Author: Dr. William Rassman

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I Was Diagnosed with PCOS Six Years Ago and I’m Losing My Hair!

I am 23 years old. I was diagnosed with PCOS when I was 17 and was placed on birth control pills. I started to take them regularly, but they started making me sick, so I quit taking them and didnt take them for several years. Just recently I went back the the practitioner who diagnosed me with this and she placed me on a slow-release iron tablet daily along with a new birth control that has iron in it.

I have started losing hair around the middle-back of my head mainly around the crown area. It looks like my part is getting a lot wider, and the part is spreading down to the back of my head. I used to have really thick curly hair but now it is getting thin around the top, and in some patchy areas.

At first, since I am a Registered Nurse, I thought stress was causing it. The last time I went to the doc, she said I was anemic with low iron levels, hence putting me in daily iron, so I thought my anemia was causing it. I’ve been on and off birth control, so I thought that could be another cause.

Am I too young to use a topical treatment such as Rogaine? or Sephren? Sephren is an oral and topical treatment for hair loss in women. What do you recommend? I feel like I am losing more and more hair by the day and it really stabs a knife into my self image and self confidence. I’m desperate for some answers. I wish someone would lead me in the right direction so I can start growing hair in those thinning spots. I don’t want to be bald by the time I’m 30. PLEASE HELP!!

Polycystic ovary syndrome (PCOS) causes hair loss in women who can also inherit the genes for balding/thinning. It is a very difficult condition to treat, as the treatment is often unsuccessful. Since you’re already under the care of a doctor, I’m not sure what I can offer. You need a good doctor/patient relationship.

Hormone therapy might help with the PCOS-related hair loss, though since you mentioned stress and anemia, those are other potential reasons for your thinning hair. I just have no way to know what is causing your loss, or whether it is a combination of things. You aren’t too young for minoxidil (also known as Rogaine, which is FDA approved to treat female hair loss), but the oral Sephren is just a vitamin supplement with no peer-reviewed published clinical evidence that it works.

There is a new cosmetic treatment that we’ve mentioned here called Scalp MicroPigmentation (SMP) which we offer to address the thinning problem in many women. One such patient can be found here.

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I was Norwood Class I and Took Propecia for 8 Years. Can I Stop Taking it To Have A Baby?

Hi Dr – Firstly just wanted to say thank you for the wonderful work you are doing on this site!

I took Propecia 1mg for 8 years, but a couple of years ago I noticed I was losing ground (NW1 – NW3). I increased my Propecia dosage to 2mg and have been taking this for the past 2 years and experienced no side effects.

I am 34 years old now and thinking of starting a family. My question is: Is it safe to be on 2mg Propecia a day and trying for a baby? If I completely stopped Propecia now, how long will it take for the drug to be completely out of my system? I really worry that, so much Finasteride will pose a risk to my unborn child? I will be discussing this with my doctor, but you are a specialist in this field and would really appreciate some advice.

First and foremost, please follow up with your doctor and address your question to him/her.

I have some issues with your history and you need to follow your doctors recommendation. If you are a Norwood 1 or even 3, I question if you should have been on Propecia. Propecia does not work to prevent a mature hairline from forming. Propecia is meant for the frontal area, the top and the crown areas. It is sometimes taken in hopes that it will help with the frontal corners but that decision is up to you and your doctor. At least you didn’t have any side effects and you seem to have done well. Another issue is that higher dose of Propecia doesn’t really work any better than the 1mg dose.

Finally, Propecia does not affect conceiving or having a baby. There is no evidence of this. For those who are still worried about it, Propecia has a half life of about 4 hours in the blood stream. This means almost all the medication will be out of your blood stream in 1 day. With respect to tissue fixation and possible traces left in your body it can take between 1 to 2 weeks. Considering the thousands of men who may have fathered children while on the drug, to my knowledge there has been no medical issues or legal issues.

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I Was Prescribed Propecia After the Doctor Just Glanced At My Head

I am a bit of a hypochondriac, I admit it, and every once in a while I really fear losing my hair. I am a 26 year old male and haven’t experienced shedding, hair in the drain, etc, but I recently looked in the mirror and worried that more scalp may be showing than before. Of course this could be my imagination, because I don’t look at the back of my head very often. No history of hair loss on my father’s side. On my mother side, I have one cousin with hair loss, but neither his father (my uncle) nor my grandfather had hair loss. I have always had very thin/fine hair.

I recently went to a dermatologist, who after looking at my hair for about a half a second, said I had early signs of MPB and prescribed me propecia. He didn’t ask about my history or symptoms at all.

I don’t want to take the propecia unless I am certain that I am losing my hair. I’m not convinced that I am, but I also don’t want to delude myself either. I was wondering what advice you could give me. I am sending a couple pictures, if that can help you give me a recommendation. Many thanks.

I discuss all of the time that the diagnosis is made in the early stages before hair loss is evident by mapping out the scalp hair for miniaturization and establishing a metric for it. If you don’t do it this way, then the next step is recession and frank balding, not something you want to find all of a sudden. The early miniaturization will show the beginning process very clearly so that if you take appropriate medications, you might stem the problem before it gets to frank balding. If you do not have miniaturization, then you probably do not have early balding and do not need medications. A simple glance of the head is not going to cut it for a case like yours.


2008-04-18 16:35:40I Was Prescribed Propecia After the Doctor Just Glanced At My Head

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I Was Prescribed Beclomethasone Dipropionate

I had gone to dermatologist for the hairloss problem. He prescribed Finasteride along with Beclomethasone Dipropionate lotion. I want to know how does this Beclomethasone lotion function. Any side effects of it and for how long it has to be taken ?

Finasteride 1mg is for traeting androgenic alopecia (genetic hair loss in men). Beclometasone dipropionate is a corticosteroid that is used to treat skin disorders, like eczema or psoriasis… and is not usually used for treating androgenic alopecia. Do you have a skin disease?

Perhaps you should ask your doctor, since he/she is the one that prescribed it to you. I can’t give you advice on how much or how long to use a prescription medication, as I didn’t prescribe it and I don’t know what you’re treating.

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I Was Told to Oil My Scalp Despite Already It Already Being Greasy

I am a 30 year old male with some hair loss problems. I have been suffering from seborrheic dermatitis for about 2 years. My scalp is naturally quite oily due to this problem. I recently went to a trichologist and he suggested that oiling scalp is a must, no matter how oily the scalp is. My questions are

1. Is it good for me to oil my hair despite greasy scalp? Would it not aggravate seborrheic dermatitis?
2. Trichologist recommends washing scalp daily with a shampoo containing saw palmetto extracts. Do you recommend daily washing?
3. Can I resort to options like Finasteride? Minoxidil again would probably aggravate seborrheic dermatitis?

Thank you ..

I think that the trichologist should be the one to speak with for questions #1 and #2. I don’t know why those recommendations were made. Finasteride and/or minoxidil will not help your seborrheic dermatitis.

If you have hair loss issues and want and medical treatment or assessment, you should see a physician. From a medical point of view, oily hair or scalp does not cause genetic balding and shampoos (even with saw palmetto) do not treat genetic balding.

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I was told not to do a hair transplant!

I was told that I haven’t lost enough hair to fill in the highlighted areas where I’ve been balding (see outline of my thinning). Do I need to loose more hair to become a better candidate? I consulted two clinics about the number of grafts for my hairline. One said 2000 the other said 2500-2800. Above 2000 seems like too much to me, but I’m not sure. Any feedback is appreciated.

Why undergo a hair transplant if you don’t need it? Hair transplants accelerate balding, especially in younger men. You would likely lose much of the hair presently on your head if there is significant miniaturization present, so maybe a transplant would be switching from what you have to transplanted hair with marginal gain other than the surgeon making money at your expense. There are great medical treatments for your hair if you think you are thinning. Get a doctor that knows how to treat you medically.

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I Was Told To Put Vaseline on My Transplanted Grafts

I am a 33 year old female and just had a hair transplant 3 days ago. I was told that I had to put vaseline on the grafts and on the donor site twice a day for about a week. This keeps my whole head really greasy and I can’t go out without a bandana or hat on. I washed my hair with shampoo (very lighly where the grafts are) but it seems that it doesn’t get clean. Is this really necessary? How can I get the vaseline off my hair? If I could have clean hair, I would be able to go out and it would “hide” my transplant but I feel like the vaseline just plasters my hair to my scalp and the “wet” look really makes the transplant stand out. What would you recommend?

I never use or recommend Vasoline, because it is difficult to manage and remove. The general purpose of the Vasoline is to keep the grafts moist to prevent crusting, but I generally believe that it is best to take off the crusts by a good washing technique before they form and get fixed in place. It is impossible for me to get to you in a timely manner and it would be inappropriate for me to give you advice on a piece-meal basis without a doctor/patient relationship established and the internet is not the place for this activity. As you have a doctor, best to follow his recommended course. You might ask him why he does what he does so that you can understand his/her thought process.


2006-04-08 15:41:10I Was Told To Put Vaseline on My Transplanted Grafts

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I Was Responding to Finasteride, But I See More Loss Lately — Should I Switch to Dutasteride?

Dr. Rassman and co,

Thank you so much for this blog, it is a great source of information and truth.

My question to you: I am a very good responder to finasteride, have been on it since 2010. I have recently been losing more and more hair especially from my temples and hairline. Would you think or recommend that i switch to dutasteride?

Also i added Rogaine foam since 2012 and have noticed only slight results and maybe even some accelerated losses from the hairline and temples.

Thank you

The decision to switch to dutasteride is one that should be made between you and your prescribing doctor. I rarely prescribe dutasteride, however, when I do prescribe it, I usually require the patient to have had a course of finasteride first. I would allow a switch to dutasteride only on a case-by-case basis, so I can’t recommend it for you (especially because you’re not my patient and I don’t have your medical or hair loss history).

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I Went Off Propecia After 14 years and Lost My Hair!

I started taking Propecia when the drug first hit the market. There was some early hairloss when I started the medication. I stayed on it faithfully for about 14 years and last year I decided I did not need it anymore and would try to be off of it. I had no side effects, but I wanted to be free of taking drugs. About 1 month later, the hair loss started and got really bad by the third month. I am not sure why I did not go back on the medication, but I was scared. My hair loss was worse than when I started on the drug.

After almost a year I made the decision to go back on the drug and saw the hair loss stop again and some hair started to grow back. Will I get it all back?

As you were off the drug for almost a year, I would not be surprised to see little regrowth. Only time will tell, and this time stay on the drug as it is a lifetime commitment.