April 2009 – Page 11 – Balding Blog

April 8, 2009

Has Anyone Died from Using Minoxidil? – Hair Loss Information by Dr. William Rassman

Ive been using minoxidil for some months now then I started experiencing prolonged chest pains. Reading the other questions posted here I’m just wondering: Has anyone died from using minoxidil? Or at least are there cases when users developed drastic health problems from its use?

I’m not aware of any reported deaths from using minoxidil, but I did find that there was something published in the Journal of American Academy of Dermatology over 20 years ago titled, “Deaths associated with topical minoxidil therapy“. The problem is, I can’t find any text from it, nor have I found anything referencing minoxidil related deaths since then… so the title could be misleading. It has been reported to kill cats though.

Minoxidil was originally an oral blood pressure lowering medication. When you put it on the scalp, it can be absorbed in to the blood stream and cause low blood pressure related symptoms which could restrict coronary and brain blood flow (in theory) causing a heart attack or stroke. If you are having chest pains, it may not be related to minoxidil and could just be coincidental… or you may be unmasking a serious heart related issue. I would urge you to go see your doctor and have your heart checked out.

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April 8, 2009

Finasteride Side Effects — Readers Asks People to Get a Grip! – Hair Loss Information by Dr. William Rassman

How come people can’t get a grip?

There is so much hysteria out there about the sexual side effects of Finasteride on all the balding forums and blogs that I though I should link a couple studies that might calm some of this down.

Medscape (*Editor’s note: requires login)

Journal of Sexual Medicine

Both of those independent studies were done with the 5mg dosage and both are aimed at explaining the occurrence of sexual side effects from taking the drug. The second one is especially interesting because it involved splitting users into two categories, ones who were told about the sexual sides and one who were not…big surprise; the ones who were informed of the sides reported side effects at a MUCH greater frequency then the people who were oblivious.

Both studies conclude that side effects are very rare and in most cases are psychological. Archives of Dermatology (PDF file)

Then there is this study done recently at the University of Bologna by Dr. Antonella Tosti where:

“The IIEF, a brief, reliable questionnaire, was self-administered to 236 patients taking Propecia® and 236 age-matched males attending the Department of Dermatology of the University of Bologna”

She concluded that sexual dysfunction is actually less common then reported in the literature and there was no real statistical difference in sexual dysfunction between the men on Propecia and the men who weren’t on anything.

I am someone who was considering taking Propecia but I was on the fence after all the horror stories I read, finding these articles really helped put my mind at ease and I hope they can help others as well.

I thank you on behalf of all the visitors to this site who are in a panic or undecided about this subject, which you so nicely elucidated!

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April 7, 2009

Traction Alopecia and Hair Transplants – Hair Loss Information by Dr. William Rassman

I am 20 years old as of January of this year and I am female. I always had very long very full very beautiful and healthy hair but in my later years of high school i began doing a lot of processing to change the color on numerous occasions, this resulted in, while still long, very damaged stringy hair. One day I made the decision to cut it and it was more healthy than it had been in a very long time and very very full, however I was not confidant with the length and made the incredibly stupid decision to get hair extensions, of course I only know how stupid it was now that the damage is done. The type I had were individual pieces adhered by small metal tubes that were then clamped to stay in place, and I would say I had approximately 200 of them in at one time. I have noticed an incredible loss in the fullness of my hair not just in the ends but in my scalp. I feel that I’ve lost approximately 50-70% of my hair which I hope is me overreacting but I have lost many nights of sleep and it’s taken a toll on my sanity and my life. I am exploring the option of hair transplants since they say that is the only solution for traction alopecia which i’ve diagnosed myself with. I will be seeing a dermatologist in a few days so I will have more details but I was hoping you could tell me a few things about the transplants. From what I’ve read they are said to have good to excellent results in patients with traction alopecia but I would like to know:

Will the transplanted hairs have the capacity to grow to the desired length?

Some transplant doctors practice a method where they are able to put grafts in between existing hairs which is what I will require since the thinning is all over. I am wondering, will it be necessary to cut the existing hairs short? I am hoping this is not the case.

The only hair that has not been touched by the extensions and is healthy enough to be used as donor hair is in the front and is not a very large section. I am wondering, can the same donor area be used more than once if more hair is required to fill the missing spaces than the donor area can create at one time?

This hair is 100% certain to grow back just as full as before, yes?

Is there any scarring that will arise as a result of this? Do the risks for scarring increase if the donor area is used more than once?

I hope that you will reply to this message because I am very distraught and extremely depressed which I’m beginning to fear may lead to further hair loss caused by stress, and am rigidly searching for answers to this problem. Thank you for taking the time to read about my story and I’m hoping to hear from you soon.

You’ve likely seen your dermatologist by now and have a better idea of the degree of your hair loss, but I hope these answers to your questions help a bit.

Yes. Transplanted hair will grow to the same length as the hair in the back of your head, since that is where the hair is being moved from.
No. We routinely leave the recipient area long and do not cut the areas where we are going to do the transplant.
Unlikely. Hair for transplantation is taken from the side and back of the head. I would have to evaluate your alopecia before giving you an opinion.
Almost. Nothing in this world is 100% certain, but I would expect that hair transplants will grow at a 98% confidence factor.
Yes. The donor area does scar and the degree of scarring depends upon many things, including:
1. the number of surgeries
2. the size of the donor strip
3. tissue factors unique to each person
4. the surgical technique used

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April 7, 2009

Shock Loss 6 Months After FUE Procedure? – Hair Loss Information by Dr. William Rassman

Its been 6 months since my HT Follicular Extraction surgery, and I notice that i have been shedding hair for the last month. The hairs that have been falling out have been robust and as thick as my donor hair. Initially after my HT, I never remembered any of my transplanted hairs falling out. Is it possible i never had an initial shed?

As I usually map out the scalp hair for miniaturization in advance of a hair transplant, I know quite a bit about what is happening when someone like you has this type of problem. Shock loss can occur as long as 6 months after a surgery, but I agree with you that it should not impact normal, non-miniaturized terminal hairs.

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April 7, 2009

Is Singer Fergie Balding? – Hair Loss Information by Dr. William Rassman

I just saw this photo of the singer Fergie from Black Eyed Peas and don’t know what to make of it. is she just under bad light or do you think she could be losing her hair? it kinda looks like a female pattern huh.

Examiner.com – Fergie might be balding

Fergie It does appear in the photo that the singer known as Fergie has got some thinning in the female pattern… but to what degree, I couldn’t say. Does she have actual loss or is it just bad lighting or something else entirely? No clue. I’ve never met her and this one photo makes it difficult to form an opinion.

Hair loss in women is not uncommon, particularly if she’s in the entertainment business and relies on wigs and hair extensions to change her look from day to day. Extensions can create traction on the hair, resulting in something like what you’d see in that photo. Also, chemical processing of the hair can lead to this… and she’s certainly changed her hair color and character over the years. Here’s an example patient of mine that can give you an idea of what Fergie might look like if she is suffering from female genetic balding from the top looking down — here.

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April 7, 2009

How Many Months Does it Usually Take for Regrowth from Propecia to Occur? – Hair Loss Information by Dr. William Rassman

Dear Dr. William Rassman,

First I want to thank you for your updated and truthful blog. It has surely helped me and obviously many others understand the many things about balding. I am a 25 year old male with what I would perceive as a Norwood III. I have significant loss in the hairline but no baling spot in the back or top the head. I’m not going crazy about the loss of hair but surely want to do whatever it takes to try and stop it from becoming worse.

After reading your blog I know that I have pretty much three current options that I am comfortable with: finasteride, minoxidil, and of course surgery. I don’t feel as though its bad enough to go for surgery right now and find that topical solutions just don’t outweigh the effort (id rather shave my head instead of having to apply the stuff daily), so i started finasteride about three months ago. I have very little if any side effects from the finasteride and have no problem taking it daily. As you know, three months isnt a long time to be on finasteride and its hard to tell if it is actually working for me. however, I plan on taking it for at least a year before I come to a conclusion.

I know that finasteride’s focus is to prevent further hairloss and any regrowth should be looked at as only a positive benefit but my question is that if I were to see any regrowth, how long do you think it would take? Again, I am not taking finasteride with the assumption that it will result in regrowth, I am just wondering when it would be noticeable it regrowth were to occur.

To give you a little background of my family history, there are a few people on both sides of my family that have receding hairlines and thinning on the top of the head. However, there is no one (and i even asked some elders) in anyone’s recollection in my family to have a completely shiny “chrome dome” scalp.

I realize that thing email is particularly long for such a small question but I wanted to give you as much information without pictures as possible. Thanks for any reply you might give and thanks again for having such an informative blog!

Graciously,
Anonymous

I am sorry, but you will likely not see regrowth on your front hairline (or front corners) if you are Norwood Class 3. It’s very rare for those areas to improve from medication. If regrowth happens it is mostly on the top crown areas where there is miniaturization. The best outcome for you on Propecia is slowing or cessation of hair loss in the front. If this happens it would take about 6 to 12 months for you to appreciate.

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April 6, 2009

I Have 50% Miniaturization – Is That Significant? – Hair Loss Information – Balding Blog

Hey Doctor, I just had a miniaturization study done the other day by Dr. Bernstein in New York (who I found out about thanks to this site) and he said I had about 50% miniaturization on the front of my head while the crown/back was all normal and prescribed me 5mg Propecia to cut it into 1/4s. I didn’t take the chance to ask him any questions about it, which I regret. So I was hoping I could ask you:

Being 20 years old, would you consider 50% miniaturization a significant amount of hair thinning?

Being that right now I just have hair thinning and there’s really no signs of balding to the untrained eye, am I at a better advantage to responding to Propecia?

Also, could the propecia actually reverse the miniaturization, at least to a certain degree, or is it much more likely that it’ll just halt it/slow it down?

Block Quote

Yes.
Yes.
Could go either way, or none at all. I can’t predict how you’ll react to a medication.

50% miniaturization is a predictor or hair loss or balding in the area where the miniaturization is found (in your case, in the frontal area). Sooner or later, the balding will be evident to the naked eye, but with finasteride, it may slow it down or reverse it. You should repeat the miniaturization study in a year and see what has happened ,and then you will have a better idea of the hair loss progression and the speed of the process.

April 6, 2009

Taking Saw Palmetto Capsules with Provillus? – Hair Loss Information by Dr. William Rassman

I’ve been taking Saw Palmetto Capsules for the hair loss control but discontinued because I started taking provillus dietary supplement(because containing Saw Palmetto), Can I continue with the Saw Palmetto capsules (The reason: I’m interested in the protate benefits)along with Provillus. Thank you in advance for your help.

Saw palmetto and Provillus are over the counter natural supplements, though Provillus now contains minoxidil along with saw palmetto. The use of saw palmetto may or may not work, but one of the problems is the dosage between different manufacturers and as it is an herbal remedy it is not covered by the FDA regulations for claims. I really don’t believe it works in treating hair loss, but I also see no harm in taking it. I would be careful not to take excessive dosages of any natural supplements, though. Unfortunately, I cannot tell you what an excessive dose of saw palmetto would be.

Provillus has 5% minoxidil in it now with their “improved formula” (it should say so on the bottle), which means that it is now as good as the cheaper generic minoxidil you can get at any pharmacy or most supermarkets.

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April 6, 2009

Is a Ceramic Flat Iron Different from Regular Flat Iron for Hair Health? – Hair Loss Information by Dr. William Rassman

I just read your article about flat irons and I was impressed with the information, the reason being i purchased a ceramic flat iron in which i was told it was the healthy way to get the hair straight but after using it about six times i started experiencing breakage like you described in the article. So my question is do you know anything about ceramic flat irons being different from regular flat irons?

Ceramic hair iron The article you’re referring to can be found here, just so everyone is on the same page.

That article is a good review of the process. As I understand it, a ceramic hair iron ceramic is supposed to be more gentle on hair compared to a traditional metal hair iron, but the best information for you would be obtained through a good hair stylist who has experience with this process. Other sources you can try include cosmetology schools for stylists or even Wikipedia.

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April 6, 2009

Impotence from Minoxidil? – Balding Blog

hi doctor. i have been using regaine 2% from 3 years last year i started with regaine 5% and now i stopped because i’m really afraid of its side effects. are they true? i mean the side effects such as partial or total impotence? i have to declare that the effect of regaine was amazing and now i dont know what to do?

thanx a lot

Well, Wikipedia does list that as a side effect of minoxidil (Rogaine/Regaine), but I’ve yet to encounter a patient that has experienced that. Anyone can update Wikipedia, and the revision history shows that someone added that to the side effect list just a few months ago. In other words, someone is goofing around with Wikipedia.

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