Month: March 2008

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Hair Loss InformationI’m Female, My Doctor Has Me on Propecia for Hair Loss, But I Want Avodart – Hair Loss Information – Balding Blog

my dermatologist has me on propecia for hairloss. i am 55, female and have read that avodart may give better results. my dr. says she has not heard of avodart. i didn’t mention this was not the intended use of the drug. anyway, i think i may need to find another doctor. do you have anyone in orange county you might recommend?

thanks.

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Go seek out another dermatologist. I personally would not treat a 55 year old female with Avodart (dutasteride) unless they had Polycystic Ovarian Syndrome (PCOS) or a similar problem.

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Hair Loss InformationPainful, Clumpy Ejaculations After Starting Propecia – Hair Loss Information – Balding Blog

Hi there-

I’ve surfed through past entries, and was unable to find a post specific to the problem I’m having.

I began noticing the signs of MPB in my late teens, and a more prolific loss in my early twenties. I’m 24 years old now, and have been on a Propecia/Rogaine regiment since visiting a dermotologist last year.

Within two weeks of consistent Propecia use, I began to have painful ejaculations and the consistency of my semen became clumpy/very gelatenous. I was told that sexual side effects usually subside with continued use, and indeed, ejaculation is no longer painful. My semen consistency is mostly normal now, but it occasionally reverts back to that of the initial months of taking the medication.

Ever heard of a similar experience?

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I have been aware that the consistency of the semen changes in some men, but I have not heard about painful ejaculation. Talk to your prescribing doctor about this issue.

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Thanks, My Stylist Doesn’t Believe That I Had a Hair Transplant! – Hair Loss Information by Dr. William Rassman

I had two transplants at NHI over the past 5 years (last one was 3 years ago) and the results are fantastic. Whenever I get a haircut I will tell the stylist that I had the transplant procedure done just so they are aware of the line scar in the back and don’t cut my hair too short back there. I find that as long as I tell them before they get started, its no big deal and the scar is never visible, even with a $15 Supercuts haircut that I get. BUT, I usually end up spending the 10 minutes I’m getting my haircut explaining to them that yes, this is a hair transplant and no, I’m not just joking around. Nobody believes me! Outside of getting a haircut, I never mention it anyway… but the one time I tell someone, they don’t believe it. So that just goes to show that you did a damn fine job. Really incredible work and as you can probably tell I am thrilled with the end result. I’ve included a couple photos that you can use for your blog.

Thanks, doc. I’m very, very, very pleased.

I’m glad to hear that nobody believes you — that means we were successful! In all seriousness, this is how any good hair transplant should be. We never want patients to be easily spotted as having had a hair transplant. The end result should always look natural.

This patient had 1,737 grafts transplanted over two procedures.

Update Dec 2008: [Photos removed by request]

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Hair Loss InformationMy Hair Has Changed, But There is No Miniaturization – Hair Loss Information – Balding Blog

In your opinion, if there is no miniaturization does that mean there is no hair loss? I recently had my hair mapped for miniaturization by Dr. Pak in San Jose, CA. He found no miniaturization beyond what is normal. It is possible that I have experienced a telogen effluvium, I mistakenly took a testosterone booster for a month about 8 months back, I also had 4 surgeries this past summer. I know for a fact that my hair has changed some in the past year, but I don’t show any miniaturization upon examination. Should I be worried?

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In the interest of patient confidentiality, I will keep the answers generic. If you have specific questions or concerns you can call our office at 800-NEW-HAIR (800-639-4247) for a personal consultation / discussion.

Having no significant miniaturization should indicate that your hair loss state at that point in time was stable. You may have lost your hair in prior months and may have even experienced telogen effluvium, but there is no way to tell with a miniaturization study, which just shows hairs that are in the process of being lost.

If you take testosterone or anabolic steroids, you could “kick start” the genetic balding process, but as stated above, if you do not show signs of miniaturization at this point, it indicates things are stable. Most people will undergo changes in hair texture with age, but frankly there is no way to tell. I would recommend watching the hair over time with repeat miniaturization studies in the hope that your hair will become more full.

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Hair Loss InformationMy Hair Is Growing Slower – Is This a Sign of MPB? – Hair Loss Information – Balding Blog

Hey Doc,
I’m a 21 year old white male, my father is 42 and has a full head of hair. I know my mom’s father was balding but only met him in his 50’s and didn’t know when it began. I’ve noticed a decline in the thickness of my hair. There’s no balding at the crown but there is thinning and receding at the hairline. I’ve always had a naturally high hairline, but I do notice my hair used to grow quicker and be thicker all around. At my age is this a sure sign of MPB? Or can you experience these effects without having the gene? Thank you

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Hair that is miniaturizing grows at a slower rate and the more miniaturized it is, the less it grows… until it eventually just stops growing. For those people who miniaturize all of the hairline, for example, their hair will not grow at all and sometimes it takes up to a year to fall out completely. Some men will change the thickness of their hair as they go from childhood into adulthood. The way you tell the difference between changes in hair thickness and miniaturization as an early sign of balding is to:

  1. Use a micrometer to measure the thickness of your hair in the back of your head and at different areas in the front and top.
  2. Have your hair mapped out for miniaturization to see if there are differences between the hairs in any one area which reflect miniaturization.

This way you will know what is happening.

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Hair Loss InformationAfter 4 Years, I Still Feel Pain in the Donor Area – Hair Loss Information – Balding Blog

After almost four years, I feel pain around the donor area. I doubt the doctor has cut too deep and damage my nerve or muscle. What is the way to identify the source of the pain?

Thanks!

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Possible nerve damage or irritation is a potential risk of hair transplant surgery as well as other surgeries which involve a deep cut in to the skin. Rarely, I have seen cases where a patient may experience pain in focused areas around the donor scar. With time this should resolve. However, after four years you may want to go back to your surgeon and discuss what this source of pain may be. Without a direct examination, I do not believe I can advise you on a possible source of your pain. An examination of your scalp will show if the major nerves are intact, and if you have a trigger point from which the pain can be elicited. This should be part of a doctor’s examination of you, something I would do if I were your doctor.

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Hair Loss InformationValue of HairDX Test? – Hair Loss Information – Balding Blog

Again, thank you for this informative website. It was in the news recently about having a genetic test done to see if one has the balding genes and what to expect. www.hairdx.com is the website for the company. I have two questions regarding this.

How accurate do you suppose this test is in regards to future hair loss and the likelihood of it occurring on someone who has this exam done?

Secondly, what value if any would you see in having such an exam done?

Thank you for your time as always!

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I am having a problem with the use of this test, but I am not against it if someone wants it. Based upon the test alone, I would not start treatment for hair loss, but when hair loss starts, I would commence treatment in men ASAP. So the test will not drive me to do anything. In terms of accuracy, I suspect it does what it says it does accurately. The issue is what does it mean and what do we do about the test results when there is no balding present?

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Hair Loss InformationMy Doctor Is Giving Me Cortisone Shots for Small Hair Loss Patch – Hair Loss Information – Balding Blog

I have a small patch of hairloss on my scalp. My doctor has started cortisone injections to the location and has suggested that I also use Women’s Rogaine in addition. Is this a common practice? I am concerned because the instructions on the Rogaine box says not to use it for patched of hair loss or non-hereditary hair loss. Is using Rogain with Cortisone injections normal?

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I don’t like to get between a patient and a doctor who knows more about that patient than a one line question asked to a hair loss blog. In other words, I would suggest that you cross examine your doctor about this. I really am not the right person to ask advice in this situation, as you aren’t my patient and I simply don’t know enough about your medical history to give a proper response.

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Hair Loss InformationIs the Mechanism of Finasteride Understood? – Hair Loss Information – Balding Blog

Dr. Rassman,
Out of curiosity, is the actual biochemical mechanism of finesteride well understood? If the mechanism is enzyme inhibition and the drug is present in excess in the body, why would it not completely stop hair loss? Does the drug lose effectiveness because there is too much DHT in the system to inhibit or is there some secondary or tertiary contribution to hair loss beyond DHT?

(I guess I’m asking for your general thoughts because I’ve been reading the literature and haven’t found much)

A sincere thanks for your time and expertise.

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The drug competes with DHT in a competitive process and it seems to win out about 70-80% of the time. That is why I believe it does not block the entire receptor site. That is a technical answer. With regard to other agents causing hair loss, I am sure you are right in your suspicions.

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Hair Loss InformationHair Changing Color – Is The Sun Bleaching It or Is It Connected to MPB? – Hair Loss Information – Balding Blog

I am 26 years old and I am going bald. My hair is brown on the edges but it has turned blonde on the top. I used to think the sun bleached it but I think going bald has something to do with it. Is the hair turning from brown to blonde in the balding area connected with going bald?

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When the hair miniaturizes, it often loses pigment and will get lighter. I can not tell you what is happening to you without seeing you myself. You need a diagnosis. Get your hair mapped out for miniaturization and find out if you have male pattern baldness (MPB).