Dr. William Rassman – Page 1276

August 17, 2009

In the News – Combing Too Often Means Hair Loss? – Hair Loss Information by Dr. William Rassman

Snippet from the article:

Put that comb back in your handbag — a study by an Israeli dermatologist has found that too much combing of the coiffure leads to hair loss, the daily Haaretz reported on Monday.

During a test 14 women recorded their daily hair loss and combing habits, with those combing more losing more hair, the research found.

Read the full article — Don’t brush with baldness: put down that comb

The Internet is full of useful information, but as I’m sure you all know, some of it can be deceiving. The article states that an Israeli dermatologist studied just over a dozen women and came to the conclusion that women that comb their hair twice a day have far more hair loss. The study went on for just a month, but what is unknown is the type of hair the women have, their ages, health condition, type of brush used, plus various other factors that would be important to note in a study like this. In fact, I found the original article published in Israel, with a quote from the dermatologist that conducted the study. He says, “It’s a very simple experiment, very primitive, you could say, not high-tech.” I’d have to agree with that. It seems to be pretty incomplete… but it sure makes for a good headline in the news.

Bottom line, if you are rough with the comb and your hair is long and you pull on it when you comb it, it may just fall out eventually. Men with genetic balding and miniaturization have a more fragile hair that is easily traumatized, so I always suggest that people are careful when they comb their hair and not be abusive to it. Gentle combing done very frequently will not cause hair loss.

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August 17, 2009

In the News – Fish Oil Benefits for Cardiovascular Disease Confirmed – Hair Loss Information by Dr. William Rassman

This is a general health posting, unrelated to hair loss.

Snippet from the article:

Fish oils are so effective at helping protect against heart attacks, they should be taken daily by everyone, say doctors in a new review of the effects of omega-3 fatty acids.

The doctors say their review found that there is now “compelling” evidence that the omega-3 fatty acids in certain fish and other sources not only prevent cardiovascular disease, but may even help treat it.

The study, published in the Journal of the American College of Cardiology, reviewed data on four trials involving almost 40,000 participants that showed the benefits of omega-3 fatty acids in the prevention of cardiovascular disease, in treatment after heart attack and, most recently, in heart failure patients.

Read the rest of the article — Fish oil’s heart benefits overwhelming, say docs

Being bald is OK, but dying from heart disease should not be in your cards.

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August 17, 2009

Problems After Switching to Generic Finasteride – Hair Loss Information by Dr. William Rassman

I started using Propecia 5 years ago at the age of 25. I wasn’t sure if my stress level was affecting it (went through a really horrible breakup) or if I was having genetic hair loss. So I started to take it and all was fine. 2 summers ago I stopped taking it thinking it was probably just stress and 2 months later, I noticed the hair was indeed falling out. So I started up again. Until 2 months ago i was taking propecia but then just decided to switch to finasteride as many of my friends and clients (I’m a hair stylist) swore by it and so I switched.

I’m noticing my hair has thinned as if I stopped taking it altogether. Is this possible? I have the 5mg finasteride and cut into quarters.

Also, I was reading online about symptoms of testicles/penis “feeling cold” and shrinking frequently is related to the propecia/finasteride usse. I have had A LOT of that and am wondering if it’s related since the prostate is directly involved.

I appreciate the time you give in reading and answering my questions. Thank you.

Taking generic finasteride 5mg and dividing in to quarters is the same as taking Propecia (finasteride 1mg). There should be no difference at all between the two, except for cost savings and the requirement of cutting the 5mg generic pill.

I might just be under the wrong impression, but from the brief description of your history, it seems you are not being followed by a doctor and almost blindly treating your hair loss issues with medications that may or may not be right for you. You really need to see your doctor and discuss these concerns with him/her, as you may have other medical issues not related to finasteride use. Shrinking testicles and a cold feeling are not usually side effects of taking finasteride. Even in the remote chance that it is, you cannot afford to not get it checked out. You may have a medical condition causing your problems. See your doctor, please!

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August 14, 2009

Am I Losing Hair Because I Switched to Generic Finasteride? – Hair Loss Information by Dr. William Rassman

Hello,

About 3 months ago I switched from Propecia to the generic Finasteride 1 mg manufactured by a Thai pharma company (bought overseas). Also, for the last 4 weeks I have trouble sleeping and irregular sleeping patterns due to international travel (ie. jetlag, time difference etc.). Lately I am noticing excessive hair loss in the bathroom sink (about 3-4 times my average) after a shower. Should I attribute that to the lack of proper sleep or to a potential ineffectiveness of the generic Finasteride? I had been on Propecia for over 5 years before I switched, which represents an “investment” as you can imagine.

Thank you.

Hair loss is genetic. I doubt jet lag or proper sleep has anything to do with what you are describing, but stress might.

Generic finasteride and Propecia (finasteride 1mg) are the same medication, just marketed differently. Unless you are getting your finasteride from a shady Internet site (particularly the sites that sell prescription meds without a prescription required), I doubt it has any clinical significance. Keep in mind there are many reputable overseas drug manufacturers, but I don’t know which maker or brand you ended up with. In the end, if you are unsure of the validity of your medication, share your concern with your pharmacist or your prescribing doctor. The ultimate decision of going back to brand name Propecia is up to you.

For the record, I routinely prescribe finasteride in two ways:

Generic: Available in 5mg strength, with instructions for the patient to take 1/4 pill a day (generic 1mg finasteride isn’t sold legally in the US due to patent laws).
Name brand: Propecia, which is already the 1mg dosage that is FDA approved to treat male pattern baldness.

I leave the decision up to my patients whether to take a brand name versus splitting a generic. I do not see any difference with respect to clinical results; the only difference is financial saving. If you are worried about the generic finasteride, then go for Propecia and then there should be no doubt.

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August 14, 2009

Diffuse Hair Loss, Brittle and Yellowing Nails – Hair Loss Information by Dr. William Rassman

I have been experiencing heavy diffuse hair loss for about a year now. My nails are very dry, brittle, have long vertical ridges and split very easily. My big toenails are yellow in color and have been falling off their beds with new ones growing under, for the last 5-6 years. My skin is also very dry. My skin is very dry too.

My scalp is itchy, and when I scratch it I have grainy, sand like white stuff in my nails. Could you please tell me how this hair loss can be controlled? Is it fungal in nature? Or is something else going on inside the body?

Thanks.

Generally, it does sound like you have a fungal problem (onychomycosis), but please see a dermatologist so that he/she can make that diagnosis and provide a treatment path. This isn’t something I can do over the Internet. Your hair and nail conditions could be completely unrelated, but I’d need an examination to determine that.

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August 14, 2009

Does Dr Farjo Endorse the Scalproller Like It Suggests in the Press Release? – Balding Blog

I saw that Dr Farjo was quoted in this press release for some scalp roller. The link is here: Breakthrough Therapeutic Tool Presented to 400 Leading Hair Loss Surgeons.

It also says “Furthermore, the latest research on behalf of Intercytex by Dr Bessam Farjo, and pioneering studies by Dr George Cotsarelis provide evidence that Scalproller therapy may produce new hair growth independently of any other treatment.”

So is Dr Farjo endorsing this tool?? Thanks!

The following response is by UK-based physician Dr. Bessam Farjo:

Response by:

Dr Bessam Farjo
United Kingdom

Pangaea is a company I have known for about 10 years which started out making a scalp fibres camouflage product called Nanogen which we sell on to some of our patients. They have become involved in a variety of other hair products over the years, but earlier this year they approached me after the Intercytex data suggested scalp ’stimulation’ made a positive difference to the hair counts. They showed me their Scalproller device and they suggested it could help stimulate hair growth on the principle of causing scalp injury, and they also speculated that it would significantly aid minoxidil absorption into the scalp. They discussed a number of other interesting ideas and projects and I agreed that the principles behind their Scalproller suggestions are scientifically plausible. We are currently in discussions about writing appropriate protocols for clinical trials. I can not endorse the Scalproller device itself until further clinical research is at hand.

–

Learn more about the author of this article, Dr. Bessam Farjo, on his BaldingBlog profile or at his website.

August 14, 2009

Does HairDX Tell Me How Much Finasteride I Should Take? – Hair Loss Information by Dr. William Rassman

Using HairDX to help understand if continuing Propecia is appropriate

I’m 29 with a full head of hair, but it’s a bit thinner than it used to be. I started Propecia six months ago after having some miniaturization detected on the front and top of my scalp. I have yet to notice any positive impact from the drug, but feel Propecia might be affecting my sexual performance. Whether I’m imagining side effects or not, I have been thinking about decreasing dosage or stopping Propecia altogether — I’d rather not have to be on a ED drug in my 30s, especially if Propecia isn’t helping me.

Would it be worthwhile having the HairDX test done to help me weigh the costs and benefits of continuing Propecia? Furthermore, does HairDX offer any insight into how hair loss might progress over time, the degree of hair loss that might occur, or the minimum Propecia dosage I might respond to?

HairDX The CAG repeat test from HairDX (marketed as “Finasteride Response Test“), will tell you if you may respond to drugs like Propecia. Start from there and then discuss the findings with your doctor. To my knowledge, there is not direct quantification of the HairDX test for CAG and the dose required of drugs like finasteride.

The standard HairDX test won’t tell you how much hair loss you’ll see in the future — just whether you have the genetic markers for hair loss.

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August 14, 2009

Does the Entire Follicular Unit Miniaturize or Just Individual Hairs? – Hair Loss Information by Dr. William Rassman

Doctors say follicular units contain 1,2,3, and sometimes even 4 hairs per unit. My questions is, when miniaturization occurs, does the whole follicular unit get affected at the same time or does the individual hairs within the unit miniaturize at a different pace and time frame? Hopefully my question is clear.

Best regards! I know you keep busy with the blog and practice!

When miniaturization occurs, each hair within the follicular unit seems to have its own time clock, but the follicular unit itself will miniaturize in the patterned area at a different pace, area by area. Often in young men, the frontal hairs will miniaturize faster than the hairs on the top of the head, about 4 inches behind the hairline. As the hairs within the follicular unit miniaturize and it progresses, one hair at a time may drop out and die before another one within the follicular units takes its genetic course.

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August 13, 2009

Hair Transplant – Multiple Procedures or One Large Procedure? – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

With regard to future donor density/yield, what is the better option:

Several small strip procedures or one very large procedure?

What I’m basically asking is which one would be more detrimental to your donor supply for future transplants (possibly affecting laxity)?

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I have to speak in generalities, something that I do not like to do as every situation is different. Generally speaking, the less the number of surgeries the better for the donor supply, but as larger and larger sessions are tackled, the surgical team is as critical as other items such as donor density and laxity. Each surgery has a built in waste factor (I estimate it in a good doctor’s hands at about 4-5% in a strip surgery) so two surgeries will produce more waste (a relatively small amount of waste). In the hands of a surgical team not designed for very large sessions (over 2000-2500 grafts), the larger session might cause a longer surgical time, more time for the grafts to be out of the body, and more time for dessication (drying of grafts causing graft death). Longer surgeries require more anesthesia and a skill in managing the anesthetic requirements is critical for larger sessions. In the rush to keep pace among the field’s leaders, many groups try to offer larger sessions (3000-5000 follicular unit graft range) even though they are ill prepared for this service. Some groups dishonestly sell these larger sessions and do not deliver on them, yet do charge for them… causing a fraudulent transaction (more common than most doctors will admit to, i.e. “It’s the other doctor, not me!”).

You were right to ask about the future donor supply. Very large sessions may reduce your donor supply very significantly when they are done, so it is good to understand what the session will do to the Master Plan for the patient. Running out of donor supply could be a critical error if it is done in one session. Look at today’s 12:31pm post (2 down from this post) and look at the real donor supply. Any hair taken outside this rim of hair is not permanent so if the doctor goes too high or too low, you may find out in the long term that what you received is not permanent.

August 13, 2009

Hair Loss Information100% Donor Scar Elimination? – Hair Loss Information – Balding Blog

Dr. Rassman,

Do you think that 100% elimination of donor scars will be possible in the future? Technology is always improving and it seems like scars could be emliminated. Are there any other possibilities other than Juvista and Acell that are being researched? Thank you for all the helpful information.

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Scarring happens as a result of all surgeries. There is no such thing as 100% elimination of a scar and treatments like Juvista and Acell will not dispose of scars entirely. The key to dealing with scars is to keep them very, very small. In the case of a donor scar, it can be as small as 1mm wide naturally in good healers, or reduced to that level on occasion. For bad healers, there really is no solution. By “bad healers” I mean those people who stretch their scars after the wound has healed.

Techniques such as the trichophytic closure repair of a wound in the donor area works well in many, but not all patients. For more info on the trichophytic closure technique, see here and here.