April 2009 – Page 7 – Balding Blog

April 16, 2009

Will Dutasteride Maintain the Finasteride Benefits? – Hair Loss Information by Dr. William Rassman

I have switched from finasteride to dutasteride recently – my hair is definitely receding as i stopped taking anything for around 18 months. I started taking proscar again for a year before switching to avodart – will i lose all the hair that was kept or regrown by stopping finasteride and switching or will avodart just continue where proscar left off?

kind regards

If your transition from finasteride to dutasteride is transparent (stop finasteride one day and pick up dutasteride the next day), then there should be no impact on the switch as both drugs block DHT at the level of the hair. Keep in mind that appropriate dosage for dutasteride as a hair loss treatment has yet to be approved by the FDA.

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April 16, 2009

Why Doesn’t Minoxidil Require a Prescription? – Hair Loss Information by Dr. William Rassman

If Minoxidil is a drug, why does it not need a prescription? Sure, things like toothpaste and acne medication also list “Drug Facts” but sodium fluoride and salycilic acid seem natural, whereas minoxidil doesn’t. I asked a similar question like this before but it wasn’t answered.

That is an FDA decision. It originally was a prescription item, but someone put in an application to the FDA to release it for general over the counter sales. The FDA must determine safety and effectiveness and I guess that they determined it safe enough.

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April 16, 2009

Prescription Rogaine for Women? – Hair Loss Information by Dr. William Rassman

Is there a different prescription strength Rogaine for women? If so, is it by prescription only?

Rogaine The 2% and 5% Rogaine (minoxidil) solutions are available without a prescription, but some doctors might prescribe a 12 or 15% generic minoxidil that is formulated by pharmacists. Rogaine (name brand minoxidil) does not come in a prescription strength.

Since this drug is known to drop blood pressure in some people, high concentrations of it can cause fainting, chest pain and general weakness… and if you get these higher concentrations be careful to titrate your dose with any side effects as discussed above. Generally, the higher the concentration, the greater the impact on hair loss so some doctors recommend the high dosages to maximize benefits.

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April 16, 2009

I’m Shaving Every Day, But Can’t Grow a Beard! – Hair Loss Information by Dr. William Rassman

hey doc my question is about facial hair im 30 years old and tried everything to grow a beard and it seems like its never going to happen. is there anything i can do? i tried alot of different things like shaving everyday and nothing seems to work. i never seen my father grow one but he has a thick mustache that i also wished i had. can you give me any advice please? thanx

If you father did not have a beard (only a moustache), you may be following in his path. I personally wish I had no beard hair, but alas, the good Lord never asked me. Shaving can be quite a chore.

Minoxidil applied to the face might work to grow facial hair, but it isn’t intended to be used for that. Transplanting an entire beard can be done, but it might not be wise. Transplanting a moustache can be done along with or without a goatee. Contrary to popular belief, shaving doesn’t make the hair grow in thicker.

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April 16, 2009

I Want to Transplant Hairs from My Toe to Eyebrow – Hair Loss Information by Dr. William Rassman

Do you do eye brow transplants?

I have toe hair, and I would like to either remove it or have laser done to get rid of the hairs. I don’t like my eyebrows, because they are thick. The color matches between my eyebrow and my toe hairs and they seem to have the same texture.

I think I would be a good candidate if you did.

Yes, we do eyebrow transplants! Body hair transplants (from the back, chest or leg) have been attempted in the past with minimal success because the telogen cycle is long, at times longer than the growth cycle. Although scalp hair transplant to the eyebrow is routinely done, it does not always produce soft eyebrows that women want if the scalp hair is anything but fine. Keep in mind that scalp hair is generally more coarse than eyebrow hair. Thus, eyebrow transplants for men with coarser hair produce a more aesthetically pleasing result (as men generally want bushy, coarse eyebrows like Einstein or Mark Twain — well, maybe not that far). That being said, many of my patients (who are women) were very satisfied with their eyebrow results. The key point is that everybody is different and each patient needs to have realistic expectations and goals and know the limitations of such surgery with regard to the thickness of the hair being transplanted. This goes for any type of surgery.

I would not object to toe hair transplanted to the eyebrow, but it would be purely experimental and the growth rate may be less optimal because the sleep cycle (telogen) is relatively long, possibly longer than the growth cycle. The reason I suspect that this is the case is that I have rarely seen very long hairs growing from the top of the toe. I would want to know more about what the patient expects and what other hair may be available as an alternative.

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April 16, 2009

Female Hair Loss in Crown — Is It from Antidepressants? – Hair Loss Information by Dr. William Rassman

My hair started to thin around the crown (on the left side) about a year and a half ago. I think it is because of the Antidepressants Lexapro & Celexa that I have been on for the past two years. Prior to that I had no problem. It is only in one area. I do wear braids but have been for the better part of 20 years with absolutely no problem. Can the thinning be resolved if I go off the medication and will my hair grow back? Thank you!

This is a discussion you should clearly be having with your prescribing doctor. These medications can cause hair loss, but that does not mean that the hair loss you are experiencing is from them. You need to be evaluated by a good family doc or dermatologist for finding out the cause for your hair loss.

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April 15, 2009

I Can’t See My Scalp Unless It’s Under Direct Light – Hair Loss Information – Balding Blog

Hi William, Jae –
First off I’d like to say thanks for hosting such a great blog; I’ve found myriad answers to my questions on here over the past year. The reason I’m writing is because I’m concerned that my Rogaine regimen isn’t working as well as I thought it would. I’m 26, and of Southern Italian descent (with a bit of Brasilian thrown in), so my hair is rather coarse. I keep it very short, and have it cut every four weeks or so. I first began using Rogaine about 1 1/2 years ago when I noticed some thinning around my crown. While I still have a full head of hair, I’ve noticed as of late that it’s gotten a bit thinner in that region, even though I’m still using the product on a daily basis. I’ve read that people tend to lose more hair in the Spring/Autumn, so I’m wondering if that could be the case. Likewise, you can’t see any hair loss unless I’m seated directly under a bright light – that’s the only time you can see my scalp. Since my hair is on the tight and curly side, I’ve noticed that it’s always clumped together in spots, but I don’t think that’s entirely it. My question is – since you can’t really see my scalp unless I’m under a light, does that mean it’s a harbinger of what’s to come?

Thanks.

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It seems like you’re looking for some sort of endorsement from me that you are not balding. Seeing your scalp under direct light could be a styling issue, it could be an issue with the character of your hair changing (any chemicals/products used?), etc. Generally if you can’t see through the scalp, one might conclude that there is no balding… but to be sure, you should have a physician microscopically examine your scalp (which is what I call miniaturization mapping). Perhaps you are losing your hair in the crown and the Rogaine isn’t doing much for you, but I’d just be guessing at this point.

By the way, when the hair is not coarse, some people see their scalp even without being under a direct light… and they are not balding.

April 15, 2009

Young Teen Has White Hairs! – Hair Loss Information by Dr. William Rassman

Hello. I am thirteen and I was in class one day and a friend say i had white/gray hair all over in the back and side. I checked at home with two mirrors to see and I saw ALOT. Is it just the glare of the sun/light or is something wrong with me and i first thought if it was my showerr hair product. Whats a good recommendation(Dying it, Different hair product?)

You could dye it, but at 13 years old you should get a parent involved in the process. You’ll want to do a spot test for dye to make sure you don’t have any allergies (it should explain this on the packaging). White/grey hair isn’t terribly common in someone your age, but it doesn’t necessarily mean there’s anything wrong with you. It’s likely just genetics.

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April 15, 2009

Stopped Propecia for 2 Months Then Restarted — Now I’m Losing Hair! – Hair Loss Information by Dr. William Rassman

I took propecia pretty faithfully for all of 2008 and for some reason still unknown to me, stopped for the month of Dec and Jan. I started taking it again in Feb and then come March, I started shedding hair like crazy. When will the catch-up loss stop?? Its scaring me like crazy!

If you don’t know why you stopped taking Propecia, how are you sure you remember when you actually stopped taking it? I can’t give you an end date for the catch-up loss, as I wouldn’t know how to determine one. The hair loss may never catch up, even with just a 2 months hiatus. You need to hope and pray that it will reverse to where it was prior to your stopping the drug.

Readers, take note: If you’re serious about keeping your hair, do not follow in this man’s footsteps by forgetting to take the daily finasteride.

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April 15, 2009

Mystery Hairline Bumps? – Hair Loss Information by Dr. William Rassman

I have small bumps near the hairline of my scalp that dont itch. There aren’t many bumps (about 5 or 6) and they are concentrated near the the side hairline (by my ear). These bumps eventually shrink and turn into a scab. If I get the scab out of my hair I notice there is a hair in the center of the scab. Also, I notice when my hair falls out sometimes I there is a little ball like thing attached to the end where the root is. Sometimes there is a small white see through flake of skin with hair in the middlel as well. I lose a lot of hair and have been using hair for about 9 months. I have been seeing a dermatologist for the past 6 months at least once a month and he has prescribed different medicines but I feel like he hasnt even examined my scalp. I had blood tests run and everything came back fine. I have also had one cortizone shot to the hip (which he said would reduce inflamation) but it just made me feel sick. He also prescribed a topical ointment for psoriasis that I have to wear for at least 4 hours a day with a shower cap on but it doesnt seem to help. I have seen pictures of patients with psoriasis and it looks nothing like my scalp. Could you please help me?

Unfortunately, this is something that I can not help you without seeing you. If your dermatologist can’t figure it out, perhaps you should seek out another dermatologist.

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