Author: Dr. William Rassman

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Misdiagnosing MPB Due to Unsymmetrical Hairline Maturing?

hi dr rassman
i just had a question regarding asymetrical hairlines. if as a young child 12 or so you had a natural non symmetrical hairline and as time went on and your hairline matured, would it be possible to misdiagnose the patient as having androgenetic alopecia due to the unsymmetrical patterns produced by this condition?

thank you for your time

Early balding should show signs of miniaturization if your hair loss is genetic. Either see a doctor or take charge of your diagnosis by mapping your scalp. The choice is yours.

People with asymmetrical hairlines will develop maturing hairlines that may even out the symmetry (or they may not). Balding occurs in those with the genetic propensity for it, whether the hairline is symmetrical or asymmetrical.

As hair in the maturing hairline undergoes apoptosis (cell death, possibly because the number of hair cycles in the juvenile hairline may be limited and reached), it could just fall out without going through miniaturization. It could be an incremental fall-out, starting close to the leading edge of the hairline and then working its way back. I don’t get the opportunity to study the young man who matures his hairline and then keeps everything else without signs of balding, other than in my nephew as I watched his maturing hairline appear without miniaturization. One case study does not tell us the answers, so I look at these comments as academic.


2009-04-28 14:55:41Misdiagnosing MPB Due to Unsymmetrical Hairline Maturing?

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Mixing Latisse and Minoxidil?

I have been reading a lot about the drug Latisse as a possible use for MPB. My doctor prescribed me a generic version to try.

Do you think I could mix it in a bottle of minoxidil and use it or do you think it might need a different carrier agent or a stronger version to work.
I know you are not involved in this kind of research but I would appreciate your opinion

While I am not directly involved with this type of research, I have seen patients who have tried Latisse (bimatoprost) on their own scalps without success. I also have been told by a scientist (a patient) who is familiar with Latisse that just applying it to the scalp does not work. If only it was that simple.

As Latisse is packaged in very small quantities for use on the eyelashes, the costs for applying it to the scalp are out of reach for most people. I’m not aware that a generic version is available for sale in the US. The last I remember reading, a generic drug manufacturer was seeking FDA approval to market a generic bimatoprost, but it was being challenged by Allergan (makers of Latisse). If there’s anything more recent about this, I’m not aware of it.

As for your question about mixing Latisse and minoxidil — this isn’t something I’ve heard done before, and I don’t know what kind of results could be attained by going this approach. Have you talked to your prescribing doctor about it?


2012-06-21 10:36:14Mixing Latisse and Minoxidil?

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Mom’s Male Family Is Bald — Dad’s Family Has Hair

if my mom’s father and brothers are all bald and my dad’s family including my dad all have hair, where does that leave me in the genetic mix?

Balding genes can be inherited through the mother or father’s family line (54% may be the maternal side connection). Even if you have the gene, there must be environmental influence to express it and for men it is hormones, time, and stress. The balding genes are not fully understood and there is what is called “expression” of the gene, which means that having it and showing it are two separate things. In other words, you may or may not have the gene and if you do, you may or may not show the gene with genetic balding in your lifetime, yet you can still pass that down to your children or children’s children who may then show it with balding in their lifetime. You won’t know until you begin to lose hair and then you will have to be examined thoroughly.

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Moderate Crown Thinning — Should I Use Rogaine?

If I only have moderate thinning at the crown, is it worth the risk using rogaine if I may lose hair and make a somewhat bad situation worse? In other words, if it only works 50% of the time, why should I take a chance that the Rogaine causes intial hair loss and then hope I get it back with it working for me? Is this initial hair loss rare or common? If it only happens 5% of the time I will risk it but if it happens 20% of the time, it isn’t worth the risk to me. Can you help me out? Thanks.

It seems you have already made up your mind, but you may consider seeing a doctor to have your hair in the crown area measured for the degree of miniaturization (for an objective documentation) and explore other medical options, such as Propecia (finasteride 1mg). To blindly start a journey (medical treatment) without a map (miniaturization study) would not be very smart.

Minoxidil does not cause hair loss that lasts if shedding does occur, and whatever is lost from the initial shed should regrow back. I don’t have statistics to show what percentage of users the shedding occurs with.

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Mixing Minoxidil with Olive Oil?

is it ok to mix minoxidil with carrier oil, for example olive oil for easy application in scalp?? I hate the spray form, it gets into my ears and grows fur.

I don’t know what oils will do to the absorption of minoxidil. Sounds like you are inventing a new approach, but don’t expect me to endorse it or justify its safety. If you’re really disliking the liquid, you could try the Rogaine Foam.


2007-12-11 10:39:21Mixing Minoxidil with Olive Oil?

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Months After Extreme Illness, I’m Still Losing Hair

Hi,
I’am 19 years old and suffering from a great amount of hair loss. I got extremely ill about 4-5 months ago and almost lost my life. After the hospital i lost a lot of hair but eventually went to normal a month or two after. A couple of months after, i started losing even more hair. When i wash my hair, lumps of it fall out. I have seen many doctors but they all say nothing can be done. I have been taking Nutricap for a little over a month now and I see no difference. Any suggestions? I feel like i’m going to be bald by 20!

Hair loss after a major illness can be normal. I can’t explain why your loss stopped and restarted. It may all grow back in about one year time frame. If you were going to eventually bald due to genetics, the illness may have kickstarted your genetic process early… but if the hair grows back, then you don’t have to worry about that being the case. You’ll just have to be patient, though.

Look on the bright side — you didn’t lose your life!

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Month After Eyebrow Transplant, Still Red with Bumps

Hi. Dr. Rassman,
I had an eyebrow transplant a month ago and still have redness and bumps like goose pimples. Most of the donor hairs have fallen out but I haved had a few pimples in the donor area. I still have not been out in public since (work out of my house) it looks obvious something was done to my face. Am I one of the few that this procedure might not work? I’m starting to worry, and I do see my doctor next week for a follow up. Your thoughts would be greatly appreciated. By the way I’m a 47 yr. old male with fair skin. (Swedish mostly). Thank you

The best thing is to follow-up with the doctor who did your eyebrow transplants. It seems you may have local irritation and may have developed local folliculitis, which can all be a normal part of healing or it can be an infection of the new follicles. There’s really no way for me to tell if there is something wrong from just a brief description without knowing what was done and how it was done (only your doctor knows this information) and what it looks like to my eye.


2006-10-10 13:37:45Month After Eyebrow Transplant, Still Red with Bumps

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More About Topical Finasteride

Dear Dr. Rassman:
I have a question about finasteride as a topical solution. There is much speculation that topical usage of finasteride is as effective as oral administration. I even heard that some chemists are grinding finasteride and dutasteride into some vehicle like alcohol and apply it topically. There is also a company (www.hairgrowthmd.com) selling combined minoxidil and finasteride as a spray product and claiming the success with no side effects. Considering the fact that finasteride has large molecule size ( C23H36N2O2 with a molecular weight of 372.549), it is hard to predict that the topical form is to have any effect on the hair follicles (they have to penetrate the epidermis and enter the capillaries in the dermis and subcutaneous layer). As far as I know, FDA has approved only oral administration for 1mg a day for male patterned hair loss.

Do you have any opinion or suggestion regarding to use finasteride in a topical form?

P.S. There is also one publication on this: “Hajheydari Z, Akbari J, Saeedi M, Shokoohi L. Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia. Indian J Dermatol Venereol Leprol 2009;75:47-51”

thanks

I would like to believe that the problem is solved with topical finasteride, but I need a good solid peer reviewed article to make these claims credible. The study you mentioned does conclude with, “Finally, we suggest replication study of more samples, with longer period and assessment of patients’ satisfaction after treatment.” — and I agree that it needs more work done before one could reasonably conclude that a topical finasteride is as good as the oral treatment. The problem I see is that if it is not effective and you take the topical preparation instead of the oral proven medication, you will lose hair irreversibly the longer you delay treatment.


2009-06-16 15:54:53More About Topical Finasteride

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More and More Differently Textured Hairs Are Growing On My Scalp

Hello Dr. Rassman,

First I want to excuse for my not-so-good English.

I am a 23-year-old male. About 2 years ago I noticed my hair thinning all over the top of my head and the hairline slowly eroding away from its original position. I’ve been on finasteride for about 20 months.

Anyway, I’ll get straight to the problem… About half a year ago I noticed strange-looking random hairs on the top of my head. My natural hair colour is dark brown, but mentioned hairs are ebony black. Not only that, but they are at least twice thicker and very wiry. They are easily noticeable, because they don’t mix with my normal hair when combing. Even though my hair is around 3” in length, they stand there almost vertically, slightly curled up.

As I mentioned, 6 months ago they were just some couple of random hairs. Lately I have noticed more and more of hairs like that sprouting up. They look nothing like my hair. In fact, they don’t look like human hair at all. At least not the kind you’d expect one to have growing on his head.

I’m really clueless as to what is going on with me. I have tried searching all over the Internet. I have found people with similar problems, but no one really knows what they are about.

Perhaps You can help me.

Thanks!

Hmm… so you are saying you have non-human like hair growing on your scalp? Is there a correlation with a full moon? Do you have an urge to howl?

Sometimes hairs can have different textures and there may be no direct reason for this. Maybe it is hormonal. I do not know. If you’re concerned, you should see a doctor about it.