Dr. William Rassman – Page 1411

September 19, 2008

Taking 1 Propecia in the Morning, 1 Propecia at Night? – Hair Loss Information by Dr. William Rassman

Hello Doc. My question is this. I’m currently taking propecia 1mg tablet daily. Since propecia has a half life of 8 hours, will taking it in the morning and then 12 hours later at night increase it’s effectiveness? My concern is that I take propecia in the morning and take it every 24 hours like is intended. But doesn’t the drug work only 8 hours out of 24? So the other 16 hours dht is attacking the hair follicle? Please clarify. Thank you for your time doc.

The drug fixes to the tissues and the hair follicles, which lasts longer than 24 hour. The half life is the time in the blood stream, not fixed to your tissues. Just stick to one Propecia pill a day.

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September 18, 2008

5-Alpha Reductase and Propecia – Hair Loss Information by Dr. William Rassman

If Propecia reduces DHT by blocking the 5-alpha reductase enzyme, does stopping Propecia mean that the normal production of 5AR will take place once again or are the blocked 5AR enzymes gone forever (I’ve heard the latter on message boards like propeciahelp.com).

The block from the enzyme 5-alpha reductase is not a complete one (I believe I read it was about 80% with Propecia) — and it is always there. When you stop Propecia, the enzyme continues to do what it always does and is not “gone forever”, as you read on those message boards.

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September 18, 2008

Blocking DHT in Post-Menopausal Women? – Hair Loss Information by Dr. William Rassman

What is the best form of DHT blocking for post menopausal women. Is it safe to use propecia in my case?

Dihydrotestosterone (DHT) does not usually cause hair loss in women. As mentioned before (Female Genetic Hair Loss Is Different From Male Genetic Hair Loss), the common causes of women’s hair loss are different than typical causes of men’s hair loss.

Although the DHT blocker Propecia (finasteride 1mg) is not approved by the FDA for use in women, there are doctors that will sometimes prescribe it for women, but these are highly individualized cases that require patient education and informed consent. First, the woman should make sure that they are not carrying the breast cancer genes. If they are not, then there is little downside that I know of. Many, many doctors are prescribing Propecia for post menopausal women because the protective effect of estrogen is reduced. The reports, however, are anecdotal and not trustworthy.

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September 18, 2008

Born with a Bald Spot – Hair Loss Information by Dr. William Rassman

ive had a bald spot on the side of my head since birth. hair has never grown there before. the spot is about 1.5 in. by .75 in. can a hair transplant fix this? would it look natural? and how much would a spot like that cost?

What you describe seems simple enough. A hair transplant should generally cover the area well and with natural results. It would likely involve a few hundred grafts. Our surgery fees are listed on our website, but our minimum fee is $3000 for any procedure. Sometimes if the spot is small, a reduced fee can be arranged under special circumstances.

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September 18, 2008

Forehead Feels Cool, Seeing Wrinkles After Using Minoxidil – Balding Blog

I have used minoxidil for my hair thinning on the vertex and hairline and it is working great! Except I’m noticing a disturbing, growing sensation on my forehead since I have been using it.

Whenever I would apply the minoxidil, my forehead would have a cool, wet sensation for about 20 minutes as if cooled water was running over it but it wasn’t the minoxidil or water. Nevertheless, I have been using it for 2 months and my forehead feels STIFF and I’m noticing wrinkles! I’ve read the 2 archived topics about wrinkles & minoxidil (i.e.”Using Propecia at Temples, Wrinkles From Minoxidil…” ) but I found documented studies about how it effects collagen synthesis (see: Medscape & Investigative Ophthalmology & Visual Science)

I’m assuming that minoxidil would be the cause of my facial stiffness (so bad, it feels like my forehead is duct taped) and gradual appearance of wrinkles. I’m a 25 year old male. I would greatly appreciate it if you could reply. Thank you so much!

Aside from that previous post from a reader, I’ve never heard complaints about wrinkles being caused by minoxidil. None of my patients have reported that to me. The studies you sent are interesting, but I’m not convinced that minoxidil will cause wrinkles. You might have some kind of allergic skin reaction to an ingredient in your formulation of minoxidil. I’m just speculating, of course.

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September 18, 2008

Galeatomy Procedure – Balding Blog

Dear Dr. Rassman,

The question is in regards to the galeotomy procedure – originally pioneered by Dr. Lars Engstrand out of Sweden – I believe. The procedure was also popularized by the late prolific health writer Paavo Airola in his many writings.

I find this sunbject very interesting and have noticed an increasing interest for this procedure on the hair-loss forums, but very little information exists. I have heard that this procedure is quite effective and yet it seems to be totally ignored (or suppressed) in this country. What do you know about this procedure? Do you think it works? Do you have any first hand experience with anyone who has had it done? Do you, or can you, perform it? Does anyone in the U.S. perform it?

Please take the time to share what you know about this interesting topic.

Galea The galeatomy has been around for years. For those of you who do not know, above the skull lies the periosteum (the living membrane above the bone) and then the galea. Above the galea lies the scalp, which is very mobile (try to move your scalp around and you will see just how mobile it is). The scalp has a clear blood supply coming from the front, sides, and back of your head. The blood supply lies above the galea, so cutting the galea makes no sense. It is not easy to get to the galea unless you cut open the scalp. We have done galeatomies years ago with scalp reductions and today’s hairline lowering procedures, and brow lifts will frequently dissect the galea as part of the mobilization of the scalp. As working below the galea is relatively bloodless, it is a terrific surgical plane to work in. Cutting the galea will not increase the blood supply to the scalp, but will just produce morbidity if it is done in isolation of some good surgical reason to do it.

Competent doctors do not do perform this barbaric procedure for the treatment of hair loss.

September 18, 2008

Scalp Flexibility and Lack of Blood Flow – Hair Loss Information by Dr. William Rassman

Hi,

I’ve noticed that my thinning area’s scalp is also very thin and stretched very tightly onto the skull, unlike the area where I have no thinning which has a thicker scalp with more cushion and flexiblity. What causes this? Is it the lack of bloodflow to the area? This only occurs on the thinning areas…

You are very observant. The loss of hair produces the loss of infrastructure, which is all of the associated parts of the hair organ including blood vessels, dermal fat, collagen, nerves, and muscles associated with the hair that take space and causes that cushion you are noticing.

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September 18, 2008

What Should I Do After Propecia? – Hair Loss Information by Dr. William Rassman

I’m 22 and have early frontal hair loss which I noticed 6 months ago and been on Propecia for 2 months now. I got a miniturization study done and the doc said I have it in the frontal area and a little on my mid anterior and he said it’s significant for my age (well in my opinion any thinning my age shouldn’t happen!). You always say Propecia works best for young men my age and we have a good chance of reversal and halt the hair loss but since men who start thinning my age are usually the baldest and have faster hair loss the others, how good in the long can Propecia work then? I know I’ll be fine for about 2-3 years but what then?

And it’s funny how weak MPB is in my family. Nobody except my father and mom’s brother had MPB but not until theirs 30s. My father is a NW5 at age 64 and my uncle is a NW3 with mid anterior thinning as well at age 40.

I have many male patients that first got great benefits from Propecia at your age, and now 10 years later they still have those benefits. I’m not sure how to answer your question — as I’ve said before, I can’t tell the future. Maybe there will be another drug available? Maybe your hair loss stops completely? Maybe you decide in 10 years that you hate hair and would rather shave your head? For now, stick with what is proven to work (Propecia).

There are patient results statistics for after 2 years and after 5 years on Propecia available here, and hopefully that will give you a little more peace of mind.

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September 17, 2008

My Hair Looks Thin Under Direct Light, But I’ve Seen No Recession – Hair Loss Information – Balding Blog

I have one of those panels right above my bathroom mirror with lightbulbs, and whenever I look at my hair in the mirror, the front looks like it’s thinning as I can see scalp. But my hairline is the same as it’s been since I was 15 (10 years ago) — no recession whatsoever that I can tell. And my hair does not seem to look like it’s thinning in the temples but rather in the general frontal area from temple across the middle and to the other temple. Furthermore, when I come out of the shower I comb my hair back, and then I take a handheld mirror, and bend over so I can see the top of my head in the mirror, the front of my hair looks like it’s thinner than the middle or back from the top view. From this description only, what would you make of this?

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When your hair is wet, you might have more see through hair. Also, as you age, some people get finer hair. Under direct light, your hair may appear thinner. It doesn’t sound like you have any hair loss, and I really can’t suggest anything for you to try.

September 17, 2008

Taking 3 Months off Propecia to Evaluate Hormone Levels – Hair Loss Information by Dr. William Rassman

I’ve been taking propecia for nearly four years, and my endocrinologist would like me to take 3 months off of it to evaluate some hormone levels that were questionable at best, particularly low FSH.

My question is, can you take 3 months off propecia without any harm being done? How long can I realistically go off it and be able to take blood tests without the finasteride having any impact on the tests – is it 3 months or less? I have read that the half-life of propecia is less than a day so, ideally, couldn’t I take blood tests after, let’s say to be safe, a month and it’ll be okay?

Thanks in advance!

If you were actively balding and taking Propecia for a long time, then stopping it for 3 months can produce “catch up” hair loss in that time frame. I am not an endocrinologist nor your doctor. You should be address these concerns with your doctor. Maybe your doctor has his/her own reasoning.

I really don’t know your situation of low follicle-stimulating hormone (FSH) or why you are taking Propecia to evaluate hormone levels. Some of what you say makes me wonder if you are even balding or have androgenic alopecia. One thing that I do know is that the serum half life of Propecia is several hours (4 to 6 hours). I do not know what impact it has on FSH. Ask your doctor.