Month: August 2007

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Risks to Child if My Girlfriend Becomes Pregnant While I Take Propecia? – Hair Loss Information – Balding Blog

Hi Dr Rassman,

This question concerns Propecia and pregnancy-although I don’t believe this specific issue has been raised before on your site.

In the UK, the British National Formulary is a publication which provides UK healthcare professionals with authoritative and practical information on the selection and clinical use of medicines. General Practitioners routinely refer to the BNF for advice on prescribing, contraindications etc.

Re Propecia, the following guidelines are given;

Cautions

‘Dutasteride and finasteride decrease serum concentration of prostate cancer markers such as prostate-specific antigen; reference values may need adjustment. Both dutasteride and finasteride are excreted in semen and use of a condom is recommended if sexual partner is pregnant or likely to become pregnant. Women of childbearing potential should avoid handling crushed or broken tablets of finasteride and leaking capsules of dutasteride.‘

Now what concerns me is that I am having unprotected sex with my girlfriend. She is taking the contraceptive pill, but if there is even a small chance she could get pregnant, shouldn’t I stop taking Propecia or use a condom?

Given that GP’s are advised to recommend men who are on Propecia to wear a condom if the woman is likely to become pregnant, what are the risks for the foetus/child if she becomes pregnant?

I’m aware that you have written about this before, but with the British medical guidelines, it seems more serious than initially realised.

Thanks.

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The British medical guidelines and American medical guidelines are similar.

It is always a good idea to use a condom to be ‘extra safe’. The Merck material shows minimal if any, Propecia (finasteride) in the male ejaculate. The following statement is made on the Propecia website: “Contact with the semen from a man being treated with PROPECIA is not a risk to the unborn child of a pregnant woman“.

Officially, you can continue taking Propecia while trying to conceive a child.

However, some doctors and patients are still cautious about using Propecia when trying to conceive. Because of this, some doctors recommend you temporarily stop taking the medication during the fertile period when you are trying to conceive with your partner and best to stop for only a week when your wife is fertile. You can also stop taking Propecia for two weeks and I doubt it will have any significant negative impact on hair.

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My Progesterone Is High – Hair Loss Information – Balding Blog

Dr. Rassman,

For the last 3 or 4 months, I’ve been suffering with seborrheic dermatitis, and diffuse hair loss. I went to my dermatologist, who did a fungal test on me. The test came back positive, I ALSO had the rare adult tinea capitis. However, my treatment of griseofulvin is just about over, and im still suffering from diffuse hair loss. I had my family doctor check my horomones, and thyroid. All my hormones came back normal, except for my progesterone is high!! Not to mention my hair seems to be thinning in my temple areas recently, but isn’t progesterone supposed to inhibit the male hormone DHT? Please help, im shedding alot!!

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These are all different issues and you are trying to make sense of it by linking it all to hair loss. If you have a high progesterone level it may just be a coincidental finding. It depends on what other physical problems you are having or how much higher than it normally is to be considered high. You may just have a high progesterone level that is normal to your body. If you are female you may be in a specific menstrual cycle (see Female Genetic Hair Loss Is Different From Male Genetic Hair Loss). As you can see I do not have all your medical history or information to give you a specific answer. You should address these concerns with your doctor who ordered these tests. In summary, treat your hair fungus, follow-up with your doctor, and see a hair specialist (dermatologist or a hair transplant doctor) if you continue to lose hair. It is just not possible to diagnose or even make logical guesses for this over the internet.

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If I Stop and Restart Propecia, Is It Less Effective? – Hair Loss Information – Balding Blog

Hi Doctor,

What happens if I start-stop finasteride. I took it for 1 year. Stopped for a six months. Started again about a half-year ago.

I know I don’t get its benefits while I’m not using it, but is the drug less effective the next period I use it? Am I tolerant/ habituated to its effects now? Thanks for your help!

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Think of it as “Two steps forward, one step back”.

If you stop Propecia for a lengthy period of time (few months to a year) you will likely lose some hair (that benefited from the drug itself). If you start it again, the hairs that were lost may not grow back. This does not mean it is less effective the next time you started using it again, it means that there is possibly less survivable hair to regrow.

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Hair Loss InformationBald Spots in Facial Hair – Doctors Say It Is Alopecia Areata – Hair Loss Information – Balding Blog

I am a male of age 33. I have lost hair in three patches at chin and at upper part of neck. The patches have grown a bit in size and looks threatening. I went to a couple of physicians, they called alopecia areata. Now I am being prescribed:

Candid Lotion
Minoxidyl
Nuforce 150 tablets

Please suggest about this. I am losing my confidence everytime I see a mirror. Can I get out of it?

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While surgery is never indicated for active alopecia areata, there are some doctors who specialize in this disease. See Alopecia Areata in a Patient with a Miracle Cure for details.

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Shock Loss Risks – FUE vs Strip Harvesting – Hair Loss Information – Balding Blog

I heard of the possibility of shock and its harm to cause loss of existing hair from hair transplantaion. How frequentlly does this happen and is the risk lower with follicular unit extracton?

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Shock loss occurs in the recipient area, so the method of extracting the donor hair is not impacted. The best way to reduce the risks for shock loss is the use of Propecia (finasteride 1mg) to be taken orally prior to the surgery and for the subsequent 6-8 months.

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Bald Spot The Size of a Quarter Just Found on the Back of Woman’s Head – Hair Loss Information – Balding Blog

Dear Dr.,

I am 23 years old and have had full thick hair my whole life. Recently when I was washing my hair I felt a bald spot on the back of my head close to the top of my neck. It is about the size of quarter. I have no other bald spots on my head nor is my hair hair thining anywhere. I have gone to get blood work done, and the have checked everything from my thyriod to the female horomone levels. Everything has come back normal except for my white count which came back at 13, which is just a little high. They still cant figure out what is going on. what do you think could be possibly going on?

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Infection (ringworm) and alopecia areata are just two examples of diseases that can produce what you’re seeing. You need to see a good, competent, and caring dermatologist.

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Dickkopf-1 – An ‘Upregulated Gene’ Associated with Hair Loss – Hair Loss Information – Balding Blog

Yo, doc!

I’m not sure if you’ve read the study yet, but here’s yet another delicious piece of the pie:

Dickkopf-1 biggest factor in DHT signalled hair loss.

Recent studies suggest that androgen-driven alteration to the autocrine and paracrine factors produced by scalp dermal papilla (DP) cells may be a key to androgen-potentiated balding. Here, we screened dihydrotestosterone (DHT)-regulated genes in balding DP cells and found that dickkopf 1 (DKK-1) is one of the most upregulated genes. DKK-1 messenger RNA is upregulated in 3-6 hours after 50-100 nM DHT treatment and ELISA showed that DKK-1 is secreted from DP cells in response to DHT. A co-culture system using outer root sheath (ORS) keratinocytes and DP cells showed that DHT inhibits the growth of ORS cells, and neutralizing antibody against DKK-1 significantly reversed the growth inhibition of ORS cells. Analysis of co-cultured ORS cells showed a significant increment of sub-G1 apoptotic cells in response to DHT. Also, recombinant human DKK-1 inhibited the growth of ORS cells and triggered apoptotic cell death. In addition, DHT-induced epithelial cell death in cultured hair follicles was reversed by neutralizing DKK-1 antibody. Moreover, immunoblotting showed that the DKK-1 level is up in the bald scalp compared with the haired scalp of patients with androgenetic alopecia. Altogether, our data strongly suggest that DHT-inducible DKK-1 is involved in DHT-driven balding.

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Interesting study! Thank you for the information. The complete abstract is available here, at the Journal of Investigative Dermatology.

Since I really have nothing further to add, perhaps they should consider a name change — something other than Dickkopf. It is bad enough that Propecia is already associated with a similar sounding, although untrue, side effect.

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If Dutasteride Is Approved for Prostate Treatment, Wouldn’t It Be Safe for Hair Loss Treatment? – Hair Loss Information – Balding Blog

Dr,
with reference to the reply you gave me regarding the below thread on the 15th August 2007: ‘Would You Prescribe Dutasteride If It Was Approved for Treating Hair Loss?‘

You stated that the safety concerns have yet to be fully established until FDA approval is give. I believe I am correct in stating that Dutasteride is already approved, but not for hair
loss so wouldn’t it be safe for human consumption irrespective of the fact that hairloss approval has not been given?

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The average age of men that seek treatment for hair loss is different than the age of those that require treatment for prostate disease. Older men generally do not have children, while younger men do. So for example, how long does one have to be off the medications before pregnancy is safe? That is unknown. The recommended dosage of dutasteride to prevent hair loss is also unknown. Yes, dutasteride itself is proven to be safe in older men with prostate problems and is FDA approved for treating the prostate, it is still undergoing testing for a greater segment of the adult male population that are looking to use this drug for treating their genetic balding.

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Too Much Scarring From Previous Transplants, So I Want Body Hair Transplantation – Hair Loss Information – Balding Blog

Hi Dr.,

Are there any Doctors in New York City that are performing Body Hair Transplant (BHT)?

I have a lot of scaring from my previous transplants (no more donner area available). My hair on my scalp is also thinning more, resulting in my existing transplants not to look natural. I
would like to visit with a BHT Doctor in New York City.

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I believe Dr. Robert True in New York does body hair transplants (BHT). I am generally not an advocate of BHT (see I Want Body Hair Transplants for my reasoning).