Dr. William Rassman – Page 1773

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.

Paid advertisements (not an endorsement):

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.

Paid advertisements (not an endorsement):

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.

Paid advertisements (not an endorsement):

July 19, 2006

Tramadol, Pain Killers, and Hair Loss – Hair Loss Information by Dr. William Rassman

Hello Doctor, I was wondering if the drug Tramadol, or any other perscription pain killers (possibly even neruontin) could cause hair loss? I took Seasonale for one month about a year ago, and my hair was falling out in chunks. It slowed way down after that, and I am now on Yaz (like Yasmin) which I heard is good for women with that kind of hair loss. But I have taken Tramadol pretty much every day since last september for chronic pain, and since then I noticed my hair is a lot thinner on top, mostly in the front but its thin all over. I just stopped taking my tramadol a week or two ago and the hair loss has decreased by about half. Do you think this is just a coincedence and that I truely have female pattern baldness, or is there any correlation between pain medication and thinning hair and if so will it grow back? Thank you so much!

Many medications can cause hair loss. It is virtually impossible to tell if Tramadol is causing your hair loss especially when you are taking other medications. Moreover, stress and chronic pain can also be a factor with your thinning hair.

Paid advertisements (not an endorsement):

July 18, 2006

Hair Loss InformationThe American Board of Hair Restoration Surgery – Hair Loss Information – Balding Blog

Dr. Rassman
Firstly let me tell you how much I have enjoyed your blog comments for the many young men and women suffering from hairloss. I am a 33 yr old male, who is scheduled for hair transplant surgery in a month. I have learned from your comments and want to ask you some questions. I have hair loss in the frontal/tempural area with thinning in the crown area. The thinning has improved since I started taking Propecia last year, no side effects thank God.

Is 33 a good age?

My doctor is Dr. [name removed] and he is a Diplomate of the American Board of Hair Restoration Surgery. Can you give me an opinion on this qualifications?

I was concerned with scars, and felt comfortable since he is also a Plastic Surgeon, is my assumption correct?

I am also concerned with shock fall. Is it permanent? How much help does Propecia offer?

My doctor has not done a miniturization study on my scalp, that concerns me, although he did examine me the first time and I am scheduled for anohter consult. Should I request this?

I also use Nizoral shampoo, and it seems to help, what have you heard about the benefits of this product if any?

Lastly, coming from a father that is a Vascular Surgeon, I know that confidence in the physician is important. I just did not get a second opinion, and have been trying to educate myself as much as possible. I feal my chances are pretty good, I hope to get strong results. I thank you again for your comments and help you offer on-line…..with the high pace life physicians lead its unlikely. I commend you for that.

Block Quote

Your father is correct in stating that confidence in your physician is very important. That being said, BaldingBlog is not a place for a medical second opinion. You should either address these issues with doctor or formally make an appointment with another hair transplant surgeon for the second opinion.

Credentials are important and being a member of the American Board of Hair Restoration Surgery may make it more probable that he is a good doctor. I am familiar with doctors with such credentials who I would not have as a surgeon, though. I, for example, have refused to become a member of the American Board of Hair Restoration Surgery because there is no formalized training for the accepted doctors and no peer review for what they do. When I received my credentials for General Surgery, I had completed 5 years of formalized, supervised training before I was allowed to take a series of written and oral examinations. The American Board of Hair Restoration Surgery credential only requires that the surgeon does 100 surgeries (without any supervision) and pass a written (very easy) examination. That does not make them qualified in my eyes. Now with that said, many of the doctors who have received the American Board of Hair Restoration Surgery credentials are good doctors and quite competent, while some are not. It continues to be a buyer beware situation for the hair transplant buyer (see: The Truth About Cheap Hair Transplants).

I have addressed shock hair loss before. Propecia in a balding male will reduce the risks of shock hair loss. If Nizoral shampoo is working for you, then use it. I feel strongly on the mapping out of the scalp for miniaturization. I do not like doing things blindly, because then I really could not lay out a good Master Plan.

July 18, 2006

Is There a Pill to Prevent Shock Loss? – Hair Loss Information – Balding Blog

What is fallout/Shockloss? Is there a pill or something I can take after surgery to prevent it, or is it temporary and nothing to worry about?

Block Quote

I just made a post related to this yesterday (see How Long Should I Take Propecia Before Transplant to Prevent Shock Loss?).

Shock loss occurs when the follicle becomes ‘insulted’ by swelling and inflammation, causing the hair to shed from the follicle. The follicle then enters a resting state and may never go back to an active state (if there is genetic balding in that particular follicle) or after a period of time it may go back to an active state and grow normally again. We suggest taking Propecia before the surgery to help minimize shock loss after hair transplantation because the hairs that are genetically impacted have the greatest risk of permanent loss from the shock of the hair transplant process. Propecia minimizes this risk.

July 18, 2006

Can I Tell If I Have MPB By Pulling? – Hair Loss Information by Dr. William Rassman

I was wondering how to actually notice hair loss. When I was 25 I remember visibly seeing hairs in the shower and in my sink. Since then I have slightly receded but that is it. I am now 31 and I notice one or two hairs when I put gel in my hair and a few on the floor in my bathroom. I also notice I can slightly tug a few hairs out every once and a while. It just as easy to pull them from my sideburns as the top of my head. No one on either side (first and second generation) is bald in the back of the head. All related men do have recession and slight thinning (which I think is common). It looks like pattern 2. Is the fact that I notice the hair in my sink, tub and by pulling a sign of hair loss or MPB?
Thank you!!

No, you cannot tell if you have male pattern balding (MPB) by simply pulling on your hair. It is normal to lose 100 hairs a day. You may be able to see MPB pattern under a hair densitometer, which is a special microscope for the hair, by demonstrating miniaturization of hair. To make the actual diagnosis, the patterns of thinning and miniaturization can be mapped out for predictive purposes.

Paid advertisements (not an endorsement):

July 18, 2006

Hair Loss Acceleration from Propecia Means It’s Working? – Hair Loss Information by Dr. William Rassman

Dr. Rassman, thank you for your very imformative site!!

If after starting Propecia, one’s hair loss temporalally accelerates, would this be a sign that the drug is working and that regrowth is likely (i.e., would one be better off if they actually see accelearted loss versus not seeing it)?

When regrowth occurs with Propecia, is the initial hair very fine or does it grow back as normal hair?

Sometimes it is thought that Propecia, when it is working, may accelerate the cycling of the hair. If this happens, there is a possibility that hair loss might worsen temporarily after starting Propecia. Most people who are responding to Propecia should be minimizing or preventing further male pattern hair loss and that is what most people tell me.

Paid advertisements (not an endorsement):

July 18, 2006

How Long Should I Take Propecia Before Transplant to Prevent Shock Loss? – Hair Loss Information by Dr. William Rassman

Dear Dr Rassman,
I have been reading your blog for quitesome time and have benefitted a lot from it. I have leant from you that propecia is helful in preventing shockloss. I’m planning on a HT session say like in a month. Would it help me in countering shock loss if I started using propecia today?…or should I be on propecia for a specific period of time say like 6 month, before I go for a Transplant.?

If you have been evaluated by a doctor and have a diagnosis of male pattern hair loss, Propecia may benefit and prevent or reverse the hair loss. Propecia may also prevent shock loss from a hair transplant and I generally recommend that it is best to take it one month in advance of the surgery if possible. Certainly, being on it as early as possible is best, but even the day of surgery will work better than none at all. The enzyme that makes DHT is at work all of the time and blood levels of Propecia are achieved in an hour or two, so hopefully some value should be there even if first taken the same day of the transplant surgery for the prevention of the transplant shock you asked about.

Paid advertisements (not an endorsement):

July 18, 2006

My Hairline Was Too Low, So I Plucked Some Hairs – Hair Loss Information by Dr. William Rassman

When I was 19, I thought my frontal hairline was a little too low, so I unthinkly grabbed some tweasers and plucked out some of my hair from the left towards the middle of my frontal hair line (on more than one occassion).

Ever since then, my hair has not looked quite the same in that area and I occassionally experience a slight burning sensation there.

I am now 22 and am wondering if there is anything I can do to ease the burning sensation around there as well as encourage the regrowth of hair in that area. It just does not look quite natural and like it did before I did this plucking.

Have you heard of a situation like mine and do you have any specific recommendations for a situation like this?

I would really appreciate your help and advice.

Local irritation from plucking hair is common in people with chronic picking of their hair (trichotillomania), The hair loss from your frontal hair line is likely permanent, especially if you have transitioned from a childhood hairline to a mature hairline which is normal at your age. You should see someone like me (or find a doctor in your area at ISHRS.org) to determine a long term plan defining what to expect.

Paid advertisements (not an endorsement):