Month: January 2008

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Hair Loss InformationDoes Hair Transplanted from Head to Pubic Area Change Characteristics? – Hair Loss Information – Balding Blog

I read one of your blogs re: Pubic hair transplant, which refers to Head to pubic area. I assume this means that you use hair from the head to transplant into the pubic region. Does the transplanted hair take on the characteristics of pubic hair (thicker, coarser etc) or does it retain the charactistics of scalp hair (finer, longer growing)..

Thank you

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The hair character generally is maintained like its original location. I have seen some more waviness in those with straight hair when it is moved to the pubic area, but it does not become kinky.

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Propecia Gave Me Side Effects – How Can I Get My Sex Drive Back? – Hair Loss Information – Balding Blog

I am concerned about the loss of sex drive from taking propecia. I took propecia for about 6 months and my sex drive was non existant. I stopped taking it over a year ago and it has returned, some what, but not nearly where it was before. Is there a product that will help it return, or anything that can be done? I would rather be bald with a strong sex drive, than a head full of hair without one.

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Sex driveYou need to go see your doctor for a physical examination and possible testing. While Propecia can cause a decreased sex drive (in 1 to 2% of men), it is temporary since the drug only lasts in your blood stream for about one day. After one year, I hardy doubt your sexual problem is due to Propecia. You need to see a doctor for further evaluation. In fact, erectile dysfunction may be one of the first signs of an underlying medical problem.

Here are a few facts about sex drive / erectile dysfunction / impotence that I found at Minnesota Men’s Health Center:

  • One in 10 men (10%) in the world have erectile dysfunction.
  • 30 million men in the United States have erectile dysfunction.
  • 50% of men with diabetes have erectile dysfunction, frequently within 10 years of diagnosis.
  • The likelihood of erectile dysfunction increases with age: 39% at age 40, 65% over the age of 65.
  • Smokers have a higher likelihood of erectile dysfunction.
  • Men who smoke more than 1 pack per day have a 50% higher chance of impotency than nonsmokers the same age.

And from the Mayo Clinic:

Nonphysical causes:

  • Psychological problems. The most common nonphysical causes are stress, anxiety and fatigue. Impotence is also an occasional side effect of psychological problems such as depression.
  • Negative feelings. Feelings that you express toward your sexual partner — or that are expressed by your sexual partner — such as resentment, hostility or lack of interest also can be a factor in erectile dysfunction.

Physical causes:

  • Nerve damage from longstanding diabetes (diabetic neuropathy)
  • Cardiovascular disorders affecting the blood supply to the pelvis
  • Certain prescription medications
  • Operations for cancer of the prostate
  • Fractures that injure the spinal cord
  • Multiple sclerosis
  • Hormonal disorders
  • Alcoholism and other forms of drug abuse

The physical and nonphysical causes of erectile dysfunction commonly interact. For instance, a minor physical problem that slows sexual response may cause anxiety about attaining an erection. Then the anxiety can worsen your erectile dysfunction.

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Hair Loss InformationWhy Do You Only Recommend Starting Propecia and Not Minoxidil Too? – Hair Loss Information – Balding Blog

Dr. Rassman,

I’m a 32-year-old with a Norwood 2-3 pattern in the front and some very mild but immistakable loss in the Crown. I very recently started taking propecia and am strongly considering trying that in conjunction with Rogaine Foam. Your esteemed colleague, Dr. Bernstein recommends the use of both of these products simultaneously, right off the bat. You suggest that one hold off on Rogaine until propecia has been shown to be ineffective, as it causes “dependencies”…

Not to create friction, but what is the source of your disagreement on this? What do you mean by “dependencies”? I don’t understand because doesn’t propecia create a dependency as well? (i.e. if you stop taking it, you lose all of the benefit)…

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There is no disagreement. I would also recommend Propecia and Rogaine. But, think ahead for a second:

  1. Once you start both Propecia and Rogaine, you need to take both for life.
  2. You will never really know which medication is working more or less if you start both at the same time.
  3. Rogaine can be difficult for many men to follow the twice a day application (a pill like Propecia is easier to deal with and faster to take).

If you can accept the above, I agree you should take both Rogaine (minoxidil) and Propecia (finasteride 1mg). Both create the same dependencies and I’ve never tried to downplay that. If you stop either medication, the benefits received (maintaining or regrowing hair) will be lost, therefore you will depend on both to keep your hair loss in check. The medications work differently, so finasteride can’t retain hair grown by minoxidil and vice versa.

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Hair Loss InformationMistaking a Large Hair Whorl with Crown Hair Loss – Hair Loss Information – Balding Blog

I want to express my appreciation for a good website to Drs. Rassman, Pak, Gazoni, and Zeballos. As a daily reader on this site, I see that Drs. Pak, Gazoni, and Zeballos never get any notice though they are contributing editors.

I have two questions:

The first being that does balding on the crown always start in the center or can it start on the right or left sides and progress to the other side? It seems (what I see everyday) that crown balding starts in the dead center of the crown.

Secondly, is it common for most men to mistake the beginnings of balding on the crown as the result of having a large “hair-swirl” which can give the appearance of miniaturization? I notice some men have large “hair-swirls” and some have small or even hardly detectable “hair-swirls.”

Even if you cannot answer these questions due to the many you receive, thank you for providing this informative website! If you do answer these questions, thank you in advance!

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A good analysis for miniaturization with microscopic examination will show what is balding and what is not. Generally, crown balding does not start in the center of the crown, but just in front of the swirl (or whorl, as it is also known). The actual swirl and the hair behind it may vary with different degrees of miniaturization. It is not unusual for the hair behind the swirl to be stronger and less miniaturized than the hair immediately in front of the swirl, and this distinction may point to the final pattern of hair loss in a particular patient.

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Hair Loss InformationHow Long Can Propecia Slow the Balding Process? – Hair Loss Information – Balding Blog

When you say that Propecia slows down the balding process, are you talking months? Years? Decades?

Does this differ by person? If so, what’s the most common occurence for young men in their early to mid twenties with early MPB? Do they keep their hair for just a couple more years or do the effects last until their 40’s?

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Yes, it differs in each person. Propecia can work wonders on men in the early balding years 20s to 30s, but it can also work wonders on men in their 70s (which I have seen). Some readers report that they don’t see the same resistance to DHT after 5 or 6 years, some report that Propecia is still working perfectly fine for over 10 years. Please understand that this is very individualized and I do not know of any statistical breakdown of age groups. Also keep in mind that even if you are still losing hair when taking Propecia, the RATE of hair loss is likely still slower than if you were not taking the medication at all.

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Hair Loss InformationHair Transplants for Long Hair? – Hair Loss Information – Balding Blog

I have long hair, and I’ve been taking Propecia for around a year. The results seem to be good, however, I am considering a transplant. In all the pictures I have seen, men receiving transplants tend to have very short hair. My question is this; do I need cut my hair short for a transplant? Please let me know if pictures would better assist your assesment.

Thanks

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No, you do not need to cut your hair short for a hair transplant. Actually, long hair will cover up the surgery in most people and we routinely recommend keeping the hair as long as possible. You may set up a telephone photo consultation with us by filling out the form here or calling 800-NEW-HAIR. If you’d like to send photos, please use the address on the Contact (and reference this post).

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Hair Loss InformationHey Doc! – Hair Loss Information – Balding Blog

DoctorHello Doctor.
I notice that a lot of questions here start with “hey Doc,” or “Wassup Doc,” or something similar.

Does this bother you at all? I’m sure if I had spent years in education and training to get my M.D. and everyone kept referring to me as “Doc” rather than “Doctor”, i’d be slightly annoyed but maybe that’s because my ego is larger than yours. It seems only polite to refer to a professional such as yourself by your proper title, or at least, Mr. Rassman.

I also notice your hairline seems quite healthy. If you don’t mind me asking, are you on medications yourself or are you simply one of the lucky healthy-haired males?

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I really don’t have a doctor complex and many people get familiar with me and I don’t mind. As long as they aren’t calling me something vulgar…

My frontal hairline is natural, but the crown of my head is transplanted.

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Hair Loss InformationWhat Causes DUPA and Can Hair Be Restored? – Hair Loss Information – Balding Blog

If Diffuse Unpatterned Alopecia is not related to DHT, the main cause of hair loss, then what causes DUPA. So if DHT level’s are not related to Diffuse Unpatterned Alopica, then that means that there should be some hope of restoration since DHT is not the cause of DUPA.

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We do not know what causes DUPA. I have had some success with finasteride with patients having DUPA, but as it is not statistical and more anecdotal, I can not even recommend this approach with any real certainty of success.

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Hair Loss InformationBody Hair Transplant – A Case of 100% Failure – Hair Loss Information – Balding Blog

I saw a patient earlier this week who had a well known surgeon place hundreds of body hair grafts into a bald area of his scalp about two years ago. This surgeon is one who promotes his body hair transplant procedures quite heavily, particularly on various websites and hair loss forums. No, I won’t name names (do your research and you’ll probably figure it out). There was 100% failure for the body hair to grow. Yes, a complete disaster. As one might expect, this patient was quite angry because he spent $11,000 and had great hope for this procedure, as he was depleted of donor hair from the back of the scalp.

Those looking to use body hair to transplant into their scalps should strongly consider other options if they are available, as this is not the first time something like this has occurred. I’ve read various reports and have heard quite a bit about this level of growth failure before.

Respectfully, the patient has requested that his photos not be published here.

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Could Finasteride Be Affecting My Sperm? – Hair Loss Information – Balding Blog

Dear Doctor,
I have been taking Propecia for years. My wife and I are trying to have our first baby. She has gotten pregnant twice, however both have resulted in her getting a D & C. There have been problems with cell growth after conception in that an empty sac forms with nothing inside. Could finasteride be affecting the genetics of my sperm?

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There are many potential reasons why your wife may have trouble conceiving. There are two issues that are known with regard to sperm while taking Propecia —

  • Reduced semen volume is very common, but usually the presence of sperm is good.
  • A recent report in the medical literature suggests that Propecia may cause reduced sperm counts, so I would have your sperm tested for this.

I would think that Propecia is low on the list of many more common possibilities.