September 2006 – Page 3

September 27, 2006

I Have an Itchy, Bright Red Scalp – Hair Loss Information – Balding Blog

(female) I have had an extremely itchy and bright red scalp for about 5 months. Now recently, it burns too. My hair is falling out. Looking back on pictures, I have about half the hair volume that I used to 2 years ago. My scalp is extremely oily also. I am a natural red-head, but now my hair is almost blonde in color and very brittle. I haven’t colored my hair at all. What could it be? I had blood tests done and they were all ok. I’m desperate for some answers! Please give me an idea and will my hair grow back?

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There is no crystal ball. I can not tell you what is happening to you without examining you. If you are out of the California area, see a good dermatologist for an evaluation. There is no substitute for a good doctor and a one-on-one assessment in person. If you are in California (or are planning a trip out here), I have offices in Los Angeles, San Jose, and Newport Beach, and would be happy to provide a free consultation.

September 27, 2006

Hair Loss InformationHigh End Wigs – Hair Loss Information – Balding Blog

I did recently hear about a company that offered “high-end” wigs attached by some kind of inverted preasure. Do you know anything about this?

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I do not know what you are referencing here. There is one company that offers ‘high end wigs’ for a starting fee of $50,000. They use small clips to attach the hair system to the hair that is still there, one by one. There is a great deal of maintenance as the hair grows, the attached artificial hair must be advanced one by one to the growing hair to make up for the growth. If you want a referral to this high end wig maker and can afford $50,000, call my office. This company has offices in Beverly Hills, New York and Paris, although I do not recommend them as a rule.

If you send me more information on the ‘inverted pressure’ attachment system, I will give you an opinion.

September 27, 2006

Using Body Hair for Eyebrow Restoration – Balding Blog

(male) I have a question regarding eyebrow restoration. All of the websites I’ve been to for doctors who specialize in eyebrow restoration describe the procedure in the same way. They all talk about using donor hair from the scalp. Is there any alternative way of obtaining donor hair, i.e., from a different location on the body, so as to eliminate the issue of transplanting hair that may or may not have the same characteristics as eyebrow hair, and hair that will continue to grow unless trimmed periodically for the rest of a person’s life? What about using arm hair, leg hair, or chest hair? Also, is it possible to obtain donor hair by extracting, rather, plucking, existing eyebrow hair? Can the follicles be extracted that way?

Body hair has a long sleep cycle. For every body hair that you transplant, less than 4 out of 10 will grow at any one time because of this long cycle. Hair from different parts of the body have different sleep cycles. I’ve answered this before a few times, most recently here.

Your thinking is good, but the cycling of the hair makes this approach not practical. I would be reluctant to moving eyebrow hair around. There is a possibility that if it is move, it may not regrow, so I avoid this solution. All hair can be extracted using the FUE techniques that I have pioneered (see Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation).

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September 26, 2006

Hair Loss InformationFather Went Bald at 19, I’ve Still Got My Hair at 21 – Hair Loss Information – Balding Blog

Hi! My father started balding, according to him, when he was 19, and from there it progressively got worse. Now, only a horse shoe of hair remains on his head. I’m 21, and my hair is very thick, and it continues to grow without stop. Moreover, it seems like, genetically speaking, i didn’t inherit his side of the family, i look nothing like him, and my appearance looks like family members who have had thick hair for all their lives. Does this mean, taking into consideration that i have a thick set of hair, that i didn’t inherit those genes?

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Your father sounds like a Norwood Class 7 patterned hair loss (see image at right). Usually if you are going to inherit this pattern, you would already have signs of it as that pattern usually starts showing miniaturization at your age. These very advanced hair loss patterns are nearly complete by the mid-20s. That is, of course, no guarantee, but it does sound like you have inherited your hair genetics from some other person in the family.

Until you reach around age 26, you will not know if you are going to have genetic balding (possibly a balding pattern less severe than your father’s pattern), as most men show some signs of hair loss by that age if they are going to develop genetic balding.

September 26, 2006

Hair Loss InformationLosing Hair from Coumadin (Warfarin) – Hair Loss Information – Balding Blog

Why can hair loss occur after having been administered Coumadin? What causes this? Do the majority of Coumadin patients experience this? Please offer any information regarding hair growth after.

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There are many medications that causes hair loss as a side effect. Coumadin (Warfarin) is one of those medications that may cause hair loss. Nobody really knows why this occurs.

There are two important points patients should understand:

If you are on a medication under the care of a doctor, you should NOT stop the medication on your own just because you believe it has an undesirable side effect. You need to address your concerns with your doctor and explore other options TOGETHER. Your relationship with your doctor should always be thought of as a partnership.
The relationship between your hair loss and a specific medication may just be a coincidence.

September 26, 2006

Women and Propecia – Hair Loss Information by Dr. William Rassman

I am 49 year old female with very thinning hair, primarily in the crown. Can women of non-childbearing years take Propecia? Have any studies been done on its effectiveness in women?

There are women who take Propecia (finasteride) and it has worked for them. That being said, it has not been well studied in women and it is not recommended for women, because the long term effects on female cancer risks (ovarian, uterine, breast) are just not well known.

There’s a good overview written earlier this month about female hair loss options — Treatments Available for Female Hair Loss

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September 26, 2006

So Where’s the Generic Propecia? – Hair Loss Information by Dr. William Rassman

Dr,
Any word on generic propecia getting to the market yet? I know some company has the patent and that you would keep an eye on it, but I havent heard anything.

Propecia is a brand name for finasteride 1mg tablet. Propecia (finasteride 1mg) is still under patent protection and is not available in generic formulation.
Proscar is a brand name for finasteride 5mg tablet. Proscar (finasteride 5mg) is now available in generic (less expensive) formulation.

There has been some confusion on websites that Propecia (finasteride 1mg) will be available in generic formulation, but it is my understanding that it is not the case. I know it has been pointed out here that 1mg finasteride was listed on the US FDA website, but it being listed as approved for sale is different from it being on sale (which in my understanding would be in violation of Merck’s patent rights). This applies to countries where US patent laws and treaties exist.

Since Propecia and Proscar are both the same medication in different strengths (1mg vs. 5mg), some patients prefer to save money and take generic Proscar (finasteride 5mg) and use a pill cutter and divide it into 1/4ths (which makes about 1.25mg). When a pill cutter is used, it often is not exact and there is a tendency for the pill to break apart so that you have to estimate what is about 1mg. I personally do not think that there is a difference if you are slightly above or below the recommended dose.

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September 26, 2006

Propecia and Testicular Pain, Follow-Up – Hair Loss Information by Dr. William Rassman

I saw the post today mentioning the testicular pain when on Propecia. I’ve been on Propecia almost 5 months now. I did have intense testicular pain after about a week or two on the drug. But right when I was about the quit, the pain went away and I haven’t noticed it since. Hope this helps.

I generally tell patients not to overreact to things. This is a good example where a little patience solved the problem. Thanks for sharing it with us.

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September 26, 2006

Propecia and Minoxidil Combo Questions – Hair Loss Information by Dr. William Rassman

I am a 26 year old male who is experiencing early signs of balding on the crown and around the vertex. I have been to a trichologist who suggests that I use a combination of propecia and minoxidil to try to stabilse and hopefully regrow some hair. My question is; if I stop using one of these hair loss treatments would my hair loss accelerate quicker than if I never took them? Would you recommend a combination of the two drugs? Does stopping one have more of an effect that the other? And finally, what can I expect from this sort of treatment and if it is successful how long can I maintain my hair at its current stage? Many thanks

For a 26 year old, I do not recommend the use of both Propecia (finasteride) and minoxidil for the following reasons:

Propecia goes to the root of the problem (assuming genetic hair loss is present).
Minoxidil confuses the situation and does build dependence if there are benefits from it.
If you stop taking minoxidil and there is dependence, you only know by stopping it (bad way to find out).
In most young men, minoxidil is of little help.
I recommend minoxidil only after Propecia fails to work to meet the expectations of the patient. The incremental value of minoxidil will be seen 8 months after starting it, so at the least you will know if it is working.

If you stop minoxidil or Propecia, you will not lose more hair that you would have normally lost without having taken it in the first place. Lastly, I can not tell you what will happen to you from an email inquiry like this.

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September 26, 2006

Gynecomastia and Finasteride – Hair Loss Information by Dr. William Rassman

Hi, Is there any conclusive evidence that the regular use of Finasteride (Propecia) for hair loss can result in Gynocomastia as a side-effect?

The Physician’s Desk Reference does not list this drug as a possible cause of Gynocomastia, but I have heard mixed stories from individuals.

Results of any known conclusive studies in this regard would be appreciated.

Gynecomastia is a known side effect from the use of Propecia. I do not understand the mechanism of action for it, but when it does happen, most men usually find it as a reason to stop using Propecia. Fortunately, I believe that the incidence is well below 1 in 300 men. I don’t know of any studies off the top of my head, but if any blog readers happen to have a link to any studies posted online, please feel free to post the link in the comments.