Author: Dr. William Rassman

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Adding Avodart Once a Week to My Daily Propecia?

Doctor Rassman, I am sure you get this questioned asked alot, but in your opinion as a hair restoration expert, do you think by adding 0.5 mg avodart once a week to a every 1 mg propecia regimen can make a difference in loss of hair or even gain?

There was a study of a an individual who took one avodart pill once a week to a propecia everyday regimen and he saw substantial growth. The study was only on one person, but its not a conicidence that it happened when he added the low dose of avodart once a week? or do you think avodart and finasteride at the end of the day still produce the same outcome? I know at the 2.5mg it produces the best results, put more of a high side affect profile, and very expensive.

Both Avodart (dutasteride) and Propecia (finasteride) work in a similar mechanism by blocking the formation of DHT, but I have often stated that treating androgenic alopecia is not only about blocking DHT. I do not believe if you block DHT 100% you will stop or reverse the balding process.

I’m not sure which study you’re referring to, but if it was an anecdotal report on ONE patient, it isn’t something I would put a lot of stock into. Please note that just because there is study results available, it doesn’t necessarily make it the golden truth. Now with that said, many doctors believe Avodart is a better medication for stopping hair loss than Propecia, but I am concerned about sexual side effects and the few reports of sterility that came from Avodart.

A few patients that I treated with Avodart did get a response after Propecia stopped working as well for them. That is as much as I know. I couldn’t tell you if adding a single Avodart dose per week will make a difference, though.

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Advanced balding reversed (photos)

I’m 25 years old. I was starting to lose my hair when I was 16. It was very rapid process so when I was 20 my situation is almost NW7. 132 days ago I decided to take this regime ( I don’t want to mention about decision phase)

first 120 day, I started with the big 3 + dermaroller 0.5 mm x1week (dut(0.5) once everyday+ minox %5 twice everyday + nizoral 2-3 times per week with no side effects) biotin(10000) + zinc(50) + d3(5000) + collagen peptides(tablet) + omega3(with fish oil) all of them x1 everyday ogx biotin shampoo

Everything was good for me. It was like a miracle you know. My hair like born again. My head was full of baby hair and they were getting stronger day by day (or its just it seemed to me like that) On day 118, I just noticed to shedding, probably it has began before that then I shaved my head to zero guard. In this 14 days I shed like crazy. It’s like the first day when I was start this, I read something about shedding but I’m still worried about that this will be failure for me. So I bought something and added my regime. It’s been 2 days since I started using. Apple cyder vinegar tablets(750mg) x1 everyday, l-cysteine (500mg) x1 everyday, vitamin A (25000iu) x1 everyday, iron (65mg + 325mg fer.) x1 everyday, Ubiquinol (100mg) x1 everyday, Collagen peptides powder 15g with cold water everyday, dermaroller upper to 1.5 mm x1 week, Castor oil x3 days of week with massage 2 hours waiting, hyaluronic acid after dermaroller

I uploaded every angle and lights position of my head with day numbers. https://imgur.com/gallery/E0KiyIz. So I just need your help. What should I do? Should I continue or It was just a good short dream that end with failure? If I will continue, what would you suggest me to add?

Amazing results in just 80 days. It seems to be working. I would love to see better focused photographs. My recommendation is stick to it.


2020-06-12 09:38:03Advanced balding reversed (photos)

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African American Hair Expert

I’m an African American female and want to know which is better for my hair, pressing with a hot comb or using a non lye relaxer (like Precise). Also, I have hair loss and hair is very thin. I had a hair restoration in June 2005 by Bosley. Can you please recommend things I can do to improve my hair? Do you consider yourself an expert in dealing with African American hair?

I believe that I was the first person to place follicular units into an African American and started the trend that allowed for the use of small grafts in African hair types. As you may know, hair transplantation is a ‘peg in a hole’ surgery, but African hair is curly (like a cork screw) and therefore placing it into a round hole can be a difficult challenge to the inexperienced hair transplant surgeon. I guess that would make me an expert for transplants into African American hair types.

With regard to your other question, I am not an expert in the best ways to ‘relax’ hair, but I see problems with those individuals who have this done improperly. I am an expert in the complications of such treatments. I would have to examine you to make any recommendations.


2006-01-16 10:00:14African American Hair Expert

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Aderans Research Institute’s Presentation from Stem Cell Meeting on the Mesa

hello dr
what do you think about this video: YouTube

This is Aderans Research Institute’s presentation from Stem Cell Meeting on the Mesa (a stem cell conference) about a method of cellular hair regeneration that they’re calling Ji Gami. It was posted a few days ago, but the audio is extremely low and it is difficult to hear, so I’m not going to be able to comment on the actual content of the video. I’m just posting this for those that might have better speakers and some interest in their research.

I’ve embedded the video here:

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Added dermaroller to finasteride treatment (photo – from Reddit)

After years of using Finasteride + Minoxodil, my thinning got worse in January. So I added a dermaroller 1.5 mm every 7-10 days. Major progress in 6 months!

Nice improvement. There is no doubt that the use of a dermroller induces wound healing which brings on hair growth to those who recently lost the hair. Add that to the finasteride that held on to your hair, and you are a fortunate man.


2020-06-12 23:18:25Added dermaroller to finasteride treatment (photo – from Reddit)

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African American Female with Bald Crown

I am an african American female 35 years old. My entire crown is bald. What do I do now? I’ve been using 2% minoxidil and it continues to fall out.

You need to be seen for close examination of your hair and scalp. A diagnosis should be made. You could have a variety of non-genetic hair conditions causing it. You might have genetic female balding limited to the crown as well. I need to know the miniaturization mapping results of your scalp and the pattern of your hair loss before making any diagnosis and treatment plan. You need a good doctor to take charge of your hair loss.


2007-03-09 10:32:36African American Female with Bald Crown

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Advice from Someone That Has Had 9 Procedures

Dr. Rassman,

I’ve had lots of procedures done; I’ll say at least 9 since 1995. I’m 41 now. I know that’s a lot. I’ve had at least 4-5 done at one center, then about another 4 done at a well know hair transplant center here in DC. I’ve even had gaps of up to 4 years between procedures because of money issues. I’ve spent at least over $20,000.00 so far. I was never given a “Master Plan”. Every person only evaluated me, then asked, “How many are you looking to get right now?.” Me being new to transplant never really realized that once you start the process, you should, in my opinion, every year get as many grafts put in as you can afford. Well, I had really bad scarring in the back going across from one side to the other which was corrected a bit. My head of hair is not nearly as full as I would want it. Actually, right now it’s still very thin in spots here and there. Sometimes I’m just so depressed about it. Don’t make the mistake like I did. If you go for transplant procedure, get another job, work part time, anything to get that head full of hair. Too many procedures, cutting, stitching, etc. spells trouble. I know.

One of the groups did a great job of reducing my scarring in the back of my head. I was also told that in a couple of years ago that lab grown hair follicles will be available. Do you agree? I’m at that point where I feel this would be my last and only alternative.

You have a tragic story. You were not placed on this Earth to give doctors money every year to get hair moved and to manage scars on your head.

The only patients that have had over 4 procedures with me are those that were very, very bald (9,000+ grafts) or very, very obsessive (I fondly call them my ‘hair addicts’). Most people should be completed with 1-2 procedures. Informed consent requires doctors to tell you what is in store for you, what you can reasonably expect a hair transplant will do for you, and when it will be completed. That is the doctor’s moral and legal obligation and the fact that you did not have that happen, means that you must have been victimized from hopping around to different doctors. You should have held your original doctor accountable for finishing what he/she started (in a perfect world of course). I know, unfortunately, that many people who go to doctors that are not responsible or accountable are caught in a difficult position. My suggestion is that you consider going to a doctor who will give you the real scoop as to what, if anything, you can expect going forward. If you need repair work on the scar, that doctor should be able to let you know what is in store for you. As you are on the east coast, may I suggest seeing Dr. Robert Bernstein in New York. He and I literally wrote the book on repairs.

I want to also comment on your hope that soon, hair will be grown in a lab to solve the hair supply problem. I am sorry to burst your bubble, but I don’t believe that will happen in any reasonable timeframe to get you the extra hair you may need. Many doctors are promising lab grown hair in a few years, but the ignorance by these doctors seems pervasive on this subject. My opinion is that we will not see lab grown hair for more than a decade from now. So for the readers who are postponing decisions on hair transplants to wait for lab grown hair, you need to ask yourselves if you really want to wait until you are 70 years old to get the more youthful look.


2007-12-14 09:25:11Advice from Someone That Has Had 9 Procedures

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Adverse Event Reporting in Clinical Trials of Finasteride

A new meta-study finds the following:

“Of 34 clinical trials, none had adequate safety reporting, 19 were partially adequate, 12 were inadequate, and 3 reported no adverse events. Funnel plots were asymmetric with a bias toward lower odds ratio for sexual adverse effects, suggesting systematic under detection…”

From Wiki definition: A meta-analysis comprises statistical methods for contrasting and combining results from different studies in the hope of identifying patterns among study results, sources of disagreement among those results, or other interesting relationships that may come to light in the context of multiple studies.[1] Meta-analysis can be thought of as “conducting research about previous research.”

The report is interesting but a Meta Analysis is only as good as the clinical trials it is analyzing. All studies have its advantages and pitfalls. If adverse or sexual side effects were being examined, I question why other (much larger and comprehensive clinical trials) of finasteride 5mg was excluded.

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Adrenal Problems and Hair Loss?

Is there a correlation between adrenal fatigue/insufficiency and hair loss (in the form of total head miniaturization, but yet have no balding, no recession.) I have very low DHEA levels and high cortisol levels…. would chronic/high physiologic stress levels induce hair thinning/miniatuzization?

Yes, it is a possibility, as low adrenal function in such conditions as Addison’s disease affects about 1 in 100000 people. Hair loss throughout the body is a reported finding in this condition. I do not have experience with following people with this disease, as they are treated with appropriate hormone supplements. I have never seen a patient with Addison’s disease and studied the existence of miniaturization or a follow-up of this in a treated patient. Sorry that I can not shed more light on your question.


2006-10-26 12:05:04Adrenal Problems and Hair Loss?