June 2008 – Page 9 – Balding Blog

June 13, 2008

Propecia Baseline – Hair Loss Information by Dr. William Rassman

Hello, I hear a lot about how a majority of men maintained or improved hair counts compared to the baseline measurement on Propecia. However, I can’t seem to find when this baseline measurement is taken. Since Propecia takes about 3 months to “kick in”, is the baseline measurement the hair count at that time or the hair count at the beginning of Propecia treatment?

Thanks for your help!

I suggest that you get a baseline count when you start taking Propecia and repeat it yearly, as it does take a while to see the medication’s benefits. I personally prefer miniaturization studies, because it is the miniaturized hairs that benefit from the Propecia, not as much the increased hair count. To get a very accurate hair count, you would have to tattoo a spot on the scalp, so that same spot that you first counted will be the same spot you count a year later. Most people would be unable to find that exact spot without a permanent mark of some type on it. Miniaturization studies will look at sections of the scalp, not just one spot.

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June 12, 2008

Hair Loss InformationYou’re Losing Hair – What Do You Do Next?! – Hair Loss Information – Balding Blog

Im sure these are some basic questions you’ve answered before, so feel free to direct me to a previous answer. I’m 42, and my hair is starting to both thin and recede, It bothers me quite a bit.

you say very often get examined by a professional. where do i start? is this my regular doctor, or i need to go somewhere else.

What is the difference between rogaine and propecia, and who would be best to recommend what would make the most sense for me?

thanks very much for any help you can provide.

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Doctor You should go to a good dermatologist with an interest in hair loss. Call his/her office to find out if they are the best one to treat you. Alternatively, you can see a hair transplant doctor (they have an obvious interest in hair), but don’t get yourself rushed into surgery. I see quite a number of men with problems like you describe.

There are huge differences between Rogaine (minoxidil) or Propecia (finasteride). For starters, Propecia is an oral prescription medication and Rogaine is a topical over-the-counter medication. They each have their own set of possible side effects and they both are currently the only FDA approved medications for treating hair loss. I usually recommend Propecia for early hair loss, but as it is a prescription medication, your doctor will be able to give you all the proper information about it. I wrote about this briefly before — “The two drugs work differently. Propecia is more predictable than minoxidil, but they could work together. I have seen hair come back with minoxidil, however I have seen more patients show great benefits from Propecia.”

For more, Wikipedia has good info about minoxidil and finasteride.

Please note: the above image is not an endorsement of child doctors.

June 12, 2008

Type I and Type II DHT – Hair Loss Information by Dr. William Rassman

I don’t understand the difference between Type I and Type II DHT. Why does finasteride only block Type II? DHT is DHT right? Also, if you’re going to lower DHT levels by blocking it from forming, why not just block all of it?

In the clinical trials for Propecia, I heard they tested finasteride at 20mg and its effects on hair loss were marginally better or more or less the same. And if Propecia is great but not perfect, there must be something else causing hair loss, perhaps another enzyme acing on type II or 5AR or another enzyme acting on Type I DHT.

Is it possible for Propecia to cease hair loss where it is forever?

Cheers for your time.

DHT is DHT. It works on different receptors in the body and these are discussed on RXList.com. Essentially, “The type 2 isoenzyme is primarily active in the reproductive tissues, while the type 1 isoenzyme is also responsible for testosterone conversion in the skin and liver.”

The last question in your message is not clear. If you are asking if taking Propecia forever will keep the DHT blocked at the same level forever, then the answer is no. There is no forever anti-DHT treatment. Your body will eventually start to produce more DHT than Propecia will be capable of combating, and you may begin to see hair loss again years and years down the line. Some doctors actually increase the dose of Propecia to combat at progressive ineffectiveness, but there is no proof that a higher dose works, but it may be a logical direction to go if the drug is less effective after years.

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June 12, 2008

Pretoxan – Hair Loss Information by Dr. William Rassman

Dear Dr.,

There is a new product called Pre Toxan, (or Pretoxan) containing L-Arginine, the website is: www.pretoxan.de

Could you please let us know your opinion, is it safe?

Thanks

I looked at their site (thanks to Google’s translatation service) and the “science” they mention just makes no sense. From what I gather, Protoxan is a shampoo that mixes the ingredients in Procapil with L-arginine. The site mentions that it, “boosts the synthesis of important components at the epidermal junction where the hair anchors to the skin.” And that Procapil, “has active compounds that help to anchor the hair follicles more firmly in the scalp, allowing hair follicles maintain their youth. By stimulating cell communication and metabolism, follicle anti-aging is promoted and anchoring molecules are rejuvenated. This helps prevent premature hair thinning, hair loss and MPB (male pattern balding).”

Excuse me if Google’s translator didn’t turn that into perfect English, but I think I see what they’re trying to say… and there is no science here. There is a poorly documented clinical trial on a limited number of men which is designed like a double blind study, but just does not cut it. The product may work, but there is no clear cut evidence that it does what is says.

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June 12, 2008

I Started Losing Hair Before I Hit Puberty! – Hair Loss Information by Dr. William Rassman

dear doctor,

PLEASE HELP ME!
i am a 16 year old male teen. the hair on the top of my head has been thinning since age 9-10, and i fear that at the rate i will not have hair on the top of my head by this time next year. this has been 6 long years that have been devastating to my self-confidence and i dont know if i can deal with being bald at age 16.

i did plenty of research on my dilemma, and i didnt find any record of a case that is similar to mine. i have been to a doctor, and have been tested for things such as thyroid, but it always come out negative. my doctors dont really seem to care much to help me. they tell me its just hereditary, but i dont understand how it could be. i started losing my hair before i hit puberty, and also my my whole family still has there hair. even my grandma and grandpa who are in his 70’s have nearly all there hair.

at age 12 i was told to start using rogaine, but stopped because i know that there is something else wrong that is not being found. every day i wake up and look in the mirror to see that i have lost more hair. it getting harder and harder to hide it from my friends. and everywhere i go im constantly reminded of it because my hair shows up everywhere like in my sink, or on my desk at school.

anyway, please please please answer me back. you’ll be the one person in the world that cares enough to truly help me find out the problem and hopefully the answer. thank you for listening.

I wish I could offer you some solid advice or anything of substance, but you really need to be examined, as your case is quite unusual. I couldn’t do you any justice by just guessing at your problem via the web. As you indicated in your email that you’re located in New Jersey, try to arrange a visit with Dr. Robert Bernstein (with offices in Fort Lee, NJ and Manhattan, NY). He can examine you and offer suggestions.

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June 12, 2008

Eat Rice and Get Scalp Massages Daily to Make Hair Regrow? – Hair Loss Information by Dr. William Rassman

I was at the hair salon yesterday and overheard another customer telling his stylist to keep the top a little longer because he was starting to bald. The stylist told him “my father was losing his hair until he started eating rice every day and my mom massaged his scalp. Then his hair grew back and although he’s 72, he looks like he’s in his 50s”. Now I know enough to realize that this sounds like just a cheap way to get your wife to massage your scalp on a daily basis, but is there ANYTHING to the rice thing? In Asian countries, there is still hair loss and rice is a dietary staple, so I am guessing that right there dissolves the theory. I wanted your insight though. Thanks, doc!

Well, Asians do have less hair loss than Caucasians, but I don’t believe that anyone has connected it to rice. The dietary differences may play a role, but how? I don’t have the answer to that.

I used to massage the scalps of my children when they were younger. It was a bonding experience of sorts and I joked that my magical fingers surely kept them healthy! Maybe I should’ve added a bowl of rice at the same time as the massage so that my oldest son wouldn’t have lost his crown hair! While a scalp massage might feel nice, it won’t regrow lost hair.

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June 12, 2008

Donald Trump’s Bad Hair Day – Hair Loss Information by Dr. William Rassman

UK’s Daily Mail has a new article up — A step-by-step guide to the gravity-defying Donald Trump combover — which includes some rather unflattering photos of The Donald’s infamous hair. And as everyone knows how bad his hair looks, that is really saying something!

The article hints that Mr. Trump’s combover is just hiding some balding, but I’d guess that he has had multiple poorly done hair transplants and is using this hairstyle to mask it as best he can. This is just rumor, though.

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June 12, 2008

Capsaicin for Treating Hair Loss? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,
What is your take on using capsaicin for hairloss? It’s my belief that Zhang Guang 101, a Chinese “herbal” product that is popular overseas, contains only capsaicin as its active ingredient. Having used a few bottles myself, I’m fairly certain that this simple molecule found in chili peppers is responsible for any hair growth effects that the product claims. I’ve only been using it for a couple weeks, so I can’t give a definitive testimonial. There has been research done on the effect of capsaicin on hair growth. It supposedly promotes the release of IGF-1, which is crucial for hair growth. It also stimulates pain receptors and releases substance P. Can you take a look and tell me what you think? Thanks.

Administration of capsaicin and isoflavone promotes hair growth by increasing insulin-like growth factor-I production in mice and in humans with alopecia

From the article:
“These observations strongly suggested that combined administration of capsaicin and isoflavone might increase IGF-I production in hair follicles in the skin, thereby promoting hair growth.”

Capsaicin is found in chili peppers and even in pepper spray. I don’t have any experience with this, though I read the article and will wait to see if it may become a treatment modality. I’m not opposed to new treatments by any means, but I will need to see actual proof before I throw my support behind it. At any rate, I’d think it would cause incredible tingling in your scalp, just as eating a very spicy pepper can numb your lips.

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June 11, 2008

DHT and Milk – Hair Loss Information – Balding Blog

Dr. Rassman, I came across this interesting article. It talks about how there are DHT precursors in milk. What’s up with that??!

Cure-Guide.com

Could milk at all contribute to the balding process? Sure it might not cause baldness, but is it reasonable to believe that it could have an adverse effect on our hair growth?

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Cow Essentially, whatever the cow ate will be in the cow’s milk. The milking cow that is in high milk production will have considerable hormones circulating in her blood stream normally. The milk that “contains placenta-derived progesterone and dihydrotestosterone (DHT) precursors” will flow to the milk drinker. If the farmer put steroids in the cow as well, then you could get those into your system and any of these could potentially cause hair loss.

Now I’m not trying to cause a mass panic and tell people to swear off milk or dairy. The article that you provided the link to discusses what may be in the milk, but this has never been studied scientifically to my knowledge. I guess that there is not much money in studying it.

June 11, 2008

Pimples on the Back and Sides of My Head – Hair Loss Information by Dr. William Rassman

Hi Dr.

I am a male 37 years old and from middle eastern background. I have been suffering from pimples with white pus, mainly they appear on the back of my head or on the side, they come two to three in count in one time, then they go away and after 2 to 3 days other ones develop. I have been suffering from this for the past 1 year and 5 months. They are painfull when I squeeze them and let the puss out.

In my early years from 12 to 18 years old I suffered from acne especially in my face, it left some gentle scars but was a problem in my life back then.

I hope that you can help to diagnose my problem before going to a doctor for check up.

Thank you.

You should see a dermatologist. Unfortunately, I can not help you without examining your scalp. This could be recurrent folliculitis, but if it recurs and moves around, this is something you need a doctor for, because antibiotics may be needed.