Dr. William Rassman – Page 1866

February 6, 2006

Iron Levels and Hair Loss – Hair Loss Information by Dr. William Rassman

Dr Rassman,

I am a 27-year-old female who has experienced a gradual overall thinning for the past 10 years. It is now fairly severe. I have always had low iron levels and saw a hematologist for over a year. My ferritin levels have hovered between 14-35, despite taking a 325mg ferrous gluconate supplement daily.

My ferritin is currently 14 and my hematologist says that since the laboratory test range is 10-150, my levels aren’t so bad; that it would take anemia to cause hair loss. My B12 is also in the low range – 325 on the 200-1200 normal zone. I feel that I must not be absorbing iron if the levels haven’t changed despite taking a supplement and I am frustrated by wasting more time without being able to rule this out as a source of the thinning. My two younger brothers have male pattern baldness but I am loathe to accept genetics are to blame for me too…

My question is: how low do iron levels have to be to be considered a legitimate cause for hair loss? And how soon would regrowth occur after normal levels are restored?

Thanks so much for your time.

Anemia is a very broad topic to tackle. There are many causes of anemia, like microcytic anemia and macrocytic anemia. Microcytic anemia is caused by iron deficiency, thalassemia, and various chronic disease. Macrocytic anemia is caused by folate and B12 deficiency. There is no cut off level of iron that one can define as the starting point for hair loss. Ferritin & Vitamin B12 deficiencies may produce hair loss and anemia and they may accompany other vitamin deficiencies including the entire B group [Vitamin B1 (thiamin),Vitamin B2 (riboflavin), Vitamin B3 (niacin), Pantothenic acid, Biotin, Vitamin B6 (pyridoxine), Folic acid (folate), Vitamin B12 (cyanocobalamin)].

Have you tried to take iron with vitamin-C? Sometimes that may help to increase absorption of iron. Liver and red meat have high iron levels. Your doctor may have evaluated your GI tract for mal-absorption problems leading to some malnutrition or other vitamins and nutrient deficiencies, each which may contribute to hair loss. If the normal level of iron is restored, it may take a few months before you can see noticeable regrowth of hairs.

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February 6, 2006

Propecia, Paxil, and Erection Problems – Hair Loss Information by Dr. William Rassman

I am 27 years old and have been on Propecia for about 3 weeks (I am thinning at the top and crown, and just a bit of scalp is showing, but the balding process has started). I have also been taking Paxil for almost 3 years. Recently, I found that my erections have become harder to my maintain and are not nearly as hard or big as they used to be. This concerns me greatly.

If the side-effects are from Propecia, will they ever go away of I stay on Propecia?

Would a switch to Proscar make a difference?

I am weaning myself off Paxil, could this help?

How can I have both hair and erections?

Am I best to get off of Propecia and start to think about transplant procedures?

Thank you!

The effect of Propecia on sexual dysfunction may be temporary, but if they continue for more than a couple of months, then it may prevail. This would only be assuming that the Propecia is the cause of your sexual problem. You can stop Propecia for a month and see if it makes a difference, or you may want to cut the dosage of Propecia down to half a pill per day as an alternative to stopping it. Proscar (packaged in 5mg) and Propecia (packaged in 1mg) are the same medication, finasteride.

Paxil can cause sexual dysfunction which will probably subside, assuming that you can wean Paxil with the endorsement of your doctor. Your hair issue and your sexual dysfunction issue may need separate doctors. These issues are too important to try to solve by yourself.

February 3, 2006

Balding Football Star Matt Hasselbeck and Super Bowl XL – Hair Loss Information – Balding Blog

Now I’m not a huge sports nut, but I read enough news to know what’s going on. The nation seems to be obsessed with the hair, or lack thereof, of the Seattle Seahawk’s quarterback Matt Hasselbeck. I caught a few sportscasters on ESPN talking about his “shiny dome” a few nights ago, and since, I have noticed numerous respected sports journalists harping on, or even supporting, Matt Hasselbeck because he is bald. Even Hasselbeck himself is discussing it in the media, “Anybody losing your hair, you can root for us, too,” he said. “Anything to get the home-field advantage here in Detroit.”

Now it’s interesting that this is such an issue. I mean, from what I have read, he is a good Quarterback; it is not like he cannot do his job. Why is the media judging him because of his hair? Is he not marketable enough? Can’t he sell enough Wheaties boxes? Take a read through some of these articles, and let me know if you think it’s and issue.

Washington Post – from Tony Kornheiser, also an ESPN analyst
“On the other team, there’s Matt Hasselbeck, like me, an innocent victim of male pattern baldness, a Rogaine casualty; maybe not the MVP, but the MPB of his team. How can I not root for him? He isn’t shaved like one windbag I know (hint, hint) who claims to be able to grow hair, but in reality is as bald as an egg. He isn’t waxed and plucked like some freaky bowling ball. He’s just lost everything on top, and still — like a real man — he lets the sides continue to flourish. (Plus, his brother has such a hot wife, which has to frost Matt, because he’s a much better quarterback.) Yeah, it’s nature over nurture for me. It’s the brotherhood of the bald.”

USA Today
“Quarterbacks aren’t bald. They aren’t supposed to sport receding hairlines. Maybe that’s why Hasselbeck won’t be the most highly touted quarterback in the Feb. 5 Super Bowl at Ford Field. Maybe that’s why Pittsburgh Steelers quarterback Ben Roethlisberger, possessor of a manly brown beard, was bronzed Sunday when his team beat the Denver Broncos in the AFC Championship Game, even though Hasselbeck’s play was equally dominant.”

USA Today
“I mean, follicle-challenged Matt Hasselbeck is a fine passer and field general, but poor dude looks more like a meat-cutter than he does cool Joe Willie. ‘You gotta pull for the beard, Hasselbeck has no hair!’ said Dan Fouts, who had the best set of whiskers ever among NFL signal-callers, on Tuesday.”

Outsports
“In contrast, Seattle’s two biggest stars sport no hair on their heads, whether by nature or choice. Quarterback Matt Hasselbeck is only 30, but is severely folically challenged, so much so that a Seattle newspaper asked readers to send in doctored photos showing Hasselbeck with hair. If the Seahawks win, can a Rogaine endorsement be far behind? Running back Shaun Alexander is totally bald, but it appears more like he’s opted for the shaved-head look by choice.”

ESPN’s Page 2, The Sports Guy
“Why NOT Hasselbeck? Bald is only tough-looking if you’re Michael Jordan or Charles Barkley.”

February 3, 2006

Hair Loss InformationWill Propecia Thicken the Hairline? – Hair Loss Information – Balding Blog

I’m 25 years of age with miniaturization all around the hairline (about 2-3 cm deep) especially in the area above the temples. I would estimate in this area I’ve lost about 50 – 60% of density in the last 3 years. I also have some vertex thinning but it’s in an early stage so it isn’t obvious but it is definitely thinner. I’ve been on propecia for 7 months now. My question is if propecia is effective for me is it likely that the already thinned area in the front will continue to thin while the areas behind remain strong as they haven’t yet been impacted my MPB? Is there a possibility I could have a solid, healthy hairline just receded more after the thin areas are gone? Or do you think my hairline will continue to be thinner the mid scalp?

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Please send photos so I can see you; make sure the photos show with your eyebrows lifted high as you frown. Get good frontal and side pictures and send them to the address on the Contact page.

Propecia can slow hair loss, but usually will not reverse frontal hairline loss. It probably will fill in the crown, but by now you should have seen a gain as you have been on the drug for 7 months. What I am particularly concerned about is the difference between a mature male hairline and balding, so the photos will help me make that distinction. This is critical, because you do not want to undo a mature male hairline with hair transplants if that is all that is happening in the front.

February 3, 2006

Hair Loss InformationWhat is the Choi Implanter? – Hair Loss Information – Balding Blog

I am reading your site with great interest. I have also looked into the Choi procedure, and one well-known Choi advocate in the UK (where I also live) offers what seems to be a reasonable package, in Athens Greece. I was wondering if you could tell me more about the Choi procedure and does it yield the BEST results, with regards to density with least scarring as it is claimed? Why do some people say that FUE is not so effective? Is an “needle implanter” better than the conventional method? What about the use of Choi around the world? For instance USA, Japan, Australia? Any advice you can provide would be greatly appreciated!

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The Choi implanter is just a surgical tool. It makes some aspects of the transplant easier to perform, especially for those people who did not develop the difficult placing skills with the more traditional transplant tools used throughout the world. An instrument is only as good as the person using it, so I can not package the tool with the technique. The Choi generally requires ‘skinny’ grafts, which tend to dry out more easily, therefore, this instrument requires special skills, different than those that do not have to make the grafts skinny. Some people believe that skinny grafts do not grow as well. I believe that in the right hands, with the years of experience, skinny grafts should grow as well a chubby grafts. The grafts we make are half way between skinny and chubby, just my preference.

The Choi implanter did not develop a following in the United States. In Asia and other parts of the world, it is very popular. I do not believe that it is any better than anything else that the surgeons have perfected in their native countries.

To answer your questions about FUE, I would suggest that you look at the FUE category of this blog.

February 3, 2006

Hair Loss After Scalp Pimple – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman, I hope you can answer my question. I got a small pimple on my scalp a month ago which I left alone. After the pimple disappeared my hair fell out in that area leaving a small circle of a bald spot. Will my hair ever grow back on that spot? If it does how long will it take?

Your hair will likely grow back in a few months. Patience is a virtue. If it does not grow, then you will need to see a dermatologist to look for other causes of hair loss.

February 3, 2006

Head Tingles, Hair Loss, Infections, and Bleach – Hair Loss Information by Dr. William Rassman

hi there – i’m only 19 yrs olds and in the last year i have started balding all over the top of the head, espeically at the back in quite a serious way. i have thought that it was because i used to bleach my hair alot as a child but recently my scalp has started to itch alot. i am using pills, expensive “thickening” shampoo and other products on a daily basis to try and stop this balding but none of it is working. i was wondering if you think if its from the bleaching or is it possible that i have a scalpal infection causing the balding and itching. if so what can i do.

thank you for you time

First, you may want to stop much of what you are doing, as you may be causing your own problems. Then, if it continues, seek out a good dermatologist. If you are experiencing genetic hair loss, none of what you are doing will address the cause of the balding or thinning. People who treat themselves are gambling without the education or skills needed to address the problem.

February 3, 2006

Hair Loss Information » Inflamil and Hair Loss – Balding Blog

Ive read articles indicating that inflammation of the scalp is a contributor to hair loss. What are the effects of scalp inflammation? If inflammation affects hair loss can anti-flammatories such as Inflamil help?

Yes, certain types of an scalp inflammatory conditions can cause hair loss but it is not a diagnosis, but a symptom as I believe that you are using it. They may include auto immune diseases, dermatitis, eczema, psoriasis (with a great deal of scratching) and infection in combination or alone. Inflamil, according to info I found on the web, has the following ingredients: 10% Feverfew, 10% Thuja Occidentalils, 10% Epibolium, 5% Green Tea Extract (see green tea catechins) and 1% Mentholum verum. It may work but you would be treating something blindly with a series of ingredients that does not have documented safety and effectiveness clearly defined. In other words, you will not know what it is that you are treating nor what effect these ingredients are having. I would doubt that auto-immune disease will not be impacted by these ingredients nor will some of the other problems that cause scalp inflammation. Again, the diagnosis of an inflamed scalp is only a symptom of something that may be going on. You need a diagnosis.

February 3, 2006

Hair Loss Information » Lichen Planopilaris and Hair Transplantation – Balding Blog

I am a 55 1/2 yr old female. I have been diagnosed with “lichen planopilaris”. I am tired of scalp injection. My doctor said the next step is probably 3 hair transplant. There seems to be no information on this disease. Is there anything else that can be done? In addition, I am on a generic rogaine formula. April will make 1 yr. on this product.

Any advice? Also, I know the cost for a transplant vary with different results.

See DermatologyChannel.net for more information on this disease. The problem with transplantation is that if the disease is active and is autoimmune in etiology, then a hair transplant may be doomed from the start. Inactivity of Lichen Planopilaris in the autoimmune arena must be determined before starting the costly hair transplantation process. If you and your doctor believe that it is under control and inactive now or sometime in the future, a test hair transplant with a limited number of grafts (about 10) taken with an FUE approach will tell you if a larger hair transplant procedure will work. Either these grafts will fail to grow (indicating that the disease is still active from an autoimmune perspective) or they will grow (indicating that the disease has become inactive). It should take 5-8 months to determine success or failure of the transplant. For those people who have an autoimmune cause, reactivation of the process is always an added risk.

February 3, 2006

Sleeping with Products in Hair – Hair Loss Information by Dr. William Rassman

Does it hurt to sleep with Toppik and hair spray on your hair or should they be washed out each night?

I do not believe that sleeping with Toppik and hair spray would cause further hair loss. The Toppik will probably get on your pillows and make a mess if it comes off.

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