Can You Clarify Why There Is a Time Period it Takes for Propecia to Start? – Hair Loss Information by Dr. William Rassman

Doctor Rassman, I appreciate your great blog. There is no more informative site on hair transplants. I am 51 yr old male with the following question on propecia:

Having gone through all of your archives, and other sites, I still am confused as to what exactly happens when one takes propecia that makes it necessary to weight six to eight months before we can tell if hair loss is being stopped. I know you use the terminology of anagen cycle but could you be more detailed and explain this a bit better. I have read web sites claiming hair loss stops in 4 months on propecia, but other doctors, like yourself and Dr. Bernstein suggest no benefits with regards to stopping hair loss until at least the 6th to 8th month. Could you clarify this, please. Knowledge is power.

Everyone responds differently to Propecia (finasteride). Some people get great results rapidly, while other go the ’slow route’. Usually, the better results (quicker) are seen in the younger man or the man who has had recent hair loss, more so in the crown than the front. The 8 month recommendation is a ‘catch-all’ recommendation, knowing that the good studies on the drug show effectiveness between 8-12 months. The visual benefits require hair length and as the hair grows at about 1/2 inch a month, it takes time for the hair that grows under the influence of the Propecia to work its way up the ‘visual’ shaft. Much of what we report here are statistics that we have learned work well. Be patient and wait it out if you have just started taking the medication.

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Olive Oil, Honey, and Cinnamon Cures Hair Loss?! – Hair Loss Information by Dr. William Rassman

According to Pakistan’s Daily Times, a hair loss treatment of honey, oil, and cinnamon is effective.

The referenced article made me smile. I suspect the readers will also smile. Although the article talks only briefly about hair loss, the exact wording is as follows:

Hair loss: Those suffering from hair loss or baldness, may apply a paste of hot olive oil, one tablespoon of honey, one teaspoon of cinnamon powder before a bath and keep it for approximately 15 minutes, and then wash the hair. It was found very effective if kept for 5 minutes.

In Southeast Asia, cow dung is an inexpensive alternative. Not western style, right? Go ahead and try this concoction out, but be sure to stay away from bees.

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

I have been taking prednisone for almost a year and do not know when I will be able to discontinue it. I am 44 years old (female) and my normal thick red hair is thinning dramatically. Are there any supplements that will slow the thinning process down?

Steroids have the effect of thinning out the hair. I do not know of anything that you can take to minimize the impact of the prednisone, but you should still get your hair mapped out for miniaturization and get a diagnosis. Although the prednisone may be the cause of the hair thinning, you still may have other problems and a good medical evaluation would be indicated.

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Hair Loss InformationForum Discussing Propecia Side Effects – Hair Loss Information – Balding Blog

hey doc

I was interesting in starting propecia to stop my hair fall but it seems that i’m freaked out now. look at this link please
http://finasteride.jconserv.net/viewtopic.php?t=189

could that be true??

please comment on this

Block Quote

The site you sent does not contain balanced informational. Side effects are rare and are listed in the material supplied on Merck’s Propecia website.

You can follow those that run in panic mode, or are critical for unsubstantiated reasons, or are the exception to the rule. As the reference piece is extensive, please write to me again with any specific section that you want me to address, but first please review the link to the Propecia site above.

1000 Days for Hair Growth Process? – Hair Loss Information by Dr. William Rassman

Good evening, Dr Rassman,

Firstly, may I compliment you on a most professional and helpful site.

Secondly, I would like to know what time of the day is best to take Propecia. Also, I have read that the first stage in the hair growth process lasts for about 1000 days. So why does it take only 6 months for Propecia to start working?

Thank you.

I realize I just posted something similar to this earlier today, but I generally recommend that you take Propecia in the morning, for that is when the testosterone level is highest and the drug levels are highest in the first few hours of taking it. The half life is 4 hours, so by evening, the circulating levels of the drug will have substantially dropped. There are also ’tissue’ levels of the drug that last beyond the half life of the drug in the blood.

As for hair growth, there is no 1000 day rule. I believe that the drug kicks in a few months and may last for many, many years. It varies between patients. Please see Propecia and Hair Count.

I See Pitting Around Grafts After My Hair Transplant – Hair Loss Information by Dr. William Rassman

Hello,

I am 28 years old and had 700 grafts at the age of 23. Just over four months ago I went for a second procedure for 1450 grafts. I have noticed small pits where the grafts are when light shines down on my head. I am terribly regretful for starting this when I was young, just out of college and very emotional. why do I see pits? I went to a very reputable doctor. Is this normal when transplanting hair? My only hope is the new transplanted hair will mask the scarring.

Thanks

Just five years ago, few doctors were using Follicular Unit Transplantation (FUT). I might assume that the grafts that were used were relatively large, and those larger grafts tend to have more skin in the transplanted grafts that tend to form pits, cobblestoning and other changes in the recipient area. The techniques of FUT, which we defined in 1995, set the standard that had been slow to catch on. You should ask your doctor just what type of grafts he/she used. One way to tell is if your doctor used a microscope for the dissection, it showed that he/she probably was doing FUT. FUT does not pit as a rule.

You need to be evaluated by an expert in repairs who follows the rules outlined in our two classic articles on the subject Follicular Transplantation: Patient Evaluation and Surgical Planning? and The Aesthetics of Follicular Transplantation. The repair of a faulty transplant takes clear skills, so be sure that your doctor has those skills. Ask to see some of the patients that your doctor repaired to get one more step of confidence in your doctor’s skills.


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Lost All Pubic Hair After Radiation Therapy – Hair Loss Information by Dr. William Rassman

I lost all my pubic hair after cancer radiation therapy. I am hirsute guy with hairy chest, legs, arms. The blank spot now looks terrible and I’m embarrassed in the gym shower etc. Is there anything I can do?

Transplants should work well. Head hair may grow in curly, so it is worth a try. Underarm hair may also work, but the yield may be less due to the shorter growth cycle. Beard hair works very well. In older men, that would be my first choice. What is your age?

My Transplant Doctor’s Post-Op Paperwork is Incredibly Stringent – Hair Loss Information by Dr. William Rassman

I recently went for a transplant and the post op paperwork I was given by my doctor seems incredibly stringent. Things like, laying straight up/at a 45 degree angle for a week, no aerobic exercise for 3 months, no weight lifting for 6, can’t be in contact with smoke/dust/pets for 4 weeks, etc.

I’ve read a lot of stuff on your site that actually coincides with things he’s said, but the post op instructions are quite different from what I could gather. Is he just being overly cautious to try preserving grafts?

To doI generally recommend no sex for 15 years, no walking more than 1/4 mile for 4 years… no, no… I’m just kidding.

I tell most of my patients the following:

  • They can lie flat
  • Can have full aerobic exercise in 1 week (even run a marathon if they want)
  • Limit weightlifting greater than 25 lbs for 4 weeks and keep the back straight
  • No sit-ups or pull-ups for 4 weeks
  • May play with pets in 1 day (but no licking the transplants by your dog until the crusts are off — it had to be said)
  • Smoke and dust in the environment are not a problem unless you are not clean
  • Passive sex is ok for the first 2 nights, then everything after is a go

Does that help?

Taking Propecia at Night vs Taking Propecia in Morning – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman, I have read in some of your earlier blog entries where you said that it is best to take Propecia in the morning because testosterone levels rise while you are asleep. But I was thinking that it would be better to take the medicine for you go to bed, because then while your testosterone levels rise during the night, propecia would be in your system to stop it from turning into DHT. What do you think?

Morning is better. If you take it by 7am when your testosterone is highest, only 25% of the drug will be left in your blood stream, as the half life is 4 hours.

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