Author: Dr. William Rassman

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Hair Loss InformationPropecia and the Morning Wood – Hair Loss Information – Balding Blog

This blog is an excellent resource; I studied it extensively and used it to decide on Propecia as a course of action 3 years ago. I have a question with respect to Propecia and nocturnal erections. You mentioned in a previous post that, “the lack of morning erections is a known problem with Propecia.” Why is Propecia associated with lower quality/quantity of nocturnal erections? I am trying to assess the safety of prolonged propecia use, as the results are excellent. Could this side effect be a fast track to ED?

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WoodGetting an erection is important if it occurs when you want it. Nocturnal or morning erections are often just part of the overhead of being a man. Now that I am in my 60s, I can look at this problem differently than when I was 15 years old when my morning erections went from the time I woke until 3pm when school let out. A morning woody is OK, annoying at times, but it is important (morning or night-time) when it is called into action by the appropriate circumstance. I don’t believe that a reduced morning or night-time spontaneous erection frequency is a problem for men of any age, providing that the plumbing works when needed.

If Propecia (finasteride) reduced the frequency of morning or nocturnal erections and at the same time reduced your penis’ erection capability, then Viagra or other such drugs may be the best way to manage that problem. I suspect that the nocturnal or morning erections will be less frequent with people on this drug, but I never did a study of this for statistical analysis nor have I seen such a study elsewhere. Many men use Viagra even when they are not taking finasteride, and I believe that erectile dysfunction (ED) is a problem for 30% of men between the ages of 30-40, and 40% for men between age 40-50, and better than 50% for men over 50 years old. So the use of Propecia does not set up a man for this eventual problem, just his aging process does.

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Hair Loss InformationActor Jon Hamm’s Hairline – Hair Loss Information – Balding Blog

Hello Doctor,

I can’t remember if I asked this already but it didn’t seem to be answered. I was curious if you would characterize the actor Jon Hamm as a textbook NW2? He clearly has a mature hairline at least, but I can’t see any frontal balding.

I recently got a hair transplant and I believe my hairline will mimic his, which is quite promising considering I am about five years his junior. My wife seems to think he’s very handsome, and he clearly does not have a juvenile hairline, so there’s hope for us NW2’s eh?

Thanks!

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Jon HammMany of the photos I found of Jon Hamm show his hair longer and covering the corners of his hairline (like this one), but I was able to find a photo that shows what appears to be a Norwood Class 2 pattern (like here or here). In other words, he doesn’t have any real hair loss, just as you described. He appears to have a great head of hair.

To be sure of that NW2 though, I’d need to see his wrinkled brow and from there I can make the appropriate measurements from the highest crease of his wrinkled brow… or see photos from when he was 10 years old and compare the shape of that hairline to those that show in the reference images. But for the sake of this blog, I’ll just take it at face value.

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Hair Loss InformationCan Propecia Save My Weak Hairline? – Hair Loss Information – Balding Blog

started propecia 1 month ago have a receding hairline. have lots of miniature hairs still there. will propecia help these hairs grow thicker?

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Each case is different, and I can’t give you a 100% guarantee that Propecia will save those hairs in your hairline. I don’t even know where your loss pattern is or how old you are. I can tell you that the younger you are, the better the chances for reversing or really saving the hairline with the medication. I’ve found that men under 25 years old in your situation do better with Propecia than men over 35.

Get your hair and scalp mapped out for miniaturization to establish the baseline measurements you need. Then you can go back 6 months later with another mapping to actually have metrics and see where the Propecia helped.

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Hair Loss InformationReader Believes Estrogen is Cure to Hair Loss – Hair Loss Information – Balding Blog

Okay, this might sound ignorant, but I believe the only natural cure for hair loss is Estrogen. This is why a lot of women don’t lose their hair as bad as men, because they primarily carry the Estrogen hormone. So if scientists or whatever were to reverse the tables when actually dealing with Male Pattern Baldness and how Testosterone (the male hormone)converts into DHT, then it’s obvious that the male individual lacks the estrogen hormone which is a key factor of healthy hair growth.

For instance, if a man were to get castrated, he will grow a full head of hair because of the fact that his male reproductive organs were cut off. And having a penis and testicals is a key factor in producing testosterone in men, thus having less estrogen in their systems.

Yeah, I know this might sound ridiculous, however, I think that a man who suffers from MPB should take estrogen injections to the scalp in hopes that it will wake up his dead hair follicles and produce new ones, thus, have a full head of healthy hair. What do you think?

Oh, and I enjoy the blog…Much success and God bless…

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You are partly right. Estrogen does protect against hair loss in women, but not in men who have much higher testosterone levels. More testosterone means more DHT and for male genetically impacted hair follicles, that is death to some of the hair in the pattern of balding. Having the testicles removed will save you from more hair loss, and although you can keep your penis (as that is not part of the hair loss formulae), I wouldn’t recommend this route.

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Hair Loss InformationHBP and Body Hair Loss? – Hair Loss Information – Balding Blog

My husband has high blood pressure and he for some reason he is loseing the hair on his leg’s could that have anything to do with his blood pressure? or is the loss of the hair on his legs from something else?

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If he is taking medication for his high blood pressure, that is known to cause hair loss in some individuals, but I am at a loss to explain the hair loss on this legs as an isolated finding.

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I’m a Soldier and My Hair Loss Started When I Was in Iraq – Hair Loss Information – Balding Blog

Hello, I’m a 22 year old white male who has over the past year or so has started to have thin hair on the front of my head, and lots of hair loss on the crown. Im a United States Soldier and just returned from Iraq in June of 2009. I noticed the hair loss mid tour in iraq. Im wondering what i need to do to get my hair back, i have military benefits. What type of doctor do i need to see? Please let me know, im too you to be bald. Thanks so much for reading.

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SoldierYou should see a hair transplant surgeon who does not rush you into surgery. These are often the best doctors for getting to the bottom of your hair loss, as they deal with it daily. You can check the physician search at ISHRS.org to find a doctor in your area (or if you’re in the LA area, you can see me). Whomever you choose, he/she should be able to ascertain your degree of miniaturization and the connection to genetic balding with the ability to predict where your hair loss is going.

Assuming you have genetic balding increased by the stress of your tour of duty, Propecia (finasteride) should absolutely be in your future. Depending upon where you are in the balding process, a Master Plan that takes into account your family history, the degree of miniaturization that you show now, and your response to the drug (finasteride), will give you some insights into your hair loss future. I don’t believe that your medical benefits from the military will cover the costs of hair transplantation, assuming that is where you will end up in the future as you age.

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My Generic Finasteride Manufacturer Has Changed – Hair Loss Information – Balding Blog

Hello Dr Rassman,

Ive been on propecia for about 2 years now, for the first year i was taking the brand name tablets but i read on here that i would be able to get the generic 5mg finasteride tablets and just cut them up into 4 pieces. So since then ive just been cutting up the pills. The last time i went to pick up my prescription the actual tablet had changed and was manufactured by a different company. Ive been taking the new pill for about a month now and i feel like my hair is starting to thin at the sides again. Is this just paranoia or could a switch to a different manufacturer make a difference?

Thanks

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The manufacturer shouldn’t make a difference, but I’d ask your pharmacist about the credibility of the new manufacturer, explaining to him/her what you told me here. If you buy Proscar (genuine Merck product) I would think that it is finasteride 5mg as reflected on the label. As for the other manufacturers, I’d hope for the same, but I don’t know where your pharmacy got their supply. There are counterfeit drugs out there (particularly generics, which vary in shape and size of the pill), so the only way you could be sure is to buy a brand name such as Proscar.

Here’s a list of generic finasteride makers that I’ve mentioned before. Cipla and Dr. Reddy’s are two of the more common generic makers, and although there could be other manufacturers since that post was created, it’ll give you a good starting point.

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Hair Loss InformationDHT and Sebum Production – Hair Loss Information – Balding Blog

Dear Dr Rassman,

I have heard that DHT in the scalp is linked with overproduction of sebum, which is the main cause of seborrheic dermatitis. Does this make any sense to you? I have been diagnosed with seborrheic dermatitis, and I also have hair loss. The two dermatologists I have seen have tried various topical medicines, betamethasone, clobetasol propionate, selenium sulfide, Nizoral shampoo etc. All of these things have only inflamed my scalp even more, and my scalp continues to secrete way too much oil. Is it possible that DHT in the scalp is the underlying cause of this? Could taking propecia stop the overproduction of oil?

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As I’ve written before, the sebum/DHT connection is not supported by science. Propecia will not stop oil or sebum production. Too much oil is best treated with more frequent washing and using shampoos that are specifically designed for oily hair (see labels).

The use of steroids (betamethasone, clobetasol propionate) is something I tend to stay away from as these steroids get absorbed into the body, a less than healthy process when such medications are used in excess.

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In the News – Scalp Cooler for Chemo Treatments – Hair Loss Information – Balding Blog

Snippet from the article:

The machines work by lowering the temperature of the head and scalp by a few degrees before, during and after chemotherapy.

This reduction in scalp temperature restricts the amount of blood reaching the hair follicles protecting them from the effects of chemotherapy drugs in the bloodstream, meaning that hair loss is not inevitable.

Although the scalp coolers have been around for some years some hospitals still do not have them, or if they do, they do not have enough of them to save everyone’s hair.

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Read the full story at BBC News

The article also mentions that this isn’t an appropriate treatment for all cancers or chemotherapy drugs, but I still would worry a bit about lowering body temperature due to the scalp’s very high blood supply. Just a thought though, as this is an interesting piece.

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Why Am I Losing Hair Around My Belly? – Hair Loss Information – Balding Blog

ive had steady hair loss around my belly button hair area for about 2 years now, it just keeps getting thinner & continues on a steady pace. i dont care all that much about losing hair in that area, but my concern is the reason for it & will it spread to other areas? is this normal? thank you

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Often the belly is an area that is rubbed by belts or articles of clothing. These can cause traction alopecia. Have you gained weight and increased your belly size?