Month: October 2012

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Does Grapefruit Extract Affect Propecia? – Hair Loss Information – Balding Blog

hello dr

i want to ask you about this fat burner as it has grapefruit extract. does this product accelerate hair loss or affect propecia effects?

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Grapefruit is problematic with many medications due to the way it metabolizes, and I’d expect grapefruit extract would be similar. In simple terms grapefruit can compete with the metabolism of many drugs including Propecia so you may end up with higher levels of Propecia in your blood stream. This is not necessarily good. If possible I would NOT take grapefruit and Propecia at the same time.

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Hair Loss InformationIs There More DUPA Today or Are People Just More Aware of It? – Hair Loss Information – Balding Blog

Is there an influx in people with diffuse unpatterned alopecia nowadays or is the internet just making people more aware of this sort of hair loss?

I’ve been using the internet for the past 7 years and initially information about DUPA was scarce, in fact your website was the first place I ever saw a mention of it. and now you can find hundreds of topics from all over the web talking about DUPA.

when did you personally start noticing this type of hair loss?

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When we wrote about DUPA in the medical literature back in 1995 (PDF here), the diagnosis required that the physician look at the donor area with high power magnification.

With my invention of the hair densitometer with patent issued in 1994 (U.S. Patent 5,331,472 – Method and Apparatus for Measuring Hair Density July, 1994) the ability to look at the donor area was made feasible. It took quite a few years and constant physician education by myself and Dr. Bernstein to show the importance of this diagnosis. Doctors who had hair transplant failures discovered DUPA and then began to be a big fan of doing the high powered examination to avoid tackling such patients with surgical procedures.

To answer your question, education takes time and the doctors slowly began including the diagnosis in the range of possibilities in patients. As a result, more and more emphasis of this technology was brought to the public. The internet and this site also probably helped get the word out.

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I Lowered My Finasteride Dosage and Saw a Decrease in Shedding – Hair Loss Information – Balding Blog

Can cutting back on Fin have better results for some that don’t respond well?

I have recently decided to lower my dose of Fin. Since cutting back I have seen a large decrease in the daily hair shedding. I have been on 1.25 mg Fin for about 2 years now since I have been taking and my hair has continued to slowly get worse. It never really increased in density at all. I simply believe that I may be a non-responder.Now that I have been on .625mg, I believe that my daily loss has decreased as while after I dry my hair in the shower I do not see bunches of hair just falling out like I normally do.

My question is that, if someone is one of theses so called non-responders, could cutting back or even getting off of Fin actually help with the hair loss or will I soon see an large increase in the shedding due to my lowering the dose?

Thank you in advance

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I do not know if lowering your normal finasteride dose will DECREASE shedding. It does not seem to correlate. You must also consider that your hair loss rate may not be consistent or at a constant rate, and the change in dose may be coincidental. Your perception of shedding may be just that — a perception and not a definitive fact. Without microscopic examination or bulk analysis (objective measurements), it is difficult to tell.

I do not know how lowering your dose will affect hair loss over time. I guess only time will tell. You should talk to your doctor about changing the dose.

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Hair Loss InformationTraction Alopecia from Tight Eyeglasses? – Hair Loss Information – Balding Blog

Hello,

from 2010 until September 2011 I was wearing eyeglasses that were too tight, and I suppose the tightly fitted frames lead to a pressure-induced alopecia at both lateral scalp sides, decreasing the blood flow passing through the external carotid artery. I have attached a photo which shows the right side of my scalp, and which shows the reduced hair density.

Is this due to an ischemic process? How do I know if the alopecia is scarring and if this process is reversible? Up until now the hair hasn’t regrown. Thanks a lot

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I would think that it is almost impossible to reduce the blood supply enough in that area to produce ischemic changes. The fact that your hair is thin there could be the result of constant rubbing of your eyeglasses if they are as tight as you seem to think. Get glasses that don’t rub and see what happens. Give it 6 months to see if it improves.

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My Scalp Itches Like Something is Crawling On My Skin – Hair Loss Information – Balding Blog

I suffer from a very itchy scalp and hair loss. It feels like i have something crawling on my skin but i don’t. i do get spots as well which itch and scab over. i also have an underactive thyroid. Please help

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This could be a variety of things, from allergy to fungus to lice to other diseases. You should meet with a dermatologist who can give you an answer to why your scalp is itchy and why you’re getting scabs on your scalp.

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Hair Loss InformationMy Doctor Prescribed Nandrolone Decanoate to Treat My Hair Loss – Hair Loss Information – Balding Blog

Hi Doc,

I am 27 years old and I am suffering from MPB.My doctor prescribed me nandrolone decanoate and minoxidil 5% 2x application which worked well for 2-3 years but seems like its not working anymore for me. I am planning for making a switch on dutasteride 0.5 MG/day.

I would like to know if nandrolone decanoate really helps in treating hair loss. Nandrolone decanoate and dutasteride can be used at a same time?

Please provide some information on this.

Thank you.

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Nandrolone decanoate is an anabolic steroid and is not used or approved by the FDA for treating male pattern baldness (MPB). Anabolic steroids would likely accelerate your hair loss.

Dutasteride is not FDA approved for treating MPB, and I’ve written about the medication before many times. Some people are prescribed dutasteride (Avodart) off-label, but the proper dosage for treating hair loss isn’t clear. The only FDA approved oral medication for treating this is Propecia (1mg finasteride).

What you are doing and your treatment seem unorthodox. Please follow up with your doctor, address these issues, and get a clear explanation.

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I’m Having a Face Lift Done Soon – Can I Save the Sideburns to Transplant to My Eyebrows? – Hair Loss Information – Balding Blog

I am going to have a face/neck lift in the next few months. The skin on which my sideburns are will be cut out as part of the procedure. I wonder whether I could use those hairs to fill up my eyebrows? Could they be ‘saved’ by the surgeon temporarily for the hair surgeon?

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Face lift and hair transplant can be done with the extra hairs harvested from the face lift surgery. But it needs to be coordinated by a hair transplant doctor and be done on the same day.

So technically yes, the hairs could be transplanted to your eyebrows… but both procedures need to be organized so that the grafts are not kept out of the body for too long.

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Hair Loss InformationFUE Transection – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

One of your patients just checking in to say hi and ask a simple question:

Its been 10 years since your famous article on FUE (you link it frequently on this site)

How have your transection rates improved since then?

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Back when we originally defined this procedure and published it in a peer reviewed journal (see here), we classified patients in 5 different categories defining the difficulty in doing FUE and the transection rate. These groups still apply and there are occasional patients (under 10%) who are still not good candidates for FUE. In other words, the human physiology has not changed over time.

Some patients may NEVER be good FUE candidates. We still strive for improvements, and with Dr. Pak’s engineering and clinical background we have changed our technique with a much better instrument that we pioneered to minimize transection. We recently received a patent on this instrument. When we made the breakthrough years ago, we called it the FUE2. This technology combines injecting fluid into the wound around the punch simultaneous with the extraction. The actual instrument has an injection needle welded to it. This has allowed us to decrease our transection rate in most of the patients years ago that we called “FOX negative”. The instrument design also allows us speed in the extraction process. Thanks to these innovations, the procedure is more practical, more efficient, and just plain better than most other instruments available (at least in our hands). Note the quality of the grafts in this link. The grafts are beautiful shaped and clearly show no transection.

Transection rates of under 10% should be the norm and when the transection rates go up above this number, we address with each patient who is impacted by a less efficient process. We still occasionally perform our infamous FOX test, which is essentially a test of up to 10 grafts extracted and the transection rate examined in this test group so we can anticipate the transection rates in advance. Unfortunately, not many doctors offer this test and the world continues to believe FUE is the best way to go about surgery (without taking transection into the equation).

Worse still, many doctors may misrepresent their transection rates and claim numbers that are unrealistic in their hands, but for marketing reasons they make claims suggesting they are as good as the best doctors out there. I know of a few doctors that live in an illusion which reflects technical skills that are way beyond their reach… and we see their patients frequently in the office for a second opinion.

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My Doctor Prescribed Me Avodart When I Expected Propecia – Hair Loss Information – Balding Blog

Hi Doctor William Rassman. I was on a forum called hairloss talk, asking a question regarding my situation, and most of the users there told me to email and ask Doctor Rassman, as you are very prominent and reputable in hair restoration.

I recently visited my dermatologist regarding my hairloss, and after checking my hair he said I am showing signs of AGA, and said if I don’t treat it it will progress. From my research on the net, I figured he will put me on propecia. In fact he put me on avodart. When I told him its not fda approved for hairloss, and propecia is he said avodart is better and brings DHT down more, and propecia is nothing next to avodart. He told me to take it everyday for 2 weeks, then every other day from then on as it has a long half life. From researching on the net, many hair restoration doctors, rarely prescribe avodart for hairloss due to some dangers. whats your opinion on this?

I would love to come see you, but I live in Canada. do you think I should go see another doctor and get propecia? do you prescribe avodart to your patients? or propecia? in fact is avodart that much better than propecia?

Thanks doc, I would really appreciate a reply on your opinion. I know medical advice is not given over the net, but I just want your master opinion.

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Propecia (finasteride) is still the right drug of choice in this situation mainly due to the FDA approval, and the lower side effect frequency than Avodart (dutasteride). I have prescribed Avodart in select cases before, but usually only to poor responders to Propecia.

I don’t know where the dosage info your doctor came up with comes from (14 days of daily use, then every other day), as the dosage for hair loss treatment hasn’t been clearly defined. Avodart does have a long half life, so if you do experience side effects they will take much longer than Propecia would to leave your system. If you’re concerned about the prescription your doctor gave you, you can talk to another doctor for a second opinion.