Month: December 2014

The relationship between young men who smoke show changes in the Y Chromosome suggesting a causal relationship between the appearance of earlier lung cancer in young men than comparable men of the same age. Lung cancer has been known to have a higher in men than women, so this relationship is important. The changes can be measured in the red blood cells of smoking men. This article was published in the prestigious journal Science.

Article: J.P. Dumanski et al., “Smoking is associated with mosaic loss of chromosome Y,” Science, doi:10.1126/science.1262092, 2014.

Hello, so I have a question that I cannot get to the bottom of. I’ve been on finasteride 1.25mg for about 14 months. Right at the one year mark I started getting a burning sensation on my left hairline area and above it ( that side had no real problems). It would come and go, but then within 2 weeks the left side of my hair/ hairline got noticeably thinner and I began shedding A LOT in the shower. It started November 1st and it is now December 7 and I still shed a litany I have lost ground on that side as well as a little I my right side to. I also have dandruff.

I went for blood work thinking maybe this is a thyroid issue causing hormonal imbalances because at the start of the burning and shedding, I noticed an increased libido. Anyway, I’m not sure if fin just stopped working after a year? I’m 23 and was thinking maybe I need dutasteride now. Any information would help greatly! Hair was doing great before this random rapid Hairloss.

The best advice I can give you here is to go see your doctor. Burning sensation on the scalp is generally not normal and likely not Propecia related. Increase in libido is something I do hear on occasion with Propecia but the decrease in libido is what is most discussed on the Internet. Finally Dutateride is not recommended for genetic hair loss and it is something I generally do not recommend.

I have a hair transplant 6 months ago, can I use a tanning salon to improve my overall look?

Tanning beds give off significant amounts of UV light which can cause skin cancer, make you look older with frequent use and damage your hair (See: HERE)

I realize many people use the tanning salon for cosmetic reasons, but it is general medical advice to avoid such exposures to UV light not only for your hair but for many other reasons as UV light cause skin cancer. It is not something I generally recommend.

I am a 26 year old women with what my doctor called Alopecia Areata and it has left me with many holes on my head. He said it may go away on its own, or it may last years. I want to know if a hair transplant will solve my problem.

Hair Transplants are contraindicated in alopecia areata because any hair that is put into the bare areas, may get rejected by the disease and even cause further hair loss. You can, of course, wear a wig as so many women do with this condition. The winner of the Miss Delaware contest had Alopecia Areata and you can see how she managed her hair HERE and: HERE

Bald is definitely beautiful.

Itraconazole inhibits the enzyme ‘CYP3A4′ and the same enzyme metabolites Finasteride.

Does it mean that Itraconazole decrease the effectiveness of Finasteride?

Many drugs and even fruits (grapefruit) can inhibit CYP3A4 but it may not have a significant clinical impact with other medications. Itraconazole from my brief Internet research seems to be a “strong” inhibitor of CYP3A4. Thus in theory it would been you will have less finasteride metabolized by the enzyme and thus have more finasteride circulating in your blood stream. How it relates clinically in treating hair loss is likely not significant since some have taken a larger than recommended dose of finasteride with no significant impact on hair. In the end, I am not a biochemist or deal with theoretical enzyme metabolism.

Hello, I was hoping you could clear up something regarding the percentage of men who go bald or experience thinning.

I’ve read that only 50% of men are bald by 50, but I’ve also heard that the American Hairloss Association did a study that found 2/3 of men are bald by 35, and 85% of men are thinning by 50. These statistics seem in conflict with each other.

Does the American Hairloss Associations study reflect the percentage in ALL men, or just American men? Websites I’ve been on are inconsistent on which one it is. If you could clarify, I’d appreciate it.

To my knowledge there isn’t a landmark study of epidemiology or the prevalence of male pattern balding in men. Male pattern balding is genetic and it follows a “pattern” as the name implies. Thus by the definition, a slight front corner recession of a Norwood 2 could be termed a mature hairline which is not “balding”. However, when most people hear the term balding they assume a full Norwood 6 or 7 type of balding. The Class 3 pattern reflect the early corner recession in a maturing hairine (see: HERE)

I often write that about 50% of men have the genetic make up to have some type of balding (Norwood 3 to 7). I often write about 7 to 8% of men are Norwood 7 (completely bald with only a 2 1/2 inch rim of hair around the back and sides of the head). It is also understood most male pattern hair loss may begin after puberty, but most men start their balding process in their teenage years to their late 20s, and by the time you are in your middle age 40-50 you would have an established pattern of balding (or no balding). You will find these numbers may be variable depending on the source as you suggested.

The American Hairloss Associations on the website claim that by the “age of thirty-five two-thirds of American men will experience some degree of appreciable hair loss (I doubt this statistic), and I believe that by the age of fifty approximately 50% of men have significantly thinning hair” not the 85% suggested by the American Hairloss Association. I do not know where these statistics come from. Furthermore the term “thinning” can also mean gradual change of the character of the hair as one ages that is not genetic balding (just more fine hair evolves). Men who never go bald will have some thinning as they age but they will not go bald or show a “patterns” of balding as depicted in the Norwood scale.

The forelock is the pancake size area of hair located in the center of the frontal area found in some family lines and are often independently genetically programed to outlive the hair of the frontal area around it. David Letterman (TV late night host) has a persistent forelock and for years, it was strong while the hair around it starts to fade away. In recent pictures of him, the forelock is now fading. His father and/or grandfather probably had a forelock as well, even if they developed advance balding.

In this picture, the man (BB) showed a strong forelock, not too deep forelock with an advanced Class 6 balding pattern (leading to a Class 7 pattern) with one transplant session of 2121 grafts. He used a comb-back to cover the large balding pattern, although some hair was put in that area to hold back the ‘comb-back’ hair style. From his after picture (just one session), he had a remarkable result because his hair was medium coarse in thickness (one hair was equal to three fine hairs from other patients). We never promise such results, but when it happens, everyone is happy. Maybe he will get around to adding another session so that his comb-back style will be more minimized. From almost every angle with his hair long, he looks great.

Hi Doc, I’ve been on propecia for 4 months now and have been shedding a lot of hair to the point where my baldness is getting more visible. I’m going to stick with the treatment for a year to see how it goes I just wanted to ask if this is normal? Also the hairs that have been shedding for the last few weeks seem to only be the miniaturized hairs on the crown and hair line, could this be a good sign that propecia is working?

Genetic male pattern balding affects each individual differently. It can happen fast or slow. It can affect the front part of the scalp or the top (as it occurs in a certain “pattern”). Drugs such as Propecia help but it is not a cure or a complete solution. Each individual responds to medication (all medication) differently. Sometimes the genetic predisposition wins out. Please follow up with your doctor as it can take about 6 to 12 months to see the effects of Propecia.

Doctor Rassman I have a question. I apologize before hand if the question is inappropriate, but a lot of people online say sexual activity, and masturbation causes hairloss in those with the genes with hairloss. Im not sure if this is true, but I have read masturbation increases prolactin levels and prolactin tends to increase DHT. I know sex and masturbation doesn’t cause hairloss by itself or else every male out there would be bald, but can it cause the hairloss to speed up in those with the Genes for hairloss? I would really appreciate your input on the matter. I might be wrong.

I rephrased your question in the title of this post. With regard to any association between Masturbation and hair loss, which men would want to give up their sex lives to slow down a hair loss process that is going to happen anyway? We have talked in previous posts that the genetically impacted hairs for hair loss, just die out (apoptosis) when their time comes. It is clearly associated with age, modified by the drug finasteride. I can’t say one way or the other that sex (which ever way you have it), will increase the speed of the hair loss, as I believe that is the crux of your question.

You need want to stop masturbating and see if this helps with the hair. Let us know how that goes, or you can search your topic from our previous posts

Dr. Rassman, you prescribed Propecia (finasteride) to me about 5 years ago. I initially had some sexual side effects, namely a loss in getting a good solid erection and some loss of my desire to have sex. You told me to continue to take the drug for another 2 months, at half the dose and then if the sexual side effects were less, try to go back to a full dose. After 4 weeks at half a dose, the sexual side effect disappeared and as you said, I then went back to a full dose. I had not recurrence of any sexual side effects and have been on the drug now 5 years. On today’s visit, we both concluded that the drug stopped the hair loss and today, I have the same amount of hair as I had when I started taking the drug 5 years ago.

This is not an uncommon problem. It seems that whatever change in this man’s hormones that took place after starting Propecia, it self corrected after a month or so. Staying the course is critically important to get the benefits of the drug but this decision should be make between the doctor and patient on a case by case basis. The comment that the status of his hair loss is the same today as it was 5 years ago, is what I commonly hear. Hair loss is a progressive process. Fortunately for this man, he stopped that progression nicely.