Dr. William Rassman – Page 1403

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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October 7, 2008

Using Nioxin with Rogaine – Balding Blog

I am trying to get an unbiased opinion on whether or not I can use Nioxin and Rogaine at the same time. Of course, each company is telling me to use their product, but neither will tell me if using both together is ok! Please help! I don’t know what to do! Thanks!

Nioxin is a shampoo / hair / beauty product. It does not grow hair. Rogaine is a medication that is applied directly to the scalp and absorbed through the skin of the scalp. Nioxin does not contain the medication minoxidil (the active ingredient in Rogaine), so I don’t see why you cannot use both. I don’t understand why one would tell you to not use the other.

October 6, 2008

Hair Won’t Grow on the Back of My Head – Balding Blog

(female)
I have a problem with my hair where all of the hair all over my head will grow…except for the hair in the back of my head. I have let my hair grow down past my eyes and ears in the front of my hair, but the back of my hair barely has grown enough to pinch with your fingers. Why won’t my hair grow in the back? What can I do to get the hair to start growing??

I’m sorry, but I really don’t understand your question and I don’t know enough about your medical history. There is never a substitute for a direct examination and even a photo of you will not show clearly what is going on. Please see a doctor where you can have a one-on-one dialogue, including an examination of your head and scalp.

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October 6, 2008

Higher Sex Drive from Finasteride Leading to Increased Masturbation – Balding Blog

Dear Dr. Rassman,
I am taking finasteride for my hair and it’s working well on me. I am 23 years old. But my problem is i am having higher sex drive than before and also having increased number of masterbation. What can i do? My question is does increase in sex drive and thus increasing the number of masterbation affect the effectiveness of finasteride? If testosterone is increased by finasteride, does it affect the effectiveness of testosterone? My last question is people say masterbation is related with hair loss. If it were true then now in the world every healthy mature married men would be bald, isn’t it Dr.?

It is true that Propecia (finasteride 1mg) can cause an increase in your sex drive, but just as I always caution men who have a decrease in sex drive, do not be so quick to blame the drug. Young men in their early 20’s naturally have a high sex drive. It is normal to masturbate.

Does masturbation cause hair loss? No!!! Once again… masturbation does not cause hair loss! Your hair loss is likely caused by your genetics.

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October 6, 2008

How Long Does Hairline Maturation Take? – Balding Blog

In your experience, how long does the maturation of the hairline process take? I just recently noticed a slight recession on the corners and I was just wondering.

The maturing hairline is an insidious process and can take years to appear. The process is very slow and creeps up on most men. I watched two of my sons and my nephew gain mature hairlines, and each took a number of years to fully appear.

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October 6, 2008

Traveling to Other Countries to Get Finasteride – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman,
I’ve read from old topics that many of your patients would travel to Mexico to purchase Finasteride before it was approved in the states. Do you still have patients that do this? There is obvious financial benefits from purchasing the medication outside of the U.S., but what about the products validity? When it comes to hair loss, you surely would like the product to be authentic. What is your thoughts on this? Thanks for your time.

Finpecia I would think that when it comes to any medication you would want it to be authentic. There are many credible drug manufacturers outside the US, and you need to be sure that the drugs you are buying is from one of them. Here’s the top 50, ranked by revenue — List of pharmaceutical companies. If you buy Propecia in Mexico and it says Propecia on the bottle and looks like Merck’s product, it is probably the real drug. Granted, the packaging can be faked so we must all still be aware of drug counterfeiting. That is a real worldwide problem, so you should use your best judgment.

There is one way to get finasteride in the US from your local pharmacy much cheaper than Propecia, and that is by cutting the generic 5mg finasteride into 4 or 5 pieces. You need to have a physician willing to prescribe you a prostate drug (Proscar) to get that prescription, though. The 1mg generic (like the Finpecia pictured above) is still unavailable in the US due to patent laws.

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October 3, 2008

Hair Loss InformationFollicular Unit Extraction (FUE) Patient Guide – Hair Loss Information – Balding Blog

Dr. William Rassman I wanted to call your attention to yesterday’s announcement relating to follicular unit extraction (FUE). As the ‘inventors’ of the procedure, publishing the first authoritative article in the Journal of Dermatologic Surgery in 2002, I have taken a keen interest in the way this procedure is delivered throughout the world. Much of what I have been observing has been disturbing. Too many doctors with little experience, and skills that have not been refined, have entered the field with heavy marketing programs offering FUE. My experience, however, has shown that some patients are not good candidates for this procedure and damage to the harvested grafts can be substantial in most surgeon’s hands. The key here is graft yield and unfortunately, this is an assessment made either after the procedure is performed with careful surgical monitoring and record keeping (by recording hair damage within each graft), or 8 months after the procedure when the patient can judge the success or failure of the results on his or her head.

I realize there is a delicate balance between what we want and what we buy. Our progress in reinventing the FUE process is discussed here — new FUE breakthrough. I really hope everyone considering having an FUE surgery (or anyone just curious about how it works) will read our new guide to evaluating Follicular Unit Extraction Techniques.

So what prompted me to write a new FUE guide? A while ago, I had the opportunity to view a well known doctor extract approximately 20 FUE grafts under my direct observation. While he boasted that he had mastered the procedure, what I saw reflected far less than such mastery and the doctor obtained a significant transection/amputation rate of the hairs in the graft. That doctor is prominently offering FUE today.

The surgeon’s technical skills take years to acquire and perfect, and although there are now some very fine doctors who I believe have truly mastered the technique and can deliver a quality service, I believe that they are in the minority of those offering it. There is a substantial worldwide demand for this minimally invasive hair transplant (virtually painless during the post-operative period, the patient can return to full activities in a week including all types of exercises, and there is no linear scarring). The problem for the patient, however, is in selecting a doctor where the FUE technique does not produce a “follicular holocaust” causing a substantial loss of donor hair and a failure of the procedure. This insight seems to be hidden from most buyers, because prospective patients want to believe in the marketing hype that is prevalent on the Internet and they are sold the technique by professional marketing pitches. There is no way to determine in advance, the skills of the doctors offering to perform the surgery.

In our new FUE guide, we have defined a way for patients to examine the various doctors offering this procedure, giving them an idea of what questions to ask and what things to look for. There is no site to offer guidance in the doctor selection process so the consumer must arm himself with the knowledge and skills to make the proper judgments themselves. Hopefully, our writings will appropriately arm the readers interested in this technique.

Article link: Patient’s Guide to Follicular Unit Extraction

October 3, 2008

Tinnitus After Using Minoxidil? – Hair Loss Information – Balding Blog

Hi there

I am curious to know if yo have heard from others complaining of tinnitus after using minoxidil. I had used finasteride for some 10 years, it seems without any side effects. I stopped the finasteride and had a break for about 18 months from any treatments and then started using minoxidil 5%.Within 3 months i began to be woken with tinnitus. It is now constant in both ears.

Any help or suggestions greatly appreciated.

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Tinnitus (ringing in the ears) can be a warning sign for many serious medical conditions not related to medications, but it is also a known rare side effect of minoxidil. You need to see your doctor if you have such a problem. While it may be a potential side effect of the medication, you cannot afford to attribute the symptom to a side effect without a medical examination.

October 3, 2008

Hair Loss InformationHair Spray and Hair Loss – Hair Loss Information – Balding Blog

Can hairspray damage hair follicles and lead to hair loss?

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If you brush or comb through your hair after the hair spray dries, you may pull out hair. In men and women with varying forms of alopecia, the use of hair sprays can be dangerous with rough combing of the hair. Best to wash it out rather than brush it out. Rough brushing can be a cause of hair loss made worse with hair sprays. Otherwise, hair spray by itself doesn’t equal hair loss.

October 3, 2008

Still Shedding After 5 Months on Propecia – Balding Blog

I have been on Propecia for 5 and a half months now. I started treatement after noticing my temple area receding and a more noticable amount of hair loss. I have noticed a lot more shedding since I have been on the drug, and these areas (which are also itchy) are all over the top of my head and also on the crown. You have mentioned a few times that this ’shedding’ period usually lasts only a couple of months.

Is it possible that I am simply not responding to this drug and the shedding is MPB and would be occurring regardless if I was not on Propecia? Should this shedding phase have stopped by now? I have not noticed any significant hair regrowth. It still seems to be going backwards.

Many things are a possibility. The most common cause of hair loss is from your genetic predisposition to losing hair. While Propecia works for male pattern baldness, it does not simply cure it or stop it completely in some men. There are reports of hair loss in the first few months of taking Propecia, which is essentially thought to be accelerated hair cycling in some hairs being pushed into telogen early. Some patients may grow more hair, but other patients will continue to lose some hair. The goal is at the least to slow the hair loss down with Propecia. I doubt Propecia is actually accelerating the genetic hair loss.

You need to follow up with your doctor that prescribed you the medication for a re-examination. Also keep in mind that while Propecia does target hair in the front corners, the official reports do not indicate that it is as effective as it is on the top/crown areas. With Propecia you will most likely never regain the front corner recession.