Author: Dr. William Rassman

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Yeast and Seborrheic Dermatitis – Hair Loss Information by Dr. William Rassman

Hi Doc,

I have been suffering from seborrheic dermatitis for the last 1.5 years. I read somewhere that yeast containing food aggravate the problem. Is it true? Are there any specific food items that I should avoid?

Thanks!

There appears to be an association between yeast and seborrheic dermatitis. There’s a great article on the American Academy of Family Physicians website that says:

“Pityrosporum ovale, a lipophilic yeast of the Malassezia genus, has been implicated in the development of this condition. It has been suggested that seborrheic dermatitis is an inflammatory response to this organism, but this remains to be proved. P. ovale is present on all persons. Why some persons develop seborrheic dermatitis and others do not is unclear. The colonization rate of involved skin by this organism may be lower than that of uninvolved skin. Nonetheless, the fact that seborrheic dermatitis responds to antifungal medications is strongly suggestive of the role of yeast in this disorder.”

Read the rest of the text at American Academy of Family Physicians

Balding Forum - Hair Loss Discussion

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Hair Loss InformationIf I Switch from Propecia to Avodart… – Hair Loss Information – Balding Blog

Hi. I have been using propecia for 8 or 9 years with great success but in the last few months I’ve really noticed loss. This happened a few years ago and the hair seemed to come back after a while . I have read a little on cyclical shedding while on propecia and rogaine. Do you think it happens? I have also been under a ton of stress too. I am considering trying avodart now after reading some people are having success with it after propecia. How does one go about switching meds? I’m worried if I stop propecia and start avodart I might shed more. Also I had no adverse side effects with propecia, am I at greater risk with avodart?

Thanks

ps I love this site, it’s too funny… you have a great sense of humor.. well done

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Robo-RassmanYou need to speak to your doctor before starting or stopping any medication. So first have this discussion with the doctor that has been prescribing you Propecia. I hate the idea that people are taking my words and using that as if is is a substitution for their physician, so please consider this a disclaimer (there’s one on every page anyway). That’s a general statement and not directed squarely at you. Remember — I’m not a substitute for your doctor, unless I am indeed your doctor, in which case cyber-Rassman is likely as good as in-person-Rassman.

Moving along — Avodart (dutasteride) is not yet FDA approved for treating hair loss, so doctors that prescribe it for that use are doing so off-label. We’re all waiting with baited breath for clinical trial results, but regardless of whether the benefits are better than those of Propecia (finasteride), I’m concerned over the safety of dutasteride since the serum half-life is measured in weeks, as opposed to hours with finasteride. In other words, dutasteride stays in your system for a long time. They are different drugs, of course, so if you had no side effects with Propecia it doesn’t automatically rule you out for side effects with Avodart. There is just no magic drug that will solve your problem. I suspect Propecia is still working for you and your doctor may increase the dosage of finasteride to handle the problem, as it may show more improvement. It is just that you can’t cheat nature and the gradual process of balding may not be stopped forever.

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Topical DHT Inhibitor? – Hair Loss Information – Balding Blog

Are there any topical DHT inhibitors? I know that Propecia blocks DHT and I have tried it in the past, but the sexual side effects were really severe. I’m curious why no company has tried to market finasteride in a topical solution…will it not absorb through the scalp?

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There are some doctors and many companies that claim that they have a topical DHT inhibitor for sale, but to my knowledge, there is no such thing on the market at this time that has proven blood levels in any meaningful date. I would want to know how much has to be applied to the skin to get a comparable blood level to the oral counterpart. Again, I have not seen this. Logic does not tell you anything about effectiveness of a drug and that is what we must know. Claiming effectiveness and proving effectiveness are two different things.

It would be nice if there was one that was FDA approved and proven effective, like a Propecia shampoo. That might solve the side effect issue that seems to frighten so many men and cause them to not use the oral form of the drug.

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Hair Loss InformationIs What They Say About FUE Real or Marketing Hype? – Hair Loss Information – Balding Blog

Hi! Need your comments on the “No Touch Technique”. Is it similar to FUE. The medical group claim it to be better than the strip method. The FAQ section on their website mentions the difference between their technique versus FUE. But I am confused. Only you seem to be the qualified person to clear the doubts. Ultimately, which one is the safest and more result oriented method, which any average hair transplant patient can go through.

Thanks

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There is a lot of marketing hype in the industry, because there is big money at stake. Many doctors claim what they think you want to hear. From the time you pay for the procedure until you get the results, the time-span runs 8 months, so you see that if a doctor is not honest and sells hype, then your check clears his bank account before you ever see what you bought.

In this case, it seems that this medical group has a tool that they use that removes the grafts via the FUE technique (no strip) — but at what accuracy? How successful are the grafts to grow out? They don’t state any statistics, so I don’t have any idea how to answer your question. I do not know enough about this group to make any qualitative statement about their work.

Many times tools are used by clinics that seemingly don’t care about growth rates and just want to be able to collect your money and say, “Well, the graft is in your head. — even if it doesn’t grow due to damage from when it was extracted, I did my job.” The consumer can tell how good the doctor is by asking them to discuss the amount of damage to the hairs in the grafts when they are extracted. At our clinic, we count damage per hair in the graft and can not only tell you what we got for hair yield, but show you our records of yield per hair and per graft. In a very recent article published by a Japanese group in the Hair Transplant Forum (a print newsletter), they discuss damage per hair in each graft with FUE. Their paper mirrors our formal publication back in 2002 that says there is considerable damage to the hairs in the graft in a substantial number of patients.

Watch this site over the next week and you will see ways to tell the scam artists from the good guys. You should not believe everything you read. Just because there is a doctor selling you the service, be very careful in your decision to go the FUE route without some proof that the clinic or doctor offering the procedure actually gets good results.

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Hair Loss InformationDo Miniaturized Hairs Turn White and Curly? – Hair Loss Information – Balding Blog

Hi Im a 23 y.o male (using propecia for slight receding hairline)
Over the course of a year random hairs have started to shrink, turn curly and white from hairline to crown, sometimes in clusters. Its not noticable to strangers and I have been able to pluck them out so far. Of course I thought that this might be normal miniturization but my hair has a thick white base with a thin tip instead of the “beige/straw colored fading away” I identify with miniturization. And of course I have considered whether this is normal graying, but you see many full heads of gray hair and if this keeps up I will instead be left with a head of small white wiry growth. Any suggestions ?
Thanks

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As you are in Los Angeles, I would be happy to do a miniaturization study on you and let you know if what you are observing is the beginning of the balding process. I have an office in Los Angeles. Generally, miniaturizing hairs don’t change color. I’m not sure what you’re seeing.

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Can I Get a Proscar Prescription Over the Phone? – Hair Loss Information by Dr. William Rassman

Hello, I am a 26 year old male and have thinning hair in the frontal and top-mid portions of my scalp. I am currently taking Hydrochorot and Lisinopril for hypertension. I would like to know if Finasteride (Proscar) will interfere while taking these hypertension medications? Also, I noticed in a prior blog, I can call(800)-NEW-HAIR to setup a phone consulation and be taken as a patient over distance, with photos provided. Would I be able to get a Proscar prescription this way? If not, can you recommend a hair specialist in Phoenix, AZ that will be able to help me?
Thank you.

You can see your family doctor or just check the yellow pages for hair transplantation and find a doctor. Also, the physician search at ISHRS.org is a good place to find a doctor. I will not prescribe it over the phone for someone I have not met, but I can give you an opinion.

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My Brown Hair Turned Blonde! – Hair Loss Information by Dr. William Rassman

I have naturally brown head hair. This summer, however, my hair has turned light brown and even blond in some spots (the bangs). I am a 15 year old male. This has never happened before and I am wondering if it is permanent.

The human pigment created from the melanin in our hair follicle for brown haired people is a pigment called eumelanin. If you produce a lot of the brown eumelanin, your hair will be brown, but if you produce only a slight amount of it, your hair will be blond. Maybe your brown eumelanin production is less as you get older. This is almost certainly a genetic predisposition of having a lighter colored hair and a change in the pigments that your hair is producing. Being in the sun can bleach your hair to a lighter color and turn a light brown color into a blond color.

Balding Forum - Hair Loss Discussion

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Taking Propecia on an Empty Stomach – Hair Loss Information by Dr. William Rassman

I take Propecia daily, and have been for the last 2 years. I feel it does work, however I have a couple of worries and concerns. I take the tablet daily between 9-10 in the morning, and I always make sure I have an empty stomach, and for at least an hour after taking the medicine. My questions are, am I being over sensitive with my regime? and…

Some times I am afraid that the pill gets stuck in my throat when I swallow it. If it does, will this decrease the effectiveness of the medicine, as it will not be absorbed? How does the tablet get absorbed into my bloodstream, am I over worrying? If I spit after taking it will I lose some of the medicine? I have heard bad things if I miss a tablet that I will be back to square one!

Many thanks for your help

Where are you hearing these things? You can take Propecia anytime during day or night. As long as you remember to take it once a day is all that matters. I have written in the past you can take it in the morning when generally there is a high testosterone level, but there is no firm proof if this is actually of real benefit. If you feel the pill gets stuck in your throat drink a cup of water. If you miss a tablet, you’re not instantly going back to square one. I wouldn’t make it a habit to miss a tablet, but it isn’t going to negate everything by missing a single dose.

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Hair Loss InformationWorld Anti-Doping Agency to Remove Finasteride from Prohibited List! – Hair Loss Information – Balding Blog

WADA
USADA

The World Anti-Doping Agency (and subsequently the US Anti-Doping Agency) will be removing finasteride from its list of banned substances at the start of 2009. I can’t find any news items about this yet in the media, but according to the WADA website, the updated prohibited list won’t be made available until October 1.

So how do I know early? Well, I was forwarded a letter dated a few days ago, written by the USADA legal affairs director that states in part, “USADA has confirmed today that as of January 1, 2009, finasteride, the substance for which your client tested positive, is being removed from the WADA Prohibited List.”

Some background on the World Anti-Doping Agency from Wikipedia — “The WADA is an independent foundation created through a collective initiative led by the International Olympic Committee (IOC). It was set up on November 10, 1999 in Lausanne, Switzerland to coordinate the fight against drugs in sport.” The WADA had placed finasteride on the list of banned substances in 2005, because it was being abused by some as a way to mask steroids in urine testing. Meanwhile, the ban was punishing those balding athletes that wanted to take control of their hair loss problems. I’m glad they’ve come to their senses about this.

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Doctor Offers 4000+ FUEs in One Session – Hair Loss Information – Balding Blog

Hi there… I am a female who has had a 1600 graft transplant using the strip method and am considering a second procedure of 1,000 grafts with a different surgeon. I am very concerned about shock loss, which I did have after the first transplant. Below is an extract from a doctor’s website. I would be grateful to hear your opinions on this.

Thanks

“[FUE] allows for the extraction of 4000+ follicular units in a single day session. Removing individual follicles with a microscopic instrument allows the skin to heal quickly and naturally. Patients receive greater freedom regarding hair styling choices and a diminished healing time, allowing them to return to the normal activities of life sooner.” [note: quote edited]

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Firstly, 4000 FUE grafts in one session without damage to the grafts during extraction is something that I simply don’t believe. I would have to see it and judge the transection rate under this surgeon’s hands. As for this doctor discontinuing the use of the strip harvesting method “due to its highly invasive nature” as his site states, well, this is more a marketing ploy than anything else. If the doctor could successfully do the amount of grafts using FUE that he claims, that’s great — but as I said, I highly doubt 4,000 FUEs can be done in one session with minimal transection rates. Plus, if you were to have this done, you would have to shave your head. I don’t know that most people would be prepared to do that. You’d have good reason to be skeptical.

In your case, shock loss will probably happen again. Shock loss in women often happens on the second and third procedure, but it usually grows back. Even the anesthesia can cause it in some women.