Drugs – Page 341 – Balding Blog

January 30, 2006

Are These Side Effects from Propecia or Stress? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,
I am 23, and have had diffuse thinning for the past three years. I am currently taking propecia and minox and have been for 15 months. During that period, I have not noticed any significant regrowth, but the appearence of my hair has seemed to maintain to some degree. I am also a law student and in December I had my first set of finals. During that time, I can honestly say that I was more stressed then I have ever been in my life. Since december, I have noticed that my hair has appeared to thin significantly.It used to be thin only in the back, now I can see a thinning pattern in the front. Additionally, in the month since finals ended my libido and sex drive have significantly increased. I do not know whether that increase is due to my lack of stress, however I am speculating that the propecia has stopped working for me. I was wonding if these are typical effects if it does stop working; i.e increased thinning and greater sex drive or perhaps I can attribute both the my level of stress and current lack there of. Any help would be greatly appreciated. If propecia has stopped working for me, then I really don’t know what else I could do

Stress impacts everything in our lives. Your hair loss and thinning is certainly (assuming you have genetic hair loss) being made worse by stress. Propecia sounds like it has slowed or stopped the present hair loss, but as male genetic hair loss is a progressive process, it is only a matter of time until you notice more thinning/recession. The sex drive issue relates to many things. Men can find sex to be a good outlet for frustration and hiding from problems. Propecia can initially cause an increased sex drive due to the increase in testosterone levels, but the sex drive of a man your age should already be high, so perhaps your body is just learning to deal with the stress better. Could it be that your normal sex drive is what you are now experiencing?

With regard to your thinning and possible genetic hair loss, you should get your hair mapped out for miniaturization to determine if the hair loss is genetic and to what degree it is progressing. You need a Master Plan for your future hair loss. As you are in Los Angeles, I would be pleased to see you myself at no charge in my LA office. If you are interested, please call my office at 800-NEW-HAIR to set up a free consultation with me.

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January 30, 2006

Hair Loss from Propecia – Balding Blog

Hey. I’m 20 years old and I have also had a further back hairline, but only on the side. it looked fine. A year ago i asked my doctor about it because it was a little thin on the right side and he prescribe propecia. Well i had been taking propecia for about 8 months every other day, when all of the sudden my hair was coming out like 15 hairs at a time. when i ran my fingers through my hair tons came out. I lost about an inch and a half on my hairline in 2 to 3 months. My hairline was fine before but it was just thin on the right side. It crazy its bother me alot. So i quit taking the propecia a little less then a month ago. I mean i cant even grow facial hair. so it feels weird that im losing my hair. PLease help. Could this be temporary?

Dealing with someone like you over the internet is very difficult or almost impossible. As I have said many times on this blog, you first need a working diagnosis. Getting your hair and scalp mapped out of miniaturization should at the least establish a proper diagnosis. Having someone with my experience, for example, is critical in making the judgments you need. Questions that stand out for me include:

Are you going through accelerated hair loss?
Do you have other causes of hair loss?

I would want to go through an extensive history on your overall health and the family tree in terms of balding, hair growth (when and where), etc. Get a good doctor and do not treat yourself. It has been said that “A person who treats himself, has a fool for a doctor”.

January 30, 2006

Losing Hair from Rogaine – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,
I started using Rogaine almost 2 months ago. My hair was getting very thin and each year I had less hair. Before using Rogaine, I never saw a hair in my shower drain, but somehow I was losing hair. After using Rogaine, my hair loss did not get worse in the first 2-3 weeks, but now, after almost 2 months of using Rogaine, I noticed a lot of hair in my shower drain every day. what shoud I do now? should stop using it? or should continue? I use twice a day, a little more than 1ml of 5% Rogaine.
Thank You

Shedding of hair may occur shortly after starting Rogaine. I would suggest that you ride out this phase considering the short period of time.

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January 27, 2006

Switching from Rogaine to Propecia – Hair Loss Information – Balding Blog

Hello sir,
I am currently 20 and have over the past year and a half witnessed my hair line gradually recede. I am finding it hard to keep positive and confident, although it is not at an extreme. I am in constant fear of what the future could hold. There is no sign of baldness on my mother’s side yet my father and my grandfather are both completely bald. My brother who is only four years older than me started wearing a wig at the age of 21. I am not completely sure of what kind of level baldness he is at but I’m sure it’s not pretty. I fear that I am to walk the inevitable genetic path placed in front of me, which is getting me rather down.

I am currently using rogaine extra strength for men, which I’ve been using for around 5 months now and am still seeing a gradual thinning of the hair line and am not sure if it is working or not, or even going to work at all. I was thinking of perhaps using propecia, yet if I do I cannot afford to maintain using both treatments. I’d be very interested in what you’d have to say about my situation and whether making the jump from rogaine to propecia could have consequences.

Thank you very much.

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Propecia has been shown to have better results than Rogaine in treatment of hair loss from male pattern baldness in young men. You need to get your hair and scalp mapped out for miniaturization to have a proper diagnosis, so that your doctor can develop a Master Plan for your overall situation. Both Rogaine (minoxidil) and Propecia are good treatments, but the actions are different. As you have been on Rogaine for 5 months, I would hold off until you get the examination complete. Then add Propecia (assuming the diagnosis is confirmed and metrics are in hand), and then follow-up with another examination 8 months after to see where your hair loss is at.

January 27, 2006

Hair Loss InformationAppropriate Amount of Grafts in Frontal Area – Hair Loss Information – Balding Blog

Dear Dr Rassman,
I am a 24 yo male who has experienced hair loss in the frontal region and am told that i am a Norwood type 4. I went to see a surgeon/dr in Australia. He told me that the best treatment was to have one large megasession and that he would use 2500 grafts on the frontal region. I am curious as to know whether this is an extreme amount in that region and your feelings on megasessions. I was also wondering that given my age how many sessions in my lifetime will i need and how frequently do people my age have to have more done. If i had a megasession would there be enough hair in my donor area if i did suffer more hair loss. Is there any way of doing a procedure, where you have existing hair, to transplant it to that area to prevent it if it was to fall out. Does one procedure in people’s liftime exist if they stay on propecia (which I am on, and doesn’t seem to be working that well).

Sorry for so many questions Dr Rassman. Thank you very much for your time.

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For a Norwood 4A balding pattern, 2500 grafts in a single session sounds like a reasonable number that might meet all of your needs, depending how large the area is. Most people have about 6,000-8,000 grafts available in their donor area, but the actual number may vary. That is why we measure everyone’s density to determine a Master Plan for the worse case scenario of hair loss. Your age is a bit young, but if the pattern of loss is relatively complete and did not reverse after taking Propecia on a trial basis for 8 months, then a transplant could be reasonably done. Hopefully with Propecia that is consistently taken, the hair loss will at least slow or stop, stalling any need for further transplants for some time. Provided that you keep the work done to the frontal area, there is little worry about running out of donor hair for most people. I would discourage work in the crown at your age.

January 27, 2006

Propecia Linked to Male Breast Cancer? – Hair Loss Information by Dr. William Rassman

There was some reference in the 7-year Proscar study to a statistically significant increase in male breast cancer among the participants taking 5mg of Proscar daily.

Any thoughts or perhaps you have seen further research?

By the way, your visit from Jimmy and Adam on the “Man Show” was hysterical. You handled those guys with style. Well done!

Thanks for your comments on the Man Show. I fully enjoyed doing this as well as many other similar programs.

According to the New England Journal of Medicine (Volume 349:1569-1572 October 16, 2003 Number 16, Prevention of Prostate Cancer with Finasteride) there was only one case of male breast cancer in this study group of almost 19,000 men (see CNN article: Baldness drug may reduce prostate cancer risk).

Gynecomastia (breast nodules in men) is more common and is often painful when it occurs, but this is not cancer. There is no evidence that cancer is a risk, but if there is a history of breast cancer in your family, I might consider finding out if the gene for breast cancer susceptibility (BRCA1 on chromosome 17 and BRCA2 on chromosome 13) is carried in you (see Do We Know What Causes Breast Cancer in Men?). If you carry the gene, then you might avoid Propecia. The good news is that you can test for BRCA1.

January 26, 2006

Continued Balding After Hair Transplant – Hair Loss Information – Balding Blog

I have read a lot about mega sessions and micrografts, etc, and don’t doubt that they can produce satisfactory results if done properly. My question is: what happens as time goes on and balding continues in the untreated areas? I assume a patient would have to keep coming back every so many years to fill in the newly balding areas. How many times can someone go “back to the well” as it were. I am 43 years now, and have a receding hairline (especially at the temples). My concern is that when I am 60 or 70, I will look ridiculous with a perfect hairline but balding at the crown.
Thanks

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This is a good quesiton which I have answered in many ways before. Generally the hair loss for most people tends to plateau after the age of 35, and by the time someone reaches your age, the final pattern can be estimated by mapping out the scalp and hair for miniaturization so that you do not play ‘blind man’s bluff’ with your hair. If you will advance to a very balding pattern, then some of the hair in that pattern will be miniaturizing now, so it will be easy to see under high powered imaging.

If you take drugs like Propecia, it has several advantages, including reduction of the progressive nature of the hair loss, and probably preventing prostate cancer. Both are desirable side effects of the drug.

In most men of your age, chasing the hair loss is unusual. It is usually more of a problem with men in their 20s who get a transplant, are destined to become very bald, and who do not take Propecia. With a good Master Plan, you should never look ridiculous at any age after having a transplant, providing that you have the conversation with your surgeon and he/she is honest about his/her answers and not a salesman going for the cash that is your bank account and wanting it to be in his instead.

January 26, 2006

Sex Drive and Erections – Hair Loss Information – Balding Blog

I am a 36 year-old male. I have been taking 1/5 of a finasteride (Proscar) pill daily for about 6-7 years. I have heard that Proscar can have harmful effects on male sex drive and erections — my question is, when this does happen, can it happen gradually or does it happen in the immediate days/weeks/months after starting the drug?

I ask because there has been a noticeable decline in my sex drive as well as the frequency and quality of erections over the years, and I don’t know if it’s normal for my age, or possibly due to the drug. I’m still quite functional sexually if I pick my spots, but those spots seem to be less and less frequent, and when I do get involved I’m prone to lose it unless I take Viagra beforehand (1/4 of a pill seems to work very well for me).

Please help! Would greatly appreciate any insight you can offer on my situation. I’m not sure but I think 36 is too young for this stuff.

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Every man over 25 knows that their penis does not behave like it did when we were 15. There is an interconnection between our erections and our sex drive. If our erection is not strong enough, if we do not last long enough, or recover fast enough, then what we may call erection problems (Erectile Dysfunction / ED) may become a matter of our focus. From the impromptu polls I have done in my mostly male practice, many men in their 30s find that Viagra improves their erections. Question: Does it improve from a 15 year old vantage point or a 36 year old vantage point?

Your “sexual problem” (I only used quotes because I am not sure to what extent there is a problem) may be ED or it may be caused by Propecia (but that usually comes within the first month of taking the medication, not after years necessarily). If you stop the Propecia for a few weeks, and the ED and sex drive goes away, then you can assume it was Propecia induced. You can check your testosterone levels; hopefully they will be normal. If you have some aging effect and you are satisfied with Viagra, then use it. There are doctors that specialize in ED, so if all alse fails, you can see one of them so if you go this route, you are best starting off with your family doctor. If you decide to stop the Propecia for 2-3 weeks, the drug will be out of your system in a couple of days and within a week you should see some benefit if it is Propecia related.

January 26, 2006

Propecia And Unprotected Sex – Hair Loss Information – Balding Blog

Can you tell me, When using Propecia (3 months) is it safe to have unpretected sex without dangering female partner?

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There is no danger to your partner from finasteride (Propecia) by having unprotected sex while you are taking this drug. Propecia’s manufacturer, Merck, does not warn of problems in this regard.

The question I am often asked is whether unprotected sex and pregnancy could cause problems for a man on Propecia. I believe that the answer to this question is that getting your lady pregnant should not be a problem when on Propecia, but if you are concerned about it, then you might stop taking it during the period when she is most fertile. I’ve written about that previously here and here.

January 25, 2006

Hair Loss Medication Side Effects – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman
I have always thought about doing something for my loss of hair which is mainly in the front. I hear about all these products (propecia, procede, avacor) they all sound so great but it’s hard to trust on any of them since they don’t mention any possible side effects. I read about the gentleman who loss a lot of his hair when he used procede and I’ve heard that propecia may cause low sperm count. Are these side effects common? Is there any place where I can find such information? I guess most products (like medicine) have possible side effects. I just need to know how common this occurs. Thank you

I have no direct knowledge about ProCede. Avacor’s main active component appears to be minoxidil, which is cheaper if you buy it as generic minoxidil. Propecia does not reduce the sperm count, but can reduce the volume of the ejaculate that goes with the orgasm. Your sperm count should be as potent for getting your lady pregnant as before you took Propecia. The good news about Propecia is that it stays in your body less than a day (90% is out of your system in a day and effectively 99% is out in the second day). Keep priorities, do your research, and get a good examination by an expert doctor.

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