Author: Dr. William Rassman

Posted on

Applying the Rogaine Liquid is Difficult!

My boyfriend has just started using the generic Rogaine from Costco in liquid form, and I have been helping him since depositing a dropperfull of liquid on the bald spot is not an easy thing to do alone. I use the dropper to distribute the liquid around the spot, but no matter what we do it seems that much of it runs off down his neck or forehead. The rest sits in the few hairs he has left in little droplets.

My questions:
– are we doing this wrong somehow?
– should I be putting on a latex glove and trying to spread the solution around with my fingers?
– would the foam work better? He has the typical bald spot at the crown of the head, with just a few fine hairs and mostly just scalp. But I have found in my research that an awful lot of guys say the foam just melts from your body heat and runs off anyway…

Suggestions or pointers to articles would be much appreciated!

Your problems are well shared by many users of liquid minoxidil, thus Rogaine Foam was created so that the medication stays on the area you want to treat. It may “melt” and run off as you say, but it is better than the liquid in my opinion. If you still want to use the liquid (or your boyfriend does, more precisely), you can apply the liquid with a gloved hand. That might be best anyway, since you’re not using the medication.

Posted on

Anyone Taking Propecia for a Decade? (with Photos)

Hi, I just want to know: do you have many patients who have been on propecia for 8-10 years and yet still have a healthy head of hair on their heads?

Alternatively, do you have many patients who have taken propecia for a long period of time and have gone bald?

I have a number of patients who went to Mexico to get Propecia (finasteride) before it was sold in the United States (maybe 10 years or so ago). One in particular (24 years old at the time), who was balding in the crown, reversed quite nicely on Propecia and maintained that reversal without any progressive miniaturization over the 10 years. Because he was young, the drug worked beautifully. His crown was never transplanted but he did receipve alightly over 6000 grafts in the frontal area. He now has a crew cut.

I have not seen anyone who stayed on Propecia go bald, but I have seen many, many men who were taking it and decided to stop, who then went either very bald or very thin.

Before Propecia on left; After Propecia on right:



Posted on

Application of minoxidil, finasteride and the use of Dermaroller (called “The Big 3”) from Reddit

This is a combination of treatments commonly used by many young men on the Reddit post. There is evidence that minoxidil plus the Dermaroller works by itself to some degree but adding finaseride makes is a more certain response as shown here after 5 months of use.


2019-02-12 06:40:17Application of minoxidil, finasteride and the use of Dermaroller (called “The Big 3”) from Reddit

Posted on

Are blood DHT levels important before taking finasteride

Hey, so I’m planning to get a DHT test to check out the levels before starting finasteride. I’m wondering whether it is the amount of DHT or the sensitivity that matters when it comes to balding or other effects? Basically is it a waste of money to measure DHT levels if they don’t correlate with anything?

I personally think that it is not worth doing. What you want to know is: will the drug work for me? Changing drug blood levels doesn’t tell you that information

Posted on

Do I apply minoxidil twice a day, really!

I’m planning to start minoxidil but not sure if I can manage applying it twice a day. I can apply it in the morning but my schedule is random everyday. Most days I don’t get home till around midnight so if I have to apply it then I’d have to wait till 2-4 hrs before I can sleep.

Once a day at night is fine. I recommend that you take a hot shower and then apply it before bedtime. The heat will open the porse in the scalp and increase the circulation so that more of the minoxidil will be absorbed.


2017-12-16 06:55:42Do I apply minoxidil twice a day, really!

Posted on

Appreciation email from Reddit poster

I wanted to voice my gratitude for your posts! You are seriously one of the most helpful posters and it even makes me a bit emotional that you’re willing to make those posts day in day out. Hair loss can be terribly confusing, but your insightful posts about the current understandings make everything much clearer. Sorry if this message comes across a bit awkward but I really just wanted to let you know you’re very much being appreciated

Thanks. I have worked hard for people impacted by genetic balding for years and have published extensively in the peer reviewed medical journals educating doctors and bringing breakthroughs in the field. Posting on Reddit has given me great satisfaction as it does on baldingblog.com. It allows me to give back some of the things I learned and help a lot of people who are ‘lost’ the hair hair loss conundrum where few doctors seem to understand hair loss. I do this because my patients have made me so successful in the field.

Posted on

Appropriate Propecia Dosage

I was prosribed propecia two months ago to have every other day. My hairloss already seems to be beginning to stabilize over this short time. Hopefully I might get some regrowth in the coming months! I was told the 5 alpha reductase reduction with propecia is still just as effective as if I was taking it every day. However I have read elsewhere that you need to take it every day. While I don’t doubt the advice of my medical professional, I have read here, and elsewhere that I need to take it every day to get maximum benefit. Are there two schools of thought as to the appropriate dosage? Or is it that, as the onset of my MBP is very recent my medical advisor is of the view that I would get an effective response on a less frequent dosage. He claims to have many patients who get a good response taking propecial every other day. Thanks for your help

The recommended Propecia dosage is one tablet once a day.

Some doctors may prescribe half a tablet once a day or one tablet every other day, however these are not the official recommended dosages. One reason is that official clinical research has found that the once a day dosing gave the maximum benefit from male pattern hair loss. Another more important reason is that the half life (the time it takes for half of the drug to be eliminated by the body) is only 5 to 6 hours. So theoretically on the days you do not take Propecia, your thinning hair will have no benefit from the drug. You should always follow the advice of your primary doctor and discuss these concerns with him or her, especially before stopping or changing any drug regimen.

Posted on

Are Back Acne and MPB Linked?

Thanks for answer, I make this question due the tons of speculations ive heard about back/chest acne related with male pattern baldness, does exist any relation between them?

None that I’m aware of. Where are you hearing this stuff? Acne on your chest or back is unrelated to male pattern baldness.

Posted on

Are Certain Hair Colors More Likely to Go Grey?

Are people with certain hair colours more likely to go grey as they age? I notice a lot of people with salt and pepper coloured hair but I can’t think of anyone I’ve seen with that level of brown and grey hair, or red and grey hair etc.

All hair colors would generally grey as the person ages. The degree of greying and how fast the person goes grey is dependent on their genetic predisposition. I am not aware if there is a correlation with hair color and going greying.

Posted on

Appropriate Amount of Grafts in Frontal Area

Dear Dr Rassman,
I am a 24 yo male who has experienced hair loss in the frontal region and am told that i am a Norwood type 4. I went to see a surgeon/dr in Australia. He told me that the best treatment was to have one large megasession and that he would use 2500 grafts on the frontal region. I am curious as to know whether this is an extreme amount in that region and your feelings on megasessions. I was also wondering that given my age how many sessions in my lifetime will i need and how frequently do people my age have to have more done. If i had a megasession would there be enough hair in my donor area if i did suffer more hair loss. Is there any way of doing a procedure, where you have existing hair, to transplant it to that area to prevent it if it was to fall out. Does one procedure in people’s liftime exist if they stay on propecia (which I am on, and doesn’t seem to be working that well).

Sorry for so many questions Dr Rassman. Thank you very much for your time.

For a Norwood 4A balding pattern, 2500 grafts in a single session sounds like a reasonable number that might meet all of your needs, depending how large the area is. Most people have about 6,000-8,000 grafts available in their donor area, but the actual number may vary. That is why we measure everyone’s density to determine a Master Plan for the worse case scenario of hair loss. Your age is a bit young, but if the pattern of loss is relatively complete and did not reverse after taking Propecia on a trial basis for 8 months, then a transplant could be reasonably done. Hopefully with Propecia that is consistently taken, the hair loss will at least slow or stop, stalling any need for further transplants for some time. Provided that you keep the work done to the frontal area, there is little worry about running out of donor hair for most people. I would discourage work in the crown at your age.