August 2008 – Page 10

August 11, 2008

Showering and Hair Loss – Hair Loss Information – Balding Blog

I read on the Internet somewhere that after you exercise, you should ALWAYS shower afterwards, to keep your scalp from getting clogged with dirt, sweat, and thus aiding against any further hair loss. Any truth to this?

What are your thoughts on shower heads that are set on a “massage” setting? Is the deep vibratory water pressure harmful to your hair follicles?

Thanks for your time.

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Nope, no truth to that.
It feels good on your scalp, and you can continue to do it as it will not hurt your hair or cause hair loss.

August 11, 2008

Finasteride Compounds – Hair Loss Information by Dr. William Rassman

Thanks so much for writing this blog. When ever I have hair loss questions, I always start be searching your blog. I recently received an email from my doctor about his own brand of finasteride. In his email and on his website he refers to it as “compounded finasteride.” He also states that it is not an overseas generic and that is custom-compunded by a US Pharmacy. A quick google of “compounded finasteride” shows that there a few doctors in the US now offering this.

I was wondering if you knew anything about it? I’m all for saving money but I want to make sure I’m getting the same stuff. What exactly does “compounded” mean?

There are more and more “compounded” versions of finasteride on the market today. Most of these versions have the important medication, finasteride, along with other ingredients that when combined allow the physician to claim his or her own brand of finasteride. The important point here is that in most these concoctions, finasteride is the only FDA approved medication to combat hair loss and all other additives are very unlikely to help and from an effectiveness point of view, it must be taken orally as there is no science to support other ways to take it (skin, inhaling, or rectal use).

In most states, doctors are allowed to mix their own medications so if they know what they are doing and it is legal in the state that they do it in, then I guess it is legal. I know nothing about mixing medications. Some interesting historical reading includes:

August 8, 2008

Hair Loss InformationStomach Pain and Bloating from Propecia – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I just wanted to say thank you for providing some very useful information and answers to questions on your website.

Although I have full coverage, I have been experiencing thinning hair throughout the top of my head since my early 20’s (Im now 25). Finally, I decided to visit a dermatologist last year. After asking questions about my family history (my father has experienced hair loss), he recommended that my hair loss is from genetic factors and prescribed Propecia. However, there was no miniaturization performed.

My 6 month experience with Propecia has been fairly unique. Within the third month of taking Propecia, I experienced a pretty good shed. I also noticed after a few weeks that my hair was becoming very oily (I have never had oily hair in my life). Around that same time, I was noticing that I had some abdominal bloating which was very uncomfortable. In the 4th month, I stopped taking the medication (due to the stomach pains) and within a week these pains went away.

My dermatologist encouraged me to resume propecia as I was simply “connecting the dots” to link cause and effect. After doing so, within a couple of weeks the stomach problems returned. At that point, I discontinued the medication. It seems I am worse off then when I started as the hair caused by shedding never fully returned and the scalp is now more visible (however, my hair is no longer oily).

Have any of these problems been reported or am I experiencing a very unique situation?

Thanks for your help.

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Although what you are describing is not common and is not usually one of the side effects of the medication, you may be having an adverse reaction to the medication. With the half life of Propecia (finasteride 1mg), one would expect your side effects to disappear sooner than one week after you stopped taking the medication. Have you tried taking half the dose you were taking to see if you have any side effects? I would also make sure you have a miniaturization study done by a specialist in order to properly diagnose your hair loss problem.

August 8, 2008

Topical Finasteride — Would it Work? – Hair Loss Information by Dr. William Rassman

Dear sir,

i would like to try one product containing topical saw palmetto and topical finasteride !

i am only 20 years old,i would like to know if i will have the same orally finasteride side effects(reduced libido),thank you

There is no evidence that finasteride on the skin can predictably be absorbed. Interestingly, Merck (maker of Propecia) warns that women should not touch Propecia because of a threat of absorption, particularly in pregnant women, yet there is little information on this subject. I’ll try to get some clarification from Merck for a future blog post. I am also not familiar with topical saw palmetto having any value for hair loss treatment.

According to an article from the Journal of Drugs in Dermatology in 2004, 5 alpha-reductase and finasteride in pattern alopecia and acne: “Topical finasteride is well absorbed, but clinical results were minimal with this mode of drug delivery.”

The bold styling was not part of the original article — I added that to drive the point deeper. The question about topical finasteride has been asked of me many, many times, and I hope this explains why finasteride comes in an oral pill rather than a spray, gel, foam, cream, or even a suppository.

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August 8, 2008

Razor Bumps – Hair Loss Information by Dr. William Rassman

I suffer from occasional razor bumps/ pimples on my scalp. One website recommended using a mild facial cleaner one or twice a week on the scalp. Would you recommend this course of action if this is folliculitis?

Would also like to thank you for recommending Propecia back in February (Is It Ever Too Late to Start Propecia and Minoxidil?). Have been taking Propecia since then and am really pleased with the results seen in such a short time. Crown is
really beginning to fill in progresively!

Razor From your description this sounds like it may be a form of mild folliculitis, but I can not tell without properly examining these lesions. I would recommend you be examined by your physician.

From the folliculitis article at eMedicine — “For recurrent uncomplicated superficial folliculitis, use of antibacterial soaps and good hand washing technique may be all that is needed. For refractory or deep lesions that have a suspected infectious etiology, empiric treatment with topical and/or oral antibiotics that cover gram-positive organisms may be of benefit.”

For the above reason you need to have your physician make sure you do not need more aggressive treatment.

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August 8, 2008

Am I Just Wasting Time with Hair Loss Medications in My 50s? – Hair Loss Information by Dr. William Rassman

Doctor

What do you suggest for a man in his 50’s with thinning in the crown, but otherwise a good head of hair? I can cover the thinning with a small amount of toppix. I started propecia a few months ago and noticed less hair in the sink but much increased shedding in the crown in the last month. At my age am I wasting my time with medication and just get a transplant or wait it out and see what happens with propecia?

Though I don’t have a frontal receding problem now I assume I may have one in a few years following my brother and father. Will a crown transplant limit my donor area for future transplants if I need them?

I know hair loss in your 50’s is unusual, but its in the family. I’m just a late bloomer. Thanks

At this point it in order to see the benefits of Propecia you have to be patient and wait at least 8 months to see if it is helping or if it is at least keeping you from losing more hair. I would not stop the medication after only a few months treatment. I would recommend you get a miniaturization study and then before you do stop the medication, follow up to see if there are clinically evident positive results from the finasteride. Remember, everyone has a limited supply of permanent (donor) hair. If you have a transplant to the crown area you will limit any donor hair that you have for future transplants. Although I would suspect if you have not had any frontal hair loss at your age, you maybe a Norwood Class vertex variant.

A good friend of mine (age 77) went on finasteride for his prostate, and his crown area (which was almost completely bald) regrew a good amount of hair. We see late balders as well, so someone of your age could start balding late in life and still get a great benefit from this drug.

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August 7, 2008

Hair Pull Test – Hair Loss Information – Balding Blog

Dr. Rassman,

If propecia has been successful treating my Diffused Patterned Alopecia, should I still have a positive result from the Hair Pull Test (i.e., still find hairs after conducting the Test in the balding areas)?

Thanks.

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The hair pull test should be done by the physician, and not by the patient, as it is more complex than the name makes it out to be. Just pulling on some hairs and seeing clumps of hair fall out does not mean you have a positive hair pull test. The hair pull test is performed by taking a few strands of hair between the thumb and forefinger and pulling on them gently. Hairs in anagen (growing) should remain rooted in place while hairs in telogen should come out easily. You then figure out what percent of the hair is in the telogen stage. For more information on the cycles of hair growth, see Hair Follicle Cells Growth Stages.

Shedding of hair can be variable from day to day and is greater in certain seasons (spring and autumn). Washing you hair prior to having a hair pull test can also affect the results. Genetic hair loss does not cause a positive hair pull test. And it should go without saying, but the image to the right is NOT the actual hair pull test, and you shouldn’t have to worry about your doctor doing this to your head when conducting the test.

August 7, 2008

Hair Loss InformationLittle Richard’s Hair – Hair Loss Information – Balding Blog

I am amazed at how young Little Richard the entertainer looks.His hair looks unusually full and straight for a black man at his age.

Is this his hair or does he use a system similar to Michael Jackson’s?

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I’ve never met the man, but after looking at his pictures, it really looks like a good afro with lots and lots of styling… but more probably, it is a hair piece or wig. I don’t know how similar it is to Michael Jackson’s though.

August 7, 2008

Non-Genetic Hair Loss from Stress? – Hair Loss Information by Dr. William Rassman

I tried to find this on your site but was unable to. You talk about stress pushing along what is already genetic. but I was wondering can stress cause hairloss even if you are not genetically predisposed?

In general, stress can cause hair loss in those that are genetically predisposed, as well as those who are not predisposed to the classic patterned balding. Any type of stress — physical (recent surgery, illnesses, even childbirth) or emotional (death of a loved one, work or family related) — can trigger or exacerbate hair loss. Women seem to have some syndrome where they get stress hair loss that cycles with the stress, growing after the stressful period and falling out when the stress increases. I have not seen this in men. The term telogen effluvium does apply.

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August 7, 2008

My Mom is Allergic to Minoxidil — Might I Be Too? – Hair Loss Information by Dr. William Rassman

Hello,

My question is in regard to Minoxidil. About ten years ago my mother tried the product and ended up having a very severe allergic reaction. Her face and throat swelled greatly and she was convinced she was going to die. Thankfully, she ended up ok after several months of treatments and recovery. Doctors told her that because she applied the product after scraping her head, it most likely entered her bloodstream and resulted in the reaction she experienced.

I am now 28 years old and have been losing my hair for about 5 or 6 years. I would very much like to try Rogaine, but I am afraid of having an experience like the one I just described. My question is whether an allergy to Monoxidil is hereditary, and if there is a way to be tested in advance to determine whether or not I am allergic.

Your response is greatly appreciated, and please accept my apology if this topic has been covered before.

Most medications reactions are not true allergies. A true allergic reaction to a medications cause, itching, rash, swelling, difficulty breathing. From your description it sounds like your mother had a true allergic reaction. A family history of reaction to a specific drug does not mean that one has an increased chance of reacting to the same drug. You can do a skin test where you apply minoxidil to the skin (a very small area on your arm, possibly the size of a pea) and then wait to see if you react to it.

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