Author: Dr. William Rassman

Posted on

Side Effects from Finasteride, But No Side Effects from Dutasteride? – Hair Loss Information – Balding Blog

Hi Doctor!

I am very happy that I found your great site! I am 24 year old male with about a Norwood 2. Here in Hungary I dont think we would have good doctors being expert in hair loss treatment. I visited one of them (advertised by the spectral dnc site), but she stood against taking pills for my hair loss at such a young age (and after reading some hair loss forums I think she seemed to be incompetent in the topic). However a lot of international sites contain posts by even younger men successfully applying medications. I insist on trying them because any more hair loss would destroy my self image.

My frontal hairline must have started receding about when I was 20. The previous and this summer I observed that my frontal hairline rapidly shedded about 2-3 millimeters and I have a bit high forehead already. All my existing hairs are thick and they suddenly switch to short light hairs so the thinning is not gradual. What I want is to keep my current hairline from getting worse, but I would like to aim regrowing some hair, and I would have a few questions regarding this. I may also have some thinning on the entire crown, but Iam not sure about that, maybe its only my hair dresser who lessens the density…

I already tried Spectral DNC for 6 months with no success. (Note that the source of the DNC was not trusted but I admit that it was truly minoxidil because it made the hair on my hands and face much stronger…) I want to attack the problem at its roots so I would like to take finasteride or dutasteride. Is it possible for some men to keep all their hair with finasteride? I have a lot of small light hairs along my original juvenlie hairline. Do I have a chance to regrow them, or is it going to remain just normal bald scalp for sure? What do you think about starting with dutasteride 0.5mg if I want better results (www.dutasteride.com)? I read about some men with side effects on finasteride, but great success without side effects on dutasteride, is this possible? Thanks for your answers!

Cheers

Block Quote

AvodartIf any medication made it so you kept all of your hair, that could be considered a cure. At the risk of sounding like a broken record, there is no cure for hair loss. Finasteride (and perhaps dutasteride) will slow the loss down, possibly regrow hair, and should hopefully maintain the existing hair for some time.

Dutasteride (also known as Avodart) has a longer half-life and is a stronger medication than finasteride. If you see side effects from finasteride, I would assume you’ll have those same effects from dutasteride… but they may be stronger and possibly last even longer. Dutasteride was studied as a prostate medication in men over 50 years old, and I don’t have all the info because as far as I’m aware, proper studies of younger men taking it to treat hair loss have yet to be released. It also isn’t approved by the United States FDA for treating hair loss and thus, I can’t recommend it at this time.

Regardless, both finasteride and dutasteride are prescription medications and you’ll need to talk to your doctor about taking either. If your doctor wishes to prescribe dutasteride to you, that’s not my call to make.

Posted on

Hair Loss InformationWhat Could Cause Histogen to Fail? – Hair Loss Information – Balding Blog

Hi Doc,

i’m sure you heard and saw Histogen’s Pilot Study and the general comment i saw in all the forums were that is really promising. i hope you can answer my question..

what do you see that MAY be a downfall in Histogen HSC plan? and do you think its results are more promising than hair cloning? i know that we have been hearing the quote “3 to 5 years time” BUT i dont think science had ever had such results than now so things are moving i guess..

Block Quote

HistogenI suppose the downfall could be the same for any new company in this space — financial backing. If the trials don’t go as well as expected, it may be harder to secure additional funds to keep making progress. I’m just speaking in generalities though.

I do not follow Histogen’s business or science plans close enough to scrutinize its progress, so I do not really have an opinion on its technology. The last I read about the HSC pilot program, it looked promising but only had a couple dozen participants… and it wasn’t known if the results would last for any significant amount of time.

It may be the hope to most (if not all) readers out there for a cure to balding, and I could only share the same hopes as any other.

Posted on

LaserComb Cooking DHT? – Hair Loss Information – Balding Blog

I came across an interesting blog post of a guy stating that by the prolonged use of laser comb (holding it in position for a long period) allows it to neutralize the effect of DHT by making the scalp to secrete it along with some sebum and that it gave him wonderous results in the long run

could you please share us our comments on this, do you think that his claim has any credibility?….

Block Quote

CookingLaserComb does not cook DHT, nor have I seen evidence that any of the hair lasers do anything to DHT. People can believe what they want to believe, but there has yet to be any scientific study that provides a connection. I suppose that maybe what the guy with a blog reported in reversing hair loss had value (possibly circumstantial), but I truly doubt the cooking hypothesis. I’ve yet to see lasers show regrowth benefits in my own patients.

Anyone can post or say anything on the Internet, but it does not mean you have to take it at face value. I suppose that goes for what you read on my blog as well, so see your doctor if you need a second opinion.

Posted on

Staph Infection on My Crown – Hair Loss Information – Balding Blog

i had a staph infection on the crown of my head. my question is that it has left bald patches in my scalp and in other areas around my head but mainly on the crown. I do not have male pattern balding but will Rogaine help regrow the hair?

Block Quote

Rogaine (minoxidil) may help regrow some hair, but it usually takes about one full year for you to notice some difference. I’d just be patient and wait out for the hair to regrow on its own if you’re certain you don’t have genetic male pattern hair loss.

Posted on

Is the Hairline More Sensitive to Testosterone? – Hair Loss Information – Balding Blog

Doctor reading this really scared me. Its from hairlosshelp.com

This is what someone posted regarding propecia

“Yes. I barely had any recession, it honestly looked like maturing of the hairline, and me having my dads hairline, it looked like thats what was happenning. Eight months in 2/3 of the front of my head fall out, I end up shedding 100+ hairs a day for 5 months, where as before Fin I only shed 15 a day. I was in so much denial I kept using it. So yah I ruined my hairline. Thankfull it’s growing back, but I probably permanately turned on the balding genes in those hairs, because it raised my testosterone so much. My testosterone used to run around 650, it got all the way up to 900 on fin. And, by the way, fin DID DO what its suppose to – it lowered my DHT signifcantly, it’s the testosterone that killed my hairline. Hairlines are beleived to be more sensitive to all androgens.”

Is it true? The hairline is more sensitive to testosterone and fin make the testosterone go up?

I would really appreciate it if you can answer this question ASAP. Im sure alot of people would also want an answer to this question.

Block Quote

The hairline is less sensitive to DHT blocking, but I don’t know if it is more sensitive to testosterone. The probability is that frontal hair experiences apoptosis (cell death) at an earlier age than the hair in the crown in most people.

In regard to the story you read that was posted about Propecia, that is one person’s experience and the story hasn’t been validated. I won’t make light of what this person says, but it isn’t objective and I just don’t believe everything I read (particularly on message boards where anyone can sign up with fake information). You can find all kinds of claims on the Internet, but who will validate the story?

And even if it is true, what would you like me to add? Are you asking for reassurance that Propecia will not cause hair loss? You will lose your hair with or without Propecia if you have the gene for male pattern baldness. Hopefully you have a doctor to work with, so talk to your doctor. Get the facts straight. If you look hard enough the Internet, you will probably never leave your house due to the fear mongering that goes on.

Posted on

Did I Lose Part of My Hairline Because I Stopped Propecia for a Week? – Hair Loss Information – Balding Blog

hi doc,

A few months ago i was studying for exams, which was obviously stressful. Around that time i ran out of propecia for a week, suprise suprise, i then realised my left hairline had taken a beating which wasnt there before. my question is, is it possible that i lost hair by stopping propecia for a week? if i lost hair because of stress when can i expect to see it grow back?

thank you

Block Quote

PropeciaIt does not quite work that way. Just because you stopped Propecia for one week does not mean it caused the loss of your frontal hair. I wouldn’t expect you to notice much loss in benefits from a week off the medication. Moreover, Propecia isn’t really as effective for treating frontal hair loss and works best in treating crown/top hair loss.

Now there are rare occasions where medication does provide some regrowth at the hairline, but these are very rare and it most likely won’t regrow. There is no medication that can prevent or reverse this with any level of certainty.

As well, stress-induced hair loss in those men with genetic hair loss will likely not regrow. Perhaps your hairline is maturing?

Posted on

I Was Told to Use Minoxidil After My Hair Transplant – Hair Loss Information – Balding Blog

Hi
I recently had a direct implantation and I was told to use minoxidil 5% which I am not sure if is something I would like to use because of its many, quite weird for me,side effects.

Is it essential after implantation? or is there something else I could use that could be safer? thanks

Block Quote

RogaineMinoxidil (Rogaine) isn’t essential after a surgery, but Propecia would be recommended to prevent shock loss (and taking it before surgery would be optimal). I hope your surgeon discussed the possibility that the transplant could cause additional loss around the recipient area, and taking Propecia before the surgery could help to prevent that.

What weird side effects from minoxidil are you talking about? It could cause skin irritation, which isn’t too “weird” to consider for a topical medication. That being said, side effects are rare in both minoxidil and Propecia, but you’re under the care of a doctor already so I’d expect you should discuss these with him/her.

Posted on

Hair Loss InformationCan Food Cause Hair Loss? – Hair Loss Information – Balding Blog

I would just like to ask if a food can cause hair loss. Because I have a project for school and my topic is about hair loss vs. aging. For example if i eat a mango it will caused hair loss? is there something like that? THANKS~!

Block Quote

MangoMango does not cause hair loss. In fact, I do not know of any specific foods that would cause hair loss. Perhaps if you have a severe allergy to a certain food, that could cause hair loss… but in general, normal foods do not cause hair loss.

Good luck with your school topic. If you want more information about hair loss, you can read my book — Hair Loss and Replacement for Dummies.

Posted on

Scalp Reductions Done Today? – Hair Loss Information – Balding Blog

Hi Doc! I’ve just about made it through all 800+ pages on the Balding Blog and have a couple of questions about scalp reductions. I know you and most hair restoration physicians discredit them, but are there ever cases where one could be performed? Assuming good scalp laxity, how much could be removed without causing the slot deformity in the back? Some physicians still list some form of scalp reduction on their site and I’m wondering what they do these days that won’t cause more problems later.

Block Quote

Scalp reductionScalp reductions are not the “gold standard” in treating male pattern hair loss, because the results are sub-optimal and you end up with a scar along the top of your scalp that will be visible with continued hair loss. Although I hate to use the term “never”, I will say that I can not imagine using scalp reductions on any patient today.

Now with that said, a few of the old timers that have judgments and experience with follicular unit transplantation may find an indication for performing a scalp reduction and it might be reasonable in their hands to do a few. If the scalp reduction is limited to no more than 1-2 surgeries, then the probability of a slot deformity would be minimal and the thinning of the scalp will also be minimized. Reductions also tend to lose their value over time (a term called stretch-back) and the patient would need to understand that risk.

I had 3 scalp reductions in 1992-1993 and my scalp became very thin and easily damaged by sun. I also had a full stretch-back, resulting in a return to the original balding pattern from before the first surgery. The medical-legal risk of scalp reductions to the doctor is not insignificant in today’s litigious society, so few doctors will face the legal risk with complications that were so frequent in the early days. In the 1980s, doctors would do these frequently because the money was good ($2,000-2,500 per procedure) and the skilled doctor would be able to do it in 15-20 minutes. So the attraction to do something so profitable was irresistible for many doctors, bringing out the larcenous side of those who had that tendency. Add to that the need for 3-6 surgeries in most people and that made the money look better and better for the doctor, so much so that they lost their sense of compassion for the patients who had the many, many complications of this procedure.

For more information, including the history of scalp reductions and photos, see here.

Posted on

A Limited Physician Survey About Finasteride – Hair Loss Information – Balding Blog

SurveyI belong to an email group of hair transplant physicians who communicate regularly to share information. Most recently, the group was polled to determine the side effects that these doctors see with finasteride.

Most doctors reported sexual side effects (range from 2-5%), breast enlargement (very rarely, seems like substantially less than 1%), reduction in ejaculate volume (substantially less than the 20% I have seen when I ask about it), bouts of testicular pain (rare), and mood swings (rare). All side effects have been reversed by stopping the medication in 100% of the experience of these doctors.

This was an informal survey, but the general numbers seem to be similar to the instance of side effects reported by Merck. If someone in our group hopefully formalizes this possibly in a publication, I will post the results.

Many of our questions posted on BaldingBlog relate to Propecia/finasteride issues, which we point out may reflect the panic of some posters on the internet. Those in panic mode or those who are very fearful do not reflect the majority of men taking this drug.