Month: June 2010

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Is Scalp Flaking Related to Hair Loss? – Hair Loss Information – Balding Blog

Hello Doctor,

Could you please provide some insight on flaking in the scalp and MPB. I have been thinning since 2001 and have been on finasteride for the past year with favorable results. Off late, I noticed excessive flaking in the scalp along with hairfall (roughly 2-3 hairs each time I run my hand through the scalp. I am not sure what could be the cause. Do you think people with thinning hair have excessive flaking when compared to their hairy counterparts?

Thanks

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Many times when a person has seborrhea (benign condition for flaking of the scalp) as the flakes fall off or are scrapped off by a person with genetic hair loss, the marginal hairs that are being lost will often fall out within the ‘flake’. That does not mean that flaking caused the hair loss.

So the answer is no, hair loss is not caused by flaking.

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I’ve Taken Propecia for Years, But Now I’m Afraid – Hair Loss Information – Balding Blog

I have been on propecia for 4 years prior to a procedure. The medication was working very well and I was holding on to most of my miniaturized hair until the procedure shocked all of it out and basically voided any benefit and progress that the medication provided me.

Since my terrible experience with this surgery, I have been doing so much research and have come across horrible side effects of propecia that I previously was not aware of…ED, breast enlargement, etc…. This has scared me so bad and is adding to my stress level which I am trying to control. I have not experienced ED up to this point, but not sure about the other…..have you seen these side effects in others and how often?

My question is that do you think (in your general experience) since most of my hair has been lost because of surgery that the propecia is not really necessary now? I just want to get off it and not take any more risks….

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PropeciaSo you took Propecia for years (including follow-up visits and prescription renewals) and somehow were never informed of any side effect potential, nor did you even read the insert that comes with the medication? If you have not had any side effects after 4 years, it would be unlikely that you will experience them now or at any time. I believe erectile dysfunction risks are about 1%, libido decrease 1%, breast enlargement much less than 1%. You should be in discussion with your prescribing doctor, not me over the internet.

Just because you had the surgery doesn’t mean Propecia is unnecessary. I don’t know where your surgery was on your scalp, but let’s assume it was done in the hairline and Propecia has kept the crown. Stopping the Propecia would just create a need for further procedures, as the hair that Propecia kept would soon be gone. Obviously this is just an example as I have no idea about your case or history, but if you stop the medication all the benefits disappear within a year.

With regard to the shock loss you experienced following your procedure, this is highly unusual in patients that are taking Propecia. I would have to know more about you, examine you, and understand just what happened and when.

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In the News – Other Doctors Starting to Warn About NeoGraft – Hair Loss Information – Balding Blog

Snippet from the article:

Hair transplant experts are excited about a new technology called NeoGraft that restores lost hair.

But they warn that a never-ending series of bad hair days could be the outcome for patients who turn to NeoGraft clinics run by poorly trained doctors and technicians.

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NeograftRead the full text — Bad hair forever? Experts: It’s possible

A little over 3 months ago, I posted my concerns about the NeoGraft hair transplantation tool and the fact that it was being marketed to surgeons that had no experience doing hair transplants. Well, now it seems others are finally speaking out.

I have personally tried to get to the company to observe the system in action, but my requests have been ignored by them. Considering that I hold many patents in this field and am a real expert on automation, their disinterest tells me that they don’t want to be observed in action. I would, of course, remain objective and if it is all that it is hyped to be, I would probably want to buy one… but that does not seem to be happening any time soon.

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Small Bumps on Scalp After Hair Transplant? – Hair Loss Information – Balding Blog

Dear Dr.,
I had a HT about a year ago utilizing the strip to micro graft method and I noticed that I have small bumps resembling chicken skin from where the hair is anchored. When this occurs from the old hair plug method it’s referred to as cobble-stones and surgery and/or camoflouging tends to help but what about when the hairs are single grafts? Do these bumps go away over time? Is laser surgery or some other cosmetic method suitable? I like the hair I have just not the rough scalp.

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I have heard complaints about bumps around the grafts after a hair transplant surgery, but frankly I have not seen them in my practice. The classic cobblestone appearance of the large, older “hair plugs” did form many skin abnormalities, and even the types of transplants done today could produce bumps if the instrument used is too large.

Bumps like you describe likely can not be repaired, but they can be camouflaged with a good hair transplant around them. Have you talked to your surgeon to find out why your result came with these bumps?

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Using Mesotherapy in Treating Hair Loss? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

First of all I want to congratulate for the beautiful book you have written (Hair Loss & Replacement for Dummies). I am a practicing dermatologist and am also working with a well known hair transplant surgeon in Hyderabad, India. I have a query regarding the benefits of mesotherapy. Where in the drugs include minoxidil, biotin, dexpanthenol and bilobine, since the drug is injected into the mesoderm where as the follicle is in mid dermis, are we justified in giving this treatment to the needy in the hope of achieving results? Since you are a pioneer in hair restoration i would be greatful to have you throw some light in this regard and clear my doubt.

Thanking you in anticipation.

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I’ve speculated about mesotherapy before, and I still don’t know much about possible benefits, if any, to give you an opinion. On random occasions, I have seen patients who have had these treatments, and Dr. Jae Pak has also visited the NHI office in Korea where it seems to be popular adjunct (as a culture).

That being said, there are no definitive or enthusiastic findings about mesotherapy as a hair loss treatment that I am aware of.

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Why So Adamant About 1mg Finasteride Daily? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

Dr. Jerry Cooley in North Carolina has said that taking Propecia three times a week is a practical dosage, and that most of his patients are on that dosage with good results. I’ve read a lot of your responses about reducing Propecia dosage and you are very adamant about the 1 mg/1 pill a day dosage and not any less.

I don’t want to put you in a tough position but in all fairness, it seems quite reasonable to think that Dr. Cooley is making a valid point. Why not jump on the wagon and start advocating the same thing? The more and more I think about it, the more and more it seems like Merck has got you secretly locked in to a deal with them. Frankly, Dr Cooley has made a believer out of me. Even my doctor in Korea has me on Propecia four times a week and he told me that three times a week is also good. I have some minor side effects, not of the sexual nature but for me it’s the dark circles. I’m curious to see if going on 3mg a week EOD will help get rid of my problem. And if so, would you care to know about it?

Here is the link to what I read: Regrowhair.com

Thank you kindly

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Tin foil hatDear conspiracy theorists all over the internet:

I advise and treat my patients based on standard medical practices and recommendations. I have no loyalties to Merck, other drug companies, or bandwagons. In fact, Merck probably does not like me so much, because I have no problem telling patients and readers of this site about the generic finasteride that ends up costing about $70 a year, instead of $90 a month for the name brand.

Our goal here on BaldingBlog, as well as in our private practice, is to empower patients with education. If you search enough through this site, you can see that we have been pretty consistent with this over the years.

Last time I checked, the standard recommended dose of finasteride for treating androgenic alopecia is 1mg a day. I realize some doctors prescribe different doses to their patients and rightfully so (because they have a medical license to treat their patients). I also realize there have been studies that support taking less than 1mg finasteride a day. In fact, some of my patients do take less than 1mg of finasteride a day… and *gasp* some of my patients take more than 1mg of finasteride a day. Each patient is unique and with different circumstances.

In general for most of my patients, I prescribe 1mg finasteride a day because as I said, that is the general recommended dose for androgenic alopecia supported by research.

Anyone interested in treating their hair loss needs to see their doctor, discuss treatment options and dosing of medications, and go by what their doctor recommends. I am only here on this site to give general information, not medical advice. You have every right to agree or disagree with my views, but this is my site and these are my views.

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Does Dr Rassman Use Styling Gel? – Hair Loss Information – Balding Blog

Hello Dr Rassman,
Just some curious questions about yourself… what brand name shampoo do you use and how often do you wash your hair? Do you take propecia? Gel for styling? Have you ever had a hair transplant? Just wanted to know how the “Master of Hair” keeps its hair.

Thanks

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Lightning handsI think “Master of Hair” sounds more like someone that can make hair grow by shooting lightning from his hands, but I appreciate the compliment nonetheless. As for my hair history:

Shampoo: I use a series of shampoos, but I don’t focus on any brand in particular.

Propecia: I don’t take it anymore, but I explain that in this post.

Gel: Recently, when I had my hair cut a little shorter than normal I found it was more difficult to manage, so I occasionally used styling gels.

Hair transplant: My entire crown was bald and I received 1600 grafts to fill it in (see this post for a photo and more complete description).

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If I Look Like My Uncle, Will I Have His Hairline Too? – Hair Loss Information – Balding Blog

My uncle on my mother’s side is completley bald and they say that I have the same facial Features as him and the hair texture was exactly like mine, does that mean that I am going to be bald too at the age of 23 ?? I have very thick hair like him

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NW7The facial features and hair characteristics are not necessarily related. If you are having his balding pattern, you need to match your age of the start of your hair loss with his. If they match year for year, then you might take after him.

Usually, the very bald Norwood Class 7 pattern patients have considerable changes by the age of 23. You need to have your scalp and hair mapped out for miniaturization and from that, you might be able to project future hair loss, but at 23 years old, it is not a 100% rule.

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In the News – Bald Men Were Banned from Entering a Chinese City – Hair Loss Information – Balding Blog

Snippet from the article:

No bald menThe rule imposed by the southern Chinese city of Xiamen barred bald people from applying for one-year multiple-entry permits, the type usually used by frequent business travellers.

Chinese authorities imposed the ban over fears that “it was easier for bald people to disguise themselves”, according to a report in the Taipei-based Liberty Times, which cited unnamed travel agents.

But earlier this year, the city cancelled the ban.

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Full story at Telegraph UK — China cancels visa restriction on bald Taiwanese visitors

Hilariously ridiculous, discriminatory, and controversial!

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Did Propecia Make Me Irritable? – Hair Loss Information – Balding Blog

Doc..I am a pharmacist..37 y/o male..I was started on propecia approx 2 weeks ago and noticed that I have become moody and irritable. do your patients complain of similar sx? is this common? does it resolve or should i consider stopping? thanks

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PharmacistYou are a pharmacist, so your post-graduate training has been the study of drugs. You do not need me to tell you about side effects and how Propecia works. In fact, you are one of the rare few that can read the entire drug profile insert that came with the medication and actually understand it!

If you are asking me if I have personally seen anyone with your complaints at my private practice, I would say yes, on rare occasions people have discussed personality changes with me and mood swings. This is not a common complaint, and I don’t have information about whether it goes away or not. If you do enough research on the Internet to see if people have complained about your possible symptoms, I am sure you will find it.

I have come across a Neuroendocrine Physician, Dr. Alan Jacobs, and he wrote an interesting blog post on his site that you may wish to read.