Month: August 2006

Posted on

Taking Avodart and Propecia At the Same Time? – Hair Loss Information by Dr. William Rassman

Hey Doctor,

Thanks for continuing to answer all my questions. I had a consultation with you about 4-5 months ago.

I have been on Propecia for about 7 years now…and it seems to be less effective than it was before. I am losing more hair, especially within the past 3 or 4 months. I have read your comments on Avodart…and it seems for some people, Avodart is more effective than Propecia, especially when Propecia stops losing its effect.

If I want to try Avodart out for a little while (I know it’s not FDA approved), would you continue taking Propecia at the same time?

Thanks again.

If you take Avodart, there is no point to using Propecia. Be careful about dosing, unless you are under the care of a good doctor.


Balding Forum - Hair Loss Discussion

Paid advertisements (not an endorsement):


Posted on

Is Miniaturization Mapping Like a Scalp Biopsy? – Hair Loss Information by Dr. William Rassman

Hello, Dr. Rassman…

Thank you fot the informative blog! I know you keep referring to “getting your hair mapped for miniaturization”. What is involved in this? Is it like a scalp biopsy? Also…what is the typical cost for this procedure? I am male, 37 years old, and i am noticing a lot of hairs in the drain, and a some recession in the temples. I plan on being in L.A. in September, can I come to your office to get “mapped”? Thanks.

I will be happy to see you in September — just call or email to setup an appointment. Mapping of the scalp does not require any surgery and is nothing like a biopsy. What we do is take photographs of the hair at the hair level, then count those hairs in the field of view that are miniaturized, compared to those that are normal. Each part of the head can be mapped accordingly. Miniaturization mapping is free, and is part of the consultation process.

Balding Forum - Hair Loss Discussion

Paid advertisements (not an endorsement):


Posted on

Patients After Hair Transplantation (with Photos) – Hair Loss Information – Balding Blog

What will I look like within a week or two after a Hair Transplant?

Block Quote

Here’s a collection of recent patients. Please note that the amount of redness is different for each person, and all of these patients had these photos taken pretty soon after surgery (between 3-10 days, as noted below). Click the photos to enlarge.

This first patient is 10 days since he had 2150 grafts. He has white skin and dark hair and wants to keep his hair pulled back. He would do better to hide the transplants by combing it forward, but this is his choice, of course. What you are looking at is a new beard from the transplanted hair which is about 1/8th inches long, just below the hair that he had prior to the transplant. The transplanted hairs were placed between his longer hair.




The second patient has 1661 grafts and had no cover at all. This is his bare skin on the 7th post operative day. Good washing and small surgical wounds are the key to fast recovery of hair transplants almost immediately after surgery. Most people who are bald worry about detection of the transplant. By about two seeks, the faint pink glow will not show. If his skin color was anything but ‘very light’ not even the pink appearance would show.




The third patient had 1794 grafts and is 3 days after his hair transplant procedure. He had short hair in the front and the transplanted hairs was placed between his short hairs. He did form very small crust that did not immediately wash off in the first day, as is often the case.




Posted on

Steroid Use with Propecia Makes Hair Loss Worse? – Hair Loss Information – Balding Blog

Dr. Rassman

I have recently read an article stating that the combination of steriod use and propecia can enhance hair loss rther than protect it and that they should not be used together. Is this true?

Block Quote

Many steroid users want to protect their hair from loss and steroids are known to increase the hormones and byproduct DHT that promote hair loss. There are more body builders using steroids with hair loss than those who work out but do not use steroids. Many body builders ask me if Propecia will help them keep their hair. The best thing to do is stop taking steroids, but using Propecia can not hurt. There is logic that any DHT block will help and Propecia (finasteride) can accomplish this in theory. The key question to ask is: Will the negative impact of steroids on my hair be offset by the positive impact of a good DHT blocker like finasteride? The answer here is a theoretical, “probably”.

Posted on

Hair Loss InformationIf Propecia Stops Working, How Bad Can Hair Loss Get? – Hair Loss Information – Balding Blog

Dr. this question has been asked before but there never seems to be a clear cut answer from anyone I have asked.If I am a good responder to propecia if and when the benefits do decrease will my hair get worse than at my starting point or go back to my starting point and maintain. This is all if I keep taking it. Thanks Dr.

Block Quote

The 5 year data from Merck shows that after 5 years, the average patient comes close to his starting point. There is a suggestion that after 5 years he will be worse off than his starting point. This is a bell curve statistic which relates to the average person in the study. You are not average, nor am I. Some people will do better (good responders) and some worse (bad responders).

I hope that answers the question for you.

Posted on

Taking Minoxidil at 15, Dermatologists, and Miniaturization – Hair Loss Information – Balding Blog

Hey Doc, once again your site is freakin awesome. I sent you mail a few weeks back, and you asked what I meant by recession at the sides. I’ve changed the mail I sent so I’m more clearer:

I am a 15 year old Indian male, and I recently discovered my receding hairline. For a week or so I thought it was a mature hairline since everyone in my family has one (noone is bald though). Anyway I went to see a dermatologist and she said it’s male pattern baldness because of the recession on the sides (on your miniaturization diagram at http://baldingblog.com/2006/08/04/miniaturization-2, the areas I have recession in are T1 on both left and right). She
prescribed Minoxidil 5 % for 12 months. I just wanted to know if you think I should take Minoxidil at such an early age or get another opinion. BTW, when I raise my eyebrows my last fold of skin is 3/4 inch away from my hairline. And the recession of my left and right sides are an inch away from my hairline.

Another question, I talked to my dermatologist about having my hair mapped out for miniaturization, and she had no idea of what I was talking about. Do all dermatologists have machines for minaturization or do I have to see someone else. THANK YOU for taking the time to answer my question…your site is more helpful than the dermatologist I visited.

Block Quote

You may be experiencing the appearance of a maturing hair line. That would correspond to the “T1″ area in the diagram in Miniaturization: Critical to the Master Plan for Hair Loss. Minoxidil is therefore not appropriate for you.

With regard to the question about miniaturization, print out the reference article in the link above and show it to your doctor. In addition, I just wrote another piece worth reading, How Propecia Works on Hair and Why Miniaturization Mapping is Important.

Posted on

Menopausal Woman Losing Hair – Hair Loss Information – Balding Blog

Dear DR. I’m suffering with great deal of hair loss, I’m a 53 yr old woman who is currently going through menopause, I went to my family Dr. and showed him the amount of hair that had fallen out of my head for 3days and he said it was way to much for menopause so he did some blood work on me and everthing came back ok. So I know its not my thyroid…. This happened about last yr as well, and I went to my hairdresser and he gave me some shampoo that seemed to help. But I haven’t had to use again until now..Why is my hair falling out like this? I also notice that even after washing my hair, if I sweat that my hair and scalp really smell bad. Please help if you can. Thanks

Block Quote

The cause of hair loss in women is not as straight forward as it is in men who usually follow a specific male pattern balding. Over 50% of women going through change of life homone fluctuations experience significant hair loss. All women need to be medically evaluated for a variety of causes of hair loss reflecting medications that they take and conditions that are known to produce hair loss, best reviewed by your doctor. There are many potential causes of hair loss in women and most are not readily treatable. If the cause is genetic, treatments are not very effective. Minoxidil is one of the few drugs that work for some women.

If you have seen your primary care doctor and have ruled out medical causes of hair loss, you may want to have your scalp hair evaluated for a specific pattern of hair loss by getting a miniaturization study. I often sound like a broken record when I talk about miniaturization, but it may provide a clue or help monitor your hair loss/gain. With respect to menopause, it is often a contributing factor that may have started a cascade of events for your hair loss, which may be irreversible.

Posted on

Minoxidil Applications, Pantovigar – Hair Loss Information – Balding Blog

Dear Dr Rassman
Two questions please: first, it is recomended to apply Minoxidil twice a day, in the morning and evening. Does it matter if I apply it later, around midday?

Second: what do you think about Pantovigar?

Many thanks.

Block Quote

Many doctors feel that if minoxidil is not used twice a day it has substantially less value. Generally, twice a day means as close to 12 hours apart as is socially reasonable.

Everything I researched on Pantovigar seems to be in German — I do not speak or read German. No further comment can therefore be made by me at this point in time.

Posted on

Thinned Hair From Continued Stress – Hair Loss Information – Balding Blog

I have gone through a period of very high stress and very poor nutrition, and my hair has thinned dramatically from the full head of hair I had. I am 58. My Father and Mother both had full, thick hair when they died. Will this come back as long as I have stress in my life, and is there anything I can do to help my body repair. My nutrition has improved. Thanks.

Block Quote

I know nothing about your sex (male or female) or if you’ve had any medical tests that may indicate disease, and on and on. See a good doctor and be sure you are completely healthy first. Then a hair expert will have value for you.

Posted on

I Experience Bald Patches, But Don’t See Hair Falling Out – Hair Loss Information – Balding Blog

Im a 34 black women for the past year I have seen bald patches in different parts of my hair, the good news is the hair grows back, but takes about 3 months. The only thing is there is no evidence of hair comming out of the head, no hair on my bed, just wake up in the mornig to find bald patches but don’t see where that hair disapeared to.

Block Quote

If it was there when you went to sleep and not there in the morning, and there was no hair anywhere in the bed, no hair in your fingernails… hmmm.

I’m sorry, I don’t know what to tell you.