Dr. William Rassman – Page 1520

January 18, 2008

Why Does Stress Cause Accelerated Hair Loss? – Hair Loss Information by Dr. William Rassman

Stress is acknowledged to accelerate MPB. My question is how much stress would it take to increase hair loss to a noteable degree. Would everyday stress, for example the stress in which everybody would at least arrive at in work or home cause an acceleration or when you mean stress do you mean a really long drawn out period of total stress. What is responsible in stress which causes acceleration in MPB, raised testosterone?

Medicine is a descriptive science, and the observations that stress contributes to hair loss is something we have observed. I do not believe everyday anxiety (being late for work, for example) is stressful enough to cause hair loss, but I also do not know how to calculate the degree of stress a person has in their lives. People tell me that they’ve noticed their hair falling out with divorce and other severe relationship or family problems, financial problems, and so on. These are the types of long, drawn out stresses that can cause hair loss. If you think about the saying “I’m pulling my hair out” that many people use when under pressure, that describes the stress people are talking about.

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January 17, 2008

Hair Loss InformationI’m 8 Days After Surgery – Can I Do Kung-Fu? – Hair Loss Information – Balding Blog

Hi there,

This will be my 8th day of post-op HT and I have read several blogs regarding what kind of physical activity is ‘allowed’ and which ones are not recommended.

Any movement involving the trapazieus muscle was not recommended, anything with weights heavier than 25lbs was not recommended either. Can I assume that doing something along the lines of push-ups, dips, and squats with no weights other than your own body weight and perhaps yoga is fine?

How about something like Kung-Fu with no contact to either the graft or donor area?

Thank-you v. much

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For recovery from a follicular unit extraction (FUE) procedure, everything can be done. For recovery from a strip harvesting procedure, always test your trapezius muscle for contraction. The more the tightness created at the neck, the more of a problem that could be created from such activities as sit-ups and push ups. Squats are probably alright.

January 17, 2008

A Big Batch of Rogaine Foam Questions – Balding Blog

Hello Doctor,

I’m male, 37, 6,1, 180lbs, don’t take any medication and my hair is about 1.5 – 2 inches long and sometime 3. I have male balding on the top and receding hairline. In the past I have had thick and lots of hair, now the top is thinning to a point were I get sun burns and makes me cold in the winder. This is the part that I really don’t like as I hate wearing something on my head.

My question is, when looking at Rogaine, which product is best for me? Here’s my thinking, some with questions:

It is important that the solution gets in contact with the scalp, so with “longer” hair will the foam product be as effective?

Is volume and length of hair need to be considered when choosing product?

With the foam product how do you know one is using the right amount?

There has been remarks about the smell of the foam, are there scent free versions [coming]?

How can one test the product without buying a full size?

Is there a difference between the different brands, besides price?

Is there a generic foam vs. Rogaine?

Thanks.

Rogaine Foam

Yes, the Rogaine (minoxidil) needs to be in contact with the scalp in order to be effective. Hair length doesn’t matter, but volume of hair could play a role in getting the medication to reach your scalp. Just be diligent and move your hair around to get the minoxidil onto the scalp.
See answer above.
I would think there is some instructions on the packaging. The Rogaine Foam site says “the total amount of foam applied should not exceed half a capful.” For the liquid, the recommended dose of the Rogaine 5% topical applied twice daily.
I have no idea if they’re making a scent-free version.
I don’t know if Johnson & Johnson (makers of Rogaine) offer a free sample of the foam. Drugstore.com sells it at $22.79 for 1 month or $42.49 for 3 month supplies. The best price depends on your own research.
The foam is reported to have better absorption than the liquid formulation, but I do not believe it is a significant advantage to achieve a drastic difference. Generally speaking, a generic minoxidil 5% solution would be the least expensive (most bang for your buck).
To my knowledge, there is no generic version of Rogaine Foam.

More information can be found on the Rogaine Foam site. Remember, before starting any medication you should see a doctor (a hair transplant doctor is fine) for a good initial evaluation. You may also be a candidate for finasteride (Propecia).

January 17, 2008

Can My Hair Miniaturize In Different Areas at Different Times? – Hair Loss Information by Dr. William Rassman

Hello docs,
My question is pretty simple: can your hair begin miniaturizing at different times? For example: let’s say you start losing your hair in the vertex area first; then, maybe a few years later you start thinning in the crown area as well? Does this just mean that your body is playing catch-up, or does it mean that the end result is total loss in one area versus partial in another?

We do not bald symmetrically, so your observations are correct. The patterned hair loss which everyone references generally does not occur uniformly. Miniaturization varies by part of the scalp and the genetic patterns you inherit. Although most hair loss is started with signs of miniaturization, sometime this miniaturizing does not show and the hair loss occurs anyway. The time line for miniaturization and balding varies between people and can be erratic.

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January 17, 2008

Follica to End Baldness? – Hair Loss Information by Dr. William Rassman

Are you familiar with Follica and their technology to generate completely new hair follicles on the scalp? This company seems to be headed by a who’s who in the field of hair loss….Dr. Vera Price, Dr. Rox Anderson, and Dr. Cotsarelis from Penn State University where this technology was first discovered. I see where they recently acquired 5.5M US from investors to conduct a clinical proof of concept study on 50 or so volunteers. Since everything they use to accomplish this is already FDA approved and/or already being done (microderm abrasion + application of special proteins), it seems like this could really be the “holy grail” to end baldness much sooner than expected (at least sooner than NEOSH101 or Intercytex).

Have you been following this exciting development at all or do you have any thoughts on this technology?

Follica The work sounds exciting and I look forward to reading more about their research in medical journals. I have not been following it though, because the information on it is cursory and does not give me the insights I need. You are right, the people associated with it indicate a general excitement that has been generated. There is a quick write up on Follica here.

For those wanting to read the news about their recent $5.5 million round of funding, you can check it out here.

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January 17, 2008

Hair Loss Information » Going Bald from Chemical Hair Straightener? – Balding Blog

Can you go bald from using a chemical hair straightener regularly? I follow the chemical straightener directions to a tee. I’ve been straightening my hair about every month and a half for 2 years. My hair grows very fast and it takes about a month for the chemically processed hair to be completely out. i keep my hair short. I’ve had no side effects whatsoever thus far. I am concerned about the future. I am a male age 25.

There are may women who believe their hair loss was due to chemicals they put in their hair (perms/straighteners), but take comfort in knowing that the most common cause in men is genetic male balding. If you notice hair loss, I would absolutely stop using chemicals to see if that is the cause. For now, it seems that you’re in the clear.

January 17, 2008

Hair Loss 2 Weeks After Starting Lexapro? – Hair Loss Information by Dr. William Rassman

It could have been coincidence, but I started shedding hair about 2 weeks after starting Lexapro. I was also taking agomelatine with it (a new expiremental antidepressant). I had been on agomelatine for several months without effect. I have taking Lexapro before and this didn’t happen. I stopped both about 5 weeks ago.

My questions is: If a medicine causes hair loss, how long after stopping it would the hair loss continue? I stopped both and I want to go back on the Lexapro for anxiety but i don’t want to start shedding again. How long does it take for medicine to START causing shedding, and how long does it take for it to STOP if it was in fact the Lexapro? I was on a very low dose (5 mg) for only 4 weeks, so it seems unlikely to do this.

I have researched telogen and anagen effluvium and I don’t know if this could be what happened? Or maybe it was just MPB kicking in again after 9 years of being on Propecia and was coincidence?

It seems like you have done your share of research. The hair loss could be coincidence after starting either medication, or it could be telogen effluvium, MPB, etc. Your guess is as good as mine. I don’t see anything in the literature about agomelatine (also known as Valdoxan) and hair loss, but many antidepressants are known to cause hair loss. I’ve written about Lexapro in the past.

If you have genetic male pattern baldness then I would think that would be high on the list of possible causes. If this was due to the medication, nobody would really know when or if your hair would grow back to its normal state. Hair loss and hair growth cycles are in the order of several months, so I would conservatively give it a year. Before stopping any prescribed medication, please speak with your doctor.

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January 17, 2008

How Can Hollywood Actors All Have Such Great Hair?! – Balding Blog

It seems very unlikely that 90% of the actors in hollywood would have full heads of hair. For some it seems that their hairlines are still similiar to teenagers and the others have a thickness to their hair that is almost unreal. I just can’t believe that so many of these celebrities could be so lucky. My question is what percentage of these celebrities would you estimate have ever used propecia, and/or have had a hair transplant?

Jason Statham I don’t know how frequent balding is in Hollywood actors. We know that people with hair generally get jobs easier and that may apply to actors, as well. Also, not everything you see is what it really is. That’s the magic of Hollywood. Actors have images that they have to maintain, and when they start balding many actors will use a topical camouflage such as Toppik or even a hair system (like the type John Travolta has been seen with) to keep the particular look they are known for.

On the flip side, there are what seems to be a growing number of major actors letting their natural balding looks prevail; action stars such as Bruce Willis and Jason Statham (see photo), for example. Of course, the list goes on and on.

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January 16, 2008

Hair Loss InformationDostinex (Cabergoline) and Propecia – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

I’m a 28 year old male. About 6 months ago I was diagnosed with a rare pituitary condition called hyperprolactinemia. This disorder is genetic in my family, and mine is a very mild case. The treatment is a single half-dose of cabergoline (marketing name Dostinex) taken once a week.

Male pattern baldness also runs in my family and I’m starting to show thinning on the crown of my head. My dermatologist suggested I try the propecia/rogaine route. Since propecia affects the endocrine system I am a bit reluctant to take it without knowing more about possible side effects or interaction with the cabergoline. I don’t think it should and my dermatologist said she wasn’t aware of anything and I haven’t found anything about it on the web, but I wanted to get another opinion before I started propecia. I also read online that minoxidil from rogaine may have a side effect of increasing prolactin – the condition I have too much of. Do you know of any cases like this? If so, should I reconsider starting propecia, rogaine, or both?

Thanks!

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Dostinex At this point, it is very difficult to accurately assess the cause of your thinning hair. As far as I know, cabergoline does not have hair loss listed as a potential side effect, however, this does not mean that this drug can not cause this in you. Also, certain diseases / stresses to the body have also been known to cause hair loss. Lastly, as you have mentioned, male pattern baldness could be the cause of your thinning hair. You definitely need a miniaturization study to determine the extent and locations of most of your hair loss (i.e. does it correspond to MPB?).

There have been reports that minoxidil may be related to the development of hyperprolactinemia, definitely something you don’t need more of (see Drugs.com – Interactions between cabergoline and Minoxidil). The main point here should be that before you start any medication, whether it be Propecia or Rogaine, you should have a coordinated discussion between your physician that is treating you for the hyperprolactinemia and your dermatologist. To answer your question though, I haven’t read about Propecia (finasteride) and cabergoline interactions, but again, please discuss this with your prescribing physician.

January 16, 2008

Hair Loss InformationMy Father Has a Class 6 Pattern – Does Propecia Have a Chance to Work for Me? – Hair Loss Information – Balding Blog

Hi, you’ve stated that everyone responds differently to Propecia, but that it often works better in younger men (I assume in their very early 20’s) as a general rule since they’re mostly likely in the early stages of MPB. However, I believe you’ve also suggested that Propecia can only slow down the process for a younger man who may be headed towards a class 6 or even 7. Does this mean that only young men with a history of lower class balding on the Norwood scale in their family can have their hair loss stopped or even reversed with Propecia? Is it unrealistic to think that Propecia even has a remote chance of stopping hair loss in a 21 year old that has noticed some general thinning but has a father with a class 6 hair loss stage on the Norwood scale?

Thanks for your response in advance. Also, I wanted to compliment you on the website, it’s a great resource and I’ve enjoyed reading it.

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Just because your father is a Norwood Class 6 patterned balder, does not mean that you will be that. You may have different expression of the gene or inherited it from another line on your father’s or mother’s side. Since we can not predict your pattern with certainty, slowing down the loss with Propecia (finasteride 1mg) makes common sense no matter what your final pattern will be. So instead of significant hair loss in your 20s, maybe you can push it back to your 40s. If you get your hair mapped out for miniaturization, then at some point your final hair loss pattern can be predicted and from such an examination you can establish a good Master Plan for your future with a competent, caring doctor.