Drugs – Page 342 – Balding Blog

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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January 24, 2006

Taking Propecia and Viagra – Hair Loss Information – Balding Blog

First off I have learned alot from your web site. I’m sure all your readers are very greatful. I know I am!! My question is If someone already suffered from impotence and taking viagra or a simaler product for this would mixing propecia with it for hair loss be a problem. Is it a safe mixture in other words?

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There is no difficulty taking Viagra and Propecia. They do not interact with each other. This way you can enjoy both good sex and great hair. That is a winning combination.

January 24, 2006

RK19 vs Propecia vs Minoxidil – Hair Loss Information by Dr. William Rassman

At age 59 what results can I expect from RK19? Can RK19 be used with Finasteride(propecia) and Minoxidil? Which is a Better program? Is a Dr.’s prescription required?

RK19 is a product that sells over the counter and can therefore be purchased from their website. Minoxidil can also be purchased without a prescription. Propecia, on the other hand, does require a doctor’s prescription. I have no personal experience with RK19, but after reviewing the photographs, I am more than concerned. The blonde picture was foggy, and the other two pictures seemed to have a scalp coloring agent in them. That makes me suspicious. Let the buyer beware, so use this as your guide in trying to figure out what to do. Please review what I have said in the past on this blog about RK19, as well as what I have said about safe and effective hair loss remedies.

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January 23, 2006

Benefits from Minoxidil and Propecia – Hair Loss Information – Balding Blog

I am 21 years old and noticed a receding hairline and thinning of hair about 2 years ago. My hair loss is mainly the receding hairline. I am in my 9th month of the EXT program at [name removed]. By the way anyone considering it dont do it! it cost me $2,600 for a year and all they do is give you shampoos, conditioners, vitamins, and minoxidle. You can buy all that on your own for much cheaper. Anyways i have noticed that my hair is thicker on the vertex and my front hairline has gotten a little better. It is growing little baby hair. I have 2 questions. I just started taking propecia 2 months ago along with the program. I dont like minoxodil because it makes my hair greasy and its hard to style my hair in a nice way when minoxodile is in it. My question is if i stop taking the minoxidil but keep taking propecia will the benefits of the minoxidil remain, or will they just disappear?

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If you stop the minoxidil, you might lose hair if some dependence built up. Alternatively, once you start, switch to minoxidil for women, as it has an alchohol base and is easier on the styling with the same hair benefit.

I would have hoped that you would have started with Propecia first, and nothing else. Then if after 8 months there is no benefit, possibly go to minoxidil. I do not sell any products to gain a profit so I am never in a position to make a distinction between what is in your interest and mine. Only your interest is what counts. The Propecia value will show in 8 months after taking the drug. Please wait it out and possibly stop all of the other things you are taking except minoxidil, which you may be hooked on by now.

January 23, 2006

Hair Assessment in Early Balding – Hair Loss Information – Balding Blog

Hi Doctor,

I am a 26 yr old male started thinning about 11 months ago sometime in december last year. My hair was really thick before so obviously I didnt realise I was thinning when it kicked in during the early stages.

Observations :
1. I notice about 18 -25 hair every morning on my pillow. Most of these hair are very fine and shorter than usual. Some of them have a white bulb at the end.
2. Even at work I notice about 4-5 hair falling on my desk/ keyboard everyday even when I gently rub my fingers on my scalp.
3. During a shower when I apply shampoo on my hair I get about 10 – 12 hair sticking on my hands/fingers even though I shampoo very gently. I wash my hair with shampoo and conditioner ( Clairol Herbal Essences/ Nizoral; was using Garnier Fructis earlier) about 5 times a week usually after a workout.
4. My Hair is thinning all over my scalp. Even on the back although since there is a higher density of hair so No scalp is visible.
5. Some of the common symptoms I have experienced in the past 8-9 months are itching, flaking/daindruff, A kind of burning sensation as if there is some heat generated from my body which is burning the hair roots on my scalp, and obvoiusly my hair is a lot thinner than a year back.
6. I do not see any receding of my hairline( thank god for that)but the area right behind my hairline/top has some noticeable bald spots where it seems like the hair thinned a lot and i have lost some hair.
7. Been on propecia for almost a month and do experience some pain in my balls of late (after ejaculation) however I dont think its reduced my sex drive or erections but I am determined to ride it out.
8. Overall When I examine my scalp minutely,I notice my hair still grows fast however the quality of hair is much more thinner than a year ago annd as a result a lot of scalp is noticeable. I probably have some hairloss too.
8. The worst part is I am not able to comb my hair like before and if I make it puff from the top/front My scalp is very visible from the front. I really woe the fact that I should have taken corrective measures early (when visible hair loss/thinning started about 10 months back but like most people I was in a denial mode and just would not digest the fact that I was loosing/thinning for good.

I have spent many sleepless nights on this issue in the past month and literally think bout it every 30 minutes.
I am a vegetarian and take about 100 grams of whey protein (courtesy GNC) per day for supplementation. I would say My professional life isnt that stressfull at all. The pics in the album were taken with a Kodak 4.0 MP digital camera under bright light.

1. I am applying Minoxidil twice a day but I am thinking bout changing it to once a day at night. I apply it mostly at the top and some on the vertex. Also its too flakey and makes it look like I have daindruff on my hair. Do you think this is a good move and is once a day 5% effective ?
2. From my pictures can you tell me whats my norwood scale ? I am thinning considerably from the top. The hair on the top of my scalp are very thin compared to last year. As a result They tend to clump together when I make them wet or when I apply hair gel. Sometimes in the morning when I gently rub a wet hand on to my scalp I get about 6-8 hair sticking into my hand. Will Propecia or Minoxidil make them thicker again ?
4. From the pictures how bad is my vertex ?
5. Realistically what are the chances I will retain my “Hair Glory” I had in Sept 2004 ? Or is it all downhill from now ?
6. Is there any way i can get the thickness measures with a densitometer in the North California area ?

Photo Album at [link removed for privacy]

Most of the pics in the first album were taken immediately out of the shower. these days I just stand under the shower and let the water wash the shampoo itself with out rinsing it off after applying. No towel dryng too. Notice how the thin hair clumps together from the force of the shower and my scalp is exposed. Or Am I balding on those areas ? looking at my current situation do you think I should continue using minoxidil 5% I started it 2 weeks back in panic I use it twice a day for now. Should I cut it back to once a day or totally eliminate it ?

I would appreciate your assessment of my situatiocn.
Best regards

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Your photographs are consistent with genetic hair loss, but there is no substitute for a good examination as I have said many times in this blog. You should not be your own doctor. The miniaturization mapped on your head will allow the doctor to determine the pattern of the hair loss. The Propecia you are taking will probably stop much of what you are seeing, but you do need to have the examination for miniaturization, or you will not ever truly know if you are actually benefiting from the drug, or if the problem was just temporary and drugs were not necessary. You discussed your hair glory, wanting to go back. I can not (nor can anyone else) predict your response to Propecia, although I have seen some men return to their ‘hair glory’. Responses depend upon the time you have been losing hair, the genetics of each patient and the timing with regard to starting the Propecia with regard to when you actually started losing your hair. The quicker a young man starts Propecia, the greater the overall effect I generally see. As to your question about using Minoxidil while also using Propecia, I’ve talked about this a few times before: here, here, and here. I am in Southern and Northern California, and would be happy to perform such an examination on your free of charge. I can not make a doctor recommendation in the North Carolina area, but you could take a look at the physician search on ISHRS.org. Be sure to do your research before chosing a doctor.

January 23, 2006

Proscar Prescription – Balding Blog

Hi Dr. Rassman,

I was wondering if it would be possible for you to write me a prescription for Proscar which I can cut into 4 pieces. If not, do you know a physician who will? Also, is there a good method for cutting it evenly? Thank you.

Yes, I can write a Proscar precription for you, but you will have to come into the office for a check-up and diagnosis. Since you indicated you are in the Orange County area, you’re not too far from my Los Angeles office. You can use a pill cutter to cut the pill into 4 or 5 parts. These are sold in every pharmacy for a dollar or two.

January 23, 2006

Will Avodart Lose Effectiveness After 5 Years, Like Propecia Does? – Balding Blog

Hi Dr,
We know that the study on Propecia shows that after five years, users typically lose most of their regrown hair, and that propecia continues to deter hairloss but that hairloss does continue over time.

My question is…why? Is it that Propecia no longer effectively inhibits DHT after 5 years (body develops an immunity, DHT serum/scalp levels therefore increase.) Or, more likely, is it that there are still undetermined factors which contribute to hairloss, even though the type 2 DHT inhibition rate remains constant?

The question links to avodart. If avodart is just a *much* stronger DHT blocker, and if DHT-inhibition is not the cure-all to hairloss, can’t we expect that Avodart too is equally limited in its scope?

I don’t see how type 1 inhibition and long half life can help in the overall process if there’s more ground to cover than DHT inhibition.

Actually, Propecia users keep more hair than non-Propecia users even after 5 years (ie they do not lose most of their retained hair), and Propecia continues to stop or slow hair loss at the very least in the crown area for as long as you take it. I have patients who have been on it since it came out and their hair loss (if any) is undetectable.

As for those who only experience dramatically slowed loss (still a big improvement), no one knows why hair loss continues at low levels. You are correct to point out that we do not have all the answers with hair loss, the fact that Propecia works mainly in the crown for returning hair and not the front (and only in men) is proof of this. But Propecia will slow loss in the front if you catch it early enough in some people. Pattern baldness is progressive by its very nature.

You are also correct to point out that Avodart is far from being a panacea. We do not even have studies proving it’s efficacy in hair retention (although I myself believe it possible), so it cannot be the final answer or the magic pill we all hope for. Before starting more medications, you should get a metric (measurement) by having your scalp mapped out for miniaturization to determine if you have premature genetic balding.

There are still many unknown factors in hair loss, the future will bring many advances and surprises, I am sure. Until then, Propecia, Rogaine, and hair transplantation are the only means of hair loss help that have scientific evidence to prove and quantify their effectiveness.

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January 19, 2006

Balding Olympic Athletes Promoted – Hair Loss Information – Balding Blog

What are we coming to? Today’s Olympic athlete now must give up Propecia if they want to compete. According to today’s New York Times (1/19/06), Zach Lund is an Olympic athlete who is prematurely balding and he wanted hair. “So in 1999, when he was 20, he began taking Propecia. Then in 2004 he switched to Proscar. And it looks as if he grew hair, or at least stopped losing it….”

He is now faced with a choice, should he become a balding gold medal winner or a person who was eliminated from competition because he wanted a full head of hair. That is the stupid quandary that today’s potential Olympic champion must face. To be a bald champion or not an athlete at all.

The New York Times states: “At the end of 2004 the World Anti-Doping Agency added finasteride to its list of banned drugs in international sports. The agency calls finasteride a masking agent that hides the use of more nefarious drugs like the steroid nandrolone. So, one imagines, every Olympian with a spasm of hair growth must fear surprise follicle checks…. Better he should have had erectile dysfunction. The trinity of impotence relievers – Viagra, Levitra and Cialis – is not prohibited, though these drugs are performance enhancers in a certain athletic way.” Sooner or later, these three medications are bound to be added to the list of banned drugs.

What a world we live in! We may ask our athletes to give up sex to become a star. Maybe without hair, they won’t feel sexual anyway, or am I too shallow in my assessment? To see the entire article, go to: Fighting Baldness, and Now an Olympic Ban (registration required).

January 19, 2006

DHT Blocking Foods? – Hair Loss Information by Dr. William Rassman

You mentioned in a tidbit that there were people who blocked DHT with eating large quantities of dht blocking foods. What might those be, and could we get similar results by ingesting these foods. By the way, thanks very much for doing this blog. It is extremely interesting and informative.

To the best of my memory, the drug finasteride was derived by work done in primitives who ate a tuber that was unique to the rain forest and contained this drug. I am not familiar with other foods that contain it. The high incidence of hermaphrodites in the population is what clued explorers into the uniqueness of the foods these people ate, mainly because the food was eaten by pregnant women, blocking the effects of DHT which is required to differentiate the sex of the offspring. If you find hermaphrodites somewhere eating large amounts of some unique food, that might be a good clue.

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January 19, 2006

Rogaine Shedding, Nizoral – Hair Loss Information by Dr. William Rassman

Hello, I’ve never used Rogaine, in fear of the “shedding” phase I’d heard about. What exactly is the “shedding” phase, if I may ask.

And will this product cause that? And is there a list of the ingredients anywhere or should I not be asking that? I’m just very curious.

Last but not least question, if this products is discontinued, I am assuming everything on the scalp goes back to “as it was” before, and are there any products that shouldn’t be used, such as Nizoral Shampoo?

Your help is greatly appreciated. Sorry, where can I purchase only the “hair grow” product, not the cleaner etc?

To answer your question about shedding from Rogaine use, please see my past response in “Hair Loss Worse After Rogaine”.

I am not completely sold on Nizoral shampoo, although I do believe that it is a good shampoo. I do not believe it is necessarily good at regrowing hair. There is not enough scientific data to support hair growth claims. You can buy Rogaine over the counter and I doubt that minoxidil (generic form) will ever go off the market. The miniaturized hairs become dependent upon minoxidil when you take it and when it works. If you were to stop the Rogaine (minoxidil) and there was a benefit of it, you will go back to your ‘before’ status, plus losing whatever hair you would have lost prior to starting the medication. This may very well leave you worse off.

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