Month: July 2014

I’ve been using minox 5% once a day for 2 mos recently i developed constipation. Can i attribute it to minoxidil use? Do you get reports like this. Thanks

I doubt minoxidil or finasteride causes constipation. Try a fiber rich diet.

Hello. Is it possible for a man’s hairline to recede to a certain
extent, then stop receding and remain that way for the rest of his
life? For example, can the hairline recede just slightly and then
never recede any further, or will it always continue to progress into
full male pattern baldness? If it’s possible for it to recede slightly
and then stop, I’m guessing that only a small area of the scalp would
contain the genetically susceptible hair follicles, as opposed to the
large area seen in full male pattern baldness?

Men’s hair loss is mostly genetic in nature and it follows a “pattern”. That is why it is called Male Pattern Balding (MPB). You can see from the diagram where you fit in. You most likely fit into one of these “patterns” and that is it. Only 7 percent of men progress the Norwood 7 over their life time and they get their fairly young (like in the 20s).

Refer to assessing hair loss HERE

Hello Dr Rasman
hope you are doing well.
i am seeing a doctor who prescribes propecia for me. its been 3 years now am taking the drug. last time when i went to see him to prescribe the drug for me, he told me to stop using it as it may affect my future and give me erectile dysfunction, less desire for sex and maybe not getting children. i told him but am feeling fine and he said that it happens gradually and the longer you take the drug more likely the sides occur and maybe permanent. what should i do now? please i need your advice. thanks

First and foremost, I am not your doctor and I do not give personal medical advice on Baldingblog so this is not a place for you to obtain answers for your medical issues. If you do have erectile dysfunction, and you need to have that checked out as it probably has little to do with the drug. I always recommend that you ASK YOUR DOCTOR. If you have an issue, get a second opinion. This is not a place to get a second medical opinion.

Propecia does cause sexual side effects in 1 to 2 percent of men. It is reversible as far as I know from my 20+ years of experience. I realize you will read about this topic on the Internet but the ultimate factor is your decision and what your doctor recommends. I also realize doctors are human and each have their own recommendation and reasoning for treating their patients.

Finally Propecia does not cause sterility as far as I know. If you believe this may be an issue get a sperm check and consult with a urologist or a fertility doctor.

I had 3 old plug style treatments, and am in the process of having the old bullet like scars removed from the back of my scalp, and grafted into the top of my head. I had the first procedure done in October 2012, which did the front half of my scalp, and a second in Januarey 2013. The first procedures, the plugs were taken above the donor site. My last procedure, they will finish removing all the plug scars, and take out the front hairline and re-graft it into a normal hair line. The facility which I had it done at is one of the best in my state,
and said it could take up to two years for the grafts to break through the scar tissue. Is this correct information, as I have read the same thing researching different sites on scar tissue. What are for thoughts?

In general it takes 6 months to start seeing growth from a hair transplant surgery (even on the scar). It can take as long as one year to get full results. Two years is rather long and misleading to say that the grafts need to “break through” a scar. In general hair transplants to scars do not completely cover the scar adequately and do not grow at the same success as hair grafts in the front, top and crown of the head.

I often get emails for hair cloning and hair multiplication from people around the world who want to believe:

READER COMMENT 1:
Um, doc, there is a working model in place. Not just Aderans and Histogen, but Dr. Gho’s hair multiplication at HSI. Yes, say what you will about Dr. Gho’s history, but his clinic is performing daily procedures without depleting the donor — I’m not surprised that this continues to be ignored or laughed off because the procedure is patented and would render every other FUE/FUT procedure obsolete. But the truth won’t stay hidden from the wider populace forever.

MY REPLY:
I’ve already written about that HERE. Proof is in the pudding.

READER COMMENT 2:
Yes, doc, and you can eat pudding every day in their clinic if you just went over there and saw the results for yourself as I did. The donor regrows. Every day they’re doing it and they’re booked through the fall of 2011. Here’s an idea: why don’t you call them or email them and ask them to send you photo-doc proof of one of their patients as I have? Aren’t you curious? Don’t you as a peer want to reach out to them after they published a peer-reviewed article in the journal of dermatology about this procedure?

I saw Dr. Gho’s presentation at the ISHRS medical convention and read the journal article. He was doing FUE and I believe that he was splitting the follicular units in the scalp, removing a hair from the follicular unit. That would allow him to leave some hair behind and remove others producing the illusion that the hair was regrowing at the point of extraction. I would embrace what he is doing if he was actually regenerating/multiplying hairs, but as far as I could see, this was not the case. If he is splitting follicular units, I would think that telling the world that he solved the hair multiplication challenge would be less than honest. Of note the published study in 2010 was on only five individuals. After four years, I would think it would have revolutionized the world of hair transplant as we know it, if it really worked.

I read this blog entry HERE and there’s something I just don’t understand. You say that the body’s feedback loop causes raised testosterone levels in men that are taking finasteride. I thought the rise in testosterone was caused by the fact that finasteride prevents the conversion of testosterone into DHT, thus leaving more testosterone in its original form. I thought that the feedback loop DECREASES artificially raised testosterone levels caused by finasteride. You are saying the feedback loop causes a rise in testosterone on finasteride, and that makes little sense to me. Have I got this all wrong?

There are reports that serum testosterone levels rise when finasteride is used: “Finasteride treatment led to a generally modest increase relative to placebo in serum testosterone, with the greatest increases occurring in men with low baseline testosterone levels.”
Even my colleague Dr. Bernstein writes about it HERE We also wrote about it yesterday: HERE

I am aware of a couple of places in Los Angeles that claim, they offer hair cloning. Since all of the so called kinks haven’t been worked out yet, isn’t there a potential of a cell being cancer producing.

Cloning hair in Los Angeles? It would have made Time Magazine, Newsweek, New York Times, and all the major headlines if it was true. Cloning hair does not exist as of 2014 except in the hands of sleazy people. The claim is likely a marketing gimmick and it may be subject to the California Medical Board’s attention on false advertising if it is promoted by a doctor.

With regard to your question concerning cancer and hair cloning, there is a risk of cancer in some animals who were given stem cells. This produces an unknown factor with stem cells and if it ever went to human use, this question will be on the top of the FDA concerns that would have to be addressed.

Hi doctor. how are you. I have asked you questions before and you have replied to my answers, and I want to thank you for that. Keep up the good job.

Correct me if I am wrong. In this article that someone posted to you it states that finasteride lowers T levels(testosterone) as well.
here is the link: http://baldingblog.com/2010/09/13/mercks-fda-submitted-propecia-documents/

Here is my question. I thought finasteride lowers DHT and increases testosterone by about 15% or something. Does finasteride lower testosterone as well? And how would this affect building muscle and body building?

please clarify this for me doc.

Propecia slightly raises testosterone initially but eventually your hormone levels should return to normal. The reports in the literature seems to go both ways. Some reports indicate a rise in Testosterone while others show a decrease. Unless you are a biochemist/pharmacist doing research, I do not think these are significant issues. Propecia will not make you into Arnold Schwarzenegger or Urkle.

You are trying to make sense and correlate biochemical hormonal variation with clinical issues that may not be related. If you are asking your question for pure scientific purposes, I would take a course a biochemistry for a better understanding or speak to a research pharmacist/biochemist. My desire to revisit my biochemistry days and contemplate professorial issues are not really there.

I do occasionally run into men who are heavily into weight lifting and body building and use anabolic steroids. One of them was convinced that Propecia made them weaker and gave them a disadvantage. A few have insisted taking Propecia to counteract the hair loss from their anabolic steroid use and didn’t report any changes in strength or muscle mass. But these are all anecdotal (non-scientific) and subjective stories. In my humble opinion, Propecia has negligible impact on testosterone and strength. Even the professional world of sports have taken the position that it is not a performance enhancing drug.

Many readers here on Baldingblog are here to seek information for their hair loss issues. There are many who are “scared” or concerned with side effects from Propecia which can actually help with male pattern balding. The most noticeable side effect in question is the concern for erectile dysfunction or loss of libido as there are numerous Internet sites that propagate this issue.

While everyone has their right to express their opinions and I would like to assume what they are experiencing is “real” to them, I would like to caution the reader to keep in mind the big picture.

People take medication to treat something. But ALL medications have side effects! And if a medication has side effects that cause erectile dysfunction and decreased libido, then you need a doctor to manage it. Some medications that have many known side effects (which include erectile dysfunction) that are commonly used include: Paxil, Prozac (psychiatric medication), Lipitor (cholesterol medication), Metoprolol (blood pressure medication).

Many men who do not take any medication also experience sexual dysfunction as part of their aging process or as a result of some problem with penile blood flow from conditions such as vascular disease or diabetes. Sexual dysfunction may be more frequent than what we all may expect because nobody really wants to admit they have a sexual problem. After all it is a sensitive topic! Propecia (finasteride) has a sexual side effect risk of 2%.

Now if in the end one experience a real side effect from Propecia, you can always STOP taking the medication. But always discuss these issues with your doctor first! At least you tired! Because all side effects from Propecia is reversible.