February 2009 – Page 12

February 4, 2009

Took Dutasteride for 2 Years, But I Might Have Side Effects Now — Should I Switch to Propecia? – Hair Loss Information by Dr. William Rassman

Dear Dr Rassman,

I’m 23 yrs male. My hair was thinning and growing very slowly. I’ve been on Generic Dutasteride (Dutas) for exactly 2 years now. I’ve had very good results and my grows really fast. I’m not sure if I’m experiencing side effect or am I just stressed because of money problems. My sex drive and erection is not strong as I would like it to be, but this could also be natural right? So I’m not sure if they are side effects.

I want to switch to Generic Propecia now and just hope my sex drive and erection would be strong as I would like it to be. But I’m worried that if I switch to Propecia, I might start losing hair. I just wanted to know your opinion on what you would do if you was in my place? Thanks

Dutas I really don’t know why you are having erection problems. While dutasteride can possibly cause erection problems, if you have been taking it for 2 years without problems I doubt the medication is the cause. I would consult with your doctor for a complete examination. Also keep in mind, dutasteride will last several months in your body (possibly up to a year) if you stop taking it.

If you are asking for my advice on what will happen if you switch from dutasteride to Propecia, I don’t have a clear answer for you. Dutasteride blocks more DHT than finasteride, so you might see some difference there. All of this points to the fact you need to be followed by a physician who can follow your specific issues and give you objective and accurate recommendations. I’m not your doctor and I’m just making general observations.

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February 4, 2009

Removing Scales from Scalp is Causing Hair Loss – Hair Loss Information by Dr. William Rassman

Hello,

I have seborrheic dermatitis of the scalp (since last 3/4 months). I had almost 25 % of scalp covered by thick scales. After my GP prescribed me for Nizoral(2%) and salycylic acid+sulphur solution (i also use tgel alternately), the flakes started to loosen up and are coming up after shower.

I gently remove the loosened scales which come at the end of the hair. But in this process i have suffered hair loss. Do you think this hair loss is reversible once the condition is controlled? My age is 27 (male).

The hair from one time hair loss should grow back, but you need to know why your seborrhea is so severe. Maybe you have psoriasis, which looks like seborrhea, but is often much worse. Check with your doctor.

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February 4, 2009

Poor Diet, Insomnia, High Miniaturization – Hair Loss Information by Dr. William Rassman

Hello Doc,
I went to a hair loss specialist near where I live. She examined my hair and noticed that I had miniaturization well above 40% even in the permanent zone. She refused however to say that it was DUPA, but rather claims that my very poor diet and sleeping patterns have caused this and that it may reverse. Granted, I hardly ate for 7 months and I have rampant insomnia, but this seems very farfetched. Can I trust her?

Starvation can cause hair loss. Starvation can induce genetic hair loss and accelerate it if it is present. As I have not had a patient suffering from starvation and haven’t been able to microscopically map out the scalp of a patient like that, I can not tell you what it means as far as the type of loss experienced. In fact, I can not tell you what you mean when you write that you “hardly ate for 7 months”. I am not being disrespectful, but you are only telling me part of your history and clearly the doctor you met with may have more information than I do. Try to build a bond with the doctor you choose. If you don’t trust her, go to another doctor who you can trust and get another opinion. That is the way the medical system works and BaldingBlog is an oddity in that it really does not fit into the medical system, as it is just a source for information.

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February 4, 2009

Drug Holiday? – Hair Loss Information by Dr. William Rassman

What is your opinion about taking a drug holiday for a few weeks every few years to keep from developing a tolorance to Propecia? After 10 years on the drug things don’t seem to be working too well any longer.

If you stop Propecia, you will lose hair. A drug holiday makes no sense, but it is not unusual for a person with genetic balding to eventually lose out in the “war” between the drug Propecia and the balding process. The good news is that it is a slow process, but if you go on a drug holiday, you may find that your hair falls out faster. Tolerance makes no medical sense with this drug.

Think about insulin and the diabetic. If the diabetic stopped taking insulin for 2 or so weeks, he may die. Not a good holiday.

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February 3, 2009

Beckham and Finasteride – Hair Loss Information – Balding Blog

Dear Dr. Rassman,
Im always thankful to you as I visit your blog every alternative day. I also thank your blog for saving me from buying the useless hairmax laser comb. I am a 21 year old male, allergic to minoxidil and have been losing hair for more than three years now. My hairline is still intact but have thinning all over.

My first question is that can you think what david beckham might have done to regrow his hair. I have the exact same case, and heres the links to before and after pictures of him. Before and After. Please answer this question as its very important for me to know the answer.

Also, I consulted two dermatologists which belonged to the most famous hospitals in dubai, and both refused to give me a prescription for finasteride saying I am too young(one was upset) and this made me scared of the drug. What would you do if you were instead of me?

Do you find this information on this site reliable? Drugs.com – Finasteride side effects

Was that study done on finasteride 1mg or 5mg?

I apologize for this long e-mail. Thanks in advance.

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Beckham

It is difficult to tell in the after photo, as it isn’t close up and the lighting is different. It looks like his hair is just a bit longer or he could be using medication. I’m not even sure how much time was between the before and the after photo. I did write about David Beckham previously.
I’m not sure why your dermatologists would say you were too young at 21 years old to take finasteride. The studies on the medication were on men age 18 and up and the medication was shown to be effective.
Yes, Drugs.com is a reliable site.
If you’re referring to the study mentioned in that Drugs.com link you sent, I believe that is on the 5mg finasteride.

February 3, 2009

Hair Loss InformationPropecia Side Effects After Just 3 Days? – Hair Loss Information – Balding Blog

Hi,

I have been taking Propecia for 3 days and have noticed that my erections seem softer and do not last as long. Is it too soon for me to be experiencing such alleged side effects? Your response would be greatly appreciated.

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There are many possibilities. The power of suggestion is sometimes more powerful than drug or side effects. If you think you are going to have a sexual side effect (after reading all the horror stories on the Internet) you will likely have a side effect. The real world sexual depression with Propecia is about 1 to 2 percent and may take weeks to appear. The real world power of suggestion (or placebo effect) is much higher.

February 3, 2009

Why Is Increased Hair Loss Listed as a Minoxidil Side Effect? – Hair Loss Information by Dr. William Rassman

I looked up Minoxidil on Mayo Clinic’s web site, and it said a side effect was hair loss. Seems a bit contradictory, ay?

The use of minoxidil may promote hair cycling. If it does, the initial stage could be hair loss, but that will go away in 2-3 months and the anagen cycle starts up.

February 3, 2009

I’m Worried Finasteride Will Lessen My Chances of Having a Male Child! – Hair Loss Information by Dr. William Rassman

Hello Dr R

As other chaps have commented – you operate an informative website but can you answer or provide referal to those who perhaps can. You cant know everything and yield a scalpel as well

Here is my situation. I am almost 40 years of age, been on finasteride since 2000, almost a decade. No significant side-effects and kept the majority of my hair. Probably in the next year or two, I shall conceive a child (hopefully a boy) but a healthly child is the main thing.

My questions to you

1. If finasteride has no real toxicological effect – why hasnt Merck released a study showing men who have been on the drug produce healthy children of either sex. I mean more the hormonal imbalance the drug does than the toxic effect. Hormones do play important roles even if that one causes hair loss.
2. Half life of the drug is cleared within a couple weeks or so. But how long would it take for the hormone levels to reach what they were prior to ever taking the drug in the first place
3. Is it possible to test for certain hormones to guage their levels to quantify this OR is this futile

My biggest fear is that the use of the drug would jeopardize having a healthly baby and also lessen the chance of having a male one!

Thanks for your unbiased opinion.

The half life of finasteride is about 4-6 hours so it is almost completely gone in 24 hours. There may be some tissue fixation that occurs and I would expect that it would take 1 or 2 weeks to clear that (just a guess). I can not comment on why Merck does or does not do something like gathering the statistics that go beyond safety and effectiveness (FDA requirements). You can write Merck and ask them directly.

I do not believe that there is any evidence of sex gender preferences conceived when a man is on finasteride. There is no evidence that babies are anything but normal when the father is on finasteride. We know, however, that this drug is dangerous for women who are pregnant particularly in the first trimester.

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February 3, 2009

I’m Eating Soy and Broccoli Every Day to Fight MPB – Hair Loss Information by Dr. William Rassman

I’m interested in fighting MPB without drugs so I am taking interest in soy and broccoli. I read that both contain goitrogens that affect iodine and the thyroid. I’ve been drinking like a whole carton of soy (8 servings) and a head of broccoli each day (probably a few servings) and I don’t consume dairy. I just bought a kelp supplement for iodine and it says to take one capsule a day which provides 276 percent of DV of iodine. But because I eat so much soy and broccoli each day, should I be taking more i.e. two, three, or four a day? I’m a big guy so maybe that makes a difference. I’ve also eaten chicken livers before and those contain like 1000 percent DV of vitamin A, so several kelp capsules can’t be too bad right?

I don’t think broccoli or soy will grow hair, but I do know that it produces gas. I know I don’t need to say it again, but indulge me — male pattern baldness is from genetics. You really can’t fight the cards you are dealt from a genetic perspective, as there is no cure for balding. Good luck against the fight!

Also remember anything in excess can also be bad for you, so use your judgment.

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February 3, 2009

Coffee After a Hair Transplant? – Balding Blog

Hello,

I was curious if you think that drinking coffee is bad after a hair transplant. I drink about 2-3 cups per day. Do you think it hurts the blood supply to the hair transplant by constricting the blood vessels? Thanks in advance. God bless.

Coffee Coffee does constrict blood vessels, but I do not believe it will harm the hair follicles. The medications that doctors use during your hair transplant surgery contain epinephrine. It is used so that bleeding can be minimized and the anesthesia can last longer. Epinephrine is a very potent blood vessel constrictor (more so than caffeine in your coffee).

In the end, use your good judgment and follow your doctors instructions. I generally tell my patients not to have coffee the day of the transplant to keep them calm more than anything else.

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