September 2009 – Page 8

September 10, 2009

My Hair Thinning a Few Years Ago but Stopped — Should I Take Propecia Now? – Hair Loss Information by Dr. William Rassman

Hello. I noticed that I started thinning at the top of my head when I was about 23-24 years old. I lost quite a bit of hair but still had a reasonably decent amount of hair left. I am now almost 28 and have not really lost any more hair but haven’t really regrown it either. I have started Propecia to prevent any further loss but I was wondering if I have waited too long for any regrowth to happen. If my hair stays like this it’s ok but I do feel a little bitter at myself for not starting propecia earlier.

I would follow up with the doctor you are receiving Propecia from and get a good documentation of your current state of hair. This may be in the form of a photograph… or better yet, a miniaturization study to get an estimate of the percentage of miniaturization on certain areas of your scalp. Then you can judge if Propecia is worthwhile or at the least keep track of the hair loss progression. Lets try to take a scientific approach! Regrowth isn’t guaranteed for anyone taking the medication (some will just see the hair loss halt), so I wouldn’t beat yourself up about it.

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September 10, 2009

In the News – Women May Have Lead in their Lipstick? – Hair Loss Information by Dr. William Rassman

Not exactly hair loss related, but interesting nonetheless —

Snippet from the article:

Fact is, FDA has found lead in all 20 lipsticks tested, in significantly higher amounts than those that caused a minor media uproar when the Campaign for Safe Cosmetics (CSC) tested lipstick in 2007. The FDA detected lipstick lead concentrations up to 3.06 parts per million (ppm), more than 4 times the maximum (0.65 ppm) measured by CSC.

Read the full article — I’ll take my lipstick unleaded, please

Oh boy. Should we think twice about kissing a woman with lipstick on? I wouldn’t jump to conclusions that leaded lipstick is causing hair loss, but it is a little odd to me that the FDA is fine with traces of lead in lipstick, yet the EPA wants it out of our environment.

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September 10, 2009

Do Men Have More Shock Loss Than Women? – Hair Loss Information by Dr. William Rassman

I notice most females get transplanted hairs into diffusely thin areas and seem to get better results than men in those areas. In your experience, do men tend to get more shock loss than females? And if so why? Would a male who has female pattern balding (mostly diffuse thinning down the middle front area) have a higher chance for shock loss even if they are on Propecia versus a women with the same balding pattern?

Women are not always good hair transplant candidates because they usually have diffuse thinning, including in the “donor area” (rim of hair around the back and sides). Contrary to what you may have seen, women do not necessarily have better results than men. What you may be noticing is that women tend to keep their hair longer, curl their hair, layer their hair, or style their hair that is more conducive to disguising their hair loss.

There is no difference in shock loss for men (who are on Propecia) or women. Young men that are not on Propecia are the ones that get the worst shock loss, but both sexes can get it.

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September 9, 2009

My Transplant Wasn’t Cosmetically Adequate – Hair Loss Information by Dr. William Rassman

Hello,
I had a hair transplant in my crown area about 4 years ago. Although medically it was a success, cosmetically it did not adequately cover the bald spot and the bald spot is still obvious. I was fed up and tried shaving my head bald. This left the transplant scar clearly visible. The hair has grown back but I am now back to square one. I am not sure what to do. I think my options are to a) have more transplants in the crown, b) have hair transplants in the scar area and cut my hair short, or c) treat the scar. Are these my only options or are there other options. What would you recommend? I now feel I am in a catch-22, because I cannot cut my hair short, and I have noticeable hair loss.

Thanks

You probably didn’t get good counseling and were not given realistic expectations. Without seeing you, I can’t really give an opinion, as I do not know how “bald” you are. People have different views and I would need to see what you mean. Its all perspective. I could let you look at my (Rassman) transplanted crown and use my results as a yardstick of your expectations. If you have enough donor hair, you might be able to have more transplants to fill out the area.

Generally, it is very difficult to completely cover the bald spot on top of your head. Not because it is technically difficult, but because you might not have enough donor hair. You can transplant hair to the scar, but you will always have the scar there, although less visible. You can do a scar revision and this time the surgeon can use a trichophytic closure to hopefully make the scar even harder to detect (almost normal, but possibly not enough to shave your head). Another potential possibility is to use the FUE technique to extract hairs one-by-one and place them into the linear scar. Again, I can’t tell you what is actually possible without an exam first. For your crown, there are products like Toppik which work nicely to camouflage the area.

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September 9, 2009

I’m Losing Hair at 21, But My Dad Lost His Hair at 36! – Hair Loss Information by Dr. William Rassman

Dear Doctor. Thank you for this blog. It has helped me so many times!

I was wondering…Im only 21 and I’m already beginning to loose my hair. Actually my hair loss already began in the age of 19. But I was looking at some old pictures of dad when he was about 33-35 years old, and his baldness first kicked in around the age of 36. I really dont understand why I’m already beginning to loose my hair? Is it just bad luck, because you can’t look at your dad and foreseen when your hair loss will start? I was just thinking that 15 years is a lot before my dad’s hair loss started! Can there be another reason to my hair loss besides genes? I’m in good shape and I’m eating healty. I can litterly “pull” oyt my hair when strokeing my fingers trough it. Or when I’m washing it my hands are full hair. Thank you for your time!

Best regards

The most common cause of hair loss in young men is genetic. There could be other causes, but it is much more likely that it is your genes. The fact that there is hair loss in the family tree helps, but you won’t necessarily follow the exact same timeline of loss as your father.

A direct examination of your scalp with mapping for miniaturization will tell you the diagnosis. Then if you are positive for genetic hair loss, Propecia is a great (prescription-only) drug taken daily to address the loss problem as it will slow down the loss, possibly stop it, and if you really lost hair it might even reverse it at your age. See a good doctor.

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September 9, 2009

I Practiced Doing Headstands for Years and Now I Have a Callus with a Bald Spot – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

I am grateful for the information on this blog but after going through the forum, there doesn’t seem to be a case that is similar to mine. I am a 23 year old Asian male located in the Los Angeles area and on the top of my head is a circular spot which is nearly bald. I am 99% certain this circular spot is a callous that was developed by the many headstands and spinning I used to practice when I was 18-22.

The rest of my head is fine, I notice losing the usual hair but my crown appears to be thinning because the hair from the crown area is combed up to disguise the circular spot. Is a hair transplant the only way to deal with this callous on the top of my head and where can I go to get consultation on that procedure?

Please help, Dr. Rassman.

Headspin It sounds like you developed traction alopecia in the area that is callused. Hair transplants should solve the problem, but you must make sure that you stop standing on your head and spinning. If you want to continue to stand on your head, use a circular collar to keep the pressure evenly spread.

As you indicated you are local, you should visit me and let’s look at your problem (I’m in Los Angeles).

September 9, 2009

Hair Transplant Clinic Said I’m a Good Candidate Although I’ve Got Minor Early Hair Loss – Hair Loss Information by Dr. William Rassman

Dear Dr Rassman,
I am a 30 year old male with thick curly hair but with early hairloss on my left frontal hairline. I have been on Propecia for 5 months now and I am still unsure of it’s effect. I have also been to see a HT clinic for a consultation on my options for the future. There they inspected (with the naked eye) my hair and said that most of my scalp hair was very strong and I would be a good candidate as I had thick hair with alot of double and triple follicles. They also said I could have my hairline reconstructed but that I should limit the amount of hair transplanted as I may need more to cover future loss.

My question is does the reference to double and triple follicles sound plausible or is this something that is common to most people and were they only saying it to push the idea of HT on me,especially considering they offered to reconstruct my hairline when my loss is still only at an early stage? I would greatly appreciate any advice you could give.
Regards

I think that the reference to double and triple hair follicles reflects the follicular unit count. Hair grows in groups of one, two, three, and four hairs each. Some people with terrific density have many three and four hair groups while many Asians will have mostly one and two hair groups. The more hair you have on your head (counts) the better off you will be for future hair transplants if you ever need them. I can’t really comment on whether you are a good candidate for surgery, as I haven’t seen you.

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September 9, 2009

Female Hair Loss from Adderall? – Hair Loss Information by Dr. William Rassman

(female) Help! I have been taking Adderall (d amphetimine salts) and now my long blonde hair is falling out from the root. How can I prevent my once thick head of hair from falling out further? I take this med. for adult ADD and it is difficult to think about not being able to take it – it works so dramatically. I usually take 15 mg/day. I have tried Provigil to no avail. What actions can I take immediately?

There’s no simple solution. Unfortunately, I can not give you treatment advice since I am not your doctor and I have not examined you to form an opinion. The only action I can recommend is to discuss this with your prescribing physician. Alternately, you can also seek out a good hair expert physician near where you live. Look at the physician search at ISHRS.org to find a hair doc in your area.

September 8, 2009

Propecia Dosage, Genetics, and David Beckham – Hair Loss Information – Balding Blog

Hi Dr. Rassman, I just have a few questions. Basically, I’m 24 years old and I have had (from what I can tell) diffuse pattern thinning on the top of my head. This has progressed for the past 3-4 years now as the hairs are becoming gradually more and more miniaturized. However, it wasn’t particularly noticeable until about a year ago. At this point (as it began to bother me) I went to my doctor and upon his recommendation I obtained some Propecia.

Anyways, after the first week I had some side effects (erectile ones) and it was recommended to me that I should take a half dose. I did this for about 10 months, and from what I can tell, the half dose didn’t seem to have much effect on slowing down the miniaturization (although, who knows it may have). Finally, about a month a half ago I got up the nerve to try the full dose everyday. The great news is I am not having any side effects. However, a friend of mine told me about a study (which I also looked up online) in which it was shown that there really isn’t much of a different in potency between the 1mg and .5mg dose. This makes me apprehensive about whether the full dose will make a difference.

So my first question is, do you think I should take Propecia for another year on the full dose before I make conclusions?

As for my second question, does Propecia have a propensity to work less/more/the same on people with a patterned diffuse hair loss in your experience?

My third question is related to my family genetics. I have two uncles who are bald. Both of them thinned out around their mid-30s and had the typical norwood-scale baldness pattern with a bald spot in the back that gradually got bigger until they finally started fully balding on the front and crown around 40. I don’t have this. Does that mean anything of significance, other than the fact that I probably have this issue from their genetics?

My final question is, I met soccer star David Beckham at a dinner a little over a year ago and he had what appeared to be the same kind of diffuse hair loss I have now at the time. Since I watch a lot of soccer, I couldn’t help but notice recently that his hair is significantly better than it was when I met him. I took another look at some pictures on the internet and its almost like he completely grew his hair back. How is this possible? Have you heard anything about what he did? I know you have been asked this before, but I figured I would ask again since I know for a fact that he was thinning at the time.

Sorry for such a long email. Any comments you can make would be greatly appreciated! Cheers

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David Beckham

From what I recall, the difference is not that big between half dose (0.5mg finasteride) and full dose (1mg finasteride) of Propecia. I believe half dose is about 70 to 80% as effective as the full dose. In your particular case, I cannot really say if the problem is dose related, but as you do not have side effects from the drug now at full dose, I do not see any reason for you to cut back to half a dose. I’m not your prescribing physician, so discuss this with him/her. Remember, Propecia is not a cure for balding. Some patients will have some hair growth in the first year or two. Some patients will have no further hair loss. Some patients will continue to have hair loss. In the end, all of these patients taking the drug will continue to lose hair to some degree, albeit at a SLOWER rate than if you were not taking Propecia. You see it may not be a cure, but it slows the hair loss down.
Propecia works for angrogenic alopecia (genetic male pattern balding). You self-describe your hair loss as “diffuse”, but I have a hard time believing you actually have diffuse hair loss. Diffuse hair loss would mean the back of your head is thinning as well. If you actually have diffuse hair loss (even in the donor area), then Propecia would likely not work for you. I would see a doctor for a diagnosis and a miniaturization study to document what you are treating.
Male pattern hair loss is genetic, but if you have it, you have it. It doesn’t really matter if your uncle, cousin, grandfather, father, or brother is bald because it is very difficult to associate a predictive inheritance pattern.
I didn’t think David Beckman was thinning or balding from the many pictures I reviewed of him asked by various readers. It is possible that there is a difference in lighting or hair products or perhaps even medication. I really have no way to know. Your definition of diffuse hair loss is peculiar to me though, and perhaps we are not on the same page here. I would love to examine you if that is possible.

September 8, 2009

Miniaturization Mapping for Female Hair Loss? – Hair Loss Information – Balding Blog

Hi. Good afternoon! I have been experiencing hair loss every six months for the last two years. There is a history of hair loss in my family on both sides. I need to find out if I’m experiencing female pattern baldness. Would miniaturization mapping of my scalp tell me if I have AGA (female pattern baldness)? I’m tired of not knowing what’s causing my hair loss/shedding.

Also, do you have a location in Newport Beach?

(Female, 32 years old)

Have a good day!

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I routinely map out the hair for miniaturization when I see a patient (male or female) and it will tell me much about the health of your hair.

We will be doing consultations in Newport Beach starting in October. If you’d like to setup an appointment, call our office at 800-NEW-HAIR. If you’d like to have an appointment before October, our Los Angeles office is only about an hour away from Newport (with good traffic).