Dr. William Rassman – Page 1772

July 20, 2006

Any Products That Work Around the Temples? – Hair Loss Information by Dr. William Rassman

Hi,

I have recently been placed on a treatment of Propecia for a receding hairline and first stages of thinning of the crown. After reading information on this drug I have noticed that it apparently has no proven effect on hair loss around the temples. What products would be useful to use along with Propecia to increase my chance of actual hair growth and/or thickening? Thickening shampoo’s? Serums? Vitamins?

Thanks.

Propecia, I am certain, will slow down or stop the hair loss in many areas where genetic balding from the effects of DHT is occuring — that includes frontal and temple hair. As I have said before, many patients report that the frontal and temple hair loss has stopped with Propecia. I have seen two patients with full reversal of frontal hairloss, although this is unusual. Merck (manufacturer of Propecia) can not promote it for something that is not documented for in the FDA studies. The other cosmetics/shampoos/conditioners that thicken hair shafts by making them absorb water or vitamins will not impact the hair loss process.

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July 20, 2006

Gray Hair in Young Man – Hair Loss Information by Dr. William Rassman

I am 23 years old and have a worsening problem with grey hair. At 18, a few strands of hair slowly started to turn grey from the tips (not the roots). The graying would spread to the rest of the hair till it was completely grey. Over the past 5 yrs the grey hairs have increased and I now have about 30 grey strands all in the same area, in an area of about a few square inches. I don’t have grey hair anywhere else on my head and do not know how to stop it. I have been taking multivitamins and get plenty of exercise as well. Also, it seems odd that the grey hair is all concentrated in one area. Please advise me as to what you feel could be causing this and what I should do to treat it.
Thank you.

People gray in sections of the scalp before it spreads to other areas. I have seen people who had a single patch of gray hair in an otherwise normal head of hair that is dark. This could be in people who are very, very young (children have it at times). This is a genetic variation when it occurs. Other than the use of hair dye, there is nothing that can be done. You call this a problem and from a social point of view it clearly can be, but from a medical point of view, the hair at this point on your scalp is completely normal. If you do not like what is happening to you, you can use a variety of safe hair dyes to solve the problem.

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July 20, 2006

Nothing Would Benefit Society More than Curing Baldness – Hair Loss Information by Dr. William Rassman

I feel that nothing would benefit society more than curing baldness. The men that would be cured from this would then give society more gains, because of their newfound confidence, than could ever be imagined otherwise. I would absolutely guarantee this beyond a shadow of a doubt. Ciao

Confidence is important in any person for it frees that person from the constraints that limit human creativity. Some people measure value with dollars, some with euros. Some people measure man’s contribution with patents, some with Nobel prizes, and some with hair. I know where you are coming from.

July 20, 2006

Propecia Half-Life and Morning Testosterone Levels – Hair Loss Information by Dr. William Rassman

If the half-life of Propecia is only 8 hours (or whatever it is…less than 24 hours anyway) I’m just wondering shouldn’t it be taken at least 2-3 times a day? I know it wouldn’t be viable given the cost, but technically speaking, is this a reasonable assumption?

Also you speculated a while back that it may be better to take Propecia in the mornings as testosterone levels are highest at that point. Even though it was pure speculation, I was wondering: are testosterone levels highest in the morning or when you wake up (which may not necessarily be in the morning).

Your assumptions are reasonable. However, Merck (the makers of Propecia) has determined through extensive human clinical testing that once a day dosing of Propecia (finasteride 1mg) had the best effect on male pattern hair loss.

Male testosterone levels are generally higher in the morning if your body is in a regular circadian rhythm following a normal wake/sleep cycle. If you are a night-shift worker or sleep at different times, your testosterone levels may peak at different times.

July 20, 2006

Restarting Minoxidil Months After Transplant – Hair Loss Information by Dr. William Rassman

I had a transplant procedure (approximately 1600 grafts) 4 1/2 months ago mainly to the thinning crown of my head but some to reinforce the frontal hairline. The frontal grafts are beginning to show evidence of growth. The crown graft areas are causing some problems with redness and some sore spots that have been addressed elsewhere in this blog. The itchy red patches have made it impossible for me to continue using Minoxidil. As the patches eventually resolve am I likely to experience benefit from restarting Minoxidil even 5+ months post surgery? I am female and had one transplant 10+ years ago which was very effective at the time and from which I did not experience the same degree of problems with an itchy red scalp. It should be noted that I am 56 years old, with very fair skin and have had fine texture hair throughout my life. I was carefully evaluated prior to this procedure and determined to be a viable candidate for the procedure again. I did find a reputable transplant surgeon.

Thanks for your help.

If you have confidence in your tranplant surgeon, these are issues that the surgeon should address. You need to be examined to make sure there is no chronic infection (folliculitis) or other problems. It is always important to achieve a good patient to doctor relationship and these problems and concerns should be mentioned during your meeting.

With regard to restarting minoxidil, that is not a problem as long as the itching and active inflammation are gone.

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July 20, 2006

Taking Propecia for Telogen Effluvium – Hair Loss Information by Dr. William Rassman

If a male is suffering from a bout of Telogen Effluvium rather than MPB, would taking Propecia be either harmful or is it just totally benign, outside of the possible latent benefits for his prostate.

I doubt that taking Propecia (for men) would be harmful. However, I have many questions that were raised by your question, such as — How did you make the diagnosis of TE?

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July 20, 2006

Weaved Extensions Caused Hair Loss – Hair Loss Information by Dr. William Rassman

I have recently taken out weaved extensions (conrows) that I have worn for over 3 years. I have lost almost all my hair in the back where the braids were. Do you think this will be a permanent loss and it’s too late now?

I also just started using rogaine extra strength (5%) for men, even though I am female (since like I said I have a ton of hair loss), is this okay to do, and do you think it will help in my case of all traction loss?

It sounds as though you indeed have traction alopecia from your braids. Given that you recently took the braids out, your hair may grow back. It is too early to tell as it could take several months to see new growth. I do think minoxidil is a reasonable choice in the meantime. However, the male version of rogaine 5% is oil based and makes hair styling more difficult. The female version is alcohol based and tends to hair styling a little easier.

July 19, 2006

Norwood Classes vs Mature Hairline – Balding Blog

I am a 28 yo male who’s hairline has been receding at the temples since I was around 16 years old. It is now at around a Norwood 2/3 although there is very little recession at the front. I realise it is either slow mpb or a mature hairline from reading your very informative answers to other guy’s questions but I wanted to ask you whether its possible to recede to a Norwood 3 and remain there? I noticed miniturisation in the areas which have now receded but there doesn’t seem to be any further miniturisation. Also there is no hair loss at the crown area (yet!!)

Everybody is different! You may recede to a Norwood Class 3 and stay that way for the rest of your life. Your hair loss should stablize by your late 30’s. If you are still concerned about hair loss, you may benefit from seeing a doctor who can quantitatively record the miniaturization of your scalp hair and give you more information on its extent. If the miniaturized hair is only found in the frontal area, then you may be more confident that the hair loss will probably not progress significantly beyond what you have already experienced. On the other hand, if there is miniaturization in the crown or further back in the front (even it there is no balding at this time) then the prognosis may not be as good. In this later situation, the drug Propecia (finasteride 1mg) is the best way to arrest the process.

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July 19, 2006

Propecia and Frontal Hair Loss Over Time – Hair Loss Information by Dr. William Rassman

Hi, I am 24 years old and am experiencing some frontal hair loss. Nothing major, but my hairline has receded a few centimeters beyond what I would consider a mature hairline. On my mother’s side, my grandfather still has his hair as do most of my uncles. My father also still has his hair, but his father went bald in front.

I just started taking Propecia this week to prevent further loss. In your experience, have men in situations like mine managed to keep their frontal hair after taking Propecia for a long period of time? Or should I simply consider Propecia a stop-gap measure?

As a side note, I noticed on your blog that you suggested Propecia can only slow down frontal hair loss in most cases-that is, it will continue eventually. But I recently looked over a study on Propecia’s effects on frontal hair loss and the results seems more promising than you suggest (you are probably already familiar with it). Here’s the link: http://www.hairlosstalk.com/download/finfront.pdf

According to this study, investigators and a global assessment found that almost all the people on Propecia halted frontal hair loss (about 94 and 99 percent) over a one year period-and the study suggests that the effects even improved after a 24 month period.

Has this also been your experience?

In my experience with patients taking Propecia, I find that Propecia generally has better observable effects on the crown than the frontal hairline. I have little doubt that Propecia slows down frontal hair loss if it is clinically indicated and I have seen good results from it in the frontal area, therefore agreeing with your reference. I have seen a very small number of young men actually reverse frontal hair loss.

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July 19, 2006

Starting With Propecia and Minoxidil 12% with Azelaic Acid – Hair Loss Information by Dr. William Rassman

Hi,

I am based in London, UK and I just had a first evaluation session with a center specializing in hair loss.

The trichologist has evaluated that I was genetically pre-disposed to hair loss. I am now 37 and vertex 3, so nothing dramatic; I just want to stop the balding process.

Now, I have been prescribed Propecia 1mg + Minoxidyl 12% with Azelaic Acid. I am a little bit surprised to immediately start with the highest level of Minoxidil as I’ve read that you after time you need to increase the dosage. If in a couple of years, Minodixil 12% has decreased effect what stronger will I have to take? Also, are there some studies which show the dosage of Minoxidil has to be increase.

Thank you for your help.

You should talk with your doctor to address these concerns. When topical minoxidil is used for male pattern hair loss, some doctors may prescribe a higher concentration formulation. I like to start one medication at a time. I do not like what your doctor has given you with the ‘nothing dramatic’ view of your problem that you hold. You should be aware and informed about the potential side effects of any medications that you are prescribed. Once started on the minoxidil and the Propecia, you may be ‘hooked’ on both, for life. That is, you may be inclined to take both since you won’t know which medication is contributing more to the benefits you may see.

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