August 2012 – Page 4 – Balding Blog

August 22, 2012

Should I Bother with Medication If I’m Only Experiencing Corner Recession? – Hair Loss Information – Balding Blog

Dr. Rassmann:

My corners appear to be receding, but I don’t seem to have hair loss anywhere else.

I know you’ve said that Propecia and Rogaine’s effectiveness is limited to the crown and the top area of the scalp. But I don’t seem have any miniaturization in those areas.

Should I even bother exploring treatment with Rogaine or Propecia if I’m experiencing only corner recession?

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The best results from these medications are seen in the crown / top, but there are definitely cases with visible regrowth in the hairline. I wouldn’t suggest that it is likely for most men to see that type of result, though. In other words, it’s rare for decent hairline regrowth to be seen… but not impossible.

August 21, 2012

Do Actors Get Their Hairlines Transplanted Back to Juvenile Levels? – Hair Loss Information – Balding Blog

Is it common for actors coming to you and your contemporaries to ask to have their juvenile hairline back? Do you do agree with this procedure and can it be made to look natural? (I’m assuming a movie star would need a completely natural look).

Thanks!

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Many men want their juvenile hairlines back. They do not have to be actors. The relevant point is whether they are mentally and psychologically prepared to have a juvenile hairline for the rest of their lives. There have been actors that requested this, but so do some men of many different professions.

If you are 21 years old with early balding, you would not know where your hair loss will end up, but I understand that such a young man would remember very well where his hairline may have been just a few years before. For this and other reasons, most of the time I advise against putting back the juvenile hairline. But there are patients that insist and are fully accepting to the permanence of a juvenile hairline.

If I am comfortable that the patient will not develop an advanced hair loss pattern (higher than a Norwood Class 5) and I’ve estimated that the donor supply is adequate to follow the worst case pattern that the patient might develop (my opinion), I would consider creating a juvenile hairline on the patient. It’s really a case by case scenario, though.

August 21, 2012

I’m 17 Years Old And Wonder If My Hairline Will Get Worse (with Photo) – Hair Loss Information – Balding Blog

Hi Doc,

I am 17 and I have been very anxious recently about a receding hairline and I am wondering if it will get any worse.

I have what appears to be a NW2 hairline with very fine thin hairs around the corners of the hairline which have receded. My hair is already very thin and fine and when I was younger the corner of my hairline where blonde as opposed to my dark brown hair which I’m unsure if that has any significance. Thanks.

Is there a chance I am not balding or will I see more hair loss in the future?

Link: Photo

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It is clear from the picture, your age, and your concern that you need to see a good doctor to help you. At 17 years old with what appears to be a Norwood Class 3 balding pattern, it is a concern to me as well. It’s possible you won’t lose more hair, but there’s no way for me to know that just based on a hairline photo. You need to have an examination.

Since you indicated you’re in the UK, Dr. Bessam Farjo has offices in London and Manchester and I would suggest that you contact him, as he is local. You should also get a parent involved.

August 21, 2012

Does Early Success with Propecia Give Any Indication on the Future? – Hair Loss Information – Balding Blog

Doc,

Thanks for the great blog.

I started taking Propecia about 7 months ago at age 21 and have had great results. I’ve had some regrowth even at my hairline.

Is early success any indication of future effectiveness/longevity? I’m trying to gauge how much time I can expect Propecia to hold off baldness. Have you found any sort of correlation with your patients?

Thank you.

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It appears that people who had a good response to finasteride early do get better long term results. Like I’ve said before, I’ve had patients on this medication for over a decade with continued great results. I won’t be able to know what kind of time frame of success you’ll have, though.

If you’ve had regrowth at the hairline, that is fairly rare, but exciting!

August 21, 2012

Would a Doctor Prescribe Finasteride to Maintain a NW1 Hairline? – Balding Blog

Dr. Rassman,

It seems there are a lot of young men frequenting your site, myself included, that are concerned about hair loss.

My questions is how much recession from a juvenile hair line must occur before hair loss can be diagnosed and a treatment can be issued.

Would a responsible doctor issue finasteride to maintain a Norwood 1 hairline?

Finasteride does not usually bring back frontal hairlines and I do not prescribe it to men who are not balding. Norwood 1 or 2 patterns are not considered balding.

August 20, 2012

In the News – Baldness Cure is 2 Years Away? – Hair Loss Information – Balding Blog

Snippet from the article:

They are already talking with pharmaceutical firms about making the product, which would work by stopping the effects of a single guilty enzyme.

US-based dermatologists announced earlier this year that they had found that an enzyme, called prostaglandin D2 (PGD2), instructed follicles to stop producing hair. They identified it by screening 250 genes implicated in hair loss.

George Cotsarelis, head of dermatology at Pennsylvania University, said the one responsible for levels of PGD2 played “the major role”. He said he was now talking with several drugs firms about creating the anti-baldness product.

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Read the rest – Baldness cure could be on shelves in two years

Two years seems like a bit of a stretch, considering there is no actual product yet… but the media is easily excited about hair loss “cures” as anyone that has been waiting for new treatments has surely seen. Apparently this new hype is based on a study of 17 people, but I don’t know where this idea came from about a proven safe and effective product being available by 2014. Whether or not PGD2 will be the next great hair loss treatment, there’s a lot of work that needs to be done first.

Just to sum this article up — apparently we went from a small study on PGD2, all the way to the miracle hair loss “cure” being on the shelves in a couple years even though there is no product just yet. I’ll believe it when I see it.

August 20, 2012

Hair Loss InformationI’m Shedding Hair Months After Taking an Oral Corticosteroid for Breathing Problems – Hair Loss Information – Balding Blog

Hello Dr,

I was prescribed an 8 day cycle of an oral corticosteroid containing 20mg of prednisolone to treat a mild breathing problem. 2 or 3 days after the treatment ended, a massive hair shed started along with acne and seborrheic dermatitis all over face and back. I used to loose around 10 strands of hair when showering and this number raised to more than 80 after the treatment.

3 months have passed and my hair hair is still shedding. My hairline receded more in these 3 months than the whole last year (I have been diagnosed with MPB 1 and a half years ago and been taking finasteride for a couple of months now).

What happened after I took the corticosteroid, will this shed ever stop? I’ve been to several doctors and no one believes me or gives me a reasonable explanation, I am kind of lost. What can I do to regulate my body back to normal and stop the shedding? The hair I lost is gone for good?

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I have a hard time believing that you can’t get straight answers from doctors, particularly the doctor that prescribed you the corticosteroid. There is a well known connection between exogenous steroids and hair loss where the drug triggers genetic predispositions to balding. I can not tell you how long this might go on, as this is an individual genetic issue in each case.

August 20, 2012

Cyberchondriacs Trust Online Forums More Than Medical Professionals – Hair Loss Information – Balding Blog

In a recent comment on the blog, a reader brought up a term I wasn’t familiar with — cyberchondria — which is when a person will escalate their concerns about symptoms based on what they’ve read online. It seems like half the questions this blog gets are from cyberchondriacs, or rather, people who tend to play armchair doctor or fantasy biochemist when it comes to medicine and disease.

Have you noticed an increase in know-it-alls coming into your practice in recent years? It’s always good to educate yourself, but are we starting to get to a point where a doctor is just someone we need to see in order to get a prescription for something that we’ve already diagnosed ourselves with?

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That is a good point. “Cyberchondria” is not only limited to BaldingBlog. With the rise of the Internet, doctors battle with patients that diagnose themselves on a day to day basis. Of course it is good to educate yourself, but I would think hypochondriacs and/or cyberchondriacs make for a formidable nightmare for a lot of doctors.

August 17, 2012

Hair Loss InformationCan It Take 6 Years Before Propecia Side Effects Show Up? – Hair Loss Information – Balding Blog

I started using Propecia when I was 27 and I am now 43. I didn’t really notice any side effects until I was 33. I started having erectile difficulties then which are offset by daily Cialis use. The difficulties were loss of erection during sex and reduced ejaculate. Is it possible that it took 6 years for the sexual side effects to kick in from Propecia?

The drug has definitely helped me prevent hair loss and I would like to keep taking it but I have also dealt with some anxiety and depression issues over the last few years.

The basic question is: Can it take that long( 6 years) for side effects to show up?

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You need to see a medical doctor and have a physical exam. Many men in their 40s or even 30s have erectile dysfunction (ED) without ever taking Propecia. It’s just that they do not openly talk about it. You might also have undiagnosed medical conditions (diabetes, high blood pressure, high cholesterol, obesity, etc) that can cause ED. Or you can be taking other medications (blood pressure, anti-depressants) or drugs (marijuana, cocaine, etc) that may be causing the ED. Maybe you smoke cigarettes or you drink alcohol. I don’t know enough about you and since you’re not my patient, I’m just taking wild guesses here as to possible causes.

I suppose it is possible that after 6 years in a healthy man with none of the things discussed above, some sexual side effects may develop over time. That being said, it is more likely that if you were going to have side effects from Propecia, they would appear within the first few weeks.

I’ve written about this before here.

August 17, 2012

Hair Loss InformationCan You Get More Grafts from Strip or FUE Over a Lifetime? – Hair Loss Information – Balding Blog

Many thanks doctors for providing help to all of us!! Your blog is very interesting.

How many grafts it is possible to extract from a caucasian male with an average donor supply over the course of his life? Does it make a difference whether it is a FUE or strip? 9,000?

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This is a debate among many hair transplant doctors themselves. In my opinion, you would get the most number of grafts and hairs with the strip procedure over a lifetime to make an overall cosmetic difference. FUE (follicular unit extraction) grafts can sometimes have less hairs per graft than those harvested using the strip method. So over a lifetime FUE grafts may produce less coverage.

For maximum harvest in a theoretical scenario, you would maximize the grafts with the strip then use the FUE method when the donor area is more limited.