Author: Dr. William Rassman

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Cut My Head on a Shelf – Will I Lose Hair Around the Wound Now? – Hair Loss Information – Balding Blog

Dear Sir,

This may sound a trifling worry compared to some of the scenarios that I´ve glanced at,so I shan´t be long. This morning I cut my head on shelf at home, removing a section of scalp with hair in it. I´m unsure how deep it is, though the bleeding was not particuarly profuse and stopped after pressure was applied. I´m worried that the skin and hair particles shan´t heal and growback, and fear a small bald patch occuring. Do you have any advice or information that could be helpful? Many thanks
Best regards

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ShelfMy advice to you would be to go see a doctor to make sure there are no foreign bodies embedded in the wound and make sure there is no infection occurring. From the timing of this post, the window to have it sutured will be too late (>24hrs). If your injury caused separation of the edges of the scalp, your wound may heal with a scar, producing a small bald patch. If that bald patch bothers you, you can always get a small, minimally invasive Follicular Unit Extraction (FUE) hair transplant to cover it. If you see a doctor, he/she may determine that closing the wound may still have value, but the longer you wait, the less likely will be this scenario.

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Measurable Success with Half Dose of Propecia? – Hair Loss Information – Balding Blog

Dr. Rassman,

I have read on your blog that .5 mg of propecia once daily is believed to be 80% as effective as the recommended dosage of 1 mg.

With that being said, in your clinical practice, are you aware of any patients showing clinical or measurable improvement when taking only a .5 mg dosage of propecia once a day? In other words, what are your experiences in practice with taking this minimal dosage due to side effects?

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Most of my patients take the recommended 1mg of finasteride. There are a minority of patients who take 0.5mg of finasteride, because they’ve reported side effects or believe they just want to be on a maintenance regimen. While the 0.5mg dose is not an approved dose for hair loss, the reports show it is 70 to 80% as effective as the full 1mg dose. This is difficult to impossible for me to verify, though. To answer your question more specifically, I would need access to the studies done when the dose when optimized by Merck. I don’t have enough experience with the 1/2 dose to tell you more.

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Doctors Here Are Trying to Sell Me Hair Transplants – Hair Loss Information – Balding Blog

I live in Toronto ON I am 23 years old and am starting to notice my hair is getting a little thin. I went to see a couple of doctors to get an opinion and I felt that they all were trying to sell me something. Do you know of any doctors/specialists in the Toronto area that will give me an honest opinion and not try to sell me their products. Is it also possible I am not loosing my hair and that my hairline (which has receded somewhat although I have always had a high hairline) and that I am just maturing. I was considering taking propecia and asked my GP about it but he just wrote the prescription and sent me on my way. I do not wan’t to start taking prescription drugs until I am well informed on the subject as all the stuff I see on the internet is so confusing. I think I am a norwood 2/3 somewhere in between. PLEASE help!!! Much appreciated!

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You need a good evaluation, which is something I really can’t do via the Internet. I do not focus upon physicians in your area, so I really can not comment on other doctors, but if they are just trying to sell you on a procedure, you might consider taking a trip to New York and see Dr. Robert Bernstein. He will not sell you a hair transplant, but will give you an honest evaluation of your situation. Alternatively, you can visit me in Los Angeles, but I suspect New York will be an easier journey. Otherwise, you can check for doctors in your area using the physician search at ISHRS.org. Unfortunately, I don’t have a personal recommendation in your area.

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Are You Born With DUPA? – Hair Loss Information – Balding Blog

dear doctor,
Im a male. I was wondering if you can get DUPA at a later age like mid 30s or is it something that your born with? thank you

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I believe that diffuse unpatterned alopecia (DUPA) can appear at any age and there is probably a genetic predisposition to it. We do not know the cause of DUPA, but we assume it is like the female unpatterned hair loss… which we also do not understand.

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Is Reducing DHT / Testosterone Safe? – Hair Loss Information – Balding Blog

I understand that blocking DHT can help prevent hair loss. When I read the ingredients in alot of products that help prevent hair loss, they claim to reduce testosterone. Is reduction of testosterone safe? How does that effect the libido? Is reducing DHT the same as reducing testosterone and I’ve just misunderstood?

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In adults, DHT (dihydrotestosterone) plays its greatest role in mediating the testosterone effect in hair follicles (essentially causing hair loss in genetic hair loss conditions), and in bringing on nose and ear hair. It also plays a role in producing prostatic swelling and some feel it plays a role in causing prostate cancer in those people genetically prone to it.

Reducing DHT is not the same as reducing testosterone. In fact, if you reduce DHT, you may get a very slight transient increase in testosterone. There may be products that claim to, or actually do reduce testosterone levels, but none are approved for the treatment of hair loss. In any case, use caution and be sure to consult your physician prior to use.

If you want to get into the bio-chemical details: testosterone is converted to DHT by the enzyme 5-alpha reductase. Finasteride (Propecia), the only FDA approved oral hair loss drug, works by blocking this enzyme, effectively decreasing the amount of DHT, thus decreasing hair loss. Testosterone can still act on other tissues without being converted to DHT.

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Does Lack of Research Really Mean Lack of Efficacy? – Hair Loss Information – Balding Blog

Great site, my question is in no way a personal criticism of the important work I think your doing here, but…

I’d estimate in at least 50% of responses you guys say there is little or no research to say whether the treatment in question really works. My question is, does lack of research suggest lack of efficacy?

Like everything research is either funded publicly or privately. There’s much motivation for private industry research because there’s much money to be made, but this leads to an obvious conflict of interest. I get the feeling drug companies are running projects without appropriate methodologies because their researchers don’t think they would get significant results otherwise. It is also possible negative results are not being published because they are they obligated to register studies before running them as other fields have to?

It also appears to me there is modest government/public funded research based on the lack of large scale studies that are without funding conflicts. I imagine this could either be because baldness is not seen as something worthy of much money to gov’t, or because the researchers themselves don’t think this stuff works and don’t want to spend years running huge studies to prove something they might see as pretty obvious.

I recognize my comments might not be accurate when it comes to finasteride or minoxidil, but for most other options, and my particular interests of the shampoo and laser treatments, do you think I’m correct?

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Pot of goldYou raise a valid point. Research can be biased, and you must consider who funded it and the methods used. A good example of this is the research conducted by the laser hair industry, as we scrutinized the methods and its results (see Analyzing the Results of the HairMax Laser Comb).

Your comments echo my repeated motto — it is a buyer beware market. We live in a capitalistic society, which means that we need to have financial reasons to do research, because there may be a pot of gold under the rainbow.

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Using Rogaine for 9 Months, Using Propecia for 2 Weeks – Hair Loss Information – Balding Blog

Thank you Dr. Rassman for this incredibly helpful blog. It seems that the internet is FULL of snake-oil salesmen for men losing their hair, and your site is one of the few truly helpful sites.

My question:
I’m a younger man (25) and started using rogaine foam about 9 months ago at the first sign of my hairline receding. The rogaine did not help this, and my hairline continued to recede, so I finally spoke with my doctor and he gave me an Rx for Propecia which I have been taking for 2 weeks. My question is whether I should continue to use the Rogaine with the Propecia and what I what you have seen these (or just one) of these products have effect on the temple region.

Thanks!

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Rogaine sometimes develops dependencies, but I can not tell you if you have developed them. I suspect not, just because you did not see a benefit. Nevertheless, I would continue the Propecia for 8 months, until most of the benefits from finasteride has been reached. If there are benefits from Propecia and you should stop it, you will lose all benefits fairly quickly. Both of these products will reduce hair loss, but Propecia is more certain in male genetic hair loss. Although it does happen on rare occasion, neither, I suspect, will regrow the frontal hair.

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Elavil and Hair Loss – Hair Loss Information – Balding Blog

Dear Dr.

How risky is Elavil (Amitriptyline) for hair loss? Is it the same risk factor as the SSRI’s or more risky? Also, how would you weigh the risk/benefit of using a drug like Elavil (or another similar drug)-vs- living with the anxiety?

Thank you for your time.

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Both Elavil and the SSRIs can cause hair loss as a side effect, although it is not common. There is almost always a concern for side effects from any medication, but the most common cause of hair loss in men is genetic balding. Therefore, we can not predict if these drugs are causing hair loss in your situation. I would definitely recommend that you bring up these concerns with your doctor. Before you stop taking any medication we strongly urge you to speak with your doctor.

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I Want to Transplant from My Head to My Chest! – Hair Loss Information – Balding Blog

Hi Dr. Rassman, I have couple of questions, first questions is, how much does it cost to have hair transplanted from you head to your chest. 3 inches above my umbilical area and down is very hairy,but above that area is completely hairless, it looks like I been shaving. The other question is, does it hurt. Do you have to make an incision or it is done with needles. Will the hair stay forever in that area and will continue to grow. Please respond ASAP I am really serious about having that done. Thank you

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Hair can be transplanted from the head to the chest. We actually do this type of procedure for women that want more pubic hair (usually those who lose their pubic hair with aging). The costs are directly related to the area covered and the number of grafts placed at the site. It would run between 500-1000 grafts to cover the area that you defined. The hair will grow long (like on the scalp), so you may have to cut it. If your hair is coarse, it may not look right, but finer hair should do fine. Pain is minimal (like a typical hair transplant), although it does depend on what you consider painful.

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Propecia and Blood Pressure Pills – Hair Loss Information – Balding Blog

nice site. my question is i would like to go on propecia but i take an anti blood pressure pill in the morining and a depression pill around dinner time, is it safe to take propecia along with these drugs and when should i take propecia along with these drugs ?

thank you.

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You should take the finasteride whenever you can remember to take it (no more than the daily recommend dosage, however). I would hope that you take your Propecia once a day and your blood pressure and antidepressant pills when they are scheduled.