February 2012 – Page 5

February 14, 2012

Hair Loss InformationAny Requirements for a First Consultation? – Hair Loss Information – Balding Blog

Dr.Rassman/Dr.Pak,
Is it possible for you to provide a step-by-step guide describing the procedure a patient would undergo during a first consultation at NHI, please – are there particular requirements a patient should consider in preparation for such a consultation (e.g. hair length, washing instructions, medical records, etc.)?
Thank you.

Block Quote

During a consultation, we get to know the patient, understand their personal issues about hair loss, and recommend possible treatments. That is it!

It’s not all that complicated, if you think about it. You come to see us because you are losing hair. We examine the hair, measure the hair density, look for any microscopic patterns which may not be obvious (miniaturization study). If your hair is long enough we can do bulk measurements. But most of the time (for men) the balding is obvious and thus the reason for the visit. So we mostly talk about options and educate the patient. We actually spend a good 30 to 45 minutes on the first consult on most patients. Some more, some less. And while we often think about charging a fee for the amount of time we spend with the patient, we decided the first consult will remain free for a while, at least.

As a final note, at NHI you see the physician (Dr. Rassman or Dr. Pak). You will never see or be screened by a sales man or an associate or any other version of a middle man. Getting a doctor’s opinion always reflects your best interest and because there is no sales personnel involved in the process, there is no motivation for commissions that will be earned for a successful sale. We encourage prospective patients to come to our Open House events which are held monthly. In this way, you will know that what you see is what you are going to get. Nothing is hidden.

February 14, 2012

Hair Loss InformationI’m Concerned About How My Hair Parts – Hair Loss Information – Balding Blog

Hey Doc,

Hope you’ve had a good new year! After my last question to you, I was pretty convinced I had nothing to worry about with my hair… however, there’s this part that concerns me.

I’ve been told that this is a natural parting, so I would just like confirmation that it is?
Link: Photo 1

This is my hair wet, which doesn’t show this ‘parting’ or whatever.
Link: Photo 2

When my hair is dry you can see a slight parting towards the top of my hair, in front of my crown.
Link: Photo 3

Does that look like a parting to you? Feel free to post any pictures again, if this question does get published.

Thanks.

Block Quote

I appreciate you allowing us to publish the photos.

If you are worried about hair loss (possibly seen in the first picture with your hair standing up), then you should come and see a doctor who can measure your hair bulk to determine if you are losing your hair. I can’t confirm if it’s just the way your hair parts, but I do notice a well combed hairstyle that does much to cover the suggestion of thinning in at least one of the pictures.

February 14, 2012

Doctor Wants to Do 3 Scalp Reductions On My Crown – Hair Loss Information – Balding Blog

whats the thoughts on scalp reduction? is it a good option a doctor wants to do 3 reductions on my crown area. is this now common practice ?

Block Quote

As the famous movie quote goes: “Run, Forrest, Run!!!”

Scalp reductions for treating androgenic alopecia (AGA) or male pattern baldness (MPB) is in my opinion horrible and NOT a common practice in modern medicine. I try to be neutral most of the time, but on this point I would strongly believe a scalp reduction is a bad idea… and three of them would be three times as bad.

February 14, 2012

I’ve Been Using Too Much Minoxidil and Have Chest Pains – Hair Loss Information – Balding Blog

I was using Minoxidil for over two years and never experienced any problems.However,lately I used it applying too much and not leaving 12hrs in between the applications.I developed side effects:chest pain and tightness.My question is how long those side effects will last and if I will be able to start using Minoxidil again?

Kind regards

Block Quote

With respect to chest pain and tightness, I would see your doctor or go immediately to your nearest emergency room. Your chest pain may not be related to a side effect, but a serious medical condition such as heart disease. While chest pain is an associated severe side effect of minoxidil use in some cases, this should be taken very seriously.

February 13, 2012

What If Merck Took Propecia Off the Market? – Hair Loss Information – Balding Blog

doctor rassman what are your thoughts on merck pulling propecias website down? there are articles all over the web.

is there a chance that propecia will be off the market? that sucks. so many of us use it with good results and no side affects

Block Quote

I’ve been sent links to articles about the Propecia site being pulled down, but the few I’ve seen were actually just cleverly disguised advertisements for a class action lawyer. We posted about that site being down a couple weeks ago.

Now I don’t know Merck’s intention (as I am not part of their inner circle), but I would be really surprised if Propecia is pulled from the market. I know there are some people beating a drum about it, but consider this — the 5mg dose of finasteride (Proscar) will always be available as a prostate treatment, so even if Propecia (1mg dose) went off the market, one could switch to 1/4 of a Proscar pill daily. Proscar has many generics in the marketplace and it is used in benign prostatic hypertrophy.

When Propecia goes off its patent protection, many manufacturers will produce the drug at the 1mg level. I realize there are already generic 1mg producers for some markets, but those pills aren’t legally sold in the US yet. When that patent expires late next year, I can’t say that Merck will continue to produce Propecia as the prices come down due to competition from the generics. But either way, finasteride will still be available.

February 13, 2012

In the News – Doctors Not Always Honest with Patients – Hair Loss Information – Balding Blog

Snippet from the article:

Trust your doctor? A survey finds that some doctors aren’t always completely honest with their patients.

More than half admitted describing someone’s prognosis in a way they knew was too rosy. Nearly 20 percent said they hadn’t fully disclosed a medical mistake for fear of being sued. And 1 in 10 of those surveyed said they’d told a patient something that wasn’t true in the past year.

The survey, by Massachusetts researchers and published in this month’s Health Affairs, doesn’t explain why, or what wasn’t true.

Block Quote

Read the rest — Study finds MDs not always honest with patients

The results are based on a survey of over 1800 doctors across the US from 2009, “to see if they agree with and follow certain standards medical professionalism issued in 2002″. In another study, doctors suggested that they color the truth with presenting issues on the seriousness of illnesses more positive than it is.

In a recent symposium I (Rassman) attended, the doctors in the audience were asked how many of them would not discuss dying with their patients. More than half raised their hands. When probed why, the doctors cited issues like (a) the time it takes to manage a dying patient is significantly more than they can allot, and (b) they are uncomfortable in dealing with death and dying.

February 13, 2012

Hair Loss InformationWhat Kind of Doctor Specializes in Hair Loss? – Hair Loss Information – Balding Blog

I know you are primarily a hair transplant specialist, but who would you recommend as someone who only specializes in hair loss? It seems most doctors a visit are more knowledable about transplants than they are with hairloss.

Block Quote

Some people see a dermatologist, but hair transplant doctors are generally the most knowledgeable when it comes to hair loss, because they specialize in hair. Just don’t get pushed into surgery, but use their expertise to help determine a treatment plan (or rather, a Master Plan).

February 10, 2012

Hair Loss Information » Understanding Catch-up Hair Loss After Stopping Finateride – Balding Blog

My question is to do with ‘catch-up hairloss’ after quitting finasteride.

If DHT gradually destroys the hair follicle and finasteride protects the follicle by reducing DHT, then why would there be such a fast ‘catch-up’ hairloss after quitting finasteride?

My thinking is, say your follicles have 3 yrs left before DHT finally destroys them. Then you go on finasteride for 5 yrs before quitting, surely your follicles would then still have 3yrs left, much like weather proofing a wooden fence?

Good thought, but finasteride does not block 100% of DHT… and DHT may not be the only factor here. More importantly, as much as your logic may seem true or make sense, in the real world catch-up hair loss from cessation of finasteride does not work that way based on many patients we have observed. We all have an internal clock, and your follicles are still on that clock (call it the apoptosis clock) so that the clock’s time advances regardless of whether you are on finasteride.

We’re just observers to a body process we barely understand.

February 10, 2012

In the News – Men with ED Should Check Their Eye Pressure – Balding Blog

Snippet from the article:

Men with erectile dysfunction (ED) have a nearly 3-fold greater risk for also having open-angle glaucoma (OAG) than men with normal erectile function, report researchers from Taiwan in an article published in the January issue of Ophthalmology.

A case–control study matching 4605 men with ED with 5 control patients each showed that after controlling for potential confounding factors, men with ED had an odds ratio (OR) for a prior diagnosis of OAG of 2.85 (95% confidence interval [CI], 2.10 – 4.07), write Shiu-Dong Chung, MD, from the Division of Urology at the Far Eastern Memorial Hospital in Taipei, Taiwan, and colleagues.

“Our findings suggest that prospective studies should be undertaken to develop the appropriate clinical guidelines for evaluating concurrent or subsequent ED in OAG patients,” they write.

Read the rest at Medscape — Do Glaucoma, Erectile Dysfunction Have a Common Cause?

This isn’t hair loss related, but I’m sure there is a percentage of this site’s readers that are interested in ED-related studies.

February 10, 2012

Calculating Baldness? – Balding Blog

Dr Pak/ Dr Rassman,

I asked you about your baldness calculator over a year ago in this post. That post referenced the original post from 2007.

Any further progress on that baldness calculator? Sorry if I am persistent but you Doctors seem to be the only ones out there challenging the status quo and giving us new options for hair loss. One can’t help but be a little curious.

By the way, have a great New Year!

The US Patent was just awarded (but not published by the USPTO yet) a couple of months ago. Now Dr. Pak and I have the challenge to think through the design and engineering issues, which is not an easy process.

Don’t hold your breath for us to complete this process quickly, as it isn’t a high priority right now. But I do appreciate your continued interest!