Dr. William Rassman – Page 1699

December 11, 2006

If I Stop Taking Propecia, Do the Benefits Disappear Gradually or Immediately? – Hair Loss Information by Dr. William Rassman

Doctor,

I have one note regarding one of your lines here at this question http://www.baldingblog.com/2006/10/31/if-minoxidil-and-propecia-work-best-in-the-crown-how-can-i-save-my-hairline/ your words (the hair loss picks up again and makes up for the time the drug was effectively holding the hair there) , does that mean once you stop taking propecia your hair in the front get lost as if this hair was gained by the medicine even though if it was just restored by the medication or it would take the normal way of losing hair as if you havent taken the medication in the first place??!!

Please Clarify..!!

Best Regards..

I use the term ‘catch-up hair loss‘ which means that the hair loss will occur at an accelerated rate over the months after stopping the drug. You can probably expect that you will lose all of the benefits of the Propecia (finasteride) plus whatever hair you would have lost (had you not taken the drug) in the 3-6 months after the time you stop taking it.

If you note that the hair loss has started (after you stop the medication) and you go back on it, some of the lost hair may reverse if you react to it quickly.

December 11, 2006

I’ve Been Taking Propecia for Years, But I Notice My Hairline Getting Worse Now – Hair Loss Information by Dr. William Rassman

First of all congratulations on the great web site. It’s really useful! My question is about Rogaine. I’m 32 y.o. and have been on Propecia for the last 7 years. It seems to be working OK but for the last 18 months or so I’ve noticed my frontal area may be a little worse. Should I consider adding Rogaine to my treatment or will it be useless on the frontal area? Thanks in advance for any help!

You can try adding Rogaine. Chances are, it won’t help a ton in the frontal area (it works best in the crown), but it is worth a shot. I like the idea that only one change will be implemented so you will know in about 6-9 months if the addition of the Rogaine works. As you are probably aware, Propecia will not stop the hair loss all of the time, but it always slows it down. Congratulations on staying the course. This is what every balding man should be doing.

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December 11, 2006

Swelling After a Hair Transplant – Hair Loss Information by Dr. William Rassman

I had really bad swelling three days after my hair transplant. My right eye closed completely. Is this usual?

The swelling we see three days after a hair transplant is dependent swelling, working its way down from the scalp to the face. Clearly it takes time to work its way down.

The other day, a patient called me on the evening of the third day telling me that one ear was an inch away from his head, had shifted in position and was pointing downward. I told him that I did that intentionally so that he would be able to hear ground termites in his older house. I’m joking! Actually, I found out that he slept on the side where his ear had the problem. I blessed him, told him to take two aspirin and it would be better in the morning. Indeed, by morning his ear was fine. Dependent edema!

A few years ago, we did a study on the use of steroids, with small, medium and large dosages used. As the dose went up, the swelling came down both in frequency of occurrence as well as the amount of swelling seen. At the dose we use today (40mgs prednisone daily starting the morning of the surgery and going out 4 days) swelling is rare and significant swelling is even rarer. It was so obvious, the study was stopped and the higher dose became our routine.

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December 11, 2006

What If I Take Propecia, But Don’t Need It Yet? – Hair Loss Information by Dr. William Rassman

If you take proscar 5mg tabs & cut it into 4’s, will it work the same as propecia ? That’s what i’ve been doing. It’s cheaper. Also, if you take this & don’t need it, could it make you lose your hair ??

Proscar is the same medication as Propecia — finasteride. They just come in different dosages.

Never take a drug that you do not need. Get your hair mapped out for miniaturization to find out if you need it and if you have genetic balding that needs to be treated. Taking Propecia when you do not need it may have some long term problem that was heretofore not discovered yet. Why take any risks?

December 11, 2006

Will I Follow My Dad’s or My Older Brother’s Hairline? – Hair Loss Information by Dr. William Rassman

Hello Sir,

I have read many forums on hair loss and I find yours to the best and most unbiased. My question has to do with balding progression. My dad started loosing his hair at 17 and progressed to what I would believe to be a Norwood 7. However my brother who takes after my Mom’s father has alot of hair except for a very slight recession at the temples and a slight bit at the crown… He has had this since he was 27 and even at 32 it has not progressed any further… Recently I myself have noticed that in my crown it is getting a little thin, in the exact same place as my brother. In your opinion would my hair pattern mostly resemble my brothers? I am now 22 with no real hair loss just a slight thinning of the crown, and worried that I could become a norwood 7 like my dad. I have recently went on propecia however just in case.

Just a guess, but I suspect that your father (with his Norwood class 7 pattern) had balding that must have been fairly extensive by the time he was 22. You could be following the pattern exhibited by your brother. Get your hair mapped out for miniaturization and you can make a better educated guess.

December 8, 2006

Do Animals Go Bald? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

Do any animals go bald? If not, why don’t they?

Thanks.

Yes, there are animals that do go bald. I know of some mice with alopecia that is similar to some human family lines (alopecia totalis). Also some mice lose their hair as they get older and some have complex polygenic diseases that produce hair loss such as alopecia areata. There has been much written about mice, because they have been the human experimental models, but I am certain that similar problems must exist in other mammals. Guinea pigs are known to lose hair when they are pregnant (like some human females).

Doctor Said I Can Quit Propecia After 6 Months – Hair Loss Information by Dr. William Rassman

Hi doc. I’m 20 years old and nw 1,5. I’ve been using propecia medication for 6 months with very good response but in the last appointment with my doctor he told me ‘it’s time to quit propecia and you will no more lose your hair.’ I have doubts what should I do? Can it be real, is it possible to beat MPB by taking early medication? If my doc is wrong what my decision have to be? Thanks.

Propecia (finasteride 1mg) works through inhibiting production of DHT, which is responsible for male pattern baldness. By stopping Propecia, you allow the DHT to be made from testosterone again, which can deleteriously affect your hair growth. If you look at this diagram of Propecia effect on hair count, you can clearly see that the rate of hair loss increases in patients who stopped Propecia and were put on placebo (solid circles on graph) and even after restarting them on Propecia after one year, the number of hairs doesn’t reach to the patients who continued using the medication.

The only reason to stop taking the medication is that a diagnosis of genetic male pattern hair loss is not present. To make this diagnosis, your doctor can map your scalp and if there is no miniaturization present, I would agree to recommend that you go off the Propecia; however, if miniaturization is present, then you should stay on the drug for the rest of your life as there is no cure for MPB. Talk to your doctor and make sure there is not any other reason for discontinuing the medication. You can take a copy of this blog posting and go over it with your doctor.

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December 8, 2006

Expired Facial Cleanser with Benzoyl Peroxide Caused Moustache Bald Spots? – Hair Loss Information by Dr. William Rassman

I have recently noticed in my moustache i have 2 very very small spots which are missing hair. it’s very random but i did use an expired facial cleanser with Benzoyl peroxide. could this have caused it? will hair grow back? can i rub minoxidil for it grow back?

I doubt expired pimple medicine has cause hair loss. Even if on a remote possibility, hair should likely grow back.

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December 8, 2006

I Think 2-Hair Grafts Look Too Thick in the Frontal Hairline – Hair Loss Information by Dr. William Rassman

Hi Dr Rassman! If I pay for lets say 1000 grafts, do I have the right to achieve 2000 hairs (placed in the front) if I only want 1-hair graft in the front? 2-hair grafts don’t look good in the front (by front i mean about 1 inch), it looks too thick. My hairdoctor and I have different thoughts about this! Your opinion?

Thanks and God Jul “Merry Christmas” as we say in sweden.

I generally put a wide transition zone of single hairs in the frontal line. I believe that the ‘line’ is not actually a line, but a zone where there is a transition from the bald forehead to the thicker hair about 1/2 to 1 inch behind. The thicker area should have two hairs each, but that is a negotiation between doctor and patient. Generally, if you make single hairs from two and three hair grafts, there is a hair death rate, as not all of the hair will survive the break-up of the follicular unit. Great skills are necessary to accomplish this with the greatest success rate possible. I realize you are not in the US, but if you do make it out to California or if any other readers come to one of our open house events, you can look closely at the hairlines we have created and I think you will see what I am talking about in person. Alternatively, you can take a look at the Patient Photo Gallery on the NHI website.

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December 8, 2006

So If I Get Shedding from Propecia, Does That Mean It Is Working? – Hair Loss Information by Dr. William Rassman

Dear Doc,

I have been on propecia for three months. After my pills ran out I got a little lazy and didnt renew my perscription. In fact I havent been on the drug for almost four months. During this time I noticed considerable shedding, which I guess, reading from your blog, is to be expected. My question is though, does the shedding mean that the drug was actually working? Or is it some abnormal side-effect?

FYI I am 22 and baldness runs in my family.

Sounds like you figured it out. Please be smart and go back and stay on the drug. Discuss this with your prescribing physician.

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