Author: Dr. William Rassman

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Should I Stop Using Minoxidil When I Start Propecia? – Hair Loss Information – Balding Blog

Hello Doctors

I am 20 years old and Ive been using 5% Minoxodil foam for 4 months now (on a recommendation from my practitioner), and im seeing little in the way of progress (been losing hair and receeding since I was 18). I am going to see my practioner next week about getting a prescription for Propecia (im not worried about the side effects).

Would you recommend continuing the use of 5% Minoxidil along with Propecia, or stop using the foam whilst using Propecia?

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Many patients use minoxidil (foam or liquid) while taking Propecia. If your doctor prescribes the Propecia, you can continue the minoxidil daily. There is no problem with this. Keep in mind that if you see positive results, you won’t know which medication was the reason (or if both were) — so you’ll need to continue using both for life or risk losing the benefits by stopping one.

I wouldn’t have expected much progress at only 4 months of minoxidil use, particularly if you’re looking to treat a receding hairline. These medications work best at the crown.

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So Nothing Can Be Done for Alopecia Universalis Patients? – Hair Loss Information – Balding Blog

Is Alopecia Universalis a dead end?? hair cloning and transplant isn’t beneficial at all in this stage ?

Thank you

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There is no medical cure for alopecia universalis patients. Cloning isn’t available and transplantation isn’t an option, since alopecia universalis patients don’t have hair to harvest.

There is an alternative option — Scalp Micropigmentation (SMP). We have had one alopecia totalis patient treated with SMP. Look for Client 26 here (4th one down on the right).

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Is My Low Density Because My Scalp Is Stretched and Spreading My Follicles Apart? – Hair Loss Information – Balding Blog

Hi Dr. Rassman et al.!

I am a 22-year-old Caucasian male with blond hair, a NW2 hairline and somewhat low hair density. I’m not worried about my hairline, but my low density bothers me.

Here’s the thing: I have hydrocephalus, and with it an abnormally large head circumference. I’ve always had thin hair, but I shaved my head for the first time the other day and the density really scared me. Given my history of thin hair, is it possible that my low density is due to my scalp being “stretched” and causing the follicles to spread apart? The hair at the back of my head is slightly denser than at the top, but it’s very fine and light-colored. I know this is an unusual question and I understand if you can’t offer any answers.

Thanks for your time and all the advice you give!

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I suppose if you start with a normal scalp hair number (100,000 hairs), but with a large head circumference (large area), you would have a lower hair density (hair numbers per unit area). But for those with normal head circumference, you can still have low hair density because some of us can be born with low hair numbers. It’s just the way we are different.

Hair color and skin color can also contribute to the perception of hair density or fullness. High contrast (dark hair / light skin) can be perceived as a lower density than low contrast (light hair / light skin). Hair length can also change the perception, as longer hair looks more full than shorter hair.

Finally, hair style can be a factor, as well. Curly hair looks more full than straight hair. These factors may be common sense, but it all plays a factor in how one perceives density and fullness of hair.

If you were to visit us, we could measure your hair density in different parts of your head, compare one part with another and give you an assessment of your total hair count and any differences that are area dependent.

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Hair Loss InformationIf a Transplant Was Successful, Could Some Grafts Be Rejected Years Later? – Hair Loss Information – Balding Blog

Dr Rassman

Assume one has a successful transplant. Is it possible for some of the yielded grafts to die or be rejected some time (even years) after the operation? I am not talking about hair loss, nor about grafts that are genetically doomed. I am talking about healthy grafts, from a safe zone, that are transplanted and bloom normally but after some time die. If it is possible what would the chances be and why would it happen?

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If the transplanted hair grafts have successfully taken and have grown hair, they should last as long as the hairs from the donor area. Over many years some donor hairs may eventually fall out and die (senile alopecia) or experience a temporary hair loss (telogen effluvium/ stress related hair loss). If something like that would occur, then the transplanted hair will experience this same fate.

With respect to graft rejection, it is highly unlikely to happen since the transplanted hairs are your own (autologous graft). Your body will not reject the material from your own body in normal circumstances. Over the past 22 years, I have seen a few patients that reported loss of donor hair at about 5 years post transplant. I have no explanation for this, but the incidence is far less than 1% in my estimate.

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Hair Loss InformationI Changed My Finasteride Dose Based on What I Read Here and Saw an Increase in Hair Loss – Hair Loss Information – Balding Blog

Hi Dr. Rassman,
I am 19 years old and have been on Proscar for the last year. My hair loss has begun quite slowly but it is somewhat noticeable around the temple area. Obviously it is hard to tell just how much hair I have saved or whether it has slowed the progression at all. However, in the past few weeks I have altered my dosage and believe it has caused a slight increase in hair loss.

Originally my doctor suggested a 5mg pill cut in half and taken every second day, but after reading your answers here about how long the pill lasts in the system I reassessed with the doctor and decided on a 5mg pill cut into four and taken every day. Seeing as this only changed three weeks ago, do you think it is purely coincidental?

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If there is one thing I want all readers to understand it’s that you need to establish a relationship with YOUR doctor, and obtain and resolve your medical issues with them. I’m glad you talked to your doctor before changing the dosing, but if you do have issues you should contact that doctor for his/her take on it.

In general, Propecia (finasteride 1mg) taken every day is used for the treatment of androgenic alopecia (genetic male pattern hair loss). Many men cut the generic finasteride 5mg into four parts (since cutting it in 5 equal pieces is very difficult). Other doctors may have their own opinion and treatment regimen, but the recommended dose is finasteride 1mg taken every day.

Finally, it takes several months before you see any effects (benefits) from finasteride. I occasionally read emails and comments where someone notices some change in their hair (loss or gain) after several days or weeks, but that is unlikely. So what you’re seeing may just be coincidental.

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I’m 22 Years Old With a Great Hairline, but Thinning At the Top! (with Photo) – Hair Loss Information – Balding Blog

Hi! I’m 22 years old and am about to turn 23 and am very concerned about some hair loss/balding. What is most frightening is how sudden this is. Is all hair loss a sign of balding or can hair loss happen suddenly due to external factors?

While doing research on balding, I saw the pattern charts. I don’t seem to be following any pattern, but the thinning of my hair is certainly noticeable to me. My friends don’t see it yet, but I can at least style it for now to hide any thinning.

I’m seeing thinning at the top of my head… My hairlines have NOT receded and I am not experiencing any loss of hair on the sides. Do you have a guess as to what pattern this could be? Do you think it’s balding or temporary? Is there anything I can do to slow or stop it?

22 seems like a really young age to lose hair :/ especially for someone who aspires to work in the entertainment industry..

Thanks for any help or advice

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Click the photo to enlarge.

 

We generally think that men recede front to back and with the presentations of the Norwood classifications these seems to be the case; however, I do see people maintain strong frontal hairlines and lose hair behind it. This is why when we examine a patient we test for hair bulk behind the hairline and in the crown. Often, to my surprise, I see loss of bulk in the top and/or in the crown, even when it does not appear deficient with my naked eye.

If you take a person with medium weight dark brown or black hair that has a loss of 50% of the hairs in the top and crown, you likely will not be able to tell that there is hair loss. If the bulk analysis shows hair loss in the top and crown, that is a good reason for taking finasteride and it will often control it. By taking two measurements about a year apart, you will know for sure if the hair loss continues, is stabilized, or if it reverses.

At 22 years old, it isn’t abnormal to see hair loss if you have the genetics for it. But I don’t have any idea if this is genetic balding, disease, diet, stress, etc. You need to have an examination to hopefully determine what is going on with your loss and try to get it under control. Knowing what is going on allows you to be proactive in what happens to you.

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Hair Loss InformationWhy Can Testicular Pain Occur from Finasteride? – Hair Loss Information – Balding Blog

I got two questions linked to finasteride and side effects:

1. Why does testicular pain occur when taking finasteride?

I’ve read somewhere that the testicle is working overtime to produce more testosterone as it senses that DHT is low and is trying to compensate. I don’t know if this is true or not, but is there any “official” explanation?

2. Is there any connection between finasteride and penile shrinkage?

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You should not have testicular pain when taking any medication, including Propecia / finasteride. If you have testicular pain it may be a serious medical emergency. I believe it was less than 1% that had this side effect in the clinical trials, so it is quite rare. I don’t have a reason for why it could occur at all, though.

I would strongly advise you to follow up with your doctor. What you read on the Internet (and even BaldingBlog) does not substitute for a face-to-face personal relationship with your physician, and that includes exploring the cause of your testicular pain. Finally, finasteride do not cause penile shrinkage.

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Hair Loss InformationCould My Topical Eczema Medication Speed Up My Hair Loss? – Hair Loss Information – Balding Blog

Hello Dr.

I’ve have eczema on my forehead and cheeks, i’m using miconazol/hydrocortison twice a day for ten days now.

Because i’ve to put it on my forehead, close to my hairline when i wake up and going to sleep, could it speed up my hairloss? It’s also on my cheeks so if it comes on my pillow is it dangerous for my hair?

Thank you

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Please use medication as directed by your physician. Hydrocortisone can be absorbed by the body and can contribute to hair loss if it is used in excess. Very small amounts work well for its primary purpose.