Author: Dr. William Rassman

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After 18 Months on Propecia, Should I Expect More Regrowth? – Hair Loss Information – Balding Blog

Dr. Rassman,

First off, Thank you for the excellent information you provide here on Balding Blog. I have been following your site for years now during college in Ohio, and I must say it has been my primary source of information in my research regarding hair loss. Now that I have moved to Los Angeles after graduating school I’ve had the opportunity to meet you in person, which was exciting for me after following your blog all this time!

Anyways, I am currently wondering how much more regrowth with Finasteride I can hope to see. I have been on the drug since August of 2010 and continue taking it today without fail. My results have been fairly typical. In this time I have seen some minor thickening / reverse miniaturization of my frontal hairline and my crown which had minimal thinning has went completely back to normal. This was indicated by you during my bulk analysis and miniaturization mapping exams.

I would like to add that I had the HairDX Finasteride Response test done in Ohio before starting the drug and my CAG score of 23 indicates I should only have a slight response to the drug, but I did start taking it at age 26 when my hair was only in the early stages of thinning. I know everyone is different but typically/statistically do you see much more regrowth in patients like me after 18 months of Finasteride use?

Secondly, what are the chances I would suffer shock loss at age 28 and having been on the drug well over a year if I had a transplant done to restore my frontal area. (You said I was an early Norwood 3 pattern).

Thanks for everything

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I believe that improvement while taking finasteride has been reported for as long as 24 months.

Shock loss is often protected by finasteride… so as long as you stay on the medication, having a hair transplant should not produce shock loss.

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Patient Results – Hairline Restoration with 2000 Grafts (with Photos) – Hair Loss Information – Balding Blog

Here’s a man in his early 30s that was tired of looking older than he actually is, with a Norwood 3A pattern. We restored his hairline in just one procedure of 2000 grafts, and with the hairline came the youthful appearance we’re all after. The after photos were taken at around 11 months after his hair transplant. Click the photos below to enlarge:

After (1 procedure of 2000 grafts):

 

Before:

 

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Hair Loss InformationIs Sebum Rich in DHT? – Hair Loss Information – Balding Blog

Hello dr.Rasmman your site is really informative.Thank you for all this information.I have a question to ask.Is sebum rich in dht and testosterone? I mean if you don’t wash your hair and have an oily scalp,can this accelerate male pattern baldness allot sooner than it would normally start?

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I’ve written about this before. And as I said then, most of the claims of sebum containing high concentrations of DHT (thus leading to hair loss) seem to be coming from companies that sell shampoos. These claims are just not supported by today’s science.

Taking finasteride does seem to reduce the amount of sebum, but the connection between sebum and hair loss (because it contains DHT) has no basis.

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NanoSal Minoxidil – Hair Loss Information – Balding Blog

Hello,
I’ve been trying to find people who have been using Nanosal for a while to know the results but the only references all I can find are from 2005! Are there really minoxidil products out there that use nanosomes for delivery, is it any good? Thank you.

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Most of what I can find online about NanoSal is from 2005-2006. If it was anything special, I am sure the medical community or the drug companies would have picked up on it by now.

So I’ll open it up to the readers — if you’ve used NanoSal, please feel free to post about it in the comments section.

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Hair Loss InformationPatient Results – Over 7800 Grafts and a Scar Revision (with Photos) – Hair Loss Information – Balding Blog

This patient had 3 strip procedures, which yielded 7846 total grafts. His donor scar in the back of his head was revised with reasonably good results and a reduction in the width of the scar. You will find before and after photos of his hair transplant and the scar revision below.

Click the photos below to enlarge:

Scar revision (Before on left / After on right):

 

After (3 procedures totaling 7846 grafts):

 

Before:

 

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Could Minoxidil Change My Eye Color? – Hair Loss Information – Balding Blog

Hello Dear Doc

For hair loss i am using minoxidil 5% solution on my scalp and my eyes burn. Eye burning and irritation is known side effect of minoxidil and i wonder if it might change eye color?

There is a medicine named larissa which may change iris color used for eye lashes.

Thanks for your support.

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I am not familiar with Larissa, but perhaps you mean Latisse (bimatoprost ophthalmic solution), which has rare reports of permanent eye color changes in people with blue/green eyes. Latisse is used to grow eyelashes and it is presently being tested to grow hair.

There are no reports with minoxidil changing eye color, but if you’re experiencing burning eyes after using it on your scalp (a common side effect), you should consider discontinuing use if it becomes too bothersome.

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Shedding Short Hairs – Hair Loss Information – Balding Blog

Hi. I’m a 22 year old female. My hair is pretty thick but I’ve been going through kind of increased shed period. I’m mostly worried because I’ve been shedding some hairs that range from an inch to about three inches and then I have my normal length shed. I don’t have an extensive family history with genetic balding and I’m pretty healthy. I guess all I want to know is a few short hairs normal? I shed at max 7 of those hairs a day but usually less.

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I would think shedding about 100 hairs a day is normal, long or short. Most of those hairs you likely don’t notice (they blow out in the wind, fall out as you walk, etc). Your hair cycles may not be coordinated and that would produce variable length hair. This is the first time I’ve really thought about that, but it would make sense from what you told me.

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I Got a Haircut 18 Days After My Transplant and I Felt Pain – Hair Loss Information – Balding Blog

I’m 18 days post op and i just got a hair cut today. I asked the lady cutting my hair to be gently when she combed my hair, but for some reason she didn’t pay much attention to my request. She rubbing up against my recipient site several times, i definitely felt some pain. While i know grafts are generally anchored after 9 days because of your joint study with Dr. Bernstein, but is it possible my grafts were damaged internally?

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You may still have some tenderness, but I do not think you have anything to worry about that far out from your surgery. Shame on your stylist for not listening to you!

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I Haven’t Seen Any Results from Propecia After 6 Months – Is Time to Give Up? – Hair Loss Information – Balding Blog

Hi doctor Rassman. you have an amazing blog and are so informative when it comes to hairloss.

I have been taking propecia (the brand version from merck frost) for 6 months and 3 days to be exact. (I started taking it on June 1 2011, and today is december 3 2011). I have seen no change in my hairloss at all. My hairloss has not gotten better, or it hasn’t gotten worse. It is at the same rate prior to taking propecia. So basically its like I have taken the propecia for nothing. They say you are suppose to see less hairloss by month 3. this is now month six and still nothing.

I went to see my dermatologist and he told me that since I haven’t seen any results within these 6 months that I should stop taking it if I want and further treatment with it will make no sense since it has done nothing in the first six months.. he basically left the decision up to me. These were his exact words, “If I were you, I would stop taking it because since it has done nothing, i don’t think it will be of any benefit, but its up to you. you can keep taking it for another 6 months and see where that goes”.

Now this is my question to you doctor rassman. I know you can’t give medical advice and such, and I completely understand. I just want your opinion on the matter. Since you are a hair restoration specialist, I feel that your opinion is far greater than any dermatologist.

do you think 6 months is to soon to give up? should I continue in your opinion? Have you had any patients who started seeing the benefits after 6 months and such. what do you think? I just want your opinion. I really appreciate it. thank you

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Without an examination or documentation of how your hair loss has progressed in the last 6 months, I really would not know what to advise. I can’t tell you whether you should or shouldn’t take a medication I didn’t prescribe to you, but it could be worth sticking with it for a little while longer before making a decision either way. Your doctor gave you the same advice.

We advocate miniaturization studies, bulk measurement studies, and even take photographs under consistent lighting. These tests, while not perfect, are an attempt to quantify and scientifically track hair loss. Hopefully one day we can accurately measure and document hair. As a matter of fact, we have just been granted a U.S. Patent on such method a method (see here).

If you want an evaluation of hair loss and options, I would seek a hair transplant surgeon in your area. I generally tell my patients that they need to take Propecia for 6 to 12 months before the effectiveness can be assessed. I also make it a point to tell those patients that while they may not notice any difference (or even notice more hair loss), that could mean the genetic predisposition to hair loss is winning out over what the drug can offer. It’s possible that the medication has slowed the rate of your loss, and had you not taken it for these past 6 months you’d have even more loss. Really though, I don’t have any way to know.