March 2010 – Page 2 – Balding Blog

March 29, 2010

Hair Loss InformationErectile Dysfunction a Red Flag for Mortality, Cardiovascular Events – Hair Loss Information – Balding Blog

This isn’t hair loss related, but it is still important medical news —

Red flag In a recent publication, erectile dysfunction (ED) was found to be a robust predictor of all-cause mortality and cardiovascular events in men with cardiovascular disease or those with risk factors for cardiac disease. The connection between the blood vessels of the heart and the penis show that the blood vessels of the penis mimic those of the heart when there is significant cardiovascular disease present. These findings were recently published online March 15 in the medical journal called Circulation.

Treatment of cardiac disease, once recognized, can reduce the risks of cardiac death. The findings suggest that ED is a manifestation of cardiovascular risk. They conclude: “ED is a powerful predictor of cardiovascular death and of major cardiovascular events in high-risk patients and represents a symptom of more advanced atherosclerosis and endothelial dysfunction.”

What does this mean? If you have erectile dysfunction, get your heart checked for the presence of advanced heart disease. Taking Viagra may work to solve the ED, but your risk of sudden death is higher amongst men with ED and heart disease. Sudden death is often the first sign of heart disease in 70% of men.

March 29, 2010

Hair Loss InformationIs Rogaine a Waste of Time? – Hair Loss Information – Balding Blog

Dear Dr. Rassman –

This blog is really a terrific resource. I’m 27 caucasian guy with thinning hair. Frankly, my thinning not super noticeable when my hair is dry; however it looks pretty bad when the hair is wet.

I’ve tried Propecia, but sadly, I’m one of the rare guys who got side effects (FYI they completely went away when I stopped taking the drug). My question is whether or not you think stand alone Rogaine foam is a decent alternative for us guys who can’t tolerate Propecia. I’m fine with applying it twice a day. The issue is that I just don’t want to commit to lifetime use of a medication that you think is, on balance a waste of time.

Thanks very much for your reply.

Block Quote

Rogaine Foam I’d say Rogaine (minoxidil) is a good alternative, though it doesn’t inhibit the DHT that causes hair loss. I wouldn’t say it is a waste of time, but it just works differently from the Propecia (which does block DHT). Minoxidil is FDA approved to treat hair loss, and you might see some decent regrowth. I won’t make any guarantees to how much growth you might see, but is worth a shot.

You might also consider taking a half dose (0.5mg) of Propecia, as some patients with side effects have seen some benefits and no side effects from going this route, though you should discuss this with your prescribing physician. Also, a quarter of the dose will produce half of the benefit of a full dose.

March 29, 2010

Hair Loss InformationKanye West’s Norwood Class? – Hair Loss Information – Balding Blog

What is Kanye West on the norwood scale?

Here is a pic of him: photo. He wrinkled his brow there. His wrinkle doesn’t touch his whole hairline, but he doesn’t look NW2. What is he?

Block Quote

Kanye West’s hairline is slightly ‘V’ shaped and that reflects (in the photo) a mature hairline. I don’t see any loss, so classifying him on a hair loss scale doesn’t make sense. I don’t believe that Dr. Norwood classified the mature hairline. When looking at the shape of his particular hairline, I wonder if he is clipping the leading edge in some of the photos. I found more photos to review here and here.

March 29, 2010

Hair Loss InformationIs it Normal to See Hairs on My Pillow Daily? – Hair Loss Information – Balding Blog

Dr.Rassman,

This might sound like a very stupid query. Is it common for a man who is not thinning to see hairs on his pillow everyday in the morning.

Block Quote

Pillow You know, after years of answering thousands of questions here on BaldingBlog, nothing is a stupid question.

It can be normal to see hairs on your pillow everyday. The average person loses 100 or so hairs per day without balding present at all. Though if you’re seeing 100 hairs on your pillow, then that isn’t going to be normal unless you’re bedridden.

March 29, 2010

Hot Weather = More Hair Growth? – Balding Blog

Hi Dr. Rassman.

I was wondering if you knew why hair seems to grow longer/faster in the Summer time. I don’t know if this has ever been scientifically proven, but I have always noticed this with myself and my hair dresser says she notices it all the time with her clients. I assume it has something to do with the warm whether.

If this is true, do you think heat/body temperature would have any affect on the way finasteride behaves?

Temperature Hair growing faster/longer in the summer isn’t a proven fact, but if it is something you notice I can’t dispute it. I’ve read all kinds of theories about why hair might grow faster in the summer (if so, likely due to hormones), but some people believe that hair actually sheds at a higher rate in the summer compared to the winter. Unfortunately, there is no good science on this subject. Maybe it is from a subjective perspective.

There is also no correlation that I am aware of with respect to body heat and finasteride. For that matter, humans are warm blooded and our body heat stays right around 98.6 degrees Fahrenheit (37 degrees Celcius for those outside the US), perhaps fluctuating only around a degree F.

March 26, 2010

Hair Loss InformationHair Transplant After Stopping Minoxidil? – Hair Loss Information – Balding Blog

Hey Doc,

This is my second post on this Blog. I’ll repeat my initial sentiments with regards to the first-grade work you do on this site. You can’t begin to understand how useful and good this blog is.

I’m 23, and spotted some thinning a few years back. I tried Minox 5% for about 4weeks, and stopped due to skin irritation. I’m convinced that using and then stopping minox has impacted my hair terribly. I’ve been on propecia for about 9months with limited success. It has always been my intention to at some point enquire about a transplant. My question is about the affect of stopping minoxidil on a future transplant.

I understand that upon stopping minox there is a shrinking of capillaries, and consequently blood supply to the scalp. If this is the case, and I were to go ahead with a transplant, would the new grafts be affected? Would it be possible to have a successful hair transplant, after having stopped minoxidil? Have you experience of patients in similar positions?

I hope that makes sense. Your help would be greatly appreciated. Thanks for reading.

Block Quote

The only problem with stopping minoxidil is from the dependencies on the hairs that have been benefited. I tell my surgical patients on minoxidil to continue using it up until the night before the hair transplant and then restart it 2 weeks after the procedure. The blood vessel impact from minoxidil on the scalp will not impact a hair transplant. I’ve had plenty of transplant patients that use minoxidil prior to surgery and have never seen any kind of issues related to using the medication.

If you stop minoxidil at the time of the transplant and decide to never restart it, the withdrawal effects of the drug I have discussed here before will become the risk. It won’t effect the transplanted hairs, but you will lose any benefits you had from the medication.

March 26, 2010

Hair Loss InformationPrinting Hairs? – Hair Loss Information – Balding Blog

Hey Doc,

I just saw this: Scientists Use 3D Printer to Create First “Printed” Human Vein

And it got me thinking, what if it was possible to ‘print’ human hair follicles from your own cells and have them implanted?

Block Quote

Printer I like your way of thinking, but you can’t put together possibly disassociated facts to make them work. I suppose that is the first step to innovation, though. I suppose anything is possible in the not-so-near future, but I see an influx of angry emails whenever I poo-poo on any future technologies by telling them that if it ever were to become reality, that it would be many, many, many years away.

I do appreciate you sending me the link though.

March 26, 2010

Hair Loss InformationHow Long Does Telogen Effluvium Take to Regrow? – Hair Loss Information – Balding Blog

(female) I was diagnosed with Telogen Effluvium triggered by Thyroid and possibly low Ferritin/low Vit D. I lost about 1/2 of my hair Feb-April 2009. The thyroid stabilized Aug 2009 and Ferritin/Vit D returned to normal Jan 2010. I’m not seeing any regrowth. In general, would you expect my hair will grow back (it’s now been 1 year since it fell out)?

Block Quote

There is no certain answer to this question when there are complex underlying issues that caused the hair loss. The more issues, the more difficult it is to predict. I would hold out for a full year since your iron levels were normalized and see if over that time the hair came back. I wish I had a more specific time frame to give you, but it’s just not that simple.

March 26, 2010

Dr. Pak’s Life in the ER and NHI – Hair Loss Information by Dr. William Rassman

This is a personal story written by Dr. Jae Pak:

Jae P. Pak, MD While I am fully trained in hair transplant surgery by Dr. Rassman and it has been my primary practice over the years, I am also trained in emergency medicine. As such, I keep up my skills as an emergency physician at local hospitals in the community a few times a month. This gives me a unique perspective in my professional and personal life. I see the best and worst in people.

Despite what you may think about hair transplant patients, they come from all walks of life. They are not the super wealthy or the Hollywood celebrities. Sure, there are a few of those, but most of my patients are plumbers, teachers, taxi drivers, businessmen, students, etc. Most of my hair transplant patients are healthy, happy, and pleasant. I usually set aside 30 to 60 minutes to bond with them know about their personal life and to establish a true doctor-patient relationship.

In my emergency medicine practice, as you can imagine, I see mostly sick and unhappy patients. And despite what you may think of emergency medicine (as you may see it on TV), its not all about trauma, gun shots, and life or death. Sure, I see my fair share of life or death with gun shots, motor vehicle crashes, and heart attacks, but the good portion of patients I see do not belong in the ER. Due to the overcrowding and long lines in the ER, I do not have the luxury of spending time and bonding with the patients I see, as there are literally lines of patients to be seen. Without going in to a long tirade of how the our health system is broken, I would like to share a story:

I saw a patient in the ER the other day who was about 18 years old. She called the ambulance because she had diarrhea and stomach cramps for a day. When I walked into the room, she was sitting on a chair eating Doritos with a Diet Coke clenched in the other hand. While I doubt that the Diet Coke would help her deuce and half physique, I knew she couldn’t have been in too much distress as she was able to tolerate the spicy flavored corn chips. So when I asked her why she called the ambulance, she looked at me straight in the eye and stated she didn’t have a ride to the hospital and didn’t want to take the bus. We all have had an upset stomach and don’t think to rush to the ER, so when I asked why she felt it necessary to come to the ER, she said she didn’t have any medication at home and didn’t know what to take after the 3rd diarrhea episode, so she though she would get help from the ER. When I asked her if she had a doctor to call, she said she didn’t have a regular doctor and she always comes to the ER to get her all her care because its free.

At this point, I was curious to know why she would think my services in the ER would be free, so I asked her to elaborate. Setting aside her multitasking of texting her boyfriend on her shiny iPhone and sipping on the Diet Coke, she proudly presented a card from her fake Louis Vuitton purse — a disability MediCal ID, like it was her get-out-of-jail-free card. I asked her about her disability, thinking that she must have a horrible childhood disease to get the ID at such a young age. As she continued on with her texting, she told me she is disabled because of her lower back pain issues. She further elaborated that her mom actually helped her get this disability status so she can collect the monthly SSI check from the state, just like her mom. Naturally, back pain is the reason why she does not work or go to school when I asked about her life at home. And aside from the fantastic emergency care I was to provide for her, she demanded I check to see if she was pregnant because she was a day late and didn’t have the money to buy a pregnancy test from the drug store. I was happy to inform my patient after the “free” thousands of dollars worth of work up, that she just had a case of normal stomach flu and that she would be fine. She seemed unfazed after I gave her the results of her pregnancy test and requested a free taxi voucher to go home, because her boyfriend was busy and the mom was nowhere to be found. When the social worker could only help her out with a free bus ticket, she was very upset and asked to go outside for a smoke.

Unfortunately, this typifies a good portion of the patients I see in the ER. It is a familiar truth to most doctors and nurses, and while my story may not be unique, it is a sad stark contrast to the hardworking good intentioned patients I see at New Hair Institute who probably would not call the ambulance for a simple case of diarrhea. We are at the brink of some form of health care reform, but in my humble opinion, we will never have a true health care reform until we have people reform. That’s the extent of my social commentary and I’ll let you interpret the story any which way. Don’t get me wrong, I love working in the ER. For every 100 “typical” patients I see, I sometimes have the privilege to save a life and make a difference. Then the next day I get to come to NHI and make a difference in another way — by giving my patients hair! Those with a full head of hair couldn’t possibly understand, but to some people hair is life or death! To me, I have a great job(s) and I get to meet and help a lot of interesting people from all walks of life.

Paid advertisements (not an endorsement):

March 25, 2010

Hair Loss InformationNo Room for Optimism for New Hair Treatments? – Hair Loss Information – Balding Blog

While I don’t disagree necessarily with the premise that doing nothing now, in hopes of treatment in the future, is a course of action that is done at an individual’s own peril — the balance of this response is quite gloomy and alarming. Of course, you are the professional, and we defer to your knowledge — but you truly believe that NO beter treament will be available to the public for decades? That hits many of us prety hard. I am a realist. However, is there no room for optimism? There is a market for this, and certainly a willingness, as evidenced by the research of the past 6 years, in finding better alernatives. Those are my thoughts. Thanks for the site — more so, when it provdies hope, as opposed to narrow courses of expensive, sometimes (not always) unflatering, options.

Block Quote

Half full Hey, I was hoping for flying cars, public space travel, and a cure for cancer by now. I’d even settle for a cure for the common cold. I would like to think of myself as an optimist… you know, a glass-half-full kind of guy… but the cure for balding is not as easy as you may think. Being bald is like the color of your eyes, the way your ear lobes fold, or how tall you are. It is genetics! And as much as gene therapy is the new buzzword in science, it is a long ways off.

In the mean time, for those men who are bald, there are great alternatives. Hair transplant surgeries have evolved to a point where it is almost undetectable when done by the right surgeon and medical group. See my post on selecting the right surgeon. And when combined with medications such as Propecia, it definitely changes lives. So I am not sure what some of you are looking for, but hair transplants really are not unflattering nor expensive. While I agree at face value the cost of a hair transplant surgery may be in the thousands of dollars, remember that it works and it’s for life! It is often less expensive than a good quality wig, which has to be replaced or repaired ever couple of years. What other item can you purchase for a few thousand dollars to make you look younger and you get to keep for the rest of your life? As you say, you are a realist — it may not be the fountain of youth, but for the optimist, its the next best thing.