Author: Dr. William Rassman

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I’m Wondering if the Humidity Here Has Made My Finasteride Less Effective? – Hair Loss Information – Balding Blog

Hi Dr. Rassman;

Thank you for this blog and the excellent information you and your team provide. I have one quick question – does the temperature at which Finasteride is stored change its effectiveness?

I’m a 23 year old male, and I’ve been taking 1mg Finasteride for 2 years and 9 months (when I first noticed my hairloss), and my hairline has remained fairly stable until recently. But over the last few months I’ve noticed it move noticeably from about Norwood II to Norwood III, and my upper scalp has begun to thin. I assume this is the result of my genetics gradually beating out the drug’s effects. But as I’m a Peace Corps volunteer living in a southern, tropical country without access to air conditioning, I was wondering if the heat and humidity could have somehow broken down the Finasteride?

What do you recommend for storing Finasteride? Would it be better to store it in a refrigerator or to risk the sometimes 100+ degree heat? Or would you say that the temperature probably doesn’t make a difference, and that my genetics are slowly winning over the drug?

Thanks for your response!

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We are told not to let the medication heat up, and you should realize that humidity could negatively effect its potency. The balance between the drug and the normal course of the hair loss process is very difficult to analyze; however, effective drugs of all types do depend upon low humidity and no increase in temperature over 100 degrees F.

As for storing in it a refrigerator, I’ve answered that before here.

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In the News – Hair Science International Claims Hair Loss Cure, But Actually Just Selling Wigs – Hair Loss Information – Balding Blog

Snippet from the article:

A ”CUTTING EDGE” hair loss clinic that says it can cure baldness in fact hands out cheap wigs to cover bald spots. Hair Science International was fined $100,000 after Consumer Affairs Victoria exposed scores of false claims made by the Melbourne-based company that advertises to have “20 years in Hair-loss research across the globe”. The business even starred footballers Brent Guerra and David Hale on their website.

Consumer Affairs Victoria took the company, former director Steve Sindiris and ”senior hair loss specialist” Joseph Zwaigoft to Melbourne Magistrates’ Court after unhappy customers spoke out. Customers claimed they paid $6,000 to $8,000 for poor-quality hairpieces which were glued on to their head. Hairpieces also needed to be reattached every five to six weeks for an additional fee.

Consumer Affairs Victoria alleged that the company claimed it could grow hair on synthetic liquid skin and then attach this hair to the client’s scalp.

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Read the rest — Hair loss clinic fined over wig claims

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DHT and Genetics – Hair Loss Information – Balding Blog

If you say DHT is produced in all men, then how is it genetic? And why some get bald and some have a full head of hair even if they also produce DHT?

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Dihydrotestosterone (DHT) is produced by all men and women. Testosterone made in the bodies of men and women is metabolized by the liver, and DHT is a byproduct of this process. When a person inherits the genes for balding, this hormone causes the hair to be lost in a pattern that is genetically determined. There are a number of balding patterns that were charted, and Dr. O’Tar Norwood standardized these patterns found in men back in the 1970s.

The treatment for balding is to try to block the action of the DHT at the hair level. Fortunately, the hair follicle is very sensitive to this hormone, which is easily blocked. Propecia (finasteride 1mg) is not a complete block of the actions of DHT on the hair follicle, but about 70% of it is blocked and this reduces the impact of the DHT on the balding process.

So everyone makes DHT, but only the genetic markers in some people will result in the DHT causing hair loss.

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I Was Born with an Undescended Testicle – Is That Why I Have Diffuse Hair Loss? – Hair Loss Information – Balding Blog

I believe I am suffering from diffuse patterned alopecia aka DPA. I was born with an undescended testicle causing a hormonal imbalance in my body. I am now 24 and have been experiencing diffusing hair loss for over 5 years. Ive been scared to take the next step and obtain treatment until now.

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There is no connection between the testicle that did not descend and your hair loss. I hope you had the testicle addressed by now with a good doctor, as these testicles that are kept in the abdomen have a higher risk of testicular cancer.

The hair loss sounds like it’s probably typical genetic male pattern balding, for which you should be evaluated by a competent doctor.

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I Went Off Propecia After 14 years and Lost My Hair! – Hair Loss Information – Balding Blog

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?

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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.

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Hair Loss InformationDoctors Promising Unattainable Hair Transplant Results – Hair Loss Information – Balding Blog

Norwood 7We just spoke with a patient who had a full Norwood class 7 balding pattern with an approximate 2 1/2 inch height to the posterior rim. His donor density was very low from the pictures he sent prior to our phone consultation.

He had been making rounds with various doctors showing his picture and wanting a full head of hair. One doctor he spoke with quoted a certain dollar figure and told him that he could get a full head of hair from transplantation. I think he wanted to believe what he was told by this other doctor, and he was basically price checking with us. We told him that what he wanted was impossible, though. His goal was unrealistic and another doctor was about to take advantage of him.

Again and again, I hear of promises about bringing back hair from a hair transplant with goals that are not possible to attain. The promises from doctors who need the income seem to never stop. So as we always say — “Let the Buyer Beware”.

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Hair Loss InformationPeyronie’s Disease, a Deformity of the Penis – Hair Loss Information – Balding Blog

I found out that I have Peyronie’s disease and have been taking Propecia for some time. Is there any connection (cause and effect)?

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I looked it up. One site said that Peyronie’s was reported in 6 of 4,700 patients on finasteride, which would be an incidence of 0.13% of this population. In the general population (even in those that do not take Propecia), the incidence is between 0.5 – 13%, and varies with age. That would suggest that Propecia is not a cause of this disease and perhaps (long shot) with its lower incidence with people on finasteride it even has some protective properties.

We’ve written about this before, but the connection is still unknown.

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Hair Loss InformationIn the News – Some Men Would Give Up a Year of Life for a Full Head of Hair – Hair Loss Information – Balding Blog

Snippet from the article:

A third of men suffering hair loss claimed it affected their confidence, a survey revealed. And nearly four in 10 admitted feeling envious when they saw a stranger with a full head of hair. One in seven said hair loss affected a relationship – and just over three per cent claimed they temporarily lost their sanity.

When asked what they would swap for a full head of hair, one in 10 men said they would give up a year of their life and a quarter were willing to waive a pay rise.

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Read the rest — We’d give up a year of life to have hair, say 1 in 10 baldies

This comes on the heels of a separate survey of women that showed 16% would trade a year of life for a perfect body.

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Hair Loss InformationLots of Questions About PRP (Platelet Rich Plasma) and ACell Use – Hair Loss Information – Balding Blog

I am quite interested and for many years now have been following and consulting with numerous HT doctors around the world regarding their results of using injectable hair stimulation PRP (+/- ACell) for treatment of MPB as stand-alone non-surgical treatment. HT surgery is something I am not interested at this time due to myriad of factors (e.g., DNA genetic programming resulting in possible future progressive hair loss and miniaturization of existing hairs, accelerated loss of native hairs due to the trauma of surgery, depletion of donor hair, multiple transplant procedures / sessions over my lifetime, not every person knows if they will achieve 100% satisfied result, picking right doctor is not easy as HT doctors have varying egos/costs/skills/artistry/ethics, etc). So for now I am content with only non-surgical methods and not HT surgery.

Obviously, I am not a doctor, and just another 55 year old male suffering from MPB thinning and receding hairline….but from all these years this is the information I have been able to glean regarding PRP (+/- ACell) treatment for MPB without HT surgery:

• Currently there are no scientific studies to indicate PRP (+/- ACell) works to regrow hair. There are positive anecdotal results with some enthusiastic and cutting edge HT doctors (e.g., Dr. Jerry Cooley and Dr. Gary Hitzig) but nobody can tell me what success percentage I will achieve, and will it be significant or not. Unfortunately, there is no established, standardized, or proven protocol that has been shown to be superior to any other delivery method….and each doctor is trying something different on their own through a trial-error effort to get to the point where a proven protocol will provide consistent results.

• Some HT doctors are spinning their own PRP with cheaper equipment and injecting what they claim are optimal platelet concentrates at < 5x platelet concentrates….on the other hand there’s Dr. Cooley who claims optimal results using 5x or > platelet concentrates via the ANGEL system….and some HT doctors are now copying Dr. Cooley’s protocol after networking and sharing his notes @ various ISHRS meetings and conferences. Bottom line, it appears HT doctors are injecting differing platelet concentrate amounts in their practices depending on results….which again shows there is no established, standardized, or proven protocol for PRP (+/- ACell) hair injections.

• With HT surgery, as it is with PRP (+/- ACell) treatment by itself without HT surgery, it appears individual DNA genetic programming plays key role in determining overall treatment outcomes/success for each individual….and the ideal platelet concentration amount of PRP injected appears to have profound impact regarding how patients respond and their results….and presence of different cell types and growth factors also impact final results.

• Appears there is limited evidence to suggest lasting benefit with injection of PRP (+/- ACell) or growth factors, although there may be thickening of native hair follicles. It is unclear how long the benefits of treatment last and if the benefit will continue through subsequent hair growth cycles. However, all HT doctors agree on several factors regarding duration of treatment benefits: 1) underlying genetic balding pattern (e.g., PRP will last for a shorter time period for those who are DNA genetically prone to bald faster); AND 2) other maintenance treatments the patient is using (e.g., Propecia, Rogaine, LLLT or LaserCap, other topicals).

• Appears for many HT doctors/Dermatologists/Cosmetic Surgeons/Estheticians….especially in the United States….they charge excessive amount for PRP (+/- ACell) injections because they view as easy revenue steaming source due to desperation and gullibility of people with MPB issues buying into the HYPE for the next BIG THING or BALDNESS CURE….which it’s not.

With that in mind, I do have specific questions regarding personally using PRP (+/- ACell) for MPB without HT surgery. These questions may seem anal and more detailed than normal, but I have to ask because of the personal costs involved, and the fact there are still no established, standardized, or proven protocols to date for PRP (+/- ACell) hair injections for MPB without HT surgery .

• What specific protocols are you using that provide consistent results for PRP (+/- ACell) for MPB patients (without HT surgery)? Where did you receive and why did you determine to use these specific protocols?

• What centrifugal equipment are you using for PRP platelet concentrations? What PRP platelet concentration levels are you getting? What amount of PRP (+/- ACell) injections for individual patients? And how do you determine concentration level amounts of PRP (+/- ACell) injections for individual patients?

• How much do you charge for PRP (+/- ACell) injections?

• How many PRP (+/- ACell) injections per year do you recommend someone getting? Is PRP (+/- ACell) injections perfectly safe over the long haul many years from now due to stimulating cell growth? Obviously, cancers are concern for everyone and nobody wants to wake up or stimulate genetically predisposed cancer cells, etc.

• How many PRP (+/- ACell) injections for MPB (without HT surgery) have you performed to date? How long have you been performing these PRP (+/- ACell) injections in your practice?

• What is the success percentage of total PRP (+/- ACell) injection patients for MPB (without HT surgery) that actually grow more hair and increase diameter size of existing miniaturized native hairs? From these successful injections, can you measure or visually see the significant or appreciable percentage difference in overall hair growth and appearance for your patients? (e/g., 25% better stronger looking hair?/50% better stronger looking hair?/75% better stronger looking hair, etc)?

• Do you have portfolio of these patients before/after photos that I can see on-line? Even better if possible, can I contact these patients myself either via email or telephone to ask their overall impressions regarding their results?

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The above text was written to my private email and is a good overview of the PRP topic, so I have included it in our blog.

I do not engage in using PRP and ACell for hair growth or in hair transplantation. We do use on occasion ACell with the patients permission for donor wound healing, but we do not charge the patient any money for this. We absorb the few hundred dollars for the ACell since we cannot positively claim its benefit. Once I see value, clinical proof, and scientific proof, I can change my mind about the offering.

I don’t believe that these treatments are anything more than human experimentation for profit, or just a profitable venture. Desperate people will spend lots of money chasing the pot of gold under a distant rainbow.

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Hair Loss InformationMedium vs Medium Coarse Hair – Hair Loss Information – Balding Blog

Dear Docs,

is there any way to determine one’s hair shaft thickness (whether coarse or medium etc) without microscopic measurements? Some websites suggest that coarse hair needs more time to dry than normal, others claim that fine hair reflects more light and can’t be felt between thumb and index finger. Are these statements true? Sometimes I realize that even in my donor some hairs vary in colour and thickness, cant remember if this has always been the case. On top of that, whats the difference between medium and medium coarse?

Thanks

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I suppose you can use a micrometer and caliper to measure the shaft diameter, but I wonder how this information will be helpful to you? If you have fine, medium, or coarse hair, that is just who you are. Hair can vary in thickness depending on what stage of the growth cycle they are in.

As for defining medium and medium coarse, it sounds pretty self-explanatory to me. Medium hair thickness is the middle of the spectrum, and medium coarse would be just between medium and coarse.