August 2006 – Page 11

August 15, 2006

Going Off Medications Causing Female Hair Loss – Hair Loss Information by Dr. William Rassman

Hello Doctor!
I’m not unique, but have a specific question regarding female hair loss & regrowth. I am slowly going off of Topamax (w/Dr. supervision), and have recently gone off my birth control pills. I have extensive hair loss, to the point of clogging the shower drain daily (frightening!). I’m using topical Rogaine 5%, but have only done so for a month. How long does it take for hair to grow back? I’m confident mine will once my body adjusts to all of the medication changes. And does hair typically continue to fall out post-medication use? Please advise? Thank you!

Your question has a number of moving parts. You have recently stopped oral contraceptives and are tapering down on Topamax (both known causes of hair loss). Also, you have decided to start using Rogaine 5% for your hair loss, which if tolerated well, can only help. The standard time for hair to grow back once it has fallen out and gone into a ’sleeping cycle’ is about 4 to 8 months. If your hair loss is due to medication, it should hopefully grow back once the medication has been stopped. Given that you are under the supervision of a physician, I suggest getting a full medical workup to rule out other causes of hair loss.

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August 15, 2006

As Accutane Treatment is Ending, Propecia Stopped Working! – Hair Loss Information by Dr. William Rassman

Help! I’m a 36-year-old who has been on Propecia for about 8 years. Over the past couple of months, I have noticed a dramatic thinning of my hair. Interestingly, the thinning appears to have started just as I ended a 6-month Accutane treatment. What is happening? What can I do now that Propecia has stopped working? Am I a good candidate for Avodart?

I’ve written you three times on this matter. Please answer. I’m desperate!

You could have thinning secondary to Accutane build-up. Stopping Accutane may help. Avodart, as I have said over and over again, is not FDA approved for hair loss. Although it is used by some doctors, I have only prescribed it once and am not about to start going ‘off label’ for many reasons that I do not wish to discuss here. Simply put, safety and effectiveness have not been demonstrated for Avodart in the long term on young men with hair loss. I am not your doctor and you need to have a doctor who is vested in your condition. Between you and your doctor, you need to build a Master Plan to deal with your hair loss. You need to have your hair mapped out for miniaturization to see if the thinning you are seeing is ‘patterned’ or not. Pattern analysis of miniaturized hairs may help you distinguish the difference between genetic hair loss and Accutane effects. Give it some time and see what happens in the next 6 months.

August 14, 2006

Will My Hair Transplant Look Natural? – Hair Loss Information by Dr. William Rassman

Dr.Rassman, I am 25/yom, with significant thinning in my frontal hairline, and temples. I was taking propecia but stopped because of the side effects, and I heard it doesn’t work for receeding hairlines. I have consulted a Hair transplant doctor here in michigan, and he says their are some miniaturized follicles, but at the same time it may be too early to get work done, because of future hair loss. I can’t stand waking up everyday and finding new balding and thinning areas, it’s killing my self esteem. They did reccomend 600 grafts if I decided, which I am seriously considering. But will it look natural? Will it cause other natural hairs to fall out? And should I be taking propecia? Please help sir, I would be so grateful. Thanks so much.

I cannot make a diagnosis or give a second medical opinion via the internet, because I am limited to your description and I have not examined you in person. When a doctor says “it may be too early to get work done”, you might want to let his words ’sink in’ and consider this as reasonable advice. If the doctor makes his living doing hair transplants, then if that doctor did not want to sell you a transplant, it should add a bit more value to the recommendation to hold off doing a transplant. As a general rule, before you consider a hair transplant, you and your doctor should review the Master Plan for your furture hair loss and your expectations with the various options. After both you and your doctor are in agreement to have drug therapy (such as Propecia) or undergo a hair transplant, then you can work from that plan. At the hands of a good hair transplant surgeon with good planning, a hair transplant should look natural and undetectable to anyone looking at it. I have many patients whose transplants looked so good that they could have even fool my trained eye.

August 14, 2006

Traction Alopecia From Having Dreadlocks for Only 4 Days? – Hair Loss Information by Dr. William Rassman

I’m 18, female and I had my hair backcombed for dreadlocks. They were very tight and after four days I combed out my hair. Both the backcombing and combing-out process made me lose some hair. Do I have traction alopecia and will my hair grow back like it was before?

I would doubt that traction over a 4 days period will cause hair loss. If you lost any hair, it may take a few months for the hair to grow back in.

August 14, 2006

Propecia Beyond 5 Years – Hair Loss Information by Dr. William Rassman

Hey Dr. Rassman…I’ve been reading your blog almost daily and have seen alot of questions about the long term effectiveness of Propecia (especially after the two year mark). I wanted to ask you a question that will help me feel better since I am just past that 2 yr mark. I am 26 yrs old and have been using propecia since 24. When I started using propecia I had hair loss that was not detectable to others..my only goal here was to maintain my hair.. When you talk about propecia losing effectiveness , are you talking about losing ground with the new hair propecia is responsible for growing.. or falling behind your starting point.

Of course, I’m just asking your opinion from your experience of seeing many patients over many years.. Do most people stay at or above their starting point after 5 yrs or more? thank you

Finasteride at the 1mg dose will not guarantee that you will stop your hair loss. Some people stop it and some people reverse it. Some people just see it slow down. I think that it works in all men, just maybe not as effective in some as in others. Over time the hair loss tends to progress, so if the drug worked for you initially and works less well now, that is the time to see a doctor to get a Master Plan in your hand for your hair loss and its future. It may be time to consider doing more about it if it bothers you much.

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August 14, 2006

Hair and Weather Temperature – Hair Loss Information by Dr. William Rassman

Hello Doctor.

Do you think that taking propecia prior to exercise could increase your testosterone levels better than in the morning?

I usually go to ski in summer in a indoor installations at 0 degrees C and notice a small improvement in my hair texture comparing to the external temperature at 40 degrees C here in Spain. Is that possible or do cold and hot temperatures have no effect in hair?

Thank you very much

I generally tell my patients that it is best to take finasteride in the morning when normal testosterone levels are highest. It makes the most sense to me. I would also doubt that exercising and the drug have any cyclical impact on testosterone.
We can logically believe that if hair is a good insulator, it should get thicker when the seasons change, much as animals do with thicker coats of fur in winter. But humans have asychronous hair cycling, which means that we do not shed (thin) at a particular time of the year and grow hair stronger at other times.

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August 14, 2006

GNC’s Mega Men Vitamins and Propecia – Hair Loss Information by Dr. William Rassman

Hello. I am a 23 year old African-American male. I was planning to start taking GNC’s Mega Men Vitamins but then I learned of its inclusion of DHEA. I was also about to start taking Propecia as it was recently prescribed for me. Will this negatively affect the effects of Propecia? Or is Propecia powerful enough to where me taking GNC’s Mega Men won’t matter? Thanks.

Some things that you are referencing cause hair loss. Propecia may protect against the effects of building DHT levels caused by the anabolic-like steroid metabolites you are also planning to take. There is some balance here, but no assurance that what you want to happen will actually happen (i.e. cancelling out the bad effects with blocking agents like Propecia). Like a seasaw, it is a balancing act.

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August 11, 2006

Hair Loss InformationTrichophytic Closure Questions – Hair Loss Information – Balding Blog

When the strip harvest method is used, a linear scar is produced, but what if the doctor uses a trichophytic closure, would the scar be “virtually undetectable”? Would I be able to buzz-cut my hair without the scar being noticeable?

And also, does the number of hairs that grow through the scar vary by the person? And for my last question, if I felt the back of my head for the scar, would I feel it even if I couldn’t see it? (Would there be a bump where the incision was made)?

Block Quote

Good judgments in determining the size of the donor area is the best determinant of the size of a donor scar. When the incision is too tight due to the piece of excised scalp being too large, then the enemy is tension. The use of special closure techniques minimize the scars and the tension, but a bad judgment at the time of surgery can not be offset with a repair process.

The readers interested in the subject of scars, may conclude that special techniques can make the scar disappear. Many surgeons would like you to think that their wonderful skills guarantee that the scars on their patients are either non-existent or non-detectable. I believe that the only surgeons who have never seen scars from strip harvesting are those surgeons who have never done the surgery. If any surgeons give you this line, then that surgeon is not honest, for scars (much of the time) have little to do with the surgeon and much to do with the patient’s healing capabilities, when proper techniques are used.

The use of trichophytic incisions do not offset bad judgments or poor surgery, but when used, they can close the gap in a 2-3 mm scar that usually accompanies a donor wound. The scar will still be present even if it is covered by hair, and yes, you may be able to feel it.

August 11, 2006

Skin Changed Color After Moustache Transplant – Hair Loss Information by Dr. William Rassman

i had 900 grafts trasplant on moustache and goatee area !!! after 2 weeks when i shaved my skin turned pink and orange and darker on the side !!!! is it a common thing ? how long it will last before it fades away and i also have a lot of pimple on my chin!! the fact that i shaved afeter to weeks is gonna affect the grafts…….thanx doctor

You should address these issues with the doctor who did your surgery. A good patient/doctor relationship is critical in achieving a desired goal. I would be concerned about things like pimples, because early folliculitis can behave that way. Two weeks after a hair transplant your skin may still be healing and it is sometimes normal to have some discoloration (especially after shaving, which causes irritation even more). The degree of discoloration should be something judged by your doctor so that you know if it is beyond what he expected.

August 11, 2006

Rejuvx – Balding Blog

What is your opinion on the product rejuvx for male pattern baldness? Is it any different from Rogaine?

http://www.rejuvx.co.uk

I wonder if some of the companies may be sending me emails just for me to mention their product on this very popular website. I don’t know if that is the case here, but I’m just thinking…….

I have reviewed the material on their website and can’t find anything of real value for the treatment of hair loss. There is nothing mentioned on their site to suggest that this product has anything in it that will regrow hair like Rogaine (minoxidil) could. There are crazy claims of DHT neutralizing, which makes no sense to me. I can’t even tell if it does the job that it claims to do — that is, providing a good shampoo and conditioner.