Author: Dr. William Rassman

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Accutane Hair Loss is Permanent?

Hello Dr. Rassman last you told me to go to a doctor in ny, I went to see him but he stated that he just didn’t know. I a 3rd round of accutane over 2 years ago, and have experienced hair thinning since.. I am very distraught since I thought the ny doctor could give me more answers and explanations as to how accutane could possibly damage hair follicles forever. I’ve been researching but its all about people like me complaining aobut the accutane induced hair loss, but no reason how it could do this damage. I was told that accutane works by reducing your sebacous gland. I had no idea that sebum would play a role in thinning or damaging hair.. I don’t know why doctors are saying it can be permanent, when in the past they said its only temporary.. and its been over a year, my hair is so thin. I’m taking biotin and I’m not even sure if that will work. I have no one to turn too. Can you explain to me what needs to be done, or how it can damage the hair follicles, if accutane only effects the sebacaus glands. thanks.

Medical clinical science is as much a descriptive science as a biological science. That means we describe what we see, possibly more than we understand what we see. Do not be too hard on the doctor, because I am sure he told you what he knows. As for scholarly doctors, that doctor is as scholarly as they come. We know that Accutane does, at times, cause permanent hair loss (that is what we see) but if we really knew why, then we could surround the cause of it and maybe fix it. I do not have the answers you are looking for, nor do others I have asked. Sorry!


2006-06-21 10:59:49Accutane Hair Loss is Permanent?

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Accuracy of Miniaturization Mapping?

How accurate is miniaturization analysis? My trichologist said unless you examine hair bulbs and shafts under microscope, you cannot determine the exact cause of hair loss. She also said that any thinning looks like male pattern baldness. What do you think of her opinion and the microscopic hair analysis?

A miniaturization mapping is just looking at the hair under a microscope and comparing it with normal hair that is often in the general area you are studying! I have never understood what the trichologist is looking at under the microscope. The accuracy of our mapping process is regional, based upon the changes that occur in miniaturization (often progressive) with genetic balding. More importantly we evaluate the pattern of miniaturization (under a microscope) at different areas of the scalp to determine how extensive it is in areas where future balding will occur, which will always miniaturize prior to becoming bald. Early in the process, the naked eye will often be unable to pick up the changes in thinning, so the mapping here has great value. And in case you missed it, I’ve provided tips on performing your own miniaturization mapping:

  1. Mapping Your Own Scalp for Miniaturization, Part 1
  2. Mapping Your Own Scalp for Miniaturization, Part 2
  3. Mapping Your Own Scalp for Miniaturization – VIDEO

To answer more specifically to what your trichologist said, you don’t need to examine the hair bulbs and shafts under a microscope to determine the exact cause of hair loss. The cause of hair loss is genetic balding in probably 99% of men. We use a miniaturization study to find out if there is early balding and then quantify it as well. We also use a miniaturization study to plan for treatment (medical or surgical) and follow the progress of such treatment plan. Drugs like Propecia may reverse miniaturization.

Finally, if you do not have male pattern baldness (women, for example) looking at hair or its bulb under a microscope wouldn’t tell much unless there is a telogen effluvium. Generally after taking a good medical history and examination, doctors do a scalp biopsy in women (as a last resort) to determine if there is a pathological process or order blood tests to see if there is an underlying medical issue.

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Accutane and hair loss

I went to the dermatologist the other day and she diagnosed me with TE. I am 21 years old and male. She blamed it on stress, when in reality I’m not stressed. What I believe it’s from is the 5 month accutane course I finished up in October of 2016. I honestly didn’t notice much shedding, but I have a ton of hair, and it’s short too. My barber told me I had uneven hair growth in January. Since then I can feel/ seethe spots that I am in shedding in. To this day I’m still shedding. Is there something I should do about this? Is this normal? Should I just let time do it’s thing?

Accutane is known to produce hair loss and the effects can last ujp to a year after you stop the drug. Go back to your dermatologist.

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Accutane for Acne, Propecia for Hair Loss

Hi Im 22 years old and my hair has been thinning really really bad for like the last year or so.

I just started on my second month of propecia and I know its too early to see any changes, but my problem is that I also have an acne problem and my dermatologist is going to put me on Accutane. I know accutane contributes to hair loss also so i just wanted to know if I could be taking both at the same time? or just any advice you can give me.

I doubt that Propecia (finasteride) will protect against possible hair loss from Accutane (isotretinoin). There aren’t known interactions between the two medications, but this subject needs to be discussed with the treating doctor, not with us over the web.


2010-07-30 08:47:29Accutane for Acne, Propecia for Hair Loss

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Acne, Dandruff, Hair Loss, and the Unexplained Mysteries of the World

I believe acne and dandruff and hair loss are related. They are all caused by cells that go through their cellular life cycle at much faster rates than normal. How can this be denied?

I believe Bigfoot, the Yeti, and the Loch Ness monster are all related. They’re unexplained mysteries that can’t be proven. How can my claim be denied?

Honestly, it is very easy to deny something and much harder to prove something. Show me scientific proof and I won’t deny your theory.

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ACell Hair Multiplication Study at NHI

ACellLast week I wrote about the ACell presentation at the recent International Society for Hair Restoration Surgery (ISHRS) meeting that may have opened the possibility for a patient’s hair to be multiplied in his or her own scalp. ACell’s MatriStem has had some early success with growing hairs that were plucked and then placed into recipient sites on the patient’s scalp, and although this is a major breakthrough, significant work remains before this becomes a practical hair loss treatment.

For those that missed my post from last week, here is a little background —

    ACell, Inc. has developed and refined an Extracellular Matrix (ECM), a natural biological material derived from porcine (pig) tissue. When ACell’s MatriStem product is placed into a surgical site or wound, it is reabsorbed and replaced with new, more supple tissue, rather than a firm scar. The ECM stimulates the body’s own cells to form new tissue specific to that site. When applied to hairs plucked from elsewhere on the body, this is called “auto-cloning”, as new hairs are derived from the process.

We are currently studying the use of ACell for scalp hair multiplication (auto-cloning) as well as the facilitation of wound healing in follicular unit transplantation procedures. For those individuals interested in auto-cloning, we will be happy to see you in the office for a more in-depth discussion of the opportunity. Details will not be discussed over the phone but will be covered by the doctor during your consultation.

People interested in working with us in a study can participate at no cost, but because of the newness of the process, we will be selective as to which patients we accept. A limited number of patients who are not selected for a study may be eligible to obtain this procedure as well for a special fee. We will also be using ACell in the donor area of on our traditional strip surgery patients to promote better wound healing at no additional cost. Please call my office at 310-553-9113 to set up an appointment for a qualifying examination.

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Accutane and Hair Transplants

Can you receive or do you recommend getting a hair transplant while on Accutane (isotretinoin)? My understanding is that the drug disrupts cell division and skin regeneration. Will this delay healing?

Yes, having a hair transplant while you are on Accutane it is not a good idea. You should wait a year without the drug ensure that the transplants will work and grow well. There is no point in spending money and your donor hair if you are not going to have good results.

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Accutane

I began to lose my hair in the frontal region of my head, shortly after beginning to take accutane. Is there any thing that will help?

Hair loss from Accutane is a known side effect. First you must weigh the options of stopping the Accutane. Your doctor should be able to help you make the right decision. The lost hair may return, so you need some time to observe what happens. If the hair does not come back within 8-12 months, then you might need a complete evaluation with a doctor like me, who specializes in hair loss.

I have previously discussed Accutane on my blog, which can be found below:

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ACell update for NHI ACell for hair replication and ACell for scar improvement

Based on case reports of Dr Hitzig and Cooley from 2010, and the spirit of science we have tried to replicate the cloning claims by applying for clinical research through an institutional review board (IRB), also known as an independent ethics committee (IEC) or ethical review board (ERB), IRB.

We had two category of ACell trials:
(1) ACell to promote new hair follicle regeneration from plucked hair, thus creating two hairs from one hair as the plucked hair is assumed to grow back. This in essence is viewed by some as cloning.

At this time, at about the 3+ year mark, our patients who received ACell for hair regeneration have not reported growth and we had seen all of them at the 6th month and 12 month point in time. If you read the ACell update from ISHRS Alaska 2011 conference, it would seem the ACell cloning was only hype.

(2) ACell to promote wound healing and less scar formation. This involves ACell that is incorporated into the strip donor wound.

At this time, at about the 3+ year mark, some patients have reported less pain after the surgery and a better looking scar (those who have had more than one surgery to compare their own experiences). But the overall width (size) of the scar is not any better (smaller). In other words the scar may NOT be smaller, but they are less pink and seemed to heal faster.

In summary we have spent thousands of dollars applying for the IRB permission as well as materials cost as well as staff hours for not so stellar results. More importantly it is regrettable to those patients who have participated in hopes of unlimited hair to only receive nothing from their effort. ACell may have some place in wound healing and we still offer this option to our patients at no cost.

To be clear: ACell does not grow hair. ACell does not make the scar smaller. Acell may heal the wound better but there is no clear proof of this. This observation is merely subjective.