Month: December 2006

Posted on

Hairline Lowering Procedure – Hair Loss Information – Balding Blog

can you lower a woman’s hairline without transplants?

Block Quote

Yes, the hairline can be lowered by a technique that differs from hair transplantation. In this technique, a strip of skin is removed from just below the frontal hairline and a trichophytic incision will be used to blend frontal hair into any scar that forms. The cosmetic result of a lowering hairline surgery is immediate and it is less labor and time consuming compared to hair transplantation. One disadvantage of this technique is the possible presence of a linear scar at front of the hairline. The scar could be hidden with a minimal delicate hair transplant surgery in front of it for a better cosmetic result if it is a problem. See other posts on this subject here.

Posted on

Difficulty Concentrating When Taking Propecia – Hair Loss Information – Balding Blog

I have been on Propecia for just over 2 weeks. This second week, I have experienced notable fatigue and a cloudy head with a lowered ability to concentrate. My lifestyle has stayed the same; if anything I’ve been getting more sleep than normal.

Have you heard of this type of side effect? Is it something that might go away as my body adjusts? Should I decrease my dosage from 1mg to .5mg?

Thanks for any advice you can provide.

Block Quote

I have not heard your type of complaint before from any of my patients. I would wonder if you have been too focused in looking for changes on this drug. If you look hard, you can make these changes occur on a psychological etiology. If you were my patient, I would advise you to ‘stay the course’.

Posted on

Combining Minoxidil and Finasteride – Hair Loss Information – Balding Blog

Hi Dr. Rassman:

Could you please summarize the findings of scientific studies that examine the effect of combining Minoxidil and Propecia?

I’ve been using Propecia for about a month, and am considering also taking Minoxidil. I’m a 26 year old male, and ONLY have baldness near my forehead.

Thank you

Block Quote

An animal study done on monkeys in 1992 has shown that finasteride and minoxidil have additive effect on density of the hair. Human comparisons are speculative. I would suggest that you run out the course of 1 year on finasteride before adding minoxidil. This way you will know what the effect is, answering your own question.

Reference: Hair growth effects of oral administration of finasteride, a steroid 5 alpha-reductase inhibitor, alone and in combination with topical minoxidil in the balding stumptail macaque. J Clin Endocrinol Metab. 1992 Feb;74(2):345-50. Diani AR, Mulholland MJ, Shull KL, Kubicek MF, Johnson GA, Schostarez HJ, Brunden MN, Buhl AE.

Posted on

Bumps on the Head After Hair Transplant – Hair Loss Information – Balding Blog

it’s been like 6 weeks after my hair transplant..and i had using this hair product and starting to notice that are some bump on my hair…(grafts) don’t know if i should still use it or not?

Block Quote

If you have bumps on your head, you may have folliculitis and should see your doctor. Generally, after 3 weeks you should be completely normal and can resume whatever you normally did before the hair transplant. Folliculitis or cysts in the scalp are most often caused by (1) remnants of the previous hairs that were not shed but put below the skin or (2) pieces of the sebaceous glands that are putting out sebum below the skin and collecting below the skin, or (3) grafts that were placed too deeply or piggybacked one on top of the other from inexperienced or less than fastidious team members placing the grafts.

Posted on

Meds for Temple Hair Loss? – Hair Loss Information – Balding Blog

hi i’m 24 years old male and have noticed a slight loss of hair about an inch long in a triangular shape at both sides of my temple, is there any medication which helps this area, ive been taking procerin for nearly a year but am not sure if its working or not, thanks in advance

Block Quote

I would need to see what you are talking about. There is a genetic disorder called triangular alopecia that you may be describing. If you have this condition, medications probably will not help.

Posted on

Propecia Success Rate vs Placebo – Hair Loss Information – Balding Blog

Dear Doctor,
Most of us would agree that wikipedia is one of the most common sources of information on the web. Looking at common hair loss treatments on wikipedia(http://en.wikipedia.org/wiki/Baldness_treatments) I found that the positive effects of propecia are not described sufficiently (as they are in your blog). Moreover, it says that “Propecia has a reported 29-68% success rate (vs. 17-45% in patients receiving a placebo)” whereas your posts report that almost all men have some positive effect. If possible, please clarify.

Block Quote

Several studies were conducted on Propecia (finasteride 1mg) to compare its effect with placebo on hair loss or growth. To answer your question, I present the numbers of one study comparing the effect of finasteride with placebo in the growth of crown hair. In this study, hair growth was compared over a period of 5 years. In this experiment, initially investigators evaluated patients’ hair growth and came up with the below numbers:

  Finasteride Placebo
1 Year 65% 37%
2 Year 80% 47%
5 Year 77% 15%

The same study was repeated, but this time an independent team of investigators rated standardized photos in a blinded fashion (reviewers were not aware which patient took finasteride or placebo). The numbers were different, but still statistically significant as shown below:

  Finasteride Placebo
1 Year 48% 7%
2 Year 66% 7%
5 Year 48% 6%

There are some other studies looking at different aspects of hair growth and as a result you may see different numbers. In clinical studies, you may find different numbers presenting the same facts, but if you go to the detail of the study, you will notice that they are not necessarily concentrating on the same parameters. The difficult element not covered by these studies is the ability for finasteride to arrest the hair loss (stop or slow its rate of loss). I am personally certain (in my professional opinion) that finasteride reduces the rate of loss in all men with genetic hair loss.

The drug company (Merck) only report what was studied and can not guess or postulate on what they might logically conclude are probable outcomes in different situations. If it was not studied, Merck will be silent. Being under FDA regulations, they are tightly controlled as to any claims that are made. To get more information about a study, you need to look at the methodology of the study to understand what particular variables are being evaluated. Professionals like me, are allowed to voice their professional opinions and are not held to the same type of restrictions as Merck.

Posted on

Wide Scar After Transplant – Hair Loss Information – Balding Blog

I had a hair transplant using the strip procedure 18 months ago. The scar in the donor area is 5mm to 7mm wide. Unfortunately I can’t cut my hair shorter than grade 4.5. Can you please tell me what would be the best option to reduce the scar. I am also thinking of having about 1000 grafts transplanted in the previous transplant area to gain more density and cover up the thin patches. Do you suggest the 1000 grafts should be taken while removing the existing scar together in order to achieve a smaller scare? Please guide me with the best options.

Thank You

Block Quote

The answer depends upon many variables, such as:

  1. donor density
  2. scalp laxity
  3. the surgical dynamics and wound tension at the time of the last surgery
  4. the techniques to be employed at the proposed surgery
  5. the skill of the surgeon

Your goals should be reasonable and you should go with the opinion of your surgeon if you trust him/her. The scarring may or may not be the fault of the surgeon. It could be the way your body heals. Many times I would do both a scar revision and an additional transplant all included in one step. Special care would be given to minimize risks of recurrence. See:

Posted on

Male Nipple Pain from Finasteride – Hair Loss Information – Balding Blog

I have been taking Propecia for just under a year with really no ill effects, and some good results. But in early November 2006 about 5 weeks ago I noticed discomfort and some swelling in my right nipple. I had a sonogram and was put on two different antibiotics for one week, each to no avail. The doctor thought it was mastitis or a staph infection. I had blood work done and all appears normal. I spoke with a surgeon today and he said I had Gynomastia and needed surgery next week. I want another opinion.

Can I simply stop using propecia and substitute with another treatment? Must I have the surgery? Please help thanks

Block Quote

It is very difficult for me to judge your nipple problem over the internet. My answer therefore will be in the general view, not specifically targeted to give you a medical opinion. If I were to examine you directly, my opinion would be based upon having all of the facts, which is simply not the case right now.

There is usually no rush to tackling even a small nipple mass in a male when there is pain present. Stopping Propecia is a reasonable thing to do and if the nipple pain is induced by the drug, then the pain should go away in a week or so. I am not sure if your sonograph found anything positive (a mass or tumor) that is driving your doctor to push you to a surgery. Ask this question to your doctor.

Posted on

When Would Shock Loss Occur? – Hair Loss Information – Balding Blog

I’ve been reading your blog and find it a great probable one of the best sources on the web for transplant facts! Thanks!

You recently replied to one user about Shock loss. I’m considering a transplant for my receding hair line at the temples. Though am worried it may damage my surrounding hairline which is healthy and in abundance. If shock loss were to occurr, is there a high risk it could be permanent? When would it kick in – immediately after the operation? And would propecia help several wks after the op?

Block Quote

Shock loss is a dilemma for some of the hair transplant patients. It usually happens in the first 1 to 3 months following the procedure and usually is not reversible in men. Bear in mind that shock loss happens mostly to the hair follicles that have some degree of miniaturization to them and the strong terminal (normal) hairs are quite resistant to shock loss. Several methods have been suggested to eliminate this problem. Many physicians say that topical agents like minoxidil and GraftCyte prevent shock loss, although there is no supporting evidence for this and no such claims in the manufacturer’s product inserts or claims. I had actually studied this use of these two medications on one side of the head many years ago and found no difference between the two sides.

Finasteride (Propecia) would perhaps be the most advantageous medication for reducing shock loss, if patients start taking it before the time of surgery. My recommendation to you is to start finasteride if you haven’t already. It is not well documented in any formal literature, but I believe starting the medication at least two weeks before the procedure is most valuable. If you miss the two week window, starting it anytime will be better than not taking it. The rate of shock loss has significantly dropped in our practice in the years since we have used Propecia, and I believe it has to do with us strongly recommending its use before surgery to all of our male patients.

Posted on

Bad Reaction to Dye? – Hair Loss Information – Balding Blog

Hi!
I was just wondering…my dad dyed his beard the other day…and it is now swelling ans pussing yellow out of it…is there anything we can do? What is it that he has?

Block Quote

He may be experiencing an allergic reaction to the dye. An allergic reaction may happen with contact to almost any substance. The first step of treatment is to remove the irritant agent and if possible wash the area with appropriate solution. I guess that solution may be a bit late for your dad now. Allergic reactions are usually present as self-limiting skin irritation with swelling and redness. If the allergic reaction is not improved spontaneously over a reasonable time period, or if it continues to spread rapidly, your dad should be seen and treated by a doctor. Pus coming off of the scalp is very worrisome, so actually, now is probably the best time to see a doctor in case it might get worse.