Dr. William Rassman – Page 1402

October 9, 2008

Why Do We Have Finer Hair in the Hairline? – Balding Blog

Why in the very front of the hairline the hairs are not the same thickness, why are some of the me finer than others?

Every person should have finer hair in the frontal hairline. I have measured the thickness of the hairs at the frontal hairline, those hairs about an inch behind the hairline, and the hair in the back of the head (donor fringe area). The frontal hairline hair is thinner. A patient of mine called it “angel hair” and it is this hair that allows the gradient from the bald forehead to the thicker hair behind the hairline. That is the way it is, genetic of course.

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October 8, 2008

Is Norwood Class 3 the Mature Hairline in Some Cases? – Hair Loss Information – Balding Blog

It is known that the maturing hairline, the NW2, is not part of the genetic balding process. A NW3, however, is considered the first stage of the balding process. It has been documented that propecia is not effective in treating the mature hairline, but it can treat the frontal hairline if you have genetic balding. Now for the question: In rare cases, the NW3 IS the mature hairline for some. In those cases, would it be likely that propecia could help halt the progress of a NW3 even if it is the mature hairline?

Block Quote

The Norwood class 3 has considerable corner recession and does not reflect the maturing hairline. Please review this guide to the maturing hairline that I wrote about 2 years ago: Juvenile vs Mature Hairline — Am I Going Bald?

Hopefully that will clear up any confusion.

October 8, 2008

Any Completely Scarless Transplant Techniques? – Balding Blog

Are there any hair transplant techniques available that allows you to completely shave your head? Or do all of them leave a visible scar of some kind? If they do, how closely cropped does the hair have to be to hide the scar?

The closest thing available is minimal punctate scars that are produced with follicular unit extraction (FUE). The smaller the punch, the less obvious is the scar, but the missing hair follicles become evident if the density is low. In individuals with high density, the use of a 0.7mm – 0.8mm punch will produce an almost scarless appearance, but if you shave your head, you might see it. The hair should be about 1/8th inch long to hide most FUE scars made with small punches.

October 8, 2008

High Amount of Ejaculate After Taking Propecia – Hair Loss Information by Dr. William Rassman

Dear Doctors,
first of all I would like to take this opportunity to thank you and your wonderful team for your help. I have a question which I hope you can help me with.

I have been on Propecia for 5 months, but I have not seen much effects. I suspect this is due to my extra high levels of testosterone. My amount of ejaculate is higher than normal, something like adult film standards or even more. This has been told to me by my partners. So in order to tame my high level of testosterone, should I embark on taking 2 1mg pills of Propecia a day rather than just 1? I’m just afraid the Propecia is not able to work properly on me.

Thank you very much
Best regards to your entire team

I have rarely had increases in ejaculate due to Propecia reported to me. This drug should not be used to control the ejaculate and you should stick to the recommended dose of 1mg.

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October 8, 2008

I Have Less Hair Now After My Hair Transplant a Year Ago – Hair Loss Information by Dr. William Rassman

I had about 2,500 grafts transplanted approximately one year ago. The grafts grew in pretty well for about 7 or 8 months, then I exerienced some shedding. I know have less of the transplanted hair that I did 3 months ago. Funny thing is that it seems I also lost some of the hair from a prior transplant years ago. This is dissapointing and depressing. I believed that hair that had begun to grow would not fall out again, and I do not have an auto-immune disease. Any ideas? (I’ll try and get a follow-up with my surgeon. Thanks

If you had any original hair still left in the transplanted area, you could lose that hair and cause your problem. If all of the hair that is thinning is transplanted hair only, that is rare. We call the donor area hair “permanent hair,” but is it really permanent? In a very small percentage of the population, the donor hair can thin permanently. If that happened in your transplanted hair, the same would be apparent in the donor area, as both have the same source. I always measure the density of the donor area prior to a transplant so if this happened, I would have a measurement to compare to.

In a very small percentage of patients, hair that has been transplanted can be lost… and if that happens it will usually return. I do not understand the cause of this when it does occur, but I have seen it a few times and most of the time the hair came back. Please do have a follow-up with your surgeon and express your concerns.

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October 8, 2008

Political Talk — John McCain Could Use a Hair Transplant – Hair Loss Information by Dr. William Rassman

Hair transplants have come up a couple of times in the current US Presidential election. First, Senator Joe Biden’s plugs and subsequent repairs were the hot topic of political Internet gossip for a few days back in late August (Joe Biden’s Hair Transplant). Then, last night’s presidential debate had Senator John McCain, in a contorted logic, making reference to needing a hair transplant. Should we assume that this might be billed to Medicare healthcare reimbursements?

See the video, courtesy of Politico:

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October 8, 2008

With No Visible Signs of Balding, I Took Propecia and Lost My Body Hair! – Hair Loss Information by Dr. William Rassman

Dear Doctor,

I am a 40 year old male living in the UK with no particularly visible signs of balding though I noticed over the last couple of years my scalp was becoming visible when having my hair cut wet at the barbers. I started taking Propecia (I used an online clinic here in the UK) about two years ago as I was just keen to preserve the hair I have (which hitherto had been wavy and thick) Since then I have lost all the hairs on my arms, my chest hair has disappeared and my pubic hair is rapidly dissipating. The hair on my head has thinned out all over to an alarming degree particularly over the last three months (especially at the side of my head and the base of my neck)and there is a constant tingling/burning sensation in my scalp. I would be most grateful for any advice (even if just a recommendation of someone in the UK you could recommend)as I am totally despairing of what is happening and just don’t know what I should do as looking at previous queries on your blog it seems that stopping may actually exacerbate matters.

Taking any drug when it is not necessary exposes you to side effects of the drug. Better not take a drug unless you understand the benefits and liabilities. Plus, medication you buy on the Internet may not be what you think you are buying (particularly prescription drugs purchased without a prescription). I’m glad you realize you need to see a doctor, and while I am a doctor, you really need a physician who can actually examine you directly and treat you.

The loss of body hair is a potential side effect of Propecia but it would take considerable time to see that side effect (which is very, very rare). There are other conditions that can cause body hair loss, and a good dermatologist should be able to help you in that regard. I don’t have any physician recommendations in the UK, but you can use the search at ISHRS.org to find a hair transplant doctor in your area (don’t get talked into surgery though — these doctors just understand hair).

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October 7, 2008

Does Alcohol Help Prevent Hair Loss? – Hair Loss Information by Dr. William Rassman

Does alcohol help with MPB? I’ve heard alcohol has estrogenic effects. THe reason I’m asking is b/c I have two older brother, one 41 and one 39, and the older one drinks fairly often and has no MPB whatsoever, but the younger one is Mormon and so doesn’t drink and has a receding hairline.

Nope. There is no connection between alcohol and balding. If there were, growing hair could become a real party time.

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October 7, 2008

If It’s Not 30-40%, What’s Your Patient Percentages for Finasteride Side Effects? – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,

I just wanted to congratulate you on your site. As always, it serves as a source of reliable information with little bias.

That being said, I have a question regarding a post that appeared on your site today (Oct. 1, 2008). You say “I can say with certainty that the notion of 30-40% of patients taking this drug (Finasteride) experiencing side effects is laughable. It simply is not true.”

However, you don’t comment on what you believe the actual percentage of Finasteride users have side effects? In your clinical experience (and those of your colleagues) , is it actually 2-3%? I realize that there are lots of forums that attack Propecia, and as you have pointed out, those with a complaint often shout the loudest. However, it’s stats like these (regardless if they are unsubstantiated) that make many men who are thinking about Propecia apprehensive about initiating therapy.

I’d be interested in hearing your comments on this. There are far too many sites/forums that portray Finasteride in a less than favorable light. I’m not implying that these side effects are made up, and that they don’t exist – I think you have been quite honest with readers that they do. But I think this issue needs to be settled. Are there any studies being conducted (aside from Merck) that are looking at the percentage of users that experience side effects? I currently have a decent amount of hair, and if I were to start therapy today, and just hold on to the hair I have for a few years, I would be more than happy. I know I am candidate for Propecia (through examination by a physician). However, I have been sitting with a full box of Propecia for a couple months now because I have been too worried to start treatment. My worries about potential side effects are only exacerbated by comments like these.

Please respond when you can.

Thanks!

While I am flattered, I do not believe it is up to me to settle anything. I simply give factual medical opinions to my patients and I also write such opinions on this site. The fact is that the negative sexual side effect of Propecia is about 1 to 2%. Based on my clinical experience with many patients who have been taking Propecia for many years, that statistic seems accurate. In fact, of those with side effects at all, more patients I see report higher sex drive than lower sex drive. Most have no side effects to report.

You are a man who is obviously concerned about side effects. Look at this this way — if YOU have a negative side effect, statistics should not matter to you. If you have a side effect, your statistic is 100% (all or none). That being said, the side effect is reversible and you have the option not to take it. What are you worried about?

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October 7, 2008

Throat Swelling with Propecia Use – Hair Loss Information by Dr. William Rassman

Thank you for posting such useful information on this site. I want to ask some basic questions regarding post-op care that I haven’t seen posted (or maybe I’m not searching correctly either).

I recently had a 2500+ graft procedure just in case that matters for some of the questions posted:

1. Approximately how long after surgery should a patient expect to see bumps on their head? I am roughly 5-6 weeks out of my transplant, and I still see some pimple-like bumps on my scalp (sometimes even a random scab here or there that easily comes off after showering & soaking). I’m just curious to know how long it might take to see everything go away and return to normal.

2. There are still some areas from the incision that seem to be little tender, which I mostly notice when I apply shampoo in the shower. Is it normal to experience some form of (mild) tenderness around 6 weeks out of surgery? I believe you’ve posted before that around the first month, the incision is about 70-80% healed.

3. Have you ever heard of anyone experiencing slight swelling in the throat after starting Propecia? I started taking Propecia after my procedure, and noticed some minor swelling in my throat, but now it seems to have gone away. I also noticed I was more tired than normal, but that was probably due to causes unrelated to using Propecia or having the surgery (although I followed roughly the same sleeping pattern as I did pre-surgery). In either case, I was curious to know if you had heard of these types of effects from using Propecia.

Many thanks!

While it is a pleasure to educate on issues of balding and hair transplants, I don’t understand why a recent hair transplant patient will have such basic questions to ask when they have their own surgeon. Was this not explained in your post operative instructions? Is the doctor not available? Here is a link to some of the basic questions after a hair transplant procedure from my NHI website: Post-Op Course in Follicular Unit Transplantation

To answer your questions more specifically, some redness or bumps may be common or it may indicate an early infection or folliculitis. I would follow up with your doctor if this is of concern. Scabbing should be gone after 5-6 days unless you have not been washing your scalp well. Some areas on the donor site can be tender, but in the recipient area it can also suggest early infection, though I do not have any way to tell.

I have not heard of swelling in the throat after taking Propecia. Swelling in the throat after taking any medication is a very serious and possible life threatening side effect suggestive of a potentially dangerous allergy. You could have a possible allergy to an inactive ingredient in the Propecia, but I am just guessing. I would follow up with your doctor and stop taking any medication that causes swelling in the throat.

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