Author: Dr. William Rassman

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Propecia Costs Per Year – Hair Loss Information by Dr. William Rassman

how long does one need to use propecia to witness the benefits, and does it require continued usage-as in ad infinitum? how much does a yearly prescription cost on average?

Propecia runs between $700-900 / year, plus there are rebates offered by the drug company Merck. Cutting Proscar into 4 pieces will reduce the costs to about 1/3rd, but your doctor will need to be willing to prescribe that to you. Proscar is a prostate medication (finasteride 5mg), while Propecia is the same drug, but in a 1mg pill and FDA approved for the treatment of genetic male pattern hair loss.

There is a generic Proscar available, which also helps cut the cost. A generic Propecia is yet to be available legally in the U.S. due to patent laws.


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Where Are the Published LaserComb Trial Results That Lexington Promised? – Hair Loss Information by Dr. William Rassman

Has Lexington fulfilled their promise (that they made over 3 months ago on this very site) by publishing their FDA lasercomb clearance study in any peer reviewed medical journals?

You’re right. A rep for Lexington posted in the comments back in March of this year stating, in part –
“We are currently drafting a medical review of the study to be submitted to a peer-reviewed journal. We have every intention of publishing the study and making the full results available for public scrutiny.”

I’ve yet to see anything of the sort. We are all waiting…

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Worse Case Scenario — I’m Allergic to Minoxidil and Propecia Makes Me Slow – Hair Loss Information by Dr. William Rassman

I’m allergic to minoxidil and Propecia makes me stumble over words. I’ve been off Propecia for 8 days now and I’m pretty much back to how I was before Propecia, wit wise. My hair was thinning before and it still lookes the same now.

The only other real options I have are this saw palmetto and soy/equol. If this equol does inhibit DHT from working, does this mean we have to consume soy everyday? What if we go on a month safari to somewhere in Africa where soy is not prevalent? WHat then?

I am not sure if soy/equol actually inhibits DHT. For that matter I am not convinced that even saw palmetto inhibits DHT, but there are some suggestions that it does impact the prostate and may impact the hair. It might be a good gamble to use this provided that saw palmetto does not produce the same effects on you. I have not seen any good scientific literature pointing to these claims. Here is a seemingly unbiased summary I found from a simple Google search regarding saw palmetto: Pharmacology of Saw Palmetto.

You, the consumers, drive this industry as we are all trying to find the next best thing. The cure for balding, the cure for aging, etc. We latch on to loose associations and circumstantial evidence. We read things on the Internet which are not all true. We like to believe in commercials and promotions (”looks good, sounds good, must be a true” type of attitude).

That’s my two cents worth of rambling, but if you are asking for my personal opinion as a physician, my answer is: I suppose it won’t hurt, but it probably won’t work. I always say “It’s a buyer beware market,” but maybe I should rephrase the last comment as “It’s a price is right market…”. For a few dollars (or euros, pounds, etc) we seem to think it may be worth it.

By the way, who says there is no soy in Africa?

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Adding Rogaine Years After Starting Propecia – Hair Loss Information by Dr. William Rassman

Dr. Rassman,
I have been on propecia for roughly 6 years. I recently felt that it had lost a little bit of effectiveness, although I am also obsessive compulsive which probably played into that line of thinking. My question is if I begin to add rogaine to my regimen will I have some benefit. I guess I am confused whether or not any lost hair is salvageable after 6 years. Would the propecia keep some hairs salvageable for rogaine to take effect after this long?

Lost hair is likely not “salvageable” after many years. Remember that there is no cure for genetic hair loss. Drugs such as Propecia (finasteride 1mg) will slow the process. Propecia is not losing its effectiveness, your hair loss process is continuing so that your genetic predisposition is showing through. Or, as you said, your OCD may be causing you to over-examine your hair to try and find fault where there is none. I couldn’t say beyond speculation.

Hairs grown or maintained from Propecia will not be maintained using Rogaine, so if you stop taking Propecia, you will likely have “catch up” hair loss. In other words, your hair loss will progress to be as if you never took the drug in the first place. I believe Rogaine (minoxidil) can help, but it is the same story as Propecia on its limitations.

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Does Rogaine Foam Cause More Shedding than the Rogaine Liquid? – Hair Loss Information by Dr. William Rassman

I have read all over that Rogaine Foam causes vast more amounts of shedding than the liquid form. Is this true or do both cause the same amount of shedding (which of course varies by person)? I would like to know this because both are using the same growth agent in Minidoxil so I do not see how one could cause more shedding then the other. I have used the liquid form of Minidoxil for 2 months and have not experienced great amounts of shedding so I do not want to switch to Rogaine Foam if it will cause alot more.

I have not seen this in my patients, so I can not comment on the shedding comparison between the Rogaine foam and the liquid. If any readers want to share their experience with this, please leave a comment.

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Dutasteride vs Propecia – Hair Loss Information by Dr. William Rassman

Is dutasteride better for treating hair loss than Propecia?

In the Journal of the American Academy of Dermatology (Volume 55, Issue 6, December 2006), a 24 week randomized placebo-controlled study compared the two medications. DHT levels went down and testosterone levels went up on dutasteride. The results of this limited study suggested that in high doses, dutasteride had more hair growth than Propecia (finasteride). A total of 416 men were tested. There were more side effects on the higher doses of dutasteride.

This question has come up over and over again. We are waiting for the results of the Korean study to understand the meaning of the above publication. To get to the root of the question of effectiveness, we must know the results of dutasteride over a long time period and we must know the risks. There are reports of not only increased side effects such as more impotence or decreased libido, but there is also a significant impact on sperm count and possibly fertility in men. As there is a long half life of the dutasteride, the reversible nature of decreased sperm counts are not known. I would not suggest that every person rush to get this medication unless Propecia is a failure and there are reasons for trying the alternative. Please note that dutasteride is FDA approved to treat the prostate (marketed as Avodart), but it is not approved to treat hair loss, so it would be off label for the doctor to prescribe it and most doctors will not take the medical-legal risk for this off label use.

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Get a Scalp Biopsy! – Hair Loss Information by Dr. William Rassman

(female)
Could you please make sure you tell everyone to get a Scalp Biopsy in all of your replys. It took 3 years of different “doctors” before I asked for one. Immediately it determined what type of Baldness I had and I was given appropriate drugs for the diagnosis. Many thanks

Some women have telogen effluviums, diffuse alopecia areata, and other conditions. The use of scalp biopsy for some women is part of the diagnostic work-up. Be sure that the doctor who does it is a dermatologist and works with a good dermatopathologist who knows how to read what he/she sees under the microscope.

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I Want Hair Transplanted to Grow Forward – Hair Loss Information by Dr. William Rassman

Dr. Rassaman

I’ve never posted on this site before so i’ll try to make this question as understandable as i can.

Im a 33 yr. old male who up until about the age of 25 had a female type looking hairline that grew straight up and backwards very close to my eyebrows like a wall of hair,and hair on the sides of my head in front of the temples that grew very close to my eyebrows that came up to meet my unusually low and thick hairline.However i never liked having a hairline that low and that thick,and quite frankly i never liked that it grew straight up and backwards.It just didnt compliment my face at all.I hated it.The hair behind my hairline grows what seems to be almost straight forward in comparison to the hairline which grew straight back.

When my hairline matured and receded along with the sides leaving only the forward growing (yet thick and still full head looking)hair left it totally changed the way my face looked for the better i was in heaven.But now that hair behind the hairline is starting to recede and thin out badly.

My question is is it possible to receive a hair transplant that only replaces the forward growing hair that was originally behind the hairline and the hair on the temporal area only rather than having to have a full thick straight up and back growing looking hairlne???

I ask this because as foremontioned i never looked good with that full thick straight up and back growing looking hairline and i always force combed my hairline forward and i want to be able to only have that hair back that naturally falls forward and not that straight back and low;wall of hair hairline.All of the hairline transplants photos i’ve seen all look like the Dr. tries to give you back that straight up growing looking hairline when you were a teen which never suited me.But i never find someone whos transplant looks like the hair naturally falls forward without that thick straight up wall of hair hairline…………. Is this possible to achieve at this point in time Dr.????

Thank you for your time,it’s very much appreciated.

Men with window’s peaks or even the juvenile hairline may have hair that does not point in the normal forward direction. I have never seen it as a problem for the hairline reconstruction, but I would be hesitant to make a comment about your unusual hairline without examining you personally. When I do a hair transplant in the frontal hairline, the hair is placed pointing forward parallel to the floor and when I go back further, that angle increases upward slightly. If some of the hair is sticking up, I might conclude that the hairs that point up will just follow the ‘crowd’ of the thick transplant hair and be outweighed.

I’d have to either see you in person or if you have access to a video camera and can upload the video somewhere like Youtube, that’d be a great way for me to see your hair (make sure the lighting is good).

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My Hair Fell Out After Brow Lift Surgery and Regrew With Different Characteristics – Hair Loss Information – Balding Blog

(female)
Dr Rassman,

After having a brow lift type surgery ( no lift but same incision ) a lot of hair all over my head fell out. What grew back were strange hairs. Some are very fine only about 3 cm long, and look crimped. Others are thick coarse hairs that look like afro or pubic hairs. Together these hairs are all over the crown and have been growing this way for about 4 years now. My Dr said these hairs have nothing to do with the surgery but they all started a few months after the surgery.

I am 99 % convinced that they are related and would appreciate any information you might have. Also some of the coarse hairs have are less so closer to my scalp, that would indicate that time is possibly helping a bit. The very fine ones have not changed.

With Kind Regards

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I have not seen this type of change associated with a brow lift incision. I have seen hair loss with a finer hair appearing in front of the brow lift incision, but I have not seen someone change variable parts of the scalp hair and not other parts. I would have to examine you to make sense of the process you are discussing. The use of good conditioners after washing should minimize the kink in the hair.