Month: September 2006

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Water with Chlorine or Shampoo with Sulfate Causing Hair Loss? – Balding Blog

Hi Dr. Rassman,

I have heard that shampoos containing sulfate can cause hair loss. Is this true if you have genetic balding? I was also told to buy a shower filter b/c the chlorine from the shower water can cause hair loss. Is there any truth to these statements? I am a 26 y/o male losing his hair and I am taking every precaution to prevent any further hair loss. I appreciate your help Dr. Rassman

I researched the relationships between sulfates, chlorine, and hair loss. There seems to be many opinions, good and bad. It all sounds hokey pokey to me — no science backing up the opinions I read. Who told you to buy a shower filter? I’m just curious to know where your source got their information.

If you believe that you have genetic hair loss, my suggestion, as always, is to:

  1. get your hair mapped out for miniaturization
  2. get a diagnosis after the mapping
  3. build a Master Plan for your hair loss
  4. follow that plan


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Right Hairline Improved with Propecia, Left Hairline Has Gotten Worse – Hair Loss Information by Dr. William Rassman

Hey doc, I’m a 19 yrs old male and I’ve been on Propecia for about 8 months. I’m happy to say that my right hairline has improved beyond my expectations. Unfortunately, I haven’t any improvement on the left side of my hairline, in fact it has gotten worse. I have shoulder length hair and I’m considering shaving my head (which would throw 8 months of Propecia use down the drain), for my hairline from the front appears akwardly unbalanced (one side its thick while the other is see-through). Before I make such a hasty decision, I was wondering if I should try 5% minoxodil or anything else you’d recommend? And the comb over at my age is not an option. Thanks.

What you are telling me is that the left hairline probably showed more balding than the right, so that the right side’s loss was easier to reverse (being more recent). In men of your age, Propecia works well to reverse ‘early’ hair loss. By all means, shave your head if that is what you want to do, but for your own sake, do not stop taking Propecia. If you are balding at 19, chances are that it will progress more rapidly than on those not starting as early as you, so staying on the Propecia will slow or stop it from progressing. Stopping it will just get you where you would have balded had you never started taking it and as your genetic code has planned for you.

Many young men tell me that they are losing frontal hair when they are just developing a mature hairline. The normal child’s hairline moves up about 1/2 inch in the middle and 1 inch on the corners. One side is often faster than the other side, making the hair loss appear out of balance (symmetry). Could this be what is happening to you?

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Remarkable Before and After Hair Transplant Comparison (with Photos) – Hair Loss Information by Dr. William Rassman

This patient of mine just sent me his recent after photos with permission to publish these for my readers. I was very happy to see his results and the joy it brought to me made my day. As with many of my patients, he elected to show off his hairline in his hair style. He had two procedures totalling 4774 grafts. The change is quite remarkable, and this patient is understandably very excited about his new ‘image’. He says…

“So this has been the first summer since the mid 90’s in which I didn’t spend MOST of my time in a hat! It really says a lot about how the procedures have changed my perception of self.”

Click the photos below to enlarge.

Before photos – taken September, 2004:

After photos – taken September, 2006:

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Do I Have Any Donor Left After My 10 Hair Transplants? – Hair Loss Information by Dr. William Rassman

From 1998 to 2004 I had about ten transplant surgeries done,and each time I had between 200 – 300 grafts done. After having read your blog the last few months, I now wish I would have had fewer surgeries, and more grafts done at those times. For the most part I am pleased with the results that were achieved, but I would like to have one more transplant surgery to hit those last few problem areas. Is there any way for me to tell if there is any donor area still available? My scars have appeared to have healed well. Since the last surgery I have moved 1500 miles from where my doctor is located, so if I am to have any additional work done I will need to locate a new doctor. I would appreciate your thoughts, and I really enjoy this forum you provide. Thank you.

Your situation requires an in-person examination to learn the opportunities and risks for more hair transplant surgery. The distribution of the scars and the width of the scars will probably dictate what can be done in one more surgery. I have an airfare reimbursement program offered to those traveling from out-of-town (see NHI Travel Program). I would be happy to talk with you over the phone to define your problem and goals.

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Hair Loss InformationMy Doctor Advised Against Washing Recipient Area for 2 Days After Surgery – Hair Loss Information – Balding Blog

i had a procedure done at another clinic yesterday. they advised against washing the recepient (graph) sites for two days. essentially allowing scabs to heal and fall off two weeks later. I am in the public eye(professional speaker) and had to have a thorough celeaning today. So i di wash my scalp today against there written directions. i was able to see the removal of 75% of the one day old scabs and it looked like 8-10 graphs came out as well. I did not sit under the shower i used the cup pouring method and the gently rubbed the scabbs with my figertips..am i alright or did i maybe wash away my follicles unknowingly? again i saw about 8-10 in my scalp dislodged after the shower. did not look like many came out…no bleeding whatsoever by the way. your thoughts?

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I always have the hair washed within the first day after surgery and offer that process in my office for our patients. The key to a fast recovery is to get the scabs washed off fast. The longer they stay in, the longer you must be gentle with the wash. In the hands of a professional wash, the wounds will be very clean by the very next day. We also wash it vigorously at the end of the procedure to get all of the crusts off quickly. Unfortunately, many doctors do not focus upon getting you looking spiffy in a day after the surgery.

This patient below came in one day after surgery and the pictures were taken immediately after he had his hair washed. The recipient area has an obvious pink hue against his white skin. His native hair was long enough (I told him not to cut his hair prior to the surgery) to cover the entire transplanted area when he combed it forward. White skin shows pink clearly and had his skin color been tan, the pink hue would not show much or at all. As you zoom into the picture, you can see the transplanted grafts and the hair contained in those grafts clearly without any crusts to increase the detection of the transplant in the bald scalp. People who have native hair with grafts transplanted between the hairs have automatic coverage from the native hair and the transplants can be completely hidden. Within a few days, the only evidence of a transplant will be the beard that appears in what is now the pink area. Click the photos to enlarge.



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Hair Transplant Sales Pitch vs Patient Education? – Hair Loss Information – Balding Blog

It’s well documented that minoxidil may cause some initial shedding. I’ve also read this can occasionally occur with Propecia as well. My question is, will this be only an initial occurance or is it possible shedding may occur in cycles?

I’ve been using both Rogaine and Propecia for nearly eight months now. Occasionally I’ll notice greater spurts of hair loss. But in the end, I find it hard to detect any overall thinning.

I’d like to get my hair mapped out for miniaturization. But the most prominant hairloss physician in the Orlando area basically used my $60 office visit for a ten minute sales pitch for a hair transplant.

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What you described is, unfortunately, a doctor who has hia/her own agenda in mind, not yours. Hair transplant physicians should bring their expertise to educate you, diagnose you and answer your questions. If, after the visit, you do not feel that you are better informed, then you have learned something important — do not go to that doctor. The sales pitch is disgraceful behavior and as you probably know, I speak strongly against doctors who just try to sell hair transplants rather than meet their patient’s needs.

With regard to your questions on shedding, I believe that once you are on either Propecia or minoxidil for 8 months, any shedding from these medications should not occur. Hair shedding, other than the normal hair cycling that everyone has which impacts about 10% of the hairs on your head at any one time, should not occur unless the hair loss process is progressing more rapidly into a new accelerated phase of hair loss.

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Prozac Causing Clumps of Hair to Fall Out Within Days – Hair Loss Information by Dr. William Rassman

Hello,
I’m 35 years old female. Due to my panic attacks, I was on Zoloft for 3 months and changed to Prozac for 5 days, but it’s was too strong for me and my hair was falling, so I stopped the medication and everything was great because my panic attacks also stopped, but after one month later, all of sudden, last 4 days or so, whenever i touch my hair, big clumps of hair falls out every day and I’m very concerned and worried. What should I do??? PLEASE HELP!!1

You need to see a good doctor who can figure out what is happening to you. Woman’s hair loss is complicated. Prosac or Zoloft can cause hair loss along with many other medications. You need to get evaluated by a good doctor. In New York, make an appointment with Dr. Robert Bernstein.

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Pill Cutters and Creativity – Balding Blog

People have mentioned that they cut Proscar into 1/4’s or 1/5’s…I haven’t had any luck finding a pill cutter that will cut a pill into such fractions – do they exist at all, or are all these people just using a standard pill cutter and trying to slice them up by eye? Seems like it would be very difficult to cut them accurately given the size of the pills…?! Or do multi-way slicers actually exist?

Every pharmacy I have been to has had pill cutters. Just ask them! Many of the drug companies do not want you to cut their pills (Viagra, Cialis, Propecia, Proscar) so they round the pills to make it difficult. Use your creativity and you will solve the problem. I’m sure someone out there has made a multi-split pill cutter, but I’m not familiar with any off the top of my head. Many people (and I even recommend this) will cut Proscar into 1/4 and get 1.25mg of finasteride per dosage, because it is easier to cut that way.




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Balding Forum - Hair Loss Discussion

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My Penis Does Not Work on Propecia! – Hair Loss Information by Dr. William Rassman

I found that my penis seems to have no reaction everyday morning after take Propecia. I’ve been on Propecia for around one and half month. My doctor tels me not to worry and continue to take Propecia. He tells me the side effect is dramatic when taking it at the first month. Is it right???? I am worried that I will become sexual handicap if I keep taking Propecia. What should I do?

A small number of people get both a decreased libido and erectile dysfunction with Propecia. If you are one of these, I would suggest the following:

  1. Stop taking the Propecia for a week or two. The problem should go away.
  2. Start it again, taking a half pill a day instead of a full pill. If the problem comes back, try a quarter pill a day after stopping it again for a week or two. If the problem is still there on the lower dose, then your choice would be to give up your sex life (not a good plan) or forget Propecia and look at other options for hair loss including minoxidil and/or hair transplants.

There are a small number of people who can not take this drug because of sexual dysfunction problems. Are you sure that you do not have a sexual dysfunction problem without Propecia? Don’t blame it on the drug if you have a problem even without it. There are many causes of sexual dysfunction which might be best handled by a good doctor/urologist.

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