March 2006 – Page 4 – Balding Blog

March 28, 2006

Hair Loss InformationPropecia Side Effects vs Avodart Side Effects – Hair Loss Information – Balding Blog

1.If I use PROPECIA and report side effects, will the side effects occur with another 5AR inhibitor e.g. DUTASTERIDE?
2.Finasteride inhibits the enzyme 5AR.So we will have more testosterone in our blood. Why can sexual side effects occur?

Thank you for your time.

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If you have any side effects associated with finasteride (Propecia), you will likely have side effects with dutasteride (Avodart). Dutasteride has the same mechanism of action as finasteride, but it blocks 5 alpha reductase type 1 and type 2 isoenzyme. Finasteride only blocks the type 1 isoenzyme. Please note that blocking type 1 and type 2 isoenzyme does not necessarily mean it will work better. More importantly, dutasteride is not recommended (nor approved by the FDA) for use in Male Pattern Baldness (MPB).
Finasteride blocks 5 alpha reductase, which is an enzyme that converts Testosterone t0 Dihydrotestosterone (DHT). DHT is the hormone that has been linked with MPB. When taking finasteride there is a transient effect of more testosterone, but it is only temporary because your body has other ways of metabolizing the temporary increase in testosterone. Sometimes there may be sexual side effects (1 in 10 increase in sex drive or 1 in 100 decrease in sex drive), because testosterone is a hormone responsible for sexual drive (and many other normal body fuctions).

March 28, 2006

Medicines and Hair Loss – Hair Loss Information – Balding Blog

Can my high blood pressure medicine (Triamt/HCTZ tab 37.5-25) cause my hair to have breakage?

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Yes. Blood pressure medicines (and many other medicines) can cause hair loss. However, you should consider other sources of hair loss before focusing on a medication.

You should first be evaluated by your primary care doctor, because hair loss may be a symptom of an underlying medical problem.

A less than exclusive list of medications that cause hair loss are: allopurinol, arsenic, apirin, l-asparaginase, bismuth, bleomycin, boric acid, bromocriptine, carbamazepine, carbon monoxide, chlorambucil, chloramphenicol, cimetidine, colchicine, clofibrate, clomiphene citrate, coumarin anticoagulant, cyclophosphamide, cyproterone acetate, dactinomycin, danazol, diethyl carbamazepine, dipyridamole, doxorubicin, ethionamide, etoposide, etretinate, fenifibrate, gentamycin sulphate, guanethidine, heparin (telogen effluvium after 6-16 weeks ), hydroxychloroquine, ibuprofen, idoxuridine, indandione, indomethacin, interferon, iodine, isophosphamide, levamisole, levodopa, lithium, mepacrine, mercury, mesalazine, methisazone, methotrexate, methyl CCNU, methysurgide, metoprolol, mitomycin, mitrexantrone, morphine, nadolol, nafoxidine, nicotinic acid, nicotinyl alcohol, nitrofurantoin sodium, norethisterone, estrogens, oral contraceptives, para aminosalicylate, phenindione, phenprocoumon, potassium thiocyanate, procainamide, propanolol, selenium sulphide, sodium aurothiomalate, sodium valproate, spironolactone, sulphasalazine, tamoxifen, thalium acetate, thiamphenicol, terfenadine, trimethadione, troxidone, vasopressin, vincristine, vindesine, vitamin A, warfarin.

Sometimes I wonder if the hair loss side effect really occurs or if it is just verbiage that the drug companies put into their warnings to cover their legal ‘derriere’ in the event that it occurs. I so rarely see most of these drugs in action, so I am not really in a position to agree or disagree with what is published in the warnings posted on these medications.

March 28, 2006

Nioxin, Procerin, Bleaching, Laser – Hair Loss Information – Balding Blog

I am a 27-year-old black American male with European and Native American lineage. I have started noticing hair loss around 2 years ago. My hairline is receding in the corners of my scalp (starting the V) and I have noticed that the hair on top of my head is thinner (shorter) than the hair on the sides and back. Of course most other people don’t notice it but I think it is more so because either they don’t really pay attention or they want to say what they think I want to hear. I have started using Nioxin Shampoo and conditioner within the last month along with minoxidil on the top part of my head. I was wondering is this is a good solution or am I basically wasting my time. I use to take Procerin but I’m not sure that it ever worked. I still have a good amount of hair on the top of my head but I would really like to fill in the corner and make the top thicker. Also I want to bleach (maybe even dye) my hair and I was wondering would that accelerate my hair loss? Also, does laser therapy work? I just found this website today and I was really impressed with how genuine your responses seem. Thanks for your help.

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As I’ve said previously, Nioxin makes a good set of products that are popular, but there appears to be nothing in it that will stop hair loss. I’ve also commented on Procerin and laser therapy previously. Good starting points for blog posts about lasers can be found here and here.

Dying your hair, when done in the hands of someone competent, should not have a negative impact on your hair. As long as there is not any chemical trauma, your hair should be fine.

March 28, 2006

Inflammatory Scalp Disease – Hair Loss Information – Balding Blog

what is inflammatory disease on scalp ?? Is it different from male pattern baldness? I get lots of itching on my scalp…and directly entering norwood class 6… but my doc saw my hair under some glass which looks like a huge magnifying glass and said its male pattern baldness…

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Inflammatory scalp disease is when there’s an inflammatory process occuring in your scalp causing hair loss. There will be macrocyte and other white blood cells releasing histamine and other chemicals to cause the inflammatory process. The diseases which can cause skin inflammation are psoriasis, alopecia areata, eczema, a variety of autoimmune problems, or infections. This is different for male pattern baldness (MPB), because MPB is caused by DHT attacking the follicles through growth interference and not by an inflammatory process. Some forms of inflammation do not cause hair loss, so you will need a doctor to help confirm your diagnosis, which sounds like what your doctor was trying to do for you.

March 28, 2006

How Can I Be Assured That Treatment Will Work For Me? – Hair Loss Information – Balding Blog

I am 23 years of age and have a bald area in the front portion of my head. Many doctors who i have consulted told me that i have class 4 hair loss and can’t be treated by drugs. This may be true somehow because my hair started falling out from the age of 17 and i didn’t take a treatment then. Can you assure me that if i get treatment now, my problem will get resolved?

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“In this world nothing can be said to be certain, except death and taxes.” – Benjamin Franklin

I can stop here with the answer, but if you’re not satisfied please read on:

I can not assure you that a medication will work for your hair loss. In fact, no one can assure you that any drug treatment will work. You stated that you were seen by “many doctors”, which I assume included an examination, and were still told that your hair loss couldn’t be treated with medication, yet you wrote to ask for my opinion. I suspect what the doctors were saying in ‘doctor speak’ is that Propecia usually does not regrow frontal hair so a Class 4A balding pattern (where all of the hair in the front is gone), I suspect the hair will not regrow. In a 23 year old (without seeing pictures of your balding) I would assume that there is still some hair in the frontal distribution and that what hair is there is miniaturized. Miniaturized hair will often respond to Propecia to some degree in a young man, even if it is in the frontal area. Unless you try, you will not know.

I suppose I should be flattered to be thought of as a hair loss authority to give you assurance on a medication. If your scalp has been examined for miniaturization and you have a diagnosis of Male Pattern Baldness (MPB), medication such as finasteride (Propecia) may work, but there are no guarantees.

If you need another medical opinion, feel free to make an appointment with me.

March 27, 2006

Transplanting Animal Fur to Human Heads? – Hair Loss Information – Balding Blog

Bear

You mentioned joking about transplanting animal fur to human heads.

Why isn’t this possible? Only because of an immune response to the hairs as a foreign body?

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What animal did you have in mind? As if fur coats aren’t bad enough, what would PETA say?

You answered your own question — the body’s response to the hairs would prevent transplanting animals to humans (or humans to other humans, unless they are identical twins).

March 27, 2006

Hair Loss InformationTrying 15% Minoxidil – Hair Loss Information – Balding Blog

I am a 46 year old balding man presently at class 5. I have tried minoxidil up to the 12.5% concentration (Xandrox) but has not worked for me. I also have had one transplant session of about 400 grafts (not NHI) but most of the grafts are gone and obviously am not happy with the result. I just wanted to know if you would recommend my continuing the 12.5% minoxidil or even try the 15% treatment just to slow down the balding process and keep me from going to class 6 or class 7.

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Your question is troubling me. Transplanted hairs are permanant and very successful so if yours failed, something is wrong. It is also troubling that you only had 400 hair grafts when you state you are a Norwood Class 5. That would hardly have an impact on your appearance. If your hair transplant was a failure, it is my opinion that you should follow-up with your original hair transplant doctor to discuss the failure with him/her. There are instances where patients believe their hair transplant was a failure because they also had ongoing hair loss. Could that be your situation?

Furthermore, if minoxidil 5% or 12.5% didn’t work for you, what makes you think 15% will work? Minoxidil, like all drugs, has its limitations and higher concentrations may have adverse side effects. Depending on your medical history and a good diagnosis of hair loss, I would also consider finasteride (Propecia) as another option.

March 27, 2006

Tribestan and Propecia – Balding Blog

Dear Doctor,
Recently I have been prescribed with Tribestan to boost my testerone level. But i have been taking Propecia for a year now and the effect from propecia is good and i am a more confident man now of course with more hair too.

My question is can Tribestan be taken together with Propecia? will it cause more hairloss? or any side effects?

Thank in advance. Desperately needing a answer… Best Regards

Tribestan is not a medication. It is a natural supplement that is available over the counter without a prescription. Since Tribestan is not a FDA approved product, there is no medical evidence for its efficacy or its precise mechanism of action. There are endless internet sites that promote Tribestan (as I have found), but there are no formal FDA approved or medical data on Tribestan, nor are there any studies that show safety and / or effectiveness. For those reasons there is no way for me to tell if there would be adverse effects when taken with Propecia. There is no medical evidence.

I do not know your medical history to know how or why your “testosterone level” is low. Perhaps you should be seen by your primary care doctor for a complete physical.

March 27, 2006

Suicidal Thoughts After Hair Transplant – Hair Loss Information by Dr. William Rassman

I am devastingly depressed from my strip procedure…I made a very very bad mistake by doing a “fill in” procedure when I was 27 (something I regret more than anything) not realizing I would eventually get 2 other procedures of over 1000 grafts later and have a scar that I can not cut my hair short or shave my head…

I am having suicidal thoughts and wish I never did this at all..Id give anything to have no scars and just shave my head like I should have done. I was too young, uneducated and stupid at the time I made the decision for the first procedure. Now my friends with less hair than I have, Im jealous of.

Is there anyway to cover up this strip scar with FUE? DOes the donor area have to be shaved to do this? Will it cover it enough to cut my hair short again? Should I wait for potential hair multiplication someday?

Your opinion and expertise is appreciated. Im overwhelmed here..please help

Thoughts of suicide are a major red flag for me. When depression leads to such thoughts, then medical intervention is needed. You need to connect to your family doctor and discuss these thoughts, so that he/she can help you deal with a far more important issue than what is going on on the top of your head.

I do empathize with the trauma that you describe. From a medical and surgical viewpoint, these problems are not difficult to deal with, but they should take a back seat to your mental health. Just to list a series of options that may apply to your scar, they include: fascial techniques to reduce scars, transplants with FUE to fill in scars, and a Trichophytic closure technique that allows hair to grow through the scar, and camouflaging the scars to reduce their detectability. This is not meant to be a comprehensive listing, but just enough to tell you that once you get your mind clear and focused and can manage your suicidal thoughts, there are many options that can be considered for you.

With regard to things like hair multipication and cloning, I am disheartened when I read the rumors on the web telling that these technologies are around the corner. They are still quite a ways away from becoming a reality. See the Hair Cloning category for more.

March 27, 2006

Propecia in 20 Year Old Male – Hair Loss Information by Dr. William Rassman

I am a 20 yr old male who noticed a large amount of hair coming out while in the shower and during the day; I have also noticed visible miniaturization in the strands that fall out. I am about NW2 now, and I notice slightly less density on the very front of my hair line. At my age, are there side effects to taking Propecia? Are there any other courses of action?

Also, I am in Europe; do you know of my options here? (Is Propecia available/branded under a different name/does it require a proscription?)
Thanks!

The drug Propecia can be taken at any age. There are possible side effects, but they are rare and vary per person. Please review the many, many posts on this blog that discuss Propecia and side effects.

Some countries have not yet allowed the drug in, while others allow it to be sold under a doctor’s guidance and control. I am sure that if you ask your doctor for finasteride, you will find it in the 5mg dose and then would have to cut it into 1/4 dosages to treat hair loss.