February 2006 – Page 8

February 16, 2006

Gynecomastia from Propecia – Hair Loss Information by Dr. William Rassman

Dr. Rassman, Are there any alternatives for someone who has developed side effects from propecia. I began to develop gynocomastia from it after three months and I am no win the process of looking for something else to slow down hair loss.

Also, thanks for having this blog!! You rock!

Gynecomastia (painful nodules that appear in the male breast) is a rare complication/side effect from Propecia. I believe that even Avodart has the same side effect. My heart goes out to you. Get a good Master Plan, which may be critical to defining what your future hair loss has in store for you. Minoxidil may help as well, but it usually does not stop the hair loss in the young man.

February 16, 2006

Fungus Caused Scar Tissue – Hair Loss Information by Dr. William Rassman

My scalp was infected with a fungus that since has been treated. I have bald spots now due to scar tissue. Can anything be done to regrow hair in these spots?

Fungus infection tends to be superficial, affecting mostly the hair shaft. However, when the infection is deep and untreated for a long period of time, then scars can form and the hair loss can be permanent. The inflammatory process of your scalp caused by fungus can be treated with a steroid once the fungus is irradicated. However, I am not certain if a steroid will help once scar tissue has been formed. Wait for a few months and look for any hair growth before attempting any treatment. Generally, I would give it 6-9 months before considering anything more radical.

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February 16, 2006

Caput Quadratum – Balding Blog

dear doctor,
i am a 21 year old with a naturally high hairline. when i was a baby i had a caput quadratum (if i spelled it correctly). but now its bothering me a bit because people keep asking me if my hair is falling off. what do you suggest? thank you

Caput quadratum is an irregular shaped skull resulting in frontal bossing or a prominent, sometimes square, forehead. It’s name implies a problem in newborn babies.

Using hair to change the appearance of the shape of the head is something that is worth considering. I have used hair transplants to hide skull defects in the frontal hairline by bringing it down, on the back of the head to make a flat skull appear rounded, and side of the head defects from brain surgery or accidents and I burn patients have had wonderful benefits from hair or scalp redistribution. Please send me some photos and let me know where you are and how to reach you by phone so that I can call you after I review the pictures. Anything we discuss will be kept private and will not be shared with my readership, that is, unless you specifically allow it. Please send your photos to the address on the Contact page.

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February 16, 2006

Actor Salman Khan and Hair Loss – Hair Loss Information by Dr. William Rassman

NOTE: I do not know who performed hair transplants on Salman Khan. I get many emails asking who did his surgery, and I have no idea. Sorry.

Dear doc,
Have you heard about Salman Khan, the most famous Indian actor? He is open about undergoing a hair transplant. Might help us if you have some information. Thank You.

ps: Thanks, you are doing a wonderful job which will earn you good Karma

I looked at his website and I did not see his present balding problem, so the hair transplant appears like a good one, at least from the pictures shown. I do not have any information on Mr. Khan, however.

Celebrities need image for much of the persona they create for their professional career. I have transplanted many of them in my Beverly Hills office so I am very familiar with the mind set and the importance of image on career. Some of the actors who were at the beginning of their career believe that the hair transplant was pivotal because of the confidence they got in themselves when they returned to their normal hairlines (at least their image of what they thought their normal should look like). It is difficult to be creative and free if you are bogged down with issues of self confidence and as looks are so important in the modeling, TV and movie business, I have found models and actors far more courageous and driven than the typical man who suffers from image in silence.

February 15, 2006

Taking Avodart While Starting a Family – Hair Loss Information – Balding Blog

I’m a 25 year old male with hair loss problems. I started to take Propecia about a year ago and then found out about Avodart. I started taking this drug about 3 months ago. Very recently, I found out that my girlfriend is pregnant. I want to know if through my sperm can my baby have birth defects?

I’m very scared of having a child so early in my life and finding out that it comes out with birth defects.

Please Advise!!!

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The issues of safety and effectiveness have not been fully explored in the youth like you with Avodart. Without that information in a research controlled, FDA approved study, there is no way to tell the answer to your question. Unfortunately, the manufacturer has not elected to sell into the hair market, despite the good blocking effect that Avodart has on the targeted enzyme. The FDA has certified this drug for prostate disease and I suspect based upon this, the drug should have no impact on the egg fertilized by the sperm of a man taking the drug, or when having unprotected sex during pregnancy.

Avodart (Dutasteride) blocks an enzyme called 5-alpha-reductase, which is necessary to change testosterone to another hormone that causes the prostate to grow. The effects of dutasteride have a prolonged half life, measured in weeks or months (which means it hangs around the body for quite a while).

Women who are or who may become pregnant should not take dutasteride or even touch dutasteride capsules, because it can cause changes in the genitals (sex organs) of male fetuses and this drug should not be exposed to children. It is not clearly defined if enough of the drug (or for that matter any of it) can cross into the woman through intercourse from a man who is taking it and it is even more of a stretch to think that it can be built up in enough quantities to reach the pregnant female and then the unborn fetus. With that said, every source I’ve read tells the doctor and patient not to use it in women who may become pregnant or who are nursing. Much of this may just be ‘protective’ language for the drug company, but I can not say for certain.

In any event, I do not prescribe Avodart for these very reasons. A cross over from Avodart to Propecia information may reflect on the same issues, except for the long half life of Avodart. For information on Propecia and pregnancy, please read:

Propecia and Pregnancy, is it safe? on HairLossTalk.com
Propecia and Pregnancy – Part 2 on HairLossTalk.com

February 15, 2006

Is Miniaturization at The Crown Considered Maturing? – Hair Loss Information – Balding Blog

If I have some miniturization at the crown and diffusely all over, this would not be considered a mature hairline would it?

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Miniaturization of hair (greater than 20% small or thin shafts) is considered balding, irrespect of its location. A mature hairline begins roughly around 1 finger breath above the tip of your frontalis muscle at the frontal area and about 1 1/2 or 2 fingers breath at both corners. If you have diffuse miniaturization all over your head, consider checking your permanent zone for miniaturized hairs. A condition called Diffuse Unpatterned Alopecia (DUPA) means that you have miniaturization all over your head including the permanent zone in the occipital area. In the classic male pattern baldness, there is less than 20% miniaturization in the permanent zone in men.

February 15, 2006

Woman with See Through Hair – Hair Loss Information by Dr. William Rassman

I am a 30 year old woman and I have always had very fine hair, even as a teenager. I am almost 100% certain that its genetic (thanks Dad!). I am also a type 1 Diabetic. After a fairly serious diabetes-related illness about three years ago, I’ve noticed my hair coming out when i wash or comb it. I don’t know if its because I’m getting older, because of my health problems or that I am just noticing it. My hair is so fine even when it isnt coming out that its possible even normal hair loss is very noticeable. I have no bald patches as such, but when my hair is wet you can see right through it and when i put it up i have to arrange carefully so that my scalp can’t be seen.

I am confused about the options available to me, especially if I’m not actually losing hair but just have very fine hair. Which treatments are suitable and effective for someone like me? I’ve read about non-surgical replacement, but I don’t actually have anything to replace.

Thanks in advance

Fine haired people have see-through hair. I’ve written about see-through hair in men before. The same applies to girls with fine hair (more-so with very fine hair), but keeping the hair longer and often in pony tails, may have hidden the see through nature of the hair.

You need to have a good mapping of your scalp to determine if you have genetic hair loss, diffuse alopecia, or other general hair loss problems. With your very fine hair, a real expert is needed to make the distinction. A hair system (wig) or hair additions will give you a fuller look, but the cost in terms of accelerating hair loss may be a problem, especially if traction is applied consistently.

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February 15, 2006

Straight Hair Styling Tips? – Hair Loss Information by Dr. William Rassman

I have very dry hair. I just had all the dead ends cut ( about 2-3 inches but want to grow my hair out long — it’s shoulder length now). I have wavy hair and only like it straight. Is it better to blow dry it straight or use a flat iron when it is dry. Also I have the wet to straight flat iron. What is the healthiest way to get straight hair? I use thermasilk and aveda hair emollient. Do these products help?

This is not a medical question, it is a styling question and you need to have a competent stylist work with you to do what works and what is safe and effective. Sorry, I can’t help you.

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February 15, 2006

Removing the Pluggy Doll’s Hair – Hair Loss Information by Dr. William Rassman

My boyfriend has hair plugs. He got them when he was much younger (he is 35 now and has had them for at least 8-10 years).

I really don’t like them, they have a doll hair look to them that is described on your site. He is starting to bald and thin in the back now. I asked him if he can shave his head and he told me he couldn’t due to the implants.

What are his options? We are both interested in correcting or bettering the situation. It is obviously a sensitive topic for me to bring up. I love him a lot …and want to try and find a way to improve his hair situation. I know he wants to as well.

Can you help?

They say great women are behind great men and great relationships. I admire you taking the helm and trying to help your boyfriend. The pluggy look is never good, and repair procedures reflects much of what built my practice in the past 15 years. The best way to answer this is to link you to Dean’s Story, which is a step-by-step account of one patient’s repair procedure, complete with photos that might be considered too graphic for some. It’s all in there.

Other resources that will help you and your boyfriend make an informed decision:

Article: The Art of Repair in Surgical Hair Restoration Part I – General Aspects of Repair and Basic Repair Strategies
Article: The Art of Repair in Surgical Hair Restoration Part II – The Tactics of Repair
Results: Repair Work Photo Gallery – Before and after patient repair photos

February 15, 2006

Nioxin, Minocycline, and Hair Loss – Balding Blog

I am 17 and noticed that my hairline has started to recede. My hair line has always been some high on my head but now that ive noticed some hair loss it doesnt look very good. I just want to know if something else can cause receding hairlines or is it just MPB. If it is MPB can propecia help me? Im going to see a dermatologist to get a referel for a hair specialist to get a miniaturization done. Also what are your thoughts on nioxin hair products? And last i would like to know if minocycline can cause hair loss?

The rise in your hairline may be the maturing process common in men between 17-29. It rises about 1/2 inch in the front and up to an 1 1/2 inches in the corners and this is not genetic hair loss. Nioxin makes a good set of products that are popular but there is nothing in it that will stop hair loss. Minocycline is an antibiotic which is often used in the treatment of acne. If you are being treated for that, are you taking other medications? Some acne medications cause hair loss. I need a better profile on you, but it sounds like you already have a good doctor so stick with him/her.

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