February 2007 – Page 10

February 12, 2007

Hair Loss After Anesthesia – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

Im a 22 year old male from San Jose. I went to your NHI office when I was 22 and I was told to start taking Rogaine and propecia. It worked. However, in november of 2006 I had eye surgery under general and local anesthesia. Since then my hair has been falling out like mad. I was wondering what is the average time for this fall out to cease and will the hair I regrew on rogaine and propecia come back?

Hair loss is caused by four factors:

genes (for the genetic defect)
hormones (produced normally from the testicles)
time (the longer the hair follicles are exposed to the hormones, the progressive nature of the hair loss will demonstrate itself)
stress

Your surgery and anesthesia cause enough of a stress to accelerate your hair loss. If you are on Propecia and it still happened, you are now entering another phase of the hair loss process. It may not come back, but you should come back to see me and we will analyze this together.

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February 12, 2007

Hair Damage from Hot Straightening Iron – Balding Blog

Hi, I have caused extensive damage to my hair through the use of a hot straightening iron. I am a 31 year old male who had minimal recession at the front and thick hair all over. My hair is now damaged and thinned all over from the hot iron and has recessed at the front dramatically in 6 months due to the damage. I have regrowth coming through but not really at the front from the damage. Is it wise to start propecia at this point I’ve stayed off using it waiting to see where the hair may grow back but after 6 months have not seen much at the front.

Thanks

You need a diagnosis as to the degree that genetic balding may be present. I would want to know where the damage is — is it limited to a particular area? There are many things that an examination of your scalp would show me, so rather than shoot from the hip, I would suggest that you go to a hair expert or dermatologist to work through the problem with you. It sounds bad, too serious to be treated over the internet.

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February 9, 2007

Hair Loss InformationExperiencing Propecia Side Effects for All 9 Months of Use – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I am a 26 y/o male who has been taking propecia for about 9 months now. I have been experiencing sexual side effects for the whole time I’ve been taking the medication. I have read in blogs/articles that the side effects tend to go away after prolonged use. If they were to go away, would they be gone by the 9 month point?

If they should have been gone by now, I have no choice but to decrease the dosage to .5mg. Why do you recommend being off the drug for 2 weeks before switching to the .5mg? I understand that its b/c you want to side effects to go away before switching….but will the side effects not go away if you switch immediately from 1mg to .5mg and continue to take daily?Can you please explain the rational behind this b/c I am afraid of losing more hair by not taking the medication for 2 weeks. Please respond Dr. Rassman, these sexual side effects are depressing me quite a bit. Thanks for the help.

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The sexual side effects associated with Propecia are generally temporary. Taking 1/2 the dose may also alleviate the side effect. Taking 1/2 dose is 70% as effective and it is certainly better than taking no finasteride.

Before considering changing any drug regiment you need to discuss this with the doctor that prescribed you the medication. You may have another medical problem unrelated to the use of Propecia that is causing your sexual side effect. Some men can not get over this sexual side effect problem and then for a good sex life, they would not take this drug. Minoxidil is a reasonable alternative in such situations.

The purpose of stopping the medication for two weeks is to determine if Propecia was what was causing your side effect. In theory even this method is flawed, because of the placebo effect.

February 9, 2007

Hair Loss InformationHairMax LaserComb Receives FDA Approval? – Hair Loss Information – Balding Blog

I received two emails recently about the HairMax LaserComb, so I’ll combine my response into one…

EMAIL 1:

I was watching The Big Idea with Donny Deutsch last night, and a representative from the makers of the Hairmax Lasercomb announced point blank that they had received FDA approval to make claims for hair growth. He mentioned something like 19 new hairs per centimeter. This is a big deal. I was expecting a bigger announcement, and now I cannot find any press release or report announcing Hairmax’s FDA approval. If the comb is in fact FDA approved to stop hairloss/regrow hair, it’s something I would consider adding to my regimen. Have you heard anything about Hairmax gaining FDA approval?

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EMAIL 2:

Hello Dr. Rassman,
I recently read that the Hairmax Laser Comb has now been cleared by the FDA as a product which is “clinically proven to promote hair growth in males with androgenetic alopecia (Norwood II A to V with Fitzpatrick skin types I to IV)”. Here is the link: hairmaxforum.com

I’m a bit suprised that I have not heard more media buzz about this. Is this now the 3rd FDA approved method to treat MPB? I have read your prior posts on the subject and am just intrested to know what this new FDA approval actually means. Any thoughts? Thank you

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This came out of the FDA and this is the exact wording in the final page of the FDA letter in January 2007:

Indications for Use
510(k) Number (if known): K060 305
Device Name: HairMax LaserComb
Indications for Use:
The LaserComb is indicated to promote hair growth in males with androgenetic alopecia who have Norwood Hamilton Classifications of la to V and Fitzpatrick Skin Types I to IV.

It is important for the readership to note that just because this is cleared by the FDA, it does not mean that it is guaranteed to grow hair. I would like to see an independent scientific study with adequate statistics, done by a third party. If I saw that, I would be comfortable in recommending it depending on the results the study found. I have not seen the company’s submission science, so I can not endorse this and would not recommend that everyone go out and buy one. Frankly, I’m just not convinced, despite FDA clearance.

February 9, 2007

58 Year Old Woman Looking to Take Propecia – Hair Loss Information – Balding Blog

I’m a 58 year old woman, who is getting a lot of hair loss near the front of my head. This has been going on for about 6 months, and I’m not sure if I should start Propecia (correct spelling?) or Minoxidil. I’m hypothroid,and take a combination of armour thyroid, and synthroid, the latter being more a culprit in hair loss I’ve read. If my being hypothyroid will always keep me losing hair, is there any point to starting a hair serum/medication?

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Women after menopause have been the subject of one of the studies on finasteride (Propecia). The study, involving 137 post-menopausal women with androgenetic alopecia (male pattern baldness) who were treated with Propecia vs. placebo for 12 months, could not demonstrate effectiveness of Propecia. Another study shows it might help, but the statistics are just not there. Minoxidil is the only FDA approved medication for women with hair loss at this point.

Hypothyroid condition and synthroid are both blamed for hair loss. Although hypothyroid disorders may increase hair loss, I assume your thyroid hormone level is corrected being on thyroid medications. If in doubt, discuss it with your endocrinologist. As I said before, there is no systemic medication for treatment of hair loss in women now.

February 9, 2007

Western Diet Contributes to Hair Loss? – Balding Blog

Dear Doctor,

What is your opinion on “reports” that MPB was essentially unheard in Japan before WWII yet it’s common now? I’m specifically referring to this website (http://www.newstarget.com/z012893.html) which cites prevention magazine. The article starts with “For men, Dr. Klaper says that a low-fat diet may help slow down the balding process…” I’m concerned that my “western” diet might be contributing to my receding hairline. Thank you

Interesting reading! The author says, “We can blame the typical American diet for yet another unfavorable thing: Hair loss”. I don’t believe that there are any good studies that relate diet in various cultures to balding genetics. I know that wigs are hot businesses in Japan and Korea, but that does not tell much about the thrust of the article. The article speaks for itself. No further comments are needed by me. Thanks for the reference.

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February 9, 2007

Using Minoxidil with Toppik – Hair Loss Information by Dr. William Rassman

Hi,

I’m 43, male and have just had a FUE. My question is how do i use Minoxidil if i already have Toppik in my hair? My surgeon has said that i should use Minoxidil for 6 weeks to help the transplanted hairs. Will this help? What if i don’t use the Minoxidil?

Regards and many thanks for this great service you are providing.

If you want to use minoxidil and Toppik, I would apply minoxidil first, let it dry, then apply Toppik.

There is no study to prove the minoxidil will help your transplant to grow faster. It may help, but nobody really knows. Your transplanted hair should grow regardless of minoxidil. It may help keep your existing hair from falling out.

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February 9, 2007

Stopped Propecia, Saw Catch Up Hair Loss – Hair Loss Information by Dr. William Rassman

Dear doc,

I am a 22 year old male with thinning hair and a family history of baldness. Last summer I started taking propecia, but was too lazy to renew my perscription after three months. Since then I seem to have experienced the “catch up” hairloss I hear so much about and now, five months later, Im thinking of going back on it and staying for the long haul.

My question is though, should I expect any diminished results from restarting the treatment? Does propecia somehow lose its efficacy if you stop and restart it? Is it worth going back on?

Thank you for your time.

I hear about catch up hair loss over and over again. So many men start and then stop Propecia and experience hair loss upon stopping the drug, which just shows that it was working. Just go back on it and stay on it this time. It will not lose its efficacy, but you may be more ‘down the road’ on the balding process for stopping it.

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February 9, 2007

Minoxidil with Azelaic and Retinoic Acid – Hair Loss Information by Dr. William Rassman

Dr. Rassman,
Could you please comment on the the various minoxidil solutions offered by Dr. Lee (www.minoxidil.com) and whether his claims are substantiated. Specifically, I am very curious to hear your opinion regarding the use of azalaic and retinoic acid (either with or without minoxidil) as regrowth stimulants and DHT inhibitors. Are they of any benefit and, if so, are they likely to be any more effective than minoxidil alone?

Generic minoxidil may have enhancers added and they include axelaic acid and retinoids. I have no opinion in their isolated use, but when combined with minoxidil, they increase the blood supply to the area of application. This is a like a minor burn and it can be irritating to the skin. It, to my knowledge, is not a DHT inhibitor and I do not personally believe that it will make minoxidil more effective.

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February 9, 2007

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

Hi

I am a 22 year old male. I just started to lose my hair about a year ago and have been on propecia for 3 months with some slight improvement. I am a smoker and was wondering that if you smoke while on propecia do you limit propecia’s effectiveness to grow new hair more than a person who does not smoke. Any help would be much appreciated.
Thanks.

There is no information on smokers who take Propecia. Best to stop smoking for your general health, but alas, maybe your parents have already told you this.