Month: March 2013

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Hair Loss InformationCould Fasting 2 Days a Week Slow Down the Pace of Hair Loss? – Hair Loss Information – Balding Blog

Dear Dr

There has been a lot of interest in the UK about intermittent fasting where an individual eats normally for 5 days a week and then fasts for two (not on consecutive days). There was a BBC horizon programme where it was shown to reduce IGH-1 (growth hormone) and improve insulin sensitivity. It is claimed that when a body goes into fasting mode the body starts to repair itself better by repairing cells rather than producing more cells. It was suggested that this may be beneficial to age related diseases, cancer etc.

Do you think this would slow down the pace of hairloss if insulin sensitivity improved and/or IGH-1 was reduced? Has research been done on this approach? Your thoughts would be appreciated

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Genetic hair loss is not a disease. Balding is a genetic trait, like your height, body build, hair color, the way you look, etc. Even if this ‘fasting’ has value (which I would doubt), it will not change your genetics. Significant fasting can actually accelerate hair loss. You are what you are and although your patterned balding can be modified with drugs or transplants, your balding pattern is fixed in your genetics.

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Will Cloning or a New Drug Be the Next Treatment for Hair Loss? – Hair Loss Information – Balding Blog

Hello Dr

Are there or have you heard of any new potential treatments for hair loss that we might likely see in the next 5 years or so? There doesn’t really seem to be anything new since the discovery of propecia and that was some time ago. In your opinion will it be hair cloning or some form of drug if there is anything on the horizon

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There is a lot of activity with clinical trials going on, but we are not privy to them. We, like you, wait to see which treatments rise to the top. I couldn’t say whether cloning or a new drug will be first to rise, though. It all depends on the ongoing research and development.

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If Testosterone Peaks In My 20s, Why Am I Now Losing Hair at 40? – Hair Loss Information – Balding Blog

My question is about the link between DHT, testosterone, aging and hair loss.

If DHT levels are related to testosterone levels, and testosterone peaks at about age 18-22, how do we explain a hairline that does not even begin to recede until age 40? Does DHT increase with age? Do follicles become more sensitive to DHT with age? Is hair loss that begins at an older age caused by something other than DHT?

I will be turning 40. Up until about 1.5 years ago, my hair was very full – no signs of loss at all. Since then, it has gradually receded above the temples and it feels a little thinner on top. I’m not interested in Rogaine or Propecia, but I would like to understand what’s happening.

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If you are losing hair (in a pattern), you probably have genetic balding. It generally happens in the early 20’s to the 30’s, but there are always exceptions to the rule (and it can happen in your 40’s and 50’s). In my opinion, it does not have to correlate with the levels of DHT, because it is programmed in your genes… and your genes will express your balding pattern as it was programmed to do. You can have very high levels of DHT and never go bald if you do not have the genes. Or you can have very low levels of DHT and still go bald because you do have the genes.

In the end, the best treatment for genetic balding in men is finasteride tablets daily to slow or stop the loss as long as possible (for those men with the genes for balding, so that DHT can be minimized). If you are not interested in the medical option (Rogaine/Propecia), then the surgical option would be hair transplants to address the corner recession.

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What is the “Leading Edge” of the Hairline? – Hair Loss Information – Balding Blog

Hello Dr,

First I would like to thank you for writing this blog which has been very helpful to me. I was wondering what exactly you are referring to when you mention the “leading edge” of the hairline? Is that the center of the hairline just above the furrowed brow or does it include the whole “edge” of the hairline? Also I was wondering if it is possible that the hair thinning at my temples is just a sign of a developing mature hairline? Thank you!

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If you believe you are losing hair on your temple area, you may have a component of genetic balding. I am not sure that dicing out the semantics of descriptive terms will help in diagnosing a condition. Leading edge just means the frontal edge of your hairline.

Send us pictures and with your eyebrows lifted enough that you crease the forehead and we (as well as the readers) can comments on your hairline location and appearance. Your question and pictures would probably be more suited for BaldingForum.com.

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Could Alopecia Areata Evolve to Totalis or DUPA? – Hair Loss Information – Balding Blog

I have been recently diagnosed with alopecia areata (one spot) and have had several HT session in the past. Recently been under a lot of work related stress. and my hair has been thinning all over event in the safe zone (I am 48 Years old). And the back of my scalp has a see thru appearance. So I am wondering if this is diffuse alopecia areata that could evolve to alopecia totalis or DUPA since my donor area is very thin?

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Anything is possible, but not probable. Alopecia areata without any treatment often will resolve over time (which can take up to one year).

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I See Redness Above and Below My Strip Scar from 20 Years Ago (with Photo) – Hair Loss Information – Balding Blog

Dear Doctor Rassman,

First of all, thank you for your blog, it’s a huge source of information. I had a hair transplant over 20 years ago. It has not given me the result I was (naively) looking for. This is why I want to shave my head with a no guards clippers. Then I am looking to fill my scar with SMP to hide it. I took photos today as part of the consultation but I noticed I have small squares of reddened skin above and below the scar. Do you have an idea what this could be and would you have any advice to maybe soften it? You have my permission to use my photo.

Thanks and all the best

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And thank you for allowing us to publish your photo here. Click to enlarge:

 

We routinely perform Scalp Micropigmentation (SMP) at our office on a daily basis for the type of scars you have. In fact, most scars we see are worse than the one you show. I’m not sure why you’d still see any redness around the scar if you had your surgery two decades ago, though. A topical hydrocortisone might reduce the redness, but you should talk to your dermatologist about this.

If you would like more information on having SMP done, you can call our office at (310) 553-9113 or (800) NEW-HAIR for a consultation with a doctor. And for those interested in seeing a before/after example of SMP done over a strip scar, here’s one such patient:

SMP

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Hair Loss InformationIs Taking Two Propecia Pills Dangerous? – Hair Loss Information – Balding Blog

Sometimes I take Propecia right when I wake up, other times I take it at the end of my morning routine (shower, shave, etc). There have been times where I might’ve taken two tablets in the same morning, since I had forgotten whether I took it already. That has made me wonder, is taking two tablets of Propecia in one day dangerous? I try not to do it on purpose, but I figured it was better to have two tablets than no tablet.

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Taking two Propecia (finasteride 1mg) tablets by mistake is not dangerous. Some men take five times the Propecia dose for prostate conditions (5mg finasteride is Proscar).

You should NOT be taking more on purpose, because it will not do much with respect to hair loss/growth. One Propecia taken daily is the recommended dose for the treatment of male pattern baldness. If you happen to take two by mistake, you’re not likely to see problems… but it should be noted that the more drug you take over the recommended does, the higher incidence of sexual and other side effects.

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Hair Loss InformationI Wore a Bandana for 2 Hours a Day and Now My Hair Is Thinner! – Hair Loss Information – Balding Blog

hello doctor,
i wore a bandana everyday for 2 hrs at the gym for about 3 months. i just was not comfortable wearing something so tight on my head so i stopped and haven’t worn it since. 6 months later i feel like i am loosing strands of my hair when i wash it and that my hair at the front of my head has gotten thinner than it used to be. is it possible that wearing a bandana for such a short period can result in hair damage?? If so, what can i do to fix this? thanks!

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Wearing bandanas or hats (even all day) does not cause male pattern baldness. Unless you are wearing something that is very tight so that it is constantly causing friction and traction to your hair, it would not matter. If the hair loss was caused by the tight pulling, we call it traction alopecia. In your case though, I would highly doubt that what you’re seeing is related to your limited bandana use.

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Hair Loss InformationI Haven’t Had Any Libido Effects, but I Think Finasteride Is Making Me Lethargic – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

Had yet another question about finasteride. I have been using it for a year now, and am quite sure have not progressed (with hairloss) any further, so it has worked quite well in that regard.

Question is this. In your practice have you heard or seen reports from patients who complained of severe tiredness, lethargy due to the use of this medication. Strange thing is that the horror stories they talk about in regards to libido etc. I have not experienced any of those in these 12 months (fingers crosses), in fact I feel I have a higher libido…its strange

The one side effect I feel I am noticing, is this nagging feeling of tiredness lethargy, and a blue sort of mood. I wouldnt say its depression its just an alteration of mood. Its quite annoying, and then you see these reports about suicidal ideation with finasterdie usage … worries me. Just dont know what to do, the pill is doing really good for my hair, but these side effects are quite annoying. Nothing sexual, thats all great, but just a strange nagging feeling of tiredness, lethargy and depressive moods. Comes and goes. And this doesnt seem to be in my head, since I am not going through something too major in my life, or a very stressful time.

Anyways I will definetely discuss this with my doctor, but just wanted to know what your opinion on the above matter is, and if in fact you hear such reports from your own patients…thanks in advance

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You have the right idea about discussing this with your doctor. There have been reports where patients (mostly from websites) refer to “fogginess” and symptoms like depression in people on finasteride. In my private practice over the last 10 years with thousands of patients on Propecia (finasteride), including myself and my son, the complaints of mood alteration is probably around 10 people. The complaints of sexual issues in my experience has been around 1 to 2 percent, which correlate with the reported incidence.

It is also interesting to note from my experience, that for those who have been very worried (scared) to take Propecia due to all the materials they have found on the Internet, and eventually did go on to take Propecia, almost all of them ended up with the negative side effect. I do not mean to discount any real and physical conditions, but there is also something to be said about the power of the mind.

Finally, I have seen many patients who were very depressed with other psychological issues, but those patients were not on Propecia / finasteride. I am not sure if there is a clear link, but it is something you need to speak to your doctor about.

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I’m In My 30s and I’ve Waited Almost 10 Years Before Finally Deciding to Treat My Hair Loss – Hair Loss Information – Balding Blog

Dr Rassman,

I’m 30 and although I have been losing hair since my early 20s, it’s only after I got my hair cut very short recently that it hit me how much I am balding (I am somewhere between Norwood 2 and 3).

Like many men, I find it very difficult to accept and it is causing me a great deal of stress. However I have decided to act on it before it’s too late, and so I am taking Propecia as of today. I am also using Rogaine foam 5% and although it seems to reduce the hairloss, I wonder if I should stop now that I’m taking Propecia.

In several of your posts, you suggest that Propecia works best for men in their 20s, and also that the number of years between the start of the hairloss and taking Propecia affects the results.

Does this mean that I should not expect great results from Propecia, being in my early 30s and having waited nearly 10 years?

Thank you for your excellent blog!

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The results will depend upon how much miniaturization you have in the remaining hair. Propecia works well for early miniaturization, which is what men in their 20s have. It still works in men of your age, providing that you have not lost the hair and are presently bald. Propecia does not work well for areas of complete balding, but on occasion, minoxidil may bring out hair were minimal hair is present. I can not advise you without seeing your photos and establishing at least a telephone consultation with me.