February 2008 – Page 9

February 14, 2008

Topical Finasteride Research – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,

As I scour the internet for information about new developments in the treatment for balding, just thought the readers might be interested that it appears some effort is being put into
researching/developing a topical version of finasteride to treat hair loss:

PubMed – Development of liposomal systems of Finasteride for topical applications: design, characterization, and in vitro evaluation.

Take care.

Seems like interesting research. Thanks for bringing it to our attention. The next step, with regard to the hair restoration field, would be to determine if it is equal to or better than oral finasteride in the treatment of hair loss. Clearly more work is being done for the formulation, as that is not finalized yet.

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February 14, 2008

If Hair Loss Is Not From Environmental Factors, Why Does Hair Only Fall Out On Top? – Hair Loss Information by Dr. William Rassman

My question is that when men are bald why is it usually only on the top of the head? it seems as though environmental factors should be considered as a cause. Sun, wearing hats, showering etc.

Now i understand that most causes seem to be genetic but it just makes me very curious why it would not be the whole head.

The sun, wearing hats, showering, etc. will not impact hair loss. It is all in the genetics. If I knew the answer to why genetic hair loss only impacted the top of the head (not counting diseases like alopecia universalis), I could be a rich man. Unfortunately, the answer is not known.

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February 14, 2008

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

Good day doctor, I was reading a short article about hypothyroidism, and I was left with a few lingering thoughts. Perhaps you might be able to answer my questions:

a) Would you say that hair loss due to hypothyroidism is a common or a rare incidence among those who suffer from hair loss?
b) Or, among the various symptoms of hypothyroidism, is hair loss a common or rare occurrence?

I understand that there may not be good statistics to answer these questions, but perhaps you might be able to shed some light, based on your experience.

Hair loss is one of many symptoms of hypothyroidism, but the frequency of it is not reported. Patients suffering from hypothyroidism usually have other symptoms along with hair loss, including weight gain, cold intolerance, fatigue, weakness, constipation, and depression. The diagnosis of hypothyroidism is made through blood testing for the level of T4 (the main thyroid hormone) and TSH (thyroid stimulating hormone).

Most of the patients in our practice suffer from male pattern baldness (MPB). Patients concerned about hair loss should have a miniaturization study to determine if the pattern is consistent with MPB or if there is an underlying medical condition causing the hair loss.

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February 13, 2008

Hair Loss InformationDo You Have An Opinion on Individual Doctors? – Hair Loss Information – Balding Blog

Do you have any insight on Dr. [name removed]? As in do you think hes skilled and ethical? Please would like your advice

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Over and over again I am asked such questions. I just can not answer them, because I could be at legal risk if I thought badly about a particular doctor and voice my opinion over the internet… and there are many doctors in this field who I might not speak highly about.

There are some websites that claim to be consumer advocates and give such information to potential shoppers. Some of them provide a service and some do not. It is important for the readers to understand that many of these websites charge doctors a fair amount of money for an endorsement. That may not mean that if a doctor is not endorsed on the website, he/she is not a good doctor; it means that they do not want to pay thousands of dollars a year for such endorsements.

This is a buyer beware market, a theme I proclaim over and over again. In this blog, I tell consumers how to find a good doctor and I do not charge for any of that advice. So why do I add content to this blog day and after day addressing such questions as how to select a hair transplant doctor? The answer is that this is part of an overall philosophy I have to educate the public and to let the public know that there are many good doctors out there who perform quality hair transplants. Today’s modern hair transplant creates results which are indistinguishable from a person who never had a hair transplant and is blessed with a good head of hair. At our Open House events every month, many of our patients come in to help me illustrate that very point. I stress ethics in the field, tell the consumer how to hold a doctor responsible for their work and warn the consumer that this is a buyer beware market and the burden is on them, as a buyer, to do his/her research to get a quality job done.

For more information on doctors — what to avoid, how to find a good one, what some don’t want you to know — see:

February 13, 2008

Hair Loss InformationAfter Taking Propecia for 2 Years, Suddenly I’m Shedding – Hair Loss Information – Balding Blog

Hi,
Love your site. I am a 37 yr old male and I’ve been on propecia for about 2 yrs (with very little shedding). I’ve recently started shedding quite a bit, almost like the propecia stopped working. Is this normal??? Please help!!!!

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Propecia (finasteride) does not cure hair loss. When your genetics ‘push’, then Propecia becomes less effective. Please note that I said less effective. If you were to stop the drug, then you would be on a wild ride to hair loss. As I am not your doctor, it is difficult for me to tell you what I would do. I might consider Avodart (dutasteride) under certain situations, but if I did, the dose would be high and sexual side effects may become evident. Sterility may be a price, as it has been reported (with reversal not clear). The Master Plan may include a hair transplant, but that would depend on many factors. You need to have a good relationship with your doctor.

February 13, 2008

FlutaGel – Hair Loss Information – Balding Blog

What can you tell us about FlutaGel?

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Flutagel is a gel that contains 1% flutamide as the active ingredient, a drug that is used to treat prostate cancer. It acts by inhibiting the uptake and/or binding of dihydrotestosterone (DHT) to the target cell receptor. To date, no clinical studies have been done to prove its efficacy in MPB. In theory it sounds great, but this does not always translate into the clinical arena. It needs to be studied further to evaluate its safety and effectiveness.

The website for this is at Sinere.com if you want to try to find more info.

February 13, 2008

Hair Loss InformationReader Says John Travolta’s Hairpiece Is Not Costly – Hair Loss Information – Balding Blog

The hair like Travolta wears is NOT costly as mentioned in the article.Also not required to go into a salon to have it attached.There are a number of sites on the net that sells this type of quality piece for less than 200 dollars.I have 2.Also Hollywood hair web site shows John`s hair for 159.00

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Thanks for the information. It seems like you’ve done your research… or perhaps you’re just selling something. These type of hair systems can go for thousands of dollars, but there will always be a cheaper company there to undercut the more expensive model. Plus, I assume that like many celebrities, John Travolta would have a personal stylist, adding to the overall cost. Judging by the photos (see here) though, perhaps his stylist got the day off.

February 13, 2008

Worried Sick About Shock Loss Potential! – Hair Loss Information by Dr. William Rassman

Dear Dr Rassman,

I am having my second HT transplant soon to refine my frontal line and to provide more density at the sides. I am worried sick about shock loss. Is there a possibility of this happening with new grafts that will be placed between the newly transplanted grafts that are growing well?

Thank you.

You should not have shock loss with transplanted hair — that is, hair that has been moved from your permanent area to new recipient sites. If you’ve had a previous transplant in the past 3 years or so and are taking finasteride, the risk of shock hair loss is very low.

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February 13, 2008

Merck’s Site Doesn’t Say Anything About Initial Shedding from Propecia – Hair Loss Information by Dr. William Rassman

Dear Doctor,

Great website !!

Re: Propecia and Minoxidil – The reality please

I am been sending you several emails regarding the following questions which I very much appreciate if you could answer:

– Propecia and initial shedding: Several comments on the internet mention that this medication may cause increased shedding at the beginning of the treatment (3 to 4 months). However, nothing thereupon is mentioned in the Merck product description. Moreover, this does not correspond to the timeline for results indicated in the propecia website (www.propecia.com). This website indeed indicates that one may on the contrary expect reduction of hair loss within 3 months and some regrowth within 6 to 12 months. Similarly, several dermatologists to whom I spoke indicated to me that this initial shedding my occurr with Minoxidil (which acts as a growth stimulant) but not with Propecia. What is your experience in this area with your patients. What is the reality please ? If initial shedding was a common effect of Propecia I am sure Merck would have mentioned it in the product description just like the makers of Rogaine did for Minoxidil ?

Minoxidil 12.5 + Azelic Acid 5 % in the form of a cream: I have been advised by a clinic in London to combine the use of Propecia with this cream. However, I am 36 years old and I have JUST started to thin (on the crown but not on the temples and hair line). Do you think that addition is necessary or would propecia be enough.

Age concern: I hear that propecia best works for men under 30. However, if I have just started to thin (since a year) at 36, does this mean that the medication will have little effect.

Many thanks

I have never actually seen a patient with shedding from Propecia (finasteride 1mg), but I have read many such complaints through this site. Maybe I just get the unusual bad news. Maybe there’s some commonality (outside of taking the Propecia) that isn’t being said. That is a problem with getting one email from a random reader that I may never hear from again. I don’t have enough medical history to really know what to make of it all. I can not comment on adding the combination of minoxidil 12.5 and azelaic acid 5% cream, but the acid does irritate and may cause increase absorption of the minoxidil (that is the theory, anyway).

You are correct that the best results from Propecia are in younger men, but I have seen many men in their 30s get wonderful benefits from the drug. It will be what it is and it will be better results than not trying the drug at all.

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February 13, 2008

Intercytex vs Follica – Hair Loss Information by Dr. William Rassman

Doctor Rassman,hi again. I am a frequent reader of your blog and once again I say thanks for keeping such an interesting and useful source of great information. My question is in regards to Intercytex and Follica. I keep reading about these companies and it is hard not to get excited about the possibilities described there even though actual products/treatments may take a while (if ever) to come out. Anyways, my question is which company (between those two) do you find more promising? I know this will be just a guess or opinion, but I would certainly appreciate your feedback! Thanks a lot!

Your guess is as good as mine. We never really know all of the facts and much of what is known appears to be for public relations purposes. At this point, I don’t really have an opinion when pitting one against the other.

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