Dr. William Rassman – Page 1199

April 12, 2010

Is Taking 0.2mg Every Three Days as Effective as 1mg Daily Finasteride? – Hair Loss Information by Dr. William Rassman

Dear Doc,
Just read that 0.2mgs of finasteride taken once every three days is just as effective as 1mg daily at this site: hairloss-research.org

Is this bollocks?

That is just the opinion of one doctor, and I am also aware of similar opinions regarding low dose finasteride (though taken daily). I generally prescribe and recommend the standard 1mg treatment dosing to treat hair loss. From some research I have read, lower doses of finasteride 0.5mg and 0.25 mg will have an impact on DHT, but less of an effect can be expected from these lower doses.

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April 9, 2010

Female Hair Loss and No Family History to Look At – Hair Loss Information – Balding Blog

Hello,
I have been losing my hair for the past 2 years. It started falling out in droves when I was on Ortho Lo and started taking Bupriprion, then Lexapro then back to Buproprion for 2 years. I as well was getting my entire hair dyed for about 5 years. I am Korean but don’t have any genetic history to go off (am adopted). Am at my wits end. Supposed to go to Kaiser dermo soon. Do you think all the above contributed to rapid hair loss?

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Sometimes a certain pattern emerges which could point to genetics, and other times it may be a medical issues or medications issues. There are many reports online that bupropion (Wellbutrin) causes hair loss, and I’ve previously written about Lexapro and hair loss. Many anti-depressants have hair loss risks… and depression itself could be a cause. Among the possible side effects of Ortho Tri-Cyclen Lo, I see “loss of scalp hair” listed. So really, there’s a number of things that could be the cause, or it could be completely unrelated to medication.

Female hair loss can be difficult to pinpoint a cause, as there are many potential reasons for the hair thinning in women. Some of those reasons include anemia, thyroid disease, connective tissue disease, gynecological conditions, and emotional stress. For more, you should read Female Genetic Hair Loss Is Different From Male Genetic Hair Loss.

April 9, 2010

What If I’m Already Taking Anti-Rejection Medication for an Organ Transplant? – Hair Loss Information – Balding Blog

Dear Dr Rassman,

You’ve written before that hair transplant from another person or the dead are not possible because it’d mean the recipient needing to take anti-rejection meds and the risk being much greater than the benefit.

But what if a potential hair transplant patient has already had a previous heart/liver/lung etc transplant, and so is already committed to a lifetime of anti-rejection meds, would it then be possible (even if only theoretically) ? If so, has it ever happened, and is it something you yourself would be ethically comfortable with and technically confident of getting a natural looking result with ?

Thankfully, this is not a situation I’m in myself but presumably there must be some small percentage of your patients who this would apply to and it’d be interesting to know. Thanks!

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What you are asking is theoretically possible. However, one of the many side effects of anti-rejection medication is hair loss.

In the last 15 to 20 years of my practice, I don’t recall seeing a heart/lung/kidney transplant patient nor have I met someone willing to donate their hair to someone else. I think people may be more willing to donate one of their kidneys than their hair… which says something about how important hair is to most people, eh?!

April 9, 2010

I Don’t Want to Invite Breast Cancer by Taking Finasteride! – Balding Blog

Dear Dr,
My dermatologist has suggested me “Finax” (Dr.reddy’s Lab) 1 MG and 2% minoxidil and Aminexil topical lotion (Since Iam allergic to 5% it causes itching in my case). Now I went through this web site: MHRA

It explains the possibility of breast cancer in men with Finasteride(5 mg). I dont know whether you have answered this question previously or not. Now After purchased finax for 3 months (90 tablets) what am I supposed to do? I dont want to invite the risk of breast cancer for the sake of hair. And have you seen any cases of male breast cancer which I think is very rare compared to female.

Finax Dr. Reddy’s Finax is generic finasteride and sold in 1mg and 5mg doses. I believe that their production in India is an FDA approved facility, but sale of the generic 1mg in the US would be a violation of the patent rights of Merck… which is why this medication isn’t available here in the US yet.

I’ve never seen a case of breast cancer from finasteride and some recent studies of a few thousand men failed to show the connection that the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) warns of. For women who have a history of breast cancer, there may be an increased risk when taking finasteride… and this is just one of the reasons the medication isn’t approved for women. The MHRA warning itself states, “Fifty cases of male breast cancer have been reported worldwide with the use of 5 mg finasteride (Proscar) and three cases have been reported with the use of 1 mg finasteride (Propecia).” So there have been 3 cases of male breast cancer out of the million+ Propecia users?

The warning also mentions, “the overall incidence of male breast cancer in clinical trials in patients who received 5 mg finasteride was not significantly different compared to patients who did not receive finasteride” — so why was there a warning at all? I don’t know how a connection could even be made. If you’re really worried about this, don’t take the medication. It’s not worth the anxiety. Personally though, I don’t see how this is significant enough to warrant a warning at all.

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April 9, 2010

Why Don’t Transplanted Hairs Grow at the Same Time? – Hair Loss Information by Dr. William Rassman

Dr Rassman

I have a query that has always interested me but I have never quite found the answer to. Why does newly transplanted hair grow at different timelines to each other (either scientific or theoretically). For instance I had a hair transplant nearly 6 months ago. Today I could see a couple of new hairs popping through, yet my first good initial growth that I could visibly see was just before the 3 month mark. I find it amazing that there can be such a time buffer between growths, yet all the transplanted hair was inserted in my head within a 4 or 5 hour timeframe!! Surely all the hair should grow back within that timeframe??

Thanking you for your time.

I do not have a good answer for you, but I can offer some speculation. Some hair follicles remain dormant longer than others, but it has nothing to do with the time it took to place the grafts in your scalp. All of the hairs on the head are growing at different and overlapping cycles. So naturally the transplanted hair would behave in a similar way. It may have something to do with the time in the cycle the hair was in when it was moved.

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April 9, 2010

Would Drinking a Lot of Water Impact Propecia? – Hair Loss Information by Dr. William Rassman

In a recent post (Propecia and Coffee) you mentioned that some people believe that the increase in urination from drinking coffee and/or alcohol might diminish the impact of Propecia.

I currently drink about 1 gallon of water a day and because of this I urinate a lot. Could this prevent me from seeing maximum results from Propecia? Should I drink less water?

Water With respect to the post you are referring to, I never stated I believe in the theory that urination will make Propecia less effective. People write about these things on the Internet and the speculations get propagated (as I have probably contributed). So no — I do not think drinking and increased urination contributes to less efficacy of Propecia. I wouldn’t worry about it.

But, isn’t drinking a gallon of water a day considered excessive? I’d be concerned with possible water intoxication or hyponatremia.

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April 8, 2010

Thicker Body Hair from Propecia, Forehead Hair from Minoxidil? – Hair Loss Information – Balding Blog

Hey Doc,

In the thirteen months I’ve been taking propecia I’ve noticed that the hair on the rest of by body has been growing at a much faster rate. I’ve also noticed that in the the four months I’ve been using rogaine, small hairs have been growing on my forehead and my eyebrows are definitely getting much thicker. Is there a correlation between them or am I just paranoid? This seems odd to me since nobody in my family is as hairy as I am at the moment Also, how long does rogaine usually last for before its effects begin to die out? I’m a 21 year old male with middle-eastern background.

Thank You.

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Propecia (finasteride) blocks DHT. DHT is known to be responsible for secondary male characteristics, such as body hair. At least in theory, if you block DHT you would have less body hair. I have heard and seen on several occasions patients stating they got less body hair after a year of taking Propecia, but you would be the first one to say you have more body hair as a direct result of it. This can also be coincidence as well.

If anything, I would suspect that Rogaine (minoxidil) is causing body hair growth and is responsible for the growth of forehead hair. You must be either applying it to your forehead or absorbing some of it into your body, causing a systemic effect. Another thought is that you are only 21 years old and some men continue to mature in their secondary sex characteristics (body hair, for example) into their mid 20’s. I realize you are trying to make sense of all this even by comparing yourself to your family members, but sometimes it just is the way it is.

April 8, 2010

Hair Loss InformationTransplanting Hair to Cover a Scalp Keloid? – Hair Loss Information – Balding Blog

I am an African American male age 46 with a keloid on the back of my head which resulted from two surgeries to remove it. Now I have a keloid the size of a strawberry which leaves a bald patch in my hair. Can a hair transplant or hair patch be put in that area to cover it for good? If so will it cause more problems in the future or no?

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I often see patients that wish to cover scars (and keloids), but hair growth on this tissue can be less than optimal and patients often require addition surgery to increase the density of hair. In the end, the scar and keloid is still there, but it might be covered with the new transplanted hairs.

Transplanting into keloids, however, also runs the additional risk of making them worse. If you’re known to form keloids on the scalp, then having more surgery (like a hair transplant) could result in more of the same. You already tried to surgically excise the keloid on your scalp and it caused it to grow larger? I don’t think its worth the risk, though without an examination I couldn’t make a definitive opinion.

April 8, 2010

High Blood Pressure, Heart Palpitations, Stress from Minoxidil? – Balding Blog

Hi Doctor –

I was using propecia (Finax 1mg) since Nov’2009 till Feb’2010, I was also using minoxidil 5% tropical solution. During Dec and Jan I experienced palpitations and Feb I felt stress around my face and chest which turned out to be high blood pressure 145/90. This did not happen for a month and then again suddenly I have started palpitations and sometimes feel stress. I have stopped the usage of both the medicines since 3 weeks but nothing seems to work.

Please help me out with how much time it should take to get rid of these side effects, do I need any medication that can help me wash this off easily… I have developed sleeping disorder as well. My physician who advised me for this is not ready to believe that these medicines can cause these issues.

Looking forward for you help. Thanks

Here are the listed rare side effects for topical minoxidil — “Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); changes in hearing or vision; difficulty breathing; excessive, sudden weight gain; fainting; lightheadedness; increased chest, arm, or shoulder pain; increased heart rate; pounding heartbeat; swelling.”

And here are the listed rare side effects for finasteride — “Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); breast enlargement, lumps, pain, or tenderness; nipple discharge; testicular pain.”

So what you describe as stress in your face could be an allergic reaction to either medication, but this doesn’t explain your blood pressure spike. In fact, minoxidil is taken in pill form to lower blood pressure. Stress is a likely reason for any abnormal sleep patterns, and the stress itself could be from your health. What troubles me is that you still are experiencing issues even after stopping the medication, leading me to wonder if your symptoms are unrelated to your hair loss treatments and could possibly signal a serious (undiagnosed) underlying medical issue.

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April 8, 2010

Rogaine Shedding Scares Me! – Hair Loss Information by Dr. William Rassman

I’m planning to travel out to LA for a consultation [from overseas]. How far in advance do you recommend booking an appointment.

One final question. A few folks have mentioned nasty sheds that are associated with rogaine, and in particular with rogaine foam. If you read the blogosphere, it’s enough to scare one stiff. In your experience, how frequent are the sheds and do they often result in a negative cosmetic change in the short term?

Thanks

The more notice you can give for an appointment, the better… but if you’re in from out of town with a fixed schedule, we’ll do our absolute best to fit you in whenever you can stop by. I look forward to meeting with you.

As for minoxidil shedding, I think its pretty rare but I honestly haven’t kept much referential data on it. Since it is an over-the-counter medication (meaning a doctor’s prescription is not needed), I don’t have much follow-up with patients regarding it. If the shedding does happen, it should stop within a few months… but it doesn’t happen for most people.

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