September 2008 – Page 7

September 18, 2008

5-Alpha Reductase and Propecia – Hair Loss Information by Dr. William Rassman

If Propecia reduces DHT by blocking the 5-alpha reductase enzyme, does stopping Propecia mean that the normal production of 5AR will take place once again or are the blocked 5AR enzymes gone forever (I’ve heard the latter on message boards like propeciahelp.com).

The block from the enzyme 5-alpha reductase is not a complete one (I believe I read it was about 80% with Propecia) — and it is always there. When you stop Propecia, the enzyme continues to do what it always does and is not “gone forever”, as you read on those message boards.

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September 17, 2008

My Hair Looks Thin Under Direct Light, But I’ve Seen No Recession – Hair Loss Information – Balding Blog

I have one of those panels right above my bathroom mirror with lightbulbs, and whenever I look at my hair in the mirror, the front looks like it’s thinning as I can see scalp. But my hairline is the same as it’s been since I was 15 (10 years ago) — no recession whatsoever that I can tell. And my hair does not seem to look like it’s thinning in the temples but rather in the general frontal area from temple across the middle and to the other temple. Furthermore, when I come out of the shower I comb my hair back, and then I take a handheld mirror, and bend over so I can see the top of my head in the mirror, the front of my hair looks like it’s thinner than the middle or back from the top view. From this description only, what would you make of this?

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When your hair is wet, you might have more see through hair. Also, as you age, some people get finer hair. Under direct light, your hair may appear thinner. It doesn’t sound like you have any hair loss, and I really can’t suggest anything for you to try.

September 17, 2008

Will Rogaine Foam Regrow Hair Lost from Traction Alopecia? – Hair Loss Information by Dr. William Rassman

Hello Doc,

I have a thinning hairline not caused by MPB, it happend because over the years i used to tie my hair tightly in a ponytail. I am thinking of using rogaine foam? can you use this for the hairline? and what are the effects?

Thanks

I can’t say for sure whether it’ll work, however, I suppose Rogaine is worth a try (either in the foam form or the oily form). Read the directions on the bottle for application instructions.

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September 17, 2008

Taking 3 Months off Propecia to Evaluate Hormone Levels – Hair Loss Information by Dr. William Rassman

I’ve been taking propecia for nearly four years, and my endocrinologist would like me to take 3 months off of it to evaluate some hormone levels that were questionable at best, particularly low FSH.

My question is, can you take 3 months off propecia without any harm being done? How long can I realistically go off it and be able to take blood tests without the finasteride having any impact on the tests – is it 3 months or less? I have read that the half-life of propecia is less than a day so, ideally, couldn’t I take blood tests after, let’s say to be safe, a month and it’ll be okay?

Thanks in advance!

If you were actively balding and taking Propecia for a long time, then stopping it for 3 months can produce “catch up” hair loss in that time frame. I am not an endocrinologist nor your doctor. You should be address these concerns with your doctor. Maybe your doctor has his/her own reasoning.

I really don’t know your situation of low follicle-stimulating hormone (FSH) or why you are taking Propecia to evaluate hormone levels. Some of what you say makes me wonder if you are even balding or have androgenic alopecia. One thing that I do know is that the serum half life of Propecia is several hours (4 to 6 hours). I do not know what impact it has on FSH. Ask your doctor.

September 17, 2008

Sex After a Hair Transplant – Hair Loss Information by Dr. William Rassman

I just had my first hair transplant and it says to not have sex for one week. Is masturbation ok the evening of or day after? or will it possibly cause some grafts to fall out?

I remember a billionaire I performed a hair transplant some years ago. He had an interpreter with him (came from Asia) and I jokingly told him not to have sex for 3 years. I remember laughing and I thought he understood it was a joking comment. Three months later, his interpreter called and told me that his boss told him ‘to hell with the transplant’, and he didn’t care if it ever grew, but could not handle the abstinence from sex for any more time. I realized how humor is very cultural and he revered my medical and surgical skills and took my joke as a directive, not as the humorous “masterpiece” that I intended. Obviously, it was a dumb joke that got lost in translation.

Anyway, I generally recommend passive sex for the first 1-2 nights, then go for it which ever way you feel up to it after. With regard to masturbation, wait a day to be safe.

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September 17, 2008

Omega Fish Oil and Hair – Hair Loss Information by Dr. William Rassman

Hello Doc,
I have recently incorporated Omega 3-6-9 fish oil pills, Multi vitamins and Vitamin B12 into my supplement routine for working out, and was wondering if any of these pills will have any negative impact on my hair. I take the supplements as directed, without “pushing the limits” of them. I have also heard that Omega Fish Oil pills can actually be good for your hair, and was wondering if there is any truth to this?

Omega 3-6-9 fish oil pills, multi-vitamins, and vitamin B12 are all ok and may help you maintain your general health and perhaps your hair health as well. I do not know of a good scientific paper discussing these benefits on hair loss or faster hair growth, though.

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September 17, 2008

Can We Use Donor Hair from Animals?! – Hair Loss Information by Dr. William Rassman

Hey Doc,

This is a bizarre question, but I was wondering if it is possible to get donor hair from animals that are similar to humans? I know it may sound curl or just flat out stupid, but I was wondering if its even possible?

Thanks

We use animal hair for wigs all of the time. Let’s say hypothetically that it is possible to use animal hair for transplants — which animal did you have in mind? If you picked the animal of your choice, what do you think PETA (People for the Ethical Treatment of Animals) would say? Hair transplant isn’t life or death, like a liver or heart. If PETA supports your cause (or you don’t care about what they think anyway), what doctor will you go to? A veterinarian? If a doctor is willing to do the surgery, what do you think your friends will say? It gives a whole new meaning to “sexy beast” …

The answer to your question is — no. Your immune system will reject it in a matter of weeks. Anti-rejection medication would be far too risky to use for a cosmetic procedure.

September 16, 2008

Will Hair Pulled Out With the Root Grow Back? – Hair Loss Information – Balding Blog

Hi Doctor,
Is it true that hair pulled out with it’s root will never grow back? Thanks

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A while ago, one of my patients was mugged in East Los Angeles (not a good part of town). As he was getting roughed up and his wallet taken, he was held by his hair (which was about a year out of his surgical procedure of 3000 grafts) and they broke his nose. After they got his money, they kicked him, pulled out his new 5 inch long hair, and he fell to the cement. The police and ambulance came and when they wanted to take him to the emergency room, he refused to go to the hospital and had the ambulance deliver him to my office, all bloody. Crying about his hair and the ordeal he’d just been through, he told me the story. I reassured him that the hair will grow back and strongly urged him to have his face sewed up and his broken nose attended to.

In most cases, pulled hair (from the roots) grows back. That man came back to see me 6 months later with most of the hair now growing out. He was very appreciative.

September 16, 2008

Transplanting Hair Between Existing Hairs – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

How dense can hair transplant be done assuming that there are plenty of donor area with thick hair and the target area still has 50% density? Can hair transplant be done in-between existing hairs to make the hair thick again?

Tried Propecia but stopped after 2 days because of side effects. I appreciate your help on the matter.

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You can transplant between existing hairs without difficulty, providing that the existing hairs are permanent and not miniaturized. I have seen patients receive very dense hair by transplanting between hairs that were previously transplanted.

September 16, 2008

ISHRS Doctors that Still Do the Punch Grafts? – Hair Loss Information by Dr. William Rassman

I was looking over the website of the International Society of Hair Restoration Surgeons. I was using the “Find a Doctor” feature and also looking at the sub-categories of procedures performed.

Am I missing something? Why is there even a sub-category currently listed for doctors who perform “punch graft” procedures? Furthermore, why are doctors even advertising that they perform it?

Isn’t that procedure obsolete? Who would even want it? There has to be a reason that the procedure is listed and that doctors advertise performing it – I would hope. Is the punch graft procedure indicated in any situation? If not, what gives?

The follicular unit extraction (FUE) procedure is in a way a mini-punch graft involving just one follicular unit. Instead of using 6mm punches, we use 0.9mm punches.

Unless there is something I am not aware of, the punch grafts are obsolete. I found the list of doctors that are listed as those still performing this archaic method — ISHRS Physicians that perform Punch graft transplantation. I must assume that this is just outdated information on the site and will inform the ISHRS to find out if my assumptions are correct. I sincerely hope I’m right and that no doctors in the ISHRS are currently doing this procedure. Fingers crossed.

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