March 2010 – Page 8 – Balding Blog

March 10, 2010

Hair Loss InformationPropecia Shedding Started After 6 Months – Hair Loss Information – Balding Blog

Can Propecia cause shedding after 6 months? Or is it just a sign that it is not working as well as I once thought? My hair density seemed to get better but after the 6 month mark I have noticed a big step backwards. Thanks guys for the great info.

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If shedding were to occur, it generally begins upon starting Propecia and ends within a few months. If you see accelerated loss 6 months after starting the treatment, that is uncommon and might not be shedding from the medication. As for what it is, I couldn’t say with any certainty — but that is why talking to the doctor that prescribed Propecia to you is important.

If there were miniaturization studies with mapping of the scalp done prior to starting the Propecia, then this question could be answered a little better, as a new mapping would show changes since the original mapping. Baseline studies will tell you if this is an acceleration of your balding process.

March 10, 2010

When is Balding with Fine Hair Considered Noticeable? – Hair Loss Information by Dr. William Rassman

I hate to keep bothering you, but I’m full of questions! With fine hair, how much hair can be lost before it is considered noticeable? 25%? 50%? I am 4 months into using Propecia, and have new hair sprouting all over. I am surprised, as I have been losing hair for 20+ years. I am going to see where Propecia takes me, then finish it off with transplants.

In general, you need to lose about half (50%) of your original hair density (in even distribution) to notice social thinning but that also reflects your hair and skin color. In those with platinum blonde hair, you might be able to lose 80% before it is socially detectable. On the other hand, if you had black hair against white skin, a loss of 20% might be socially detectable. In other words, you need to lose between 20-80% of your original hair density to have others notice that you are thinning and this is based upon hair and skin color and the character of your hair. Of course, you (yourself) would notice that you are losing hair much sooner. This is generally if you lose hair evenly everywhere (and not in a pattern).

For those who respond well to Propecia, it takes about 8-12 months to see early differences… but it will not regrow all the hair you lost. Propecia mainly works to sustain what you ALREADY have and make those finer (miniaturized) hairs thicker and healthier. This will make it look like you have more hair as your hair diameters are thickening. You see, it’s not only about the numbers. Also be careful and note that Propecia should not be considered a cure to balding, but rather it slows that process down (dramatically) in some patients.

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March 10, 2010

Reishi Mushroom Inhibits 5-Alpha Reductase? – Balding Blog

Hello Dr. Rassman,

I know that you don’t put a lot of stock into herbal remedies for hair loss, but an article I found on the Reishi Mushroom does have some interesting information regarding the mushrooms effects on 5-alpha-reductase.

Perhaps you’d like to look at this: Study

Thanks for you wonderful blog and let me know what you think in regards to this helping at least slow hair loss.

It would not surprise me to find finasteride type of molecular formulations in things that grow. The original finasteride was identified in the Amazon rainforest as the natives ate tubers that had DHT-blocking abilities. In the naked native people it was clearly seen that the children did not develop their external genitalia (their penis) until they were close to puberty, there was something wrong. The drug finasteride (a DHT blocker) was eventually formulated from the analysis of this tuber. The sexual side effects were also identified in some of the children who were hermaphrodites, probably caused in the first trimester of the mother’s gestation. So I would want to know more about the Reishi mushroom (pictured at right) before you use it, and I would take Propecia (finasteride) rather then take a gamble on anything unknown. Propecia is taken by millions of men, so we know the side effects, rare as they are.

March 10, 2010

In the News – Permanent Hair Loss from Cancer Drug Taxotere – Balding Blog

Snippet from the article:

Women who took a drug to fight breast cancer say they were never warned of a side effect – permanent hair loss – that left them looking sick long after they were treated for the disease.

“I had a normal head of hair and I am now completely bald,” said Cynthia MacGregor, 50, of Montreal, who has been diagnosed with alopecia universalis, a loss of all body hair.

Another sufferer, Shirley Ledlie, 51, of Brittany, France, said: “It’s like having ‘I am a cancer sufferer’ tattooed on your forehead. … I look like an 80-year-old, ugly old man.”

This lasting side effect of the chemotherapy drug Taxotere, in combination with other drugs, came to light when cancer patients began living longer. These women are now finding that survival comes at a cost.

Read the full text at The Globe and Mail — Women who took chemo drug say they weren’t warned of permanent hair loss

Taxotere (docetaxel) slows the growth and spread of cancer cells in the body, and is used to treat breast, lung, prostate, stomach, and neck cancer. Hair loss has been a known side effect of this medication, but the possible permanence is just coming to light.

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March 10, 2010

Can Propecia Results Improve During the 2nd Year? – Hair Loss Information by Dr. William Rassman

Hey doc,
I am 13 months in on propecia and my hair is a little worse than when I started. I have read that best results occur at 18-24 months. So have you ever had anyone who was unhappy with their results after 1 year on propecia, but the results improved during year 2?

I can’t recall such a situation with one of my patients, but we do know that Propecia will build and some people report gains after the second year of use. Continuing the medication is up to you, but I’d speak with your prescribing doctor about this.

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March 9, 2010

I’m Not Seeing a Drastic Difference a Year After Hair Transplant – Hair Loss Information – Balding Blog

Dear Dr.,

I had a hair transplant (840 3-4 follicular grafts) in February of 2009. The areas treated were the large crown and also throughout the temporal areas. I still do not see a drastic difference. I am not sure why. I am continuously also using Rogaine foam and Propecia. When under any bright lights, I see such thinning as to where the transplant was supposed to have worked. I am not sure if something went wrong, or everyone’s bodies are different; thereby it may look better within another year. Have you heard of my situation? Does a hair transplant take up to another year in order to see better hair density results?
Thank you!!!

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Without knowing more about your case, it would be difficult to provide much precise information. Sometimes a thin look can appear under harsh lighting because of your hair color, hair character, thickness, etc. The Rogaine and Propecia are good to continue using, but after a year you should’ve seen results by now from the surgery. Everybody is different, every surgery is different, and every medical group is different, but it generally takes 6 to 8 months to see the beginning results of a hair transplant surgery. Either your surgery has failed or you continued to lose more of your native hair and what you are seeing is the lost native hair. I have seen transplant failures, and generally these occur because of surgical errors, inexperienced or sloppy teams or techniques, or rarely the presence of some associated disease like diffuse alopecia areata (though this is unlikely in men).

I’d discuss this with your surgeon to find out his/her take on why your grafts haven’t grown. Be sure to compare your current look to pre-operative photographs, because sometimes patients don’t realize just how bald they were before the surgery (the hair grows in gradually so its hard to notice if you’re not focused on it all the time).

See this recent post for more — If There’s No Growth a Year After My Hair Transplant, Should I Just Get Another One?

March 9, 2010

High Metabolism and Female Hair Loss? – Hair Loss Information by Dr. William Rassman

Hi,
I have seen your website and I have a question to ask. I just want someone’s opinion on some thing. I’m 26 years old (female) and I have hair fall and I have been to few doctors and I have blood test done for so many reasons and they all show normal. I still experience hair fall and I’m still trying to figure out what to do. I was told that my hormones are very high I want to know is it anything related in having high metabolism? Is their any way to be tested or checked for high metabolism? Please let me know about this soon.

Thank You

A high metabolism should not cause hair loss.

You are stabbing in the dark to find answers, and unfortunately I won’t be able to help here either. I don’t know what tests you had done, their results, family history, etc. Go back to the doctors you consulted with and get answers from them.

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March 9, 2010

HairDX Finasteride Response Test Accuracy? – Hair Loss Information by Dr. William Rassman

Thanks a lot Dr. for this helpful blog site that keep us well informed about baldness. Two weeks ago, I did a HairDx test (rxr) for finasteride response. Do you think such test is accurate enough to build upon? How much it’s acurate per cent?

HairDX There are two HairDX tests — one which shows if you carry the genes for balding, and one which suggests how sensitive you are to finasteride. The statistics on both of these are not 100%, but HairDX doesn’t provide an actual accuracy percentage that I could find. I don’t have enough experience with HairDX to know how accurate they are first hand, but I would expect they’d be as accurate as possible. There are multiple reasons why accuracy could be skewed, including data collection errors, software errors, and disease.

It’s also worth noting that their Service Agreement page does say, “HairDX is providing no guarantee that the Service measurements will be successful or provide accurate results.”

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March 9, 2010

Are You Sure Minoxidil Doesn’t Block DHT? – Hair Loss Information by Dr. William Rassman

You’ve stated on your website that minoxidil doesn’t block DHT. How do you know this? Perhaps this is the mechanism by which it regrows hair. I’ve tried finasteride and dutasteride with virtually no results. While my result with minoxidil hasn’t been spectacular, it has definitely been superior to the other two drugs.

Minoxidil has a known side effect, in that it will grow hair when it is taken orally or applied to the skin. Women complained of the appearance of facial and chest hair when this drug was used as an antihypertensive drug. I can’t state with 100% certainty that it doesn’t block DHT, but that is not what is reported. What has been reported is that minoxidil is a vasodilator, not a DHT inhibitor.

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March 8, 2010

Senile Alopecia Years After a Hair Transplant? – Balding Blog

If I get a hair transplant but develop senile alopecia many decades from now, when I’m in my 70s or so, will it be a problem?

If you develop senile alopecia when you are much older, if your doctor produced a Master Plan for you, this should not be a problem. The doctor would have accounted for such a process in the plan, provided that he performed follicular unit transplants in a pattern that would give consideration to such a change.

Transplanted grafts will mimic the changes in the donor area, so if the donor area lost 30% of the hair, then the hair transplants will lose 30% of the hair in the grafts. Unfortunately, there are not statistics on this available, but this conclusion is based upon years of observations that I have made.