Author: Dr. William Rassman

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Would 4 or 5 Months Off Propecia Make a Big Impact on My Hair Loss? – Hair Loss Information – Balding Blog

I had to stop taking propecia last year because i couldn’t afford it. 4 or 5 months went by before i could afford to start taking it again. Will i grow back the hair i lost in this 4/5 month period? Would this have had a big impact on my hairloss?

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Any hair you lost in those 4 or 5 months would not be regained by getting back on Propecia. That thinning is sometimes referred to as “catch-up” hair loss, which is the loss that would have occurred if you never took the Propecia in the first place. You didn’t lose more hair than you would have, but you lost all the benefits of Propecia. If you restart Propecia it is as if you started from day one… which is why we advocate that you continue taking it.

If you cannot afford Propecia (1mg finasteride), there is generic 5mg finasteride for sale at a cost of around $60 a year. Yes, a year. Any pharmacy will have this 5mg generic. You just need a doctor that will prescribe this higher dose to treat hair loss (it’s a prostate medication otherwise), and you’ll need to cut the pill into 4 pieces (easier than cutting into 5 parts).

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What’s With the Itchy Scalp I Feel As My Hair Falls Out? – Hair Loss Information – Balding Blog

Hello, I am female and have been dealing with diffuse hair loss for over 10 years. My hair seems to get more fragile and difficult to deal with every year and medical science has been useless in helping me. The thing that is bothering me though is that as my hair gets thinner it becomes “prickly” causing an itchy/crawly feeling over my whole head that is seriously annoying me. I have tried tar based shampoos to stop the itchy/crawly feeling and it does give a temporary relief but it also increases the amount of hair I lose and gives it a horrible dried out texture. Is this a common theme with hair loss and how does one deal with it? I do not have any scalp conditions that I know of or any Psoriasis. Thank you.

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I really do not know what you have other than hair falling out and an itchy scalp. Perhaps you need to see a dermatologist for a good examination. We hear itchy dry scalp and hair loss as a common theme, but it is such a vague symptom it is often hard to pinpoint the exact cause. The two issues could be unrelated.

There is a theory that hair loss in women reflects an autoimmune problem. An itchy scalp can be caused by an autoimmune process.

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Do Doctors Know to Even Look for Body Dysmorphic Disorder? – Hair Loss Information – Balding Blog

Hi Dr. Rassman
I truly believe that HT surgeons like yourself offering good and honest advice to the general public, are few and far between. As we both know hairloss can be a devastating condition for any man. My severe worry is, that given this invaluable tool we call the internet, alot of misplaced paranoia is given to very young people (17-25) who should be enjoying their youth and the best years of their lives. It is of major concern to me, given the easily accessed nature of the internet, how (a minority) of young men (and women) may be posting pictures of their hair when there really is nothing wrong with their appearance.

I only mention this as i myself am a long term sufferer of a mental disorder know as “Body Dismorphic Disorder” and although there is nothing wrong with my hair, i have severe BDD. I know BBD sufferers are a minority but i believe especially when it comes to cosmetic procedures, sadly for alot of sufferers (especially the young) it is often overlooked.

My main question is, do professionals as yourself check for such (sometimes severe) disorders when assessing a patient and given the devastation they can cause among sufferers, how do surgeons like yourself deal with, what can be life or death situations for sufferers of this chronic condition?

Thank you for your time

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I obviously can’t speak for all doctors, but we do occasionally see men and women with body dysmorphic disorder in our clinic, and for some of those patients much of the consult time is spent on counseling them.

Most of the time these patients are already under care for BDD when we see them, but otherwise we refer them to psychiatrists.

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Does Any DHT Reduction Shrink the Prostate? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I regret to inform you that after recently undergoing a v. successful hair transplant I was prescribed 1.25 mg of finasteride every Mon, Wed and Fri. This is all good news but the bad news is that when I got to my laptop I got on the internet and started researching the drug and found the scaremonger sites about permanent side effects. Although I’m skeptical and like you believe more in scientific research plus I am impressed at your responses to people who ask about the drug, it has still planted a seed in my head. I’m going to make a decision on whether to take the ‘risk’ soon but first have some questions that I cant find the answers to.

1. Does ANY reduction of DHT i.e. any amount (1.25mg every other day-5mg daily) of a suppressant like finasteride result in a shrinkage of the prostate? Or is it possible to suppress the hormone enough to slow hair loss but not interfere with the prostate?

2. I took Avodart 0.5mg for a year and got slight ED. I was prescribed it for hair loss in the UK which I’m sure is not ethical. I stopped taking it but that was about 2 years ago, I’m 25 now and as finasteride is weaker is it logical to assume that the sides if I get them may not be as bad even though I’m older and my neuro endocrinal system and gonadal system (I think that’s right) could be at a different stage to when I was 22?

3. If you have looked at some of the YouTube videos and forums for the men who claim to have permanent side effects from the drug, although you haven’t seen their medical records or examined them and I know you are professional in that you don’t like to jump to conclusions, if you made an educated guess what would you assume has done this if it isn’t the drug?

I know that the decision is mine to take, but I am worried about the stuff I have read. I feel that your answers to these questions could help me make my decision. Thank you

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I am curious about your research on the Internet. As you found your “scaremonger” sites on finasteride, have you researched the “scaremonger” sites on hair transplants? Because you will find many and it will be a double whammy for you since hair transplants are permanent (side effect from finasteride are not).

To answer your questions:

1. Finasteride in 5mg is used for certain prostate conditions. Finasteride in 1mg or 1.25mg should have little or no impact on prostate health, but the inferences are there.

2. Avodart (dutasteride is the generic name) works in a similar way as Propecia (finasteride is the generic name) by blocking DHT production. Side effects from dutasteride and finasteride are similar, but with dutasteride being a stronger medication, it’s difficult to suggest you wouldn’t experience any side effects from finasteride. No matter how similar they are still different.

3. I have seen some of the YouTube videos, but you highlighted what many of these videos tend to be with a single word: “scaremonger”. I can’t begin to hypothesize what those people are going through, but there is clearly an agenda. They do not like finasteride. That doesn’t mean finasteride is the cause of their problems, but some people simply aren’t willing to look past that to see if there is something else going on.

You decision should be made with your doctor (not me).

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Is It Normal Shedding If I Just Lose Hair on the Top? – Hair Loss Information – Balding Blog

hi,
i have read a lot from this webpage so I thought I would ask you as you seem to be a very good doctor. I have been paranoid for some time now about hair loss. I have been to many doctors and they all say im fine, I have no bald people in my family, but I am suffering from this paranoia every day.

I wanted to ask you, I know that it is normal to loose 70 to 100 hairs a day. But is it normal to have some months of the year when you shed more? and when I am shedding is it normal that most of the hair comes from the top of the scalp and not from the back and sides? I’m asking this because my dermatologist said it is but it has me very confused. Please can you help. I have no bald spots or receding line just paranoid that all the hair falls out on top.

Thank you

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You say you have no bald spots, receding, or thinning, but yet you feel paranoid about balding. If you have seen many doctors and even dermatologists, and they were not impressed, I do not know what more I can add. That makes me wonder if you have a psychological problem rather than a hair problem. To be fair, hair loss affects people psychologically so I really cannot say what you have or do not have.

Some people shed more hair at certain times in the lives, but that does not mean they will go bald. Normal shedding is generally from all over the scalp, but perhaps you’re just noticing it from the top of the head… or rather, that is just the area you’re focused on.

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I Don’t Have Genetic Balding, But Am I Losing Hair from Alcohol? – Hair Loss Information – Balding Blog

am 29 years of age, do NOT have genetic balding, and I consume too much alcohol. I have noticed my hair thinning a bit towards the front. Is this because of the alcohol?

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BeerII don’t know how you can say with such authority that you do not have genetic balding, and then go on to say you’ve got thinning hair starting at the front of your head.

While being an alcoholic won’t make you go bald, many alcoholics have dietary and vitamin problems which can lead to hair loss. Still though, just because you think you don’t have genetic hair loss, it doesn’t hurt to see a doctor to find out if that is indeed the case.

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Hair Follicle Structure? – Hair Loss Information – Balding Blog

Hi Dr.Rassman,
I find this blog full of great info and discussion. My question is concerning hair follicle structure and balding. I notice recently that when some of my hair falls out I have two or even three strands of hair connected together. They seem to be connected together by the root or what looks like a “white bulb”. Does this indicate follicular damage or a sign of permanent balding? Thanks for your time.

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A follicular unit consists of one, two, three, or sometimes four hairs, and that is the basic anatomy. It is natural to see two or three hair follicles fall out. When hair falls out during normal hair cycling, the entire follicular unit falls out with a bulb and a new hair starts up high in the dermis which grows down into the deep dermis. This does not mean you are necessarily balding, as this can be normal hair cycling and happens to every human being with hair.

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Do People Actually Care About a Man’s Hairline? – Hair Loss Information – Balding Blog

Before I begin, I want to thank you for taking the time to answer all these questions. You and your staff are tremendous!

My question is what is/are the best hair products (etc. gel, mousse) to use after receiving a hair transplant over a year ago?

I have a receding hair and have trouble styling my hair so I ALWAYS wear a hat. I have no confidence in myself and extremely self-conscious about what others think. In your opinion and stories that you might have heard, do people, peers, or women actually notice or care about a man’s hairline?

Thank You!

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I believe that most of the readers would answer your question with a strong YES — people do notice. Today, I met with two men separately (20 and 25 years old). The 20 year old man still had his juvenile hairline, but there is evidence that one one side is moving to a mature hairline. The 25 year old has lost his juvenile hairline and now has the leading edge about 1/4 inch above where it belongs. One side is slightly worse than the other side. Both men had strong family histories of balding and both were very handsome. They felt strongly that the changes that had started to see had impacted their self image. Both look, from a distance, to have a great head of hair and neither man had any see-through appearance.

I also met with a 83 year old who recently lost his wife to breast cancer. He started dating again and was concerned that his receded frontal hairline made him look older than he thought he should look like.

So do people notice or care? Absolutely!

As for the best hair products to use following a hair transplant — really, styling aides are best evaluated by trial and error or by your local hair stylist.

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LaserCap – Hair Loss Information – Balding Blog

I have not seen any postings regarding the new LaserCap device that is now available for a cost of $3000 and would like to get your opinion.

Here’s a brief summary:

LaserCap is a 224 laser, portable, wearable under any hat device for intensive at-home use low level laser treatment, with comparable power to the leading FDA cleared in-office laser dome device – please see enclosed comparison chart (link here ). LaserCap is currently in pre-clinical testing in preparation for FDA trials to demonstrate efficacy as a hair re-growth device in women and men with androgenetic alopecia. LaserCap’s predicate device for FDA submission is the in-office 82 laser stationary dome device MEP-90 which was recently cleared by the FDA for efficacy in promoting hair growth in females with androgenetic alopecia.

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LasercapWe have posted many times on the efficacy of lasers for hair growth, and in my opinion, it simply does not work. But alas, it’s my opinion… and if you or anyone who buys and wears a “laser cap” can show me proof of the before/after results, then maybe my opinion will change. For a $3000 baseball cap with lights in it, it seems like an expensive gamble.

Realistically as I think more about it, it would be very difficult for me to recommend a product like this to someone with a straight face. It makes me wonder if generations in the future will point to this device and laugh as they point to the vibrating-belt weight loss machines from the 1950s.

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Running and Hair Loss – Hair Loss Information – Balding Blog

Is there any truth to the fact that running will help with Baldness? Since increase in blood circulation.

RunningAlso, what can i take to increase my blood circulation?

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Where do these urban legends come from? No, there’s no truth to running as a treatment for hair loss. And before someone asks, running won’t make you lose hair either.

With respect to blood circulation, as long as you can feel the tips of your fingers and toes and it’s warm, I suspect you gave good blood circulation. Hair loss is not related to blood circulation — it is genetics.