Month: January 2006

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Switching from Rogaine to Propecia – Hair Loss Information – Balding Blog

Hello sir,
I am currently 20 and have over the past year and a half witnessed my hair line gradually recede. I am finding it hard to keep positive and confident, although it is not at an extreme. I am in constant fear of what the future could hold. There is no sign of baldness on my mother’s side yet my father and my grandfather are both completely bald. My brother who is only four years older than me started wearing a wig at the age of 21. I am not completely sure of what kind of level baldness he is at but I’m sure it’s not pretty. I fear that I am to walk the inevitable genetic path placed in front of me, which is getting me rather down.

I am currently using rogaine extra strength for men, which I’ve been using for around 5 months now and am still seeing a gradual thinning of the hair line and am not sure if it is working or not, or even going to work at all. I was thinking of perhaps using propecia, yet if I do I cannot afford to maintain using both treatments. I’d be very interested in what you’d have to say about my situation and whether making the jump from rogaine to propecia could have consequences.

Thank you very much.

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Propecia has been shown to have better results than Rogaine in treatment of hair loss from male pattern baldness in young men. You need to get your hair and scalp mapped out for miniaturization to have a proper diagnosis, so that your doctor can develop a Master Plan for your overall situation. Both Rogaine (minoxidil) and Propecia are good treatments, but the actions are different. As you have been on Rogaine for 5 months, I would hold off until you get the examination complete. Then add Propecia (assuming the diagnosis is confirmed and metrics are in hand), and then follow-up with another examination 8 months after to see where your hair loss is at.

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Hair Loss InformationAppropriate Amount of Grafts in Frontal Area – Hair Loss Information – Balding Blog

Dear Dr Rassman,
I am a 24 yo male who has experienced hair loss in the frontal region and am told that i am a Norwood type 4. I went to see a surgeon/dr in Australia. He told me that the best treatment was to have one large megasession and that he would use 2500 grafts on the frontal region. I am curious as to know whether this is an extreme amount in that region and your feelings on megasessions. I was also wondering that given my age how many sessions in my lifetime will i need and how frequently do people my age have to have more done. If i had a megasession would there be enough hair in my donor area if i did suffer more hair loss. Is there any way of doing a procedure, where you have existing hair, to transplant it to that area to prevent it if it was to fall out. Does one procedure in people’s liftime exist if they stay on propecia (which I am on, and doesn’t seem to be working that well).

Sorry for so many questions Dr Rassman. Thank you very much for your time.

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For a Norwood 4A balding pattern, 2500 grafts in a single session sounds like a reasonable number that might meet all of your needs, depending how large the area is. Most people have about 6,000-8,000 grafts available in their donor area, but the actual number may vary. That is why we measure everyone’s density to determine a Master Plan for the worse case scenario of hair loss. Your age is a bit young, but if the pattern of loss is relatively complete and did not reverse after taking Propecia on a trial basis for 8 months, then a transplant could be reasonably done. Hopefully with Propecia that is consistently taken, the hair loss will at least slow or stop, stalling any need for further transplants for some time. Provided that you keep the work done to the frontal area, there is little worry about running out of donor hair for most people. I would discourage work in the crown at your age.

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My Son Has Been Losing Hair Since 18 Months Old – Hair Loss Information – Balding Blog

Hello Dr. Rassman.

My son began to lose patches of hair since he was 18 months old. Doctors say that can be due to stress or Alopecia Areata. His father was diagnosed with that a few years ago and he was also told that his own father had it too when he was stressed. My son’s grandfather and father recovered their hair, but they didn’t begin so young. I am extremely concerned about this. My son has also dark lines under his eyes and is a very picky eater. The only thing he loves is milk. My son began losing hair in his top right side, it spread down then it happened in the left side, after that he lost a couple of patches on the back of his head, and now, he lost a big patch in the middle of the frontal part and the last is on the top of his head… Please give me your advice. Thank you very much.

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Alopecia Areata is found in family lines, like yours. The treatment of this disease must be done by experts who specialize in this. Check with a good Dermatologist for the appropriate referral. I have little to offer you via the internet for this problem.

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Propecia Linked to Male Breast Cancer? – Hair Loss Information by Dr. William Rassman

There was some reference in the 7-year Proscar study to a statistically significant increase in male breast cancer among the participants taking 5mg of Proscar daily.

Any thoughts or perhaps you have seen further research?

By the way, your visit from Jimmy and Adam on the “Man Show” was hysterical. You handled those guys with style. Well done!

Thanks for your comments on the Man Show. I fully enjoyed doing this as well as many other similar programs.

According to the New England Journal of Medicine (Volume 349:1569-1572 October 16, 2003 Number 16, Prevention of Prostate Cancer with Finasteride) there was only one case of male breast cancer in this study group of almost 19,000 men (see CNN article: Baldness drug may reduce prostate cancer risk).

Gynecomastia (breast nodules in men) is more common and is often painful when it occurs, but this is not cancer. There is no evidence that cancer is a risk, but if there is a history of breast cancer in your family, I might consider finding out if the gene for breast cancer susceptibility (BRCA1 on chromosome 17 and BRCA2 on chromosome 13) is carried in you (see Do We Know What Causes Breast Cancer in Men?). If you carry the gene, then you might avoid Propecia. The good news is that you can test for BRCA1.

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Can Toppik Accelerate Hair Loss? – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman
Again, thank you thank you thank you for spending the time to provide this blog. It is an oasis in the desert of misinformation on MPB. I have a quick question:

Can products like toppik / couvre and / or hairsprays accelerate hair loss? Are there any negative repurcussions to using such products? I havent noticed any accelerated hairloss but I use toppik and hairspray everyday and wondered if they could be damaging my hair in any way?

Aside from my concern, I strongley recomend toppik to anyone with thinning hair. I’ve found it really helps for cover up / concealing purposes.

Thanks Again

I totally agree. Toppik (color-matched keratin protein fibers) and hair spray (glue, basically) are excellent additions to any hair loss sufferer’s cosmetic arsenal. I also highly recommend trying different styles to maximize the hair that you have (one of the reasons women’s hair loss is underdiagnosed is because they take the time and try different tricks to camoflage it well). As for these adjuncts causing hair loss the answer is “No” – there is no evidence that these affect your loss in any way. Chemical hair loss CAN occur with chronically chemicaly treated hair, but these two products do not fall into this category so you can continue to use them without fear.

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Continued Balding After Hair Transplant – Hair Loss Information – Balding Blog

I have read a lot about mega sessions and micrografts, etc, and don’t doubt that they can produce satisfactory results if done properly. My question is: what happens as time goes on and balding continues in the untreated areas? I assume a patient would have to keep coming back every so many years to fill in the newly balding areas. How many times can someone go “back to the well” as it were. I am 43 years now, and have a receding hairline (especially at the temples). My concern is that when I am 60 or 70, I will look ridiculous with a perfect hairline but balding at the crown.
Thanks

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This is a good quesiton which I have answered in many ways before. Generally the hair loss for most people tends to plateau after the age of 35, and by the time someone reaches your age, the final pattern can be estimated by mapping out the scalp and hair for miniaturization so that you do not play ‘blind man’s bluff’ with your hair. If you will advance to a very balding pattern, then some of the hair in that pattern will be miniaturizing now, so it will be easy to see under high powered imaging.

If you take drugs like Propecia, it has several advantages, including reduction of the progressive nature of the hair loss, and probably preventing prostate cancer. Both are desirable side effects of the drug.

In most men of your age, chasing the hair loss is unusual. It is usually more of a problem with men in their 20s who get a transplant, are destined to become very bald, and who do not take Propecia. With a good Master Plan, you should never look ridiculous at any age after having a transplant, providing that you have the conversation with your surgeon and he/she is honest about his/her answers and not a salesman going for the cash that is your bank account and wanting it to be in his instead.

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Himalaya Hair Loss Cream – Hair Loss Information – Balding Blog

Dear Dr.Rassman,
I am 18 years old.I had a normal hair growth around 4 months back.I stayed in a place called shimoga and for the past six months,I am staying in bangalore pursuing my studies.I have been suffering from hair loss for the past 3 months.I wish to confirm that nobody else in my family is bald.I have a receding hair line and this is worrying me a lot.At present,I am using Himalaya Hair loss cream for the past one month.I even consulted a doctor and he said that it was normal at this age.Is the hair loss due to any diet deficiencies or due to change of water and weather as such?How can I regrow my hair and make it stronger.Please tell me how I can increase the density of the hair follicles.Please reply.Sir,I will send the photos within a week.I am losing approximately 60-70 hairs per day and the hair line has receded considerably.Please help

This is the hair loss cream I am using. http://www.himalayahealthcare.com/products/hairloss_cream.htm

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Himalaya Hair Loss Cream is another of the herbal medications for hair loss with lots of claims and no proof for its impact. The site does not suggest that there is anything new there.

It sounds like you are undergoing male patterned hair loss, but the loss of your frontal hair line may just be the maturing process that occurs in young men through the age of 29. Normal daily hair loss is between 100-150 hairs in the average caucasian, less for Indians or other Asians. Get your hair checked out first and stop the panic. Send me those pictures you were talking about to the address on the Contact page.

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Hair Loss InformationFemale Balding from Weave – Hair Loss Information – Balding Blog

My daughter is 18 years old. She wore a hair weave on a consistent basis for almost a year. This has resulted in her severe hair loss. She is bald due to hair loss on 70% of her head. I did take her to a dermatologist, and he has prescribed a steroid base ointment for her to put on her scalp. Currently, she is wearing a wig. This helps with the mental aspects of losing her hair. I would like to do more. The research that I am reading concerning her conditions says that her hair may not grow back. How can I reassure her that her hair will grow back? Do you know how long it takes for hair regrowth?

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Unfortunately, using a wig may forego recovery. This is a catch 22, which means that she might have to avoid wigs and let her hair recover first. The question is: Is her traction alopecia permanent? One may never know unless you give it 8-12 months. Be sure that the diagnosis is traction alopecia, for there are many causes of Female Hair Loss which need to be screened for.

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Contrast Between Scalp and Hair – Hair Loss Information – Balding Blog

Female – I have been thinning for years and as a result, have been bleaching my hair. My rationale is that this lessens the contrast between the scalp and the hair and makes the hair loss less noticable. Recently, I went to a new stylist who told me that my theory is false and that dark hair will make the hair less transparent and therefore less noticable. It’s been three days since she did my hair and I have to say that I think I was right. I think the new darker shade makes the hair loss more noticable. Am I nuts? Should I go back to being a blonde or should I stay a brunette?

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When the scalp and the skin are closer in color (white skin and blonde hair) the impact of thin, see-through hair is less obvious. Styling with puffed-up hair styles are popular in women who also dye their hair to get a fuller look. That is more of a styling issue. Don’t worry, you’re not nuts. If you’re more comfortable with being blonde, I’d say you should go blonde. Go with what you’re comfortable doing, and with what you think looks the best.

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Sex Drive and Erections – Hair Loss Information – Balding Blog

I am a 36 year-old male. I have been taking 1/5 of a finasteride (Proscar) pill daily for about 6-7 years. I have heard that Proscar can have harmful effects on male sex drive and erections — my question is, when this does happen, can it happen gradually or does it happen in the immediate days/weeks/months after starting the drug?

I ask because there has been a noticeable decline in my sex drive as well as the frequency and quality of erections over the years, and I don’t know if it’s normal for my age, or possibly due to the drug. I’m still quite functional sexually if I pick my spots, but those spots seem to be less and less frequent, and when I do get involved I’m prone to lose it unless I take Viagra beforehand (1/4 of a pill seems to work very well for me).

Please help! Would greatly appreciate any insight you can offer on my situation. I’m not sure but I think 36 is too young for this stuff.

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Every man over 25 knows that their penis does not behave like it did when we were 15. There is an interconnection between our erections and our sex drive. If our erection is not strong enough, if we do not last long enough, or recover fast enough, then what we may call erection problems (Erectile Dysfunction / ED) may become a matter of our focus. From the impromptu polls I have done in my mostly male practice, many men in their 30s find that Viagra improves their erections. Question: Does it improve from a 15 year old vantage point or a 36 year old vantage point?

Your “sexual problem” (I only used quotes because I am not sure to what extent there is a problem) may be ED or it may be caused by Propecia (but that usually comes within the first month of taking the medication, not after years necessarily). If you stop the Propecia for a few weeks, and the ED and sex drive goes away, then you can assume it was Propecia induced. You can check your testosterone levels; hopefully they will be normal. If you have some aging effect and you are satisfied with Viagra, then use it. There are doctors that specialize in ED, so if all alse fails, you can see one of them so if you go this route, you are best starting off with your family doctor. If you decide to stop the Propecia for 2-3 weeks, the drug will be out of your system in a couple of days and within a week you should see some benefit if it is Propecia related.