July 2007 – Page 11 – Balding Blog

July 6, 2007

Taking Viagra to Counteract Side Effects of Propecia? – Hair Loss Information – Balding Blog

Doctor if sexual dysfunction is a side effect of propecia,and if i stop propecia the balding process will resume,could take viagra counteract the sexual side effects of propecia,and allow to continue to take propecia? And if not,would minoxidil alone do the job? Thanks in advance.

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Good question. First, only about 1% of the male population get erectile dysfunction from Propecia. There is no contraindication for using Viagra while on Propecia. The two medications do not have any interaction and it is safe to take them together. In fact, I recommend the use of Viagra (Cialis or Levitra) to the patients who experience erectile problems. A man whose sex drive is reduced while on Propecia will often not be helped by Viagra, as this only impacts the strength of an erection. Most young men do not have a lack of sex drive or an erectile problem, but as they get older (e.g. 30% of men in their 30s have ED, 40% in their 40s, 50% in their 50s, etc.). As ED is often present in men (with denial), the addition of Propecia may make the problem worse. Still, again, it is relatively infrequent.

July 6, 2007

Where’s the Double Blind Study on Equol or Procyanidin B-2? – Hair Loss Information by Dr. William Rassman

You say you are interested in research for new and improved hair loss treatment methods. Can I ask why no one has decided to do a serious, double blind study on Equol and MPB? Or even Procyanidin B-2? There is anectodal evidence these could help, as you admit. Why NO progress on ANYTHING in the US besides fin? Couldn’t an Equol pill make money if a study proved it worked for MPB instead of just hancuffing DHT? Why aren’t you leading the charge on some of this stuff, when you have access to the best research and best minds – and as you claim, a physician should CONSTANTLY seek better ways?

It is one thing to be a physician and another to be a researcher. It takes lots of money, time and logistic effort to conduct even a simple study, let alone a good, reputable study with many patients enrolled. While it is true that I am interested in research and science, I do not have the resources to take on such an endeavor. Perhaps you should pose this question to the drug companies and business entrepreneurs or find the funding to organize such effort.

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July 6, 2007

Do Men Have More DHT As They Age? – Hair Loss Information by Dr. William Rassman

I was wondering Testosterone levels are supposed to be highest when men are in their 20’s, yet for most men the effects of DHT are not seen until later. Do men have more DHT as they get older (past the 20’s), even though produce less testosterone? Do men develop more DHT receptor sites when older or produce more 5AR enzyme when older to convert testosterone to DHT? They don’t have these DHT receptor sites in the scalp when younger, just older? Like a cancer that just appears after so many cell divisions and the genes reach a certain point? LOL, well just wondering why men have more DHT (hormone) when older if produce more testosterone when younger, I’m sure a lot of other people would be interested in that information, Thank you very much for any info or sites that may have info!

You ask a very good and interesting question. You sound like you are just about to take a biochemistry exam. Unless I am mistaken, DHT levels will correspond with testosterone levels. Generally, less testosterone (an aging problem) should produce less DHT. The reason why you see balding men who are older (when testosterone levels are relatively lower than their younger years) is that it is likely a late expression of the genes that affect hair loss. On a counter note, most balding men will report that their hair loss began in their late teenage years (when their testosterone levels were the highest).

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July 6, 2007

Can Concealers Such as Toppik or DermMatch Effect Finasteride? – Hair Loss Information by Dr. William Rassman

Hi dr Rassman! thanks a lot for this wonderful site. I am wondering ıf you see some hair loss signs in your son, what will you do FIRST to treat it? and also, have you ever used concealers such as toppik, dermmatch, couvre….? can they effect the working of finasteride? thanks a lot.

If my son had early miniaturization, I would immediately start him on Propecia. That is what I did with one of my three sons. The use of concealers should not impact finasteride.

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July 5, 2007

I Want a Scar Revision – Hair Loss Information – Balding Blog

I was wondering if you would do scar revision for my donor scar. I don’t think I had a very good doctor. What would the cost of a tricho closure be approximately? I have seen your photos and some look great, I can hardly tell there is a scar. Thanks!

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We are constantly researching to come up with better methods to manage the donor area for improving the donor scars. Scar formation has to do with several factors — the surgical technique is only one of them. One important factor that patients tend to forget is their different healing potentials. Not everyone is a good healer and some patients develop widened scars regardless of the meticulous methods that are used. We usually do a scar revision for our patients with no cost to them. For those patients who are referred from other centers, we charge a minimum fee including a trichophytic closure, but we need to evaluate you with regard to the size of the scar, know how many surgeries you had, and determine the looseness of your scalp before we can tell you if we think that we can help you. You may call the office for a quote on our minimum fee — 800-NEW-HAIR. It is possible that this could be done over a telephone consultation.

July 5, 2007

Hair Loss InformationHead is Still Numb and Donor Area Still Hurts a Year and a Half After Surgery! – Hair Loss Information – Balding Blog

Dr R…You can publish. I paid for 1,600 grafts a year and a half ago [with a local doctor]. Horrible results! This is a photo the night after my surgery. My head is still numb on top & hurts in the back after a year and a half!!

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After a few weeks, any anesthesia (numbness) of the skin should abate unless it is in the back of the head and one of the major nerves was cut. It is not clear from your comment if the pain and numbness is in the top and back. The major nerve will control the back and top of the head. If you say you have had horrible results from the transplant, then confront the surgeon that did it and ask him/her for his/her opinion. Then get a second opinion (you can come see me in Los Angeles) to assess what grew or did not grow. Access to your preoperative and post operative pictures will be critical for me. As a smart consumer, you should know that you can get answers and you should pursue those answers. Hopefully, your doctor will respond to your concerns. Speaking with your doctor directly, is the first step you should always take.

July 5, 2007

Baldness Calculator? – Hair Loss Information – Balding Blog

Hello!

I am 19 years old (going to be 20 in september).

I have a noticable receding hairline and I have now for 6-8 months or so. I am terrified of going bald!

I used a baldness calculator and it said I would be bald by my late 20’s. How reliable are these calculators?

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I don’t know of any publically available, reliable baldness calculator yet. The best way to determine what your final pattern of hair loss will be is to have your hair mapped out for miniaturization and see what areas are being impacted. In a young man, maybe only the frontal area is starting to bald and as you get older, the balding may progress more towards the back. Miniaturization studies will show that progression and if you start treating it with Propecia, you might find out that the problem will arrest or possibly reverse for a while. See a competent doctor and get your hair mapped as I’ve suggested.

As an aside, we have developed and submitted U.S. Patent applications for a type of baldness calculator. We are working on building it now, but it will take some time to get the right design and we will not manufacture it until we are satisfied with the iterations we work out.

July 5, 2007

Root Stimulator – Hair Loss Information – Balding Blog

i have hairloss in my crown area and recently started using a root stimulator product and ive noticed small bumps in that area. could this be new hair emerging?

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I don’t know what you mean by “root stimulator” (it may be a marketing term, not a medical term), but new hair growth usually does not present like that. What is usually called hair growth, seen with available hair loss medications such as topical minoxidil (Rogaine) or oral finasteride (Propecia), is thickening of the miniaturized hair. The effects of these medications are to stop or slow down the rate of hair loss or sometimes to thicken the current (miniaturized) hair. Check this with your dermatologist if you see new bumps in your head.

July 5, 2007

Bumped My Head 10 Days After Transplant – Hair Loss Information – Balding Blog

Hiya, I had hair transplant surgery on my temples about 10 days ago. Today I bumped my head on my left temple and it became slightly red. I wanna know if this is dangerous and would affect my hair transplants. Also some of my new hair fell out with the scabs about 8-9 days after surgery. Is it too soon for it too fall out?
Please help!!

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It would be unusual for loss of the root of the grafts at 10 days post transplant. We have published on this subject and found that the root of the transplanted graft stays in even if the top of graft came out at 10 days. What did your doctor say about it?

July 5, 2007

Is Propecia Making My Hair Lighter in Color? – Balding Blog

Dear Dr. Rassman,

First of all, your website is very helpful and I commend you for offering your expertise.

My question is about a return to natural hair color while on Propecia. I am 28 years old with thinning hair, which has always been naturally thin but I am definitely balding recently. My hair is blonde but has darkened a bit over the years (a dirty blonde now). I have been on .5 mg propecia every day/every other day for 2 months now.

I noticed that much of the hair I lose is shorter, thinner, and a black color compared to the rest of my healthier hair strands. But recently since I started on propecia, the base of the hair falling out is a very light color, while dark towards the end. The lighter part at the root is about 2 cm or so and matches my more ‘natural’ hair color.

Is this an effect of Propecia? Does it mean that Propecia is having a positive effect returning my hair color/strength/thickness to it’s natural state? Why would thinner hairs be so dark in the first place?

Thanks for any answer you can give!

Miniaturized hair is lighter in color due to less melanin pigments present in each hair. Propecia can help thicken the miniaturized hair and by doing that make new hairs look darker. The light hair that you are losing may be the cycling miniaturized hair. Since you recently started taking Propecia, you may gain some of the original color back in the growing hair. Your miniaturized hair may continue to grow for a year or more and may eventually stop growing if Propecia can not keep it at bay. That is the reason most patients will see some return in color during the first year of taking the medication.