Author: Dr. William Rassman

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I’m Concerned That I’ll Be in the Last Generation of Bald People – Hair Loss Information – Balding Blog

in reference to a quote at the end of this article:

Link: Baldness cure could be for sale in just two years

I am concerned that in the next two years they will come up with a drug that will retain hair, and I (25 yo male) will be the last generation of bald people. The rest of my life it won’t be normal to be bald…. urgh? do any of these ‘on the horizon’ cures actually regrow hair???

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I wrote about the possibility of the baldness cure being just a couple years away here.

You’re assuming a lot to suggest that it won’t be normal to be bald for the rest of your life, and even then, there are options like Scalp MicroPigmentation (SMP), hair transplantation, and even medication, to make it so that you don’t appear bald. I expect that we’re more than just two years away from the cure being a reality, but research is ongoing. And even if balding is somehow completely eradicated for future generations, there will still be millions of men around the world that have hair loss, so I wouldn’t get too worked up about it being abnormal.

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My Dermatologist Said He Can’t Tell If I Have MPB (with Photos) – Hair Loss Information – Balding Blog

Doc

I’m 19 year old and I’m afraid I’m losing hair, even though my father has a head full of hair, because of the irregularity of my hairline and recession at the temple.

I’ve consulted a dermatologist that said I have seborrhoeic dermatitis and that he can’t tell whether I’ve male pattern baldness, thinning or receding hairline before my dermatitis is cured but even using the foam, nizoral and pills he prescribed I still have dermatitis and I’m afraid I’m wasting time when I could be curing my hairloss.

I really want to know what do you think? Do I have a receding hairline and hairloss?

I took these pictures this morning, feel free to publish them. Thanks

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Click the photos to enlarge:

 

I will post your photos for the readers that may like to comment, but if a doctor examined you in person and couldn’t diagnose genetic male pattern baldness, I don’t know how we could be expected to provide a diagnosis just based on photos. It does appear that you may have some hairline recession, but you’d need your hair bulk analyzed and scalp mapped for miniaturization in order for me to be able to know if you’re thinning in various areas of the scalp. The photos don’t show me that.

I am not sure why you would not want to follow the recommendation from your doctor, who gave you a treatment plan. Did you use the medications he recommended for the length of time he prescribed? If you feel your doctor is wrong with the diagnosis, then you should seek another doctor for a second opinion. Treating seborrhoeic dermatitis wouldn’t be a waste of time, though.

And just to be clear, there isn’t a cure for hair loss.

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My Doctor Won’t Prescribe 5mg Generic Finasteride and Propecia Is Too Expensive! – Hair Loss Information – Balding Blog

Hello how are you? I am patient under dialysis treatments because my kidneys do not work anymore, and I wonder if some of your doctors could prescribe me generic 5 mg. My doctor did not want to prescribe generic finasteride 5 mg, the doctor just prescribe me Propecia, but is very expensive. It cost more than 80 dollars for thirty pills, I can not afford to pay that, I’ll be waiting for your reply. thank you!!

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You can make an appointment with any dermatologist or a hair transplant doctor if your doctor won’t prescribe the 5mg. Did he give you a specific reason for not prescribing it (even if you are instructed to cut the pill)?

You would first need to have a good medical diagnosis for androgenic alopecia before you receive a prescription for Propecia or its generic finasteride. In general, there is a consultation fee for patients, but most hair transplant doctors waive the first visit fee.

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Is Finasteride Growing Black Vellus Hairs At My Hairline? (with Photos) – Hair Loss Information – Balding Blog

Hi Doc,

I’m 22-years-old and have been on finasteride for a little over a year. I had my hair properly examined 4 months ago and the doctor confirmed that finasteride has increased my hair density significantly.

I just noticed little black hairs on my hairline. I’m wondering what they are? I don’t believe I had these hairs when I started treatment. Could these be miniaturized hairs that may eventually turn into terminal hairs? They seem a little dark to be vellus?

Thanks

P.S. You’re welcome to use these pictures on your blog.

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Click the photos to enlarge:

 

Finasteride 1mg doesn’t usually regrow the frontal hairline or vellus hairs. With that said, everyone has vellus hairs at the hairline, so perhaps you are just noticing them for the first time as you are paying more attention to it? The only real way to tell is if you have a BEFORE photo of the same area, and if your doctor does bulk measurements on your hair. That would prove one way or the other if there is a reduction of hair mass, usually caused by genetic balding.

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Hair Loss InformationWhen I Use Hair Gel, I Can See My Scalp! – Hair Loss Information – Balding Blog

Hey there, I’m 28 years old. When i put gel in my hair I can see my scalp. It looks completely normal when its dry. Am I balding? I never noticed this before

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If you use hair gel or any hair styling products, it will be separating out sections of hair to expose the scalp. It’s the same concept as when your hair is wet. If you think you are balding, see a doctor. In simple terms, styling your hair a certain way can make your hair look full OR thin. Various lighting can also make your hair appear thinner.

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Can Propecia Elevate Dopamine? – Hair Loss Information – Balding Blog

In early 2011 I had a rare adrenal tumor removed called a pheochromocytoma. Doctors also removed the affected adrenal gland the tumor was attached to. This type of tumor spontaneously, without provocation, releases epinephrine, norepinephrine and dopamine. Chemicals collectively referred to as catecholamines. These are your fight or flight chemicals and when the tumor releases them you feel very “wound up”. After the tumor was removed, my catecholamine levels went back to normal and I again felt normal.

In late 2011 I started Propecia. I started on .5 milligrams per day and later reduced that dose to .5 milligrams 3x per week, which I am currently taking. A dose much lower than the standard dose of 1 milligram per day. Almost immediately after starting Propecia, I began to feel like I did when I had the tumor. Spontaneously “wound up” even in the absence of external stimulus.

Recent testing reveals my catecholamine blood levels are back up and my oncologist suspects another tumor. Appropriate scans for tumor detection are occurring “as we speak”.

Are you aware of any evidence that Propecia can cause elevated levels of epinephrine, norepinephrine or dopamine? I have read numerous claims that Propecia can cause anxiety. If this is true, could this anxiety then trigger a “chemical cascade” in which catecholamines are released at high levels.

Thank you for your expertise in this matter.

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I know I must sound like a broken record, but you really need to discuss personal medical issues with your doctor.

I wouldn’t expect Propecia to have anything to do with dopamine or other catecholamines. Propecia is a 5 alpha reductase inhibitor, which works to diminish the conversion of testosterone to dihydrotestosterone (DHT).

In my experience, the anxiety caused by Propecia are in those men who read too much about Propecia’s side effects on the Internet without discussing the issues with their doctor. Then again, anxiety could indeed be a rare symptom associated with Propecia, but it’s something that needs further study. The studies that I’ve seen which link Propecia to anxiety or depression were based on interviews with men from a Propecia complaint forum, and the bias is something I’ve discussed before.

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Finasteride After 10 Years – Hair Loss Information – Balding Blog

Hello dr Rassman, i’m sure you have read the 10 years old finasteride study being conducted on 118 men. It was found that 10 years later 86% of men had the same hair compared to the baseline. Do you believe this is true from your experience?

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The uncontrolled study you’re referring to is this — Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up.

And to answer your question — yes. I don’t know if my percentages would line up exactly since I haven’t done the statistical analysis, but this drug is very effective at stabilizing hair loss as I see it on a daily basis in the patients I’ve been treating (some for over 10 years).

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Hair Loss InformationMore Info on Generic Propecia in the US – Hair Loss Information – Balding Blog

Dr Reddy's 1mg finasterideWe received quite a few phone calls and emails after yesterday’s post about Dr Reddy’s 1mg finasteride (generic Propecia) now becoming available in the US, so we called some pharmacies in the Los Angeles area to get pricing/availability info:

Costco:

In stock! $47.37 per 30 day supply at Hawthorne, CA location (compared to $73.92 for name brand Propecia). Costco has an online price checker, but it’s not showing the 1mg generic in the system yet.

Target:

In stock! $67.99 per 30 day supply at Los Angeles location on La Cienega (compared to $73.92 for name brand Propecia)

CVS:

In stock! $70 per 30 day supply (compared to $98 for name brand Propecia)

Walmart:

Not in stock as of this posting (Jan 8, 2013)

Walgreens:

Not in stock as of this posting (Jan 8, 2013)

Rite Aid:

Not in stock as of this posting (Jan 8, 2013)

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There isn’t a significant savings from the generic at CVS or Target, but Costco has the lowest price so far at under $48/mo. It doesn’t seem like there will be a huge drop in price until perhaps the 180 day exclusive window is up and other pharmaceutical companies can make their generic Propecia available. I have no estimates on what the price point might be 6-12 months from today, but I hope the price does come down considerably in that time.

Pricing and availability could change at any point, so you should call your local pharmacy for info.

Photo source: Twitter @KerriLynn_C (hat tip to KP)

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My Hair Keeps Going Through Seasonal Sheds That Worry Me – Hair Loss Information – Balding Blog

Dear doctor,

I am a 22 years old male with very little family history of male pattern baldness. Yet a few months ago (I think last may or april) I started to experience some drastic hair loss. I was literally shedding all over my clothes, the tub, the kitchen floor… As I grew really desperate I went to visit a dermatologist who told me I was going through telogen effluvium. I actually changed my diet at the beginning of the year by becoming a vegetarian, so I figured it made sense that my hair would undergo a moment of weakness. I took various vitamins for two months or so and things seemed to get better until october.

I have always been very sensitive to the changing of season, hair-wise, so it didn’t worry me at first, but now I find it weird that this is still going on to the present day. But what confuses me the most is the nature of my sheds. I had already noticed that I would lose hair that were a lot shorter than the others (my hair is mid-long), although they seemed to have the same thickness. This could all be a result of effluvium. However, I started to find these days hairs that were thinner than what they should be… Some of them have a normal length but are just pretty thin and fuzzy. Others are also really small… I have no visible recession of my hairline (yet ?). I can tell my hair still fall from all over my head, even in the areas never affected by AGA. But I am scared to death, are those tiny sheds a definite sign of MPB ?

I hope you will answer my message. Sorry if I made a few mistakes. Regards.

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You should get baseline measurements on your hair bulk to determine the significance of the shedding, and quantify just how much hair you are losing over time.

As for a seasonal shedding, I’ve had a few reports emailed to me from readers over the years about this, but there is no medical explanation that I know of for it. Humans have asynchronous hair growth, which means that we do not shed in seasons, but do so relatively uniformly over the year.