February 2010 – Page 6

February 12, 2010

Hair Loss InformationActor Jon Cryer’s Hair Loss, Again – Hair Loss Information – Balding Blog

I’m a celebrity gossip fan (for better or worse). I know you recently wrote about Jon Cryer from Two and a Half Men, but I just saw this new photo of his balding pattern. It is way worse than I originally thought!! What Norwood Class would you estimate he’s at? I’m just curious.

TMZ: Jon Cryer — Out in the Open

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The last post we made about Jon Cryer was just couple months ago, and at that time I wasn’t sure what was going on from the photos I was shown. From these pictures, his hair loss pattern appears to be at least a Norwood Class 3A, if not more advanced along the type A patterns or even the 4-6 pattern with high miniaturization; however, without a top down view and a rear view, I really can’t make the diagnosis.

Photo from TMZ via INFdaily.com

February 12, 2010

I Want a Hair Transplant, But Don’t Want Propecia Anymore – Hair Loss Information by Dr. William Rassman

I stopped taking propecia 6 months ago, after having taken it for 18 months. I believe the drug did stop my hairloss and I may have even gained some growth. I stopped taking the drug however, as I became very uneasy with it and the side effects. I am now using regain extra strength. My hairloss has returned and continued as expected. I am now seriously considering a transplant, but do not wish to go back on propecia. As my hairloss is very slow (over the passed 17 years), is it okay to undergo a transplant, but not use propecia?

Propecia is a great medication, but to a minority of patients the unwanted side effects may be an issues (as it is in your case).

You do not have to be on Propecia for a hair transplant surgery, but if you are under 30 years old and started to lose hair in the past 5-8 years, you run a risk of developing hair transplant shock with loss of hair from the transplant. I don’t know your age, but you mentioned losing hair for 17 years, so I’d assume you’re over 30. You still run the risk of shock loss, but it is less. Plus, without the medication the progressive nature of hair loss will cause your native hairs to continue falling out. As long as you know these facts, it is a decision you and your doctor need to make together.

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February 12, 2010

Chewing Propecia – Hair Loss Information by Dr. William Rassman

Hello Dr.

Do you have any opinions on chewing up Propecia vs swallowing it? Is it true if you chew it, there is better change of all getting absorbed? Or would chewing it somehow ruin in the inherent chemical makeup? Thanks.

Some medications are meant to be chewed, but if the medication is meant to be swallowed, I would swallow it as it is written in the instructions. Propecia is one of those medications that was meant to be swallowed. I really do not believe it would help with the absorption if you chewed it, plus, I don’t think it would taste all that great.

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February 11, 2010

Does a Mature Hairline Have Vellus Hairs? – Hair Loss Information – Balding Blog

Hello Dr. Rassman! I’ve found your blog to be extremely helpful and I’d like to ask you a question:

I’m 19 years old, and I’ve noticed thinning at the corners of the hairline, with thinner, shorter hairs, extending (as far as I can tell with close inspection – no microscope available yet unfortunately) about 1.3″ above the highest crease of the wrinkles at the corners, and it doesn’t seem to go any further than that (the hair also feels thinner at the corners) and the middle of the hairline has settled two thirds of an inch above the highest crease without thinning behind it.

I’ve come to understand from various blog posts that there are more smaller (or vellus) hairs at the hairline than at any other spot on the head, which leads me to my question: If developing a maturing hairline means the hairline moves back an inch or so, does the mature hairline position have the vellus hair common in hairlines before/during the maturation, or do some of the hairs in the mature hairline become vellus hairs during the maturation process?

I hope you find the time to answer this question, with kind regards from Israel.

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Peach Vellus hairs are short, fine, light colored, often barely noticed hairs, which develop on most of the human body… and on the scalp they are part of the follicular unit. Some people might call it peach fuzz, and these hairs are not only on your frontal or maturing hairline, but they’re also found almost everywhere on your body — except lips, backs of ears, palms of hands, soles of feet, certain external genital areas, navel, and scar tissue.

The leading edge of any hairline has hairs that are often thinner than the hairs further back. That is why a doctor must create a transition zone when he/she transplants the frontal hairline, or the transplanted hairline will look like unnatural. Obviously, nobody with a hair transplant wants the world to be able to tell their hairline was created by surgery. As you are only 19 years old, determining your future hair loss prospects may be a bit difficult just by trying to judge the frontal hairline and seeing fine vellus hairs. You probably need a miniaturization study, a physical exam, and a good family history to start any sort of guess work.

February 11, 2010

Severe Rash from Provillus – Hair Loss Information by Dr. William Rassman

I’m a 61 year old male and began using Provillus treatment about two years ago. The results were encouraging and after about four months, I felt lots of new hair growth all over my scalp, about 3/4″ long. Some if this fell out but enough continued to grow to make a real difference and I was happy with the result.

I continued using the product for about a year with no problems. Then I re-ordered the product gave me severe rash all over my scalp and hair in some of the really aggravated areas fell out or at least has stopped to grow. I queried the supplier about the product because of the rash and also because the viscosity of latest shipment was decidedly higher than the original. The advice was there was an improvement to the product which brought about the change in fluidity. Obviously this was the end for me using a scalp treatment (I experienced the same effect later with Rogaine)

Not wanting to take defeat just yet, I’m thinking about trying a laser comb. Do you have any advice for me? Thank you

It sounds like you have developed a skin allergy to the product. This can happen. Perhaps you’re allergic to an ingredient in the Provillus, particularly if you say they changed the product before you ordered another shipment. I really don’t have any way of knowing. You can try using regular minoxidil, which is the active ingredient in Provillus. Then again, minoxidil itself is known to cause skin irritation in some people (see side effects). It’s worth a shot, I suppose.

With respect to the LaserComb, it is our feeling that it does not work. We’ve written extensively on this subject. See those posts here.

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February 11, 2010

Mild Depression from Finasteride? – Hair Loss Information by Dr. William Rassman

Doctor,

Love the site, check it out routinely.

I noticed someone previously had written you having had bad side effects from Propecia. You said for him to send you what the effects were to see if he was doing enough to counteract them.

Well, I tried three go-rounds with finasteride. Twice via Propecia (for about 1 year each), and once via Xandrox 15% w/Finasteride as a topical solution. All three times I experienced noticeable mood changes; I would describe it as almost a mild-depression as well as loss of libido. What do you prescribe for patients like myself with these problems to counteract these side effects?

Thanks

Coincidentally, I was going to post something today about a recently published article in Prague Medical Report discussing the relationship between finasteride and depression in some people. From time to time I’ve gotten comments about changes in mood, possibly resulting from finasteride use. Although these are reported in the Merck studies, there is not much information on the mechanism of such side effect possibly because they are very rare. I found this quote from an abstract in a medical journal, which might shed some light on the mechanisms of finasteride action…

“In the course of finasteride treatment the decrease of the concentration of circulating steroids with known inhibitory activity on GABA-ergic excitation in the brain is very probably an important factors contributing to the development of the symptoms of depression seen in some isolated cases of finasteride administration.”

Read the full abstract here — Finasteride treatment and neuroactive steroid formation.

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February 11, 2010

Increased Tear Production from Propecia? – Hair Loss Information by Dr. William Rassman

After a year on Propecia, my hair loss has slowed to the point that its virtually noticeable. My hope is that my hair loss will incur very slowly over time, thus losing my hair on a more age appropriate time-line. Losing my hair now, at such a young age, will probably bother me more than losing hair 10 years from now.

The only side effect I experience is increased tear production. When I am having an emotional dialog, my tear ducts are more active. This has been a very strange experience! Even so, my Doctor is unsure whether or not Propecia is the cause. The problem is not nearly severe enough for me to consider stopping the medication. Overall, Propecia has been working great!

I would challenge your first paragraph, as men of all ages are impacted by hair loss… and no one likes to look older because of balding.

I am not familiar with tearing problems from Propecia. I don’t recall ever reading any report of this or having any patient mention it. I’d check with an eye doctor.

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February 11, 2010

Gynecomastia and Avodart – Hair Loss Information by Dr. William Rassman

My question is what to do about gynecomastia from Avodart, which stays in your system for months (maybe even a year) after discontinuation. Since the usual treatment for drug induced gynecomastia is to stop taking the drug, this is essentially not an option with Avodart.

My doctor feels otherwise, but wouldn’t you think a more aggressive treatment such as tamoxifen would be warranted? There is already a lump you can feel, and my understanding is that this will become permanent if it lasts more than six months.

Any advice what I should do?

You need a doctor to guide you in a direction here, and your prescribing doctor is the one to go to. I would probably suggest that you just discontinue the drug, maybe switch to finasteride in very low doses, but I am not your doctor.

I don’t have experience with using tamoxifen as a treatment, as described here. Hair loss is listed as a possible side effect from tamoxifen, by the way.

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February 10, 2010

Why Do I Need to Sign a Disclaimer Before Hair Transplant Surgery? – Balding Blog

If Hair Transplant is so safe, why do clinics require patients to sign “disclaimer” before surgery? I was quite freaked out seeing the paper basically saying ‘Oh, BTW, you could die and it won’t be our fault’. Not the best thing you do right immediately after popping Valium and right before heading for the chair.

Gavel I agree disclaimers can be a bit daunting and scary when you read each and every line. While we live in a litigious society that necessitate us from signing disclaimers, it is also a way to give full disclosure of all risks involved.

Signing a full disclosure or a disclaimer after taking a Valium (while you are intoxicated) is probably unethical and against the law, but it is something that should be discussed with you before any surgery or any activity when you are in a clear state and of sober mind. In my practice I mail out full informed consent documents days before surgery so my patients can have a chance to read it in the comfort of their home. We also review the entire consent form on the day of surgery before any medications are given. There should be no hidden surprises. This is how it is (or how it should be) for all medical centers and hospitals.

By the way, yes, you can die from a hair transplant surgery. This happened just a few years back (see here). To be fair, there were special circumstances behind that death, as the transplant itself is a very safe outpatient procedure with patients fully awake during the surgery. Unless someone has a heart attack or a stroke during the surgery, a hair transplant in itself is not a life threatening procedure.

February 10, 2010

What If I Want to Practice Hair Transplantation Surgery on Myself? – Hair Loss Information by Dr. William Rassman

If I was crazy enough and with a high pain toleration, could I buy the equipment need to do a “Home FUE” on my body hair? I guess I would need a punching tool and an implanter.

I have very dense and thick leg hair, so as a project I could collect all my leg hair in a strip on one leg to see what kind of coverage I could get for a future strip-transplant if needed, I’m not bald yet. But if I go bald,and there is no histogen or other cloning breakthroughs. I would think, using all my scalp donor to cover the front, and top + all my leg hair to cover the rest, and keep it buzzed down, I would still be quite happy.

I know you don’t like bodyhair on scalp,but if it was a single strip of dense hair on my leg it would be different, right?) + I like my hair buzz cut.

I know this is ridiculous, and something you wouldn’t recommend, put THAT aside, my question…. Do you need a license to buy this tools? Feel free to make a joke about this plan, I know it’s waaaay out there…..

I can joke about your plan, but there really is not much to say. I suppose you can do anything if you are really determined to do it. I am told you can even find instructions to build a nuclear bomb on the Internet. It is your body and if something goes wrong, you can have a life threatening skin infection and die. I will agree with you in that your idea is “ridiculous”, but unlike an atomic bomb, an explosion is not the problem.

I get calls from time to time from doctors wanting to purchase FUE tools, but I don’t have them for sale. You might be able to find a supplier on the web, but I’ve actually posted a similar request a couple years ago from someone wanting to be their own bathroom surgeon. I obviously can’t condone this.

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