July 2008 – Page 8 – Balding Blog

July 16, 2008

If Some Medications Cause Hair Loss, Could They Prevent Propecia From Helping? – Hair Loss Information by Dr. William Rassman

Hello,

I am 19 and have been taking Propecia for over a year with no results whatsoever – my hairline has continued to recede rapidly. I have also been taking Wellbutrin for two years, which has a side-effect of hair loss.

I have read that Wellbutrin can “jump-start” the balding process. If this is true, could stopping taking Wellbutrin allow for Propecia to begin reversing my hair loss or stopping it? Or has the genetic process begun and is it too late?

Propecia works by blocking the formation of DHT. The hair loss side effect of certain medications, most likely will not come about from the action of DHT, so the two are not connected. At 19 years old, you are most likely experiencing the maturing hairline so it is possible you don’t have genetic balding (I haven’t seen you, so I’m unsure). A mapping of your scalp for miniaturization will show that diagnosis one way or the other. Propecia will not stop the formation of the mature hairline and the loss of the juvenile hairline.

Talk with your doctor about other medications that might not have a hair loss association. Get the diagnosis of genetic hair loss to know what you are actually experiencing and do not stop taking Propecia if you have genetic hair loss as this will only worsen your situation.

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July 16, 2008

Finasteride Has Retained My Hair for Years, But I Want to Use Rogaine Foam for Regrowth – Hair Loss Information by Dr. William Rassman

Hi Doctor,

I been on finasteride around 4 to 5 years. I believe it has help me slow down my hair loss. But I would like some regrowth. I still have no bald spots yet. I’m thinking about using Rogaine Foam to see if I can regrow some hair in the frontal and mid front part of the top of my scalp and thicken up the vellus hair at my temples.I have Mostly diffuse thinning but more thinning in the mid front. I know the makers of Rogaine have to say that it only works at the crown however I have read it does work in the frontal area of the top of the scalp, vice versa. I’m confused about it and also scare of speeding up my hair loss and not recover from the shed rogaine causes at first. I heard rogaine is more of a regrowth treatment and that propecia is more for maintenance. If I can just thicken up and have a bit of regrowth in between the hair where I’m thinning I’ll be happy with rogaine foam. Have u had patients or know about other doctors patients that have used rogaine for the frontal part of the scalp with success? Just looking for a professional thought about this and a peace of mind. your answer will be greatly appreciated.

Thanks

Certainly there is no problem with adding Rogaine Foam to your treatment regimen. Make sure that you do not stop the Propecia, because the mechanism of action is such that if you stop it and replace it with Rogaine, you will have “catch up hair loss”. Stopping the support from the Propecia will be exposing the hair to DHT if it is withdrawn.

With regard to Rogaine shedding, it may not be a very big problem, but if it occurs it should disappear in a couple of months or so.

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July 15, 2008

Hair Loss InformationIs My Chest Pain from Minoxidil? – Hair Loss Information – Balding Blog

I had used minoxidil for hair growth 12 months ago for 4 months. I stopped it. That time I have not observed any side effects. Now I am again using the same to control the hair fall. Now I am feeling like chest pain (muscular). Is it because of minoxidil..? how safe this medicine ..? because chest and heart are more important than the hair.. Thanks in advance

Block Quote

Chest pain with minoxidil may indicated coronary artery disease, because minoxidil can drop blood pressure and cause reduced circulation to the coronary arteries (angina). Please see a doctor to make that diagnosis, as taking minoxidil may be the way you find out that you have some serious heart problem.

July 15, 2008

Will Propecia Grow Hair for Me? – Hair Loss Information by Dr. William Rassman

Hello Doctor,

I am a 36 yr old black male. I am totally bald in the crown area and the top of my head, as well as my temple area. My hair only grows on the side of my head and the bottom of the back of my head. Will propecia help me grow hair so I am at least not bald and have some hair on the crown and top of my head.

I don’t know enough about your medical history to make any assessments. If your loss is early, Propecia will work best for you, but you may be describing extensive balding so without a set of good pictures, I can not advise you. If you’re still experiencing hair loss, Propecia will likely slow or halt the loss and if you should have miniaturized hairs in the crown, it might even grow some hair. If you’ve been completely bald on the top and front for 10 years, Propecia probably won’t regrow hair there, but I couldn’t say for sure as each person reacts differently to medication. Best to send pictures if you can not come in to see me.

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July 15, 2008

Why Can Some Men Have Less Grafts and Still Have a Fuller Look? – Hair Loss Information by Dr. William Rassman

I am 36yrs old and am considering getting a HT. I need a little in the front and some on top. What are the risks of shock loss in males over 30? I would also like to know why some men receive less grafts and their hair look fuller than some who receive more.

Risks of shock loss following hair transplantation occurs in young men, but Propecia/finasteride usually prevents it.

The value of a hair is not equal amongst all hairs. A fine hair may have 1/4 of the bulk of a coarse hair, so a transplant in a coarse haired person will be fuller (hair for hair) than on a fine haired person. A good character wavy hair will cover better than a straight hair. A kinky hair will have even better coverage. Also, the difference between the color of the hair and the scalp (contrast) has a lot do to with the result of a transplant. Add to that, the artistic skill of the surgeon and the distribution of the transplanted grafts and one patient can have a very different result, all things being equal, from one surgeon to another.

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July 15, 2008

We Want Solutions, Not Lectures!!! – Hair Loss Information by Dr. William Rassman

I find your responses to be irritating. Specifically, they take on a condescending tone, are pointless as most recommend seeking medical advice. What is the point in this forum if that is the pat answer. Of course they should seek medical advice.

Sometimes people just want encouragement and hope. Not a …”you should do this… you need to do that… Not helpful at all. Sorry, that is just my observation.

I have not been able to find many (if any) articles on the internet that indicate relief of symptoms and offering a solution.

We just want a solution, not a lecture.

Soapbox Your point is well taken, but please recognize that many people who write to me want a medical opinion on their condition, something that I can not give without examining a patient and without being able to ask questions. Also, many times my hands are tied by legal restrictions (I am a doctor, but not the doctor of those writing in) and therefore the best suggestion I can give is to visit their doctor. 95%+ of patients seen by the doctor can have a diagnosis by taking a careful history with good observation. This is particularly the case in diseases of the skin and hair where x-rays and blood tests are generally not needed, just experience and skills in the art of diagnosis. Telling me in an email that “my scalp itches” does not tell me much that I can use in diagnosis or offering relief. For example, last week I posted a question from a reader that said it felt like something was crawling around his scalp and I suggested that he might have head lice. In a situation where I could do a face-to-face examination, I would have seen the head lice crawling around his scalp had that been the right diagnosis.

You asked for solutions that bring relief. If that was so simple, then the doctor’s role of history taking and examination would have no value. I offer 2-3 hours a day to the blog to help when I can (sometimes more, sometimes weekends), and many, many emails are screened. I wish it was an easy task, and if only life were simple! As you can see, I volunteer my services on this blog and do not make my living from doing it, but what I do get from the effort was a way to stay in touch with people and a reason to research many of the questions that had great value to my learning experience. Even at 66 years old, I am still a student.

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July 15, 2008

Stopping Propecia After a Month – Hair Loss Information by Dr. William Rassman

I am 27 yr old male. Slight thinning in crown for 1 yr. So I took Propecia for 1 month but decided to stop since my thinning process is rather mild. My concern is will my thinning condition worsen with the stopping of propecia after 1 month of consumption. Is my hair already dependent or addicted to the medication? Will my hair thinning process goes back to original speed or end up with accelerating thinning speed?

I doubt that one month of Propecia will have caused dependency. Before you stop it, you should discuss this with your prescribing doctor (as with any prescription medication), and you should be getting your hair mapped out for miniaturization to find out a baseline for genetic hair loss. Maybe you don’t have it, maybe you do. Be smart with the decision and find out.

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July 15, 2008

Showering After Applying Minoxidil – Hair Loss Information by Dr. William Rassman

Im 29 and have just started a course of quarter proscar daily to hopefully halt my receding hairline and thinning crown. I was considering complimenting this with 5% minoxidil as the 2 together appear to give good results. I dont think the twice daily application of minoxidil would be a problem but my question is, if i were to take a shower and wash my hair around 3-4 hours after an application would this decrease the effects of the minoxidil?

Thanks

The minixodil will have been absorbed by the skin within an hour or so. Showering and washing your hair four hours after applying the minoxidil should not be a problem.

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July 15, 2008

I Think I Lost Hair Because of Exercise – Hair Loss Information by Dr. William Rassman

I have lost most of my hair because of exercise. I stopped exercise for couple of months & retrieved almost 30% of my hair loss. but the problem is I am a fitness professional and cant live without a workout but as soon as I start my workout which includes weight training I start losing my hair. can anybody help me? whats the relation between exercise & hair fall? if you see, most of the body builders are bald but why?????

There is no connection to exercise and hair loss unless you have a telogen effluvium that is caused by stress. Are you stressed when you exercise with your clients? Even this scenario is far fetched. I would have to examine you and take a careful history to understand your problem better. I would be venturing a guess without knowing more.

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July 14, 2008

Worse Case Scenario — I’m Allergic to Minoxidil and Propecia Makes Me Slow – Hair Loss Information by Dr. William Rassman

I’m allergic to minoxidil and Propecia makes me stumble over words. I’ve been off Propecia for 8 days now and I’m pretty much back to how I was before Propecia, wit wise. My hair was thinning before and it still lookes the same now.

The only other real options I have are this saw palmetto and soy/equol. If this equol does inhibit DHT from working, does this mean we have to consume soy everyday? What if we go on a month safari to somewhere in Africa where soy is not prevalent? WHat then?

I am not sure if soy/equol actually inhibits DHT. For that matter I am not convinced that even saw palmetto inhibits DHT, but there are some suggestions that it does impact the prostate and may impact the hair. It might be a good gamble to use this provided that saw palmetto does not produce the same effects on you. I have not seen any good scientific literature pointing to these claims. Here is a seemingly unbiased summary I found from a simple Google search regarding saw palmetto: Pharmacology of Saw Palmetto.

You, the consumers, drive this industry as we are all trying to find the next best thing. The cure for balding, the cure for aging, etc. We latch on to loose associations and circumstantial evidence. We read things on the Internet which are not all true. We like to believe in commercials and promotions (”looks good, sounds good, must be a true” type of attitude).

That’s my two cents worth of rambling, but if you are asking for my personal opinion as a physician, my answer is: I suppose it won’t hurt, but it probably won’t work. I always say “It’s a buyer beware market,” but maybe I should rephrase the last comment as “It’s a price is right market…”. For a few dollars (or euros, pounds, etc) we seem to think it may be worth it.

By the way, who says there is no soy in Africa?

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