Drugs – Page 334 – Balding Blog

March 24, 2006

Regenix, Avodart, and Minoxidil – Hair Loss Information by Dr. William Rassman

i’m 22 and have been thinning in the crown/back/top for about 3 years. i’ve used minox 5 % and propecia for a couple of years, switched to dutasteride 10 months ago…with no results.

i am going to continue the avodart…but i’ve recently started a regimen from Regenix out of LA. i was wondering if using minox 5 % once a day is enough to avoid a major shed? regenix took some hair samples and ‘formulated’ a treatment just for me. do you know if Regenix is worth my time and money? also, could it be that the avodart takes a while to start showing results? any advice is much appreciated.
thanks.

I am assuming that you are a male, not female. With that said, if you have genetic hair loss and it is progressing rapidly, then it sounds like you have real problems. I may sound like a broken record here, but you need your scalp mapped out for miniaturization and then get a working diagnosis.

Avodart, in theory, is as good or more potent than Propecia. Minoxidil must be used twice daily to get any reasonable effect. I do not know about the special formulations of Regenix you asked about. To me, it sounds like you are playing with fire with a blind-fold on. Please get a working diagnosis first so you will know what is really happening.

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March 23, 2006

Happy 34 Year Old Taking Propecia (with Photos) – Hair Loss Information – Balding Blog

I wanted to share these photos with the blog readers. This 34 year old man came to my office in late 2003. He has short hair and when he let his hair grow out, it was puny looking, without bulk or body (see first photo). He went on Propecia and one year later, his hair grew out thick and full (early 2005 – see 2nd photo). I had asked him to cut his hair short when he came in again for a better assessment of his balding pattern (early 2006 – see 3rd photo). His miniaturization partly reversed with the Propecia, and he is one happy guy!

I apologize for the quality of the 1st photo. It was taken with a Polaroid camera, and the photo came out slightly blurred. However, the photo does still show the sparseness of his hair, which is the only point I was trying to make by showing it.

Before
After
After

March 23, 2006

Propecia and Frontal Hair Loss – Hair Loss Information by Dr. William Rassman

I heard from one of the hair transplant surgeons that I spoke with that Propecia doesn’t necessarily prevent the hair loss in the front of the head, but often helps in the back.

I’ve been taking Propecia for almost two years now, and have noticed that the hair loss in the back of my head has stopped, and perhaps sligtly improved. My hair has been gradually falling out in the front — I’d love to hear your thoughts about this. Is it true about the front vs. back loss?

In general, Propecia is more effective in the vertex (crown) area than the frontal area. I have seen it reverse hair loss in the front in a small percentage of young men (under 35) so I know that it does impact both regrowth (less common) and prevention (more common), but the results are statistically far more impressive in the top and back of the head. I recommend that you continue to be on Propecia.

March 23, 2006

Smoking Cannabis After Hair Transplant – Hair Loss Information by Dr. William Rassman

First off let me say I find your answers to be very informative.

My first question is: Will cannibus affect my hair transplant I had on Feb 08/06? I don’t smoke cigarettes but cannibus helps me deal with my occasional back pain.

Secondly when can I resume my normal jogging of a couple miles in the morning? As well as doing chin ups and push ups? I have been told exercise of these sorts will only expand the the donor scar.

Thank you and i appreciate your advice.

Medically speaking, smoking cigarettes (even the cannabis / marijuana kind) promotes poor wound healing by decreasing blood circulation. It may have an impact on your hair transplant, however, I do not know how much of an impact it will have.

Exercises such as sit-ups that may have a potential to stretch the back of your scalp will also have an impact on your donor scar. Running 1 week after surgery is not a problem. Although you can probably resume most of your regular activity after one or two weeks post surgery, the scar takes about 6 months to a year to completely set and in the first 3-6 weeks, the wound structural elements that make for good solid healing change and build. I generally tell my patients not to do the type of exercises that stress the neck muscles like body press or sit-ups for up to 6 weeks. A few of my patients even ran marathons a few weeks after surgery without any negative effects.

March 23, 2006

Taking Propecia with Saw Palmetto – Hair Loss Information by Dr. William Rassman

Is it safe to take propecia and saw palmetto together, and if so how much saw palmetto? Can either of these effect facial hair growth or acne?

BerkeleyWellness.com states: “Because dietary supplements are essentially unregulated in the U.S., you can’t be sure what you’re getting when you buy a saw palmetto product (or any supplements). There are many preparations on the market (with different amounts of fatty acids, for instance, and some in combination with other ingredients of questionable benefit). They may not have the same effects.”

For the same reason, there is no way of knowing how much saw palmetto is actually in a tablet even when a specific dose is written on the bottle. Furthermore the exact mechanism of how and why saw palmetto works is not well understood. It may have an effect on DHT like finasteride, but nobody knows for sure as the science has not defined the actions. It has been sold in natural food stores for the treatment of benign prostatic hypertrophy (BPH), treating men who can not urinate well. One may argue that it may also help with male pattern baldness (MPB), but there are no medical studies to support either claim.

There is no way to tell you if it is safe to use saw palmetto with finasteride (Propecia) or if it will affect facial hair growth or acne. If saw palmetto is really a blocker for DHT as some feel is the case, then you could be increasing the dose of DHT blocking to the point of decreasing your libido (a bad trade). I do not recommend saw palmetto for MPB for the aforementioned reason.

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March 21, 2006

Propecia for Hairline – Hair Loss Information – Balding Blog

Hello again doc, I’ve taken your advice on taking procepia instead of saw palmeeto pills. I still have a patchy thinning hairline that’s type I on the right side and type II on the left side. My question is, how long will it take until my hairline thickens and returns to type I on both sides? My dermatologist prescribed Proscar for a period of one year.

And one more question, my mom is in her late 40’s and has been thinning and receding around the front as well, though her’s is more apparant. Is there anything you can recommend for her? Thanks.

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These drugs will probably not reverse the frontal hair loss. It will be more preventive for future hair loss if the cause is genetic. If you are talking about Norwood Class 1 to a Norwood Class 2, then this could be just a maturing hairline and I do not frankly know if Propecia /Proscar will stop the hairline from evolving naturally. My question for you is: How do you know that you have genetic hair loss? You need to have your hair mapped out for miniaturization to determine if you have hair loss.

Wiht regard to your mother, female hair loss has been extensively covered in previous blog entries and I refer these to you and to her.

March 21, 2006

Pantogar – Balding Blog

Dear Doctor Rassman,
I have been on propecia for one year. I want to ask you if I can take pantogar tablets (which is a supplement for hair loss and gray hair) along with propecia? Or will there be any negative interaction between them? Thank you vry much for your answer in advance.
Sincerely,

Pantogar capsules contain: Thiamini nitras 60 mg, Calcii pantothenas 60 mg, Cystinum 20 mg, Faex medicinalis 100 mg,Acidum paraminobenzoicum 20 mg, Keratinum 20 mg

I do not know about Pantogar, except for one article I found that seems somewhat credible: EHRS

As I have no first hand knowledge of it, I can not comment on any overlap with Propecia.

March 21, 2006

Transplant Risks, Stopping Propecia After Hair Transplantation – Hair Loss Information by Dr. William Rassman

What are the risks of hair transplantation?

Will I keep balding after a hair transplant?

Can I stop my hair loss with Propecia?

I am 35 years old and a Class NW 3V, will I get very bald (like a Class 7)?

A Doctor told me that I needed 3500 grafts, Is this a reasonable goal for a NW 3V?

Hair transplantation is a surgical procedure and entails all of the risks of an outpatient procedure. The risks of death and severe complications (in good hands) should approach zero. The usual risks such as infection, drug side effect/overdoses, and the like are rare. Scarring risks for strip surgery are about 5% for a scar measuring greater than 3mm. Folliculitis (local infection/cycts of hair follicles) is not an uncommon problem in the post operative course over the first few months as the sebum builds under the skin and can not get out (this is easy to treat). Most people do not have much of a problem with things that go wrong from the surgery. The biggest problem is for the patient to match his/her expectations with what the surgeon can deliver. Miscommunication here is the biggest problem of all because either patient or doctor often oversell the results.
Male patterned genetic hair loss is a life long process, but most people stabilize or slow down the progression by the time they are 35. From that time forward, hair loss is usually slower. This is what a good doctor will cover as he develops a Master Plan for your hair loss with you.
If you take Propecia (for men only), then hopefully if your goals are achieved with the drug alone, surgery may not be necessary. If Propecia alone does not solve your problem (typical for the NW 3V or more advanced balding patterns), then transplants may be necessary to achieve your goals. Again, that is where the Master Plan is customized to your needs.
A Class 3V varies in size and degree. The ability to supply enough hair from the front and crown depends upon your densities, scalp laxity, hair characteristics, shaft thickness ,and color/contrast of hair to skin. Each person is different so the actual answer to your question is that each person is different and what is good for one person may not be food for another.
It is not unusual for me to perform a session of 3500 grafts, but that depends upon what is safe and what is in the best interest of the patient according to his Master Plan. If you are 25, I would probably not consider the crown transplant. If you were 45 with good density and scalp laxity, then this may be a reasonable option depending on other factors that would be defined in an extensive consultation.

March 21, 2006

Avodart vs Propecia – Hair Loss Information by Dr. William Rassman

Is there any evidence that avodart is more effective than propecia?

During the 2005 International Society of Hair Restoration Surgery (ISHRS) conference in Australia, there were some suggestions that Avodart may be more effective than Propecia. However, the FDA has not approved Avodart for treating male pattern baldness, most likely because the drug company has no interest in this particular market. FDA studies are driven by the profit motive of the company, and the company (which I believe started and then stopped the appropriate studies) indicated no intent to pursue this market. Nobody can not make any proofs on the effectiveness of Avodart, and therein lay the crux of the problem. Some doctors seem willing to write prescriptions for this ‘off label’ use of the drug depending upon the safety issues defined by the drug company for Prostate use.

March 21, 2006

Hair Loss with Bald Spot Above Ear – Hair Loss Information by Dr. William Rassman

This is a follow-up to Hair Loss from Propecia:

Well i also moved a couple of months before this happened. Also about two months before i moved, i dyed my hair. So im wondering if this could be telogen effluvium? Ive dyed my hair alot in my lifetime and it has seemed to make it thinner but never any hairloss of the front. And if it did it grew back and I just didnt pay my hairline much atttention back then. My Mom’s dad was bald. But thats about it. My dad has a receding hairline but he is 57, and he still has plenty of hair and i dont think he will ever go complety bald. No one else in my family is bald. I also have an almost bald spot on the side of the right ear and my hair is thinner on the sides and the top than the back. I have no good hair doctor in my area so please help.

Please send me photographs. With a bald spot now above your ear, it is possible that you have other causes for your hair loss, rather than pure genetic causes with MPB. Singular bald spots may indicate a series of other etiologies, including infectious or autoimmune causes. Any good dermatologist can address this and even with pictures, there is no substitute for a direct examination by a doctor. Dermatologist are all over the US. See the American Academy of Dermatology to find a dermatologist in your area.

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