Month: January 2023

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Tangled Hair From Styling Products Used to Cover Bald Spot

Dear Dr. Rassman,
First of all thank you for caring enough about all our concerns to have this blog. I’m writing to ask you about tangled hair. I have kept the top of my hair long for many years now to comb back and cover the balding crown but my hair is coarse and somewhat curly. For some reason when I shampooed I began being unable to wash out all the build up of gel and hairspray and it was difficult to comb through. At the beginning I used to force the issue and would pull out lots of hair. Now I’m much more gentle but its still frustrating to not be able to comb through. I’m afraid I’m damaging my hair more and more. What would you recommend? Any shampoos that could clean this build up? What about detanglers?I haven’t fared better with them either. On another note, several years ago I had a transplant which I believ was good. But I now am planning to have another and am certain you or your staff at NHI will do it. I received your materials in the mail (Thank you), I’ve heard about your excellent reputation from other sources also.I like that you’re not ONLY interested in the $$$ but you have a passion in an artistic sense as well as a humanitarian love. God bless you and I look forward to hearing from you. Let me see you! A round trip from Las Vegas is very inexpensive now as the summer season comes into swing.

I’d see a good hair stylist with experience in African hair (they understand tangling and how to untangle the hair without pulling it out). It sounds like you need to get styling control on what you use and how you use it. Traction alopecia can occur with pulling on normal hair, but imagine if you can lose normal hair by pulling on it — what would happen to weak hair that is miniaturized from the genetic balding process? Bad news.

Visit me in Los Angeles if you want a hands-on examination. I will map your scalp for genetic hair loss and give you a glimpse into what will happen to you in the future (by developing a Master Plan for you).


2006-06-22 12:31:09Tangled Hair From Styling Products Used to Cover Bald Spot

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Taking Two Drinks per Month During Pregnancy, Can Reduce the IQ of Your Baby

It has been well-established that heavy drinking during pregnancy causes problems for the fetus, but, after studying 500 newborns at the University Hospital in Erlangen Germany, they found higher levels of a particular chemical, Ethyl Glucuronide, in women who had two alcoholic beverages per month. They followed these babies to the age of 6 and found that these babies have a lower IQ than normal babies by 4 points. This suggests that even less drinking can also cause the problem and would obviously be a major problem for children.

Taken from New Scientist 28 July Page 13


2018-08-15 09:16:04Taking Two Drinks per Month During Pregnancy, Can Reduce the IQ of Your Baby

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Taking testosterone, the debate goes on but heart attacks are up for those who take it (debate below)

After years of studying the twists and turns of hormone replacement therapy among women, Montreal-based epidemiologist Christel Renoux, MD, PhD, shifted her focus to its use in aging men — a path that’s proving no less controversial. “There is a passionate debate around testosterone replacement therapy; you have strong, strong believers it is really having a benefit and others say the benefit is modest and not worth the risk. You can see that it is really dividing even the scientific community,” she told theheart.org | Medscape Cardiology. Following the publication of two articles linking testosterone replacement therapy with an increased risk for myocardial infarction (MI) and stroke, the US Food and Drug Administration and Health Canada issued warnings about using testosterone products for age-related low testosterone and required a warning on product labels. The European Medicines Agency, however, found no consistent evidence for such risks.

Prescribing patterns appear equally conflicted, with one recent study showing testosterone prescriptions plunging in 2013 after publications of the cardiovascular safety concerns, while another report found spending on testosterone nearly quadrupled from $108 million in 2007 to $402 million in 2016. Rates of hypogonadism, however, have remained stable, suggesting that aging but otherwise healthy men with low testosterone may be turning to testosterone replacement therapy (TRT) as an elixir for aging and dwindling sexual function. “We are at the early stage of the debate. We need much more work to clearly delineate is there a place, possibly, for testosterone replacement therapy and in which clinical scenario and at which age,” said Renoux, from Jewish General Hospital and McGill University, both in Montreal, Canada.

Renoux and colleagues’ latest work provides no easy answers, despite a large cohort of 15,401 men, aged 45 years or older (mean 60.4 years), diagnosed with low testosterone without evidence of hypogonadotropic or testicular disease in the UK Clinical Practice Research Datalink database between 1995 and 2017. Most patients received testosterone gels or creams (56.8%) and 33.6% received injections. The results show a 21% increased risk for the composite of MI and ischemic stroke/transient ischemic attack (TIA) in current TRT users vs nonusers after adjusting for more than 20 potential confounders (hazard ratio [HR], 1.21; 95% confidence interval [CI], 1.00 – 1.46). This corresponds to an adjusted risk difference of 2.4 events per 1000 persons per year, the authors reported July 18 in the American Journal of Medicine.

MI and stroke risk was highest in the first 6 months to 2 years of continuous use and mostly driven by an increased risk among men aged 45 to 59 years. Risk was also increased in men with and without prior cardiovascular disease (CVD), but the results did not reach statistical significance. Surprisingly, current TRT use was associated with a lower risk for all-cause mortality (HR, 0.64; 95% CI, 0.52 – 0.78) and past use with an increased risk when compared with nonuse (HR, 1.72; 95% CI, 1.21 – 2.45). “It’s difficult to reconcile on one hand an increased risk of cardiovascular disease, which is one of the leading causes of mortality in older men, and at the same time finding a strong predictive effect on all-cause mortality,” Renoux said. (Text taken from Medscape)

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Taking Testosterone and I Am Losing More Hair. Will Finasteride Stop It?

Running testosterone with Finasteride is fine. Finasteride is a 5-alpha reductase type 2 inhibitor (which you, of course, know). It is not a DHT blocker, but it does block the conversion of testosterone to DHT. Therefore, a DHT derived agent (Winstrol, Halotestin) will still function in all its wonders and will of course have all its side effects on hair, rendering Finasteride ”useless” since it is being bypassed by the DHT-agent.

People who take testosterone and are genetically prone to hair loss will get hair loss even if they take the drug Finasteride, which is only 70% effective at blocking the DHT at the receptor level.


2018-05-15 08:38:17Taking Testosterone and I Am Losing More Hair. Will Finasteride Stop It?

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Taking Testosterone and Dutasteride 4 months after a hair transplant

I had a hair transplant 4 months ago and found out that my testosterone levels were low, so I went on Testosterone. My doctor prescribed Dutasteride to protect my native hair. What do you think?

With hormone supplements or testosterone, you run the risk of losing more native hair, not from the donor area or the transplanted hair, but from the native hair. Taking Dutasteride, which has a sterility side effect, is not in the best interest of my patients so I rarely prescribe it.

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Taking Rogaine for 9 Years and Want to Switch to Propecia Now

I’m 30 and have been taking rogaine for the past 8 or 9 years. I recently got a prescription for propecia. Should I gradually get off of the rogaine?

Assuming that you have benefits from the Rogaine, you should assume that your hair is minoxidil dependent. That means that if you stop the minoxidil, the hair may fall out. Propecia will not prevent this phenemonon. I would suggest that you stay on the Rogaine and get your hair mapped out for miniaturization before starting the Propecia so you know what you are doing.


2006-07-06 09:35:35Taking Rogaine for 9 Years and Want to Switch to Propecia Now

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Taking Propecia with Liquid

Sorry for the naive question, but would Propecia’s efficiency be affected if not taken with water (i.e, Milk, Cola, etc)?

Propecia will work even if you take it with whiskey (although if you take it in the morning and take it with whiskey, then you probably have an alcohol problem and not just a hair issue). Water, milk, or cola will do just fine.


2007-01-12 08:46:42Taking Propecia with Liquid

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Taking Propecia While Trying to Have a Baby

I have been taking Propecia for about 8 years. My wife and I are anxious to have another child. I completely stopped taking Propecia for about 5 months when my wife and I started trying to have our first child two years ago as I was afraid of side affects. He is perfectly healthy. Was that necessary or advisable? Should I stop taking it while we try to conceive again? Thank you.

There are many answers to this question depending upon the doctor and his interest in practicing and giving advice on what could be sensitive medical legal issues which are at time at odds with what is in your best interests. Very little, if any, Propecia comes from the sperm into the woman’s womb. Merck (the manufacturer of Propecia) does not warn men wishing to have children to stop taking the medications for your situation. That, in itself, tells much of the answer to your question. Some doctors, however, tell their patients if they are worried to do the following:

  1. stop taking the Propecia during the one week that fertility is present or stop it through the entire period from conception to the delivery of the baby
  2. use a condom when your wife is pregnant
  3. stop the drug completely during the entire pregnancy

I feel that the first part of #1 may be wise if you do not trust the drug company disclosures and to adopt #2 if you are really worried. These two steps are extreme, while #3 is almost crazy because you will abandon all of the benefits of the drug and get progressive hair loss during the 9 month pregnancy period, based upon no evidence that this is a problem. See my previous answer to this question here: Taking Propecia While Starting A Family.

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Taking Propecia While Starting a Family

I am consuming propecia for the past 6 month and i can see good results. My question is, i and my wife would like to have a baby. Is it safe to have a baby while i am on this medication because i have been told by a pharmacist that i should stop consuming propecia for at least 1 month before planning to do so. He said that it will probably do damage to a newly born child.

The half life of Propecia is 4 hours. That means that in 4 hours, there is 50% of the dose remaining, in 8 hours 25% remaining, in 12 hours 12.5% remaining, in 16 hours 6% remaining, in 20 hours, 3% remaining and in 24 hours 1.6% remains in your system.

Now the official answer from Merck is that you can continue to take Propecia while you are trying to get you wife pregnant. Different opinions from different doctors who are generally skeptical, tell their patients the following:

  1. Stop taking the drug while you are trying to get your wife pregnant.
  2. Stop taking the drug while your wife is pregnant.
  3. Stop taking the drug the month you are trying to get your wife pregnant and when successful, go back on it.
  4. Stop taking the drug for the one week a month when your wife is in her fertile period.

Clearly, this is your decision. I tend to recommend #4, not because I believe it, but because it is reasonably safe and will minimize the time off the drug. I am always concerned about losing the benefits of the drug, and running the risk of a dramatic hair loss.

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Taking Propecia Temporarily to Prevent Shock Loss Before Hair Transplant

Hey doctor, love the site. thank you for your time and effort in maintaing baldingblog and all the help you’ve given to everyone who reads it.

quick question. i’m wondering what your opinion is on patients taking propecia temporarily (immediately before ht and for a certain time after) in order to protect against shockloss from a transplant. Many doctors advise this to patients who refuse to take propecia or cannot from side effects. i wonder if you think this is a good idea, or should patients completely avoid finestaride if they’re not going to continue with it? Thanks.

I generally advise men to take Propecia (finasteride 1mg) before and after a hair transplant surgery indefinitely. If a patient is completely resistant to taking Propecia for long periods, I generally advise them to take it at least one year post surgery. It may aid in preventing shock loss and the patient may even see some benefits from the medication and decide that they will continue taking it.