ProCede with Medical Conditions? – Hair Loss Information by Dr. William Rassman

I am a 47 y/o bm with mild hypertension and graves survivor. i have about a 2in spot near the rear crown of my head and thinning, curly, wavy hair on top. Can ProCede help me without aggravating my medical conditions?

See my previous comments about ProCede. I do not know what it does nor what you can reasonably expect of the product. On their website, they make a statement about their line of products being unsuitable for those that have had hair transplantation, but then they go on to add that it is non-toxic. If it is not for use by those that have had transplants, then it suggests to me that there is some kind of potential toxicity to it. I’m sorry, but I can’t reliably answer your question about using the product with a medical condition, but I do suggest you look into the ingredients and ask your doctor if these will cause you health concerns.

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February 7, 2006

Hair Transplants in Women vs Men – Hair Loss Information by Dr. William Rassman

I’m a 45 yr old woman who has been slowly losing my hair over the past 20 years. Currently, I have the typical female baldness (not completely bald, but lots of scalp showing through) just past the hairline. Blood tests revealed no thyroid issues, but I’m well on my way to menopause as far as hormone levels. I’m healthy as far as diet and exercise, have normal stressors in life, take no meds. There is no history of female baldness in the family, but my mother has always had thin, fine hair. I’m about ready to go the transplant route, but keep reading that it could be hormonal or vitamin based. My ob/gyn and dermatologist are both at a loss to explain it as other than bad luck. How do I know for sure if I’ve exhausted every avenue before resorting to transplants?

You must have the complete work-up of tests (see Female Hair Loss for info) and then get a good, caring, competent, and ethical doctor who understands when a transplant can help and what it will do for you. Setting realistic expectations is critical. Woman’s hair loss is very different than men’s hair loss with regard to the judgments and artistic distribution for transplantation. I use the metaphor that it is easier to make grass grow on an empty lot, than it is to make a green lawn even greener. Bald men scalps are like the ‘empty lot’ , so any hair artfully placed and distributed is easily appreciated. Women are more like the green lawn and making it greener is difficult as expectations may not relate to the reality of what the transplant will bring. That is why a choice in the correct hair transplant surgeon is so critical. You must be confident that the surgeon is going to give you transplants because it will help you, not just to put money in his/her pocket. Like all industries, the axion: ‘Let the Buyer Beware’, prevails.

February 7, 2006

Hair Mapping for Miniaturization | WRassman,M.D. BaldingBlog

Hair Mapping for Miniaturization

Feb 7, 2006/by William Rassman, M.D./0 /Favorites, Training

Dr.Rassman, What is hair mapping? I have a derm doctor. He did a biopsy that showed AGA. I am 59, female. I started taking Prempro again, with hope of keeping what hair I have. Who do you think I should see in the Orland Park IL. area? I have lost more than half of my beautiful hair! I am at the moment using steroid gel on the bald spots every day, I really value your opinion.Where do I go from here? I will travel any where…

P.S. My doctor loves your site/ He said he would follow your instructions!

Hair mapping means that a physician is using a densitometer or video magnifying camera to look for miniaturized hairs at multiple sites on your head. The percentage of miniaturized hairs and the thickness change in those miniaturized hairs will determine:

if a balding process is going on
the pattern of the balding process
over time and advancement or regression of the balding process

Based upon the many different published patterns of hair loss, the doctor can determine:

what pattern of hair loss you are demonstrating or probably evolving into
a look into your future hair loss based upon his/her experience with that particular pattern of hair loss as it conforms to the published patterns (e.g. Norwood Chart)
the overall health of the hair in different parts of the scalp

For example, if a man has extensive miniaturization of hair in the Norwood Class 6 pattern (under microscopic examination), he may advance to a fully bald Class 6 pattern (even if it is not evident to the naked eye). Miniaturization is looked at in two ways; first, the total number of normal vs miniaturized (narrow shafted) hair, and second, the degree of overall miniaturization on a per hair basis (e.g. 80% of the hairs are miniaturized with an average hair loss 50% of its original diameter). If, over time, the percentage of miniaturized hairs stay the same, but the diameter of the hair shafts increase to, let’s say, 80% of their original diameter with a person on Propecia, the change can be documented as benefiting from the Propecia, or reduced to 20% of its original diameter, indicating a progression of the miniaturization and a failure to respond to the Propecia.

For women with genetic hair loss, miniaturized hair follows very different patterns than for most men. For the transplant surgeon, it is critical to know the miniaturization that is going on in the proposed ‘donor area’, for if the hair in that area shows significant miniaturization (diameter reductions and the percentage of hair involved in the process), then most of the hair that is used for donor hair will fail to survive a transplant, because the miniaturized hair will not have value in the new location. As an example, if a woman needs hair in the frontal hairline but has 80% miniaturized hair in the sides and back of the head, then one would assume that 80% of the hairs that are transplanted will fail when moved from this donor area.

For the male patient who is going on Propecia, getting baseline measurements will tell something about the changes in the hair after a reasonable treatment period. An example of this would be: a young man who had 90% miniaturized hairs in the hair population from a balding area measuring a 3 inch circle in the back of the head. Let’s say he was started on Propecia and then 8 months later, the miniaturization came down to 50% of the hair in the circle. That means the drug is working nicely and some reversal of the impact of genetic balding on the 3 inch circle in the back of the head had responded to treatment.

So you can see that the value of measurements here are both for diagnosis (what is causing the hair loss and how bad it is) and prognosis (predicting the future with and without treatment). If measurements are not made, then there is no sense of control for the doctor or the patient and the cause of the hair loss can not be followed intelligently. Measurements are the foundation for clinical science. A patient with compromised kidney function gets a blood test to see the progress of the disease and the value of any treatments given. The electrocardiogram (ECG) measures the damage of the heart after a heart attack or predicts a pending heart attack. I can go on and on here, but basically, hair should not be treated any differently than other sick organ systems. There must be an end of the days when a doctor runs his fingers through your thin hair and says (somewhat magically) that he knows what is wrong and how to fix it, he knows that the density is good or you are not going bald.

Blood work will help rule out other causes of hair loss such as hypothyroidism, anemia, hormone imbalance, and malnutrition.

2006-02-07 15:43:292008-01-18 13:45:27Hair Mapping for Miniaturization

February 6, 2006

Hair Loss InformationDarker Hair Growing In After Transplants (with Photos) – Hair Loss Information – Balding Blog

Dr. Rassman:
I noticed that my hair transplants are not blonde like much of my head hair. You transplanted my head 1 year ago (1500 grafts) in the front and the hair has grown darker where the transplants are. Much of the other hair is blonde, that is, except my beard which has red hair. Now I have a three toned hair color. I can come to your office if that will help!

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(This patient subsequently visited my Los Angeles office; see photos below).

The transplanted hair came out of the back and sides where you hair is brown (today). This is the dense area that does not get sunlight and you clearly need sunlight to have the sun bleach out the brown color and turn it blonde. I call this phenomenon the ‘Summer Blonde’. My three sons are all Summer Blondes who have brown hair in the winter. When we met in the office today, you did tell me that the brown color was evident this fall, after the surfing season was over for you and you had to spend more time indoors. You then deprived your hair of the sun that it needs to turn to blonde. That is why the problem was not evident this summer when you ‘lived’ on the beach and in the surf.

The red beard is kind-of funny looking coloring, as long as you keep your goatee. If you like the three tones, then keep at what you are doing. The fact that you grew the goatee means to me that you like the red color. If you want that blonde color to show up all year around, you must either spend more time in the sun, or hit the bleaching bottle.

The photo on the left shows the brown roots of the transplanted hair in the center of his hairline; the photo on the right shows the blonde non-transplanted hair from the corner of his frontal hairline. In the summer, the area that is now light brown will become blonde like the hair on the sides. Please click the photos to enlarge.

February 6, 2006

What is Considered the Hairline? – Hair Loss Information – Balding Blog

So propecia helps the hair on top and vertex of your head but most of the time not the hairline. My question is how do you determine where the hairline ends and the top begins? Is there a certain measurement that is considered the hairline? Thank for your time Dr. I have asked alot of questions and everyone has been answered. I appreciate it very much! I’ll be in to your office sometime after I manage to get my butt out of Iraq.

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I would say the frontal area is roughly the first 3 inches above the highest crease in the wrinkled brow. The hairline should start about 1/2 inch from this crease. Propecia may slow hair loss down everywhere, but the drug is less effective in reversing it in the frontal area. There are exceptions to this rule: see Propecia Patient Results (with Photos).

On a side note, you have my support for what you are doing in Iraq. As you may know, I was in Vietnam and saw the dark side of war and the good side when I helped the people I treated in hospitals. In many ways Iraq and Vietnam were driven by similar ideals. Good luck.

February 6, 2006

NutriSol-RM from ScalpMed – Hair Loss Information – Balding Blog

I am using the hair growth product called NutriSol-RM. The Company that markets this product (Scalpmed) claims this to be a FDA approved product. I was told that this solution Vitadil-5a is all made of herbs.

However some of the ingrediants seem to be chemical in nature.

Is this product safe to use? Is this FDA approved product?

Appreciate your advise!

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I have commented before on this line of products, but I could not tell you if they are safe or effective. I took a look at the FDA registry and found no approval of any reference to this product or company. You may wish to contact the company to find out why they claim FDA approvals when none can be found and if I have failed to find the link for FDA approval, I would be happy to publish a reversal of my opinion from the research I have been able to do. If there is no FDA clearance for safety and effectiveness and that is claimed by the company, then the FDA could shut the business down. Many times I wonder why the government does not do this when so many claims are made by various companies that are clearly false and misleading. The answer probably is that the government prioritizes the degree of ‘evil’ that any one violation is and then the government factors in their costs and available manpower for enforcement.

February 6, 2006

Hair Loss InformationLower the Hairline Without Surgery? – Hair Loss Information – Balding Blog

I’m a fifteen year old guy that has a high forehead. I would like to know if theres any way to lower it without surgery.

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At 15, surgery is not really an option, unless there would be extenuating circumstances. The appearance of a lower hairline can be accomplished by shaving the front of your hair and putting glue to hold a wig in place. However, wigs produce traction alopecia (hair loss from pulling the hair), so using a wig will guarantee long term hair loss. I do not recommend doing this, but it is an option nonetheless. You might just have to learn to live with it. When you get to 30, if there is no male pattern balding that shows up, the lowering the hairline may be a good surgical option. You have a few years to wait on this.

February 6, 2006

Propecia, Paxil, and Erection Problems – Hair Loss Information by Dr. William Rassman

I am 27 years old and have been on Propecia for about 3 weeks (I am thinning at the top and crown, and just a bit of scalp is showing, but the balding process has started). I have also been taking Paxil for almost 3 years. Recently, I found that my erections have become harder to my maintain and are not nearly as hard or big as they used to be. This concerns me greatly.

If the side-effects are from Propecia, will they ever go away of I stay on Propecia?

Would a switch to Proscar make a difference?

I am weaning myself off Paxil, could this help?

How can I have both hair and erections?

Am I best to get off of Propecia and start to think about transplant procedures?

Thank you!

The effect of Propecia on sexual dysfunction may be temporary, but if they continue for more than a couple of months, then it may prevail. This would only be assuming that the Propecia is the cause of your sexual problem. You can stop Propecia for a month and see if it makes a difference, or you may want to cut the dosage of Propecia down to half a pill per day as an alternative to stopping it. Proscar (packaged in 5mg) and Propecia (packaged in 1mg) are the same medication, finasteride.

Paxil can cause sexual dysfunction which will probably subside, assuming that you can wean Paxil with the endorsement of your doctor. Your hair issue and your sexual dysfunction issue may need separate doctors. These issues are too important to try to solve by yourself.

February 6, 2006

Iron Levels and Hair Loss – Hair Loss Information by Dr. William Rassman

Dr Rassman,

I am a 27-year-old female who has experienced a gradual overall thinning for the past 10 years. It is now fairly severe. I have always had low iron levels and saw a hematologist for over a year. My ferritin levels have hovered between 14-35, despite taking a 325mg ferrous gluconate supplement daily.

My ferritin is currently 14 and my hematologist says that since the laboratory test range is 10-150, my levels aren’t so bad; that it would take anemia to cause hair loss. My B12 is also in the low range – 325 on the 200-1200 normal zone. I feel that I must not be absorbing iron if the levels haven’t changed despite taking a supplement and I am frustrated by wasting more time without being able to rule this out as a source of the thinning. My two younger brothers have male pattern baldness but I am loathe to accept genetics are to blame for me too…

My question is: how low do iron levels have to be to be considered a legitimate cause for hair loss? And how soon would regrowth occur after normal levels are restored?

Thanks so much for your time.

Anemia is a very broad topic to tackle. There are many causes of anemia, like microcytic anemia and macrocytic anemia. Microcytic anemia is caused by iron deficiency, thalassemia, and various chronic disease. Macrocytic anemia is caused by folate and B12 deficiency. There is no cut off level of iron that one can define as the starting point for hair loss. Ferritin & Vitamin B12 deficiencies may produce hair loss and anemia and they may accompany other vitamin deficiencies including the entire B group [Vitamin B1 (thiamin),Vitamin B2 (riboflavin), Vitamin B3 (niacin), Pantothenic acid, Biotin, Vitamin B6 (pyridoxine), Folic acid (folate), Vitamin B12 (cyanocobalamin)].

Have you tried to take iron with vitamin-C? Sometimes that may help to increase absorption of iron. Liver and red meat have high iron levels. Your doctor may have evaluated your GI tract for mal-absorption problems leading to some malnutrition or other vitamins and nutrient deficiencies, each which may contribute to hair loss. If the normal level of iron is restored, it may take a few months before you can see noticeable regrowth of hairs.

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February 6, 2006

Female Thinning Hair, Propecia for Women? – Hair Loss Information by Dr. William Rassman

I am a 57 year old female and lost almost all my hair on the top. I have some hair on the lower back part. Right now I am using Toppik and Couvre to hide my bald spot, but it is very hard. Can I use Propecia? Can women take it? My 25 old daughter, a 4th year medical student, has the same problem. She has seen many doctors (including Cleveland Clinic) but nothing helped. She applies 5% Minoxidil, and takes some Bl. Pr. medicine everyday but still she is losing hair fast. One doctor at IU Med School told her that she is not a good candidate for transplant therapy.

Can you help us?

If you want I can send our pictures to you.

There are many causes for women’s hair loss, such as hypothyroidism, eczema, alopecia, dieting, malnutrition, autoimmune, drugs, infection, genetics, etc. Since your daughter has seen many physicians, I assume that both of you have had numerous blood tests to rule out the many causes. Biopsies may be a next step, but your scalp and the scalp of your daughter should be mapped out for miniaturization. It would be interesting to see if the ‘map’ is similar for miniaturization by distribution, which would suggest genetic causes. Propecia is a very bad idea and not recommended for women. A biopsy of the scalp can evaluate if there is any inflammation process going on. If you would like, you may email your pictures to the address on the Contact page or come in person for a free consult to one of our offices in Los Angeles or San Jose, California.