What Percentage of Early 20s Patients Have Side Effects from Propecia? – Hair Loss Information by Dr. William Rassman

I am a 21 year old male and I have a couple questions regarding a product: Propecia. From what I’ve read, you seem to be in favor of Propecia. Although I’ve always had a high forehead, it is starting to recede on the sides. I don’t think it necessarily looks bad; I just think it’s hard to find a hair style that makes it look good. But, my question for propecia is: what percentage of people that take propecia at my age end up having sexual problems? I just assume be bald if I knew I’d have lingering sexual effects.

First of all, I like to see all patients personally and perform a miniaturization study, before starting them on Propecia. This way, I can follow the progress of their hair loss or gain in the future and I also can avoid using medication for the patients who don’t need it.

I have not seen any study that looked into the side effects of Propecia in different age groups. Sexual side effects can be complex, because it might have to do with patient’s sexual activity in different ages as much as other things. I would suspect that decreased libido in men in their 20s would be lower than men in their 50s (for example) as the sex drive in young men is generally very high to begin with.

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What If I Have Very High DHT Levels and Propecia Isn’t Getting Rid of All My DHT? – Hair Loss Information by Dr. William Rassman

Hi there,

I have been going to the gym for quite some time now and I heard that weight lifting increases hormones, which on return increases DHT, thus resulting in increased hair loss. Some lady I overheard in the chemist said that her son was weight lifting so much and started to lose alot of hair. Is this true? I heard the squat workout (which I do) is a hormone stimulating workout which increases your hormones by alot. Wouldnt this increase DHT levels to an extent that one propecia tablet couldnt get rid of? I am assuming that the propecia tablet can only get rid of a certain amount of DHT…should i take more a day?

Sorry about all this i just became really worried after this info..there are stuff on the net that say its true so im not exactly sure now..

While heavy workouts may have a slight impact on testosterone levels, weight lifting does not cause hair loss. The amount of DHT is usually proportional to testosterone levels. High testosterone will usually produce more DHT. You are asking about taking more Propecia to manage what you believe it more DHT in your body. Frankly, I do not know the answer to your question.

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I Want Amazing Transplant Results in One Session – Hair Loss Information by Dr. William Rassman

Is it possible for me to receive a hair transplantation of approximately 3,300 follicles in only one session and finally getting the amazing result like patient LG in the photo section (hair line) of NHI website ? I am a class 4A Norwood.

Patient LGAn amazing result in one session is doable in some patients. There are many factors that lead to such results, including the hair texture and thickness of the hair shaft. Remember that “supply and demand” is important and your scalp must be flexible enough to handle these higher graft numbers. If your scalp has good laxity and you have a good hair density, you are a good candidate to get high numbers, which is needed to cover a large area. Hair characters including diameter, color, and waviness also play an important role in the final results. The best way to predict this is by visiting a hair doctor. If you’re in California, I’d suggest making an appointment with us and to come to an Open House event where you can see the results of such surgeries on many people and get a thorough evaluation.

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Does Propecia Cause Prostate Cancer? – Hair Loss Information by Dr. William Rassman

I would like to know if there are further studies on Propecia to rule out if Propecia does or does not have a long term effect on causing prostate cancer.

Propecia (finasteride) is a blocker of the enzyme 5-alpha reductase. The mechanism of action of this enzyme is through preventing conversion of testosterone to dihydroxytestosterone (DHT). There is no evidence that Propecia causes prostate cancer and in fact its use is recommended in patients with strong family history of prostate cancer as a prevention for it. In studies performed at many university centers, it has been shown that finasteride 5mgs taken daily for 7 years, reduced the risk of prostate cancer by 25%.

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Aldactone and Shock Loss in Women – Hair Loss Information by Dr. William Rassman

Hello. I am a 30 year old female and have been suffering from hair loss since my early teens. I FINALLY found a compassionate dermatologist who did a scalp biopsy and I was diagnosed with female patterned baldness. I have had a consultation at (name with-held) and I am concerned with Shock Loss. I am currently on Aldactone (prescribed by my dermatologist) and would like to know if this helps prevent shock loss as Propecia does and also what are the chances of shock loss in women.

We don’t know the answer to that, because the medication has never been studied for this purpose, to my knowledge. Hair transplants in women with female genetic hair loss have limited application if the hair around the sides and back of the head is diffusely involved in the process of miniaturization. Be sure that the goals are well defined and that the donor hair that is being used is healthy for if it is not, there may not be value in the surgery.

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Roaccutane and Female Hair Loss – Hair Loss Information by Dr. William Rassman

Hi! I’m a 25 yr-old female and have recently seen a dermatologist who told me that my hair loss is most probably due to my taking of Roaccutane (have stopped since about 2 to 3 months ago).. I understand that Roaccutane is a form of vitamin A, so is it okay for me now to consume health supplements that contain vitamin A 5000IU (daily)? Will hair loss be accentuated? thanks for advising!

Roaccutane is an active anti-acne medication containing the active ingredient isotretinoin. One of the side effects of this medication is hair loss. Although hair loss could also be one of the rare side effects of vitamin A, I am not sure they are acting through the same mechanism. In fact, hair loss is mentioned as a rare side effect in many drugs. If you take supplements containing vitamin A and your hair loss gets worse, then it might be an indication to stop the supplement and consult a doctor.

Minimizing Avodart Risks By Taking It Once a Month? – Hair Loss Information by Dr. William Rassman

I think despite how much you caution your readers about the dangers of going with Avodart, as it is not approved by FDA, I think deep down you must understand how desperation will drive us to at least consider it.

With that in mind, it only just occurred to me…a while back, you mentioned that it’s possible, based on your educated guess, that only a monthly dose of Avodart would be necessary since the half-life was so long (again I emphasize for the readers that it was just an educated guess).

For those of us willing to take the risk, wouldn’t this risk be minimized by only taking it once a month? I’m thinking – why not continue to take Propecia daily, in addition to Avodart once a month? Surely, while risky, it’s a safer option for those of us who really aren’t responding to Propecia that well.

I don’t think that I said that Avodart (dutasteride) was a drug with risk, I just said that it was not approved by the FDA for treating hair loss. Clearly the drug is approved for prostate problems and is considered safe. The half life of this drug is 5 weeks, but it reaches only to 65% of its steady state level after 1 month and 90% after 3 months with daily doses of the medication. Once a month should not (in theory) create therapeutic levels in serum, but that doesn’t create it for prostate applications. Although your analysis is reasonable, knowing what dose to use is ‘hokey’. I also just don’t know how to judge if it is working, nor do I know what the best dose is, what the best frequency to take it, or whether to up the dose if it doesn’t work.

L-arginine, Pro Solution Pills, and Hair Loss – Hair Loss Information by Dr. William Rassman

I’ve searched for the answers on your site but haven’t found it yet. From what i can tell Testosterone such as HGH is best avoided as it may accelerate my MPB somewhat. Currently i take L-arginine and was thinking of taking pro solution pills as my libido has dropped and they were recommended to me. Both these products indicate they have ingredients NOT (Dehydroepiandrosterone)in them that promotes the making of testosterone. Will this accelerate MPB at all, I’ve included the sites if you have time. Thousands of people go to the same message board i do (discussing mens health) most of them use the product but nobody has posted a question in relation to MPB and a few of us are interested in the answer.

Thanks for your time

Nobody really knows what these products do and whether they truly work. There may be science behind it and what is claimed may be valid, but the evidence and non-biased scientific research are difficult to find. Moreover, the ingredients and its dosing are not regulated by the FDA, because it is a natural supplement, not a drug. If a product claims it makes more testosterone and you believe that to be true, it will in theory give you more DHT production and more hair loss.


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How Can You Ridicule the LaserComb But Support Rogaine? – Hair Loss Information by Dr. William Rassman

Hello Dr Rassman.

I have a slight bone to pick with you, regarding some interesting comments made about the Lasercomb. In one of your articles you mentioned the line “I still go by my gut feeling, an application three times a day by a comb going through the hair just does not sit right with me and my intellectual judgment (which dictates a great deal about why I think that way)”. I would like to point out the ridiculous parallels of this comment to a certain other product called Rogaine. Firstly no one actually knows how Rogaine works (the company readily admits this on there website) Secondly I dont think its any more absurd or outrageous to think a comb with lazers is any less effective than putting an alcohol like solution called “Roagine” which no one really knows ingredients of and how and why it really works on your head everyday. Or for that matter Propecia. They all take an element of FAITH! But at least the lasers have a basic theory of stimulation of the hair follicle. How the hell does alcohol going to do any better?

To answer to your question, I need to explain a bit about medical research, which could be found behind almost any new treatment modality in medicine. Any new drug needs to go through different phases of testing before becoming approved for use in humans. The LaserComb did not go through such testing, but rather got FDA approval because other such devices were approved in the past (predicate device).

New treatment modality first needs to go through preclinical testing, which involves using new treatments in the lab, including cell cultures followed by its use in animals for its efficacy and safety evaluation. If it proves safe and effective in animals, a clinical trial follows.

Clinical trial is the direct application of a new drug on humans and has four phases:

  1. Phase one is the first stage of testing drug in a small group of volunteers. This phase is done to prove safety and tolerability of drug.
  2. Phase two is performed on larger groups of patients to assess the efficacy of the new treatment and its possible side effects. This phase usually last a few years.
  3. Phase three is a randomized controlled trial on larger groups of patients (a few hundreds to thousands of subjects). It is done to define the value of a new treatment in comparison with other available treatment options. If medication passes this phase it could be offered for its general use.
  4. Phase four is performed on a longer period of time, and involves post-launch safety evaluations, long term adverse effects and technical support of a drug.

Minoxidil is a medication that was initially used for the treatment of high blood pressure. This medication was first studied for one of its side effects, “increase of hair growth” in the early 80s. After its effectiveness for treatment of androgenetic alopecia was confirmed by initial studies, it was studied on cell cultures, animals, and humans in different concentrations. Several research centers and universities studied the effectiveness of this medication and its comparison with other modalities. Since the experiments in the early 80s, minoxidil was first suggested for its use for treatment of androgenetic alopecia. It has been studied for different groups, sexes, ages, and races. Numerous research projects directly evaluated the effectiveness of minoxidil since early 80s. The result of these studies is over 100 articles that are published in major peer reviewed medical journals.

Although the application of laser for treatment of baldness sounds glorious, so far there is no reliable research papers in peer reviewed journals to prove its effectiveness for hair loss treatment. A physician, unlike a sales person, needs to see solid based research published in peer reviewed medical journals before being able to use or recommend a new treatment modality. For the LaserComb, none is available at this time.

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Differin and Hair Loss – Hair Loss Information by Dr. William Rassman

I have been using Differin topical solution on my forehead every night for nearly six years. I have recently noticed that I am losing hair that was transplanted three years prior. I did some research on the web, and there is some mention that other people (although few) seem to have experienced the same. The drug company and the prescribing dermatologist made no mention of hair loss being a potential side effect. In your professional opinion, is it possible that this topical derivative of vitamin A (related to the dreaded hair loss drug accutane) could be causing my transplanted hair to fall out after six years of use? Any input would be greatly appreciated.

Differin is a topical medication used for the treatment of acne. Losing hair is not reported as a side effect of this medication, but many of the acne drugs do cause hair loss. See the doctor who prescribed the medications to evaluate your hair loss. Maybe you are losing your native hair. It would be unlikely (but possible) that a medication that you used for six years without any problem is now causing your hair loss.

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