March 2008 – Page 9 – Balding Blog

March 13, 2008

Hair Loss Triggers – Hair Loss Information by Dr. William Rassman

You mention “triggering” the genetic switch and “turning on the switch for male pattern hair loss”. Besides hormones and age, what else do you think could turn the switch? I ask because no one in my family has lost hair. My older brothers all have full hair. Yet, I appear to be losing mine, and the dermatologist said my older brothers would be the best gauge for how my hair will be. That was encouraging, but I already appear worse than what they have and they are years older. Could using Xanax one time trigger the gene? Could a few stressful months trigger the gene? If so – do you think it can ever be stopped without medication or am I doomed to bald and bald and bald progressively more due to a onetime mistake with Xanax I took to fly?

I highly doubt Xanax would trigger hair loss. I believe you are too focused on the “trigger” that can cause hair loss, and are missing the big picture. If you have the gene (or genes) for hair loss, then it doesn’t really matter what you do, because you will lose hair. You really do not have much control over your genetic fate. While extreme stress (physical illness or metal stress) can precipitate the start of the hair loss, it is still tied in with one’s genetic predisposition.

Paid advertisements (not an endorsement):

March 13, 2008

Flax Lignans to Treat Hair Loss – Hair Loss Information by Dr. William Rassman

I’ve been suffering from some side effects with propecia, so I am looking for other solutions. Are you familiar with lignans and this pilot study?

Flax lignans: a cure for hair loss?

What are your thoughts? Could I conceivably get the same side effects?

I’ve not heard of flax lignans, which appears to be an herbal remedy… and as with any herbal supplement, safety should be somewhat of a concern. The pilot study that is referenced was sponsored by the same company that sells the flax lignans in a capsule, so their motives are highly suspect. Even in this very limited press release, the suppliers do not have a clue on the best dosage or what the dose related response might be for treating hair loss.

To top it off, this is from nearly 3 years ago — if there was anything to it, I’m sure there would be more about it in the press or within the hair industry.

Paid advertisements (not an endorsement):

March 13, 2008

Female Hair Loss After Taking HGH – Hair Loss Information by Dr. William Rassman

I was going out of town to work on a strenous work project. I decided to take hgh when I started the job. While I was away, my hairline began receding and itching. I didn’t realize it was the HGH until too late, ten weeks of use. I am female and now must hide the front of my head with scarves and wraps. I’m using rogaine. Is there anything that can reverse hgh hair loss?

You may have done permanent damage, but you will not know for a full 8 months from the time you stopped the HGH (which can cause hair loss in some people). A hair transplant may have some value if you do not recover. Unfortunately, you’ll just have to wait and see.

Paid advertisements (not an endorsement):

March 13, 2008

Can Rogaine On Healthy Hair Cause it to Fall Out? – Balding Blog

Thanks so much for this resource! I am 3 weeks post op from a HT of 4200 units. I was on propecia for 30 days prior to HT and began Rogaine / Minoxidil 2 weeks post op. I had temple work and work at the front of my hairline. I want to get the best result and minimize shock loss. I have heard Rogaine can cause shedding. Am I at risk for shedding in healthy hair zones if I apply Rogaine in it’s correct dosage to the entire top of my head, temples and along the donor scar?

Rogaine (minoxidil) on healthy hair most likely will not cause shedding, but I would strongly suggest that it only should be applied to areas of concern and not the rest of the head for two key reasons:

Cost
Side effects (or potential thereof) will occur as the area of treated skin increases

It is also worth noting that minoxidil will not influence the hair transplants to grow any better or any faster.

March 12, 2008

Hair Loss InformationIn the News – Bexarotene 1% Gel to Treat Alopecia Areata – Hair Loss Information – Balding Blog

From the article:

Topical bexarotene 1% treatment produced a 30% hair growth response among patients with alopecia areata (AA), according to research presented here at the American Academy of Dermatology 66th Annual Meeting (AAD).

“Currently, there is no cure for alopecia, and it is often refractory to treatment. So new treatment possibilities are especially welcome,” said lead investigator Rakhshandra Talpur, MD, Instructor, Division of Internal Medicine, University of Texas M. D. Anderson Cancer Center, Houston, Texas.

Block Quote

Full text — Bexarotene 1% Gel Shows Efficacy for Alopecia Areata: Presented at AAD

March 12, 2008

Side Effects from Propecia — I Can’t Cut This Pill! – Hair Loss Information by Dr. William Rassman

Dr. Rassman – my doctor prescribed proscar, quartered, which I can afford. My problem is I can’t handle the side effects. And it is nearly impossible to cut any further! So, would taking 1.25 every other day still be effective and lessen the chances of side effects?

Thanks!

Every other day is better than none at all, but you should speak with your prescribing doctor about dosing.

Paid advertisements (not an endorsement):

March 12, 2008

Rogaine Foam Response Time? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,
I am confused as to why you said it would take 1-2 years to see results with Rogaine 5% Foam versus the 3 to 4 months that is usually mentioned for any results. I thought the cycle of hair growth is generally a four month turnover process and am wondering why you said I would need to wait 1-2 years. Again, I am a 48 year old female with androgenetic alopecia. Thank you.

It takes time for the hair to grow out, so any benefit of minoxidil that is obtained in the 4-6 month hair cycle, needs to grow to styling length to see value. Sure, you might see tiny baby hairs sprouting up, but those aren’t at a length that is manageable. Hair grows at the rate of 1/2 inch a month, so by adding the numbers together, we get to the estimates I gave before –

+	4 months (growth cycle) 6 months (to grow a three-inch hair length)
=	10 months

Then add to this the reality that it may take up to a year for the full benefit of the minoxidil to be realized.

Paid advertisements (not an endorsement):

March 12, 2008

Mederma and Transplanted Hair – Hair Loss Information by Dr. William Rassman

I had a FUTH in india but there are white spots/ dolls head appeance on the recipeient area where hair were inserted. If i use mederma, would it result in loss of the transplanted hair?

Please reply.

You’ve described the older technique of a hair transplant, where pieces of skin are transplanted with the grafts and the grafts are not typical follicular unit grafts. FUT (follicular unit transplantation) should not give you the results that you describe. While Mederma is used for minor scars, I doubt it will do much for the white spots on your scalp, as this is probably the result of depigmentation of the skin edges in the transplanted grafts. I do not know if it will result in the loss of transplanted hair either, since there are no specific studies on the subject.

Paid advertisements (not an endorsement):

March 12, 2008

Double Follicular Unit Grafts (DFU) – Hair Loss Information by Dr. William Rassman

Why don’t you offer double follicular unit grafts (DFU)?

Double follicular units (DFUs) are 3-4 haired grafts that have a slight gap containing skin between the hair follicular units (the natural growing anatomical units). Some people claim that if they use them, they can get more density per square cm and that the advantage is that more density can be created with fewer incisions… which means less grafts/cost to the patient.

DFUs are essentially the old type of minigrafts and the problem with them is not only a slightly pluggy look (for those people with dark hair and white skin), but also that there is skin transplanted with the follicles. This skin becomes depigmented and forms a whitish plaque on the scalp on close inspection, particularly noticed if you have a tan or olive skin. So while it is true that this can provide more density at less financial cost, the price is in a lesser quality transplant. The older large plugs had the highest densities, so if one takes the logic that DFUs are less expensive than follicular units and are the way to go, you can also look like you have doll’s hair for about a tenth of the cost of a fdu. You get what you pay for; do not lose sight of the fact that this is a surgical procedure on your head.

So to answer your question about why we don’t offer DFU, to be blunt, it’s because we don’t offer grafts that can be detected as a hair transplant, even on close inspection. The question should be, would I do it if someone specifically asked me to do it, to which my answer would be that I would consider it if there was complete informed consent present at the time the decision was made.

Paid advertisements (not an endorsement):

March 12, 2008

Difference Between Generic Finasteride and Proscar Formulations? – Balding Blog

Dear Doctor Rassman,

I have been reading your blog for months and I have found always straight forward and interesting answers to (often) tricky questions.

I have been taking proscar (prepared as 1mg pill by my pharmacist) for 4 years (I am 26) and had slowed my hair loss thanks to it. Unfortunately,I had some erectile and libido problem But as it was not that serious so I decided to continue taking it.

1 month ago, My doctor prescribed for a generic finasteride (manufactured by sandoz) and since then I have no more erectile problem but I have the feeling that I am losing my hair again. Is it possible that the generic drug is actually working fine but give me less side effects (different resorption,… which would be great)

or the fact that my erectile problems are gone and the feeling that I am losing more hair really indicates that the generic drug is less efficient.

Thanks a lot for your future reply

There should be no difference between cutting Proscar into quarters or fifths and taking a generic 1mg finasteride pill, though the 1mg generic is not legally available in the United States. If you’re having less side effects but less results in protecting your hair, I’m not sure what to tell you. Think about why you’re taking the pill to begin with — for your hair. If you’re not getting the same results for your hair, I’d consider going back to what worked better for you, perhaps even cutting the dosage to see if the side effects go away. Talk to your prescribing doctor about this.