Author: Dr. William Rassman

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Hair Loss InformationIs Taking Two Propecia Pills Dangerous? – Hair Loss Information – Balding Blog

Sometimes I take Propecia right when I wake up, other times I take it at the end of my morning routine (shower, shave, etc). There have been times where I might’ve taken two tablets in the same morning, since I had forgotten whether I took it already. That has made me wonder, is taking two tablets of Propecia in one day dangerous? I try not to do it on purpose, but I figured it was better to have two tablets than no tablet.

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Taking two Propecia (finasteride 1mg) tablets by mistake is not dangerous. Some men take five times the Propecia dose for prostate conditions (5mg finasteride is Proscar).

You should NOT be taking more on purpose, because it will not do much with respect to hair loss/growth. One Propecia taken daily is the recommended dose for the treatment of male pattern baldness. If you happen to take two by mistake, you’re not likely to see problems… but it should be noted that the more drug you take over the recommended does, the higher incidence of sexual and other side effects.

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Hair Loss InformationI Wore a Bandana for 2 Hours a Day and Now My Hair Is Thinner! – Hair Loss Information – Balding Blog

hello doctor,
i wore a bandana everyday for 2 hrs at the gym for about 3 months. i just was not comfortable wearing something so tight on my head so i stopped and haven’t worn it since. 6 months later i feel like i am loosing strands of my hair when i wash it and that my hair at the front of my head has gotten thinner than it used to be. is it possible that wearing a bandana for such a short period can result in hair damage?? If so, what can i do to fix this? thanks!

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Wearing bandanas or hats (even all day) does not cause male pattern baldness. Unless you are wearing something that is very tight so that it is constantly causing friction and traction to your hair, it would not matter. If the hair loss was caused by the tight pulling, we call it traction alopecia. In your case though, I would highly doubt that what you’re seeing is related to your limited bandana use.

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Hair Loss InformationI Haven’t Had Any Libido Effects, but I Think Finasteride Is Making Me Lethargic – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

Had yet another question about finasteride. I have been using it for a year now, and am quite sure have not progressed (with hairloss) any further, so it has worked quite well in that regard.

Question is this. In your practice have you heard or seen reports from patients who complained of severe tiredness, lethargy due to the use of this medication. Strange thing is that the horror stories they talk about in regards to libido etc. I have not experienced any of those in these 12 months (fingers crosses), in fact I feel I have a higher libido…its strange

The one side effect I feel I am noticing, is this nagging feeling of tiredness lethargy, and a blue sort of mood. I wouldnt say its depression its just an alteration of mood. Its quite annoying, and then you see these reports about suicidal ideation with finasterdie usage … worries me. Just dont know what to do, the pill is doing really good for my hair, but these side effects are quite annoying. Nothing sexual, thats all great, but just a strange nagging feeling of tiredness, lethargy and depressive moods. Comes and goes. And this doesnt seem to be in my head, since I am not going through something too major in my life, or a very stressful time.

Anyways I will definetely discuss this with my doctor, but just wanted to know what your opinion on the above matter is, and if in fact you hear such reports from your own patients…thanks in advance

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You have the right idea about discussing this with your doctor. There have been reports where patients (mostly from websites) refer to “fogginess” and symptoms like depression in people on finasteride. In my private practice over the last 10 years with thousands of patients on Propecia (finasteride), including myself and my son, the complaints of mood alteration is probably around 10 people. The complaints of sexual issues in my experience has been around 1 to 2 percent, which correlate with the reported incidence.

It is also interesting to note from my experience, that for those who have been very worried (scared) to take Propecia due to all the materials they have found on the Internet, and eventually did go on to take Propecia, almost all of them ended up with the negative side effect. I do not mean to discount any real and physical conditions, but there is also something to be said about the power of the mind.

Finally, I have seen many patients who were very depressed with other psychological issues, but those patients were not on Propecia / finasteride. I am not sure if there is a clear link, but it is something you need to speak to your doctor about.

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I’m In My 30s and I’ve Waited Almost 10 Years Before Finally Deciding to Treat My Hair Loss – Hair Loss Information – Balding Blog

Dr Rassman,

I’m 30 and although I have been losing hair since my early 20s, it’s only after I got my hair cut very short recently that it hit me how much I am balding (I am somewhere between Norwood 2 and 3).

Like many men, I find it very difficult to accept and it is causing me a great deal of stress. However I have decided to act on it before it’s too late, and so I am taking Propecia as of today. I am also using Rogaine foam 5% and although it seems to reduce the hairloss, I wonder if I should stop now that I’m taking Propecia.

In several of your posts, you suggest that Propecia works best for men in their 20s, and also that the number of years between the start of the hairloss and taking Propecia affects the results.

Does this mean that I should not expect great results from Propecia, being in my early 30s and having waited nearly 10 years?

Thank you for your excellent blog!

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The results will depend upon how much miniaturization you have in the remaining hair. Propecia works well for early miniaturization, which is what men in their 20s have. It still works in men of your age, providing that you have not lost the hair and are presently bald. Propecia does not work well for areas of complete balding, but on occasion, minoxidil may bring out hair were minimal hair is present. I can not advise you without seeing your photos and establishing at least a telephone consultation with me.

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Would Using Stem Cells for Hair Growth Need FDA Approval? – Hair Loss Information – Balding Blog

Hi,

Have you seen this article on Stem Cells for hair growth? Wouldn’t the FDA of had to approve this kind of treatment?

Link: Doctor has high hopes for new hair-loss treatment

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Doctors have been doing this for a number of years. In fact, we tried the use of ACell with plucked hairs that were supposed to supply stem cells to grow new hair. We did this according to a protocol, had it approved by an institutional review board (IRB) and then took human volunteers to see if it worked. There was no growth with this technique despite it being promoted by other doctors who claimed success. Although we did not add platelet rich plasma (PRP) to the mix, the stem cells could be seen on the plucked hair. No response.

Using ACell and PRP is not something that the FDA must rule on. This falls within the confines of the practice of medicine. If something other than ACell was sold for this purpose and claims were made that could not be proven, then doctors who made unproven claims can be prosecuted by various state and federal agencies. The FDA uses terms like “safe and effective” and this has become impeded in the law of the land.

I would love to see this work, so I will keep a keen eye on those who are doing this and wait to see results. Seeing is believing, and so far, no evidence has been presented that this approach really works.

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Any Way to Determine The Speed of Your Hair Loss? – Hair Loss Information – Balding Blog

Dr.Rassman

Is there any way to accurately determine if you are going to be a person with very slow hair loss or a person with fast hair loss?

The reason I ask this is because I went to school with a guy who had slight recession in his temple area but wasn’t really that noticeable. It lasted like that for years and then all of a sudden it picked up and became very noticeable, and then slowed down now (I think) that he is in his early 30’s. Thanks

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A good hair doctor can measure the rate of (a) miniaturization of your hair in different areas of your scalp and (b) the changes in hair bulk over time. I use these two approaches to make the diagnosis, and when I put a person on a drug like finasteride, I can see if I was successful at stopping the balding process. It would make little sense to me to use these instruments to follow the loss of hair and the rate of loss without treatment, but it would give you an idea on the speed of your hair loss over time.

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Hair Loss and Stress Severity – Hair Loss Information – Balding Blog

Doctor how common is hairloss from stress in men? Im just talking about daily typical stress? how severe does the stress have to be to accelerate genetic balding in men in your opinion?

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Stress, if it is not well managed, can accelerate hair loss in those who are genetically prone to balding, but for most men it is genetics that are the cause. I don’t know at what severity your stress levels need to be before the loss is accelerated, as stress is difficult to measure across the board. Each person is different and will react to stress differently.

There are other conditions that cause hair loss that can be stressed induced, such as alopecia areata (there is a genetic link with it), telogen effluvium, and other autoimmune diseases. If you’re concerned that your stress is accelerating your loss, see a doctor about getting your stress under control. Chances are though, if you’re a man that is seeing hair loss, your genes are playing a larger role in the speed at which you’re thinning.

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Can You Explain the RepliCel Phase 1 Before and After Photos? – Hair Loss Information – Balding Blog

dear doctor

i have heard about the news of replicel. i searched their website and found something weird. In their paper, there are two photos in the first page, but i cannot see any change in hair density as they claim. Can you explain it to me? thanks

RepliCel PDF

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I do not know much about this, but based on what you linked to, it looks like they are proposing to test 108 men in phase 2 (it does not seem like this has been done). As they word it, it is “anticipated that implanted cells will migrate to damaged or dormant follicles and help rejuvenate them“. They do not mention the science. They seem to stress the monetary dollar amount of the hair loss market (more so than the science), so they are likely looking for investors.

Finally, I do not see much hair density in the photo myself, at least not visibly/cosmetically. Perhaps someone else more informed about RepliCel can provide more.