Author: Dr. William Rassman

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Hair Loss InformationDo I Need to Apply Minoxidil to Every Single Thinning Spot? – Hair Loss Information – Balding Blog

Hey doctor,

I have been using propecia and minoxidil for nearly 10 months now and seen almost excellent results on the hairline but not on the crown (I know it is supposed to be vice-versa). I have two questions for you:

1. Because my hair is somewhat long, I use a dropper to apply minoxidil. Do I need to apply minoxidil on every single thinning spot (massage my scalp to distribute the medicine) or does it get absorbed on a wider area? For example, if I miss the thinning spot by half an inch, will I still benefit from the drug?

2. I have used this treatment called the Nanogen Serum VEGF. However after around 9-10 months of using it I thought it didn’t have any effect at all and quit. I have seen light shedding after quitting the medicine but so far it is acceptable. My question is, they published some sort of trial results regarding their product. I couldn’t make a lot of sense and therefore wanted to ask you before being skeptical about it. Here is the link to the study.

Thanks in advance!

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1. First and foremost, you should read any instructions that came with the product. Many minoxidil packages come with some “how to” info. What you usually would do is apply topical minoxidil (Rogaine) to the areas you want to grow hair. If you put it on point A, you probably will not see growth on point B.

2. As with all products that claim to grow hair, my mantra has always been “Buyer Beware!” If you tried a product and it didn’t work, what makes you think a fancy study or a website will make a difference? It just means they used the money that they’ve made for better a marketing presentation.

As for that Nanogen study you linked to, it’s not published in a peer-reviewed medical journal and looks to be just a small test of hairs in petri dishes that sat in different solutions. There’s nothing in the study that shows the product is safe or effective.

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Hair Loss InformationNot Hair Loss News – Early Prostate Cancer Surgery Helps Men Live Longer – Hair Loss Information – Balding Blog

Snippet from the article:

Men with early-stage prostate cancer who had their prostates surgically removed were significantly more likely to be alive nearly two decades later than men who went without surgery and were monitored through so-called “watchful waiting,” the latest findings from a long-running Swedish study show.

The 700-patient study, which found similar results at earlier stages, is likely to heighten debate about the value of surgery versus observation or watchful waiting, which generally involves no immediate treatment. In recent years, doctors increasingly have embraced watchful waiting, in part because other large studies have shown that surgery provides no benefit yet has potentially undesirable side effects.

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Read the rest — Study: Prostate Surgery Helps Some Men Live Longer

The article points out that “benefits of surgery were most pronounced in men who were under 65 when diagnosed,” though there was no significant death reduction rates in men 65 years or older.

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Hair Loss InformationIf You Take Finasteride, Does It Let You Go Up One Norwood Class Each Decade? – Hair Loss Information – Balding Blog

I hope this is not a stupid question. I know in a perfect world no man would ever go bald and we would all have perfect hair. But, since its not the case and I know most men have some degree of hair loss as they age.

My question is regarding men who started balding when they were 18, but with the aide of finasteride it has been a really really slow balding process. Do you usually notice that these men, once they are in their 30’s, they are a norwood 2-2a and then when they are in theirs 40’s they are a norwood 3-3a and then in their 50’s they are a 5-5a and then 60’s either a 6 or 7?

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It’s not a stupid question, but I think you’re confused about what the Norwood classifications are for. The Norwood chart (see below) classifies the final patterns of balding. By final, it generally means that there is no going back. Of interest, the patients with the most advanced pattern of balding (class 7) usually get there in their 20s and rarely show up becoming a Class 7 at the age of 60. Norwood classes are not a guideline for balding by age or decade.

Finasteride can slow the balding process and in very young men without advanced balding, it may reverse crown loss and occasionally even frontal loss (as it did in my son). The projections you did in your question is the work of a dreamer.

Norwood chart

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Hair Loss InformationI Switched to Rogaine Foam After Using the Liquid for a Decade, But Now I Get Dizzy – Hair Loss Information – Balding Blog

Hello Doc,
This is great blog you have here.

Ive used Rogaine for over 10 years (since I was 22) to treat my balding hair. I’m mostly losing my hair at the crown. I really don’t know if its done any good but since most of the men in my family are really really bald, I think my hair isnt that bad.

Anyways in the last year I began using Rogaine Foam. I started to notice a slight shortness of breath and dizziness. I discontinued use and felt fine again. Ive been thinking of going back to the liquid rogaine. Any reason why the foam would have this effect but not the liquid? Or after 10 years why I would suddenly have this reaction to minoxidil?

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You should go get a physical exam by your primary care doctor. It may not be as simple as a reaction to minoxidil. After all the other medical issues have been explored, it may be that your absorption of the Rogaine Foam is higher than with the liquid. One of the side effects of Rogaine is a drop in blood pressure and that can cause dizziness.

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Could Anxiety and Diet Cause Diffuse Thinning All Over My Scalp? – Hair Loss Information – Balding Blog

Hi Doc,
19 male… I recently went to a hair loss specialist to get examined for what I consider DUPA-like symptoms. She looked at me and assumed that my diffuse hair loss of miniaturized hairs all over my head was simply caused by my severe anxiety and poor diet. While it is true that I have had horrible anxiety for a very long time and eat like a pigeon, it seems farfetched to me that anxiety and diet could lead to miniaturized hairs falling out everywhere, even in the permanent zone. Can I trust her, or should I seek out another specialist?

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You always have the option of getting a second opinion if you don’t trust your doctor’s opinion. I have not seen a case of diffuse unpatterened alopecia (DUPA) caused by anxiety and diet.

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My Voice Pitch and Body Hair Make Me Assume I Have Low Testosterone, So Should I Have Less DHT? – Hair Loss Information – Balding Blog

I think I am losing my hair, but don’t know why. The only reason that would lead me to believe that I have male pattern baldness caused by genetics is the fact that my dad is indeed bald. I have read that MPB is triggered by DHT production..which the amount of it is determined by your testosterone in your system. I myself do not believe that I have very much testosterone, just based like body hair and the pitch of my voice. Does the amount of testosterone one has determine the amount of DHT they have??? Is this so??

I am also not losing my hair in any one area of my scalp, such as hairline or crown of head…it just seems to have thinned itself out all over. I am hoping I am experiencing just hair loss due to changes, not genetics.

Is there a blood test or hair strand test that can be taken to determine the amount of DHT present in ones system…and the medicine one would take to block this production..is it possible to regain hair with this??

How does one officially positively determine what type of hair loss they suffer from?

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Yes, the amount of DHT reflects the amount of testosterone you have, however the impact of the DHT on hair loss is not proportional to its quantity. Testosterone and DHT can be measured in a commercial clinical lab, but the significance of the lab values as it relates to hair loss does not correlate. Thus, we do not recommend having lab tests done for treating hair loss.

If you think that you are thinning, you should see a doctor for a comprehensive exam. Some objective tests would include having a microscopic exam at different areas of your scalp (miniaturization study), and even having your hair bulk measured. These tests then should be repeated in a year to compare the results.

That said, considering your family history of male pattern baldness, chances are good that your hair loss is due to genetics. If you’re in the early stages of hair loss, a pattern may begin to emerge soon. Medication like Propecia (finasteride) might be able to halt the loss and possibly regrow some hair, but you’ll need to talk to your doctor about that.

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Hair Loss InformationDoes Omega-3 Cause Hair Growth or Hair Loss? I’ve Read Different Things… – Hair Loss Information – Balding Blog

(female)
I have been losing my hair for about 8 years. I been told all kinds of things like telogen effluvium and anemia due to fibroids. I was told that a hysterectomy would reverse the condition. It did not and its been 18 months.

I just started taking Omega 3’s 1000mg for hair growth, now I read that it causes hair loss. I have been so depressed from this. I had such beautiful thick hair. Is is true that Omega 3 will make my hair loss worse? I have about 1/2 of my hair left.

Thank You

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Fish oilAll women with hair loss need to be checked out by their doctor for hormone imbalances and other conditions that can cause hair loss. Telogen effluvium is a temporary loss, but it’s possible that a hysterectomy could contribute more loss due to the surgical stress.

As for Omega-3 pills, I’ve written before that I don’t think it has anything to do with hair loss, but I don’t know of any good scientific study that discusses possible Omega-3’s role in hair growth or loss.

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FUE in the UK? – Hair Loss Information – Balding Blog

Hello,

i am thinking of having the fue procedure in the uk and would like to know which is the best surgeon to see. Trying to avoid surgeons that have a high rate of fue failure due lack of skill.

many thanks in advance for your help.

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You’ll have to do your own research to be sure you’re getting exactly what you want and to be assured that you found a doctor you can trust, but Dr Bessam Farjo is a good place to start (offices in London and Manchester). You can also use our handy guide to selecting a hair transplant surgeon — here.

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Hair Loss InformationIs the Alcohol in Rogaine Causing My Irritation? – Hair Loss Information – Balding Blog

Dear Mr. Rassman,

Thank you for all the help you are providing the public. I am 23 years old and suffering from thinning hair. Unfortunately, we have limited options in Dubai. We have only one product of minoxidil 5% which is regaine, however, I develop scalp irritation from using it. A dermatologist asked me to try ordering rogaine foam from the US. He believes that the irritation was caused because regaine 5% is an alcoholic solution.

1) Do you think rogaine foam does not have alcohol? If yes, can you recommend any other product that contains minoxidil 5% but is not an alcoholic solution. Minoxidil is my only option and it is very important for me to find a way to avoid irritation.

2) I used the total daily dosage of regaine 5% at once a day, not twice as recommended. Do you think that is the reason for irritation?

3) I want to study whether regaine is effective with a microscope and taking pictures. How can I be sure that I am comparing the same spot with the same amount of zoom. For example, I zoomed a little and found 10 hairs in area A in the first month. I am worried that I might zoom less and find 12 hair counts after six months. Moreover, I might take a snap of another spot (beside the original one) in area A.

Thank you very much in advance.

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Rogaine Foam1. Rogaine Foam does contain alcohol, but it is the propylene glycol that is generally what causes skin irritation in some people. Rogaine Foam doesn’t contain propylene glycol. If it is the alcohol that’s causing your irritation, unfortunately I’m not aware of any particular minoxidil currently sold with zero alcohol content. I have no way to know exactly what is causing your skin irritation, though.

2. Using it only once a day might just not be as effective as the recommended twice daily application, but I doubt the lesser dosage is what is causing your irritation. The irritation is probably from the propylene glycol in the Rogaine liquid, or perhaps an allergy to one of the other ingredients.

3. I suppose you could have a permanent dot the size of a pen mark tattooed on your scalp to be sure you have the exact spot monitored each time, but I think that’s a little overkill. The better way to go about this is to have a professional check the overall hair bulk using the HairCheck instrument, then recheck it again in a year to see if the numbers changed (increased bulk means you’re having more hair growth).

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Hair Loss InformationHow Would You Inform People About New Hair Loss Treatments? – Hair Loss Information – Balding Blog

Dear Dr.,

If a new product came to market that was substantially better/more effective than propecia and rogaine for treating hair loss, how would you go about informing people of it through your blog and practice?

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I’d just simply tell them and post on the blog. I don’t hide new treatments that are proven safe and effective, but I am not going to promote the iffy ones that make unproven claims. We write about pretty much everything on here.