Month: June 2008

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Hair Loss InformationCatch-Up Hair Loss, Finasteride, and Hair Cell Suicide – Hair Loss Information – Balding Blog

Hi, Dr. Rassman.

You’ve written a number of times about the “catch-up” loss that happens when a patient discontinues finasteride/propecia. I know you didn’t design the drug, but I was wondering if you know how this catch-up process works.

What I have a hard time understanding is this: If androgenic alopecia is a gradual process of miniaturization, why doesn’t that process-when you stop the drug-just pick up where it left off at the start of therapy? It seems like something must be getting worse “behind the scenes” during the course of therapy. Is it known what that something is?

I hope that made sense. Thanks!

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Propecia (finasteride 1mg) sustains scalp hairs that are genetically susceptible to falling out. It does this by a process of competitive inhibition. When the drug is no longer available, the DHT is manufactured by the body and it ‘attacks’ the hair follicle which is like turning off the ‘life’ switch of the dermal papilla cells (which manufactures the hair follicles).

Once you stop taking the medication, you will not lose all the hair at once, but the ‘attack’ will occur over a few months. The hairs that were being supported by finasteride will go back to its pre-destined state, which is something called apoptosis (these dermal papilla cells that generate the hair follicle commit suicide — just die off).

For more about apoptosis, see ResearchApoptosis.com and Wikipedia.

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Hair Loss InformationWouldn’t Rogaine Spray Work Better Than Foam? – Hair Loss Information – Balding Blog

I saw on TV a Rogaine foam commercial and they claimed it helped 85% of men in a clinical test regrow hair. Seems like a high percentage there. Also, how the hell is someone supposed to
put foam on their scalp if their hair is only thinning and not yet bald?? Seems like spray would work 40x better.

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Yes, it seems like a very high percentage for success. In my opinion both should work and it is specific to individual preference. You can put the minoxidil that is store purchased into a spray bottle and spray it, but just be careful to avoid misting it into your eyes.

The reasoning for the foam’s existence (aside from a way to market the drug in a new way) is that it stays on your scalp longer and does not run off making an oily mess, as it is alcohol based. The primary thing that would make minoxidil (Rogaine) work better (foam or spray) is to follow the directions and apply it twice a day everyday, but compliance is not so easy for most men.

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Hair Loss InformationIn the News – Count the Hairs on Your Comb – Hair Loss Information – Balding Blog

From the article:

Want to know how much hair you’re losing?

Start counting — the hairs on your comb, not on your head.

In the June issue of Archives of Dermatology, scientists demonstrate that a so-called “60-second hair count” is a simple and reliable away to get a grip on whether you’re balding and, if so, how fast.

The procedure, which can be carried out in the convenience of your own home, may reassure the adult male — or not.

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Read the full article at Washington Post — Countdown to Hair Loss.

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I’m Histamine Positive – Can I Speed Up the Elimination of the Redness After Surgery? – Hair Loss Information – Balding Blog

Dr. Rassman,

In the past, you have stated that post-op redness in the recipient area will linger longer in individuals that are histamine positive. I have very fair skin, and I am histamine positive based on the scratch test. Currently, I am 5 months out from surgery, which consisted of dense packing 3000 grafts in the front third of my scalp.

What do you recommend to speed up the process in order to eliminate the lingering pinkness that I am still experiencing? I have also put a call into my surgeon for his opinion, but would definitely like to have your opinion as well.

Thanks in advance!

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The use of limited amounts of hydrocortisone cream may help, but long term use is not healthy. I am hesitant to make specific recommendations to you as I have not seen you and therefore cannot make a judgment for you. My general approach is to point a direction on what to do, but hopefully you will get to your doctor for specific advice appropriate for your needs.

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Hair Loss InformationCan Folliculitis Cause Hair Loss? – Hair Loss Information – Balding Blog

Hello Doctor!

I have a question about hair loss. I have been diagnosed with “folliculitis”. I’ve seen several dermatologists, and none has helped. Moreover, I am losing my hair. Can folliculitis cause hair loss? Is there any drug that can help me?

Thank you very much.

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Folliculitis is an infection of your hair follicles. It can clear up on its own or your dermatologist can prescribe you medications to treat it. You shouldn’t lose hair from folliculitis unless it is chronically infected. Keep in mind though, the most common cause of hair loss in men is genetic hair loss.

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Red, Itchy Face After Using Provillus – Hair Loss Information by Dr. William Rassman

(female)
I am writing about provillus I purchased the two month supply to see if I could get any results. I have never used any other products and I was looking only and saw the ads for scalpmed and provillus. I decided to give provillus a chance well in my second day of use I develop redness and itchiness of the face and my face felt very warm. I decided to give it a couple of more days and maybe it will go away but it hasn’t. Now my face feels like I had a very bad sunburn red itchy and dry. Is this common with this product? I stop the use of it after 4 days. I hope my face starts to feel normal soon if not I will be going to the dermatologist soon. Please post to make others beware of the side effects of this product.

I will be returning the unused product I have left but the returned guaranty (which I didn’t read at the time) states that there will be a $5.00 penalty and no shipping and handling will be refunded. I guess you live and learn and for the future I will be more aware of scams and be sure to read everything before attempting to make a purchase.

ProvillusYou don’t make clear if you used Provillus for Men or the Provillus for Women, but this does sound like an allergy to some ingredient in the product. According to the product website, both versions now contain minoxidil, which does have rash and redness as rare side effects (see list). However, I was under the impression that Provillus’s main ingredient was saw palmetto, a weak DHT blocker (if at all) — which would do nothing for women. Perhaps that changed at some point.

Provillus isn’t FDA approved, and it isn’t something I’d recommend.

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I Inhaled Toppik! – Hair Loss Information by Dr. William Rassman

Hi,

I accidently inhaled too much Toppik protein fibers through my nose yesterday and I’m a little concerned. I felt it in my nose several minutes after the application and I’m currently experiencing a slight burning sensation in my upper chest. Should this clear up on its own? And how really safe is this product?

I appreciate your help.

Thanks!

You should seek medical attention. These are fibers and they certainly can be an irritant to the lungs.

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Hair Loss InformationMy Transplant Nightmare Has Ruined My Life! – Hair Loss Information – Balding Blog

Dr. Rassman, my story is long and will probably bore you. I would just like to say that probably the most humiliating situation a grown man can be in is having a very noticable hair transplant. I am the recipient of 2 procedure in 1991, 3-4 fin NYC 1992-1999. Since then the new hair outlived the existing hair and I had to resort to shaving my head-scars, cobblestoning, high hairline and every humiliating situation that goes with it. Before this, I was a good looking young man with the world for the taking. I remember the day after reading the sports section on the Daily News and making that quick decision. I was losing, but not that much. Cut to chase- I am a NYC Firefighter for 18 yrs and I haven’t relaxed and enjoyed one second of it. Always worried about comments (which have happened) and living in close quarters with crazy guys does not help. I have spent thousands on redistribution, skin resurfacing, and all the rest of the corrective procedures. WHen my hair grows in a bit, you can still see the doll hair look after just 4-5 days. What you can also see is the fact that I don’t need that much more in order to fill in. I have alot of scar tissue and my donor area is limited. I don’t know what to do. Your websites reveals very frank talk while revealing good work. Doctor, I am so tired of living this 100% selfconcious life. I don’t go to any events, social gatherings, funerals and wakes are a nightmare, weddings forget it, my kids events. I’m tired. It’s changed me. I find I can’t concentrate on anything.My self worth is zero bacause I see what I did to myself. My career is halted. Go where I can wear a hat. I am a member of SAG-whose going to hire an actor with lines going across his head. That’s another career that’s been halted. Can I send you some pix. I don’t think FUES are out of the question. The problem is sending photos with substantial growth since I cant’ grow it that long w/o looking like a freak. This sucks! Sorry but it totally consumes me. It’s easy for a friend or wife to say-” who cares, don’t worry about it” ” you have kids to worry about”- it’s not that easy. I want my life back. The Joe Penny article fueled this email. I hope I don’t sound angry but it seems like no one listens or can understand the pain. Why even live if you look like a freak, have no career, debt, scattered thoughts ect. Can you help?

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Actor Joe Penny has been kind enough to share his experience with the repair process and some of what you are describing is just what Joe went through. Joe’s experience is a success story, while others who we have seen over the years have not been so fortunate. We’ve published the stories of many patients that just wanted to be bald again, with one example being that of a local doctor who fell victim to the process. Although his results seem to work for him, his solution was far less than I would have accepted (but one way to avoid a huge wig).

I am ashamed of the history in this profession where the old deforming type of surgeries created work like you are complaining about. It has impacted the lives of so many men and most of the doctors who did the worst type of this surgery are nowhere to be found today to solve problems like you have. Believe it or not, some of this surgery is still being performed today. You made a decision to improve yourself, and fell victim to an industry that was at best naive and at worst malicious by offering such surgeries. I wish you much success and good luck.

As you are in NY, Dr. Bernstein (with offices in NY and NJ) may be the best route to other solutions. Both Dr. Robert Bernstein and I have spent a great deal of time with patients like you. If you’re planning a visit to California, I’d be happy to see you.

For more information on repairing old hair plugs, please see:

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Hair Loss InformationNew Hair Loss Drug NEOSH101 Is Dead… Maybe Temporarily? – Hair Loss Information – Balding Blog

Hi Dr Rassman,

I am not sure if you had seen the press release about neosil being acquired by another pharmaceutical company. Press release – PDF file

It all so goes onto say that peplin does not plan commence further development of neosil’s products until next year. So should we just cross neosh of the map now?

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NeosilJust some background for casual readers that haven’t heard of this NEOSH101 product (it is a tetrapeptide aldehyde proteasome inhibitor) — A New Drug for Hair Loss, NEOSH101 by Neosil

I do not have any special knowledge of what Peplin will do with this. They don’t say the product is outright dead, but perhaps temporarily on ice? Here’s the interesting part of the press release, where it hints that they won’t be doing anything with it until at least sometime next year, though they will be advancing other Neosil products:

“Peplin intends to use the net cash obtained from the acquisition to continue the development of its lead product candidates PEP005 (ingenol mebutate) Gel for actinic keratosis and PEP005 (ingenol mebutate) Gel for basal cell carcinoma. Peplin believes that Neosil’s proprietary technologies in hair loss and acne could enable it to expand its product pipeline in the future, although Peplin does not expect to commence further development of these programs before 2009.”

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After Falling Out, Teen Girl’s Hair Regrew As a Different Color and Texture – Hair Loss Information – Balding Blog

(female)
I’m 17 years old. When I was 15 I noticed that my hair starting falling out very often. During that time I was planning my Sweet 15 I wasn’t sure if that was the reason why my hair started falling, because of some of the stress. Last year my hair started falling every day, almost a hand full. I started getting worried because cancer runs in my family on both sides and I always wondered if I had a sickness but I doubt it now because I dont have any signs of that. I’ve noticed though that some of my hair is growing back but differently. It seems to grow thicker or more brittle than the regular hair I have. My hair is dark brown but the new hairs are black. I have two older sisters, one has lost an amount of hair but thats becuase of all the gel, hairspay, and the hot tools. The other still has a lot of hair and she is 28. So i’m wondering if you know why my hair started falling out at age 15? and why are some hairs growing back thicker and somewhat curly or brittle when I have straight hair (i hardly use any hot tools).

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I could write a book on what is possible in your situation. Unfortunately, I don’t know the things that you are doing to your hair and wonder if you are using chemicals that are causing problems. If this is only stress related, then telogen effluvium could be the cause. Figuring out female hair loss is complex and you need professional advice from a good dermatologist. I certainly would not put cancer on the top of that list of potential causes.

For more possible causes of women’s hair loss, see: WebMD.