Author: Dr. William Rassman

Posted on

DHT Inhibitors and Impact on Organs – Balding Blog

how does DHT inhibiters impact other organ function?

I found an interesting article that discusses that very question in the Journal of Urology, published in June 2008. Rather than re-write an answer that has already been given, I’ll just post part of the abstract from the article –

“Profound suppression of circulating serum dihydrotestosterone induced by 5alpha-reductase inhibitors during 1 year does not adversely impact bone, serum lipoproteins or hemoglobin, and has a minimal, reversible effect on serum prostate specific antigen and sexual function in normal men. Circulating dihydrotestosterone does not appear to have a clinically significant role in modulating bone mass, hematopoiesis or lipid metabolism in normal men.”




Related Posts Plugin for WordPress, Blogger...

Balding Forum - Hair Loss Discussion

Paid advertisements (not an endorsement):


Posted on

Hair Character Changes, Prescribing Proscar, and Finasteride OTC? – Hair Loss Information by Dr. William Rassman

I was wondering a couple of things about hair loss/thinning.

I am half Asian and half Caucasian. I have read that Asian people tend to have fewer hairs per square inch of scalp VS Caucasians. When I was younger, I had very thick hair typical of a small Asian child. As I’ve gotten older my hair seems to have gotten thinner. Does it make sense that this is a result of some sort of genetic maturation? As far as physical appearance, I also went from appearing like a purely Asian child to look so white that most people think I’m adopted upon meeting my mother.

Second, I was wondering how difficult it is to actually find a doctor to prescribe generic Proscar for hairloss treatment. Is this a common thing or will I be pretty much forced to get Propecia which is much higher in cost?

And finally, I was just wondering what is keeping Propecia(or just generic Finasteride) from being an over the counter medicine available the same as Rogaine. Is it really so dangerous, for lack of a better word, that the general public can’t handle responsibly acquiring and taking it?

Hair changes its character as we age. It is not unusual for an 8 year old boy to have a coarser hair than he has when he is 20. We see that even more often as a person gets older (greater than 50-60 years old). Your physical appearance has little to do with your hair character and hair thickness (coarse vs finer).

Propecia/Proscar (finasteride) is a prescription medication. Some doctors may have an issue prescribing Proscar, but you’ll just have to ask them and let them know you’re aware that the pill needs to be cut and you just want the generic (only available in 5mg) to save money. There are many doctors in the New York area that can see you for a consultation if you are losing hair, one of which is my colleague Dr. Robert Bernstein in NYC.

As for why finasteride isn’t available over-the-counter, sometimes it can be a danger issue, other times it can be political. The FDA must decide upon a drug’s safety, effectiveness, and whether it can be managed without a doctor’s supervision. There’s an article about the road from prescription to OTC, relating specifically about the emergency contraception medication known as Plan B, but a good overview all the same.

Balding Forum - Hair Loss Discussion

Paid advertisements (not an endorsement):


Posted on

My Mom Said My Dreadlocks Are Causing My Hair Loss – Hair Loss Information by Dr. William Rassman

(male) ok, i have dreads and when someone did my hair, dreads started to fall out so my mom said it was because of tightness. i heard that a shot will regrow it. what do u think i should do? i really dont want to cut em. i bonded with them actually and i like them

Your mom is correct. The tight pulling from the dreadlocks is called traction alopecia, and that will cause hair loss (tight constant pulling for any hairstyle will cause this). I don’t know what shot you might’ve heard about, but regrowing hair lost from traction alopecia isn’t as simple as getting a shot. What you have now might just be temporary, so all hope is not lost, but at this point I have no way of knowing if it will regrow on its own or not. The best way you can tell if it’ll come back is by removing the dreads, crossing your fingers, and patiently waiting. I’m kidding about the fingers, but you will have to wait a few months (possibly up to a year) to see if the hair comes back on its own.

I can appreciate that you are attached to a hairstyle, but if you want to stop the traction alopecia from continuing, the sooner you get rid of the dreadlocks, the better. Or you can continue with the dreads and save your money for a hair transplant. Bottom line though, always listen to your mother!

Balding Forum - Hair Loss Discussion

Paid advertisements (not an endorsement):


Posted on

Hair Loss InformationThe Many Hairpieces of Jeremy Piven (with Photos) – Hair Loss Information – Balding Blog

I found this very interesting article on The Huffington Post about Jeremy Piven’s hair over the years. His hair has changed from bald to pretty much normal hair now. Any ideas on how he has added so much hair and made it look natural?

Here is the link to the article on the Huffington Post: Jeremy Piven’s Many Hairlines

Block Quote

This shows just how much the individual’s look is made by his hair. Let’s take a look at these 3 photos of Jeremy Piven…

Jeremy Piven

We (society) have developed stereotypes based on hair. For example, the Jeremy Piven on the left with the very high hairline suggests he’s aging, while the Jeremy Piven at the right is sexy and youthful looking. The photo on the left was actually from years before the image on the right. The photo in the middle (from July 2009) is just interesting to me because it looks like the hair on top of the head has a different color than hair on the sides and back. To me, that indicates a tell-tale sign for a hairpiece. Generally though, high-end hair systems can look great as long as you have the time, patience, and money to maintain them. For a Hollywood actor like Mr. Piven, he’s probably got all 3. Or at least the money and patience. The better way to go would of course be a hair transplant, which is permanent and doesn’t require the maintenance of a toupee.

Posted on

Why Do You Think Dutasteride Will Cause Sterility? – Hair Loss Information – Balding Blog

Hi Doctor Rassman

i been considering to take dutasteride for my hair loss . I been taking proscar for more than a year and seems that there is no improvement in my condition.There are many good report that dutasteride works much better than finasteride and soem of the people i know also have good result from it but from what you say, dutaseride may cause sterility in future.I can’t find any report on this.Can you please specify why will it cause sterility?And i understand that all side effects will stop once you stop taking the pills and that there are no permanent side effects.Please correct me if i am wrong as now the only concern that is stopping me from taking dutasteride is what you say about sterility.Appreciate your reply.Thanks

Regards

Block Quote

I really have no opinion of my own when it relates to dutasteride, as I’m still waiting for some kind of assurance from the FDA that this medication won’t cause sterility problems. I’m trying to find clinical reference, and while there might be more out there, one that I found referenced was published in the Journal of Clinical Endocrinology and Metabolism back in 2005. Although that study was not long term and was mainly about steroids, one of the study groups included dutasteride (although it was taken with other drugs) and indicated temporary sterility. I realize this isn’t a perfect example, and I’ll try to dig up some other studies one way or the other, as this is something that needs to be addressed.

I’m also concerned that the most recent Korean clinical trial didn’t reference sterility at all, positive or negative (I just wrote about this). Keep in mind that we want the FDA to clear this medication for hair loss treatment and address this potential problem in its review.

Posted on

The Use of Statin Drugs May Have Value for Everyone – Hair Loss Information – Balding Blog

This isn’t hair-related, but it is quite interesting and may have applicability to many of you. After you review it, you might want to talk with your doctor about this subject.

Abstract from the study:

The use of statins is widespread and many patients presenting for surgery are regularly taking them. There is evidence that statins have beneficial effects beyond those of lipid lowering, including reducing the perioperative risk of cardiac complications and sepsis. This review addresses the cellular mechanisms by which statins may produce these effects. Statins appear to have actions on vascular nitric oxide through the balance of inducible and endothelial nitric oxide synthase. The clinical evidence for these benefits is also briefly reviewed with the objective of clarifying the current status of statin use in the perioperative period. There is reasonably strong evidence that patients already taking statins should continue on them perioperatively. However, the evidence for the prophylactic use of statins perioperatively is weak and lacks prospective controlled studies.

Block Quote

Read the full text — Statins for All: The New Premed?

For years, I have been taking statins even with a normal cholesterol level. Many people who die of heart disease have normal cholesterol. Today’s regular Western diet may not be good for your health and as my father died from heart disease, the genes are there in my family line. Unfortunately, sudden death is often the first sign of heart disease (in 70% of those who have a heart attack). Although this article points to the risks associated with anesthetic risks and ways of mitigating them, my feeling is that there is a great value to taking a statin drugs routinely.

Posted on

In the News – Young Woman with Alopecia Universalis Shares Her Story – Hair Loss Information – Balding Blog

Snippet from the article:

Like any 12-year-old getting ready for her first school disco, Aimee Blinkhorn wanted her hair to look perfect. But as her mother put it up into pretty curls, she noticed a small bald patch at the back of her daughter’s head, about the size of a 50p piece.

‘Neither of us was particularly alarmed,’ says Aimee, now 26 and living in Manchester. ‘I just presumed some hair had come out when I pulled out a hair tie.’

But over the next few months, more bald patches appeared. Soon there were six of them – and twice the size of the first.

Block Quote

Read the full article at UK’s Daily Mail.

This is a great story about a courageous young woman that has been living with alopecia universalis. I applaud her for bringing her story to the public, and I hope she inspires others with this condition. If you want to know more about the disease, please see the National Alopecia Areata Foundation.

Posted on

Hair Loss InformationMy Hair Loss Consultant Was Nicer than My Doctor! – Hair Loss Information – Balding Blog

I went to a hair clinic for a consultation to get someone experienced to examine my hair and I have a couple questions, but I’ll give you the story first. I’m in my early twenties and a NW I or somewhere between a I & II at most, so I wasn’t considering surgery (felt guilty “wasting their time” but oh well). I hoped they’d focus on miniaturization/magnification, etc… But unfortunately it wasn’t until the end when I asked them did they actually use magnification. The guy didn’t really take the time to examine me thoroughly and after looking quickly at a few areas said there was possibly miniaturizing near the hairline but everywhere else was consistent and thick. He said my recession was minor and (adult hairlines are 7-8 cm from the brow?) that I had 1-2 cm before I was even at an adult hairline. My questions are:

1) The consultation advisor was very helpful and nice (unlike the M.D. who basically seemed annoyed that he wouldn’t make money from me, which I guess is understandable. The advisor implied that Propecia has little effect on any frontal areas. Is this true? I’m questioning this because he was sincerely advocating the laser comb, which seems ridiculous.

2) My brother gradually thinned and is noticeably thinner on top at in his mid-twenties. If my hairline is changing isn’t that still a form of hair loss? I’m just worried and trying to take preventive measures.

3) How certain/significant are the results of the HairDX gene test? Would you say it is worth the $250 it costs?

Thanks very much for your time taken to read this.

Block Quote

Not all clinics use magnification during a consultation, and it doesn’t make much sense to me that they try to rush you out the door if you’re not a candidate for surgery. It’s a good idea to call ahead and make sure that you will be able to have your scalp mapped during your initial consultation, so that you don’t leave disappointed.

  1. It is unfortunate that your doctor wasn’t caring or gave an annoyed impression. Not all doctors are like that, but I suppose it is better than having your doctor scam you into an unnecessary surgery. Your advisor was right though, Propecia has minimal effects on the frontal hairline other than slowing down the hair loss, but on occasions I have seen some reversal of the hairline in very young men (under 27 years old).
  2. Changing hair characteristics occurs with aging and it is not balding when it occur, but it does occur when a person is balding in its early stage. That is why bonding with a good doctor is a good idea. Think long term.
  3. I think I’ve answered this question before. The existence of miniaturization in the patterned hair loss areas is the best way to diagnosis balding, for if you have it, the test will be positive. If it is not clear and you are concerned about what is going to happen to you, then you need to ask yourself how much you’d pay for peace of mind. Remember, HairDX will tell you if you carry the gene, but not if you will lose hair, to what degree, or when it might occur.

Posted on

Hair Loss InformationCan I Even Out My Widow’s Peak? – Hair Loss Information – Balding Blog

Ok, I’m a 20 year old male, and I was born with a widows peek. Is there anything that can be done, to like, normal that out. I have never had hair on that part of my head and it’s beyond embaressing.

Block Quote

Norwood Class 4AIt is generally not a great idea to transplant hair into a non-balding 20 year old, because you must take into account the possibility that you might bald as you get older. Imagine that you got the right side evened out and then began balding to a Class 4A pattern. You would have a wing of hair where the transplant was done and then be bald to the Class 4A pattern.

You need to accept the premise that if you bald and have the frontal line fixed to your liking and desires, that you will be committed to transplanting behind it if you should lose the hair behind it so you will not look freakish.