Author: Dr. William Rassman

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Hair Regrowth Cycles – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I am a 43 year old lady with increased hairloss usually between 150-200 hairs a day at the moment.

3 years ago I had two lots of traumas which caused my initial hairloss. After eventually seeing a trichologist and starting estradex lotion (containing minidoxil and phyto hormones)my hairloss reduced this took 3-4 months to see benefit. Initial the estradex made more hair come out which trichologist said normal as the estradex gets rid of the bad hair making room for better quality hair. I was also put on a antidepressant dotheipin 75mg. 12 months ago I stopped estradex, hairloss returned, not that it totally stopped but hair did look thicker. I have started back on estradex about 3 months on side of head but the partening looking slighlty wider on one side so started using estradex along this area for last 6 weeks. Still taking dothiepin 50mg – 75 mg alt days. I have recently started vitamins saw palmetto and pygeum and stinging nettle root. Sure my telogen as increased within a day of taking this vitamin could it be related. Taking high doses off this up to 2000mg. Or do you think its the estradex getting into my system (which contains 5% minidoxil)?

When I woke up yesterday, the birds were chirping and the air was crisp and I had a great day. Today when I woke up the dog was barking and the air was smoggy and I had a bad day. Do you think I had a good day because the birds where chirping or the air was crisp? Do you think I had a bad day because the dog was barking and the air was smoggy?

Your guess is as good as mine.

There’s too many variables and no direct proven relationships in the information you provided. It is normal to lose 100+ hairs a day. For most normal people, the regrowing hair will start at about the same time as the hair is lost so that the total hair count of hairs growing on the head stays constant. If you do the math, 100 hairs lost per day is about 109,500 hairs in three years (36,500/year) and that is the normal adult hair population. The hair cycling we have discussed before on this web site, is responsible for the fall out and the regrowth that is every person’s normal. The average growth cycle is 3 years for most people, so that means that in three years, most people replace 100% of the hairs on the head with new hair, one day at a time.

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How Can I Get a Proscar, Procerin Prescription? – Hair Loss Information by Dr. William Rassman

Dr Rassman,
I had a couple questions. First, I have done some research and am interested in purchasing either Proscar or Procerin. Procerin seems to be less costly. Is Procerin as/more effective as Proscar? Second, if Proscar is the better alternative, how do I go about obtaining a prescription? Can I see any physician or do I need to see a hair loss physician? I am 21 years old and am just starting to experience the beginning stages of hair loss, but I would like to do something soon. Thank you for your time, I really appreciate it.

Proscar (5mg finasteride) and Propecia (1mg finasteride) are medications that requires a prescription from a licensed medical doctor in the US. Any medical doctor can prescribe them. The only caveat is that in our practice, we generally like to document the degree of miniaturization of scalp hair with a computer video densitometer to quantify and record the state of your hair before you start the medication, so that there is an objective record to compare the effects of the drug after a given period of time.

Procerin is NOT a medication. It is a cleverly named herb, vitamin, and mineral formula that claims to treat hair loss. You do not need a prescription for Procerin, because it is not a medication. The name Procerin just sounds like Propecia or Proscar.

Balding Forum - Hair Loss Discussion

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I Am Noticing Thousands of Hairs Falling Out – Hair Loss Information by Dr. William Rassman

Hi my name is Nick (male) i’m 17 years old and i have recently notice thosands of hairs falling out from all over my head. I have long blonde hair and have recently been waking up and there are loads of hairs on my pillow. My dad started balding at 16 does this mean i will to? also my mums dad had a full head of hair when he died at 50. do you inherit the hair gene from mum or dad? Although alot of hair is falling out there is no signs of receding from the top what so ever. do you think i’m going to go bald are these the symptons. Thanks for taking the time to read this e-mail.

It is certainly not normal to lose THOUSANDS of hairs. The average person has 100,000 hairs on their head, so if you are really losing say 3000 hairs per day, you would have been bald in a month or so, losing 2000 hairs/day would put you at bald in a couple of months, and losing 1000 hairs/day would cause you to be bald in three months. It is typical to lose 100 hairs a day. At the rate you are describing (I think it is less than you think it is) and with your father’s history of balding starting at about 16 years old, you may be progressing to some sort of hair loss. I cannot comment on whether you will be bald, because I have not examined you. Furthermore, you may want to pay particular attention to the areas of your scalp where you are losing hair. A typical male pattern hair loss spares the back side of your scalp. If you are losing hair on the back side of your scalp there may be other medical cause that you may want to see a doctor about it and get your hair mapped out for miniaturization to obtain a diagnosis. The good news for those who are balding is that when the diagnosis is confirmed, drugs like finasteride work well to slow down or stop the hair loss, particually in the young man like you.

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Initial Hair Loss Acceleration from Minoxidil? – Hair Loss Information by Dr. William Rassman

I have used propecia since the late 90’s and I believe it has effectively slowed my hair loss. But recently I began using Minoxidill due to some accelerated loss I experienced in some areas in the temples and crown. I have been using the minox for @ 4mos. Initially it appeaered that I was losing hair at a faster rate due to the minox use. But after 3 mos I began to notice the return of hair in the areas I was concerned about prior to using minox and the areas that began thinning more with the initial use of minox have also begun growing again. Here’s the question. Is an initial acceleration of hair loss to be expected when you begin using the minoxidil followed by growth due to minox use?

Some people have observed initial shedding with minoxidil and even with Propecia. You were smart to hold the course and stay with the medication to pass the shedding phase.

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Using Aloe Vera to Speed Up Recipient Area Healing After Transplant? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman:

I’m very interested in an HT to fill in my hair line but I am concerned about the redness in the recipient area after the procedure. Is there anything I can do to speed up the healing? I’ve heard using Aloe Vera can help as well some specific items such Graftcyte or Bioton spray. What are your thoughts on this?

Thanks very much and thanks for writing this blog…..it’s a great source of info for me.

Aloe vera has been known to have good healing properties. I had a great number of these plants growing in my garden in Hawaii and the leaves can be broken. One rubs the broken leaf on your wound or whatever you want to cure and according to local Hawaii folk lure, it cures everything!

I do not recommend its use but I do not see any harm by its use either. In my practice I often give a shampoo containing copper-peptide to decrease the redness after a hair transplant.

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What Should a 23 Year Old Male with Norwood 4A Pattern Do? – Hair Loss Information by Dr. William Rassman

Do you recommend that a 23 year old male with a receding hairline and visible thinning to the point of resembling a Norwood 4A should hold off on transplant options or begin preparing for treatment?

Assuming that you already started Propecia at least 8 months ago, then you need to see a good doctor to build a Master Plan. If you and the doctor hit it off and bond and he/she develop that plan, a hair transplant may be appropriate. I generally do not like to do surgery on 23 year olds, but I do violate my rule based upon the needs of my patient and the Master Plan that is built between us.

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If I Get Transplants, I Want a Perfectly Straight Hairline – Hair Loss Information – Balding Blog

So, I’m one of those losers losing his hair at 24 :(

I hear that after you get hair transplants you will always have a hairline that looks like it is receding. I do not want that- I want the hollywood straight nice hairline.

Is this possible with hair implants if I find the right surgeon?

Please advise

Thanks kindly

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DraculaGenerally, transplanted hairlines should not be perfectly straight. To be completely normal you need a transition zone between the forehead and the thicker hair with a gradual appearance of hair, not an abrupt Count Dracula hairline (see right). With that being said, I will transplant a straight “Hollywood” hairline (as you call it), but it will take some convincing that what you want is reasonable and natural. Had I transplanted Dracula’s hairline, I suspect one night when he woke up, he would realize that he was a Vampire. That’s ok for Dracula, but not for one of my patients.

I decided to show you photos of patients that look perfectly natural with a transplanted mature hairline, as opposed to the straight across hairline you’re asking about. They say that pictures are worth a thousand words, so here’s 17 thousand for you…

For what it’s worth, I noted that your location was in Northern California. NHI will also start working out of Oakland next month and I expect to have a Sacramento office shortly thereafter.

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Hair Loss InformationAny Way to Counter Propecia Side Effects? – Hair Loss Information – Balding Blog

I have tried Propecia twice for about 15 days each. Both times I stopped as I devleoped breast enlargement. Is there a way I can use Propecia but avoid the side effects (i.e. counter medication)?

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You should consult with your doctor who prescribed you Propecia to address these issues. There are medications to counter abnormal breast enlargement, but I have not personally used them to treat my patients. Most men who have breast lumps from Propecia (about one in 500 users) stop taking the medication.

The interesting part about your question is that you state you have only taken Propecia for about 2 weeks and noticed breast enlargement. This is not typical and it is more the reason why you should follow-up with the doctor who prescribed Propecia to you.

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Hair Loss InformationPropecia, Minoxidil, and Age for Hair Loss Protection – Hair Loss Information – Balding Blog

hi dr… do you think you increase you chances of stopping the hairloss if you use minoxidil with propecia???? also does hairloss tend to slow at age 40… please let me know .. thanks

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The combination of minoxidil and Propecia may make a difference in a few patients, but I personally do not recommend its use together unless the Propecia is failing to achieve the goals. Hair loss does slow down (on average) at about 35, more so at 40 and rarely is it very active in the 50s. There are exceptions to this rule and I do see men at the ripe age of 50 who experience hair loss for the first time.

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Scalp Biopsy as Child Resulted in 2 Bald Spots on Side of Head – Hair Loss Information by Dr. William Rassman

HI, I hope you can help me..im a 22 year old male and i have two bald spots on the sides of my head, one 4 times larger than the other. From what i can gather this is a result from a biopsy i had done when i was a baby due to pimples on the head. My mother took me to the doctor because they would swell up due to the chlorine in the pool. The doctor told my mother the hair would grow back and boy was he lying..to this day i have to wear black eyeshadow and keep my hair longer to keep it hidden..please tell me you know an answer to this..
thanks in advance!

Small scars on the scalp can generally be treated with a hair transplant with good results. It is dependant on the location of the scar, the size, your hair color & characteristics (wavy, curly, and straight). FUE is an easy way to treat small scars.