Author: Dr. William Rassman

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Anti-Graying Pill — Go Away Gray

Hi,

I have recently come across with this product: Go Away Gray

Your remarks will be appreciated.

I have no experience with Go Away Gray (and this is the first I’ve read of it), but I invite my readers to comment if they do have experience with this pill that promises to make gray hair disappear. What I could find on it (aside from a ton of sites trying to sell it) was that the pill contains catalase, and a study from last year did find that gray hair was caused by the body’s lack of catalase production as we age. That isn’t enough to convince me just yet, but I am open to learning more about this and reading some actual reviews. You can read more about last year’s gray/catalase stories here and here.

CBS stations around the US picked up the story and ran it in their local markets, causing at least one TV critic to dig a little deeper into why the product is getting all this publicity (see here).


2010-05-14 06:40:20Anti-Graying Pill — Go Away Gray

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Anti-Nuclear Antibodies (ANA) and DUPA

Doctor, when a patient have DUPA, his/her ANF (Anti-Nuclear Factor) is positive? I have no balding parents nor relatives (until the 4th generation above myself), but I think I’m suffering DUPA and it began just after a heavy stressing period

The diagnosis of DUPA (diffuse unpatterned alopecia) is made by mapping out your hair and scalp for miniaturization. A good examination is critical. Hair loss in men comes about for four reasons:

  1. Genes
  2. Male hormones
  3. Stress (you seem stressed)
  4. Time (the longer #1-3, the worse the problem will become)

To avoid confusion, ANF and ANA are the same thing (see Wikipedia for more info). I am not familiar with a positive ANA factor as a participating cause of DUPA. Conditions like DUPA can occur with a variety of autoimmune diseases of which some of them may have positive ANAs.


2008-05-29 15:29:48Anti-Nuclear Antibodies (ANA) and DUPA

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An Answer to a Patient’s Questions

Dear Dr. Rassman,
Thanks for taking the time the other day to visit with me and also for the very informative follow-up letter and your recommended plan for my hair transplantation. Over the last two months I have been seriously looking into the hair restoration field and have read three credible books and studied every web site of every accredited hair doctor. I also consulted with doctors that I felt were very respected in hair restoration. My conclusion is that I need to stay on Propecia consistently to preserve the hair I have right now and use the follicular unit transplantation (FUT) technique exclusively, to replace the lost hair.

But I am confused by the number of grafts recommended. So far, I have heard various numbers ranging from 1,000 to 3,000. After visiting with you and hearing your recommendation of 2500 grafts, I wrote back to a very reputable doctor who had recommended a session of 1,500 grafts and told him that another clinic had recommended 2,500 grafts. He then told me that 1) each person has very limited donor supply and one must plan a session based on future hair loss, and 2) the survival rate of transplanted grafts deteriorates as the number of them placed close to each other is increased, as is done in megasessions. He told me that other clinics have no guarantee or refund policy if the hair follicles don’t grow back, so they just transplant as many as possible, even if not safe for the patient.

So my questions are:

  1. What does ‘limited donor supply’ mean in my case? You saw my hair, how many good donor grafts in total do you think I have for now and the future? What would it be if Propecia did not work and I continued to lose hair?
  2. Have you seen any side effects with larger sessions such as more noticeable scar in the donor area, loss of transplanted grafts, excessive swelling of the forehead or longer recovery periods?
  3. Do you or can you guarantee a certain survival rate for the transplanted grafts?

I appreciate the time you have taken to help me with my hair loss problem. I guess I can’t help it, I am a natural engineer, and this being the most important decision I probably ever make I have just been researching the hell out of it! I am confident, however, that I am talking to the best source there is out there.

Part of what is important about being a doctor is the concept of mutual respect. The person who wrote the email to me on this blog, is analytical and clearly fully aware of the subject material. Good communication produces respect so a doctor should spend an appropriate amount of time and focused attention to address your concerns at the interview and in followup to that interview. I would welcome a call from you to elaborate on this blog answer.

  1. Some people do not have the donor supply and when that will be an issue, I tell them. The amount of donor hair is a calculation of density in the donor area plus laxity of the skin. Finally, the size of the bald area and the final worst case pattern must be taken into account. As measurement is critical to this process, one must make direct measurements of the density in the donor area. I was the first to publish on the measurement of the donor supply and the instrument I invented to do this is now used by every competent doctor in this industry. There are no other instruments that are used for hair measurements that do not fall under my U.S. Patent. The average patient has about 6,000-12,000 grafts to move but the wide spread reflects the many variables discussed above.
  2. If you come to our free open house events, you will meet people who had thousands of grafts and see for yourself what happens. The key to understand the safety of large sessions is to meet directly with many people who had them. I would not be doing large sessions if they were not as good or better than multiple smaller sessions. With good decision making by the doctor, large sessions should not scar more than multiple smaller sessions but there may be a cost for aggressive decisions in large session transplantation if the doctor is not experienced in such procedures.
  3. This type of complaint usually reflects the act of denial which most people exercise when they forget what they looked like ‘before’ the started the hair restoration process. Sometimes, people continue to loose hair and think that the new hair loss reflects a transplant failure when it really reflects the unpleasant idea that balding continues. To address the growth of the transplanted hair, wWe guarantee our work. Anything that does not grow, we will replace at no charge. This almost never happens, so I rarely discuss it unless asked.
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Angry Reader Points Out — Lamisil Does Cause Hair Loss!

A Google search brought me to the question and your answer from a man who was experiencing dramatic hair loss following a two month usage of Lamasil. Your reply discounted Lamasil from being a cause, citing the drug’s use for infections that in and of the condition cause hair loss.

I am sorry to tell you I find your reply specious. Look, the drug insert slip detailing the side effects CLEARLY states that hair loss is a DIRECT side effect of terbinafine hydrochloride usage. You can bet the drug company would give much not to have to include it, or any other in a list of side effects, but after 33 years of patient use, I’m fairly certain that it’s had substantiation. Hair loss is a real unpleasant and tremendously visable side effect, and tons of money is spent by men and women to counter baldness. No drug company wants to have to tell users “this could happen to you”.

Now, I am a 45 year old woman prescribed and dutifully taking on schedule terbinafine hydrochloride aka Lamasil. I have had HUGE, by the handfuls, hair loss. I am in perfect health, substantiated by my age 45 health screening, except for normal stress, the effects of aging, and toenail fungus.

Please note: I received the prescription of Lamasil for TOENAIL fungus, not fingernail fungus, not ringworm or anything else that would cause hair loss, and hair loss is NOT a result of toenail fungus, doctor. So, when you post a sincere and concerned question (which unsurprisingly you did NOT answer) with a reply disdaining and discounting the legitimacy of the issue with an answer that supports an obvious agenda on your part, you discredit yourself and your profession.

AND I still need to know if MY hair will regrow. That guy was almost certainly loosing his hair from the Lamasil. Drugs are special, doctor, and many are needful, but those side effects ARE real.

Many drugs can cause hair loss, but my position has always been to explore other, more common causes of hair loss before blaming the drug. More importantly you need to discuss starting or stopping any medication with your physician.

Lamisil is often used in the treatment of fungal diseases of the skin, such as ringworm or toe fungus. If left untreated, some fungal diseases of the scalp by itself can also cause hair loss. I stand corrected with your reference to the drug insert warning of hair loss as a complication, but many times, just because a person is on a drug that has hair loss as a known side effect, it does not mean that it is THE cause of the hair loss. Diagnosis is just not that simple.

If you believe the drug you are taking is causing your hair loss, please address these issues with the prescribing doctor. There’s a disclaimer at the bottom of every page of this site that can be summarized to say, “This site is intended to educate the public on hair loss topics and should not be used for the purpose of medical diagnosis or treatment recommendation.” Please remember that I am not your doctor.


2007-11-27 14:33:09Angry Reader Points Out — Lamisil Does Cause Hair Loss!

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Any New Hair Loss Drugs Coming Up?

have you heard of any new hair loss drugs in the pipe-line;if so what sort of amount of time will they take to become available to the general public

The FDA is the place to go to look for new drugs. These drugs must go through a clinical trial and there is no assurance that a drug that starts the process will qualify to meet the safety and effective standards of the FDA. In summary, I have no way to tell you what may happen. We all have to wait out the clinical trials.


2006-08-22 06:26:32Any New Hair Loss Drugs Coming Up?

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Any Miraculous Results from Unusual Hair Loss Cases?

Hi Dr.

What is the most unusual case you have come across during your time dealing with hair loss patients.

Has there been any miraculous results or otherwise unusual results that may give some of us extra hope?

The usual hair loss cause in men the vast majority of the time is genetics. There’s not much you can do to change what your mom and dad gave you. At times the hair loss is not uniform or symmetrical and this leads to some interesting patterns. In many patients, I have seen one side balding much faster than the other. Unusual hair loss patterns in men include a completely Norwood class 7 pattern except for the first 1/2inch of the hairline, which is completely intact. Many of these men grow out the frontal hair and use it as a strange looking comb-back hair style, and it works.

For men, we can postpone the inevitable with drugs such as Propecia (finasteride 1mg) or Rogaine (minoxidil 5% topical). I suspect in the coming years, there may be new drugs or other medical breakthroughs such as cloning, but that may take years just to get FDA clearance.

The hair transplantation methods of the past have created many interesting problems today. In the old days, plugs were put into the crown before the hair was lost, and then as the balding progressed, an island of plugs remained in the middle of a bald crown — a very weird look. Hair transplant surgery today provides awesome results. Not to toot our horn, but our patients seem to think they get miraculous results… which is a prejudice induced because of the life changing nature of the process! Look at our photo galleries to see for yourself.


2012-06-06 10:26:01Any Miraculous Results from Unusual Hair Loss Cases?

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Any Bimatoprost Study Phase 2 Results Yet?

Doc

Have you heard anything or have any idea when the phase 2 bimatoprost studies will be out?

Happy new year to you and your staff.

You’re referring to the study comparing bimatoprost and minoxidil for use on the scalp, which completed the phase 2 a few months ago. The results haven’t been posted yet, as far as I can find.

Check it our at the ClinicalTrials.gov site — Safety and Efficacy Study of Bimatoprost in the Treatment of Men With Androgenic Alopecia.

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Any Point in Taking 5mg Finasteride to Treat Hair Loss?

Dear Doctor,

I just wanted to know if there is any point of taking 5mg proscar for hairloss? From my research I think the answer is no but I have taken 5mg for last 6 weeks. I have noticed a lack of motivation and being a bit down but I am not exactly sure if they are related to taking the 5mg or due to other things in my life. Could there be any side effects for taking for the 5mg for the past 6 weeks? If I just cut down to the quarter Proscar tablet (1.25mg) will my body take long to readjust after having taking 5mg dosage?

Thanks you for your time,

Kind regards

There is no point in taking finasteride 5mg (Proscar) for treating hair loss. Aside from the increased side effect possibility, it will not work any better for hair loss. I really cannot comment on your lack of motivation and its relation to the medication. Maybe you have the holiday blues? Side effects from medications should generally reverse in about a week or two.

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Any NeoGraft and Artas® Robot Alternatives?

What other “automated” or similar hair restoration systems are available besides Neograft and Restoration Robotics?

The follicular unit extraction (FUE) technique is a simple and elegant technique conceptually, but it is highly variable or difficult in practice. Since I published my FUE article in 2002, hundreds of doctors have adapted their own automation and instrumentation. I encourage this, as one superior technique or machine may emerge. But as of 2011 it has not.

There are handful of doctors who have invented their own technique in some form or another. NeoGraft and the Artas® robots are just commercial adaptations. Both Dr. Cole and Dr. Harris have developed instruments which are diametrically opposed as to how they work. There is also Dr. Boudjema in France (one of the brightest and most creative people in the hair business) who first invented an FUE automation machine back in the mid-1990’s called the Calvitron (which is similar to NeoGraft). He always has a new approach and just recently talked with me about his most recent innovation (brilliant as always).

Real inventing requires ‘out-of-the-box’ thinking, but most of what is out there are just minor variations of each other. There are powered punches that vibrate, twist one way and then the other way, that are slow in RPMs, that are fast in RPMs, that claim sharper punches or duller punches as the key to best results, etc.. The Artus system uses sharp followed by dull punches and the Neograft uses very sharp punches. Each doctor will likely say ‘his’ instrument is the best.

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Any Patients Take Propecia and Still Have Shock Loss?

Just wondering as you have said a few times that being on propecia will decrease your chance shock loss after a hair transplant if you are under 30.

Have you had any patients under 30 who have had shock loss after being on propecia for a considerable period of time? And if so to what extent was the loss? Thanks

When I saw the great majority of shock loss cases, it was before the availability of Propecia (early 90s). Since that time, most of my patients take Propecia to protect themselves from shock loss, and there was far less of the fall out after the surgery… but it did still occur for some.

I don’t have statistics on the extent of loss or precise age, though.