to show, is a story that is best told by pictures. His problem is similar to yours, without the temple transplants.




Set 1 (above) shows his before picture with the plugs in clear view.




Set 2 (above) shows the shaved version of set one.




Set 3 (above) shows his photographs 6 weeks after the excision surgery that removed two rows of plugs. Note a very fine line reflecting the surgical excision.




Set 4 (above) shows the pictures the day after surgery where 2800 grafts were transplanted into his frontal area. This 2nd surgery with NHI to repair his hairline should be his last. As his final result will not be in, I want to show you another similar patient, whose repair procedure was documented for our website: Dean’s Story.

I know you want to avoid more transplants, but you should think twice about that because this is a well proven technique for repairs and it will get you the normal hair that you always wanted. Any hypopigmentation is dealt with through the excision and fully camouflaged from the transplant. You can, alternatively, remove the plugs either as an excision or through our FUE technique, one hair group at a time. Repigmentation will require more surgery with less certainty in the end result, than the approach I showed above. Dermabrasion does not work because it tends to produce more hypopigmentation. Lasers leave more hypopigmentation as well.

I did note that you are from southern California, therefore a visit to us in our Los Angeles office would be relatively easy. Come to our open house and meet some of these patients yourself. It is a little last minute, but there is an open house tomorrow in LA from 12pm-2pm. That may get you the confidence you need. Keep in mind that my goal is to keep your cost and the number of surgeries down, getting you to look like a normal, hairy person. That, I believe, should be your goal as well.

More repair before and after photos can be found here: Repair Work Photo Gallery Errors: http://baldingblog.com/photos/051007_before1.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before2.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before3.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before4.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before5.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_before6.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_6wks1.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_6wks2.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_6wks3.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_post1.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_post2.jpg is not accessible or supported filetype.http://baldingblog.com/photos/051007_post3.jpg is not accessible or supported filetype.

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Hair Loss 1 Year After Pregnancy – Hair Loss Information – Balding Blog

I am 32 years old & had my 3rd child 1 year ago, in August. Approximately 4 years ago I was treated for multiple symptoms of malnutrition from losing too much weight too fast. Ridges in my fingernails, major hairloss, hardened areas under the skin on my face & finally an MRI was ordered for an orange sized induration on my hip- it was negative. I got the issue under control & resolved all of these problems. I gained nearly 100lbs with my last child & now a year later my hair has begun to fall out at an alarming rate. I am not dieting & have slowly lost some weight from the pregnancy but in a healthy way. I take no hormones or birth control & I am not on any other meds. I am also in nursing school clinicals which I started 5 days after the baby came. Would I be more likely to suffer hair loss, having a history of it, than I would normally be, related to stress or diet? With it being a little over a year since the birth, I didn’t attribute it to post-baby hairloss, could it be? Thanks for any advice you may have.

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You have many variables here which are hard to put together. You clearly recognize that hair loss can occur with pregnancy along with malnutrition. You also recognize that pregnancy hair loss often reverses after a year or sometimes two. I would ask for many tests to rule in or out a series of medical conditions such as thyroid disease, which does start post-pregnancy in some women. The relationship with these hormonal diseases can also cause hair loss, particularly when combined with the genetic predisposition for female genetic hair loss.

Be sure that you are evaluated by a good generalist doctor first, then get your hair graded for miniaturization and patterned hair loss. These may fit together to point or narrow down the possible diagnosis. Start with a good, well-trusted doctor who cares about your overall well being.