Author: Dr. William Rassman

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Hypohidrotic Ectodermal Dysplasia and Hair Loss – Hair Loss Information – Balding Blog

I have a condition called Hypohidrotic Ectodermal Dysplasia and it affects the hair. I was wondering if you know anything about this condition? the hair loss is affecting my confidence. I am 21 and I live in Australia. I have asked the ozed support group and NFED and they weren’t much help. So can you please email me back and if you need any more info just ask.

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I know of the condition, but there’s not much that can be done to treat the thin hair associated with it. People with hypohidrotic ectodermal dysplasia often have a low number of hairs on the head and this produces a see-through appearance. This thin look can be helped with the use of concealers like Toppik or DermMatch, as this is a good, inexpensive way to produce the cover you need.

I’ve written more about these camouflaging agents in my book, Hair Loss and Replacement for Dummies (see chapter 8), and there might be more assistance you can find at the Ectodermal Dysplasia Society.

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Hair Loss InformationShouldn’t Finasteride Have Made a Dramatic Difference in 6 Months? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I first noticed a thinning of my frontal hair around April of last year. I am 26 years old Asian male. Hair growth slowed down and the front half of my scalp started to feel thinner than the rear.

In January this year, my dermatologist confirmed presence of early MBP and prescribed me finasteride (Proscar quartered daily). At that time I also started to use Minoxidil 5% nightly. It is now mid-June and I feel like I am still thinning rapidly. The frontal thinning is becoming visible now and I feel all the hairs on the top of my head have gotten much softer than the sides and back, which I suspect is because of miniaturization and the hairs growing thinner.

Its been almost six months. Shouldn’t finasteride have made a dramatic difference by now? Is there no hope? At this rate, I will be bald before I’m 30 and it’s a very, very, very saddening and scary prospect.

How long does finasteride take to show its effects visibly in the hair? I would be happy just to see this hair thinning halt and stabilize.

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Here’s a graphic I grabbed directly from Propecia.com that might help —

Propecia timeline

 

So really, the value of finasteride takes at least a year to see, and I’d say the full benefits may take 2 years to see. Some people might see less hair loss around the 6 month mark, but hair grows out at 1/2 inch per month… so after 6 months the hair that is 3 inches long will have just started to be exposed to the drug when it was formed.

Please understand these facts:

  1. There is no cure for genetic male pattern hair loss. Medications such as Propecia (finasteride) and Rogaine (minoxidil) help, but neither will stop hair loss completely or forever. For some men the medications can dramatically slow the progress, but eventually your genetic predispositions will win out.
  2. The front hairline is very difficult to treat with medication alone, as Propecia and Rogaine are not officially recommended for that area since it really doesn’t seem to help in clinical studies. Many patients still use these medications in hopes they’ll help that area a bit, and in some patients it may actually help to some degree.

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Hair Loss from Combat Stress, Heavy Equipment, and Wearing a Helmet for 5 Years? – Hair Loss Information – Balding Blog

Dear Doc Rassman

How are you doing doc rassman? i have an interesting question for you. and from reading your bio im sure you already have seen and know the answer for this. im 23 years old and have been in the army 5 years as an airborne infantryman, deployed to baghdad iraq for 15 months and am current back in iraq. been here a year. ive always had great hair, my buddies nicknamed me Jewfro hah. its thick, and slighty wavy. i did notice tho during my last deployment the hair on my temples was going, quick.

i was injured, put in combat stress and have worn heavy equipment and a helmet for 5 years straight, it seemed like when i came home the areas regrew. now that im back its happening again, worse, almost into a widows peak. again i am under constant combat fatigue and stress. its got me worried. im young, about to be a civilian and in college and id like to…well not look like an old beat up war horse. ive wondered if this was common or am i just balding? i know my current situation is almost more stress inducing and extreme than others who are and im sure its got alot to do with it.. just wanted to double tap. and see what i have to look forward to.. hoping to have a full head of healthy hair in my near future

Thank you

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HelmetAny stress could potentially cause hair loss (called telogen effluvium), and certainly the emotional and physical toll of war is among those stressors. I couldn’t say with any degree of certainty that your hair will regrow again, but if you saw regrowth the last time you were home, I’d hope you’d see the same regrowth the next time you’re home.

When you get back to the US, you should see someone who specializes in hair loss and can judge what has happened to you. In the examination will be a process I call mapping the degree of miniaturization of the hair in different parts of the scalp (learn more about that here). This will show if the hair loss is in a pattern consistent with genetic hair loss or not. If you have miniaturization present, the use of finasteride (Propecia) may be warranted. Helmets should not cause hair loss unless the helmet is tugging on the hair, creating traction alopecia.

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My Father and Uncles Are all Bald, So Am I Doomed to Lose Hair? – Hair Loss Information – Balding Blog

Dear Doctor:
I’m afraid to lose my hair because my father, uncles (both Mother side and Father side) are bald except one of them and also my cousins are same. Am I denounced to lose my hair? I’m 18 years old. I feel that I’m losing my hair but I don’t know whether it is normal I mean its only feeling or real. And I would like to mention that since I received an emotional shock about 2 weeks ago I feel that my hair falling speed is faster. is it temporary?

Thank you for your advice

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If you’ve got a strong family history of hair loss, you’ve got a stronger chance of losing hair. I can’t say for sure what you’re experiencing right now, but emotional stress can cause an increase in shedding and the hair could regrow… but it could also be the start of your permanent genetic hair loss. Tough to say what it is, but you can either see a doctor or wait it out and hope for regrowth.

If you do have early genetic hair loss, starting treatment earlier will yield the best chance of keeping your existing hair. You can get a test to see if you’ve got the genes for balding, which may address part of your concern, but it won’t tell you if the loss you’re experiencing now will regrow (see HairDX for more).

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Is Scalp Flaking Related to Hair Loss? – Hair Loss Information – Balding Blog

Hello Doctor,

Could you please provide some insight on flaking in the scalp and MPB. I have been thinning since 2001 and have been on finasteride for the past year with favorable results. Off late, I noticed excessive flaking in the scalp along with hairfall (roughly 2-3 hairs each time I run my hand through the scalp. I am not sure what could be the cause. Do you think people with thinning hair have excessive flaking when compared to their hairy counterparts?

Thanks

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Many times when a person has seborrhea (benign condition for flaking of the scalp) as the flakes fall off or are scrapped off by a person with genetic hair loss, the marginal hairs that are being lost will often fall out within the ‘flake’. That does not mean that flaking caused the hair loss.

So the answer is no, hair loss is not caused by flaking.

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I’ve Taken Propecia for Years, But Now I’m Afraid – Hair Loss Information – Balding Blog

I have been on propecia for 4 years prior to a procedure. The medication was working very well and I was holding on to most of my miniaturized hair until the procedure shocked all of it out and basically voided any benefit and progress that the medication provided me.

Since my terrible experience with this surgery, I have been doing so much research and have come across horrible side effects of propecia that I previously was not aware of…ED, breast enlargement, etc…. This has scared me so bad and is adding to my stress level which I am trying to control. I have not experienced ED up to this point, but not sure about the other…..have you seen these side effects in others and how often?

My question is that do you think (in your general experience) since most of my hair has been lost because of surgery that the propecia is not really necessary now? I just want to get off it and not take any more risks….

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PropeciaSo you took Propecia for years (including follow-up visits and prescription renewals) and somehow were never informed of any side effect potential, nor did you even read the insert that comes with the medication? If you have not had any side effects after 4 years, it would be unlikely that you will experience them now or at any time. I believe erectile dysfunction risks are about 1%, libido decrease 1%, breast enlargement much less than 1%. You should be in discussion with your prescribing doctor, not me over the internet.

Just because you had the surgery doesn’t mean Propecia is unnecessary. I don’t know where your surgery was on your scalp, but let’s assume it was done in the hairline and Propecia has kept the crown. Stopping the Propecia would just create a need for further procedures, as the hair that Propecia kept would soon be gone. Obviously this is just an example as I have no idea about your case or history, but if you stop the medication all the benefits disappear within a year.

With regard to the shock loss you experienced following your procedure, this is highly unusual in patients that are taking Propecia. I would have to know more about you, examine you, and understand just what happened and when.

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In the News – Other Doctors Starting to Warn About NeoGraft – Hair Loss Information – Balding Blog

Snippet from the article:

Hair transplant experts are excited about a new technology called NeoGraft that restores lost hair.

But they warn that a never-ending series of bad hair days could be the outcome for patients who turn to NeoGraft clinics run by poorly trained doctors and technicians.

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NeograftRead the full text — Bad hair forever? Experts: It’s possible

A little over 3 months ago, I posted my concerns about the NeoGraft hair transplantation tool and the fact that it was being marketed to surgeons that had no experience doing hair transplants. Well, now it seems others are finally speaking out.

I have personally tried to get to the company to observe the system in action, but my requests have been ignored by them. Considering that I hold many patents in this field and am a real expert on automation, their disinterest tells me that they don’t want to be observed in action. I would, of course, remain objective and if it is all that it is hyped to be, I would probably want to buy one… but that does not seem to be happening any time soon.

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Small Bumps on Scalp After Hair Transplant? – Hair Loss Information – Balding Blog

Dear Dr.,
I had a HT about a year ago utilizing the strip to micro graft method and I noticed that I have small bumps resembling chicken skin from where the hair is anchored. When this occurs from the old hair plug method it’s referred to as cobble-stones and surgery and/or camoflouging tends to help but what about when the hairs are single grafts? Do these bumps go away over time? Is laser surgery or some other cosmetic method suitable? I like the hair I have just not the rough scalp.

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I have heard complaints about bumps around the grafts after a hair transplant surgery, but frankly I have not seen them in my practice. The classic cobblestone appearance of the large, older “hair plugs” did form many skin abnormalities, and even the types of transplants done today could produce bumps if the instrument used is too large.

Bumps like you describe likely can not be repaired, but they can be camouflaged with a good hair transplant around them. Have you talked to your surgeon to find out why your result came with these bumps?

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Using Mesotherapy in Treating Hair Loss? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

First of all I want to congratulate for the beautiful book you have written (Hair Loss & Replacement for Dummies). I am a practicing dermatologist and am also working with a well known hair transplant surgeon in Hyderabad, India. I have a query regarding the benefits of mesotherapy. Where in the drugs include minoxidil, biotin, dexpanthenol and bilobine, since the drug is injected into the mesoderm where as the follicle is in mid dermis, are we justified in giving this treatment to the needy in the hope of achieving results? Since you are a pioneer in hair restoration i would be greatful to have you throw some light in this regard and clear my doubt.

Thanking you in anticipation.

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I’ve speculated about mesotherapy before, and I still don’t know much about possible benefits, if any, to give you an opinion. On random occasions, I have seen patients who have had these treatments, and Dr. Jae Pak has also visited the NHI office in Korea where it seems to be popular adjunct (as a culture).

That being said, there are no definitive or enthusiastic findings about mesotherapy as a hair loss treatment that I am aware of.

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Why So Adamant About 1mg Finasteride Daily? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

Dr. Jerry Cooley in North Carolina has said that taking Propecia three times a week is a practical dosage, and that most of his patients are on that dosage with good results. I’ve read a lot of your responses about reducing Propecia dosage and you are very adamant about the 1 mg/1 pill a day dosage and not any less.

I don’t want to put you in a tough position but in all fairness, it seems quite reasonable to think that Dr. Cooley is making a valid point. Why not jump on the wagon and start advocating the same thing? The more and more I think about it, the more and more it seems like Merck has got you secretly locked in to a deal with them. Frankly, Dr Cooley has made a believer out of me. Even my doctor in Korea has me on Propecia four times a week and he told me that three times a week is also good. I have some minor side effects, not of the sexual nature but for me it’s the dark circles. I’m curious to see if going on 3mg a week EOD will help get rid of my problem. And if so, would you care to know about it?

Here is the link to what I read: Regrowhair.com

Thank you kindly

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Tin foil hatDear conspiracy theorists all over the internet:

I advise and treat my patients based on standard medical practices and recommendations. I have no loyalties to Merck, other drug companies, or bandwagons. In fact, Merck probably does not like me so much, because I have no problem telling patients and readers of this site about the generic finasteride that ends up costing about $70 a year, instead of $90 a month for the name brand.

Our goal here on BaldingBlog, as well as in our private practice, is to empower patients with education. If you search enough through this site, you can see that we have been pretty consistent with this over the years.

Last time I checked, the standard recommended dose of finasteride for treating androgenic alopecia is 1mg a day. I realize some doctors prescribe different doses to their patients and rightfully so (because they have a medical license to treat their patients). I also realize there have been studies that support taking less than 1mg finasteride a day. In fact, some of my patients do take less than 1mg of finasteride a day… and *gasp* some of my patients take more than 1mg of finasteride a day. Each patient is unique and with different circumstances.

In general for most of my patients, I prescribe 1mg finasteride a day because as I said, that is the general recommended dose for androgenic alopecia supported by research.

Anyone interested in treating their hair loss needs to see their doctor, discuss treatment options and dosing of medications, and go by what their doctor recommends. I am only here on this site to give general information, not medical advice. You have every right to agree or disagree with my views, but this is my site and these are my views.