Author: Dr. William Rassman

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Stacking Propecia, Rogaine, and Saw Palmetto – Hair Loss Information – Balding Blog

I just started using Propecia. I’ve been using Rogaine for about 5 years, and Saw Palmeto for the last 6 months. Is it safe to use Propecia with Rogaine and Saw Palmeto? Please advise. Thanks

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I just returned from the International Society of Hair Restoration Surgery conference in Coronado (near San Diego), California this past week. Your question was one of the topics discussed during the meeting.

Saw palmetto is a herb that has been implicated in alleviating urinary flow, which is sometimes associated with enlarged prostate. It has not been scientifically proven to work, but it is a natural herb and consumers take it for whatever benefits it may have. Many people make the link in their minds that saw palmetto could be used in alleviating male pattern hair loss with finasteride 5mg (Proscar) just because it is used for men with enlarged prostate problems. Again, saw palmetto has never been scientifically proven to help with male pattern hair loss and is absolutely not a DHT blocker.

To date, topical minoxidil (Rogaine) and oral finasteride 1mg (Propecia) are the only FDA approved medications for male pattern hair loss. There are some that believe that using the two medications in conjuction may have a synergistic effect, as they have different mechanisms of action. I believe that using minoxidil and Propecia in combination has useful value in some people, but I’d start with one at a time. If you start with both, you will not be sure which one is working best for you, and are committing yourself to a lifetime of multiple medications, when your answer may be just the one.

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I Take After My Father in Nearly All Traits – Will I Retain His Hairline Too? – Hair Loss Information – Balding Blog

Hello,

I have a lot of physical traits from my father’s side of the family, including body and facial hair, and I have the same color and texture of head hair as my father. I have few traits from my mother’s side. My hair is just beginning to thin at 25, and I am hoping I take after my father’s side in hair loss as well, since my mother’s side has a strong history of baldness. I don’t suppose there is much actual data on the subject, but subjectively, do you think I am more likely to avoid baldness since I take after my father in nearly all other respects? I would like to get miniaturization mapping done but I doubt I could afford it yet, so any input would be greatly appreciated!

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Male pattern hair loss is genetic, but it does not necessarily follow a predictable Mendelian genetic pattern of either the father or mother’s side. There is no definite way to predict your hair loss pattern, but one way is to measure the miniaturization state of your scalp hair with a good hair densitometer at predefined areas on your scalp. Then you can periodically measure the miniaturization state and compare it with your baseline picture to see if there is a trend. A miniaturization study is free (at least at NHI).

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Woman Suing Procter & Gamble Over Hair Loss – Hair Loss Information – Balding Blog

Many people seem to find a way to make a bundle in our litigious society. There is no doubt that hair dyes can cause problems such as skin allergy in some people, burns from improper applications of the dyes, etc. Television has many soap opera presentations of such litigations. A good company like P&G should have adequate disclosures on the products to cover the individual risks of particular patients. $12 million is a lot of money. The legal costs to pursuing such a case is high and for P&G, the cost is higher just to build and present a defense. Many times, companies like P&G will pay off the pursuers just to avoid the legal costs and internal management costs for nuisance cases. The lawyers that take on such battles know that, so this is like a game of Russian Roulette with money as the bullet in the chamber. As clearly stated in the article, “Once Ross’ firm determined the extent of Mack’s injuries, more formal negotiations began.”

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Almost a Month After Hair Transplant, My Hairs Look Broken – Hair Loss Information – Balding Blog

Hi Doc, I am about 3.5 weeks removed from a 1400 Strip Hair Transplant. Alot of my hairs have “shed” and some have “broken”. When I say broken, it appears that stubs are left in my head and I have alot of stubs, and sometimes the hair (with the black bulb at the end) comes out of my head (“shed”)… Is this normal for transplanted hairs to break, is it because they die early on? The broken hairs look like hair you would see from a haircut (no bulb ends), and the remaining part looks like stubble in the head.

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These are questions that you should discuss with the doctor who did your transplant and something that you should have been made aware of. From your brief description, it seems you are shedding your transplanted hair. This is normal. If you still feel there is something else going on, you should follow up with your doctor. I am assuming that these broken hairs reflect the transplanted hairs, not the natural hair in the general area where the transplant was done.

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Adrenal Problems and Hair Loss? – Hair Loss Information – Balding Blog

Is there a correlation between adrenal fatigue/insufficiency and hair loss (in the form of total head miniaturization, but yet have no balding, no recession.) I have very low DHEA levels and high cortisol levels…. would chronic/high physiologic stress levels induce hair thinning/miniatuzization?

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Yes, it is a possibility, as low adrenal function in such conditions as Addison’s disease affects about 1 in 100000 people. Hair loss throughout the body is a reported finding in this condition. I do not have experience with following people with this disease, as they are treated with appropriate hormone supplements. I have never seen a patient with Addison’s disease and studied the existence of miniaturization or a follow-up of this in a treated patient. Sorry that I can not shed more light on your question.

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Can Hair Be Damaged a Year After Bleaching? – Hair Loss Information – Balding Blog

Currently my hair is it’s original color, but for three years I regularly bleached my hair (usually once a month). Can this process have any affect on my hair now a year later?

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After a year it shouldn’t have any lasting effect unless you burned some of the vital structures of the hair organ below the skin surface. There may be a delay in full recovery since hair growth is asynchronous and the growth cycle can vary from months to years. It is possible that when the hair goes into its sleep cycle (telogen) and then wakes up (anagen) it may return to your normal status. Be hopeful.

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Born with a Mature Hairline? – Hair Loss Information – Balding Blog

Hello doctor,
First thank you to read my question.
I’m 19 years and i never had a straight hairline. It is with curves. Could it be possible to born with a curve hairline ? Because i never had the feeling to loose them! I would be relieved if you answer me.
thank you

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We are all unique individuals and you may just have a higher hairline than others. If you send me photos of your face from the eyebrows up, I will give you an opinion about your hairline. Please take at least 2 pictures — one with your eyebrows lifted up as you look up, and the other with your eyes looking down.

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Losing Hair from Illness – Hair Loss Information – Balding Blog

When you lose hair due to illness, do you lose hair from all over your scalp or just on top? Is the location of the hair loss different than it would be with genetic factors?

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Stress such as an illness can produce hair loss. This is explained because illness requires that your body conserves its resources to fight off the illness. Hair is a high metabolic organ, consuming considerable amounts of nutrients, blood supply, cardiac output, etc.. The body diverts is support activities and abandons those organ systems of low importance. Hair qualifies for that sacrifice. I might expect hair loss to be a generalized loss over your entire scalp, possibly including some body hair as well. That being said, the illness or the stress may have set off a genetic “switch” that probably kick started male pattern hair loss process when the gene is carried by the patient.

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I Had 3 Procedures – Did I Receive Optimal Care? – Hair Loss Information – Balding Blog

Thank you for sharing your time and expertise with the hair loss community. I’ve had three successful transplants with a prominent hair transplant surgeon between the years of 2003-2005. The graph count of all three sessions was approximately 5,200. Lately I’ve noticed hair transplant sites lauding the success of a few doctors who are able to surpass 5,000 graphs in one session. Surely I would have preferred to receive my 5,000 graphs in one session as compared to three. Did I receive optimal care by my physican or did he lack the skill, resources, and know-how to produce the results (5,000 graphs)in one session? Or, are there factors that make it necessary for a person to have three smaller sessions as compared to one larger one? I’m a 48 year old male. Thanks again!

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Sometimes large sessions (5000+) may not be possible on some patients when the size of the bald area is small. If the size of the bald area is large, to get a large session you need three things:

  1. good laxity (looseness) of the donor scalp
  2. very good densities in the donor area
  3. a specialized surgical team capable of doing this work in less than 8 hours

You should always have a good, trusting relationship with your doctor. I cannot comment on optimal care and would not suggest that you received less than optimal care. Maybe your surgeon’s team is not capable of performing these large sessions in the ascribed time period. Maybe your scalp is too tight or your balding area is too small. If you describe your surgery to be a success and are pleased with the results, then that is the determinant for the quality you recieved and I would go by the results you obtained when compared to the expectations you had prior to starting the process.

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Pinpoint Procedure for Hair Transplants? – Hair Loss Information – Balding Blog

hello, i just had approx 1500 grafts strip procedure 8/25/06. the doctor used what they call the pinpoint procedure using a surrenge needle to make the inscions. what is your take on this procedure and will i need to have FUE in the future to create a natural looking hairline or does the pinpoint procedure have good enough results for a natural lookng hairline?? your advine would be greatly appreciated.
thanks

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Some doctors seem to make up terms that do nothing but confuse the public with marketing mumbo jumbo. With your confusion, this sounds like such a case. I did search for the term using Google and found the description for the “Pinpoint” technique appears to be follicular unit transplantation, of which I wrote a published classic article on the subject over a decade ago. Based on the limited text available on the doctor’s site, I don’t see anything different, new, or innovative about this technique.