Dr. William Rassman – Page 1710

November 16, 2006

Switched from Minoxidil 15% to 5% and Now I’m Shedding – Balding Blog

Dear Dr,

I have been on Xandrox15 (on frontal/temporal area) for about 6 months till date. At first I thought it didnt help much so I switched back to Rogaine 5% about 3 weeks ago. About the 2nd week onwards, I started encountering major shedding on the hairline. Now, I can see the receding areas which wasnt so obvious before. Even my hair stylist commented it at the 3rd week when I went for a haircut (I visit him usually monthly).

My question is, could it be that minoxidil 15% was working for me and the switch to Rogaine 5 % (which i had been using for past 3 yrs and didnt help with regrowth but maybe a little in delaying the frontal hairloss) is causing the shed?

Thanks!

Minoxidil dependence (and shedding after stopping it) is mostly reported in the patients who had some improvement with medication. Although there is no documentation of dependence on higher doses of this medication, with decreasing the dose, I assume that dependence could be dose dependent. That means, if you are switching from a higher to a lower dose of medication, you may experience shedding or just losing the benefit of the high dose. Again, minoxidil dependence only occurs in hair that sees benefit from minoxidil. The better the hair thickness gets, the more the dependence upon minoxidil. If you continue to have shedding after that period, you must see a hair specialist to evaluate the miniaturization of your hair and make sure this hair loss is part of a regular “pattern” baldness and that there are no other factors involved. It is possible that the shedding is the result of your primary problem.

November 16, 2006

Taking Propecia with Past Cyst on the Liver – Hair Loss Information by Dr. William Rassman

Hi

I sent you a question regarding Chronic Kidney disease which you responded to. Thank you so much. The other thing my Doctor told me I had was a cyst on the liver. I used to be a bodybuilder with a high protein diet and have taken steroids. My diet & lifestyle has changed completed since being diagnosed with CKD. A recent Ultrasound scan has shown that the liver cyst has now gone. My question is, would you advise against dutasteride or Propecia in my case?

Thanks again.

Liver cysts that are incidentally discovered during imaging studies, are usually benign and don’t affect the function of liver. Avodart (dutasteride) and Propecia (finasteride) are both extensively metabolized in liver. If you have liver insufficiency and need to be on these medications, a physician should be involved, and blood level checks might be necessary after starting you on a regular dose of Propecia, and based on that, the dosage of the medication may need to be adjusted. Based on what you are saying, I don’t think you have liver disease just because there was a cyst on the liver, but discuss this issue with your primary care doctor before starting the medication.

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November 15, 2006

Hair Loss InformationFemale Hair Loss from Ortho Evra? – Hair Loss Information – Balding Blog

I’ve been getting an increased amount of emails from women that are experiencing hair loss and are under the belief that it could be their birth control. Although I have discussed various birth control pills and hair loss in the past, it is worth posting again for new readers. Here’s one recent email…

I am a 24 year old female. I took Ortho Evra for about 4 years, until I realized that i was experiencing many of the side effects (I had no idea they were all related to the medication). One of the most troubling is the rate and the amount of hair I have lost. I have been off the patch for about a year now..and my hair keeps falling out (patches on a daily basis). Apart from cold medicine, I dont take any medications, and I just don’t know what to do to get my hair back. Please, please tell me there is something i can do. Please help me, i am so scared!!!

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First off, you should have your hair mapped out for miniaturization as part of the work-up for female hair loss to evaluate and quantify the degree and distribution of miniaturized hairs which may indicate genetic hair loss characteristics and patterns.

Hair loss in women can sometimes be caused by underlying medical conditions, so it is important for you to be evaluated by your own physician before we proceed. If clinically appropriate, the following disease processes should be considered: anemia, thyroid disease, connective tissue disease, gynecological conditions and emotional stress. It is also important to review the use of medications that can cause hair loss, such as oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin and prednisone. The following laboratory tests are often useful if underlying problems are suspected: Estradiol, FSH, LH, SHBG, Prolactin, T4, TSH, ANA, Iron, TIBC, Ferritin, Free and Total Testosterone. Any family doctor can do this.

You started off asking about Ortho Evra, so I might answer that this drug can cause hair loss, as well as increased facial or body hair growth (hirsutism). It seems that you can not win with any drug.

November 15, 2006

Hair Multiplication and Hair Direction, Again – Hair Loss Information – Balding Blog

This post is a follow-up to a question that was previously asked (see How Would Hair Multiplication Grow Hair In the Right Direction?) relating to controlling hair direction if one injected cells into the skin for hair multiplication.

If there is a mature hair follicle, then the hairs would have to be carefully placed for direction control and depth control. If hair is placed too deeply, then the hair will not grow through the skin, but will be attacked by your immune system as a foreign ‘invading’ body and destroyed. If it is placed in anything but the exact correct direction, it will not grow in the normal direction. If the hair is placed as a ‘stem cell’ that could be controlled (a big stretch in thinking), exact placement of the cell may be critical to actually growing hair. If is is a cell or a series of cells that would grow hair, would the new follicle know up from down (like a plant seed)? Clearly, there will be an art to growing hair when and if it can be done.

November 15, 2006

Bald Spots on Neck – Balding Blog

I am a 28 yr old active male in is great physical condition. Recently I have been noticing bald spots appearing on my neck where hair use to grow. Then spots where the hair use to grow are completely bald now. I am trying to find out what may be the cause of this.

This could be some peculiar genetic trait, or something like Ringworm (a fungus infection). You also might have alopecia areata. Alopecia areata can cause circular patches of baldness and could be seen almost anywhere in body, including scalp, beard, eyebrow and even eyelashes. The outcome is usually good and in most cases hair re-grows within several months. Occasionally the baldness could be permanent. Alopecia areata is an autoimmune disease and typically recovers in most cases without any treatments.

There are far too many possibilities, so you should see a dermatologist and get an opinion as well as a thorough examination of your body and scalp hair. Let an expert give you an opinion after an examination, something I simply can not do over the internet.

November 15, 2006

Follicare and Propecia – Balding Blog

Is it ok to take propecia and follicare together, since there is a vitamin you take when using follicare

I have reviewed the “supplement” listed at the Follicare website for ingredients. I can say, right off, that they seem to have put everything but the kitchen sink into the product. I do not believe it will be harmful if taken with Propecia.

November 15, 2006

Generic Propecia on the Web – Hair Loss Information by Dr. William Rassman

Hi Dr Rassman,
I’m considering buying generic propecia made in india by CIPLA

The online pharmacy is: [site removed]. Do you think this is advisable?

Cipla makes generic finasteride available in 1mg form as Finpecia and as 5mg form as Fincar, but I do not know about buying prescription drugs through online pharmacies. If you chose to purchase generic finasteride via the web, do so at your own risk.

Also, it is important to note that 1mg generic finasteride (for hair) is not yet legally available in the United States due to patent restrictions, but you can get the 5mg generic finasteride (for prostate) at US pharmacies with a doctor’s prescription and just cut the pill in quarter-sized pieces.

For more on Cipla, see their entry in Wikipedia.

November 15, 2006

Growing a Handlebar Moustache – Balding Blog

I have a decent moustache. A little on the thin side but decent. I have been letting it grow out for 5 years and I wax it. I love handlebar moustaches and I want a nice thick one instead. I have been trying to do research online but don’t see lots of information out there. I don’t know if anyone really near me does it or not. The phone pages only list baldness help. My hair on my head is thin but I keep it buzz cut anyway. Remember the movie Tombstone? I want a ’stache more like Kurt Russells and mine is really alot like Val Kilmers. Any suggestions? I guess I don’t know anything about this so I’m unsure of who to go to for the procedure and I don’t want to chance losing anything that I have.

Thank you.

A hair transplant is an ideal procedure for scars on the moustache area, but in your case, you already have a moustache and just want to make it thicker. If the problem with your moustache is the density of hair, more hair could be added with hair transplantation, but it would be scalp hair. We can not create thicker hair shafts, but if you have thin mustache hair that is about the same diameter as your scalp hair, then this might work for you. Hair densities on the scalp are probably at least twice the density of moustache or beard hair. A hair transplant simply moves hair from one area to another and as such, it should be relatively easy to double the density of your mustache hair. The anatomy and alignment of hair of the moustache is different than that of a traditional scalp hair transplant. If you decided to do this, you need to be seen by an experienced hair transplant surgeon and only then you will know if you are a good candidate for this procedure.

November 15, 2006

Lipodrene and Hair Loss – Balding Blog

I was taking Lipodrene for weight loss and it contains ephedrine group alkaloids in it. I have been losing my hair and it is getting to be a problem. I have stopped taking the Lipodrene but when will my hair stop falling out? What can I do to stop this? Help !!!!!!

We have answered similar questions in regards to ephedrine and pseudoephedrine and hair loss as their side effects. Although hair loss is not reported as a common side effect of these medications, it is mentioned in some websites (such as Bodybuilding.com) which go over side effects of bodybuilding medications. The mechanism of hair loss with these medications is not quite clear. Hair loss should be reversible after discontinuation of ephedrine with time. I am not aware of any studies indicating how long before recovering from this condition if it occurs.

November 15, 2006

Teen Girl Losing Hair, Wonders If It Is Cancer – Hair Loss Information by Dr. William Rassman

Im a 14 year old girl and about 2 weeks ago I cut my hair myself. I always do so I didnt think anything wrong was going to happen. But now any time I run my hand though my hair I have like a hair ball and it’s starting to scare me because I used to have really thick hair. My mom has thin hair. Could i have cancer? My grandmother has a history of it.

Based on what you’re telling me, I doubt that you have cancer. If there is a family history of cancer (ovaries, breast, uterus) then you should find out if your family has the gene for such cancers. If that is the case, you can get checked out for the cancer gene as well. If it is not in the family, I doubt that you need to get the genetic test. I remember when I was in medical school, each and every time I found out the details of a disease, I seem to have developed the symptoms of that disease. Eventually, I learned to disassociate my learning from my life and I stopped getting the weird diseases. At 14 years old, cancer is unusual, but that is a matter you should discuss with your parents and your doctor.

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