August 2006 – Page 10

August 16, 2006

Propecia Dosage and Biotin – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman,

I would like to know if there is any harm in taking one half of a milligram of Proscar a day instead of just a quarter milligram, reason being would it speed up the process? And, if I do start to take one half of a milligram until my hair loss is completely reversed, can I then step back down to taking just one quarter milligram of Proscar without any negative side effects? I want to be sure I don’t become dependant on taking one half of a milligram daily as this will cost much more in the long run.

Also, my dad suggested using a non-prescription drug, Biotin. Do you think I should take Biotin? Will it help, make no difference or be bad?

And I have started using hair gel again (daily), a small amount, will this be bad for the hair loss reversal?

And, is there a specific type of shampoo/conditioner I should use that will help my hair?

Thanks for your time

There is no major harm in increasing the dose of finasteride, except we see a higher incidence of decreased libido with higher doses. The higher dose does not, to my knowledge, have more value than the 1mg dose of finasteride for the treatment of hair loss. If you are cutting Proscar 5mgs into 0.5mg, then that is 10 pieces of a pill, something that is hard to do and regulate (produce a powder I suspect). A dose of 0.5mg of finasteride is reported to be 80% as effective as the 1mg dose. Now with all that said, either cut a Proscar 5mg into quarters (1.25mg) or take the full dose of Propecia (1mg).

Biotin will not hurt you provided that you take recommended doses, but it will be no substitute for the finasteride. I recommend no particular shampoo, conditioner or hair gel.

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August 16, 2006

My Girlfriend Has an Itching, Burning Scalp That She Picks At – Hair Loss Information by Dr. William Rassman

please help – my girlfriend is suffering from itching and burning on the top of her head – and she has little red bumps in that area. she picks at them until they peel or flake off – and now she is seeing her hair fall out in little small circles in this location. what can she do and what is causing this??? just some information: she is 50 y.o, in menopuase and has had this condition for about 3 months now. please help.

If she continues to pick, these bald spots may become permanent. The red areas you are looking at may be traumatic in origin from the picking. This is an obsessive condition called trichotillomania. She needs to see a good dermatologist to lock in a differential diagnosis and pick up therapy from the recommendation of the dermatologist. The signs of trichotillomania are very characteristic on an examination of the scalp, so a good doctor will easily identify this as a cause if it is what is happening to her.

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August 16, 2006

Follicular and Lymphohistiocytic Infiltrate – Balding Blog

I’m a 34 yo white healty male. When I was 30 (2 mts before I turned 31) I noticed a lot of hairs on my pillow and when I ran my hands through my hair. My hair was extreamly thick. When I was 32 I went to a local Dr. that is a hair specalist. He did a biopsy said 2 vellus hairs to 25 total hairs. Had mild follicular and lymphohistiocytic infiltrate. He says I dont have AGA.

Fast forward two years to today, Im 34 hairs still come out same rate(been on propecia 2 yrs) biopsy says I have 3 velous hairs out of 23 total hairs. My family has little to no MBP (only mothers brother and her father a little) I see zero frontal recesion, no balding in the crown. No change in the way my hair is around my head other than its getting thinner everywhere, sideburns,sides, nape of neck, crown, vertex,all thinning at the same rate. What are your thoughts?
Thank you

Biopsies should not be done to rule in the androgenetic alopecia (AGA) diagnosis. They should be saved for special forms of alopecia which require the microscopic analysis and staining techniques that show cellular details. When doctors find lymphohistiocytic infiltrate, they often look to classify other cells in the area of biopsy which should not be present in large quantities, for large quantities of lymphocytes, eosinophils, etc, may point to infection or auto-immune diseases. The diagnosis of AGA is better made with a video densitometer (see Miniaturization: Critical to the Master Plan for Hair Loss), as it is non-invasive and simple.

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August 16, 2006

Avodart Has 50% Better Regrowth Rate Than Propecia? – Balding Blog

According to http://www.hairlosstalk.com/research/men/treatment1men.htm, Avodart is said to have a 50% better regrowth rate than Propecia. If one were to choose between staying on Propecia and achieve a lower regrowth rate or to switch to Avodart, what would be the pros and cons? Thanks.

Avodart is not currently approved by the FDA for the treatment of male pattern baldness (MPB). Propecia is the only oral medication approved by the FDA for MPB. Comparisons of Avodart with Propecia are conjecture by those who make such statements. It may be fair to say (without putting a percentage to it) that Avodart is reported (by physicians who use it regularly) to work better on some patients who are not getting good responses to Propecia.

The only real reservation I have about Avodart is that it has a very long half life in the order of WEEKS versus Propecia, which has a half life in the order of HOURS. A half life of a drug is the time it takes for half the drug to be cleared from your blood stream. This does not account for the drug cleared from tissue. The point is that Avodart is a strong medication and its full effects are not known. In my practice I do not generally recommend Avodart unless there are special circumstances.

August 15, 2006

Hair Loss InformationRobotic Controlled Hair Transplants – Hair Loss Information – Balding Blog

There’s a doctor in the bay area that is claiming to do hair transplants with robots. What is this about? Robots??? Can you tell me more about this?

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Robot “Restoration Robotics, Inc. (Mountain View, CA) is a company using image-guided robotic technology to perform hair restoration by emulating the FUE technique. The robotic technology is in development. Currently, it is not approved by the FDA and the technology is not for sale”, said a company spokesperson when I contacted them. I also found this press release about Restoration Robotics from 2003, here.

I can imagine the scene of a movie with robots doing hair transplants, starring 3-CPO from Star Wars. I am sure that we will be hearing more about robotic-assisted hair transplants in the future and I doubt that it will be as frightening as I just made it sound. This is an exciting conceptual solution to the Follicular Unit Extraction (FUE) quality problem.

There is also the Medicamat Punch Hair Matic, first announced in late 2004 in this press release — Punch Hair Matic rescues baldies — which says: “Medicamat of France will be launching its new robot for hair transplantation”. I have been familiar with this company, which purchased the technology from a long term friend in the mid-1990s, Dr. Pascal Boudjema, one of the brightest inventors that the hair transplant community has ever had.

Their press release goes on to say: “The Punch Hair Matic (which is patent-protected) is a robot using micro-instruments to remove follicular units, which makes surgery simpler, faster, and less debilitating for the patient, with more convincing aesthetic results.” They report a very fast surgical time (2 hours to do 700 grafts) for the transplant (appears to be an FUE technique).

In many ways, Medicamat has been doing small punch grafting longer than I have, considering that they have been using smaller and smaller punches for many years. The evolution to smaller punches has been slow and methodical.

Today, the shoppers for FUE transplants pass through a mine field (a ‘buyer beware’ business for sure) where doctors from all over the world (with little or no training) are using manual techniques with varying degrees of success. Regardless of their expertise, they are telling the public that they specialize in FUE and are experts in the technique. At least, the robot approach promises to standardize the technique and the quality of the output. So we have a horse race now between two companies offering what may turn out to be competing technologies. Only the public can benefit here, so I sincerely hope that one or both of these companies succeed in making the business for automated hair transplants work.

August 15, 2006

Bald Spot Occurs Every Other Year, Then Regrows – Hair Loss Information – Balding Blog

I have an occipital baldness. My family thinks that I have pulled it out. In actuality, my son has the same weak spot. My dad had this circle shaped baldspot on his occipital scalp. I noticed that when I shave/taper this area. It will grow back. Sometimes long sometimes short straight hairs will protrude.. At any given rate, the baldspot on the occipital area will occur every other year. Why does this happen?

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I would have to render a guess. This is the first time I can remember having this question put to me. Synchronous hair cycling is something humans are not supposed to do. It is possible that your hair in this area has a shorter geneticaly programmed hair cycle than the surrounding hair. This would produce a bald area in the hairs that have a shorter hair cycle, but I would doubt that it would be a complete bald spot — rather, a thin spot. If you are near one of my offices in California, I would agree to map out your balding spot and compare it to the surrounding scalp. A study of the hair shaft thickness may demonstrate the answer to your question.

August 15, 2006

Alopecia Areata and Hair Coloring – Hair Loss Information – Balding Blog

is it safe to highlight your hair with alopecia areata?

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Highlighting or coloring your hair should have not have any impact on alopecia areata.

August 15, 2006

Woman Started Losing Hair After Pregnancy – Hair Loss Information by Dr. William Rassman

I too have hair thinning issues. I am 25 years old female, and this hair loss/itchy scalp began not too long after the birth of my son. At first I attributed it to post partum pair loss, but when it continued after 2 years, it became worrysome.

My hair seems to be constantly be falling out, and regrowing. I have a lot of frizzy baby hairs. My scalp is itchy, and when I scratch, in the general area I find like a granule of skin cells. It feels like the white bit at the base of a hair, only a little larger and dryer. Most of the hair that falls out also has these at the base of the hair. This is driving me crazy, PLEASE help me figure out what this is. I’ve had blood work and my thyroid is okay, and I am not a diabetic.

Thank you.

Female genetic hair loss can be triggered by pregnancy. There are unique patterns of miniaturizationi associated with the genetic process (even in females) and this pattern is easily seen with good densitometry studies mapping out the head for miniaturization. You should get this process done and if you have a genetic process then, at the least, you will know what it is that is causing your problem. For those who lose hair with pregnancy, most will reverse within a couple of years.

August 15, 2006

Masturbation! Hair Loss!!! – Balding Blog

I started masturbating when I was 12 and I continue to do now at 19. All in all, I’ve averaged 3-4 ejaculations a day, all this along with a diet that is strictly based on meat. My baldness is unlikely to be genetic since all my have have kept thier hair. So is masturbating a lot along with a poor diet the reason for my hair loss ?

I’ve gone over this before, but simply put, masturbation will not cause you to lose hair. This is an “old wives’ tale” to stop what nature pushes men to do. If masturbating would cause hair loss (even 3-4 times a day) then the vast majority of men would be bald.

Poor diet can cause hair loss. You must have a balance of the proper daily recommended foods to get a good diet. Even a daily dose of ‘fast food’ should be able to get you the balanced diet to keep your hair.

August 15, 2006

Going On and Off Propecia – Hair Loss Information by Dr. William Rassman

I read on an earlier post you believe it is a bad idea to go on and off propecia, this is exactly what my dermatologist has recommended as he is dubious about staying on the drug constantly.

If the drug works by helping block DHT production surely this shouldnt be an issue? ie in the months you dont take it DHT production may rise again, but every other months is better than not at all? Or am I being too simplistic and hair cycles etc come into it and im making things worse?

I write because on the recent resumption of taking it I seem to have quite alot of shedding.

regards

Going on Propecia and then going off of Propecia is a bad idea. I have seen many men stop it for 4-6 months and they start losing hair at about a month, which quickly becomes evident at 3 months. If they restart it again, they rarely go back to where they were before they stopped the medication. I don’t know where your doctor is getting that idea from, so I would suggest that you ask him/her for clarification.

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