Month: April 2006

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Promel – New Drug For Graying Hair? – Balding Blog

See this link from NewTechSpy.com — World’s First Drug to Reverse Gray Hair

It sounds interesting, but I cannot find any other source of information on this ‘new’ drug. I am not familiar with the drug but I wonder how it would affect skin color since melanocytes are what gives us pigment in our skin as well as hair. I would be interested in seeing clinical studies or pharmaceutical data and FDA clearance addressing the critical safety and effectiveness issues before I jump on this bandwagon. If the drug is not safe, I would rather be gray than dead. Not to say it would go that far as that would be quite an extreme example, but at this stage I do not have more information and safety is always the critical element in the decision to take a drug.




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Kevis and IntraUterine Device (IUD) – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,
i have had andorgenetic alopecia for year now. it started at the age of 12 or 13 and now i am 26. i have lost more than half of my hair. it is really devastating. i have been on kevis for about a year now. in the beginning, i felt my hair loss problem was going to be a thing of the past but now i am experiencing a great amount of hair loss. i am confused as to what is the reason. i have had an IUD inserted also about a year ago- it caused great amounts of bleeding. could it be that i now have acquired a low serum ferritin count that is causing this imbalance? i also have irregular menses, could it be a hormonal imbalance caused by the IUD (it was a copper IUD). The reason i ask this is because the IUD caused me to have delayed periods and bleeing for more than a week.
i am really stressed out and do not know if to continue the kevis or not. i am so thankful that you have a website like this for people like me.
thank you

Bleeding and anemia can cause hair loss. Low ferritin can also contribute to hair loss, as well as hormonal abnormalities which you seem to have. Kevis is incidental, I suspect. The active ingedient in Kevis is minoxidil, so I would suggest that you switch to it and simplify what is happening to you. You need to get your doctor very involved in this problem.

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I Stopped Propecia and My Hair Fell Out — I Want It Back – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman,
I have a question about using propecia. I am now 26 years old. I started noticing hair loss at about 22 years of age and started taking propecia at 23. I took propecia for about two years and it worked very well. My hair loss stopped completely and it appeared to me that I even experienced regrowth. I stopped taking propecia about one year ago. Since that time, I’ve lost a considerable amount of hair. I did not react well to my hair loss and so I have started taking the propecia again. I’m wondering how much, if any, of the hair I’ve lost in past year may return? Also, I’m interested in hanging on to every last hair in my forelock that I can. Is there any chance that adding minoxidil to my treatment could aid in maintaining my hairline while I wait for the propecia to take effect?

This is the classic thing I warn patients about. Propecia is a lifetime commitment, else balding is the consequence. You will most likely not regain all of what you lost since stopping the drug, though possibly some of it may come back. Holding on to what you have may be the thing you now need to focus on now. Any return of the hair will be a bonus. I hope that this message reaches anyone thinking about stopping their Propecia, even if they think it is not working (it most likely is working, at least in slowing or stopping the progressive loss).

Balding Forum - Hair Loss Discussion

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I Am 75 and My Hair Started Falling Out 2 Months Ago – Hair Loss Information by Dr. William Rassman

I always had a very heavy head of hair and thick eyebrows until about two monts ago. one eyebrow is gone and the other is gone in places. the hair on the top of my head is getting very thin i am 75 years my father died after his 93rd birthday and he had a full head of hair as did my mother. what could be causing this?

Be sure that you are healthy and do not have some early manifestation of some progressing medical problem. Sometimes, hair loss is an early sign of something going wrong. If I assume that it is not a medical problem, then Propecia may work to stop the process, if the hair loss is genetic with very late on-set balding. I have seen this late on-set balding in some 60 and 70 year old men, although it is very rare to commence at your age.

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Haircut After Strip Procedure – Hair Loss Information by Dr. William Rassman

Scarring from a strip procedure is a big concern of mine. What method do you use to close the donor area, and how noticeable would this scar be? For example, would my barber notice it while cutting my hair if he cut it to 1/2 inch length?

The person above is talking about removing a stip of skin for donor area harvesting, the common standard surgery for today’s hair transplant. Only about 5% of the population will have a scar wider than 2-3 mm on a single surgery. With a deep fascial closure and trichophytic incisions (see Techniques to Minimize Donor Area Scarring ) these numbers should show a smaller incidence. Even with a 2-3 mm scar, you should easily be able to cut your hair to 3/8th of an inch without being observable.

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Hair Loss from Accutane – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,
First off, thanks for the helpful site. My question is regarding accucate-induced hairloss. I am a male and started losing my hair in a diffuse pattern, all over the head but more severe on the top, after a course of accutane when I was 15. It has been a very slow, gradual loss but now at age 21 it is extremely prononunced. I probably have a little less than 50% of my original density. I wasn’t sure that the hair loss was a direct result of accutane until I had a scal biopsy done by a dermatologist recently and she confirmed that it was accuate-induced (not sure how she knew that from the biopsy but that’s what she told me – I think it was something about the “properties” of the follicle). I’ve attached 2 pictures – these were from about 8 months ago and the hair loss is considerably more now than it was then.

My first question is whether there are any clinics/hospitals/studies you are aware of that are studying the side effects of accutane – either in order to test treatments or just to track users that are experiencing side effects. I’m pretty sure that my condition is untreatable and I’m just going to have to live with it, but I would be open to trying experimental treatments in order to help others out. Second, do you think there is any use in using propecia/minoxidil to try to slow the loss, or would they be useless since this loss is probably acting by a totally different mechanism? I have used both in the past without evident results, but it’s hard to tell if they were slowing the loss or doing nothing at all.

Thanks very much for your advice.

Unfortunately, there are no solutions to your Accutane problem, other than to stay away from that drug. If you have genetic balding on top of the Accutane problem, then you should get your hair analysis for miniaturization to be sure one way or the other, the status of genetic balding compounding the problem you already have. I do not have any people to recommend who are experimenting with problems like yours. Also, please see previous Accutane related posts.

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Catch-Up Period When Stopping Finasteride – Hair Loss Information by Dr. William Rassman

Hi Dr Rassman,
Can you please explain the ‘catch up period’ scientifically when someone stop using proscar?
Kind regards

Propecia and Proscar (both Finasteride) block the effect of DHT on the impacted hair follicle. In simpler terms, it interferes with the ‘dying’ cycle for that particular hair. Each hair is programmed to live a particular number of hair cycles. It is believed that either the hair cycle is prolonged or another few hair cycles are obtained when the DHT is blocked. When the DHT is released from the blocking effect of Propecia, then it remembers where it should have been and goes directly to its genetic programming, whatever that destiny is. We see similar effects when we treat leukemia with one of the newer magic bullets. The same is true for Insulin and Diabetes, and Steroids for Addison’s Disease (John Kennedy had it). Provided that the patient stays on the drug, the disease is blocked from taking its normal course. If the medication is stopped, or the drug is not maintained at its recommended dose, these diseases may take the life of the person, or by maintaining the drug they may hold off the effects of the disease indefinitely. Propecia may hold the hair in a more healthy state for long periods (each person varies with the power of the inherited genetic profile found in that particular individual). As we are each different with different genetics, some people will have a long, more effective course with blocking DHT than others. The good news is that we are not talking life or death here, just hary or balding.

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Androgenetic Alopecia Diagnosis from Scalp Biopsy – Hair Loss Information – Balding Blog

Dr Rassman,
I’m a 27 y-o female who has experienced major thinning all over the scalp. I wrote to you earlier this year regarding how my low ferritin levels (14-ish for the past 10 years) could impact my hair loss.

I recently received my scalp biopsy results which gave me a diagnosis of “Scalp skin with intermediate and terminal hairs. No significant immunopathology. This suggests an early androgenetic effect”. It also stated that “no clear cut diminution of hairs is apparent”.

Why would this history lead to a diagnosis of androgenetic alopecia rather than CTE? If I don’t have clear cut miniaturization, and my ferritin is so low, could this be true? I am just reluctant to go on Propecia since my insurance won’t cover it for women.

Thanks very much for your time.

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These terms chronic (meaning long term) telogen (refers to a part of the hair cycle where hair goes into resting phase) effluvium (means hair shedding) and Androgenetic (means genetic and a weak sex hormonally combined into a single word) Alopecia (means hair loss) are descriptive terms, which in your case does not help. Much of medicine is rooted in the descriptive arena based upon Latin language usage. This makes doctors sound very intelligent, when the actual meaning reflects more of our ignorance. See EHRS for a better understanding of the difference between the two possible diagnoses listed above (chronic telogen effluvium/ CTE and Androgenetic Alopecia). You might identify with this piece: Channel4.com – Women Who Lose Their Hair.

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Hair Loss InformationWhy Are Some Transplant Doctors Bald? – Hair Loss Information – Balding Blog

I see that some hair transplant doctors (like Dr.Bernstein) are actually balding and still don’t have a hair transplant.Do they not trust in this procedure or are there other reasons behind?
Thanks for your time

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First, it is important to understand that the decisions to reverse balding reflects a very personal decision for each person. Being bald does not reflect any freakish state, but rather a NORMAL appearance that is the decision of each person to maintain or reverse. Some men do not find being bald as anything wrong, while on the other extreme, some people are obsessed over getting their hair back. I personally find it more extreme to wear wigs, but that is my personal view, and I chose to have hair transplants instead. Doctors who are bald have exactly the same choices. It would be wrong for a bald hair transplant surgeon to have a hair transplant just to prove that it has value to his patients. Many other hair transplant surgeons have made this election for their own personal reasons. I have not declared war on balding, not in the slightest. Bald is beautiful for some people.