Author: Dr. William Rassman

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Isotretinoin and Hair Loss – Hair Loss Information by Dr. William Rassman

Hello! I am a 24 year old female who is experiencing hair loss from isotretinoin, and was wondering what I can possibly do to help my hair stop falling out. I’ve been of the medication for a month now, and my hair started falling out about 2 months ago. I’ve now lost about half of my hair, and I’m really worried because it hasn’t slowed! My dermatoligist said there’s nothing that can be done except wait it out. I also know how freakish it’s going to look when it starts coming back in. I had long, blond, thick hair and now it’s so thin and starting to be noticeable. I tried Rogaine- used 4 bottles in 3 weeks and it didn’t seem to help. I just bought Nioxin shampoo/conditioner to try- I am desperate! Is there anything I can do- vitamins I can take, treatments, shampoo- that will help? Thank you so much!

Oh, I was on a very high dose, over 3 mg/kg of body weight; I figure that’s why I’m having this side effect.

Unfortunately, some people do experience temporary hair loss from isotretinoin. Taking a multi-vitamin may help. I agree with your dermatologist that there is not much that you can do right now and that you must wait it out. However, you might want to have blood work done to rule out other causes of hair loss for women like hypothyroidism, anemia, crash diet, contraceptive pills, and dermatitis.

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Hair Loss InformationHair Loss Product Warning Labels – Hair Loss Information – Balding Blog

Why do hair loss products say “do not use if you have no family history of hair loss”? By using these products if you don’t have a history of hair loss cause one to start losing hair? Please answer this question instead of telling me to get a miniaturization done or to use Propecia.

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I do not know the reason why they have the warning label you mention, nor do I even know what product you are referring to. If you are concerned, you can call or write the manufacturer and find out. Or perhaps you can try the product and test your hypothesis.

I often advise people who are concerned or worried about their hair loss to at least get a screening for miniaturization of their scalp hair, because you need to know WHAT you have BEFORE you treat it. Blindly buying hair growth products would be a waste of your money if you don’t know the cause of your hair loss or the degree of hair loss that is actually present. Likewise, blindly taking any of these products may leave you ‘not knowing’ if they are actually working. The same is true for taking Propecia or minoxidil when you do have androgenic hair loss because it could mean that you would also be throwing your money away if it does not work on you. This is why I recommend that miniaturization tests are done to grade the hair loss (if you have it) and then measure it (as it responds or does not respond to whatever you are treating it with) over the time that the treatment is being used. If it seems like I do make this recommendation too often on this blog site, well, that’s just what good medicine and good science is about and this is ‘my’ personal blog site and the way I like to run it. I try like hell to focus on objective things and I am not emotional about products that ‘claim’ but can not ‘prove’ value. This is why this site has become very successful in just a year.

For the record, the decision to take Propecia or any drug should be a decision made between the patient and his doctor. If I seem to advocate the efficacy of Propecia, it is due to the fact that it is the only FDA approved and well studied medication that has been shown to grow hair or slow down androgenic hair loss with any reasonable predictability. I am not a spokesperson for Propecia (nor do I have any financial interest in the success of Propecia). As a medical doctor, I base my medical opinion on safe and ethical medications and I require that all claims and issues of safety and effectiveness meet FDA approved guidelines.

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Hair Loss InformationHow Will The Doctor Know To Diagnose My Female Hair Loss? – Hair Loss Information – Balding Blog

well i have this thinning problem for the past 4 years. it was started when i conceiving my daughter 4 years back. i was prescribed chronostim for my hairloss and i used it for 2 months and my hairloss stop for a year (2005). the problem seems to show again about a few month ago roughtly on January 2006. the hair loss is diffuse and can be seen clearly on the crown. i started using minoxidil a month ago and my hair still falling.

To be honest i would like to have the hair transplant for the crown only so that it can look more dense.

my question is whether i am the right candidate for the hair transplant?. how will the doctor know that my donor area is not affected by AGA since females always have a diffuse thinning?

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A doctor should look at your donor area with a hair densitometer to look for miniaturization. The greater the miniaturization, the worse the donor hair will be for hair transplants.

The important thing to understand is that women are generally not good candidates for hair transplantation, because the ‘donor hair’ is not healthy. If there is an area of good donor hair and the balding area is small enough to make a difference with a limited supply of your ‘good’ hair, then hair transplants MAY work, but you run risks that include the failure of the hair to grow enough to make a difference, and even experiencing hair loss with the transplants (this a real risk). You need to be able to trust that the doctor is not just taking your money for a quick sell, leaving you no better or even worse off once you empty your purse.

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Hair Loss InformationDoes Transplanted Hair Grow Like “Real” Hair? – Hair Loss Information – Balding Blog

Hi, I was wondering if the hair you add on is real hair, does it grow normally just like normal hair does? How long will the surgery take? How expensive is it? Accroding to your pictures, I’m at stage two of baldness, I’m currently using procerin, but the hair still falls, not as much though, I know the problem will continue and eventually I’ll go bald. I want to add on about an inch of hair down to my forehead all the way to the corners. I want to know what’s the cost of the surgery, your response will be greatly appreciated.

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A hair transplant takes hair from the back of your head and moves it to where you need it (hairline, top, or crown). So yes, it grows just like normal hair, because it is normal hair. Pricing varies per doctor, and procedure length is measured in hours (depends on how many grafts you need transplanted). Our pricing can be found here — NHI – Fees and Financing.

Your brief description of hair loss is alarming because you state you have a Norwood class 2 hair pattern. What you may perceive as a hair loss problem may be that you are transitioning to a mature hairline, which is not a sign of balding.

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Hair Loss InformationTaking Propecia Provides False Negative on PSA Test? – Hair Loss Information – Balding Blog

Hi – I have heard that taking propecia may provide a false negative in some cases on a PSA test since DHT is lowered. Is it possible to have prostate cancer and not know it from a PSA test because propecia hid the true results?

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Prostate Specific Antigen (PSA) test is a screebubg test for prostate cancer. It is a nonspecific screening tool for doctors to consider when evaluating a patient. PSA can be affected by many non-cancerous causes such as infection, benign elargement of the prostate (BPH), or even digital manipulation (during a rectal exam, for example). Finasteride is thought to reduce elevated PSA levels so we generally take a PSA baseline test for all men over 50 prior to starting the drug.

For further reading, the Dec 2005 Journal of Urology published a 7 year follow-up study of patients taking 5mg finasteride (5x dose of Propecia) and found no significant increase in Prostate cancer risk (Dr. G. Andriole was the lead author, Ref: J Urol. 2005 Dec;174(6):2098-2104)

That article was prompted by the New England Journal of Medicine article published in July 2003, which alluded to an agressive form of prostate cancer with finasteride use (which was not correct from the follow-up study).

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Hair Loss InformationFinasteride and Cholesterol Reduction Pills – Hair Loss Information – Balding Blog

I just performed my blood test and discovered that i’m having high cholesterol level. The doctor advised me to take medicine to reduce my cholesterol level in my body.

My question is, i’m about to take Finasteride to combat my hair loss. Is there any problem of taking Finasteride together with cholesterol reduce pills concurrently as advised by my doctor?

Kindly give your advise and comment?

What is the succesfull percentage recorded after using Finasteride treatment (out of 100 people)?

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Many medications interact with one another and they all have a potential for side effects. I do not know what cholesterol medication you are taking, but most that I know of do not interfere with Propecia. I strongly advise that you address your medication concerns with your doctor or pharmacist.

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Hair Loss InformationSeborrheic Dermatitis on Eyebrows – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

I have been diagnosed with seborrheic dermatitis on my eyebrow areas. My eyebrow hair are falling off all the time. They do grow back, but I notice that the texture of the hair is thinner than before I have got the problem. Does seborrheic dermatitis affect hair follicles in such a way as to cause the hair strands to get thinner?

Thank you very much for your time.

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Anything is possible. If you scratch it, you may be pulling out hairs and eventually this will lead to permanent hair loss. You can treat it topically with a low dose steroid (1/2% hydrocortisone cream) about three applications a week, 12 hours apart. This can be purchased over the counter and is safe, unless you take too much of it. Try it for the short term. If it works, see a good dermatologist to consult on what is the best way to keep it under control.

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Hair Loss InformationScalpMed, Diane 35, and Hair Loss – Hair Loss Information – Balding Blog

Hi there,

I’m a 25 year old female. Four years ago, I took Diane 35 for about 6 months. During that time, I noticed hair falling out. My doctor at the time said that it was a “normal cycle”, and not to worry. At the end of the 6 months, though, I had lost about 60% of my hair. Not in patches, luckily, but just all over my head. It hasn’t grown back. It could be genetic, cause females on my father’s side have thing hair, but it’s so frustrating having HAD it thick before.

Do you have any recommendations? I’m thinking about going on Scalp Med to sort of provide a “boost” to the hair follicles, but I’d imagine that because it’s essentially Rogaine, it will stop regrowth if I stop medication.

I appreciate any advice you can give me.

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Minoxidil might help, but what are you really treating? You need to get a diagnosis to find out if you have genetic hair loss. To get that diagnosis, you need to have your scalp mapped out for miniaturization. You also need to be sure that you do not have other causes of female hair loss, which include eczema, malnutrition, autoimmune disease, drug reactions, infections, genetics, etc.

ScalpMed might help, but what is in it beyond the minoxidil? Diane 35 has hormonal effects (Antiandrogen / Estrogen) so messing around with your hormones may be positive or negative. It varies per person.

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Hair Loss InformationDHEA Supplementation and Hair Loss – Hair Loss Information – Balding Blog

Dear Sir,

I know you have touched on the efect of hormone supplementation in some earlier messages.

There are mixed views on whether DHEA supplmentation (say 25mg per day) in men leads to increased hair loss. While it certainly has made improvements to overall wellbeing, I always detect (or believe I do) increased hair loss while I am on DHEA and topical testosterone.

In your view, do these supplements increase risk of male hair loss and can this risk be minimised while using them? Thank you.

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DHEA and steroids do make hair loss worse. Propecia may minimize the impact and it is doubtful that it would hurt. Check this out with the doctor who is prescribing your medications.

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Do Gray Hairs Fall Out? – Hair Loss Information by Dr. William Rassman

Good morning doc. I’m a 26 year old male who is starting to go gray, pretty heavy on the sides & starting to in the front as well. Is this a good sign that said gray hair won’t fall out? Does this mean the gray hair has already passed a barrier to balding or is it just as likely to fall out as the other “youthful” (brown) colored hairs? Thanks for the great blog!

The graying of hairs is independent of balding (no relationship). Graying is genetic and not necessarily reflecting getting ‘old’, and you are not alone. I have seen many men and women who turn gray in their 20’s. The reason most people do not see them is that they hit the dying bottle and never show their secret.

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