September 2008 – Page 12

September 8, 2008

Clarify the Best Time to Take Propecia – Hair Loss Information by Dr. William Rassman

I didn’t really understand your answer to the best time to take propecia. You said the best time is in the morning because you get the half life of the drug being 4 hours thus reducing
concentration. Wouldn’t you want full concentration for better effects?

Like I’ve said in past blog posts, the best time to take Propecia (finasteride 1mg) is in the morning when your testosterone levels are at the highest. In reality and practicality, the best time to take Propecia is anytime you can remember to take it on a consistent (daily) basis.

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September 5, 2008

XX, XY, Chromosomes and Hair Loss – Balding Blog

Hi, i admitantly had a bit of a dig at the answers on this site being a little generic, repetitive and indirect in my opinion. So i have a question of my own. How accurate is the following information? This information makes sense to me. Thanks i appreciate it.

The mother has two ‘Xs’ and will always give her kid an ‘X’. The father has one ‘X’ and a ‘Y’ and will give the kid one or the other. The father, therefore, determines the sex of the child. If he gives you ‘X’ then you’re ‘XX’-a GIRL, if he gives you ‘Y’ then you’re ‘XY’-a BOY.

“X-linked” disorders are defects in one of the thousands of genes found on the ‘X’ chromosome. These disorders can range from severe mental retardation to more harmless things like color blindness or PATTERN BALDNESS. The reason that males are more susceptible to an X-linked disorder is that when mom gives her son an ‘X’ carrying the defective gene, dad gives the son a ‘Y’, which cannot back up the defective ‘X’. Women seldom get these disorders since the chances of getting two bad ‘Xs’ for the exact same gene are quite slim.

So as far as whose fault it is, blame both parents-Mom for giving it to you, and dad for not backing you up.

Now another point should be made about where to look for the bald ‘X’ in a mother’s family. You have to look at EITHER the (1) mother’s father OR (2) her brothers:

(1) Grandpa has the bald ‘X’ (and is bald) and passed it to your mom/her sisters-who give it to half of their sons. (remember mom’s brothers would only get the ‘Y’ and would not be bald in this case).
(2) Grandpa has a good ‘X’, but Grandma has bald ‘X’/good ‘X’ and gives a 50/50 ratio to kids, so half of mom’s brothers are bald.

If you are grandson of all this, then in scenario (1) you have 50% chance at baldness, scenario (2), a 25% chance.

Both (1) AND (2) are possible in the same family, but would be rare and might lead to bald women in the family (depending on other factors such as testosterone levels)

Chromosome I am not a geneticist. I am a physician. And the genetic argument as you pose is a simplified understanding of high school biology or college biology 101 at best.

The inherited traits are far more complex than X or Y chromosomes. While it is true that the father’s XY chromosome determines the sex of the unborn child, the balding gene is not in the Y chromosome. There are things called expression that distort our understanding of the genetics. Actually, no one really knows. That is why you cannot and will not find the answer… yet.

September 5, 2008

Propecia Worked Great for Years, Now I See Hair Loss — Should I Take 2 Pills Daily? – Hair Loss Information by Dr. William Rassman

hi there.

I ve been on propecia for six years with great results. The last couple of months i noticed a lot of hair loss. about 100 pieces of hair per day. Do you think it stopped working? maybe I should take 2 pills per day? or switch to another drug. or even go for hair planting.

Thanks so much

Propecia does not stop working. It is just that your genetic hair loss pattern may be showing. Propecia is continuing to work by slowing the hair loss. If you stop taking Propecia at this point you will notice a more rapid hair loss. If you increase it, it may have value at double the dose. The way to determine the effect of Propecia is to do comparison miniaturization studies over time. Then you know when and if it stopped working. Counting hairs does not do it for me. Discuss the possibility of increasing your daily dosage with your prescribing doctor.

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September 5, 2008

Keloids from Hair Transplant? – Balding Blog

Is it possible to get keloid or hypertrophic scarring from a hair transplant? How likely is it to occur? Or would the new hair hide it in any event?

Thanks in advance

A keloid is a possibility with any cut on the skin. If you have had a cut on the skin you will likely know if you keloid these cuts or not. Keloids are more common in people with African, Asian, and Hispanic skin types, and less common in Caucasians. That being said, scalp keloids from a hair transplant are very, very rare in all races.

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September 5, 2008

I Picked a Blackhead at My Hairline and a Hair with Root Came Out – Hair Loss Information by Dr. William Rassman

i woke up today, and noticed i had a whitey yellowish blackhead on my hairline, and of course i had to pick it, and when i did i noticed it was attached to the root of a hair, a little blood came out and the actual follicle now looks red, what is this condition? and will the hair grow from that follicle again?

This is a bizarre question. We all have blackheads once in a while and they are no big deal. I doubt that you will lose the hair in the long term, but what is the value (or lack of value) of one hair?

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September 5, 2008

I Had My Wisdom Teeth Removed, Now I See Hair Loss! – Balding Blog

Hi Doc,
Im 24 and have seen my very thick had of hair become very depleted and thin in the past month- six weeks. It seems very strange that my hair would thin so quickly, largely in the front and the temples, but not reduced to those areas. Prior to noticing this hair loss I had my wisdom teeth removed, with complications forcing me to take percacet and T3 as painkillers as well as an antibiotic. Could these be linked to my hair loss? How can i reverse these effects?

I have seen the hair loss process start (or become more noticeable) after a major surgery, but most of the time, it can also be coincidence. I doubt that a wisdom teeth extraction or T3 painkillers would cause hair loss, but possibly the stress involved precipitated the hair loss you were destined to have somewhere down the road? I couldn’t say for sure.

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September 5, 2008

Could Propecia Prevent Me From Having a Class 7 Pattern Forever? – Hair Loss Information by Dr. William Rassman

I’m currently taking propecia, and have been doing so for nine yeras with good effect. My question is, can I expect not to lose any more hair due to male pattern baldness as long as I’m taking propecia, or will the effect fade with time? That is, if I’m genetically destined to become a NW7, can I prevent this from happening by taking propecia for the rest of my life, or will I only delay the time to get there? Will my genetics eventually catch up with me, although I take propecia?

Fortune Forever is a long time, and unfortunately I am not a fortune teller. As I’ve said time and time again, the drug works differently in each person that takes it, so without an examination (miniaturization mapping) and a follow-up or two, I can’t make that prediction for you. So while I do not have any other-worldly prediction talents, it seems that you are doing the right thing by staying consistent for 9 years on the medication.

In all seriousness though, my best guess is that Propecia will delay the inevitable Norwood Class 7 (if you are actually going to go that far), but I couldn’t say how long or how strong the delay will be. As anyone could tell you, forever is a long time. I do know that if you stop taking Propecia (particularly after 9 years), your genetics will catch up quite quickly.

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September 4, 2008

Should 18 Year Old With Early Hair Loss Use 2% or 5% Minoxidil? – Hair Loss Information by Dr. William Rassman

I am 18 and experiencing hair loss in the past month. I have hair loss all across the top of my scalp. My scalp is also itchy in that area. My doctor prescribed me minoxidil 5%, even though I still have full scalp of hair. Is it safe for me to apply it considering that I’m 18 and that it’s still unknown how it works (what if in about 10 years, study will show that it actually causes some serious disease)? Would it be better to take minoxidil 2%? Thank you for your answer.

Rogaine 5% - Extra Strength I think either 2 or 5% minoxidil is relatively safe to use, as it has been used to treat hair loss since the 1980s. However, why are you using something without firmly knowing what you are treating? For those who follow this site on a regular basis, you can imagine what my next sentence would be…

Get a miniaturization study to know what you are treating and if you have miniaturization indicative of male pattern baldness, then Propecia is the best, best, best drug to treat it — not minoxidil. Also, minoxidil is an over-the-counter medication (sold as Rogaine Extra Strength, among other names), so there is no need for a doctor to prescribe it.

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September 4, 2008

Finasteride Does NOT Increase the Risk of High-Grade Prostate Cancer! – Hair Loss Information by Dr. William Rassman

I saw you recent post on finesteride. There is a new study by Redman MW et al that looks pretty positive for those on the drug. Check it out!!

Finasteride Does Not Increase the Risk of High-Grade Prostate Cancer: A Bias-Adjusted Modeling Approach (PDF file)

You’re referring to the post from last week — My Doctor Said Finasteride Makes Prostate Cancer Untreatable!

In 2003, the New England Journal of Medicine published a study (the trial was called the Prostate Cancer Prevention Trial — or PCPT) that concluded a daily 5mg dosage of finasteride reduced prostate cancer risk by 25% (see Finasteride Reduces Prostate Cancer Risk). In fact, the number was actually closer to 28% — and that has since been revised to nearly 30% in the study you sent from the American Association for Cancer Research. An article published in ScienceDaily about that later study points out:

“From a new analysis of PCPT data using advanced statistical modeling techniques and a complete assessment of prostate tissue biopsies, they concluded that these concerns are now resolved: finasteride actually reduced the risk of developing prostate cancer more than researchers had originally thought, did not increase development of more aggressive cancers, and the majority of tumors prevented were those that could spread and cause death.

Thanks for the reference, as it goes along with my way of thinking. And just for clarification, Propecia is a hair loss treatment that is 1mg of finasteride; Proscar is a prostate treatment that is 5mg of finasteride.

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September 4, 2008

Can Rogaine Foam Lower Blood Pressure? – Hair Loss Information by Dr. William Rassman

I have been using Rogaine foam for 2 months. I have also been on a lower sodium diet for about 3 months. I’m seeing a really nice improvement in my BP (I have been in the pre-hypertensive range). The question, I know monixidil in pill form is a high BP medication, but can topical Rogaine foam also contribute to a lowering of BP? Or should I just chalk it all up to lowering my sodium intake?

Thanks

Low blood pressure can be just as dangerous as high blood pressure, but if you have had borderline hypertension that has dropped to normal levels on Rogaine (minoxidil), then there may be a connection for you. Rogaine Foam should not lower blood pressure in general, but I suppose it could be a side effect. I would definitely follow up with your doctor regarding your concerns.

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