September 2009 – Page 10

September 3, 2009

Hair Loss InformationI Don’t Know If I Have Diffuse Loss or MPB – Hair Loss Information – Balding Blog

i was diagnosed for MPB, BUT i naturally have thin hair according to my mom. I have thinning hair at the crown and the vertex…and back of my head, left side… but i dont know whether it is MPB or diffused hair loss. Do you have any suggestions of how to find out which one without going to the doctor as there are no good ones in my city?

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If you have loss at the back and sides of your head, that is not typical male patterned baldness. It could be something like DUPA, but first, to be sure you’re actually losing hair on the back and sides, I’d take a look at this page to show you how you can perform miniaturization mapping on yourself, since you say there is no local doctors you like.

September 3, 2009

Propecia and Male PMS – Balding Blog

Hello Dr.,

I’ve been reading through your blogs and took notice to a question posted by a Dr: Propecia Produces PMS in Men?

It appears that we are in the same situation as we get PMS symptoms w/ Propecia usage. My question is, if we are getting these side effects as a result of increased estrogen as a result of taking Propecia, is there a supplement or anything we could take or use to prevent/combat this from occurring. I, as everyone else here, want/feel I need to maintain my hair like you wouldn’t believe. It is important to note I have never gotten gyno from Propecia. I’m trying hard to get this figured out so I can utilize the only real proven hairloss fighter. Thanks so much, your help is greatly appreciated!

The post you are referring to is from one reader of BaldingBlog who is not my patient, nor do I have any sort of proof that he’s actually a physician as stated, not that it makes it any more plausible. I personally have never had a patient tell me they are having PMS-like emotional symptoms from taking Propecia, and combining my patient experience with the complete lack of information about it in the medical literature, I’d have to conclude the symptoms you experience are unrelated to Propecia use. I assume you’re just referring to the emotional symptoms of PMS and not the physical ones, too (such as cramping, bloating, etc). While it does not invalidate the symptoms from one such reader, I do not think it is really an issue for me to address, as it is all mostly theoretical.

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September 3, 2009

My Dermatologist Told Me to Use Rogaine as a Preventive Measure – Hair Loss Information by Dr. William Rassman

I had a dermatologist that recommended although I don’t /appear/ to have MPB, he suggested that I use Rogaine once a day as a preventative measure, so if the thinning does start it would be severely curtailed. On one hand, this does not seem like conventional advice, and I would be paying money for drugs for nothing, but on the other hand, paying $80 a year (six months supply stretched to twelve months) for relative peace of mind regarding my hair seems like a decent investment.

What do you think? Is there any value to using medications as a preventative measure if you are not balding (yet), but MPB still runs in your family, or is it better to wait for miniaturization to start showing?

If you don’t have balding or any miniaturization, then I wouldn’t use anything. Personally, I don’t think it’ll help that much and your dermatologist’s theory makes no sense. I certainly wouldn’t recommend a medication to a patient that doesn’t need it.

If you don’t have MPB, but you are one of those people who feel compelled to try something, then you can consider Rogaine (minoxidil), as it has the least side effect potential and is available over the counter.

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September 3, 2009

Is Propecia Time Released? – Hair Loss Information by Dr. William Rassman

I’ve read that taking half a dose of propecia is not good because it is a time release drug and cutting it will release to much of the medicine at once. Is their any truth to this?

Propecia is not time released. Take it as directed. Recommended dosage is one pill daily. It’s actually quite simple. It has a half life of 4-6 hours and that means that each 4-6 hours, the dose circulating in the blood will reduce by half. Some of the drug gets into the tissue of the hair follicle and it may stay there for a few days (tissue fixation), so that is the reason you do not need a time release on the drug.

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September 2, 2009

Oral Ketoconazole? – Hair Loss Information – Balding Blog

dear sir,thanks a lot for your kindness and great care about answering my questions. dr, can ketoconazole be taken systemically to treat seborrehic dermatitis?

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There is a ketoconazole oral, but it has huge warnings about liver problems that can sometimes be fatal. That being said, ketoconazole is an antifungal medication… and to treat seborrheic dermatitis (dandruff), you would probably be better off with a shampoo.

September 2, 2009

My Mom Said My Dreadlocks Are Causing My Hair Loss – Hair Loss Information by Dr. William Rassman

(male) ok, i have dreads and when someone did my hair, dreads started to fall out so my mom said it was because of tightness. i heard that a shot will regrow it. what do u think i should do? i really dont want to cut em. i bonded with them actually and i like them

Your mom is correct. The tight pulling from the dreadlocks is called traction alopecia, and that will cause hair loss (tight constant pulling for any hairstyle will cause this). I don’t know what shot you might’ve heard about, but regrowing hair lost from traction alopecia isn’t as simple as getting a shot. What you have now might just be temporary, so all hope is not lost, but at this point I have no way of knowing if it will regrow on its own or not. The best way you can tell if it’ll come back is by removing the dreads, crossing your fingers, and patiently waiting. I’m kidding about the fingers, but you will have to wait a few months (possibly up to a year) to see if the hair comes back on its own.

I can appreciate that you are attached to a hairstyle, but if you want to stop the traction alopecia from continuing, the sooner you get rid of the dreadlocks, the better. Or you can continue with the dreads and save your money for a hair transplant. Bottom line though, always listen to your mother!

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September 2, 2009

Hair Character Changes, Prescribing Proscar, and Finasteride OTC? – Hair Loss Information by Dr. William Rassman

I was wondering a couple of things about hair loss/thinning.

I am half Asian and half Caucasian. I have read that Asian people tend to have fewer hairs per square inch of scalp VS Caucasians. When I was younger, I had very thick hair typical of a small Asian child. As I’ve gotten older my hair seems to have gotten thinner. Does it make sense that this is a result of some sort of genetic maturation? As far as physical appearance, I also went from appearing like a purely Asian child to look so white that most people think I’m adopted upon meeting my mother.

Second, I was wondering how difficult it is to actually find a doctor to prescribe generic Proscar for hairloss treatment. Is this a common thing or will I be pretty much forced to get Propecia which is much higher in cost?

And finally, I was just wondering what is keeping Propecia(or just generic Finasteride) from being an over the counter medicine available the same as Rogaine. Is it really so dangerous, for lack of a better word, that the general public can’t handle responsibly acquiring and taking it?

Hair changes its character as we age. It is not unusual for an 8 year old boy to have a coarser hair than he has when he is 20. We see that even more often as a person gets older (greater than 50-60 years old). Your physical appearance has little to do with your hair character and hair thickness (coarse vs finer).

Propecia/Proscar (finasteride) is a prescription medication. Some doctors may have an issue prescribing Proscar, but you’ll just have to ask them and let them know you’re aware that the pill needs to be cut and you just want the generic (only available in 5mg) to save money. There are many doctors in the New York area that can see you for a consultation if you are losing hair, one of which is my colleague Dr. Robert Bernstein in NYC.

As for why finasteride isn’t available over-the-counter, sometimes it can be a danger issue, other times it can be political. The FDA must decide upon a drug’s safety, effectiveness, and whether it can be managed without a doctor’s supervision. There’s an article about the road from prescription to OTC, relating specifically about the emergency contraception medication known as Plan B, but a good overview all the same.

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September 2, 2009

DHT Inhibitors and Impact on Organs – Balding Blog

how does DHT inhibiters impact other organ function?

I found an interesting article that discusses that very question in the Journal of Urology, published in June 2008. Rather than re-write an answer that has already been given, I’ll just post part of the abstract from the article –

“Profound suppression of circulating serum dihydrotestosterone induced by 5alpha-reductase inhibitors during 1 year does not adversely impact bone, serum lipoproteins or hemoglobin, and has a minimal, reversible effect on serum prostate specific antigen and sexual function in normal men. Circulating dihydrotestosterone does not appear to have a clinically significant role in modulating bone mass, hematopoiesis or lipid metabolism in normal men.”

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September 2, 2009

Appropriate Age for Female Hairline Lowering? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I have read many of yours and others posting on hairline lowering procedure for women, or ways to fix the high forehead. I am am 24 female, and I have a high forehead that I want to fix (high forehead just runs in my family). Am I too young to get the hairline lowering procedure, or does it all really depends on my skin? Secondly, I would to have consultations with professionals on this matter, so do you know any doctor in the San Diego, CA region, or near San Diego who specialize in this procedure?

Thank you very much for your time and help!

Your age is typical for hairline lowering procedures, but you need to be examined to determine if your scalp is loose enough to lower it to the degree you wish. Also, your hair should be strong and not in the process of thinning for a good result. Alternatively, hair transplants work well to accomplish a hairline lowering. I’m only a couple hours north in Los Angeles if you’d like a consultation.

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September 1, 2009

Hair Loss InformationThe Many Hairpieces of Jeremy Piven (with Photos) – Hair Loss Information – Balding Blog

I found this very interesting article on The Huffington Post about Jeremy Piven’s hair over the years. His hair has changed from bald to pretty much normal hair now. Any ideas on how he has added so much hair and made it look natural?

Here is the link to the article on the Huffington Post: Jeremy Piven’s Many Hairlines

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This shows just how much the individual’s look is made by his hair. Let’s take a look at these 3 photos of Jeremy Piven…

We (society) have developed stereotypes based on hair. For example, the Jeremy Piven on the left with the very high hairline suggests he’s aging, while the Jeremy Piven at the right is sexy and youthful looking. The photo on the left was actually from years before the image on the right. The photo in the middle (from July 2009) is just interesting to me because it looks like the hair on top of the head has a different color than hair on the sides and back. To me, that indicates a tell-tale sign for a hairpiece. Generally though, high-end hair systems can look great as long as you have the time, patience, and money to maintain them. For a Hollywood actor like Mr. Piven, he’s probably got all 3. Or at least the money and patience. The better way to go would of course be a hair transplant, which is permanent and doesn’t require the maintenance of a toupee.