Month: February 2010

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I Stopped Rogaine After the Makers Told Me It Would Only Work in the Crown – Hair Loss Information – Balding Blog

I’ve been using Minoxidil for a number of years but wasnt sure if it was working. I definitely lost hair in the crown area even though I was using the product so I got hair transplant. I called the makers of Rogaine to see if using the product would be an issue with the transplants and was told it only works for the crown area anyway. With that in mind I figured I would stop using. That was probably a mistake as I now see the rest of my head thinning out rapidly and can only assume its from stopping using Rogaine. Would you suggest going back on Rogaine and what should I be mentally prepared for if I do? I would be devastated if more hair is lost as a result of going back on it. They do say to expect hair loss at the beginning of use. Please help! thanks

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RogaineMinoxidil, when used and then stopped, can result in “catch-up” hair loss. Since you were already using the Rogaine for years, it was probably retaining your crown — if you hadn’t used it, your crown hair could’ve been gone already. It’s hypothetical, of course, since I have no way of knowing what might’ve happened to your scalp had you not used the treatment for so long.

I don’t know what type of mental preparation you should try, but just hope for the best. These medications don’t work the same for everyone, so I can’t tell you for sure what will happen. The hair may or may not come back, but there is little downside for trying. Keep your fingers crossed and your hopes high.

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Scarring Amongst Different Races? – Hair Loss Information – Balding Blog

I am a 40 year old asian male with slowly thinning hair. I’ve been using minoxidil for 4 years and propecia for 2 years now. They seem to help maintain what I have. Eventually I would like to consider surgery, but I am not bald enough according to the doctor I have seen. My question is:

1. is it better to wait until I am more bald, and, if so, why?
2. Is it true that FUT generally causes more scar in asian men? While I prefer FUE, I was told that the result is much better with FUT than FUE.

I would much appreciate your professional opinion. Thank you.

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Without seeing you, I can not address your concerns about when the best time is for your hair transplant. I generally tell patients that when it bothers them a lot, the surgery may be appropriate provided that the doctor agrees that you are a good candidate for it.

FUT (strip) and FUE are both good harvesting mechanisms. There may be better growth with FUT, but in good hands the FUE should be a fine alternative provided that you have a biopsy and are what we call “FOX positive” (see this article for more about the FOX Test). Scarring is not a racial thing except in keloid formation, which is more common in dark skinned people. If you have a scar on your body and it did not heal well, discuss this with your doctor.

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Wearing a Hat After FUE Surgery – Hair Loss Information – Balding Blog

Hi there,
I am wanting to go for the FUE procedure in Thailand to have 1500 grafts in my crown and two temples. I only have one week of work and have 5 or 6 days to recover before returning to work. I don’t want anyone to notice so i would like to wear a hat or beanie and for health and safety i must wear a safety hat at work. Will this effect the result of the outcome of the procedure or how long must i wait until i can wear a hat. Thank you.

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Hard hatYou should ask this question to the doctor who is going to do the surgery. Don’t be afraid to ask questions to the person that will be performing a permanent cosmetic procedure on your scalp. Have an open dialog!

Generally, after the transplants have passed the 3-14 day period and there is no scabbing, then wearing a hat should not be a problem provided that it does not rub on the recipient area.

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My Hair Started Turning White at 20 Years Old! – Hair Loss Information – Balding Blog

I am male at 24 age. My hair have started whitening since i was 20. Now i have nearly over a hundred white hair. How can i handle this. Is there any proven drug that fix this. Some people say that eating onion twice a day, hair become black. Is there any proof. Additional info i have used finasteride for five years. It stops loosing my hair. thnx for this site.

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White hair is a genetic trait. You can dye it if you don’t like it, but there’s no pill for it (yet). Eating two onions a day won’t turn your hair black, but it will make your breath horrible.

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Did Propecia Elevate My SGOT and SGPT (Liver) Levels? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

I am a 32 year old male with Norwood class 3.In December beginning I had started Propecia and continued with it for 7 weeks. I experienced no apparent side effects and in fact felt more energetic. There was no initial hair loss and at end of 3 weeks my hair felt fuller and it seemed that there was a decrease in hair loss ( lose fewer while combing/shampooing ).

During the 7th week a test revealed some of liver function indicators were elevated:

Value Range
A/G RATIO 1.29 1.2-2.0:1
SGOT(AST) 45.00 U/L 10 – 42
SGPT (ALT) 74.20 U/L 10.00 – 47.00

Subsequently, while still on Propecia, I also got these tested for

TESTOSTERONE 708.0 ng/dl 166 – 877 ng/dl
FREE TESTOSTERONE 4.88 pg/ml 4.25 – 30.37 ng/dl
DI-HYDRO 522.3 pg/ml 250 -990 ng/dl
TESTOSTERONE

A couple of years back testing for DHT had revealed that it was 3 times the upper limit. I was not treated for it.

I would really like to get back on to Propecia. Do you have any insights why SGOT/SGPT are elevated ( A few weeks before starting my Doctor had gotten me tested and LFT were normal then ) ? Could conversion of excessive DHT to Testosterone have caused such ? Would it be safe for me to restart Propecia ?

Regards

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LiverThis is a question you need to ask your doctor. There are many possible factors that could be in play:

  1. To my knowledge, Propecia use will not impact liver function. If you have liver disease, you may have to reduce the dose of finasteride you are taking to take the disease into account.
  2. It can be a coincidence.
  3. It can be from alcohol use the night before.
  4. It can be from other drug use. Many drugs are metabolized by the liver and Propecia is not unique.
  5. It can be an insignificant temporary finding, but unlikely.
  6. It can be from an infection you are not aware of.
  7. The list goes on and on…

    8. I generally do not pay too much attention to testosterone or DHT blood levels. Consider this: If your DHT level and testosterone levels are low (or high) and you are balding, are you going to do anything different? Because chances are, Propecia would still be recommended since genetic androgenic alopecia is visible. Genetic androgenic alopecia is diagnosed with a physical exam and a miniaturization study, not a lab test. I understand there are now genetic tests that can give you a “probability” score for androgenic alopecia, but sometimes even genetic testing does not really change the medical course of action.

    One particular 18 year old patient I recently saw paid a few hundred dollars for genetic testing for androgenic alopecia at another medical group. The results were mailed to him and according to what he said, the doctor never followed up with him. He had no sign of balding, no hair loss, and no miniaturization. He had the test done because his grandfather was bald and he was afraid of going that same route. His results showed a “probability” of androgenic alopecia, but all it really did is tell him that he was carrying the gene for balding. Just carrying the gene does not mean that the gene will be expressed, as some men who carry the gene never go to clinical balding. The report given to him got him extremely worried and instead of following up with the medical group (who tried to sell him shampoos and lasers) he came to see me.

    In my opinion, in this particular case the genetic test was a source of misery and misrepresentation. Sure, there may be a possibility that he may lose hair to some degree and have androgenic alopecia in his future, but I did not recommend any course of action (not even Propecia) for him, as he had absolutely no sign of balding or miniaturization.

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I’m 16 and My Hairline Receded After a Haircut! – Hair Loss Information – Balding Blog

ok i got my hair cut around September. It was at the bottom of my ribcage and i got it cut a little higher than my collar bone. Ever since then its been falling out a lot more. Ive asked my parents multiple times if my hair line is receding. They say its not and i also get them to look at the top area of my head. It has got thinner i can tell. My grandma says its just the seasons but i don’t know if that’s true.I am a 16 year old male.

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HaircutYour haircut didn’t contribute to your hairline changing. What it sounds like (without photos, I’m just making an assumption) is that your hairline is starting to mature. This is premature around your age, but it happens.

Your new hairstyle might be contributing to your hair looking thinner on top, but I don’t know enough about your hair character (fine, coarse, etc) or hair color to really provide much more than guesses. Maybe there’s something else going on that was coincidental to the timing of the haircut. If you’re truly concerned, have your parents take you to see a dermatologist.

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If I’m Going to Be Norwood 7, When Will I See Significant Loss? – Hair Loss Information – Balding Blog

Hello, I have a question about the different patterns of hairloss in men. My father is a full-blown Norwood class 7. I started losing hair very early (20) and got on finasteride right away. But my hairloss is not diffuse like I would expect a NW7 to bald. I only really have temple recession at this point (21 yrs.old). So my question, Does a NW7 generally bald in a diffuse pattern, or can a destined NW7 start off by losing the temple region?

In other words, do I have any hope that I did not get my father’s hair genes?

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Norwood 7You are right to be on Propecia. I can not tell you how you might lose it, particularly with Propecia on board. Ask your dad how and when he lost his hair, as that will give you some possible insight. If I mapped out your scalp hair for miniaturization, there may be some insights into the “end game”.

Most Norwood class 7 balding patterns (see diagram at right) will have considerable balding along that path by the mid to late 20s. You might not have your father’s genetic hair loss pattern, though. Cross your fingers.

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Orchiectomy and Hair Loss – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

First off, thank you for your excellent blog, extremely informative!

I am a 37 year old male who has had an orchiectomy (right testicle), which occurred about 1 month ago. So far everything is working out well (aside from fatigue) and I have not had any testosterone replacement therapy at this time. I also have some hair loss, I’d say I am about an early Norwood 3, with no loss at the crown (yet).

My question is this: What can I expect in the way of hair loss at this point? I realize my testosterone levels are lower (503ng/dl), and I’ve taken 1.25 mg of Proscar daily for about 6 months and it seems to have worked quite nicely, but I am still wondering what impact the orchiectomy might have for my hair loss. Will my hair loss advance as rapidly as it would have had the orchiectomy not occurred, or will it possibly stop?

Thanks Doc!

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A loss of one testicle will be compensated by the other testicle as it may “rise” to meet the needs of your body. Usually, the remaining testicle will increase testosterone production and this is something you can follow with your doctor through appropriate blood tests. There should be no impact on your hair loss other than what you were destined to lose based upon your genetics.

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Hair Loss Started Again After a Couple Years on Propecia – Hair Loss Information by Dr. William Rassman

Hello,
I have been taking Propecia now for about 2 1/2 years and believe it has slowed my hair loss down but has not stopped it. In the last 6 months I have noticed significant hair loss and thinning. What can I do? Also is Avodart or any other promising drugs soon to be approved to treat hair loss by the FDA? And if so when? Thank you for your time

Propecia does not show the same benefits forever. Every person will eventually lose the benefits of this drug, but the open question is when. Avodart might be more effective in people like you, but as you know, it is not FDA approved for use in treating hair loss. I couldn’t say when or if it will be approved for this, nor do I have any inside tips on upcoming drugs that are pending approval. There’s a lot of money to be made if a medication can be proven safe and effective, so I’m sure there are companies out there trying to find the next best treatment. I just don’t know who they are…

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Is it Crazy to Travel Across the Country for a Consultation? – Hair Loss Information – Balding Blog

After reading your blog from end to end, I am tempted to travel to LA at some point in the future just to consult with you. This is despite the availability of excellent doctors in New York some of whom I have met. Is it crazy to want to do this? Has anyone done this before?

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AirplaneI do not think it is out of the ordinary to travel a distance to seek a medical option from a doctor you trust for an issue that is important to you. Personally, if I have a medical issue and I have the resources to seek the best doctor in the field, I would even fly across the continent and around the world. I often have a few patients a month that do exactly that, or come from other countries. Sometimes they plan a trip around the visit, but that isn’t always the case.

Just off the top of my head, in recent months I’ve had one patient take a red-eye flight from Florida with a 6 hour layover, and another patient fly in for a visit from England only to fly back 6 hours later. A couple years ago a patient flew over from Italy with a 12 hour layover just for a consultation, but he did not need surgery as he just had a maturing hairline (not recession from a balding prospective). I am hopeful that he scheduled a full trip out of that though to enjoy Los Angeles.

I do not recommend surgery to some of these patients and they are grateful of the advice despite the long trip. Many people drive hours from distant cities as well. Hey, at the least none of them had to pay to see me, as my consultation is free! Many times photos can clue me in on what your hair loss situation is so that we can have a consultation over the phone, but many patients prefer the one-on-one exam in person. If you’re planning on visiting Los Angeles anyway, by all means call my office at 800-NEW-HAIR to setup an appointment!