Author: Dr. William Rassman

Posted on

Hair Loss InformationHow Can You Say Testosterone Doesn’t Cause Hair Loss? – Hair Loss Information – Balding Blog

Hi Dr. Rassman!

First of all I would just like to thank you for a really good blog, I am a frequent reader and very much appreciate the time you put into it. I have read several times that you say that testosterone does not cause hair loss. However in theory I believe this is wrong, but I would also like to hear what you have to say about it in practice:

As you most certainly do know, testosterone and DHT bind to the same receptor – generating the same type of response. Therefore they both have the potential to cause hair loss. However, as DHT is more biologically active and binds with more affinity to the receptor, it is seen as the main culprit in hair loss. And as long as a person has normal DHT levels, the testosterone probably does not play a big role in hair loss.

But in a person with aggressive hair loss who blocks most of the conversion from testosterone to DHT with finasteride or maybe even dutasteride. Wouldn’t it be fair to assume that the testosterone (which will also be somewhat elevated when on these meds) actually contributes to the continuous loss while on these medication?

And that this could, in fact, explain how a persons hair loss can actually progress even though they might be blocking 90-something % of their DHT with dutasteride? Any input on this will be highly appreciated.

Block Quote

It is a mixed bag, since testosterone is converted by the liver to dihydrotestosterone (DHT), which then gets to circulate in the blood stream. Increasing testosterone levels will increase DHT as well, so which is the cause of balding on those people with genetic balding?

We can not really separate what is happening neatly as you described, as the human body is a “bag” of chemicals mixed together. I realize how elegant that sounds, but that’s the most simple way to describe it. If testosterone levels rise, DHT levels also rise and in this bag of chemicals (the human body) any change in testosterone will absolutely impact DHT levels comparably.

Posted on

My 5 Year Old Has a Bald Spot at His Hairline – Hair Loss Information – Balding Blog

My 5 year old has a bald spot right on his hair line, about a 1 1/2 by 2 in. area. It seemed to have occurred when his mother was cutting his hair short with scissors so i could buzz it short later for the summer time. She cut a little too short in that and some other areas (down to the scalp). The other areas all grew back normally except the one on the back of his head. Could the hair follicles have been damaged enough to where they wont grow back any more or is a waiting game? Its been almost a year now and nothing. Should we try some type of stimulation? Any help would be appreciated.

Block Quote

I find this story difficult to surround. Short haircuts do not cause bald spots. I mean, I’ve never seen balding created from a fully shaved scalp, so the idea that a haircut could cause loss just doesn’t make sense. There might’ve been a scar revealed from previous trauma, which you didn’t see until the hair was cut really short.

This is a situation that requires a one-on-one consultation and after doing that, digging into the history and examining the 5 year old, I might then be able to help.

Posted on

Hair Loss InformationAre We Getting Closer to Solving the Donor Supply Problem? – Hair Loss Information – Balding Blog

Dr Rassman and company,

With all of the recent advances in hair cloning technology: Intercytex, Aderans, Histogen, Acell, WNT proteins, and etc., are you becoming more convinced that we’re getting closer to solving the donor supply problem and thus the hair loss problem?

Block Quote

I don’t have the answer to your question. Ten years ago, we were told that the answers would be seen in under 5 years… and now a decade later we hear the same thing. That says much about the real answer. It’s still a big question mark, though there’s some progress being made.

Posted on

If I Have FUE Surgery, Do I Need to Keep Using My Hair Meds? – Hair Loss Information – Balding Blog

I am considering surgery – FUE. I have been on propecia for 3 years now and it’s difficult to tell the effect it’s had. I mean it could be working, I haven’t seen any more hair loss really. It may have stabilised the hair loss. Or has the hair loss could have simply gone into some kind of rest bite!? If I go for FUE, would you recommend I stay on propecia – I would rather be safe than sorry! Although it does cost a lot, I currently purchase my medication for £62 per month.

On another note, about a year ago I started minoxidil to improve the density of my hair. I think it’s had some kind of small positive effect, not much though. But here’s the issue I have. If I decide on a FUE, do I have to continue on minoxidil – because I cannot afford to both this and propecia.

Block Quote

You need to continue Propecia and minoxidil to see their benefits. As soon as you stop one or the other (or both), the benefits from that medication will be gone. In other words, you’ll see hair loss. The transplanted hair won’t be the issue, as it is permanent if taken from the donor area, but it is the remaining hair around the transplant area that will be unprotected. Propecia also helps protect from shock loss following transplant surgery.

Some patients choose to use generic finasteride in 5mg (prostate medication) and cut it to smaller pieces. Propecia is 1mg finasteride and not available (at least in the US) as a generic. The 5mg generic will be a lot cheaper than the 1mg name brand. You just need to find a doctor to prescribe this to you. Or if the 1mg generic is available in your country, that might be a way to save money. Also, your doctor should be able to show you some analysis from before you started Propecia and compare it to today to find out if there are real results. Hopefully your doctor has such information for you.

Posted on

In the News – Adonia Hair Removal Cream – Hair Loss Information – Balding Blog

Snippet from the article:

A cream which slows the growth of hair by 70 per cent could result in men shaving just once every three weeks. It works on both men and women, meaning five o’clock shadows and girls spending hours in the bath shaving their legs could soon be a thing of the past.

Adonia hair serum uses organic plant oils to weaken hair formation and is being hailed as a healthy alternative to expensive hair removal treatments such as electrolysis.

More than 10,000 people have already put their names on a waiting list for the product. During trials in the U.S. the hair reducer showed an impressive 46 per cent reduction in hair growth after 21 days with a 70 per cent reduction after six weeks.

Block Quote

Read the full story — The gel that slows hair growth and lets men shave every THREE WEEKS

I can’t tell you how tired I am of shaving my facial hair, so if this is real, it would be very welcome. I can imagine women would love to give this a try, rather than shaving their legs.

The product, Adonia Hair Reducer, is for sale via a 3rd party seller on Amazon.com, but there are a few reviews that are highly suspect. Three of the four reviews were posted on the same day, and the reviewers have only written about products sold by that 3rd party seller. Glowing reviews, of course. I don’t know whether the cream actually does what it says, but the reviews I’ve found are more than likely phony, and I can’t find any other mentions of the product actually being used.

Posted on

Hair Transplant for Woman with Polycystic Ovarian Disease? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,
I was wondering about hair transplant in a female with active PCOD. I would really appreciate if you can share your experience in treating hair loss in PCOD both surgical and medical.

thank you

Block Quote

I do not have much experience treating women with Polycystic Ovarian Disease (PCOD or PCOS). Women with this disease tend to have hair loss that resembles male pattern balding, so I might treat them like men, addressing the pattern and the complaints that are given to me.

I’ve written about this before here.

Posted on

Should I Increase My Propecia Dose or Consider Avodart? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I’ve been on Propecia and Rogaine for 3 years and have been delighted with the results……up until now. Propecia and Rogaine thickened the hair all over my scalp and slowed the regression of my hairline. Unfortunately, it’s becoming apparent that my crown is now thinning, an area that had been strong prior to treatment.

I’m 28 now, and, if possible, I’d like to keep my crown hair for another few years, what are my options?

1) Would upping propecia dosage ever be advisable for a 28 year old?
2) Should I consider Avodart off-limits until it is FDA approved for hair loss?
3) What would you do if you were in this situation?

I’ve a check up with the doctor (who I’m very happy with) that originally prescribed the treatment in a couple of weeks, and will pose the same questions to him. However, your opinion is really important to me, and will help inform any decisions I may have to make.

All the best

Block Quote

You’re asking me for advice on a prescription medication that I haven’t prescribed for you, so there’s really not much I can offer. I don’t practice internet medicine.

In general, more finasteride (Propecia) might not be the solution. I’ve upped the dosage in a few patients, but too few to draw conclusions on. Some have told me that they took dutasteride (Avodart) on their own and saw success… but the half life of that medication is quite long compared to finasteride (worrisome in case of side effects, since it’s stronger than finasteride) and the proper dosage for treating hair loss with that medication is unclear.

Wait until your next doctor visit before making any changes to your treatment methods and find out what he says.

Posted on

The FDA’s Perspective on Finasteride Risks – Hair Loss Information – Balding Blog

Dr Rassman
The New England Journal of Medicine published an article that is freely accessible online to the public and addresses the FDA’s perspectives on risks and benefits of 5α-reductase inhibitors for prostate-cancer prevention and the recent additions (warnings) to the product labels.

Link: The Risks and Benefits of 5α-Reductase Inhibitors for Prostate-Cancer Prevention

Of course, I am concerned about the balance between providing helpful info to your readers and creating more confusion, especially since the article is highly technical and there is a small element of readers who believe that the FDA is in “cahoots” with drug companies (which is illogical, since the warning could theoretically decrease sales).

To me, the risk is very, very small, is likely not applicable to young men given that these studies were conducted in older men at risk, and involved finasteride doses 5-fold that currently used for androgenic alopecia, all points that have been made in the Comments section of your prior post. Perhaps one benefit of such articles, though, is making your readers appreciate that much scientific information – even the question earlier this week about finasteride and bone-marrow donation – is so easily accessible.

Block Quote

The issues of risk are more a matter of legal risks rather than actual risks, as you stated above. Remember, however, that there are lawyers standing by when any of these risks materialize real or not.

Thanks for bringing this article to my attention. I’m sure some of the more technically inclined readers will have plenty to say in the comments of this post.

Posted on

In the News – Fake Doctor Arrested For Telling MS Patient to Take Hair Supplement – Hair Loss Information – Balding Blog

Snippet from the article:

[Yevgeniy “Eugene”] Vasin charged $300 an hour to treat Cotter at his San Jose office and her home. Doctors at UC San Francisco said she had MS and put her on a regimen of medication, but Vasin told her that was wrong. He suggested she cut her medicine intake by half and injected her with vitamins. The injections included Cerebrolysin, a drug used outside the United States to treat Alzheimer’s disease, as well as baldness treatment Proserin and vitamin B-12, prosecutors said.

Block Quote

Read the full story — San Jose man charged with pretending to be a doctor

I assume the article is referring to Procerin, a saw palmetto-based tablet (if there’s a “Proserin” out there, I’m unfamiliar with it). Now I won’t debate whether Procerin works as a hair loss treatment, since regular readers already know my stance on saw palmetto… but I’ve not known it to be a suitable treatment for multiple sclerosis. Perhaps this fake doctor confused MS with BPH.