Author: Dr. William Rassman

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Lost Hair From Previous Transplant Due to Shock! – Hair Loss Information by Dr. William Rassman

I had four sessions done between 12 and 15 years ago. My hair looked great. About a year and a half ago I noticed that my transplanted hair started thinning out in the front making my hairline look rigid. I recently had another session (same doctor) and I experienced a shock factor – which I didn’t experience before. It has been six months since the last session and the results are not promising – the hair that I lost due to shock has not returned and I believe many of the new grafts have not started to grow.

Do you know why –
1)My transplanted hair started to thin out in the first place
2) Why the hair I lost to shock (transplanted area) has not returned and why the new hair is not as prominent as I thought and
3) Do I have hope? Help.

First, you must wait another 2-3 months for long telogen cycles to reverse. I have never seen a previous hair transplant lose hair and then not grow back. I have seen about a dozen men who have lost previously transplanted hair, and it always came back. If the new grafts did not grow, then I would worry if that ran in parallel with your previous lost grafts. Ask your hair transplant doctor and get his/her advice after another 3 months, then write again to let me know the status (reference this post when sending).

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Normal Characteristics of Regrowth from Propecia – Hair Loss Information by Dr. William Rassman

Hi, you e-mailed me a back a few months ago about Propecia questions. I have some more. I’m up to about the middle of the 7th month on Propecia and up until about the sixth month it seemed like the loss (bi-temporal hairline only) was continuing unaffected. However, recently I have seen between 5-10 really healthy looking hairs showing up way forward in the hairline, far from where the bulk of the remaining hair is. Also, the actual loss seems to have halted and some very fine “baby hairs” are visible around the temples and the hairline. I recently cut my hair very close so I could more easily tell what was going on. My question is since i can’t tell what is miniaturization, new loss, or regrowth, etc., are these normal characteristics of Propecia regrowth and if there are little hairs coming in around the hairline, how much more is possible (theoretically)?

I can’t answer that question, as each of us respond differently to the drug. What you are doing now makes sense. By cutting your hair you will see the new growth on your head. I have actually seen a few young men return their frontal hair from taking Propecia daily, although it is rare.

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Hair Loss InformationI Think I’m Too Young for a Hair Transplant, So I Want to Use a Hairpiece Until I’m Old Enough – Hair Loss Information – Balding Blog

Hello NHI physicians,

I’m thinking about getting a hair transplant in the future, but at the moment I think I’m a bit too young for one (under 25). I have diffuse MPB on the crown (it’s quite severe), and am thinking about shaving the top off and using a hair piece/hair system until I reach the age when the MPB is more stable.

My question is, would the glue or bonding method from using a hair piece damage my scalp in any way that would prevent me from getting a hair transplant in the future?

I appreciate all the information you all have provided on this site.

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ToupeeGlues, tapes, and even clips are methods used to hold down the hairpiece to the scalp, which can cause even more hair loss. These will likely not prevent you from getting a hair transplant in the future, but you’re running a huge risk of causing yourself more trouble with hair loss. Weaves also cause traction alopecia. There is really no way around this. The decision to go with a hairpiece is a more common decision than those that want hair transplants, possibly because of the perceived cost difference and/or the fear of a surgical procedure. The choice may be a very expensive one, however, as the 5 year cost for a hair system can run well over $15,000. See My Hair System Cost Me Over $16,000 In 5 Years! for a breakdown, as sent in by a patient.

If you are losing your hair from MPB, be sure to also consider finasteride. This is a prescription medication and requires you to meet with a doctor.

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In the News – The Harm of Dietary Supplements – Hair Loss Information – Balding Blog

I read this article in the New York Times and also found it on the International Herald Tribune site — Potential for harm in dietary supplements

Snippet from the article:

A form of substance abuse rampant in this country is rarely discussed publicly or privately. It involves abusing legally sold dietary supplements — vitamins, minerals, herbals and homeopathic remedies — all of which can be sold over the counter without prior approval for safety and effectiveness.

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This is a very important story. We spend billions of dollars trying to achieve a longer and healthier life, and when we do, we get roped in by advertisements and multi-level marketing processes which get us to buy more and more of these products. Some of them are dangerous! Please take a few moments to read this.

Full article: IHT.com

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Can Propecia Increase Estrogen In Young Men? – Hair Loss Information by Dr. William Rassman

Hello doctors,
I was doing some background research on Propecia (finasteride) and i came across some information that i wanted to seek out your erudite opinion about.

The information i came across about finasteride suggested that it may be counter intuitive to use DHT inhibitiors in young men who have no prostate problems ,because of the androgen effect it produces as related to estrogen increase. There wasn’t really too much said about that as far as the harms it could potentially cause, but i was wonderin? What about gynecomastia? Are any of these concerns of statistical relevance?

I do not believe that Propecia (finasteride 1mg) causes clinically significant increases in estrogen. I also do not believe that any possible estrogen increase is the cause of breast cysts (gynecomastia) when they appear as a rare side effect of Propecia; the reason for this is still unknown.

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

I have been using Clobex shampoo and I was wondering if this medicine can permanently heal my Seborrheic Dermatitis. Also, I was wondering if my hair will grow back once it is healed.

Clobex is a powerful steroid and should not be taken for prolonged periods of time. This can cause hair loss as well and it will not be a permanent solution to seborrheic dermatitis unless you keep taking it. It is a double edged sword, so use it cautiously and temporarily.

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Dutasteride for Shock Loss Prevention – Hair Loss Information by Dr. William Rassman

Hi, I have taken Propecia for the last 6 years, but finished on it about 4 months ago and started on Generic Dutasteride about 1 month ago, I would like to know how long before the Dutesteride will work on shock-loss? Would I recommended to start back on Propecia until the operation has been completed to not get any shock loss? The transplant will be at the frontal region (I have hair there still) and on the temples. I am 29 this year and Norwood 2.5, Thanks

If you were continuously on Propecia (finasteride) and then started immediately on dutasteride when you stopped Propecia, as they are both DHT blockers that work on the same mechanism, I would expect that the protection will be there already. For our readers, I believe you are concerned about developing shock loss in the existing hair after your get a hair transplant. I am curious if you are really a Norwood Class 2, why are you having a hair transplant?

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Femara and Female Hair Loss – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman,

I’m hoping against hope that you have any suggestions for me. I’m 45, and I was diagnosed with stage 2 ER+ breast cancer 2 1/2 years ago. 21 months ago (after bi-lat mastectomy, chemo, rads, and a complete preventative hysterectomy) my oncologist started me on Femara, an aromatase inhibitor.

My hair grew back thick and full and normal after chemo and for 16 months after I started taking the femara — then suddenly 4months ago, it’s been falling out in massive amounts. Mostly in the front and crown. I’m at a loss as I know the femara is removing all estrogen from my body — and many of the hair loss drugs out there can mess with the work of the femara. I’ve started on Rogaine, but I’m not holding out much hope for that. Are there any other treatments that are safe for me? I’m desperate. Thanks so much.

Your priority should be the treatment of your cancer and with regard to your hair loss, you need to speak with your oncologist who has familiarity with hair loss with chemotherapeutic agents. I do not know enough to help you, sorry.

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Alopecia Doctors – Dr. Vera Price or Dr. Richard Strick? – Hair Loss Information – Balding Blog

Hi,

I’m writing to you desperate for answers. About 6 months ago my hairline started to thin and recede rather rapidly after stopping ortho-tri cyclen birth control pills. My general doctor thought that stopping the pill was the cause. About 2 months after seeing the doctor I started to develop a round bald spot above my front hairline. It has slowing progressed over the last 6 months into a spot the size of a quarter with redness and tenderness along with some sporadic itching. I went to see Dr. Vera Price at UCSF in San Francisco. She had her derma pathologist review a biopsy that Dr. Kurgis of Templeton CA had taken and told me it was alopecia areata and not a scarring alopecia. However, this is where I get to my question, I wanted a second opinion because Dr. Kurgis thought it looked more like a scarring kind so I went down to UCLA to see Dr. Richard Strick who also reviewed the same biopsy slides. He said that neither he nor his derma pathologist could clearly read the slides to determine if it was either scarring alopecia or alopecia areata. Which doctor is more knowledgeable about these diseases? Who should I trust Dr. Strick or Price? Please help; I don’t know what to do at this point. Dr. Price said that having another biopsy again is unnecessary and might make it worse and she was certain it’s not scarring, but it keeps spreading every week, little by little and the redness spreads as well. I’m very worried I will have to wear a wig if this does not stop. Thanks for any advice you can offer.

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I personally know Dr. Richard Strick, because he is in the Los Angeles area (where I am based), and can speak very highly of him and his work, but I only know of Dr. Vera Price based on her reputation. These are two terrific dermatologists, and I can’t make a decision for you on who to trust more in this situation. You should have asked Dr. Strick about Dr. Price’s recommendations, as he was the last doctor you saw. I wish I could offer you some advice, but these doctors are both highly skilled in dealing with conditions like these and are much more specialized with this than I am.

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Avodart Phase 3 Trials in Korea Completed – Hair Loss Information – Balding Blog

Hi Doc,
Browsing the internet extensively, but cant find any updates to Avodart as regards to hairloss..

Any idea when this study will be complete?

Many thanks

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The phase 3 study was completed in January of this year — ClinicalTrials.gov – A Study To Assess The Efficacy And Safety Of Dutasteride 0.5mg Once Daily For 6 Months In The Treatment Of Male Subjects With Androgenetic Alopecia

I have no idea what that means in relation to submitting it to the FDA for approvals or other timetables involved. I suspect that they competed the testing period, but may not have had time to evaluate the results yet. I searched the FDA site this morning and came up empty.