Author: Dr. William Rassman

Posted on

Hair Loss InformationUsing Non-FDA Approved Medications As Last Resort? – Hair Loss Information – Balding Blog

Hello Dr.

  1. 27 yr old male, Norwood 2~2.5
  2. use propecia regularly for 3 years. This has helped greatly in preventing mpb.
  3. use minox once a day (used to do 2x a day) 1ml on hairline and 1ml on crown
  4. Within the last year my temples have drastically recided (sp?) and now my hairline is starting to go.
  5. I am noticing even beyond my hairline there is diffuse thinning and it’s frightening to look at.

Do you offer any advice on any other medication to add to the propecia and minox mix? It seems one would have to try a non-fda med as a last resort before surgery.

I was considering adding revivogen (non-fda approval considered) but I am unsure of how it’s anti dht properties will affect my hormonal levels (i.e. will the combo of propecia and revivogen cause a severe loss in the production of dht that would lead to make gyno?). Obviously propecia is a systemic medication, but what of topicals such as minox, revivogen, spiro, etc.? Are they systemic or only confined to the scalp.

Block Quote

As a Norwood Class 2, I think that you should be tested for miniaturization to see if there is balding behind the hairline. First, you need to measure just what is going on to determine if you really have the problem that you think that you have. Second, if the Propecia is working, why go to non-FDA medications and put yourself at possible risk? You need a doctor to take charge of you and give you the guidance you need.

Posted on

Hair Loss InformationDonor Hair Supply and Cell Therapy – Hair Loss Information – Balding Blog

Id like to get a transplant by your clinic soon, but do not have enough donor to produce the illusion of full coverage… Can you tell me if cell therapy will be available within a few years so i dont have to worry about donor depletion? i understand it will be in phase 2 trials at the middle or end of this year through ADERANS…. I want to get a transplant now, but will only do it if it this new donor supply or cell therapy will be out… can you give me some info?

Block Quote

Cell therapy is not going to be on the market for a few years at the least and there is still no guarantee that it will work yet. Hair transplantation for some very bald people is still the best way to go. Sooner or later, alternatives to transplants will be available. Depleting the donor supply is a real concern for some people and that is why you need a good doctor who can design a customized master plan for you to be assured that your ‘worst case’ scenario is covered.

Why do you feel that you do not have enough donor hair? Consider sending me pictures of yourself to evaluate you more fully.

Posted on

24 Year Old Woman with Thinning Hair – Hair Loss Information – Balding Blog

Im am currently 24, both my parents are sixty, with super thick hair still. The past three years i was stressed due to a new job, was dieting, took Yasmin for birth control, used a left over home straightener (relaxer) that i had saved for future use, was in a wedding and had a dresser basically use a curling iron, more like burning iron, and i had wisdom teeth surgery that had nerve damage and i could not eat for several months and still took birth control (Yasmin) during my healing of my curly hair, I was confident that anything i would do would never cause baldness, however, here i am with excessively thin hair at the front and sides of my head. i’ve already been told that i look like i’m in my 30’s instead of 20’s. Will my hair ever restore to its normal thickness? right now it is growing out straight and i have bald spots in the back of my head and the sides of my head are extremely thin and straight, I do not see hair filling in aprocess, and to top it all off I have trichotillomania. Obviously I have issues, but due to the excessive thickness and volume t the sides and front of my head only in the back. i have been eating food with flaxseed. is there anything else i can do to help my hair grow back, and will there ever be a chance for full restoration?

Block Quote

To answer you, I would have to write a book. Yes, you have issues and what you described in your questions cover almost every imaginable problem a woman can have with their hair. If you are honest in this communication, you need to get good medical care. If you have bald spots in the middle of normal hair, then you could have alopecia areata. If you are pulling my leg to test my ability to sort through such complexity, I am sure that some of the readers will not sympathize with your dilemma. Good luck to you.

Posted on

Buyer Beware – Hair Loss Information by Dr. William Rassman

Are all balding men transplant candidates?

BaldJust the other day, a 31 year old man came to my office wanting a hair transplant using the Follicular Unit Extraction (FUE) method. He had already seen 3 other doctors and I was 4th on his shopping list. I’m not knocking that — it’s a good idea to meet with more than one doctor before chosing your surgeon , even if you feel comfortable during your first consultation because comparison shopping in this industry is the best way to protect yourself. Whether I was 1st on his list or 4th on his list — I’m just glad he eventually made his way to my office. During the examination I noticed that his balding was more prominent in the front, but there was thinning everywhere, even in the donor area. His hair was light brown and his skin had moderate skin tones and people with this contrast usually show a good fullness in the ‘donor’ area, so I was immediately concerned that something was wrong with this picture. I mapped out his scalp for miniaturization and found that the hair groupings in the front, top, and crown rarely had two hairs per follicular unit, averaging half of the normal healthy hair population. The donor area had a density of 1 hair per mm square (normal for a Caucasian is 2) and there was significant miniaturization throughout the donor area, worse on the sides, but bad enough in the back of the head.

I asked him about the three doctors he had visited and he went on to tell me about their surgical recommendations and how many grafts each had suggested was the appropriate number. I asked him if they mapped out his scalp and he said each had put their hand over his donor area and told him that his donor supply was good. None had used magnification in examining the donor area, certainly not mapping out his scalp. In one pf the doctor’s offices, he only met with a salesman, who recommended the largest number of grafts of all three offices.

This patient had a disease called Diffuse Unpatterned Alopecia (DUPA) and if there is ever a contraindication for hair transplants, this is one of them. I found it more than interesting that all three of the other doctors recommended surgery and I told him that he was not now or ever going to be a hair transplant candidate. Had he undergone surgery, his donor area would have been wrecked and he would’ve had an awful result, losing more hair than any gain he could’ve possible had. The only advantage to having surgery was that the doctors who recommended it could adequately pay for that new house and car they are driving. Let the buyer beware.

Posted on

Does Lisinopril Actually Cause Hair Loss? | WRassman,M.D. BaldingBlog

Does Lisinopril Actually Cause Hair Loss?

/by William Rassman, M.D./21 /,

My Dr. told me that lisinopril doesn’t cause hair loss. You say it does. It is not listed as a side effect, so are you sure it does? I freaking out cuz my hair is falling out. I am 53 years old and had all blood work done and all came back fine. I always had thick thick hair and so does everyone in my family. I am wondering is it menapausual? I have no other syptoms and my periods are still very regular. Will it grow back in or what should I do??? Im so confused because everyone tells you somthing different.

Many drugs can potentially cause hair loss. Most of the times scientists cannot find the exact mechanism of why this happens. Likewise, scientists cannot find the exact cause of hair loss either, because there are so many different factors involved.

I have three important points to make with regards to medications causing hair loss:

  1. Before identifying a drug as a possible cause of hair loss, you should find other medical causes.
  2. People take medications for a health problem. You should not stop taking a medication just because you think it may be causing hair loss. Your health should come before your hair (especially if you are not certain that the medication is causing the hair loss).
  3. Most importantly, you should follow up with your doctor for medication changes and concerns.

If you are taking Lisinopril, you likely have high blood pressure. You should NOT stop taking Lisinopril just because it has a rare side effect that you may or may not be experiencing. Stopping high blood pressure medications puts you at risk for strokes and other serious medical complications. There are other drugs that work just as well for controlling blood pressure as lisinopril. Recent studies suggested some relationship between lisinopril and lung cancer increasing its risk by 14%.

Some women who have genetic hair loss have it appear at about your age. The best way to make this diagnosis is to have your scalp mapped out for miniaturization. If you have genetic female hair loss, then there will be miniaturization over the thinning areas and miniaturization in the ‘rim’ of hair around the side and back of your head. Mapping out your scalp is the key to this diagnosis.


2020-01-15 14:09:03Does Lisinopril Actually Cause Hair Loss?

Posted on

Penis Is Not Hard with Propecia Use – Hair Loss Information by Dr. William Rassman

I took propecia for almost two months and noticed immediately a change in the hardness of my penis during sexual encounters. They were not as hard. At my doctor’s advice, I switched to taking it every other day, but still the same result. I have since quit taking the drug and my hardness has returned, but I wish to gain the benefits of propecia. Any suggestions. I have heard that going on and off the drug can cause increased thinning of hair. Please help. Should I try rogaine instead?

BuffProblems with erections are a known side effect with Propecia. In normal young men, this rarely happens, but if you are like most men, your sexual performance is going to be less spectacular as you get older. This problem normally impacts 20% of men in their 20s, 30% in their 30s, 40% in their 40s and over 50% in their 50s. Where your performance may be at the verge of showing this change, Propecia can accelerate the process. The solution for most men is taking one of the sexual enhancing drugs like Cialis (works a full 36 hours) or Viagra (lasts for about 12 hours). This way you can get the best of both worlds (hold your hair and keep up good sex). Ask you doctor to write you a prescription and if you try it you may like it.

Balding Forum - Hair Loss Discussion

Paid advertisements (not an endorsement):


Posted on

Shower’s Water Pressure Causing Hair Loss? – Hair Loss Information by Dr. William Rassman

Could water pressure in the shower be causing hair loss? I just moved to a new state about a month ago and the past two weeks I have been noticing hair everywhere. When i wash my hair, it is stringing between my fingers, all over my pillows, i’m having to clean hair out of my brushes constantly. Could it be the water(what’s in the water), shampoo, or conditioner too?

Hair loss is not from shower pressure, and I really doubt it could be the water itself (impact in a month) or in any change in shampoo or conditioner. It would be more likely to ask yourself if you are stressed from the move and living in a new place. Stress can cause hair loss. If it is only going on for a few weeks, calm down and wait it out.

Balding Forum - Hair Loss Discussion

Paid advertisements (not an endorsement):


Posted on

Hair Loss InformationInterviewing Dr. Rassman, Part 1 (Video) – Hair Loss Information – Balding Blog

We put together a short video series for this site that showcases a little of the history of the innovations made at the New Hair Institute in the field of hair transplantation. This video does have some potentially graphic images of an FUE procedure (grafts being removed, there is a little bit of blood) — so please be warned if you’ve got a weak stomach.

I hope you enjoy part 1 of 3 below:

Posted on

My Father Had Awful Transplants from a Dermatologist – Hair Loss Information by Dr. William Rassman

I have been on finasteride for 7 years. I have pretty much maintained my same density over this period. A little more thinning in the front. I am now 36. My father had many transplants from a doctor who is a dermatologist. Not from a doctor that specializes in transplants. His transplants are awful. What should my expectations be if I wanted to get off the drug and try transplants? I am fair-skinned with wavy auburn hair, and my individual follicles are thick, but not dense.

First, the old plugs can easily be fixed today. Look at the following links for articles and examples of good repair work which can and should be offered to your father:

The second part is that taking the drug Propecia is a different decision to having transplants. They can be complementary (see: Hair Transplant and Propecia Combination Results). As for expectations about transplants for yourself, meet with your doctor and have him/her develop a Master Plan with you, so that you have your needs addressed before the procedure.

Posted on

Patchy Hair Loss — Is It Fungus? – Hair Loss Information by Dr. William Rassman

I have had patchy hair loss for about 9 months or so, I went to a derm, he said it did not appear to be normal male loss, he gave me some shampoo and wanted me to come back in 2 month, I did, he did not see any improvememts, the bald spots still become very red, and burn. I just went to a new derm, he also said the hair loss doesn;t appear to me male pattern, he gave me some foam called olux and said it may be a fungal thing, he said if no new hair growth are seen in the bald patches in 4 week, he wants to do a scalp biopsy, what will this show? I really don’t understand, what things can it biopsy turn up, what conditions could make my hair fall out in patches, also the patches are on the top part of my scalp. thanks you and any info would be helpfull.. thanks again

To answer your question I would be giving you a course in dermatology. To answer your question about the scalp biopsy, I believe he is looking for fungal infections (it would show the actual fungus interacting with the skin), autoimmune diseases (it would show certain primative defensive cells attacking the hair follicles with reactive tissues around it), and the like. It sounds like he knows what he is doing, so stick with him.