Dr. William Rassman – Page 1668

February 19, 2007

Does Miniaturized Hair Imply a Form of Alopecia? – Hair Loss Information – Balding Blog

In this answer you stated; “it is normal to have some miniaturization or thinning in the very front edge of your hairline“.

and in this answer you stated: “The maturing hairline is as thick as the juvenile hairline, as long as there is no genetic hair loss in the actual hairline (no miniaturization). Sometimes, the mature hairline is thinner (at least it seems that way to me as I look at my mature hairline), but that is just a feeling.”

These two answers confuse me since it seems that you in your first answer suggests that it is normal with some thinning in the very front, but in the second answer, it is NOT normal with some thinning in the very front. If this is not a contradiction I suppose the juvenile hairline also have some normal thinning at the very front?

I would be really greatful if you could clear these things up…

Best Regards

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Miniaturized hair means that the hair shaft is smaller than a normal (terminal hair) shaft. If you look at a follicular unit, you will see some vellus hairs (shorter and finer) and occasional thinner hair shafts, which when they are not present in substantial quantity, may be normal. As these smaller hair shafts are found all over the head, one must draw the line as to what may constitute a ‘medical condition’ that reflects genetic balding or other forms of alopecia. I have arbitrarily determined that any miniaturized count out of a population of normal hair shaft ‘terminal’ hairs, should be under 20%. When the thin (miniaturized) hair counts exceed 20%, I assume that this is a medical condition. In the frontal line, many people have thinner hairs, sometime exceeding 20% (in the first 1/2cm). If there is no miniaturization above 20% behind this first 1/2cm, then I would call this the soft look that God gave us to produce a transition from bare forehead to thick hair.

All hair shafts are not equal. In people with coarse hair, thicker hair shafts must be offset by finer frontal hair shafts and we actually see finer hair at the edge of a frontal hairline (first 1/2cm or so). The same is true for everyone, but the phenomenon I am talking about is most evident in the coarse hair person.

I hope this helps.

February 19, 2007

Spina Bifida and Hair Loss – Hair Loss Information – Balding Blog

My 24 year old son, with spina bifida (mylomeningocele) has suddenly, started aggressively going bald. I’m stunned, there is no hair loss like this on either side. My father had a full head of hair, his bio father and grandfather had crown loss after the age of 50.

Could this be related to his spina bifida? I’m very upset. It’s not enough to be a young man paralyzed, but he also has to be bald??

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Balding impacts almost 50% of men in their lifetimes. Even when there is no obvious family history, the genetics can skip generations. He should be treated like any young balding man. Get his hair mapped out for miniaturization to find out if he has the genetic pattern balding process going on. A diagnosis is critical. The best treatment for genetic hair loss is Propecia (finasteride 1mg) daily. He needs a Master Plan for his hair loss. The Spina Bifida in conjunction with balding may make for more stress, and stress is clearly something that accelerates the rate of hair loss in young men.

February 19, 2007

Radiation Therapy in 10 Year Old Caused Hair Loss – Hair Loss Information by Dr. William Rassman

Dr. Rassman, my son had a medulloblastoma at age 10. He underwent whole brain radiation with a posterior fossa boost. This left him with very little frontal hair and no hair in his inferior occiput. The hair he does have is somewhat thin. Could your type of transplant help? Is there benefit with your method for him over other, standard methods?

Hair loss is one of the most common side effects of brain radiation therapy. It usually occur about two weeks after you have the brain radiation. Hair loss is usually limited to the area of treatment, but patients may occasionally lose all of their scalp hair. Hair loss after radiation could be temporary and it may grow back within weeks to months following radiation. Higher doses of radiation and frequent radiations may damage hair follicles permanently and leave patient with baldness.

In some patients, the hair grows back with a different character. Hair color or character may also change, becoming thinner and more fragile.

If your son did not grow hair one year after radiation therapy, he needs to be evaluated by a hair specialist. If his hair loss is limited to a particular area and he has preserved good quality hair in other areas, he may be a candidate for hair transplant. What I want to know is whether there are any areas where the hair is normal. If the answer is yes, maybe there are things that might be offered.

February 19, 2007

Speeding Up Regrowth from Propecia? – Hair Loss Information by Dr. William Rassman

I have read that you say it takes 8-12 months to clearly see the new hair growing from propecia use. If the hair is kept shorter like half an inch, will you see new growth sooner.

thanks

There is no way to speed up the impact of finasteride (Propecia) or minoxidil (Rogaine), but the impact can be appreciated better if your start off with 1/2 inch hair and then observe the change over time.

February 19, 2007

Taking Dutasteride While Starting a Family – Hair Loss Information by Dr. William Rassman

Hi Doctor,

I have been taking Dutasteride to reduce hair loss in the past 3 years. I just got married recently and planning to have children. Could you please tell me will I have problems with having children or my baby may become defect because of my sperm containing dutasteride. Should I stop taking dutasteride for a period of time before starting to have children?

Thanks

Dutasteride (Avodart), as mentioned on this site many times before, is not FDA approved for treating male pattern baldness. However, if you are on dutasteride for any other reason and are planning to have children, you can do so by discontinuing the medication for at least 6 weeks before that. I say 6 weeks, but Dutasteride has been reported to have a long half life (5-6 weeks) which might mean that the drug is in your system far longer than the 6 weeks estimate I just gave you. We really do not know the answer.

Although not studied on humans, animal studies show reduction in both ejaculate volume and sperm count using high doses of dutasteride. After stopping this medication on rats, its fertility effect is reversed in all animals, while sperm count needed 14 weeks for full recovery.

Just be aware that pregnant women should not handle the medication. It can be absorbed through skin and may affect the baby. If the drug stays in the sperm, in theory, it could impact sexual development of the baby.

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February 16, 2007

Cycling Finasteride – Hair Loss Information – Balding Blog

Is it possible to go on a Finasteride “cycle” in the same way a body builder will go on a “cycle” with steroids to avoid the brunt of major side effects? Has anyone tried this with finasteride? (i.e., take it for 6 months then stay off it for 3 months or something to that effect). I understand that finasteride has a long half-life and will stay in your system for a long period even after stopping dosage. I wonder if you can avoid or limit some of the side effects.
Thanking you in advance for your response.

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Bucket Finasteride has a very short half life. If you have a leaking bucket, and it dripped slowly and you decided to stop the drip for every other day, it would just take longer for the bucket to empty, but it will eventually empty. Think of your hair as the bucket full of water, dripping out drop by drop every day, some days less than others. Cycling Propecia just slows down the loss that will happen sooner or later, but unlike the bucket of water which you can just refill, when the hair is gone, it is gone! I hope you get the message?

February 16, 2007

Doctor Said I “Probably” Have Female Pattern Baldness – Hair Loss Information by Dr. William Rassman

I am a 24 year old female. After a 7 minute consultation with a dermatologist I was diagnosed as “probably” having female pattern baldness, and I could try rogaine. Yeah, I’m looking for another doctor who might be interested in looking into exactly what’s happening and treatment options beyond minoxidil.

My question though is, some of the hairs that I shed have a weird kink in them about 1.5 inches down. I have my hair dyed and have done for about 6 years but the kink doesn’t seem to fit into any dying or styling pattern so I was curious as to whether this might be an indication of what is causing my balding?

Female pattern baldness is discussed in many posts in this blog (see Female Hair Loss). In this condition, hair is miniaturized in a pattern that may or may not be similar to the man’s pattern. The more common type of balding/thinning is female unpatterned hair loss where the hair loss is spread throughout the scalp without a clear pattern. The donor area (the fringe area around the back and sides of the hair) is often included in the balding process when the process is unpatterned and the quality of the donor hair is poor because of the high degree of miniaturization present, so women do not make good candidates for a hair transplant in the this unpatterned form. In some women, the donor area is not uniformly thin, but over time it may become thin. So if a hair transplant doctor uses this hair for a hair transplant, when the process of thinning spreads, the transplanted hair may become thin or fall out.

Diagnosis of this unpatterned condition is not always easy and the other causes of hair loss, such as iron deficiency, thyroid disorders, and autoimmune diseases should be ruled out before making the diagnosis of female pattern baldness. Above all, the patient’s hair needs to be mapped for miniaturization to confirm the diagnosis.

Kinks in your hair may be related to the miniaturization that may at times change the hair’s character and color. Again, if in doubt see a hair specialist to confirm your diagnosis and to get started on proper treatment.

February 16, 2007

I’m 72 Years Old and Losing a Few Hairs Each Day – Balding Blog

I have perused your website and your answers to many questions relating to hair loss but have not found an answer that addresses my question. I am a 72 year old male. I still have a full head of hair with very little greying but I have begun to notice that there are long hairs (few each day) in my comb. Can I stop any further loss?

Hair loss does appear in the elderly. I’m not calling you elderly, as you are only 7 years older than I am — and I am certainly not near elderly. What I mean though, is that even the elderly lose 100 hairs per day. As long as you do not look like you’re balding, don’t worry, be happy (as the song goes)!

February 16, 2007

Pulling Hair Very Hard – Balding Blog

Is it possible to pull a hair shaft so hard and suddenly that it actually removes the follicle along with it?

You can remove hair, but the generative part of the follicle will stay and is able to make another hair. Persistent pulling of hair may damage its follicle and cause permanent hair loss. This condition, which is called traction alopecia, could be seen in people who braid their hair tightly or use extensions for a long period of time.

February 16, 2007

Ritalin and Hair Loss – Balding Blog

I turned 17 about 2 months ago. I’ve been taking ritalin SR for 5-6 months now. I’ve noticed recently that my hair has been receding slowly. Currently it looks like my hair line has gone back about a good 1/2 inch.

If I stop taking this medication will my hair ever grow back?

Ritalin is used to treat ADD — Attention Deficit Disorder. It is commonly used and there are some reports of hair loss associated with this drug, however, at the age of 17, you might be seeing the early maturation of your hairline and you should want to get your hair mapped out for miniaturization to be sure that you do not have genetic balding. As you are in California, come visit me at my Beverly Hills or Newport Beach office to find out and I will map your hair and scalp (no charge for the visit).