Hair Loss InformationFamily History of Hair Loss – Hair Loss Information – Balding Blog

Hello doctor. Thanks for your time. I have medium length wavy hair. I have notice recently a lot of hairs coming out in the shower and sometimes on my pillow. My fringe feels thinner and i feel a little bit thinner on top, but my hairline does not appear to be very receding. I’ve also had an itchy scalp of late. My brother suffered hair loss aged only 21 and my uncle also lost most of his hair before he reached 30. This would make me believe it is hereditary hairloss but my hair doesn’t appear to follow the pattern that i’ve read about. Could there be another reason? Thanks.

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You need to be examined by a good doctor and the diagnosis of genetic hair loss needs to be made with objective criteria. A close microscopic examination of the scalp (all over) will show indications of patterned hair loss common in the genetic cause of hair loss in men. Please, before you jump in and start taking drugs, let’s make a diagnosis and map out the full impact of the genetic balding now. Then, knowing what you have in store for you, Propecia would be a good drug to combat your hair loss (assuming you are a young man) and a repeat microscopic examination of the hair in different areas of your scalp will show the areas that are most improved with Propecia.

Propecia and Minoxidil Together – Hair Loss Information – Balding Blog

Dear Dr.
I realize Minoxidil does not work on the front of the head (hairline). I have the classic receding hairline problem and I’m curious if you feel Propecia is worth taking in an effort to (possibly) reduce the receding hairline problem (or at least prevent it from getting any worse)? Also, is it any more or less effective to use both Minoxidil AND Propecia at the same time?

Thanks for all your great work.

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For men, I generally like to start off with Propecia first, and if there is no benefit in about 8 months, then add Minoxidil. If there is still no benefit, then transplantation may be the only option, if the hair loss is bad enough. I don’t like to do two things at once, because if you use both Propecia and Minoxidil and they work, the treatment that was responsible for the benefit (it might have only been one of them) is something that you will never know and therefore you will be ‘hooked’ on both for life. For women, there is no Propecia option, so Minoxidil is the only know effective choice available for hair loss.

Daily Hair Treatment Regimen – Hair Loss Information – Balding Blog

Dear Doctor,
Thank you for this excellent resourceful blog! My hair has been thinning excessively since past 6 months to the point that i can no longer apply gel since it shows my scalp. there has also been some hairloss. If I keep my hair dry my scalp hardly shows nevertheless hair is thinning. I recently got on propecia and some other natural treatments. Here is my daily regimen:

  1. Propecia – early morning when I get up
  2. Saw Palmetto – 12 hours after propecia 320 Mg (so that it starts working on the DHT since Propecia has a shorter half life and I doubt its effect will last 24 hours (does it ?)
  3. Nizoral Shampoo twice a week
  4. Biotin and B vitamin supplements
  5. Zinc supplement
  6. regular Multivitamin

I have some questions:

  1. How effective would this regimen be and is there anything else I can add on to it ?
  2. When can I expect to see the results ? (re- thickening of hair and reversal of some hairloss i have had. )

My hair loss seems more on the area right behind my frontal hairline. Vertex is fine.

Family history: Dad started losing his hair slowly at age 35. Grand father had hair till 60. Mom’s brother is 48 and has full head of hair. and his father had hair till 55. I am 27. Please advice. I am passing through a lot of emotions.

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Your maximum response to Propecia will be up to two years, with fully 60% seen in the first 8 months or so. Be patient and wait it out for the full course. The approach you are using seems good. The Propecia does have a half life of 5 or so hours, but there is some discussion that Saw Palmetto may block the full benefit of the drug if it competes with the 5 alpha reductase inhibition. I can not certify this problem one way or the other.

I always recommend that the degree of miniaturization that you are having is documented by a good doctor. This will, at the least, tell you if the drugs are doing their job. Long term planning with a good Master Plan needs to take into account everything from your response to conservative treatment and the probable pattern of your hair loss. Minoxidil may be something worth trying if you do not get a good response from this regimen.

Hair Loss InformationPrednisone Stopped My Hair Loss? – Hair Loss Information – Balding Blog

I am 38 (female) and have had thinning hair for a while. I was prescribed Prednisone for a different problem (poison oak) and went through the treatment process. I noticed while on the drug for awhile that my hair stopped falling out. Have you ever heard of this? It seems that every other time prednisone is mentioned, it causes hair to fall out rather than stopping it. I’m wondering if a low level dosage is ever prescribed as a treatment for hair loss. Once I finished the prednisone, my hair started falling out again.

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There are many causes of hair loss other than classic genetic female hair loss (alopecia areata, various autoimmune processes, etc..) that might be helped with steroids, while the genetic process might be harmed by these same drugs. You need to have a good working diagnosis made by a competent dermatologist to ascertain what you have. Steroids can be dangerous when used long term, so be sure you are properly managed by a good doctor.

Hair Loss InformationRecapeen, FUE Plus & Lasers for Hair Loss? – Hair Loss Information – Balding Blog

As creators of the FUE method, I presume you know what the FUE Plus method is? There is a clinic in my country that claims to have been able to boost the traditional FUE method by using a smaller tools when inserting the transplanted hair. (1) They claim that the increase in density is miraculously high, but still the improvement is impressive. Do you know more about this? (2) A new hairloss treatment called Recapeen, has been realeased. The “engine” in this package claims to be the unique pollen extract the substance is full of. Comments? And finally, 3) What is the strongest reason why to spend money on a hairtransplant rather then a laser treatment?

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I looked at the site referred to in your question. There is not enough information for me to judge what FUE plus is. When I purchase a bottle of shampoo and the company comes up with a new version of the shampoo they may add the term ‘plus’ to the name. The detergent market for washing clothes, made the most popular product in the early 1900s. That product was ‘Tide’. Then as they were improving the product, sales did not rise fast enough, so they came up with New Tide. The adjective NEW turned out to be the most popular advertising word in capitalistic history. Everyone came up with a product and then made up a NEW version of that product. I, knowing this, called my company the New Hair Institute and purchased the phone number 800-NEW-HAIR before anyone else thought of it. I was, at the time, an old fashioned marketing person, so NEW did it for me. The modern iteration of this is the term PLUS. I guess, if you did not invent FUE, then the best way to grab onto market presence is to invent FUE Plus, or at least the name. I respect the marketing brain that thought of it. The choice of doctors, of course, should have little to do with PLUS or NEW, but rather who you can trust to do the FUE on your head. Experience and judgments are critical to this choice and you sound (at times) like you are making such choices.

I did look at Recapeen and see that this miracle cure is listed with many other such potions and lotions on the respective websites. If Recapeen worked so well, one might ask why other products are listed there? I call it good marketing and diversification of strategies. Spread out well, and more people will get some part of the message. What are you really looking for?

I agree with you that hair transplants should be obsolete if these miracles worked, but then again, first I would want to see the studies and the scientific evidence that it works, because I am a cautious buyer. Every day that you chase the magical cure for balding is another day that you will continue to lose hair and progress further down the pattern of hair loss buried in your genetic cards.

With regard to laser treatments click here Low Laser Light Therapy for Hair Loss for more details.

Hair Loss InformationDutasteride (Avodart) Risks – Hair Loss Information – Balding Blog

My husband is 33 years old and is losing his hair, he also suffers with body dysmorphic disorder and is desperate to do something about his hair loss. He has already tried many different lotions and potions to try and halt the hair loss because we can not afford for him to have a hair transplant. The problem that I need advice about is Dutagen (Dutasteride soft gel capsules) he has purchased a 6 month supply of this drug from the internet but I noticed the warnings about dangers to pregnant women and the risks to male foetuses. The problem is I am 7 months pregnant with our second son and I have great concerns about my husband taking this drug knowing that there are risks to our unborn son. We also plan to have more children in the future and I am extremely worried about the risks to me and my baby now and for any unknown problems that may arise in the future regarding having more children. What information is available to me to put my mind at rest about my husband taking this drug while I am pregnant and future fertility considerations associated with taking this drug?

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Dutasteride is a known DHT blocker. I am not familiar with this drug’s concentration in the sperm and how much of it could cross into the baby. If it follows the experience with Propecia, it should be safe in this regard, but without first hand knowledge, I can not tell you the answer to this question for sure. There is a theoretical problem if it did cross the placenta and into a baby’s body, it might affect the baby’s sexual development as the drug has a very long half life. You might ask your husband to use a condom until the baby is born.

Soft Gelatin Capsules, because of the possibility of absorption of dutasteride through the skin of people who handle this drug and the potential risk of a fetal anomaly to a male fetus in a pregnant woman who absorbs any amounts of this drug, could impact gonadal development. This is a risk that is not well defined for this drug. For this reason, women should use caution whenever handling Dutagen Soft Gelatin Capsules. Your physician should inform you and your husband that the ejaculate volume might be decreased during treatment so that for women wanting to get pregnant, this might also pose risks, particularly for the fetus if the sperm contains the drug and the drug last months inside the sperm (and possibly inside the fetus).

The known side effect of a decrease in sperm volume (with Propecia and Avodart) does not appear to interfere with normal sexual function in most men, but in clinical trials, impotence and decreased libido, considered by the investigator to be drug-related, occurred in a small number of patients treated with this drug. I hope that your husband’s body dysmorphia is being managed by a good physician.

Hair Loss InformationIs My Hair Loss Normal? – Hair Loss Information – Balding Blog

Hi, i been taking propecia for a month and 1 week, this last 2 week i notice that i lose over 150 a day ( Each morring i lose around 50 hair on my pillow and around 80 in the shower). It been going on over 2 week.
Will this stop and Is this normal for taking propecia? if yes how long will this hair lost last? Do propecia cause initial hair lost?

thanks

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A typical person does lose 100-150 hairs per day. If what you see more recently reflects a change in your norm, you may be experiencing an acceleration of your hair loss. The relationship with your taking Propecia may be circumstantial and I would believe that the two are not related, but you can stop taking the drug and see what happens. The drug is out of your system usually in a day or two. If it stops the loss, then maybe there is a connection, but I have never seen that connection in others. If the loss continues, then I would go right back on the Propecia because that is the best hope for you.

There are some doctors who believe that some shedding after starting Propecia or Avodart is due to an acceleration of the hair cycling. See my previous posting on this subject here.

Hair Loss InformationAm I Covered for Hair Loss? – Hair Loss Information – Balding Blog

HI DR. RASSMAN, I would like to tell you what I am using… propecia, monoxidil 10% with retina-A .. revivogen, nizoral and n-t gel shampoo. I would like to know if you can offer me something better then this or is this plan good???? PLEASE get back to me.

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This plan seems to cover everything and every potential as the ads state. Some of the things you use are not in my bag of tricks (like retin A, which I believe probably does more harm than good because it produces a type of chemical burn to the skin). Nothing more to add.

Ordering Propecia – Hair Loss Information by Dr. William Rassman

Hi. I had my procedure with you in April. I am out of my propecia. Online purchases? Prices? I am in school, your envelope non-specific? Thanks.

Call my office at 800-639-4247 to renew the prescription and find out our current charge. There are options: you can buy it directly from us, we will mail it to you in a white box with green trim and the first time you buy from us we do give a free sample; you can provide us with the name of a pharmacy and we can call in the prescription for you; or you can ask us to send you a written prescription and you can hand carry it to a pharmacy or use it for an online purchase. As far as prices, call a few pharmacies – some of the warehouse stores are slighly less expensive, check online prices (make sure that you are getting the actual drug, not a knock-off), and see what works best for your budget. We do ask that patients sign a consent form for the prescription, and that they come back to see us each year, so we can gauge the effectiveness of the Propecia.

Balding Forum - Hair Loss Discussion

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Hair Loss InformationHerbs, Vitamins, Potions, Fava Beans, & Hair Loss – Hair Loss Information – Balding Blog

After going through this web site and reading your blog comments, I have come to believe that you are closed minded and inflexible when it comes to using homeopathic, natural herbs and other natural remidies for treating hair loss. Are you just unwilling to show flexibility and open mindedness?

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Natural supplements and homeopathic medicine may be a great alternative means to treat a condition or an ailment. Unfortunately, these supplements are not well regulated by the FDA, so claims that are made can not be often substantiated, except by rumor mills and word of mouth communications that tend to praise the remedies more than criticize them. You can’t truly know what chemicals are included in the supplements that may have been used to process the product that you are buying. What the FDA calls Good Manufacturing Processes (GMP) may not be adhered to with food, naturopathic herbs, or potions and lotions sold over the counter in natural food stores. Furthermore, these products may not be covered in the regulatory process that confirms the dosages and the purity of such product, including the safety and efficacy of them. The research and studies that show efficacy are often funded by the manufacturers of the supplements which may bias the reported results. Finally the proper dosage for such products seem arbitrary. Just because the friendly neighborhood natural food outlet, their sales rep, or a salesman in a white lab coat can attest to its efficacy, does not mean that these are safe and/or effective.

For example, Vitamin A is one of the few vitamins that when taken in high doses, can cause hair loss. I have read that this vitamin is recommended for hair loss, so many people think that if a little is good, more may be better. In the case of Vitamin A, excess doses (overdoses) can cause death, so who cares about hair loss when you overdosed on this vitamin? Vitamin C, when taken in low doses is an antioxidant that theoretically prevents heart disease, but when taken in high doses (according to a UCLA published study) it accelerates coronary atherosclerosis (heart disease). Saw Palmetto, which is believed to be a DHT blocker for the treatment of hair loss, may compete with Propecia for the enzyme block that stops DHT production, making it less effective. What is not commonly known, however, is that Saw Palmetto was used by the military in WWII as a sex drive reducer for our troops. It was added to our soldier’s food supply. In studies performed by an independent agency, the dose of Saw Palmetto varied widely by the manufacturers. As such, some people get poor response from the drug as a DHT blocker (it is a weak blocker) while others get sexual side effects, reducing a man’s sex drive as the dose is possibly too high.

Kava is a widely used herb root in Polynesia that can be used to treat anxiety. There are case reports that this herbal supplement has caused liver failure that eventually led to a liver transplant as a life saving procedure, when used on someone who could not tolerate it. Did she lose hair? Possibly so. As part of our medical education, doctors learn that fava beans are harmless, yet they can cause death in very small quantities in those people who carry a rare genetic defect . People who carry a defect in the enzyme glucose-6-phosphate dehydrogenase, can not process the fava bean toxin. This toxin then poisons the red blood cells of the body. This is a genetic defect passed from mother to child. In the Mediterranean, where fava beans long have been a dietary staple and where the genetic mutation is more common than in the U.S., physicians frequently test children for the enzyme deficiency. The fava bean’s effect on hair loss is not as well known but on a positive side, look at the statement made by Hannibal Lecter in the movie “Silence of the Lambs” who recommended it by saying: “A census taker once tried to test me. I ate his liver with some fava beans and a nice Chianti.” I guess that Hannibal Lecter did not have the enzyme defect I just discussed and it made his meal memorable.

The question I am posing here in answer to your somewhat caustic challenge to me, is that I tend to protect my patients from the unknown. When I do not know something as a fact, I might ask myself: “How many undocumented side effects or enzyme defects float around that are either caused by natural herbs that could threaten a person’s health or life that are not researched or understood?” Arsenic is a natural substance used historically to treat syphilis, but as I have said before, I would not recommend arsenic as an alternative to penicillin, which is safe and well tested (also FDA regulated through GMP standards) and accepted world-wide.

The answer to this blog entry was partly written by Jae Pak, M.D., an emergency room physician with great interests in hair loss and hair surgery. He has worked with me for almost 9 years.