Month: February 2009

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Testosterone, DHT, Acne, and Propecia – Hair Loss Information – Balding Blog

First, I would like to Thank you doctor for having this blog. I just have a couple of questions that I can’t seem to get an answer too, and I decided to ask an expert like you. I would really appreciate it if you answered this question, as it is stressing me out lately. Firstly im 23 year old male with thinning hair, and these 2 questions are a reason I am reluctant in using propecia. My dermatologist prescirbed me the propecia but he was in such rush the day I went, and I coudnt ask him my questions. I still have my prescription but I am reluctant to use it.

If DHT(the by-product of testosterone) is responsible for angrogenetic alopecia in genetically predisposed males, then why does the increase in testosterone (or even normal levels testosterone) from taking propecia aggravate more hairloss or even aggravate more hairline hairloss(as I have read in numerous internet hairloss forums, from people complaining of more hairloss from propecia)? Isnt DHT suppose to cause the hairloss and not just testosterone by it self? Or does testosterone cause hairloss as well by itself? If the testosterone will cause hairloss then what is the point of taking propecia as it will only block DHT but that will just let the testosterone or sometimes the increased testosterone that results from propecia take over and continue the hairloss in genetically predisposed males.

Also doctor I also suffer from acne as I take topical clindoxyl gel and topical differen to correct that problem. I have read numerous medical articles that DHT is a cause of acne, then why does propecia sometime cause acne as a side affect? I know its a rare form of side affect but I have read people complaining from propecia causing acne or increasing there acne. If propecia inhibits DHT, and DHT is a culprit for acne, then shouldn’t propecia help out with clearing the acne problem instead of aggravating it? Or does the testosterone cause acne and propecia raises testosterone and thus cause more acne.

I Am really confused here. I really do want to start using propecia so if you can take the time to reply and answer my question, I would really appreciate it Doctor. Thanks again

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These are questions you should ask your doctor, not us here. There is a feedback loop in the human body so when the DHT drops, the testosterone goes up to compensate for it. This is the best explanation I can give on the process. Testosterone does not cause hair loss until it is converted to DHT. That is just the way it is.

I am not an expert on acne so you should see your doctor or dermatologist on these questions. I haven’t a clue why Propecia might cause acne. I haven’t seen that in my patients, and as hormones aren’t fully understood, the connection is difficult to make.

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Hair Loss InformationSisterlocks – Hair Loss Information – Balding Blog

There is a Dr. JoAnne Cornwell who has claimed that she has developed a form of locking hair called brotherlocks and sisterlocks. She claims that they do not put any form of tension on the scalp meaning no traction alopecia. I was hoping you could look into this potential scam before it fools too many.

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This is a styling option, not a medical or surgical option. I looked at the product’s website, but I am not sure what Sisterlocks is (aside from some kind of hair extension for African hair types) or how it attaches to the hair or scalp. It seems like it’s just a technique rather than a product, but I’ve spent 15 minutes going through this site and I’m still coming up empty. Anyone else have an idea?

Sorry, but I can not help you understand it any better.

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Gray Hair, Changing Diameter? – Hair Loss Information – Balding Blog

When hair turns gray, does the diameter change?

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From my clinical experience I can tell you that the gray grafts appear thicker than the non-gray grafts. This is evident in the single hair grafts. Now that you sent me this question, I should measure the gray hair diameter and compare it with the non-gray hair diameter over the next few weeks and maybe get back to you with a small research study. Thanks for the great question!

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Normal Miniaturization? – Hair Loss Information – Balding Blog

Hi Doc, how’s it going? I wanted to ask you how much miniaturization throughout the scalp is considered normal? 10-20%? I’m male, 22 and I have been on propecia for the past 3 years. I had a miniaturization test 3 months ago and the doc said I have slight to moderate miniaturization at my hairline and crown. At my age, would my hairloss stabilize? I’m just hoping I have enough hair until the next hair treatment makes its way to the market, thanks.

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I call any miniaturization under 20% as normal, because it may reflect vellus hair. What you see in one part of the head should be similar to other parts if it is not miniaturizing so that additional piece of information helps me as well.

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I’m Not Seeing My Hair Loss, But My Hair is Thinning – Hair Loss Information – Balding Blog

Hey Doc great site, with tons of great info. Heres my deal, Im 25 and I started propecia 1 month ago, I still have a good amount of hair. In fact I have never had what many would consider hairloss. For instance I have never had big sheds, or really any that I can think of. I wake up and my pillow doesnt have any hair on it, take a shower, and maybe loss 1 hair. However my hair over the last 6 months has gotten pretty thin. When it’s dry it looks pretty good, but when I get out of the shower and its wet it looks horrible. So my question is am I shedding and just dont notice it, or is my hair just thinning. And in a case like this, how well do you think propecia will work. THANKS!

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Miniaturization can occur without shedding. Propecia (finasteride 1mg) works wonderfully on this in men of your age. Best way to educate yourself is to map out your own miniaturization.

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Hair Loss InformationHistogen’s ReGenica – Hair Loss Information – Balding Blog

Snippet from the press release:

Dr. Gail Naughton, CEO of Histogen, Inc., a regenerative medicine company developing solutions based on the products of newborn fibroblasts grown under embryonic conditions, will address attendees tomorrow at the 4th Annual Stem Cell Summit in New York. Dr. Naughton will be presenting preliminary mid-trial results from Histogen’s first human clinical evaluation of ReGenicaTM for hair regrowth.

The primary objective of this double-blind, placebo-controlled, randomized study is to evaluate safety in the clinical application of the ReGenica product for hair regrowth. Histogen is also examining product efficacy as a secondary objective, specifically looking at the same end-points the Company has seen in the animal model – new hair growth, and the thickness of new and existing hair. The study is in progress, but the Company has reviewed data from the scheduled 12 week time point and is pleased with the results to date.

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HistogenRead the full text — Histogen to Present Preliminary Hair Regrowth Clinical Results at Stem Cell Summit

This is all quite exciting! Until I see actual data it wouldn’t be professional of me to comment further, though. There’s also an article I just found from yesterday with a photo of preliminary results, and they look very promising (see here). The hair count does appear to be increased. Remember, this is all very early clinical trial stuff, but I’ll post more info as it becomes available.

Their site is here if you want to do some further research. Or to read more about Wnt proteins, as it seems that it relates to the ReGenica product, see here.

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AskMen.com Discusses Foods that Prevent Hair Loss – Hair Loss Information – Balding Blog

Snippet from the article:

If you dread trips to the barbershop and cringe every time you pass a mirror, there’s a pretty good chance you’re concerned about hair loss. Whether you’re starting to see strands of your hair at the bottom of your shower or are just worried that your thick head of hair won’t last forever, there are helpful foods that prevent hair loss. You may be, however, genetically predisposed to hair loss, and if that’s the case, there’s not much you can do but keep your fingers crossed. Making sure certain foods are in your diet will help keep your scalp healthy, happy and, hopefully, hairy. Here are some foods that prevent hair loss, which means you need to stock up.

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RaisinsRead the full article: AskMen.com – Foods That Prevent Hair Loss

I don’t expect to find much medical information on a site like AskMen.com, and after reading this article I’m more secure in my lack of expectations. That being said, I still managed to read through the article, which states that eating eggs, beans, raisins, seafood, and potatoes all prevent hair loss, and greasy foods cause your hair to fall out. The author gives his reasoning behind most of these theories, but I do remain skeptical that foods alone can solve the problem of hair loss. The reading is interesting, nonetheless.

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Hair Loss InformationSunetics Laser Gets an FDA Warning – Hair Loss Information – Balding Blog

It seems you overlooked yet another laser device maker that was issued a warning letter from the FDA. Apparently the FDA had some problems with the marketing of the Sunetics laser brush. Funny thing is if you read the warning letter (provided in the link below), the FDA acknowledges that they applied for clearance in January of 2008. It’s been over 1 year and they still haven’t received clearance!? Also it’s funny how the Lexington International’s Lasercomb hasn’t yet received clearance for hair growth in women yet that study had to have been completed at least when Lexington received their warning letter back in May. Which leads me to one final question, if 650 nm is the optimal wavelength for hair growth, and all of these laser devices are within that wavelength, how can only one device receive clearance (and only for men)? Almost forgot, here is the link to the Sunetics warning letter page.

FDA – Sunetics International Corporation Warning Letter

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The warning letter starts:

“The Food and Drug Administration (FDA) has learned that your firm is marketing the Sunetics Laser Hair Brush and the Laser Skin Brush in the United States (U.S.) without marketing clearance or approval, in violation of the Federal Food, Drug, and Cosmetic Act (the Act).”

The letter from the FDA is dated in August, 2008. The FDA usually posts their warning letters publicly months after they send them out. I don’t know if Sunetics got their act together, but I assume that is the case, as their website still shows these products. I know I’ve said it before, but I don’t believe that the low level light therapy works. It is just that simple.

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What Kind of Coverage Can be Achieved with FUE2? – Hair Loss Information – Balding Blog

Hi,
Great blog – thank you.

Just wondering if you have any results yet from the FUE2 launch? I’m considering a ht in the near future (i’m 26 and would like my hairline lowered & temples closed etc) and would prefer this to the strip option.

Can you clarify, what the coverage is with FUE2 (i.e hany man hairs per cm2 can be grafted) and how this compares with other methods please? Additionally, what are the levels of risk compared to FUE and strip…

Grateful thanks…

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There is no difference between densities achieved with FUE, FUE2, or strip harvesting. The densities are achieved when the surgeon has the donor supply needed to place in the recipient area.

Here are some FUE articles you may find interesting:

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My Hair Gets Thin in Areas then Thickens Up – Hair Loss Information – Balding Blog

Dr. Robert Bernstein put me on propecia back in the summer of 2004. I started taking propecia with a full head of hair that was starting to get thin in a couple spots. Dr. Bernstein then put me on 2 1/2 mg of proscar a couple years ago. I still have my full head of hair, and no one would even think I had thinning or any type of hair loss. Now, my question: Does hair get thinner at times than others? For instance, it seems that my hair will get thin in a couple spots, then get thicker again a few months later. I noticed a thin area on the top left side of my head this week that wasn’t there a couple months ago. I always look at my hair, so I know!! Haha….could the following be a couple of possible reasons?:

– Recent stress due to my brothers drug addiction (now in hawaii for rehab as of today, so that should go away).
– Shampoo and conditioner that I know was causing breakage, possibly from the silicone and dimethicone

Any answer would be appreciated!

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Look up telogen effluvium (good reference at eMedicine.com) and see if this fits your observations. This is the only thing that I could imagine would do what you are talking about. You should also consider going back to Dr. Bernstein for a follow-up.