Category: Drugs

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My Father Had Awful Transplants from a Dermatologist – Hair Loss Information by Dr. William Rassman

I have been on finasteride for 7 years. I have pretty much maintained my same density over this period. A little more thinning in the front. I am now 36. My father had many transplants from a doctor who is a dermatologist. Not from a doctor that specializes in transplants. His transplants are awful. What should my expectations be if I wanted to get off the drug and try transplants? I am fair-skinned with wavy auburn hair, and my individual follicles are thick, but not dense.

First, the old plugs can easily be fixed today. Look at the following links for articles and examples of good repair work which can and should be offered to your father:

The second part is that taking the drug Propecia is a different decision to having transplants. They can be complementary (see: Hair Transplant and Propecia Combination Results). As for expectations about transplants for yourself, meet with your doctor and have him/her develop a Master Plan with you, so that you have your needs addressed before the procedure.

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Skip Taking Propecia a Couple Days a Week To Make Supply Last Longer? – Hair Loss Information by Dr. William Rassman

Hi Doctor. So if I skip taking my morning Propecia a couple times a week, I shouldn’t be at risk of making the Propecia ineffective right? I just want to see if I can make this 30 day supply last maybe 38-40 days. I know the Propecia is working for me since I stopped seeing hair falling out and landing on my shoulders, but I want to make this stuff last as long as possible. Thanks!!!

Propecia has a half life of 4-6 hours, which means that it will be effectively out of your body in a day. Prolonging the time between doses will just guarantee that the drug will be less effective for you.

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Concerned About Possible Gynecomastia from Propecia – Balding Blog

Dear Dr. Rassman:
I have some questions regarding the possible side effects of taking propecia, and I am wondering if you can help to answer them?

  1. After a patient starts his medication on propecia, how long will it take for the possible side effects, such as gynocomastia to occur?
  2. If gynocomastia does occur, would it be completely reversible after the patience stop using propecia?
  3. If a patient stopped using propecia, will the severity of hair loss process accelerate? Or would the patient simply lose the hair gained from using propecia? If that assumption is valid, would a patience who stopped taking propecia only 1 or 2 weeks into the medication also experience acceleration of hair loss?

Thank you so much for you patience and time.

  1. Breast enlargement or nodules is a rare side effect of Propecia (I suspect one in 500 people might see it at the 1mg dose) and it will usually occur in the first month.
  2. If breast problems do occur, they will disappear within a month or so upon stopping the medication.
  3. Stopping Propecia for 1-2 weeks probably will produce some withdrawal hair loss, but I suspect it will be hard to see and relatively small. The longer you stop the medication, the worse the withdrawal loss will be and the more irreversible it will become.




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Cymbalta, Atenolol, and Female Hair Loss – Hair Loss Information by Dr. William Rassman

Hi I’m a 24 yr old female, with some questions I would like to ask you about my hair that is thinning. About 10 months ago I was getting a haircut and the stylist had mentioned to me that my hair was thinning a lil at the crown of my head…It wasn’t very noticable, so I didnt think anything of it, and just went on with my life…I had started taking an Anti-depresent called Cymbalta, and a high blood pressure medicine called Atenolol, at around that time as well. Well in january of 2006 I noticed that my front part of my scalp, maybe from my hairline & back 2 inches was very thin. I couldn’t understand why, because it was an over nite thing, I would have noticed if my hair was thin, and i even look back at christmas pics from the month before and my hair was like usual, so I know it was a very immidiate thing. I had disconntinued my anti-depressent and blood pressure meds, like 1-2 months earlier, because I could no longer afford health insurance, so I had been med free for about a month when I noticed the thinning frontline. its now almost 3 months later and im starting to think the thinning is getting worse in this reigion only…i started to take folic acid and a prenatal pill, because I read folic acid helps with re-growth, but I dont know what to do..I cant see a Dr, for another month untill govt health insurance kicks in, but in the meantime what should I do??..i know I had blood test run before about 8 months ago checking for throid disease, but it came back normal, so could something medical cause this..because no one in my family has a balding problem, my mom is 47 and just started to thin, and thats only because she used many products in her hair for so many years. do you think my hair will grow back or get worse?…I heard it takes about 3 months for the hair growing process to start showing, but its been about that much time and i dont see any improvments…Ive looked through the internet and read some scary stuff that can cause hairloss…but im so down about this, becuase i am soooo young, and I dont know why my hair is falling out…please help me if you could, thanks alot and have a wonderful day.

You are in need of a good doctor and there is no substitute for what the doctor does. Problems like yours can not be managed well by a doctor through the internet, nor can you manage depression and high blood pressure combined with hair loss by yourself. Look through the many posts in this blog on female hair loss to educate yourself and then get a good doctor.

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Angry Emails About Hair Products – Hair Loss Information by Dr. William Rassman

it would seem to me, if it worked as good as you say on TV, all the news media, talk shows, and anyone reliable else, would be backing this product. An infomercial is paying the TV. If It was as good as you say, you wouldn’t have to pay to have is broadcast. Remember, just because you say it’s so, doesn’t make it so.

Where do I begin? I was able to determine that this email came from someone that found the BaldingBlog by looking for ScalpMed on a search engine and just assumed that I was the one responsible for promoting this product. This is sadly not the first email I’ve received like this. Some people just seem a little angry about the ScalpMed product. I’ve never seen the TV commercial and I’ve never claimed ScalpMed is good. In fact, I haven’t promoted myself or my company in almost 10 years and I’ve never promoted a hair loss product on TV, ever. Folks, just because you found this site by searching Google for something you saw on TV, it doesn’t mean I made the commercial promoting it or had anything to do with the company or the product. I understand there is anger over products out there claiming to do things that you have not experienced, but your anger is misplaced if it is directed towards me.

I do agree with the writer of the above email though — if a product is as miraculous as they each believe is more than hinted at being a wonderous cure or treatment for hair loss, you would see as much information EVERYWHERE as you surely did when Viagra was made available to the public. Stop to think of the Viagra marketing launch and try to apply that to any magic bullet pill advertised to treat hair loss. Viagra was everywhere, and a topic like sexual dysfunction is far more embarassing for many people to talk about than hair loss. So if a miracle pill for hair loss did exist, I would think you’d see it even MORE than Viagra. You’d be getting 50 spam emails a day (with multiple misspellings) talking about selling it at a discount. You’d see it on the cover of Newsweek. You’d certainly would see it in magazines and newspapers. Hair loss is a big deal to many people.

With nearly 50% of men losing their hair, the market for a wonder drug that claims to do it all for your hair is wide open. I do recommend Propecia, because I’ve seen it work and it is FDA approved. The same recommendation goes for minoxidil, although to a lesser extent — but again, it is approved. Propecia doesn’t work for everyone all the time, and minoxidil has its faults as well. As a physician, I have a hard time recommending any product that I am not convinced works. I have no experience with ScalpMed, but there does seem to be a very polarized group of emailers who do not take a positive view of their experience with this product. If you are included in this group, could you take a few minutes and write down your experience and let me know if you were happy or unhappy, and why? I will be happy to share rational people’s emails with the readers of this blog.

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Hairline Regrew with Meds – Hair Loss Information by Dr. William Rassman

I’m a 27 year old with recession to a NW2 pattern, but thinning over a NW5 area. I’ve been using Propecia, Minoxidil and Spiro for roughly 1 year, and I’m noticing pigmented hair starting to sprout around my original NW1 hairline. However, the density on the top of my head appears to have gotten slightly worse. Maybe it’s a shed, I don’t know.

With success continuing on the hairline regrowth standpoint, do you think the thinning on top is just taking longer to grow in — or could it be possible I’ll end up with a NW1 hairline, but with a thin NW5 pattern? I understand that hairlines usually come back in (if at all) AFTER the crown and vertex have filled in…? It just seems odd to me to be having regrowth success in the one area people have a lot of trouble with, but be lagging behind in the areas that are meant to respond best to treatments.

My father has a NW4 recession/NW6 thinning pattern at 55, and my hair loss seems to be following the same pace and pattern as his did at my age. In the scenario that I don’t achieve desirable density on treatments in the next 12 months, is FUE an option to fill in the density of the thinning pattern? On that same note, if I were to have FUE done in the next 1-2 years, would it still be possible to pursuse Hair Multiplication when it became available? I can’t remember where I read it, but someone mentioned that previous HT patients would not be suitable candidates for HM for some reason. Or maybe I misunderstood/misread…?

Call it vanity or risk, but I’d rather have decent hair in my 20s and 30s, and the confidence that goes with it, and worry about my 40s onward if/when I get to them. What can I do NOW to achieve my goals, even if they’re temporary fixes until the next great drugs/procedures come along?

Thanks

Norwood Class 2

Norwood Class 1

I am very impressed with your questions, particularly the way you distinguish the difference between the way to classify recession and thinning patterns of hair loss. You are correct to assume that the impact of medication is different between the front and the top/back of your head. I do not understand why the treatments you are having are impacting the juvenile hairline (Norwood Class 2 pattern moving to a Norwood Class 1 pattern).

With regard to filling in a thinning pattern — that would depend upon many things. There are many doctors who would gladly sell you hair to fill in a thinning pattern, but there is always the really important question to ask: Will the gain off-set any loss from the transplant? Many unscrupulous doctors would like to tell you that this is preventive hair transplantation to stop the balding. When I hear that statemen (preventive hair transplants) I know that the doctor has ethical problems and $$$ are getting in the way of his/her judgment for good patient care. To get a proper answer to that question, you MUST find an ethical doctor who will answer it from your perspective. Judging that you are focusing upon a Norwood Class 1 pattern, I might think that you are overly worried. If you choose to have an FUE or a conventional strip procedure, that is an independent decision to having a transplant in the first place.

Any transplant you *or any person having them) might have will not interfere with the advances in hair cloning or hair multiplication that may come up in the future. You are worried about what you will look like in 13 years, but I would ask you to have you scalp mapped for miniaturization and if you really are thinning in the patterns you discussed above, then the drug of choice is Propecia/finasteride and that could do more to fix the thinning problem than any hair transplant you can do.

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Should I Try Rogaine? – Hair Loss Information by Dr. William Rassman

Hello Sir,

My age is 23 and like many people around the world i am also very much worried about my receding hair line (from the centre of my crown till my temple ). The density of my hair has become very less from past one and half years after i started to work for a call centre. Most call centre jobs in India are out sourced, which means i work mostly at night.

I do have read a lot of blogs on your wonderful website about hair loss and treatment. But i really wanted to know whether is it okay if i start using minoxidil for retaining my remaining hair or you would suggest me to visit a trychologist and then get the prescribed medication.

Also can a hair transplant will show the same density as normal hair..after the transplnt has been done..

thank you

If you are balding at 23, you should buy finasteride and take 1mg of this drug daily. In India, there are generic versions of this drug on the market and this is the best drug to stop, slow down, or reverse early hair loss in a young balding man. I can’t vouch for the authenticity of the generic versions available though. Minoxidil (Rogaine) is not the best first choice for a drug in a young man, as it is not reliable and it does not block the balding process from happening. Transplants should not be considered unless after a year on finasteride you still show significant balding. Doctor selection is a real problem in most countries, and I am sure that a trip to the United States may be out of the question, but take great care in selecting a doctor there for hair transplants.

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Hair Loss InformationKenalog and Female Hair Loss – Hair Loss Information – Balding Blog

I’m a 32 year old mother of 3 and first noticed an increase in the amount of hair I was losing on a daily basis about 2 1/2 to 3 years ago. I had a lot of hair so I wasn’t too worried about it at first, but the hair loss continued and now I have a significant decrease in hair volume. I went to see two dermatologist. The first one told me it was hereditary and to use Womens Rogaine. He didn’t even touch or look closely at my scalp. He also said if I did’nt tell him what was wrong that he would never guess I was losing hair, which didn’t make me feel better because I can tell the difference. I never tried the Rogaine. The other diagnosed me with telogen effluvium and recommended I take a injection of Kenalog. Which after about a year of weighing the benefits and risks decided to get the shot. It’s been about three months now and haven’t noticed any decrease in hairloss or any regrowth. It sure has messed up my menstral cycle though. I really would appreciate any advice you might have. It is really depressing as a young woman to go through hairloss. Thank you for your time.

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Telogen effluvium generally has a spontaneous recovery in 6 to 12 months. It is precipitated by hormonal, emotional, or medical stressors. Aside from seeing a dermatologist, you may want to get a complete medical physical to rule out other medical causes of female hair loss (such as eczema, malnutrition, autoimmune disease, drug reactions, infections, genetics).

Kenalog is sometimes used for hair loss, however its efficacy is not well studied and I do not believe that it works unless the hair loss is in the autoimmune category. Telogen effluvium and steroids are poorly linked for benefits, and as you said, it is messing around with your hormone balance and menstrual cycle. Unfortunately, even with a good diagnosis, you may still find that there are no suitable treatments available. At least you will be educated and can then avoid ineffective medications or treatments so that you do not have to suffer from adverse drug effects. Don’t get ahead of yourself though. See a doctor to have other causes ruled out first.

“Knowledge is power.” –Francis Bacon

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Hair Transplants or Propecia – Hair Loss Information – Balding Blog

I have been on Propecia for 6 years now and have decided to get off of it due to potential unknown long term side effects and even short term side effects that I seem to notice more as I age(Libido, minor Gyno, etc). My question is how long do you recommend I go before I consult for a potential hair transplant since it is difficult to say what my potential future loss will be right now since Propecia did have a positive effect on my loss and I would have almost certainly lost more. Im currently 30 years old and have probably a Norwood 3V and more of a Norwood 2ish in the Temporal/frontal region which hasnt changed to much since I started Propecia. Ideally I would love to get a transplant now to basically keep my existing hairline(which im ok with even though its receded a fair amount) and fill in some of my vertex while I can still conceal it with exising hair but Im worried about not being able to plan correctly since I wont be taking Propecia. Any advice will be most helpful.

Thanks

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You need to be evaulated. If you density is good and there is miminal miniaturization in the top (area between front and crown), then you may be a good candidate for hair transplants. At 30, your pattern should be evident when your scalp and hair gets mapped out for miniaturization. From that a Master Plan needs to be developed which will take into account your worst case hair loss scenario and then the supply/demand for hair transplants becomes a measurement to base a safe decision in the long term planning for any transplant process that you undergo. Stopping the Propecia is something that you should think carefully about, a lengthy discussion with your doctor to see how this decision may alter that long term plan I am talking about.

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Hair Transplant and Propecia Combination Results (with Photos) – Hair Loss Information by Dr. William Rassman

This patient had a hair transplant a few years back with me, which filled in the front and top. He has been taking Propecia for the crown. The combination is awesome. In just ONE surgical session of 2,626 grafts, he now has a strong frame to his face and filled in much of the frontal hair. The back of his head gained just enough hairfrom the Propecia to take away the heavily see through look and all of his sensitivity to being the balding man we see in his before pictures. Photographs were taken from eyebrows up only. Click the photos to enlarge.

Before:

After: