Month: June 2008

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More Worries About Propecia — I Can’t Risk My Sex Life for Hair! – Hair Loss Information by Dr. William Rassman

Hello,
i’ve recently had my second transplant and i’m almost 27, I had my first just before my 25th birthday. I have only had temporal recession mpb in the front, and I had figured that with such small areas to fill and such a good donor sample that I would be able to fill in the areas not fully but maybe 80% of the density it once was when hair existed there. I was semi happy with my first transplant yet wasn’t near the density I wanted maybe 20% with a random guess. I just had my second 4 months ago and from what I see hairs are growing in but it’s hard to tell at this point if it will get to the density where you won’t be able to see through my hair to my skin. I’m a bit skeptical. Also I am not positive but I think I have just a tad of shockloss, which I refused to take finasteride because of all these horror stories on the internet i’ve seen.

My question is where can I get the straight facts, not opinions but actual documented cases that the FDA uses in it’s analysis? I get conflicting opinions everywhere I go and it’s hard to decipher which is correct, based on fact, logical, and applicable to my situation. Now I’ve read posts on your shockloss and i’m a bit bummed I hadn’t atleast known that shockloss in men in their 20’s with an HT without using Finasteride is common. My Doctor said shockloss most of the time is temporary. Your posts say otherwise. Also I have seen posts on finasteride some saying side effects such as decreased libido or penis size is permanent, others say no. I can’t risk my sex life and would rather be bald then mess with it, but I do like having hair on my head as well. Which side do I take? It’s probably already too late to counter any of the hairloss 4 months after the surgery right? Sorry for the long question. Thanks.

I appreciate your situation, but your fear of Propecia (finasteride 1mg) makes no sense to me. If you took the medication and experienced a negative sexual side effect (1% of men), the drug will be out of your blood stream in 24-48 hours from the time you stop taking it. There is nothing permanent about it. Concerning your hair transplants, you need to have a Master Plan for what might happen to you. If you got 20% of what you expected, then do you have enough hair to follow your hair loss without Propecia as you lose it? Your doctor is just plain wrong when he tells you that hair loss from a transplant (shock loss) is temporary and I would challenge that comment if given the chance.

I agree that giving up sex is not an option, but where are you getting the idea that it is either sex without Propecia or no sex with Propecia? That is not what millions of men are experiencing today, including 99% of the men I treat with that drug.

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Long-Term Telogen Effluvium? – Hair Loss Information by Dr. William Rassman

My wife has been experiencing telogen effluvium since Nov. of 2007. In Dec. 2007 a hair pull test by a dermatologist revealed that over 50% of her hairs were in the resting or telogen phase. A second hair pull in March 2008 revealed that a 75% of her hair was in the resting phase, and a third hair pull test today revealed that 75% of of her hair was still in the resting phase. At first the dermatologist believed that a switch in birth control pills by my wife’s PCP was the cause of the TE, but now, since she switched back to her original birth control pill and has not taken and other medication since January 2008, he is at a loss to explain what is causing her TE. My wife is extremely worried because a friend of her’s told her that if a hair remained in the resting or telogen phase for more than a year that hair would be dead and could never be “woken-up.” Is this true? Can long-term TE lead to permanent hair loss instead of just constant shedding even if the hair loss is from all over the head and not localized?

Evaluation of female hair loss can be quite extensive. If your wife is experiencing chronic telogen effluvium (TE), she should be treated probably with minoxidil, but as I am not her doctor, I would suggest following her doctor’s advice, as it sounds like he is knowledgeable on the subject. Sometimes, the TE just does not go away and thus is why it is called ‘chronic’.

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HGH Doesn’t List Hair Loss As a Side Effect – Hair Loss Information by Dr. William Rassman

Here’s a link about Human Growth Hormone from the MayoClinic, a trustworthy source. It does not list baldness as any of its side effects. Although when you go to testosterone under the MayoClinic, it does list baldness as a side effect.

MayoClinic.com – Human growth hormone (HGH): Does it slow aging process?

I do believe that human growth hormone (HGH) can precipitate genetic male pattern balding, as it has some androgenic properties. I can’t explain why Mayo Clinic doesn’t list this side effect; perhaps they overlooked it or connection between the androgens and the HGH? Aside from a few patients over the years taking HGH (none that were taking anabolic steroids, which many bodybuilders use concurrently HGH), I don’t have a ton of patient references for real-world examples — but those that were taking HGH did experience increased hair loss since starting their HGH regimen.

There have also been reports on the Internet that HGH can actually help hair growth, but I’ve yet to see that at all. Unfortunately, this is not one of the areas of my particular expertise.

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Could Pregnancy Cause My Eyelashes to Fall Out? – Hair Loss Information by Dr. William Rassman

I am 10 weeks pregnant, and about 3 weeks go I noticed most of my upper eyelashes are gone. I haven’t tried any NEW makeup or meds. It looks like stubble is there as if it is growing back, but it isn’t. It’s looked the same for 3 weeks. Could pregnancy cause this?

You may have a telogen effluvium of eyelash hair, but I would wonder why it did not impact the lower lashes as well. There is not much to do other than wait this out for the moment. If it is caused by your pregnancy, then you can look past the birth of your child to see if it reverses. Let me know please.

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Is DUPA Caused By DHT? – Hair Loss Information – Balding Blog

i recently was browsing the internet looking for information about dupa and i came across this Canadian site which basically confirms DUPA is caused by DHT:

Diffuse Unpatterned Alopecia (DUPA)
DUPA is an uncommon variation of Androgenetic Alopecia in which the hair all over the head is sensitive to DHT and there is thinning everywhere. DUPA affects more women than men but the majority of women with AGA do not have DUPA. DUPA should be suspected if there are miniaturized hairs in the normally safe donor area. Hair transplantation is not an option for DUPA because there is no safe long-lasting donor hair.

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I have my doubts that DHT is the cause of DUPA (diffuse unpatterned alopecia). I believe that there is a strong genetic influence behind DUPA, but if it was caused by DHT, it would be responsive to drugs like finasteride (Propecia) or dutasteride (Avodart). I have tried both on patients and the response has been very poor. So at this point, I will have to respectfully disagree with the opinion that DHT causes DUPA.

The typical female diffuse alopecias that impact all of the hair (including sides and back of the scalp) are not DUPA, but a genetic process which happens to have the same pattern (phenotype) as DUPA in males. It also does not respond to these drugs.

As I have mentioned in earlier blog posts, medicine is a descriptive science that often does not give us much insights to the cause of what we are seeing.

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Neurontin (Gabapentin) and Hair Loss – Hair Loss Information – Balding Blog

(male)
I stopped taking gabapentin due to hair loss;however after stopping it, I am still experiencing hair loss. When will it stop if indeed the hair loss is due to gabapentin?

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I do not have any experience with this drug. Stopping it and switching it with another epileptic drug under your doctor’s direction would be the proper thing to do. You must wait it out. Neurontin (gabapentin)’s rare side effects list (see RXList.com) does include “hair disorder” — I suppose this could mean hair loss.

Generally, effluviums will last less than a year when the offending drug stops being used. Women will need a proper medical workup for hair loss. For more, see WebMD – Telogen Effluvium and Other Effluviums.

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If the FUE Technique Isn’t Predictible 100% of the Time, Why Would You Perform It? – Hair Loss Information by Dr. William Rassman

Results from FUE are variable while the strip procedure is predictable nearly 100% of the time-Does this mean the strip method is the better option as its more certain. And if this is true why would you tell people and/or use this method rather than the strip method at NHI.

I test everyone to determine how good their follicular units will come out with follicular unit extraction (FUE). I call this test a FOX Biopsy and I insist on doing this so that I am comfortable that wastage is not a problem. It is hard to match the quality grafts that a strip-method hair transplant can produce. With an FUE procedure, the bottoms of the follicular units can be stripped of their fat and supportive structures; in a strip procedure, the follicular units are all perfect. If you saw two follicular units side-by-side (one from a strip harvest and the other from an FUE), you would see a significant difference. I believe that when this problem occurs, the growth from an FUE with stripped infrastructure should not, in theory, grow as well or as thick as a strip graft. The benefit of the FUE technique, of course, is the lack of the linear scar in the back of the head, allowing for a very closely cropped haircut without noticeable scarring. We perform both techniques at NHI.

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Hair Loss Information » Hair Loss Cures in the Future?! – Balding Blog

Hey Doc, I’m an 18 year old who has always obsessed over my hairline because it’s been around a NW2 since i was born, one side worse than the other. I’m wondering about what treatments, or even the possibility of a “cure” (Let’s face it, it’s not polio), you predict will be practical and available in the next 10-20 years.

I can be optimistic at times, but I do not believe there will be a “CURE” for genetic hair loss in the next 10 to 20 years. There may be better drugs or discoveries to slow or partially reverse the balding process, however. There are some exciting things happening with hair cloning / multiplication, but their viability still remains to be seen. Time will tell.

And for the record, polio isn’t cured. There is a vaccine to prevent polio, and most countries have eradicated it completely. Nigeria, India, Pakistan, and Afghanistan still have a polio epidemic. I’m not about to write PolioBlog now, so I’ll leave the rest up to Wikipedia for all of your polio information.

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Chemical Relaxer Induced Genetic Hair Loss? – Hair Loss Information by Dr. William Rassman

Is it possible that a relaxer triggered hereditary hairloss?? I’m concerned because after using a relaxer, my hair has been falling out for about 4 years now and I know it’s been since I used the relaxer.

It sounds likely that you damaged your hair when you used the relaxers, as they are known to cause hair loss. Much of the time these changes are permanent starting on or around the time of the injury. If your hair has been falling out for 4 years, you probably have another cause for it and it should be looked at my a competent doctor who specializes in this area.

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Bald Spots Throughout My Beard – Balding Blog

I recently retired from the Army. I used to let my facial hair grow on the days I was off and on leave with no problem. I would get a full beard over time. Now when my hair grows on my face I have bald spots. I have them on both sides of my side burns, on my left check, and on the mid part of my lower right neck. I have not shaved for about 2 weeks but the bald spots are still present. I am a 38 yr old caucasion male. Thanks for your time.

You may have alopecia areata, which appears as bald spots over different parts of the body, including the beard. See a good dermatologist to make the diagnosis, as I am only guessing from what you wrote and without seeing you myself, I can not really tell.


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