Author: Dr. William Rassman

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Can I See a Trichologist to Diagnose Hair Loss?

Would trichologists be a good place to go to diagnose genetic hair loss. Consultation with examination is a bit expensive so I’d like your opinion on it. I’m seeing one in 2 days and what he plans to do is take some of my hair and examine it under the microscope. Would you have any idea on the effectiveness for diagnosis with this method vs the scalp mapping for miniaturization? I’m 26 asian male with a full head of hair (although not as thick or a lot compared to in HS)Is it still a good idea to see these specialist anyways even though Im not exhibiting any clear observational signs of balding (my diabetic father thinned and had bad hair loss at 46 and his younger brother balded in his teens…grandfather on both sides have hair although diabetic mother on father’s side has extremely thin hair pretty much balding)

I can not tell you what the trichologist will see or what he/she is looking for. Without miniaturization studies I do not believe that hair loss patterns for genetic hair loss can be anticipated. The miniaturization study is a microscopic examination of your scalp. If your trichologist is doing this, and knows what to look for, then you’re a step in the right direction.

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Can I Restart Using Rogaine to Regain Lost Hairs?

Hello, I’m a 21 year old male who started using Rogaine at the age of 19. I was worried I was losing my hair because it is very prevalent in my mom’s family. After using Rogaine for over two years I decided to stop because of the irritation it was causing on my scalp. I stopped late last January and for the first three months I did not notice my hair count change at all, but in about the past three weeks my hair has been falling out by the handfulls. If this continues much longer I may be left with no hair at all. I have been using Rogaine again now for about a week and will continue, but do you think I will be able to get back in the large amount of hair I lost that was apparently dependent on Rogaine? Will reintroducing Rogaine to the follicles bring my hair back to what it was? thank you!

The only two FDA approved products approved for male pattern hair loss are topical minoxidil (Rogaine) and oral finasteride (Propecia). They both have limitations and work primarily by slowing hair loss than growing new hair. Only a small minority of men with genetic hair loss will experience great amounts of hair regrowth with minoxidil, while Propecia will show more predictable results in someone of your age. In your case, your genetic destiny may be catching up to you. It is doubtful that restarting Rogaine will regrow your hair, but Propecia, on the other hand, may reverse recent hair loss. Both drugs may slow the process of hair loss, but if you are genetically balding, Propecia attacks the cause of the hair loss and therefore is far superior. Get your diagnosis by mapping out your hair for miniaturization and with good measurement, you will be smarter about what is causing your hair loss and what benefits you may or may not get from doing whatever you choose to do.


2006-05-22 09:47:57Can I Restart Using Rogaine to Regain Lost Hairs?

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Can I Take a Half Dose of Propecia if I See Side Effects?

Hi, Doctor Rassman,
Im a 27 year old male,my hair has been thinning since I was 23.I still got hair on top and at the front but is thinning on the crown. After tried herbal remedies like Provillus (waste of time and money, honestly) and tried different topical lotions like Revivogen( the same as Provillus,waste of time and money.) Please guys don’t even think about this kind of products,they don’t work!!!

I just decided to try Propecia after a year of research,Im still bit scared about the side effects but I think I’m going to give it a go and see if it works for me. My question is: is possible to take a dose of 0.5 daily in case I get any of the side effects? Is this safe an effective?

Thanks

You should take 1mg of Propecia (per your doctor’s prescription) and if you develop side effects, you can cut the dose… but going the other way makes no sense. 99% of people do not get sexual side effects addressing sexual performance. Why would you assume you are in the 1% group of the population?


2009-05-14 15:04:09Can I Take a Half Dose of Propecia if I See Side Effects?

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Can I Start Propecia Now or Should I Wait for My Scalp Infection to Go Away First?

Dr. Rassman,
Ive had a skin infection for about a yr on my scalp. Ive been on many prescription meds like Ketoconazole, Selenium Sulfide, Salicylic Acid and Clobetasol. Ive gone through symptoms from heavy irritation, flaking peeling of oily skin on the scalp and hair-loss, scaling, buildup, dead skin-white buildup. Lately I primarily have inflammation and buildup but it is very little and very tiny and very thin flaking during combing when scalp is dry. I’m concerned about my hairloss, thinning, shortening-Its noticeable now and continues to progress from the hair line to about 1 inch inward but is not perfectly symmetrical. Most of the hairs that fall out are with the bulb attached and I do notice very tiny hairs remaining at my previous hairline. The only thing that gives me relief is clobetasol, because I still have lots of irritation/inflammation which Ive been taking for 2 months with 6% salycilic Acid. Is it a good idea to start Propecia or should I wait for the scalp infection to go away? I took a blood test that came back Normal. Thanks

Sounds like you have a major hair/dermatological problem. These medications (like the clobetasol) are heavy duty stuff. I can only guess at your diagnosis. Taking Propecia (finasteride 1mg) will not hurt and might protect you from some of the ‘stress hair loss’ you are experiencing. I would check the use of Propecia with your doctor, but I suspect he/she would go along with it.


2008-05-29 14:20:19Can I Start Propecia Now or Should I Wait for My Scalp Infection to Go Away First?

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Can I Strengthen My Hair to Prevent Hair Loss from Relaxer Chemicals?

I am an African American female and experiencing hair loss. I currently use home relaxers on my hair because it’s easier to manage. What can I do to strengthen my hair to help prevent the hair loss? Thanks

Keep in mind that I am a hair transplant doctor. With that said, from my point of view there is not much you can do to strengthen hair. Despite all the hype, there really is no secret formula. Use what works for you. Eat a healthy diet. Minimize chemical exposure to your hair. I generally will not name supplements and shampoos to give credibility on how to make one’s hair stronger. If this isn’t satisfactory, a hair stylist might be able to recommend some products he/she is likely ready to sell you.

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Can I Predict How Fast I’ll Lose Hair Even If I’m Already Taking Finasteride?

I am 25 (almost 26) and I am starting to notice some hair loss. I have been using generic finasteride…5 mg…and I cut it into 4 pieces to take once a day. I’ve been using it for a couple years now. I also use Rogaine (the foam), though sometimes I forget to put the rogaine on.

I have noticed on this board that you mention finasteride will “eventually stop working” and there is really nothing I can do about it. Is there any way to further slow the growth down? I was thinking of upping my dosage to 2-3 mg a day of finasteride. Will this work? Am I doing myself a disservice by using the generic brand instead of Proscar?

Also, is there any way to predict exactly how much hair I will lose, and how fast?

Thanks!

Finasteride does not stop working, but your hair loss can continue while you are taking it. Some people report a noticeable decline in the benefits they saw from Propecia after the 5 year mark or so, but that just means your body is winning the tug of war over genetic balding. If you stop the medication at that point, you will see even further, faster loss (which is what I refer to as “catch-up” hair loss). Finasteride slows hair loss in men, but does not necessarily stop it. I wouldn’t up the dosage without first consulting your prescribing physician. The higher the dose, the greater the side effect risk.

To my knowledge, there should be no difference between the generic finasteride 5mg pills cut into quarters from the 1mg Propecia pill. It’s the same drug, afterall… just different dosages.

There is no way to predict exactly what your hair loss pattern will be or when you’ll get to it. You can get a good idea by mapping your scalp for miniaturization, and then mapping it again in 6-12 months to see the progression (if any). An educated guess could give you some clues at that point, but it’s not an exact science.


2009-04-21 22:58:34Can I Predict How Fast I’ll Lose Hair Even If I’m Already Taking Finasteride?

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Can I reverse my bad hair transplant?

I had a 1500 follicle FUE transplant about 8 years ago by a surgeon on Harley Street. I regret having it done now. I get the feeling that others can see the gap between the transplanted hair and behind it where my hair is thinning. Also the transplanted hair stands straight up which accentuates the difference between it and the rest of my hair. I don’t want to have another transplant as I feel that I will always be chasing the receding hair!

I went to see the surgery a couple of years ago about a reversal and they advised against it. However, I wondered if anyone had experience/knowledge of whether it was possible to have the transplanted hair removed?

I would want to see your hairline and get some good pictures of what you are looking like before rendering an opinion. I have fixed well over 1000 hairline patients. I find that the best way to fix it is to create camouflage that will take advantage of the poor grafts and fill it in with follicular units around and in front of the existing grafts (see here: https://baldingblog.com/actor-joe-penny-shows-off-his-repaired-hairline-with-photos/ ).

For those who need more, I add Scalp Micropigmentation (see here: https://scalpmicropigmentation.com/gallery/#!https://scalpmicropigmentation.com/wp-content/uploads/2016/04/new_hair_institute-scalp_micropigmentation-patient_photo-066b-smp-wm.jp here: https://baldingblog.com/repair-of-hairline-transplants-photos/. Also here is another fix: https://baldingblog.com/repair-of-hairline-transplants-photos/


2020-12-04 11:32:17Can I reverse my bad hair transplant?

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Can I Take Medication After a Hair Transplant?

Dr first this site is AWESOME and I really wish I would have read all this before I underwent my transplant 2 weeks ago…

My question is and I know you had questions simular but I’d like to add a question to it. Transplant was 2 weeks ago, and now I’m taken Terbinafine 250 MG AKA Limisil for small amount of fungus on my toes, IF, I were to see myself losing hair will taken Propecia cancel out the hair loss and bring it back to it’s normal state? Do you think it’s too soon to take Lamisal just having the surgery just 2 weeks ago? I am really trying to undertsand how Lamisil in the 1st place could cause hair loss in some!?

I am just so paranoid cause I just spent all this money on a hair transplant and dont want to LOSE any of it, and it also a catch 22 cause I don’t want yellow nails either. Thanks in Advance

Side effects from medications (except steroids) that produce hair loss are generally rare. Those people who take anti-fungal medications do not have a problem with hair loss as a rule, but you need to discuss this with your prescribing doctor who probably has more experience with these medications than I do. I tell my patients that they can take all of their medications after a hair transplant and will frequently let them take their medications before and after the surgery.

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Can I take Bicalutamide instead of fin for my hair loss?

Bicalutamide is a therapeutic chemotherapy agent with the following side effects. Why would you not take a safe and effective medication like finasteride approved for hair loss by the FDA
  • hot flashes;
  • pain in your back, pelvis, or stomach;
  • swelling in your hands, ankles, or feet;
  • increased night-time urination;
  • weakness, dizziness; or.
  • nausea, diarrhea, constipation.


2019-05-19 10:37:17Can I take Bicalutamide instead of fin for my hair loss?

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Can I Use Body Hair and SMP to Give it a Textured Look?

Hi Doc

Love your website please keep up the good work it is very much appreciated. I have been reading your website extensively and understand the difficulties with transplanting body hair ie arms, legs, chest on to the scalp different rate of growth etc. However would it be possible in the following scenario:

I usually have my hair shaved ie blade 0 or 1, thankfully I have one of those heads that look better shaved rather then with hair! I am 33 years old with black hair Norwood class 4 I am loosing may hair slowly but its not apparent yet.

Now with the combination of SMP to give it that shadow look and transplanted hair from chest, arms to give it ‘texture’ as the hair will always be blade 1. In this scenario would it be possible to use body hair combined with SMP?

Thanks Doc

We have been using FUE grafts for added texture on a person like you who gets Scalp MicroPigmentation (SMP). However, we use scalp hair… not body hair. Body hair transplant success rates are variable and the texture is not the same. If you are going for the “stubble” look, scalp hair will give you a better texture.

That said, we’ve found that after having the SMP done to the full head, most people usually realize that having a hair transplant to get the “stubble” texture is not an issue (as they once thought).