November 2005 – Page 8

November 10, 2005

Fear of Propecia’s Side Effects – Hair Loss Information by Dr. William Rassman

hi doctor,
Iam 22 years old male and my hair has been thinning for about 3 years. I took many medications especially vitamins ( biotine B5, zinc, Durance, Nutri-cap,……….), only the zinc had reduced the hair loss but not the thinning. I used minoxidil 5% but I had an excessive dandruff on my scalp ( even Nizoral didnt eliminate it. I didnt try proprcia since to its sexual sideeffects and others bad feedbacks about sexual disfunctions ( btw my friend had a bad reduction in his libdo and a raise in testesterone)….. Any advice please professor to any alternatives to stop my hair thinning.
Thanks and I appareciate your effort…

Just because your friend had a decreased libido with Propecia, does not mean that you will. If you try it and you don’t like it, you can stop it at any time and the problem will correct in a week or so. It is the BEST approach to hair loss in a young man, and there are no other proven therapies that work as well on young men. Alternatively, you can become bald, but then it you do, transplantation will be your only recourse.

Try it; you might find that Propecia is not a bad experience at all. Very few of my patients tell me that they feel anything at all on the drug. Some reported an increased sex drive. Men are highly suggestive, so if you truly believe that Propecia will reduce your libido, then it might do just that.

November 9, 2005

Doctor Refusing to Prescribe Finasteride – Hair Loss Information – Balding Blog

I am a 23 year old guy. I have been using minoxidil solution for past 6 months. I keep my hair short coz i feel my roots will have to bear lesser weight. Minoxidil 5% once a day was helping me for 5 months, then suddenly since in the past month my hair has become rough and has started falling out again. One of the dermatologist says that you should use minoxidil for 3 months… then stop usage for 1 month… then again use for 3 months… then again stop for 1 month. Does this sound ok to you?

He is not allowing me to use Finasteride 1 mg, because he says it can give impotency problems. And I’ve been losing hair from sidelocks too. I never knew this happened in male pattern baldness.

My dad is bald. He became bald at 28 due to side effects of medicines, but he always had thinning hair. My mothers side… all have thick hair, but on my dad’s side, although people are not bald, they have very thin hair (and many have cancerous disease on my dads side). My doctor still maintains I have male pattern baldness. Is there a way to test if this is male pattern baldness or something else?

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I am having problems with your dermatologist’s opinions. All doctors have a right to a medical opinion, but I am going to take a contrary view to his recommendation, because what he is telling you is not supported in the literature. Finasteride (Propecia) has to be the best hair loss medication for a young man (read the many blog questions and answers on this very subject). The decreased libido sexual side-effect is relatively rare (less than 2%) and if it were to happen, you could stop the drug and the problem would be gone in a matter of days. I strongly disagree with his opinion on Minoxidil and Finasteride.

The diagnosis of male patterned genetic balding is easily made with a densitometer (magnifying instrument used on the scalp) which will show the miniaturization of hair in the balding areas affected by the ‘defective’ genes. Diagnosis is first and foremost in your overall MASTER plan for your hair loss. A good doctor needs to perform this test and then outline the plan with you.

November 9, 2005

Your Rights as a Patient – Hair Loss Information by Dr. William Rassman

[Note: Due to the amount of emailed questions that come in daily, I’ve asked fellow New Hair Institute physician Dr. Sara Wasserbauer to assist me. All questions that she answers are clearly identified as such.]

I thought I purchased a hair transplant session and paid for 3000 grafts. I counted the hairs on my head (now one year later) and I do not believe that there is 500 new hairs there, and that is a generous quess. What might have happened? Could I have gotten 3000 grafts and they failed to grow, or was I cheated, sold one thing and received something else? How do I tell the difference and what are my options if I were cheated? Are their ethical standards amongst the doctors?

Since I can’t see you to tell for myself (email and digital photos are no substitute for real life in a case like this), there are several things which you might consider;

Check the photos: The first thing you should do is to follow up with the surgeon who did your transplant. These are good questions to ask your surgeon and he should respond with a sincere concern and answers that appear targeted to your questions. Visiting with your doctor to compare your pre-operative photographs with your current hair growth can sometimes be an eye-opening experience. If your doctor’s office is equipped with a 50 power video microscope, you can often use that to help see the grafts next to the native hair (although if follicular units were transplanted it can be difficult to tell the difference in certain cases).
Be patient: Realize that sometimes growth can take up to 18 months. Most hair docs quote a year as the time period to have the final results (90% of the growth in) but it can take longer. I would want to know more about your post-operative course. Did you have difficulty healing? Are there other medical problems or skin conditions which you have that might delay growth?
Inquire at the source: When you speak with your surgeon, ask how the surgery went! If there is a problem with growth, most ethical doctors will not only back up their work but also want to know about it so they can pinpoint potential problems and make things right.

Lastly, there ARE ethical standards in the industry, such as those set by the ISHRS, in addition to those which encompass all of medicine. If you suspect a problem with your results, your first option for recourse is to deal directly with the doctor who did the work. Before you jump in to a legal battle, be sure to know where your previous doctor is coming from, then write back to us here and we can write the next chapter for you.

By Drs. Sara Wasserbauer William Rassman

November 9, 2005

Proscar or Propecia? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,

I’ve just started using Propecia, and Minoxidil 12.5%, but have seen that Proscar has much more of the active ingredient for the same price. Would you recommend Proscar, and how come if it’s so much stronger, and better value for money, it’s not as popular?! Also I read about one of the active ingredients in Minoxidil burning the scalp Is this true? If I’m using Proscar which is 5 times the strength of Propecia, do I need to worry about minoxidil at all? I don’t really like having to apply the cream every night anyway! I do appreciate your time, & look forward to your reply!

Proscar is the 5mg version of Finasteride and Propecia is the 1mg version of the same drug. They do cost about the same and both require a doctor’s prescription. Many people buy the 5mg dose and then split it up. That is not very convenient, but there is no medical reason for me to tell you not to do it. The drug company’s studies show that for hair loss, the 5mg dose is just as effective as the 1mg dose, but the side effects go up as the dosage rises. So if you elect to take Proscar, be sure to use a pill cutter to reduce the dose so that you do not increase the possible side effects of the drug.

Minoxidil does have skin irritation as a side effect, but if you do not experience skin irritation of more flaking(or some of the other side effects), then you can continue using it. The old saying applies: Try it, you might like it!

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November 8, 2005

Celebrating 500 Posts! – Hair Loss Information – Balding Blog

I just wanted to take a moment to thank all of the readers of this site, especially those that have written in with questions and comments. This site was launched in April, 2005 with the simple goals of answering hair loss questions and educating people about hair restoration- and while the blog has achieved great success in helping people, the growth it has received in just over 6 months is beyond what I had imagined.

A few new things worth pointing out:

Upgraded search. Now that there are over 500 posts here, finding what you want in the search could get a little tiresome. The updated search feature (in the top right of every page on this site) allows you to find what you’re looking for much faster than before. If you haven’t used the search feature before, I’d recommend that you give it a try, so that you can find the answers to your hair loss questions. If you HAVE used the search before, I hope that you find that the changes are for the better.
RSS feeds. Syndicated news feeds are a great way to get the latest headlines from BaldingBlog, without actually having to visit the site multiple times a day. Yahoo, MSN, Google, and many other sites are supporting these RSS news feeds, and it is definitely a great way to keep up to date. To find out more about RSS, please read here for a brief tutorial. It really is far easier than it may sound. In fact, there are links on the right column of this site (under “Syndication”) to make it easy to add BaldingBlog to your My Yahoo or My MSN pages.
Subscribe to comments. Now when you make a comment to a page, there is a checkbox to give you the option to subscribe to the comments. When someone posts another comment in that same blog entry, you will be notified via email. Please remember, the comment form under each blog posting should be used for discussing that individual blog entry. Unique questions should still be sent by using the Contact page, of which I usually will send you an email when your question is answered on the site.

I sincerely hope you’ve enjoyed the site thus far, and please remember that this site is updated every weekday with more hair loss questions and answers. If you’ve sent me a question that hasn’t appeared on this site yet, it will be posted as soon as possible. I’d love your feedback on potential new feature ideas for this site, or your thoughts on things that can be improved upon.

Once again, thank you for visiting.

November 8, 2005

Too Young For Transplant at 23? – Hair Loss Information – Balding Blog

Hello Dr. William Rassman,
I’m 23 and i have been seeing thinning of hair well in the past two years. i have been on propecia for two years, which did stop my hair loss to a certain level but lately im noticing more hair loss even on propecia. i had an appointment at a hair transplant doctor in the past week to go see if i can get a hair transplant. I saw a counselor, not a doctor who told me that no surgeon will perform a hair transplant on me because of my age. Me being too young, he said i have to wait till i go all bald. Can you help me or suggest me of any products, any new advances medications?

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It is generally true that young men under 24 should not get a hair transplant, but it is a crazy thing to be told that you have to first go bald. Generally, I judge everyone differently, make few rules other than protect my patients from me, themselves and poor decisions. Because I am not a salesman, I make judgments all of the time about the maturity of the person I am talking with, their ability to understand what a Master Plan for their balding is going to be, and their response to drugs like Propecia. I find immature 50 year olds, and very mature 20 year olds. As I get to know the person, I would not say that someone of your age can not get a hair transplant. Medicine and surgery are a combination of art, science and compasion. You need all of the benefits of this with a caring doctor while making your Master Plan. Then and only then, can your candidacy be determined.

November 8, 2005

Hair Loss from Finasteride – Hair Loss Information – Balding Blog

Hello Dr.Rassman,
Like one of your readers I too am experiencing a drastic increase in the hair fall. I am on finesteride since last 3 months and I am shedding heavily. I am significantly more bald then I was 3 months ago and the rate of shedding is noticeably higher then any at other point in time in history. Should I stop or continue. I am in double mind. I tried minoxidil and there was exceptional growth in my frontline( like I had in my teen age) but the hair were fuzzy and not cosmetically elegant. No more than 3mm in length but pigmented. The side effects of itching and red skin and dark circle around eyes were too much for me to handle so I stopped it. Can you please do some research tell me please if I should continue with finesteride.? Thanks

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It is possible that you are going through hair loss that would have happened anyway. Hair loss has not been a reported side effect of Propecia. I would suggest that you stay the course for at least 8-12 months. If you elect to stop it, then do so carefully and consider restarting the Propecia within 1-2 months if the hair loss continues. I’ve answered a similar question a couple of weeks ago: Significant Hair Loss on Propecia.

November 8, 2005

Female Hair Loss in Temples – Balding Blog

I have thinning hair at my temples. I am in the Army and have to wear my hair up everyday while at work. My hairstylist says that my hair will grow back once I stop putting it up. However, I will be in the Army for the next 10 years and am thinking about hairloss treatments for my temple area? Any suggestions?

If your hair dresser is correct and you have traction alopecia (hair loss from traction), then you can expect little relief. Whatever is causing the hair loss must be addressed by stopping the pulling. There are other conditions, such as triangular alopecia, where people lose hair in the temples from genetic causes. This is part of the differential diagnosis that you needs to have made. See a good doctor and discuss these two conditions with him/her.

November 7, 2005

Losing Hair Rapidly at 15 Years Old – Hair Loss Information – Balding Blog

Hi, i am 15 years old and im losing my hair rapidly. The only part of my hair im losing are the temple areas so my hairline looks like a big “M” also im noticing that the sides of my hair are thinning and receding also. Im not sure what to do i dont think its hereditary because my dad started losing his hair at 35 and all his younger brothers still have there hair and his one older brother started losing his hair at 40 so i dont think thats the cause of my hairloss. Im not sure what to do its getting really bad. It’s already receded about an inch and 1/4 on both sides. I do my best to cover it as much as i can but it still hurts my self esteem alot and i need a solution so can you please give me your opinion thanks

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I am not sure we are talking about the same part of anatomy (temples or corners). Triangular Alopecia is a genetic condition that causes people to lose hair in the temples, while corner balding and recession reflects more of the typical male patterned genetic balding. You need to see a good doctor and have a proper diagnosis made. The doctor should make a good microscopic analysis of your entire scalp. Most doctors can project this evaluation on a TV monitor and show you how far the miniaturization extends. The amount and scope of the miniaturization will demonstrate the balding pattern as it may unfold. You are far too young for transplantation, but as you’ve noted that you are based in the Los Angeles area, if you’re interested you can have a parent/guardian call 800-NEW-HAIR to set up a free consultation in my Los Angeles office, so that I may properly evaluate you.

November 7, 2005

Lyme Disease and Hair Loss – Hair Loss Information – Balding Blog

I have had Lyme disease and taken massive quantities of antibiotics. I am also 57 and taking a small amount of estradiol. I also recently (over a six month period) lost 12 pounds on a diet prescribed by my endocrinologist which eliminated foods I was allergic to (wheat and dairy). my hair has been falling out for about four months now. I thought it was due to the antibiotics, but I quit them three weeks ago and the hair loss is as bad as ever, particularly when I wash my hair-a handful! I am down to half my normal head of hair (and have also lost it on other parts of my body). Do you know of a good Alopecia doctor in Los Angeles who could help me. And, of course, what are your thoughts?

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I am in Los Angeles, so I’d like you to please pay me a visit. I can add other doctors to the mix that have the specialties to deal with some of the problems we identify. It sounds like many of the elements you discussed can contribute to your hair loss. Medications, hormones, weight loss, and some types of allergies all are known factors that by themselves can produce hair loss, but first, you need to have a good, caring doctor who will look at you as a person first, and with a desired head of hair second. I might not be the right one for the entire management, but certainly I am good to have on the team.

Call my office at 800-NEW-HAIR to set up an appointment with me. The consultation is free.