Month: January 2023

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Would Cosmetic Eyebrow Tattooing Cause Further Loss?

Hello dr,
I was considering getting my eyebrows filled in with a tattoo. I have a decent amount of hair but have some sparse areas due to overplucking as a teen. I was wondering if tattooing the area will make the hairs fall out? I hear that it doesn’t from the techs who perform it but not sure if they are just saying that to get more business. I would love your thoughts as a hair loss expert on this matter. Thank you

The use of hair transplantation is probably the best solution available today for eyebrow restoration. Take a look at this post from last month and you will see the absolutely natural appearance of an eyebrow transplant.

I wouldn’t expect the tattooing to cause eyebrow loss, but I’d be more concerned about the tattooed eyebrows looking natural, particularly on close inspection. I guess it depends on the color of your brows and how sparse they currently are.

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Would Constantly Shaving My Head Destroy the SMP?

My question is in regards to the SMP (scalp micropigmentation) procedure. I’ve been taking propecia about four years now-started when I was 18. My hair has halted the balding process, but I cant tell it’s slowly creeping back up, which is what I expected anyways. I’m very interested in the SMP procedure, since scarring (even minimal) and a life-time commitment to propecia just isn’t for me. My questions are:

1) As opposed to hair transplant, how old does one have to be to become a good candidate for SMP?
2) If the procedure was done, would constantly shaving the head destroy the tattooed “hair”?
3) If after SMP, one would to stop propecia and lose their hair that was retained from the drug, would the loss of natural hair be noticeable even with SMP?
4) Lastly, are there any more recent photos you could share with us other than the ones already listed?

Thanks

Any age above 18 years old will work for me if the patient understands the positive and negatives associated with the process. There’s a list of frequently asked questions at the SMP site.

Many people will shave the head every day or every other day. This is a personal preference. Shaving your head shouldn’t destroy the SMP.

If you stopped the Propecia, you would lose all benefits of the drug and the hair loss will play ‘catch up’ to what it would have been.

We only post the photos of patients that grant us permission, but we keep updating the SMP site with new photos all the time. Keep watch on it.

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Would Birth Control Pills Effect Baldness in Men?

This is a purely hypothetical question. Would a man taking female birth control pills have any effect on male pattern baldness? What would be the effects on DHT, Testosterone, and hair health. Thanks!

The following post is by UK-based physician Dr. Bessam Farjo:


Written by:
Dr Bessam Farjo, United Kingdom
Dr Bessam Farjo
United Kingdom

Female birth control or contraceptive pills are most often a combination of synthetic forms of the female hormones, estrogen and progesterone. With regards to effect on men’s hair you may get a decrease in facial and body hair in terms of thickness and growth, although male-pattern baldness may improve somewhat or at least stabilises in a similar vein to finasteride for example. We see this effect most commonly in our practice when dealing with male to female transgender patients who use similar hormones to achieve their transformation.

However, these medications may cause a number of adverse effects in men similar to those seen with the use of other female hormones. You may experience changes in the appearance and function sex organs. Risks may include erectile dysfunction, decreased libido and lowered sperm count. Some men may also develop gynecomastia (man boobs). There may be a negative effect of general body muscle mass. In addition, the bones may develop osteoporosis (brittleness). There are other potential general health side effects of course making this an unreasonable approach to control male pattern baldness.

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Learn more about the author of this article, Dr. Bessam Farjo, on his BaldingBlog profile or at his website.


2012-04-30 10:27:48Would Birth Control Pills Effect Baldness in Men?

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Would a Doctor Prescribe Finasteride to Maintain a NW1 Hairline?

Dr. Rassman,

It seems there are a lot of young men frequenting your site, myself included, that are concerned about hair loss.

My questions is how much recession from a juvenile hair line must occur before hair loss can be diagnosed and a treatment can be issued.

Would a responsible doctor issue finasteride to maintain a Norwood 1 hairline?

Finasteride does not usually bring back frontal hairlines and I do not prescribe it to men who are not balding. Norwood 1 or 2 patterns are not considered balding.

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Would 0.25mg Finasteride Be More Effective than Saw Palmetto?

Hi Doc,

I’m a 26 year old male with a fairly aggresive NW4 developing, and need to do something to stabilize this before going for a HT next year.

I’ve grown pretty scared of finasteride side effects through the experience of a good friend who unfortunately suffered some of the psychological sides we’ve all been reading about online.

Question is, would a 1/4 dose (0.25mg) finasteride still be more effective for someone in my position than the full (320mg) recommended dose of saw palmetto? I’ve tried the latter before with no side effects, but didn’t stay on it long enough to evaluate the results.

Thanks doc and keep up the excellent work!

Propecia is finasteride in 1mg strength that you take daily for genetic male pattern (androgenic) hair loss. It’s been indicated that 0.5 mg finasteride daily is about 70 to 80% as effective as the full 1mg dose. I suppose you can infer how a 0.25mg dose may help. But in general if you are going to take a drug, you should take it as directed and speak with your doctor about all these issues. With saw palmetto, you really do not know the dose of the effective ingredients as they vary per manufacturer. Add to that the knowledge that saw palmetto has never been proven to work on hair reliably with a good scientific study.

My final point is that if you are going to read the issues of Propecia on the Internet and scare yourself with unsubstantiated reports without even seeing a doctor, the chances are you will likely have a side effect from the sheer psychological impact.

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Worst Case Progression from Propecia-Only?

From your practice, what is the worst progression of balding that you have seen with someone taking only Propecia and not anything else like Minoxidil? Like what Norwood was he before and after and how long was he taking it and how old was he?

I routinely prescribe finasteride for all balding men, so progression is not evident as the process slows down considerably. In the days when Propecia was not available, the balding process was very evident in a matter of a few years, but now when Propecia is used, I just have not seen the radical changes in balding patterns.

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Worrying about taking finasteride although I don’t have any side effects

Why does it seem that way, way more than 2% of Finasteride users experience negative side effects? I wish we lived in a world where there were clear, concise answers to whether or not our bodies would be negatively affected by this drug. I’ve been taking Fin for 3 months now – no side effects. But the more I keep reading about real & permanent side effects hitting guys, the more I don’t. know. what. to do anymore. Its a horrible feeling. It’s a decision where I now feel damned either direction I take. Thoughts?

If you are not having side effects, stop worrying as you will be like the majority of finasteride users able to take the drug without experiencing many of the problems you are reading about; however, if you keep focusing on the side effects that you don’t have, one day you will not be able to hold an erection and start blaming the drug. A cycle may be started psychologically, where you may induce side effects just from worrying about it. I have seen it happen.

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Worried Sick About Propecia Side Effect Stories!

Dr. Rassman,

I’ll try to keep this as short as possible.

I started Propecia in Summer 2007 as it was prescribed to me after a dermatologist visit in which the doctor diagnosed me with MPB. I took the 1MG 1x daily up until December 2007. I discontinued the drug because of the cost as well as a couple of close friends’ stories of libido loss and worries about impotence.

As I’ve now learned is common upon stopping the pill, I began losing my hair again and it has now become visible and very depressing. I want to get back on Propecia to help curb the hair loss as well as try any other supplements that may help the battle. However, I’m worried sick about some of the stories I have heard/read about concerning long-term use of Propecia and sexual/Prostate problems that are irreversible. How do you feel about these stories? There are multiple websites dedicated to getting the word out about permanent semen reduction, watery semen, ED, depression, etc. Is there evidence to back these stories up that you know of besides the hearsay? What is your professional opinion on these stories and the fact that the drug has only been out 10 years so no long term studies have been conducted?

Also, if I do begin the Propecia again, is Nizoral a good supplement to combine into a regimen? I have heard good things about Zinc supplements as well. Any recommendations?

Thanks so much for your time and help,
It is much appreciated

6 FingersNizoral is a good shampoo, but it won’t do anything to regrow your hair. I’ve addressed the side effects questions many, many times before on the blog — the most vocal are the ones with complaints. There are hundreds of thousands of men that use the drug that don’t spend all day on forums discussing it in a positive or negative way. Also, the complaints are unsubstantiated — I could say that Propecia grew a 6th finger on my left hand and made my skin turn silver, and how are you going to disprove that? The FDA published that the side effects occur in less than 2% of men.

You already have experience with the drug and if you did not develop side effects in the 5+ months you took it, it is doubtful that you see them when/if you restart Propecia. We are in total control of our decisions, but unwise choices may lead you further down the course of more and more hair loss.

(Note: The above image is Photoshopped, and it was not caused by Propecia. I hoped I wouldn’t have to point that out, but I don’t want any emails about it.)

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I am worried about the reported 2% risk with sexual side effect with propecia. Are the risks even higher?

The official number is 2-3% but the placebo number are almost 2%. In my practice I think that the numbers may be higher, 4-5% range. The reason that you see a lot of complaints on the internet is possibly because you are only hearing from those that have the negative sexual side effects. One of my own family members, got an increased sex drive, a complaint I do here on occasion but seem to never read about it on the internet. The testosterone levels often do go up when this drug is taken. For those that need/want to take this drug it is a matter of choice for many of them. To paraphrase William Shakespeare, “To take the Pill of not take the pill, that is the question?” Balding may be the only alternative.

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I am worried about the hair transplant damaging the hairs in the thinning area

A good surgeon can keep the recipient making instrument apart from the normal native hairs which he/she should be able to see when the recipient area sites are made.? Magnification and good lighting during the surgery allows the surgeon to see every existing hair without shaving the head. If you have it done with the robot with site making, the head must be shaved and then the robot watches out of the existing native hair, just as a surgeon would do.