Month: April 2009

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In the News – Study Shows People Would Rather Have More Hair than Money or Friends – Hair Loss Information by Dr. William Rassman

Snippet from the press release:

According to a new online survey conducted by the International Society of Hair Restoration Surgery (ISHRS), 59.8 percent of people who were asked whether they would rather have more hair, more money or more friends chose more hair. By comparison, only 26.2 percent of respondents chose more money and 13.9 percent said they would rather have more friends. Of the 1,407 people polled, slightly more women (64.2 percent) than men (59.1 percent) indicated they wanted more hair than more money or more friends.

Read the full text — ISHRS Releases Study Showing More Hair Is Still a Hot Commodity During Recession

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I Stopped Propecia After 10 Years – Hair Loss Information by Dr. William Rassman

I was taking propecia for about 10 yrs. I’m a 47 yr. old male. I just recently stopped using it about 2mo. ago fearing that I’m doing harm to my body internally. I was always able to get an erection while using propecia, but it never seemed to be full. since I’ve stopped using the product I’ve noticed that I have a full erection and better feeling in that area, but the down effect is I think my hair is getting worse. I was still able to perform so I have a decision to make. Should I start using it again before I’m completely bald? and is it a good idea health wise?

Please give me some advise its a very depressing situation. Is there anything on the market that may be a better alternative? I’ve heard that laser comb works! In the mean time I’m going to start up today with propecia. Thank you very much and I’m looking forward to hearing from you.

I’ve written many times about the Laser Comb (and variations thereof), and I’m not impressed with the results. I do not think they work as claimed.

Since you took Propecia for 10 years and then stopped, seeing hair loss should be expected. Restarting the medication will hopefully halt your hair loss once again, but I can’t say that for sure. Cross your fingers and keep up the daily Propecia if you want a chance at maintaining your hair. If you’re having a sexual side effect from the drug and yet still want to keep your hair, talk to your doctor about Viagra or Cialis.

The only other FDA approved hair drug works a completely different way from Propecia, and that’s the commonly known minoxidil (marketed as Rogaine). If you stop the Propecia in favor of Rogaine though, the Rogaine won’t maintain what Propecia kept for you. So it’s not really an alternative, but it is something to look into if you’re running low on options.

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Would Switching from Propecia to Cut Proscar Tablets Induce Hair Loss? – Hair Loss Information by Dr. William Rassman

Could switching Finasteride products possibly be dangerous on my hair? I’m currently on 1mg Propecia, but when my prescription runs out I may to switch to 5mg Finasteride tablets and cut them into 1/4ths. I’ve read that switching medications like this, despite having the same ingredients, can bring on a sudden and serious shed. Is there any truth to that and should I perhaps get another renewed prescription for Propecia instead?

No, I don’t believe you’ll see a shed from switching. Most people who switch from Propecia to Proscar do it for economic reasons, as the 5mg pill is substantially less expensive (particularly the generic 5mg, since there is no generic 1mg legally available in the U.S.). I wish the drug company, Merck, would get that message… and maybe they will, as this blog is frequent reading by their sales force.

Propecia is a brand name for a drug called finasteride in 1mg strength and Proscar is the same drug in a 5mg strength. Splitting the pill into 4 or 5 pieces is a cost saver, but as long as you are taking 1mg finasteride daily it is the same thing for treating hair loss.

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What to Do for a 21 Year Old Non-Responder to Propecia? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman, thanks again for your work here. I was wondering if you have ever encountered a young patient say, 21 years old, that did not respond to propecia. I have been on propecia for 8 months now and my thinning is becoming more evident. From my impression, you’ve held that propecia is most effective for the early stages I’m experiencing. Should I expect to see any difference between 8 months and a year (the full potential marker)?

I’m just really concerned propecia hasn’t slowed the process for me. Thanks for the help

I’ve been mentioning it a lot lately, but there is a genetic test that will determine just how good Propecia will be for you (see here). You can find a doctor in your area that carries the HairDX tests here.

I believe Propecia always works, but it could be a matter of degree. It should slow down the balding process, but the balding process could be aggressive. Generally you see the results in 1-2 years, but some indication of the benefits should be evident at this time. I would recommend getting baseline measurements for miniaturization and then get the genetic test. This combination of things should give you more insights with a good doctor at your side.

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Using Conditioner Daily, but Shampoo a Couple Times a Week? – Hair Loss Information by Dr. William Rassman

I’ve read you’re only supposed to shampoo hair a couple times a week tops, like the Europeans. But I live in a windy locale, so if I don’t use cream/pomade/wax/clay/glue and/or hairspray in my hair each day for work, when I get to work my hair looks crazy and if I don’t shampoo it, combing it after is extremely hard, especially with hairspray. Someone suggested to me that you can use conditioner everyday but I haven’t tried that yet. Any thoughts?

Considering what you said, I would recommend that you shampoo daily. There are many good shampoos have have conditioners in them.

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My Hair Is Thinned from Traction Alopecia – Hair Loss Information by Dr. William Rassman

(female) I hope you can give me the answer to a very easy question. I have traction alopecia. My hair has thinned on the top and sides. I don’t have bald spots –it’s just thin. I’m wondering if my hair will continue to thin if I do nothing, or will it just remain thin on top as it is today.

It might be easy to ask, but it’s not that easy to answer. I don’t know what your traction alopecia was caused by or how long you’ve seen the thinning going on for. Without an examination, I couldn’t tell you if the hair loss will progress or not. Sorry.

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I Called GlaxoSmithKline About Dutasteride… – Hair Loss Information by Dr. William Rassman

Today I called GSK to inquire about the phase 3 results for dutasteride, and a GSK representative said that the clinical trial results were listed on their website. However, I could only find the Protocol Summary for the trial. The representative also mentioned that he could not give me any more information on where to find it because I am not a health care professional.

Do you have access to this information? Is there someplace I can find it?

I found the completed results here (most of them are for dutasteride as a prostate treatment) — Dutasteride Result Summaries

And this is all I could find about the Phase 3 results for dutasteride as a hair loss treatment (which I assume is what you found) — Dutasteride Phase 3 Protocol Summary

I do not have access to the information you’re seeking, as it is my understanding that it hasn’t been released yet. Phase 3 results have been released for dutasteride as a prostate treatment (but not for hair loss treatment), so perhaps you weren’t clear when you spoke to the GlaxoSmithKline (GSK) rep or they were just confused.

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Hyperinsulin Anemia and Hair Loss – Balding Blog

Thank you Doctor in advance for taking my question.
I have been in poor health as well as shedding hair for over 6 months. I have finally been diagnosed with Hyperinsulinanemia, a form of pre-diabetes. My new Endo. believes this is what’s causing my hair loss and that with diet change and Meds not only will the shedding stop but the lost hair will return. As much as I want to believe him I have been on google for days but have not been unable to find much info to help me validate the doctors claims. If you have any advice for this particular situation and could please help me with these 2 questions I would greatly appreciate it.

Is hairloss (overall thinning) caused by Hyperinsulinanemia always reversible? ( I”m a 43 yo male,never been overweight, with only very slight thinning and receding before this) If so, how long after the meds take effect (about 1 month) and my overall health improves could I expect to see regrowth? My other question involves my total testosterone jumping from 340 to 550 (untreated) in less than a month and my thyroid being slightly hyper, though not enough to need treatment. Could that be any insight to reversible hair loss? My new Endo. disagrees with my first Endo’s. diagnosis as the beginnings of Hashimoto’s and feels HIA is what is causing all of my health problems as well as the hair loss.

Thank you.

Here’s where I can see a test like HairDX being quite worthwhile. HairDX is a test to show if you have the markers for genetic hair loss. That should rule out whether it is disease or genetics. If you don’t have the genes for balding, it seems likely that the hair should regrow. You should have your scalp mapped for miniaturization to keep track of the progression of the loss or regrowth. Otherwise, you’re already under the care of two different endocrinologists and I don’t have nearly as much information as they would about your condition and treatments.


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My Local Chinese Herbalist Says Hair Loss is From Sex – Hair Loss Information by Dr. William Rassman

Doc please comment on this as it has worked for me but can’t imagine how on earth it works scientifically?

A local chinese herbalist informed me that in they country men who suffer from hair loss is attributed to a high sex drive and in order to lessen the testosterone levels they would often have sex twice a day for a month and then stop for a month and then start again. I mean I thought Ive tried everything else so my wife was willing to accommodate so we did. After a month I noticed that a real reduction in hair loss. It continued to fall out but no where near what it did before. 6 months on and things are alot better then I expected.

What do you think doc can testosterone levels be reduced and lessen hair loss? it works for me

I do not believe what your Chinese herbalist told you. There may be much more to your experience than the testosterone issue which does not go up when you have sex. I would not give up sex just for hair if what he said was true. Maybe he has a sexual problem (a man with erectile dysfunction, for example) and he came up with his solution by avoiding sex. Sex and hair loss are unrelated, so what you’re telling me about the reduction of hair loss you saw sounds either coincidental or you’re mistaken.

If you have a problem with hair loss, get a diagnosis by getting your hair mapped out for miniaturization and since you indicated that you are in the United Kingdom, I’d suggest seeing Dr. Bessam Farjo (offices in Manchester and London) who might prescribe medications to stop your hair loss.

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I Wonder If I’m Experiencing Telogen Effluvium – Hair Loss Information by Dr. William Rassman

Hi. I’m a 24-year-old white male who has been having hair loss issues for about a year now. Based on family history, I know it’s probably AGA, but since I don’t seem to be following the classic NW pattern, and because the thinning became apparent suddenly, accompanied by severe shedding and following a stressful period, I’ve often wondered if I could be experiencing telogen effluvium. A hair pull test I performed on myself in May 2008 seemed to support this notion.

The shedding has long since stopped, but my hair has not returned to its normal density. My question is, how often is telogen effluvium concentrated in one area of the scalp? Almost every description I’ve read says it’s diffuse, but I’ve seen pictures of post-op patients suffering from it who have lost an appalling amount of hair on top but relatively little on the back and sides.

Generally speaking, telogen effluvium (TE) is spread throughout the scalp. This is the time to see a doctor and be examined for:

  1. A miniaturization mapping of the scalp hairs
  2. A genetic test for the balding gene, if appropriate
  3. An experienced doctor who knows what to do

This is not the place to write a textbook for a complex problem like you are describing.

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