Dr. William Rassman – Page 1189

May 11, 2010

My Twin Has Thick Hair, But I’m Starting to See Thinning! – Balding Blog

I’m a 51 year old male…. There is no baldness running in my family. My twin brother has a full thick head of hair. About 5 years ago I noticed my hair thinning a bit around my hairline above my forehead. Didn’t really give it much thought. But over the past couple of years I’ve noticed an overall increase thinning of my hair especially around the crown and the hairline. I don’t have any bald spots. Just thinning to where my scalp is more visible now.

I was in a very stressful job when I began noticing my hair loss. Not sure if that had something to do with it. I do use hair products in my hair to keep it looking nice and shiny. Is there a way to tell if it’s just a temporary condition and that my hair will re-grow or something more permanent? Not sure if I should see a dermatologist or a general doctor. Any suggestions?

If you have an identical twin he will also lose hair like you, but if your twin is fraternal then your genetic make up is not the same. Thus, your fraternal twin may not lose hair like you. The great majority of the time men see hair loss is due to genetics, and this is called androgenic alopecia (AA) otherwise known as male pattern baldness (MPB). So while most hair loss for men is genetic, it can skip generations making it impossible to simply look at your father, brother, uncles, grandfather, etc to know if you will be bald.

Hair loss from stress is different than genetic balding and it does not occur in a “pattern”, thus the term male “pattern” balding. I’d suggest your next step is seeing a physician. Either your dermatologist or general physician should be fine.

May 11, 2010

Would Catch-Up Loss on Avodart Take Longer than Propecia? – Hair Loss Information by Dr. William Rassman

Hi Doctor,

Given the longer half life of Avodart would you expect catch up hair loss – due to stopping drug – to be delayed more than Propecia (i.e 3-6 months)?

Thank you for your time.

That’s an interesting question. I do not know for sure, but I suppose in theory the catch-up hair loss with Avodart (dutasteride) may take a bit longer considering the long half life.

Paid advertisements (not an endorsement):

May 10, 2010

Only 50% of Men Lose Hair? Looks Like More! – Hair Loss Information – Balding Blog

Dr. Rassman,

In prior posts here, you have stated that 50% of men experience some degree of balding in their lifetime. Yet, when looking around at older men, that number seems much higher than that! Men like Ronald Reagan stand out precisely because so few men still have ALL their hair in old age. Reagan’s hair would not be so striking if he was just part of the 50% who never lose hair. I am just wondering what that 50% stat is based on.

Block Quote

I believe that 50% is loosely based on observations by doctors and is quoted widely (even by me). I am not aware of any specific studies that looked at men in a certain age group and categorized them on a hair loss scale. So I guess the percentage could be 42%, 51%, 69%, 71%, etc….

On a final note we generally consider 50% of men go through some degree of genetic, patterned balding. This does not account for age related general hair loss, where there is no pattern.

May 10, 2010

Airline Lost My Luggage with Propecia in It! – Hair Loss Information by Dr. William Rassman

My baggage was lost on a recent trip and I was without my Propecia for 8 days. Would this relatively short period of time without the mediction cause any problems or loss of hair that wouldn’t have occurred otherwise. Thank you. I appreciate your time and dedication.

There is some tissue fixation that lasts about 1 week so I would think that you would be alright. If we were your doctors, we could send you some temporarily or call into a pharmacy near where you are for a temporary supply. Check with your doctor in the future if it happens again.

Paid advertisements (not an endorsement):

May 10, 2010

Propecia is Causing All of My Hair to Fall Out! – Balding Blog

7 months and 6 days and im seriously thinking of giving up on propecia. I am quite vein and when I seen my hairline had receded a tiny bit I decided to go onto propecia, I really wish I hadn’t, every day since month 3, my hair falls out, loads in the shower, loads on my pillow case and loads as I pull on my hair very slightly, propecia has without a doubt made it worse, I have just decided to take 0.5 instead of the 1mg i was taking to see what happens, if I continue shedding then Im getting off. I am 100$ convinced this made me worse, I have read its impossible and ive even been told by my doctor it doesn’t make it worse, but it has. I am jeopardising any chance I could have of a hair transplant, because the hairs that are falling out are all over, back and sides as well as the top, and for a transplant they take hair from the back and sides which are falling out rapidly. Why is this happening and what should I do? It’s so frustrating

There is no way for me to understand what is happening to you without an examination. What you are describing makes no sense unless your Propecia is counterfeit (a not uncommon problem). Sure, sometimes the medication might not show much benefits, but to make the hair fall out all over, including the donor area… that particularly makes no sense.

Basically, you need a good doctor to tell you what is happening and this can not occur over the internet.

May 10, 2010

What is “Buyer Beware”? – Balding Blog

Hello, my questions is about your terminology of “buyer beware”. That is you often say all these over the counter medicines are “buyer beware” does that indicate that you believe there are some non FDA approved supplements etc. that actually do work on an extremely small percentage of people. In essences have you ever seen someone benefit from any non FDA approved treatment?

The best example of an herbal that is popular for treating hair loss is saw palmetto. There is a suggestion that there are some positive hair effects, but without clinical studies you will not see me endorse it. I’d need to see the proof beyond isolated reports by anonymous people on the internet. I’ve yet to see a patient here that had positive hair loss treatment results from an over the counter supplement.

Expectations are everything and you don’t want to have your time wasted by trying new approaches over and over again with no value as you continue to lose your hair forever. Readers of this site and of course my own patients expect me to be straightforward and not point them in a direction that could be a waste of time when there are proven safe and effective medications. Hair loss is a progressive process and every man who has it and does not take proven medication is destined to be balder and balder over time. Safety is another issue and from time to time we see the FDA take a stand and get some product pulled from the market for safety reasons.

“Buyer beware” is just a reminder to be smart about what you’re buying. It’s a notice to folks to use common sense and be more cautious before wasting your money on some truly obvious scams. If some product claims 100% success in regrowing hair, don’t you think everyone would know about it? I’d have no reason for this site if just one of these garbage products had the 100% results that are claimed, because there would be your hair loss cure.

May 7, 2010

Hair Loss InformationCan I Get Rid of the Old Hair Plug White Scars in the Donor Area? – Hair Loss Information – Balding Blog

I had grafts put in about 12 years ago, the method that was used left me with many large white holes in the back of my head in the donor area. My goal is to shave my head completely and not see those white marks. Is there a way to get rid of them? Something you can do? What about Lasers as well? By the way, what are those white marks called? It is not a strip scar but it has another name.

Thank you very much….

Block Quote

I suspect that you are talking about the drill holes that were the original way to harvest the grafts. Originally, the doctors used a hollow drill (maybe an old model of a Black and Decker) to make drill holes to core out the hairy donor skin. Some doctors never sutured these closed, leaving huge holes which filled in with white scar tissue that reflected that the wounds were left open (the process of healing is called secondary intention healing). There is little you can do about them.

They can be filled in with transplants taken out with the FUE technique or tattoos can also possibly work, but the problem is that when your hair turns white as you age, the tattooed hair will remain close to the original color (black or brown, perhaps) and over time I would suspect it’ll start to blur. In other words, I think that for a short term solution, you could create a long term problem with the tattoo.

May 7, 2010

Hair Loss InformationDoes Stress Aggravate Hair Loss by Elevating DHT? – Hair Loss Information – Balding Blog

Doctor,
I am turning 23 years old in May. I have noticed that I have been thinning on the back of my head around the vertex. The thinning seemed to have started this summer. After slightly noticing it, I asked my barber if he had noticed anything. He said that it has been relatively the same for the past 5 years that he has been cutting my hair. I have been monitoring the situation and noticed that it has thinned out a little bit more. Today when I got my hair cut, my barber said it seems to be thinning now. It is visible to me that I am most definitely thinning at the vertex especially after cutting it a bit shorter around that area. I have just entered pharmacy school and I am afraid that with stress elevated levels of DHT can affect my hair.

My question to you is, first, does stress aggravate hair loss by elevating DHT? Second, I would like to take Finisteride 5mg and cut it up into 4 pieces. That extra bit of Finisteride, is that ok? Lastly, should I use Minoxidil? My beef with that medication is that it is a vasodilator and I am afraid that I would have to use it forever, I would rather take Finisteride forever (or until I decide I just do not care). My hair loss is not noticeable; it looks like it is simply the separation of my hair. However, I know my own hair density. I believe Finisteride should be enough to at best stop any further thinning. Also, I can provide you with pictures if that would help. Thank you for your time and have a wonderful weekend.

Block Quote

I would doubt that stress is elevating DHT levels. Men with hair loss and thinning at the top/crown are mostly likely to have genetic male pattern baldness. Yes, DHT is one of the factors, but your genes are ultimately to blame. Chances are, the loss you’re seeing is coincidental to your entering pharmacy school.

If you cut a 5mg finasteride tablet into 4 pieces, that’s 1.25mg per day (if you get the pill cut perfectly)… and that’s ok. Ideally, cutting the 5mg pill into 5 pieces would be best, but getting 5 equal pieces would be extremely difficult. Using minoxidil with the finasteride is up to you. Some patients like both medications, but it could feel like a daily chore that you need to keep up with.

May 7, 2010

Hair Loss InformationAderans Expands Clinical Studies – Hair Loss Information – Balding Blog

IÂ´ve found updates from Histogen and Aderans. What can you say about this? Thank you.

Histogen: Hypoxia Induces Stem Cell Gene Expression, Protein Production and Cell Surface Markers

Aderans: Aderans Research Expands Clinical Studies

Block Quote

Thanks for sending these links. Each press release speaks for itself. The Histogen press release isn’t specifically about their hair loss treatment (they have multiple products unrelated to hair loss treatment), but the Aderans Phase 2 clinical trials expansion is for hair regeneration. Once the studies have concluded, they will hopefully be published with the FDA and then we will know better about what is offered.

May 7, 2010

Hair Transplant Results with No Detectable Scar (with Photos) – Balding Blog

This patient stopped by my office to show off his remarkable results from his single hair transplant less than 8 months ago of only 1336 grafts in the frontal area. Before photo on the left, after photo on the right; click to enlarge:

He also had no detectable linear scar as shown in the photos below. The absence of the linear scar really reflects the patient’s healing ability as much as the surgeon’s skills. I usually don’t take credit for great scars as I always do the same procedure with the same precision on every patient. Interestingly, we elected not to use a trichophytic closure on this patient and the donor scar is still undetectable. Some people just heal better than others. Why didn’t we use that closure technique? Well, he planned on having a 2nd surgery in the future, but his results were so impressive that he won’t need another procedure. Click the photos to enlarge: