Dr. William Rassman – Page 1875

January 19, 2006

Losing Hair After Spinal Injections – Hair Loss Information by Dr. William Rassman

I am 55 year old female. I have gone through alot in the past 8 months. I have a bad back and went through 12 injections in two months in my spine. They helped but then i got fat, gained 25 months from the shots. I think they were cortisol, kenolog and lidocaine. Since August no shots but i have noticed in the past 2 months or so alot of hair coming out. When I shower there is enough there the size of a golf ball and through out the day if i comb it out, hair is in the comb. But worst of all when I just run my fingers through my hair i can take alot out. I saw an endocronogist for a diffent reason but he said i can take this medication which is good for the heart and also helps hair loss. i think its called spiranolacton 25 mg but am afraid to do so. Can you tell me or suggest which kind of dr to see dermatologist ect. I also have been under a great deal of stress. Medications i take are effexor 75mg, lipitor 10 mg, fosomax 70 mg i x weekly, voltarin for back pain

if you can contact me and giver me some advice i would appreciate it

thanks

Many medications such as cortisol and kenolog can contribute to hair loss in some patients. Stress is also a contributing factor to hair loss and it sounds like you are very stressed. Spironolactones are used by some people to treat hair loss. I would advise you to see a good family type doctor to manage all of your problems and make sure that you do not have any of the causes of female hair loss. Your problem sounds a bit complex, certainly too complex for managing you via the internet.

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January 19, 2006

Rogaine Shedding, Nizoral – Hair Loss Information by Dr. William Rassman

Hello, I’ve never used Rogaine, in fear of the “shedding” phase I’d heard about. What exactly is the “shedding” phase, if I may ask.

And will this product cause that? And is there a list of the ingredients anywhere or should I not be asking that? I’m just very curious.

Last but not least question, if this products is discontinued, I am assuming everything on the scalp goes back to “as it was” before, and are there any products that shouldn’t be used, such as Nizoral Shampoo?

Your help is greatly appreciated. Sorry, where can I purchase only the “hair grow” product, not the cleaner etc?

To answer your question about shedding from Rogaine use, please see my past response in “Hair Loss Worse After Rogaine”.

I am not completely sold on Nizoral shampoo, although I do believe that it is a good shampoo. I do not believe it is necessarily good at regrowing hair. There is not enough scientific data to support hair growth claims. You can buy Rogaine over the counter and I doubt that minoxidil (generic form) will ever go off the market. The miniaturized hairs become dependent upon minoxidil when you take it and when it works. If you were to stop the Rogaine (minoxidil) and there was a benefit of it, you will go back to your ‘before’ status, plus losing whatever hair you would have lost prior to starting the medication. This may very well leave you worse off.

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January 18, 2006

DHT, Hair Lasers, Chemotherapy, and Finasteride – Hair Loss Information – Balding Blog

I have a few questions about androgenic alopecia and I’d be very happy if you could answer them for me:

1. What is a bigger factor for hairloss the quantity of DHT in the serum or in the scalp? If the scalp had levels of DHT at 0% would this stop hairloss? If that is the case is there a topical drug like Rogaine with finasterid instead of minoxydil and would it decrease scalp DHT levels better than oral tablets?

2. What is your opinion on the Lasercomb device that uses lasers to improve blood circulation in the scalp? Since minoxydil also improves blood circulation and is supposedly ineffective on the frontal area of the head would this device have the same downside?

3. Father of a friend of mine had cancer and had to undergo chemotherapy. My friend told me that chemotherapy improved his hair and even made it grow darker than before. Could there be any truth in this?

4. With propecia losing its effect over time I often see that people increase the dosages of finasteride up to 5mg per day. Would these higher doses really help or are you just putting your health at risk?

This is not really a question just observation on my part: everytime I see the after and before pictures of hair transplants the comparisons aren’t realy fair since the before picture usualy has more intensive lighting and hair combed straight forward or back and is often greasy while after picture has less intensive lighting and different position of lights and hair is combed to the side and it looks like it has just been washed. It would be nice if all pictures would be made with people having wet hair combed straight forward or back so people could really see the difference.

Thank you for your time and answers.

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Whew! You need a whole hour-long cosultation with a hair doctor to answer all of these questions, but I’ll try to give you some short answers in the meantime.

DHT and genetics are the biggest factors in hair loss. DHT is a hormone that is present in your blood (which flows through the scalp but does not reside there). There are no topical formulations of Finasteride (the molecule is too big). Any topical medication for hair loss would need to be a small enough molecule to penetrate the skin and have an effect. Minixodil does penetrate – which is why it works. Rubbing Finasteride on your head will not help and it will waste the Finasteride.
Do a search for “laser” here. To reiterate, there is no conclusive data on the effectiveness of laser therapy for hair growth.
Chemotherapy can occasionally change the character (color, curliness, thickness, etc) of hair in addition to many other unusual side effects. However, the idea of taking chemotherapy just to improve your hair is ridiculous. Chemotherapy drugs can kill you, they are used when the alternative is death. Hair changes post chemotherapy are absolutely the truth, though.
Propecia may lose its effectiveness over time (the data presently now goes out only 7 years), and some patients continue hair loss, hopefully at a slower rate. There is no evidence that higher doses will reverse this, but neither is there evidence that higher doses of finasteride pose an increased risk to health.

Finally, your observation is correct – there are methods of taking photos which will give the misleading impression of increased hair density/thickness/coverage. To really compare, similar photos need to be taken in similar lighting conditions with duplicated angles and styles. Wetting hair before and then showing dry hair after is an especially obvious tip-off that the comparison is invalid!

January 18, 2006

Hair Loss Homeopathy – Hair Loss Information – Balding Blog

Dear Doc,
At 18, i used minoxidil solution for about 6 months.I had some help and then suddenly it stopped growing and started falling again.I stopped after six months and shifted to homeopathy. By then I had already lost a lot of hair.For the past 2 yrs i have been trying homeopathy but to no avail.I keep losing to male pattern baldness. No family history except for some thinning on moms hair.Pls help.

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It sounds like you are going through rapid genetic hair loss. If the minoxidil was working initially and then after 6 months you stopped it, you probably experienced shedding of hair from the minoxidil withdrawal of the dependent hairs that you built up on the drug. You need to have your scalp and hair mapped out for miniaturization and if the results of that mapping show male patterned genetic hair loss, then you should go on Propecia. You need to block DHT with a therapeutic dose of the correct medication. Homeopathy does not offer powerful DHT blockers that are proven as safe and effective as a good prescription of Propecia. For your own good, do not waste your time, for time amounts to irreversible hair loss in those with rapid hair loss. You are using a water pistol to put out a fire that is consuming your valuable hair resources. Take command of your problem.

January 18, 2006

Is a Balding Man Shallow? – Hair Loss Information – Balding Blog

I am sorry to say that I am a shallow 28 years old former male model who has believed over the years that my looks were everything. I never had a problem with women until I started to lose my hair. The more the hair came out, the more my dating life and my sex life went downhill. Then after a while, the dandruff started and now, not only am I balding, but I drop snow from my head all over the place, leaving a trail of white flakes everywhere I sit. Is this all connected? Is god making me pay for my pretentious and shallow life of the past? I am suffering, really suffering, so please do not laugh at my email and help me.

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You are in the sensitive years when hair loss appears if you are genetically predisposed to it. If the hair loss is early, Propecia usually works nicely, but if you lost much of your frontal hair, then some of the loss may be too late for Propecia and only hair transplants can help. In any event, Propecia works well to prevent your future loss and help restore more recent loss. You may also have some skin disorder causing the flaking (or as you describe it, “snow”) that you are talking about. See a good dermatologist and find out what you have and what else it might be. It could be something simple — or something severe like psoriasis. Get a good doctor to help with a diagnosis and get your hair mapped out for miniaturization.

I can not judge what is in store for you. I do believe that each of us has the power to take command of our lives. You can elect to go bald, spread “snow” everywhere you go and withdraw into some closet, or you can address your hair loss properly, get the dandruff diagnosed and treated, and get your mental state into a place where a woman may find that you are a man of substance. I suspect that you recognized that the old, shallow you now understands that depth of character in women or men is what makes us what we are. I do not mean to lecture you, just to tell you to stop suffering, resolve your hair and scalp problem, and then face who you are by starting to look beyond the mirror, at the man who stares back at you. Hopefully when you were a model, women saw more than a hollow shell of a Ken doll. Become that person!

January 18, 2006

Hair Loss InformationHair Loss from Wigs – Hair Loss Information – Balding Blog

Hi,

I am a 52 year old African American female, who has had the struggle of being bald most of my life. When I was 12 I had a severe case of chicken pox, and left me scarred all over. Fortunately, I recoved with the skin, but the disease left large bald spots all over my scalp. I have worn wigs .. seems like forever.

The problem is no one has ever been able to help me through the years, and the wigs that I always wore, are taking out the remaining hair I have left on my head.

Is there someone I can see, to help me with this problem. I have used medications, hair weaves, etc to no avail.

Thanks

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Wearing a wig for many years can cause further hair loss as a result of the traction caused by the wigs. Traction Alopecia is common in wig wearers, those who wear turbins, and even in those women who pulled their hair into tight pony tails. Send your photos or if you are planning a trip to Los Angeles, visit my office so that I could better evaluate your situation. There are a few questions I need to answer, but can’t do so until I can see your hair loss. These questions include: What is your donor supply like? Is there enough hair for redistribution with hair transplants?

January 18, 2006

Cortisone Shots and Hair Loss? – Hair Loss Information by Dr. William Rassman

Would cortazone shots cause hair to fall out in large quanities? I had a shot about 2 weeks ago, would this cause it. or maybe my age 55 in mentapause time something to do with it?

On occasion, cortisone shots into the head can precipitate hair loss. In women who are predisposed to genetic hair loss (in those who do not have an autoimmune cause of the hair loss), cortisone may add to the many precipitating factors for hair loss, which occurs more frequently in post menopausal women. Any stress can precipitate the process. Although some doctors use steroids to treat hair loss, I do not understand the rationale for such use, unless there are autoimmune influences suspected as a cause of hair loss.

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January 18, 2006

ISHRS Australia Meeting 2005 – Hair Loss Information by Dr. William Rassman

I recently read on one of your previous blogs that you would be attending a international hair restoration conference at the end of the month and would comment further on avodart, mainly if you would begin prescribing it. I’m just curious if you have any further comments?

I apologize for not posting this response sooner. There were too many exciting events happening at the ISHRS 13th Annual Meeting for me to describe everything to you. For those that may not be familiar with this event, it occured in late August 2005 in Sydney Australia. I do recall there was some discussion about Avodart which may appear to have better result than Propecia. Unfortunately, there was concerns about whether Avodart persists for a significant amount of time in semen, which may have an unwanted affect on development in the male fetus. Currently, there is no FDA approval for Avordart to treat male pattern hair loss. I am somewhat perplexed about why GlaxoSmithKline, the drug company producing Avodart has suspended further tests for treatment of male pattern hair loss, but that would be a better question to ask the drug company.

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January 18, 2006

Microscope for Follicular Unit Transplantation – Hair Loss Information by Dr. William Rassman

What is so great about using a microscope for hair transplantation? I read some ads in the Los Angeles Times which stated: “Dr. X set new standards in hair restoration through the use of the ‘X’ Scope [Doctor’s name removed], an advanced microscope that allows more healthy hairs to be transplanted than ever before”.

At the same time, a second ad appeared which said: “Dr. Y’s new Mantis Microscope allows for greater single-hair dissection accuracy, significantly less donor hair for wastage, high hair growth success and better, denser and more natural results.”

Are you keeping up with Dr. X and Dr. Y?

Dr. X and Dr. Y somehow just came into the modern era in hair transplantation. Please look at the many articles I authored on the use of microscopes for hair transplantation which address the use of the microscope and its value. Most of what Dr. X and Y said is true. The industry standard was set by us in an article written in 1998 which conclusively showed the value at minimizing damage in harvesting grafts by the use of the microscope. What we reported was that the hair yield produced without the microscope was 25% less than the yield with a microscope. These numbers were even more dramatic in individuals with white or gray hair, where the advantages of the microscope showed hair yields from harvested strips were 40% higher than those without the microscope. The lost hairs in the count have almost certainly been tossed into the discarded tissue and were lost value to the patient. In a common idiomatic expression, ‘The baby was tossed out with the bath water’.

The focus for Dr. X and Y in claiming a breakthrough is one of ‘grandstanding’, bringing something to the forefront of importance and trying to take credit for discoveries where none is due. Microscopic dissection has been around since the 1980s’ (first introduced by Dr. Bobby Limmer). We applied the microscope to the follicular units which we defined and published in 1995 to define the standard which is now universally accepted as the golden standard for hair transplantation in everyone’s hands. The ads are largely correct, the use of the microscope is critical for significantly less donor hair wastage, high hair growth success and better, denser and more natural results. This is just what we have been doing for the past 10 years, so there is nothing new here.

So maybe the answer to your questions is: Dr. X and Dr. Y have now finally understood the standard of care and are moving into using it. It’s about time.

FYI: I changed the names of the doctors to Dr. X and Y. Buyer Beware remains the quote for the day.

January 18, 2006

Propecia, DHT, and Sperm – Hair Loss Information by Dr. William Rassman

Hello Doctor:

Thanks for you candid forum. I have three questions for you. If I’m a male on Propecia to prevent hair loss, will taking protein supplements for body building militate against the benefits of reducing DHT by Propecia? And, how can I reduce the sexual side effects of Propecia; namely, the reduced sperm volume? Finally, is there any evidence yet that taking Propecia and its active agent long term will cause permanent side effects or potential diseases?

Thanks again

I’ll answer your questions in order and they are all good questions;

Protein supplements will not change how Propecia works, namely, by blocking DHT formation. I WOULD warn you against taking any steroids which conceivably could alter hormone levels and diminish the benefits of the Propecia.
The sexual side effects of propecia are often temporary, but if they persist for you, I usually recommend trying a half-tablet twice daily or even just once a day. You will get less than the full benefit (I am led to believe that 1/2 tablet may give you 80% of the benefit), but you will at least get SOME benefit and that is the important thing.
Sperm volume and ejaculate volume are two different things. Ejaculate contains several body chemicals and fluids, not just sperm, and decreased ejaculate does NOT mean less sperm at all – as a matter of fact sperm levels for those with decreased ejaculate are usually still within normal levels, possibly higher. Decreased ejaculate volume was shown to occur in 0.8% of people taking propecia versus 0.4% of the placebo group in the initial studies (that decimal point is correct, it is LESS THAN one percent). Although the frequency of reduced ejaculate volume is reported small, in my experience after probing many men on this issue, it is far more frequent than the literature seems to suggest. If you are worried about potency or having problems with conception, I’d see a urologist and get your sperm count done.
Finally, the long term data for finasteride (~15 years of data) does not show any permanent side effects or potential disease. As a matter of fact, the data so far indicates that there is less prostate cancer in those taking it. So there you go!