Author: Dr. William Rassman

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Accutane Hair Loss is Permanent? – Hair Loss Information – Balding Blog

Hello Dr. Rassman last you told me to go to a doctor in ny, I went to see him but he stated that he just didn’t know. I a 3rd round of accutane over 2 years ago, and have experienced hair thinning since.. I am very distraught since I thought the ny doctor could give me more answers and explanations as to how accutane could possibly damage hair follicles forever. I’ve been researching but its all about people like me complaining aobut the accutane induced hair loss, but no reason how it could do this damage. I was told that accutane works by reducing your sebacous gland. I had no idea that sebum would play a role in thinning or damaging hair.. I don’t know why doctors are saying it can be permanent, when in the past they said its only temporary.. and its been over a year, my hair is so thin. I’m taking biotin and I’m not even sure if that will work. I have no one to turn too. Can you explain to me what needs to be done, or how it can damage the hair follicles, if accutane only effects the sebacaus glands. thanks.

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Medical clinical science is as much a descriptive science as a biological science. That means we describe what we see, possibly more than we understand what we see. Do not be too hard on the doctor, because I am sure he told you what he knows. As for scholarly doctors, that doctor is as scholarly as they come. We know that Accutane does, at times, cause permanent hair loss (that is what we see) but if we really knew why, then we could surround the cause of it and maybe fix it. I do not have the answers you are looking for, nor do others I have asked. Sorry!

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Did My Using Minoxidil Mess Up Propecia Benefits? – Hair Loss Information by Dr. William Rassman

In October I noticed slight thinning on the vertex and purchased 5% minoxidil. I applied this twice daily to the vertex for 2.5 months at most. I did not see any change at this time, but was tired of applying minoxidil twice a day and switched to propecia. I have now been taking propecia for 4.5 months and there is noticeable thinning on the vertex. I am also shedding quite a bit more than I ever have which has been going on for almost 2 months. I know that Propecia can awaken follicles and increase shedding, but how long does this last? Also, even though Minoxidil did not regrow any hair for me, can it have a negative effect on Propecia possibly reversing hair loss on the vertex even though I used it for only a short period of time and it did not produce any hair regrowth and thickening? Basically, did I screw myself by using minoxidil before Propecia?

No.

You may subjectively notice thinning and changes in your hair. However, it is impossible to tell what is working or not working. Consider the fact that you may be just progressing to losing more hair and taking those drugs may be slowing the process down (even if it does not seem to be). In other words it can be worse, but not because of Propecia and minoxidil. You may also consider seeing a doctor who can examine your hair under a hair densitometer to see its miniaturization pattern and quantitavely track the effects of what Propecia is doing.

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Is Missing Facial Hair a Side Effect of Rogaine? – Hair Loss Information by Dr. William Rassman

I have been using Rogaine 5% topical solution regularly for about 6 years now. It has worked marvelously for preventing the thinning of my hair at the back of my head.

Just recently I noticed two large, circular patches on my chin and neck where facial hair no longer grows. I grow a goatee and didnt mind the two empty patches but now another small, circular patch has developed in my goatee area. Could this be a side effect of using Rogaine?

Thank you for any assistance you can offer.

I would worry more about alopecia areata or fungal infection as a cause, which require a good doctor to make the diagnosis. I would doubt that this is a side effect of Rogaine.

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My Hair Loss Became Aggressive Quickly, Follow-Up – Hair Loss Information by Dr. William Rassman

Doc,

I wrote in a few days ago about receding hairline: “My Hair Loss Became Aggressive Quickly.” I gaurantee I have what is “minimization.” I can see like at least an inch deep into my hair in the front but not on the sides. I am dirty blond like you asked, but I cannot imagine it is 90% gone. 50% maybe. Now I am on day 10 of Propecia. So according to the literature, from here, I have ~80 days before I see any “changes,” if I see any at all. From what I’ve read about Propecia, the more hair you have there, the better it works. So, say I go from 50% to 60% (for instance) by the time this stuff really starts being effective (the 80 days), are my chances of getting my full thickness back LESS than if i started a month ago? Two months ago? Could it be happening that quickly? I mean I started with propecia when it was 50%, right? Which number matters, the number now or the number later? Is propecia really working this whole time, but its just not “noticeable” for 3 months? Or should I assume things will continue to get worse (thinner) before they get better?

Thank you.

If you keep counting down the days for Propecia to take effect you’re going to lose your hair out from the shear stress. Remember, Propecia will take at least 8 months to see the benefits of it working. More importantly you may STILL lose your hair even on Propecia. Propecia may help by slowing the rate of your hair loss. I have no way to tell how fast or how much.

It seem you are very concerned and perhaps even obsessed with your hair loss. You may consider seeing a dermatologist or even a hair transplant doctor for your questions and concerns. Make sure that no one sells you a surgery without, in your case, waiting out the results of Propecia. Having a quantitative (not just your estimate) measurement of your hair by mapping your scalp for the degree of miniaturization may help you and your doctor in documenting the efficacy of your Propecia therapy.

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Nourkrin – Hair Loss Information by Dr. William Rassman

Dear Dr Rassman

Great blog. Here’s my question:

A supplement called Nourkrin is being advertised a lot in London at the moment, and claims to combat pattern baldness in both men and women. It basically seems to be a nutritional pill, and the key ingredient in Nourkrin is a protein compound of marine extracts. It is is blended with an organic, soluble silica and vitamin C.

I would like to know your thoughts on whether this would help someone like me: 30 year old male, who is receding at the temples (norwood 2, not on crown), and has a history of male-pattern baldness on both sides of my family. I’m also looking at taking finasteride.

Thank you very much!

Nourkrin is as you described here, but I know almost nothing about these ingredients. I did some Google searching for it and came up with page after page of sites selling it, but nobody discussing it. Maybe you’ll have better luck in your own search, but I came up empty. Nothing else I can really add regarding the product you asked about, but I can advise you that you should have metrics taken (miniaturization) to see how bad your hair loss actually is, how it is progressing over time, and the value or non-value of this pill if you elect to take it.

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Fibrosis, Atrophic Scalp, Insulin – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

I don’t believe there is anyone in the field of hair research/restoration today as qualified, knoweldegable, and practical as you – and it is for these reasons that I have come to your blog to ask my questions.

It is my understanding that as a person loses his or her hair, the skin of the scalp undergoes a number of changes, namely there is a loss of fat, an increase in ceullar atrophy, and of course the dreaded perrfollicular fibrosis (now that’s a mouthful). It seems to me that these changes, in particular the fibrotic scarring, are the main obstacles in the way of regrowth, and THE reason propecia does not work for extensivly bald men.

1.)What can be done about this demon we call fibrosis? Can it be slowed, stopped, prevented, reversed? If we could somehow counteract collagen formation, wouldn’t our baldness problems be solved for good?

2.) If bald scalp is atrophic, how does it have the capacity to hold a whole new head of transplanted hair? Is there a limitation to the number of hairs we can transplant (outside of donor limitations) simply because the new scalp can’t accomodate it?

Finally, this last qustion may be of particular intesrest to you, becuase it tackles the baldness issue from a whole new perspective: Recent studies have suggested that insulin resistance, heart disease, and AGA are all part of one big happy family. My father is a research cardiologist and is CONVINCED that if we treated prematurely balding men with insulin drugs as if they were diabetic, that we’d indirecty be adressing the baldness problem as well. Is there any merit to this? If so, we’d love to get in touch with you and discuss things further.

I would be VERY interested to hear your response, and I thank you for giving this invaluable service to us. God bless.

In your first paragraph, you mostly defined the way the balding process impacts the scalp. The loss of blood vessels and the development of atrophic changes along with the fibrosis is the result of the disappearance of hair. Without the rapidly growing hair ‘organ’ there is no need for the infrastructure supplied by (for example) the blood vessels. So the blood vessels just disappear, because there is no end organ to feed. I believe that the fibrosis is more a reflection that something was there before (hair and support infrastructure) and not there now.

When the transplant is done, it brings with it stem cells that command the body to bring in the infrastructure to feed the new hair cells to grow into a normal hair. The stem cells induce infrastructure building. You can look at it as if the hair transplant (in addition to bringing in hair) is really a stem cell transplant with fatty and glandular tissue. For the hair to grow, it needs lots of blood vessels and therefore it commands blood vessel growth and the building the complete new hair organ infrastructure.

As your father is a research cardiologist and is convinced that some relationship exists between balding men and insulin deficiency, then he knows far more than I do on this matter. I would love to learn more about his thesis. I would like to know what he thinks should or could be done that is safe to address the balding problem. Please have him send me more information here.

Thank you for your kind words.

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Less Body Hair After Propecia Use – Hair Loss Information by Dr. William Rassman

BigfootHi Dr. Rassman, just a quick question. Upon starting propecia 7 months ago i noticed a definate decrease in body hair. Have you come across this in your practice and what would you make of it.

Many thanks

Yes, through people that have written in to this blog, I have heard that this is a side effect. I have had one patient of mine who (like you) reported reduced body hair with Propecia use. I just wish it would have done that for me because at times I feel that I look like the picture on the right.

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My 16 Year Old Daughter Has A Small Scar – Hair Loss Information by Dr. William Rassman

I was wondering if I could bring my daughter in for a consoltation, because she has a small scar on her scalp that she would like to get filled in, and we were just wondering what kind of treatment options there are. It is a very small scar, but it seems to bother her a lot, and I just want her to not worry about it anymore. She is only 16 but she is begging me to set up a consoltation. Would this be okay, or is she to young?

She is not too young and I would be happy to see her. Hair transplants work very well for scalp scars. The FUE technique works well here. That means that there will be almost no pain for the transplants or after the transplants are done.

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Shock Loss in Donor Area After Transplant? – Hair Loss Information by Dr. William Rassman

I had a transplant procedure 2.5 months ago—I am experiencing very little if any growth of the hair located below the donor scar area—my doctor assures me that this is related to some type of shock caused by the procedure and that in time it will regrow—-Is this normal??

This is not normal, but not a reason to worry. Wait it out and the hair around the donor wound should return about the same time that the transplanted hair will start growing.

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