Dr. William Rassman – Page 1758

August 17, 2006

Miniaturized Hair All Over, But Same Hairline As When I Was 16 – Hair Loss Information by Dr. William Rassman

I have miniaturized thinning all over my head (top, sides, back, sideburns and facial/chin hair does not seem as thick either) which began about 2-3 years ago. At the same time my thinning began it was accompanied by depression, fatigue. I have been thinning with every growth cycle and feeling depressed, fatigued ever since until this day. I have had my thryoid tsh checked 3 times (TSH- 1st-1.98 2nd- 2.28, 3rd- 2.36) I had testosterone checked 3 times as well (1st- 320, 2nd- 385, 3rd- 360…… ref 250-850) LH hormone levels were all on the very very low side when checked w/ all 3 testosterone testes. I had ferritin checked 105 (ref 22-322) I had knee surgery about 4 months ago (left knee bone graph w/ arthroscopy). Is there anything that is causing my total hair thinning/follicle shrinkage? Is it possible to have shrinking follicles/ thinning diameter hair that is not MPB related? I have absolutely no balding, no recession at all, my hairline is the same as when I was 16! whats the matter with me? should I use minox or propecia? I once tried saw palmetto when I first noticed my thinning about 2 years ago and it gave me ED! so I know I would probably have a tough time using prop or fin! thank you

Simply put, you need a caring doctor and a good doctor/patient relationship. That is the start of surrounding your problem. There is no easy way to get this over the internet.

August 17, 2006

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.

August 17, 2006

Transplanted Hair is Different From Rest of My Hair – Hair Loss Information by Dr. William Rassman

Please do not use my real name. I’m female, aged 54. I was born with a very high wide forehead. 8 years ago I had a scalp advancement which brought my scalp 1/2 inch lower. Two years ago I had hair transplanted from the back of my head to my my hairline. The transplanted hair became infected. Some of it fell out & never came back. The hair that stayed is course, dark, kinky & curly. It doesn’t resemble the rest of my forehead hair which is fine, straight & medium in color. Why is the transplanted hair so different from my natural hair? I also have lumps & red irritated skin where the transplanted hair grows. Did my doctor do something wrong?

Generally, if the technique of transplanting hair is done correctly, the frontal hairline should blend in with the rest of your hair. That being said, on occasion it may grow out a bit more wavy and on rare occasions it can become kinky or frizzy (very rare). Your prior surgery on your forehead and the complication of an infection may have played a part in the overall result. A good examination of the hair with thickness measurements may help understand what you think you are seeing. These are subjects that you need to discuss with your doctor who performed your surgery. If that is not possible, you should seek out another doctor for a formal medical opinion.

August 16, 2006

Avodart Has 50% Better Regrowth Rate Than Propecia? – Balding Blog

According to http://www.hairlosstalk.com/research/men/treatment1men.htm, Avodart is said to have a 50% better regrowth rate than Propecia. If one were to choose between staying on Propecia and achieve a lower regrowth rate or to switch to Avodart, what would be the pros and cons? Thanks.

Avodart is not currently approved by the FDA for the treatment of male pattern baldness (MPB). Propecia is the only oral medication approved by the FDA for MPB. Comparisons of Avodart with Propecia are conjecture by those who make such statements. It may be fair to say (without putting a percentage to it) that Avodart is reported (by physicians who use it regularly) to work better on some patients who are not getting good responses to Propecia.

The only real reservation I have about Avodart is that it has a very long half life in the order of WEEKS versus Propecia, which has a half life in the order of HOURS. A half life of a drug is the time it takes for half the drug to be cleared from your blood stream. This does not account for the drug cleared from tissue. The point is that Avodart is a strong medication and its full effects are not known. In my practice I do not generally recommend Avodart unless there are special circumstances.

August 16, 2006

Follicular and Lymphohistiocytic Infiltrate – Balding Blog

I’m a 34 yo white healty male. When I was 30 (2 mts before I turned 31) I noticed a lot of hairs on my pillow and when I ran my hands through my hair. My hair was extreamly thick. When I was 32 I went to a local Dr. that is a hair specalist. He did a biopsy said 2 vellus hairs to 25 total hairs. Had mild follicular and lymphohistiocytic infiltrate. He says I dont have AGA.

Fast forward two years to today, Im 34 hairs still come out same rate(been on propecia 2 yrs) biopsy says I have 3 velous hairs out of 23 total hairs. My family has little to no MBP (only mothers brother and her father a little) I see zero frontal recesion, no balding in the crown. No change in the way my hair is around my head other than its getting thinner everywhere, sideburns,sides, nape of neck, crown, vertex,all thinning at the same rate. What are your thoughts?
Thank you

Biopsies should not be done to rule in the androgenetic alopecia (AGA) diagnosis. They should be saved for special forms of alopecia which require the microscopic analysis and staining techniques that show cellular details. When doctors find lymphohistiocytic infiltrate, they often look to classify other cells in the area of biopsy which should not be present in large quantities, for large quantities of lymphocytes, eosinophils, etc, may point to infection or auto-immune diseases. The diagnosis of AGA is better made with a video densitometer (see Miniaturization: Critical to the Master Plan for Hair Loss), as it is non-invasive and simple.

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August 16, 2006

My Girlfriend Has an Itching, Burning Scalp That She Picks At – Hair Loss Information by Dr. William Rassman

please help – my girlfriend is suffering from itching and burning on the top of her head – and she has little red bumps in that area. she picks at them until they peel or flake off – and now she is seeing her hair fall out in little small circles in this location. what can she do and what is causing this??? just some information: she is 50 y.o, in menopuase and has had this condition for about 3 months now. please help.

If she continues to pick, these bald spots may become permanent. The red areas you are looking at may be traumatic in origin from the picking. This is an obsessive condition called trichotillomania. She needs to see a good dermatologist to lock in a differential diagnosis and pick up therapy from the recommendation of the dermatologist. The signs of trichotillomania are very characteristic on an examination of the scalp, so a good doctor will easily identify this as a cause if it is what is happening to her.

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August 16, 2006

Propecia Dosage and Biotin – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman,

I would like to know if there is any harm in taking one half of a milligram of Proscar a day instead of just a quarter milligram, reason being would it speed up the process? And, if I do start to take one half of a milligram until my hair loss is completely reversed, can I then step back down to taking just one quarter milligram of Proscar without any negative side effects? I want to be sure I don’t become dependant on taking one half of a milligram daily as this will cost much more in the long run.

Also, my dad suggested using a non-prescription drug, Biotin. Do you think I should take Biotin? Will it help, make no difference or be bad?

And I have started using hair gel again (daily), a small amount, will this be bad for the hair loss reversal?

And, is there a specific type of shampoo/conditioner I should use that will help my hair?

Thanks for your time

There is no major harm in increasing the dose of finasteride, except we see a higher incidence of decreased libido with higher doses. The higher dose does not, to my knowledge, have more value than the 1mg dose of finasteride for the treatment of hair loss. If you are cutting Proscar 5mgs into 0.5mg, then that is 10 pieces of a pill, something that is hard to do and regulate (produce a powder I suspect). A dose of 0.5mg of finasteride is reported to be 80% as effective as the 1mg dose. Now with all that said, either cut a Proscar 5mg into quarters (1.25mg) or take the full dose of Propecia (1mg).

Biotin will not hurt you provided that you take recommended doses, but it will be no substitute for the finasteride. I recommend no particular shampoo, conditioner or hair gel.

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August 16, 2006

Taking Grafts From Side of Head for Small Scar Repair? – Hair Loss Information by Dr. William Rassman

Hi, I was wondering, since my procedure only requires 50 grafts [scalp scar repair], do you think it would be okay for my doctor to make the incision to the side instead of in the middle of my scalp? Because I don’t want any scar to show when I have pig-tales or something. I forgot to ask this at my consoltation, although I doubt you would really be able to see it even if the incision was in the middle of my scalp, because the incision would be so small, and my doctor is using a trichophytic closure, so I doubt it would show anyways, but I just want to be on the safe side. Is the outcome any different if the incision is in the middle of the scalp or to the side?

Most people with a small number of grafts get an FUE harvest so that there will be no easily visible scar, no matter where the grafts come from. Alternatively, you could take the harvest with a strip from the sides, so that it could be parted in the middle without showing a scar. The FUE approach may be better. If you had your consultation here at NHI, please feel free to call 800-NEW-HAIR to schedule another consultation.

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August 16, 2006

Toppik Could Hide Skin Cancers – Hair Loss Information by Dr. William Rassman

I have been using toppic for years and what I thought was a small mole on my scalp was actually a plug formed by the toppic. Now there is a small crater and I would like your oppinion on how to address it. It is now hard to use Toppic because the fibre fills the hole everytime I use it. Thanks Dr Rassman

Using scalp cosmetics like Toppik can be good, but not all good. Occasionally what you reported does happen. Toppik does successfully hide the scalp, reducing contrast between hair and skin. In doing so, however, it can hide things on the scalp (like folliculitis, skin cancer, various skin infections like ringworm). The best way to manage this is to wash it thoroughly at least once a week to get it all the cosmetic off of your scalp. There is no substitute in getting a good look at your scalp and you should examine your scalp periodically. For older men who run the risk of skin cancers, frequent self-examinations are critical. Cleanliness is the best way to prevent what happened to you. Another good scalp cosmetic worth looking at is DermMatch.

I am sure that some people will get a folliculitis and Toppik or DermMatch can be rubbed into any open wound creating a foreign body reaction. You might want to get a good doctor to look at you.

August 16, 2006

Using Minoxidil At 15 Years Old – Hair Loss Information by Dr. William Rassman

Hey Doc, your site is awesome. I have a question. I am a 15 year old Indian male, and I recently discovered my receding hairline. For a week or so I thought it was a mature hairline since everyone in my family has one (noone is bald though). Anyway I went to see a dermatologist and she said it’s male pattern baldness because of the recession on the sides. She prescribed Minoxidil 5 % for 12 months. I just wanted to know if you think I should take Minoxidil at such an early age or get another opinion. BTW, when I raise my eyebrows my last fold of skin is 3/4 inch away from my hairline. And the recession of my left and right sides are an inch away from my hairline.

I do not have the benefit of examining you in person and this site is not intended for personal medical advice and second opinions. From what you are describing, your hairline may be advancing from a juvenile hairline to a more mature hairline, albeit a bit prematurely. This is generally not considered male pattern hair loss. To be more certain, you should have your scalp hair evaluated for miniaturization with a hair densitometer.

Also, I am curious as to what you mean by “recession on the sides”. Are you saying the the sided temple prominences are a problem as well? If that be the case, then there is more here than meets the eye.

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