Ringworm on My Stomach — If It Spreads to My Scalp Will I Lose Hair? – Hair Loss Information by Dr. William Rassman

I have ringworm on my stomach. I am kinda freaking out about it! Every little itch I have, I think it’s going to be a new spot of ringworm. I have a really dry scalp as it is, but my main question is, if the ringworm has spread to my head, will my hair fall out? Does this happen in every single case of ringworm on the scalp, or can it possibly not cause hair-loss and continue to grow?

If you have ringworm on your abdomen, it can be treated and it will not necessarily spread anywhere if it is under good treatment. Ringworm is not really a worm, but a fungus. See a doctor about this soon so you can stop freaking out!

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I Want Great Density Up Top and In Front — Not Too Concerned About How the Back Looks – Hair Loss Information by Dr. William Rassman

I have a hypothetical question:

I know, that in general you don’t transplant more than a certain ratio of hairs available in the donor area to the transplanted area. What i was wondering is if i wear my hair in a certain style (in this case a bald fade) it would’t be as important for me to have thicker hair in the back, but of course, i would want good density on the top and front. under these circumstances, would you transfer more than usual to the top and front?

I generally develop a Master Plan with each patient, unique to that patient. What I feel my job is, is to do what is in your best interests and that includes combining what you want and what I feel is ethical. Many patients have different priorities, so my job would be to come to some conclusion about your hair supply and then lay out a plan that is worst and best case possibilities to address your desires at this time.

Since your question is hypothetical, I will say that hypothetically what you’re asking for is possible under the right conditions. Also, if you were to want to do a fade hairstyle in the back (donor area), a linear scar could be visible with a strip procedure, but you’ll probably be alright with follicular unit extraction (FUE).

Dr Rassman, Your Reply About Femara and Hair Loss Was Dismissive! – Hair Loss Information by Dr. William Rassman

Dr. Rassman, with all due respect I found your response to the poor woman who asked for help re Femara and Hair loss, to be incredibly insensitive and dismissive. Didn’ t you read her history? Obviously her priority has been and continues to be, cancer, but doesn’t she deserve to look and feel good about herself, with a FULL head of hair?! Because to date, Femara has been so effective in preventing breast cancer recurrence, I am sure you’ll be receiving more requests for help to reverse or ease, the hair loss side effect. I suggest you do some research yourself and try to help us, rather than lecture us on priorities and then pass the buck back to oncologists. Believe me, as a 54-year old woman who has also gone through surgery, chemotherapy, radiation, Tamoxifen and now Femara (9 months) all with a great deal of hope and grace, what an insult it is, to be losing my hair AGAIN, along with a host of other debilitating side effects, that are destroying my quality of life. Good information from you or your colleagues, would be most welcome.

You’re referring to my post from a couple months ago, Femara and Female Hair Loss.

I do not treat cancer and certainly do not have direct knowledge of the various chemotherapeutic drugs that are used. Hair loss is usually a secondary consideration when treating a cancer. Of course, most doctors would love to find an equally effective anti-cancer drug that has no hair loss as a side effect, but that does not seem to happen very often.

Quality of life is often balanced in the treatment of cancer with the effectiveness of the drugs used to control recurrence. Doctors are very focused on the cancer and feel that side effects like hair loss are less important in the “war against cancer recurrence”. I do understand where you are coming from and my heart does go out to you. I recently reviewed a drug that was designed to treat hair loss associated with cancer chemotherapy, but I signed a non-disclosure agreement, which means I can’t speak about it because the company was concerned that:

  1. The drug was not FDA approved yet
  2. The effectiveness was yet to be proved scientifically (they started down that path)
  3. Any release of information could risk their FDA approval status

I liked what I saw and knew well how this type of drug would impact people like the woman on the referenced blog post. I would welcome the chance to become a source of good, reliable information if I had it. Unfortunately, although I care a great deal about this problem, my practice is not focused on the treatment of hair loss from cancer chemotherapy. I’m sorry if you feel that my answer was insensitive, but I did not intend it to be as such.

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Can I Just Let the Scabs Come Off On Their Own Over a Few Weeks After My Hair Transplant? – Hair Loss Information – Balding Blog

Dr. Rassman,

Your website has been quite helpful. I had a quick question regarding a hair transplant I got almost 3 weeks ago now. I got 1000 grafts mainly in the vertex area and I grew my hair long to cover up the area until it healed. Since I can cover it up well I have been extremely careful with washing and letting the scabs try to come off by themselves. I wash the area as if I was still in the first few days as I try not to rub the area or pull on the grafts. My question is, letting the scabs take longer to heal and fall off, even at week 3 now, is it bad for the grafts to still have the scabs, or if im comfortable how it looks, is it safe to remain careful. Anytime I do try to break up some scabs I feel like they are pulling grafts out so Id rather just wait it out if that is safe for the grafts. One last thing is that I am not sure if you would consider what I have at this point scabbing, as it is just mostly white crusts covering the grafts. Thanks so much Dr. Rassman.

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Once you allow the scabs to form after a hair transplant, they can take weeks to come off by themselves. This will not damage your grafts, just give you a cosmetic problem you would not have had had you washed them off as they formed.

Worried Sick About Propecia Side Effect Stories! – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

I’ll try to keep this as short as possible.

I started Propecia in Summer 2007 as it was prescribed to me after a dermatologist visit in which the doctor diagnosed me with MPB. I took the 1MG 1x daily up until December 2007. I discontinued the drug because of the cost as well as a couple of close friends’ stories of libido loss and worries about impotence.

As I’ve now learned is common upon stopping the pill, I began losing my hair again and it has now become visible and very depressing. I want to get back on Propecia to help curb the hair loss as well as try any other supplements that may help the battle. However, I’m worried sick about some of the stories I have heard/read about concerning long-term use of Propecia and sexual/Prostate problems that are irreversible. How do you feel about these stories? There are multiple websites dedicated to getting the word out about permanent semen reduction, watery semen, ED, depression, etc. Is there evidence to back these stories up that you know of besides the hearsay? What is your professional opinion on these stories and the fact that the drug has only been out 10 years so no long term studies have been conducted?

Also, if I do begin the Propecia again, is Nizoral a good supplement to combine into a regimen? I have heard good things about Zinc supplements as well. Any recommendations?

Thanks so much for your time and help,
It is much appreciated

6 FingersNizoral is a good shampoo, but it won’t do anything to regrow your hair. I’ve addressed the side effects questions many, many times before on the blog — the most vocal are the ones with complaints. There are hundreds of thousands of men that use the drug that don’t spend all day on forums discussing it in a positive or negative way. Also, the complaints are unsubstantiated — I could say that Propecia grew a 6th finger on my left hand and made my skin turn silver, and how are you going to disprove that? The FDA published that the side effects occur in less than 2% of men.

You already have experience with the drug and if you did not develop side effects in the 5+ months you took it, it is doubtful that you see them when/if you restart Propecia. We are in total control of our decisions, but unwise choices may lead you further down the course of more and more hair loss.

(Note: The above image is Photoshopped, and it was not caused by Propecia. I hoped I wouldn’t have to point that out, but I don’t want any emails about it.)

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More Finasteride = More Chance of Side Effects? – Hair Loss Information by Dr. William Rassman

Does 2.5mg of Fin every other day increase chance of side effects compared to 1.25mg everyday?

Because I cannot cut my generic proscar into 4 pieces, it crumples, and my doctor suggested I split the dose into 2 pieces and take every other day, but I’m worried that starting to take 2.5mg of finasteride when never taking the medicine before might be too excessive? Thank you doctor.

Finasteride stays in your body about a day, so after a day 95%+ will be out of your body. Does the extra dose make for a more effective treatment? Well, that is answered by the science, which showed that higher doses do not impact the value of the drug when treating hair loss. I doubt that there will be more side effects, but frankly I would not know for sure. Each person reacts differently to medication. I would stick to the recommended (or close enough to the recommended) dosage — 1mg daily. Try using a sharp knife to cut the generic Proscar into 4 pieces, rather than using a pill cutter. You may have better luck getting the proper dose that way. Or, you can buy Propecia and get exactly the correct dose without any cutting hassle.

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Is Finasteride Absorbable Through the Skin? – Hair Loss Information by Dr. William Rassman

If finasteride can’t be absorbed into the skin, why aren’t women supposed to handle it?

Great question! I assume that it is a medical-legal issue (drug company is Merck) for pregnant women, as this drug is known to have side effects on the baby in the first trimester of pregnancy. This is just my best guess, however.

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I’m Thinning on the Sides and Back of the Head, Where I Don’t Even Use Rogaine! – Balding Blog

Although you stated in your answer to the question entitled “I Had No Hair Loss, But Tried Rogaine and Now My Hair Is Different”, I believe that I am experiencing the same thing. I started using Rogaine after experiencing telogen effluvium on the recommendation of my doctor. He recommended I try it for a few months saying that it might jumpstart me out of that cycle. Anyhow, my hair has been getting thinner and ive continued to have hair loss. While it appears for the most part to be in a typical male pattern loss (crown and top of the head thinning), I’m also thinning on the sides and back, where i dont even put the rogaine. I also have a larger mixture of thin and thick hairs now, which I never really had before trying the rogaine. My question is if the rogaine causes normal hair and hair densities to thin to a new “normal”, thinner density. Hope that makes sense…

Rogaine (minoxidil) should not impact normal hair and there is no evidence that it makes hair thin when applied.


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I Think My Donor Scar Is too High and Will Show Soon – Hair Loss Information by Dr. William Rassman

I’m concerned that one of my donor scars is too high and that eventually it would show as well as the grafts taken from the area will die. I’ve had three procedures. The first was in 1997. I had 800 micro/mini grafts. Then in 1998, I had another 1000. This time the doctor seemed to place the incision in the donor area high. My third procedure was in 2007. I had 2000 FU’s placed. I think I’m a class 5 or 6 (not completely sure). During my last consultation before my procedure, the doctor told me that the scar from the previous procedure looked high.

It is 2″ above the bump at the base of my skull – about the height of my eyes and the top of my ears. I’m not sure if it was higher before my last procedure. Is it possible that it now appears a little lower given that 2000 FU’s were taken below it? Does this sound too high? Would hair mapping help me to know with greater certainty? If so, where can I go to have my hair mapped?

I appreciate your time in reading and responding to my question. I’ve read several of your blog comments, etc. and I’m considering using your services in the future.

Thanks again

Perhaps your donor scar is higher than normal, but this can be a normal thing as the doctor will make subtle judgment calls during the procedure. It may bother you cosmetically, but there is not much you can do other than to grow your hair long enough to cover the scar. From a long term point of view, if the donor hair was taken too high, it may not be in the area of permanent hair, in which case you risk losing the hair that was transplanted from that area.

You should start off with a good examination and consultation for a second opinion. That will address your concerns above. You must have a worst case scenario managed with a Master Plan for future hair loss, as you are suggesting in your questions. I don’t have a list of every doctor that will map your scalp, but you can find a transplant doctor in your area by using the physician search at ISHRS.org.

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Does the Hairline Mature Throughout Your Entire Life? – Hair Loss Information by Dr. William Rassman

Hi doc,

I am 26 years old and my whole life (Thanks to God) I’ve had a full head of thick hair, like Patrick Dempsey. Even now, my hair is very thick and full. I’ve noticed that my hairline has receded in the corners about 1 inch / 1 1/2 and my hair line in the front is still pretty similar to the one I had when I was a teenager. So my questions is that is the receding in corners normal . .. how much longer will it recede? I’ve noticed that in pictures that are 2 years older the angles are less receding than they are now . . . does the hairline continue to mature throughout your entire life? thanks!

The maturing hairline usually completes the process by the time you reach 30 years old, but there are always exceptions to this. There are some primates that develop a mature hairline or even balding when they pass puberty so we are really not that unique. Hair on your head will absolutely change as you get older, as most people find that the hair grows slower and finer to a different end length. The older you get, the more of these changes that you might see (not everyone, but most people notice it). That gorilla hair type that you may have had when you were 8 years old, will become a distant memory when you get to be 50.

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