Author: Dr. William Rassman

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Propecia and Infertility – Hair Loss Information – Balding Blog

Hello Mr Rassman.
I have found your web site and by the way , I find it really useful. I would like your opinion on one specific point. I have now been on propecia since February 2005 .

My partner and I have been trying to conceived since 10 month without any result . I did a sperm test wich showed a problem with living spermatozoon after 4/6 hours and a decreased (not huge but right on the limit) in the volume of semen being produced …. Can you tell me if other studies have recently been made on the effect of the finasteride on young male fertility ?

Thanks and best regards

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I have written to Merck concerning this question and they have a good history showing a wide safety margin for male fertility. I looked up some sites for you with case reports that focus on your question. What it means is anybody’s guess, but I believe this is where you and your doctor come into play:

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Writing Off Miniaturization as MPB When There’s a Possible Disease Causing It? – Hair Loss Information – Balding Blog

Hey Doc,
Today you mentioned that there are other causes of miniaturization besides mpb. If so, then how would you be sure it was caused by mpb as opposed to a disease? Couldn’t you theoretically write off miniaturization as mpb when there’s a more serious underlying issue? What diseases might cause this? How do you tell the difference? If there’s a receding hairline at the temples and thinning in the crown is this defenitely mpb? What about if it’s diffussed thinning? Just wondering how one might tell. Thanks!

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The easiest answer is that genetic hair loss in men occur in patterns… and these patterns are almost always diagnostic of genetic hair loss (male pattern baldness) and follow the Norwood classification chart either with thinning or frank balding.

The rest is the art of the practice of medicine and that is why a doctor adds value when you are being evaluated. Hair loss occurs with many other diseases, such as alopecia areata, ringworm, a variety of autoimmune diseases, drugs, etc…

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Intercytex – September Update? – Hair Loss Information – Balding Blog

Hi Dr. Rassman and thanks for a great website. I’m curious about the September update Intercytex said they would provide. I know you don’t work public relations for Intercytex so this could be kind of an annoying question, but when in september do they plan on updating us? seeing as it’s already half over.

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Here’s what I found posted to their site last week in their September 18, 2008 update —

    ICX-TRC – hair regeneration
    Data from the Phase II trial shows increase in hair count in 11 out of 14 (79%) evaluable subjects at 24 weeks

A little lackluster for those that have been waiting, but that’s all they have made available this month about their hair project.

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Brain Surgery Scars, Burr Holes, and Hair Transplants – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman, I have two burr holes on my temples from an operation when I was a baby. My temples receded to a mature hairline whe I was 25 & the scars are now visible (I’m 32). I don’t suffer from hairloss & seem to have the same hair as my dad who still has a full head of hair at the age of 60 (temples slightly receded). I was considering a HT to get back to my original hairline & cover the scars. I was wondering if the holes in the skull underneath could be a problem during the operation. Is there any danger (I don’t know how deep the needles go)? Thanks!

I have performed hair transplants on many post brain surgery scars and burr holes. Skills in such a situation is critical in placing hair into scars or burr holes to be sure that it does not penetrate into the brain. If the normal hairline will cover it, then this is a wonderful solution to the problem.

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Hair Loss InformationNecrotic Tissue After 3rd Transplant – Hair Loss Information – Balding Blog

I had several hair transplants that went well, so I decided on a 3rd which led to necrotic tissue damage. The doctor told me it well be ok. i had 3 holes w/ necrotic tissue, which i would treat for several months getting worst. fortunately after 3 months, the holes got as big as a quarter and black. went to the emergency room, when they said this is your lucky day after removing the black. and 3 years and 4 surgeries later, i finally got everything corrected. now i have 3 bald spots in the front of my head. i use the dark particles to hide it. any recommendations. what to do besides surgery ??

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Necrosis causes the skin to turn black (it is called gangrene). I would love to know more details, like who was your surgeon and what did he/she tell you caused this? I might be able to help, but I’d need to examine you first. As you are in Los Angeles, you should consider paying me a visit in my LA office (no charge for the consultation). You can call my office at 800-NEW-HAIR (or 310-553-9113) to setup the consultation.

Necrosis was not uncommon in the early days of megasessions when the surgeons used large punches and too many of them. This did devascularize the scalp and parts of the scalp died. There were numerous reports published that condemned the procedure because of this risk, but as the world was trying to make up its mind on the risks, I had published large series of huge megasessions with not one case of necrosis in the recipient area. Eventually the doctors learned that small holes were critical to getting not only good growth, but no damage to the skin of the scalp.

There are non-surgical solutions, including Toppik, DermMatch, Couvre (all are concealers)… and of course, hair pieces.

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Hair Loss InformationCan Propecia Stunt Growth? – Hair Loss Information – Balding Blog

Can Propecia taken by mid-teen guys stunt height growth?

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There are some teenagers who take Propecia (finasteride) under the care of their doctors, but it is generally not prescribed to teenagers. The effects of finasteride on developing teens is not clear and should probably not be used in those who are still in growth mode (usually under 17-18 years old). It is theoretically possible that it may stunt growth during the puberty years, as it interferes with testosterone conversion into dihydrotestosterone (DHT). DHT is one of the many hormones that is involved with secondary sex characteristics such as beard, chest, and pubic hair.

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I’m Very Sensitive to Products with Alcohol, Like Rogaine Foam – Hair Loss Information – Balding Blog

Dr Rassman, is it possible for a person who is very sensitive to products containing alcohol even have problems with the Rogaine Foam. I stopped the foam because it was drying out my hair alot and I noticed my hair thinning more and falling out more. Even if I go a few days without using it my hair looks better. I never had itching or redness from it but my hair texture changed to a more haylike feeling. I used good conditioners too but my hair still was still too dry and the hair diameter was thinner. I have my hair professionally colored and it even strips the color of my hair near the roots. So basically is it possible for someone to have a negative result due to even a small amount of alcohol in the product. I also notice my face retains more fluid and my skin gets more acne when I use the foam or any type of minoxidil. Would that also be considered a negative reaction to minoxidil?

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Rogaine Foam has alcohol in it, so if you do have a sensitivity it could be an issue. While the 2% minoxidil is alcohol based, the 5% minoxidil liquid is propylene glycol based (though check the ingredients on the packaging since it may still have some alchohol). You may consider trying the 5% as an alternative to the Foam. Alcohol does dry the hair out. If you’re retaining fluid in your face, that is a known negative side effect. I’d meet with a dermatologist about the acne.

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Hair Loss InformationHair Loss at a Young Age Lead to Problems with Alcohol Abuse – Hair Loss Information – Balding Blog

Hello,
I’m a 46 yr old male. My brother was killed in a horrific car accident when I was 9 yrs old. Shortly after my hair began to fall out in dime size patches. By the time I was 10 my hair was completely gone. Docs said it was alopecia and they began a regiment of cortisone shots in my scalp. It was pure hell growing up with no hair as kids are so cruel. I wore a wig through the 10th grade and finally got rid of it by 11th.

I write this because I know giving kids a false sense of the hair growing back will ultimately do more harm than good. To fit in I hung out with the drinking crowd and I’ve been paying for that ever since. I slowly became a high functioning Alcoholic. Being in the USAF working flightlines where drinking after work was the norm and promoted did not help.

I’ve come to realize that drinking was just a symptom of my deep routed problems which began when I was 9. Fear and the fear of rejection were my underlying problems. I feel you have to be straight with kids and get them into counseling at a young age. This will do wonders for self confidence and spirit. If someone had got me some help with dealing with emotions at that tender age it would have saved me a lot of time and bruised knuckles.

I counseled a kid when I was stationed in the UK and his mother was almost in tears when I told her that I knew what her young son was going through! I don’t know why I felt compelled to write this but maybe it will help someone out there

Take Care

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Thank you for sharing this with us.

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Stopping Propecia for Weeks Before a Sports Competition – Hair Loss Information – Balding Blog

I am currently on propecia. I am also considering entering some sporting competitions that require a drug test. Finesteride is banned from competition because it can be used as a “masking agent” for performance enhancing steroids.

If I stop taking propecia for 3-4 weeks, will I notice hair loss? Will this hair grow back?

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Stopping Propecia (finasteride) for 3-4 weeks may produce some early hair loss. I can’t say whether it’ll grow back, if you see any loss at all. I think that the drug may be detectable in your system for some time with the urine testing, just like steroids.

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A Week After Highlighting, I Have a Bald Spot! – Hair Loss Information – Balding Blog

(female) I had my hair highlighted approx 1 week ago, i thought everything was fine, but i now have a very sore bald patch at the top of my head,do you think this was caused by the hairdresser at all,i have had my hair done in this way many times ,but have never had anything like this happen before!

Thanks

PS, im really scared that all my hair is gona fall out!!!

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Ouch! Chemical burns from dyes start off just like you’re describing. You may want to see a dermatologist to find out if the burn did indeed go deep enough into the skin to cause the problem.