Category: Drugs

Posted on

Hair Loss InformationHair Loss in the African American Man – Hair Loss Information – Balding Blog

I am 33 years old African American and am very concerned about my hairloss. I am probably between a Type 3 Vertex and Type 4 hair loss pattern. My crown is very thin and my hairline is getting thinner by the day. I tried Propecia for 10 months and did not see any substantial differences. I stopped using Propecia because of the uncertanity of future complications.

My hair on the sides and back are very strong, but I am concerned about how a transplant would look. I have seen some guys that have that pluggy look, which looks bad. Can you give me some advise on what the best step would be.

Block Quote

A man of your age who is still at a Class 3 Vertex or Class 4 pattern, is usually not going to get very bald. In the African American, this is more typically the case, but it would be best to get a complete history of your family to be sure that your ancestors did not have advanced cases of hair loss. My concern would be that Class 4 patterns sometimes do lead to Class 5 or even to a Class 6 pattern. That is why I like trying to prevent progressive hair loss with a DHT blocker like Propecia which will probably stop or slow the progression. Stopping the progression is as important as fixing your problem correctly.

African Americans’ are the best candidates for transplant. The characteristics of very curly hair make the frontal work look awesome and the hair just covers better. It is always a pleasure to show off the results. Here are some examples from our website, newhair.com:

Posted on

What If I Stop Using Propecia? – Hair Loss Information – Balding Blog

I stopped using Propecia and over the next 3-5 months, the bald spot on my crown became large. This was 2 years ago. I have been sick about this and afraid to go back to my doctor and tell him what I did as I felt stupid. If I go back on the drug, will I get my hair back? Should I go to a different doctor?

Block Quote

There are a number of issues here. First, stopping the drug and having lost the benefits with a return of balding is a common problem. Men frequently stop the medication after they have tried it for months or years and after seeing no benefit, they feel less committed to the drug. When they stop it, there is a period of what I call ‘catch-up hair loss’ where you will lose all of the hair that you would have lost without the drug in a short time period. That is what happened to the questioner. Some people may have progressed too far between stopping the drug and restarting it. Some people may have had slow progressive loss. Each will respond differently. All I can say is that restarting is better than doing nothing. You already know what nothing did and you are now sick over doing nothing.

As far as selecting a doctor for the second round, ask the basic question that I always like to ask – Is this a man that is caring, competent and ethical? If the answer is yet to all three, swallow your pride and take your lumps. Laugh when you tell him how foolish you were. If he is a cool dude, he will laugh with you.

Posted on

Almost Bald at 40 – Hair Loss Information – Balding Blog

i’m a 40 year old white male that is totally bald on top,with hair just on the sides. i have alot of baby hair or very small white hairs in the balding spot.i’ve been bald totally on top since i was around 25 to 30 yrs old. will transplants or drugs work for me………help

Block Quote

The ‘baby hair’ you are reporting in the balding area is what we call ‘miniaturized hair’ which means that the hair shaft is reduced in diameter and takes on the fine baby hair appearance we had at birth. This is a process that precedes the final balding stage. If the miniaturization is caught early enough, there are medications (like Propecia) which may reverse the process. Near the end of the loss process, it would be unlikely that the hair can be brought back. As the process you are describing sounds like the end stage of the loss, then the only solution may be hair transplantation. This is well defined on newhair.com, which has hundreds of photos of men who have had the hair moved into the balding area from other parts of the head.

Posted on

Avodart (Dutasteride) – Hair Loss Information – Balding Blog

Hi DOC… just wanted to know what you think about avodart for the treatment of hair loss? I have been on propecia and would like to switch. Does Propecia or Avodart stop mpb permently?

Block Quote

The final story on Avodart safety and effectiveness are not out yet. All DHT blockers last only as long as they are active in your body. Propecia is ‘good’ for 24 hours only, so you must take it every day. Avodart lasts 3+ months (possibly in your body for over a year), however they recommend a daily dose for prostate problems, which makes no sense to me. I have gotten reports that Avodart is a better DHT blocker for balding than Propecia, using a slightly different mechanism of action. I have not yet prescribed Avodart, but I am presently reviewing the indications for doing so on a case by case basis. There are early signs that point to Avodart’s effectiveness, but there is more involved when one goes outside the FDA guidelines for prescription drugs.

Posted on

Blood Pressure Medication and Minoxidil – Hair Loss Information – Balding Blog

Ron asks…

I am one of your patients ,I take high blood pressure medication would there be any advantages to taking Minoxidil orally in addition to or instead of my present medication?should I ask my doctor about this ? What dose would be effective ?

Block Quote

Ron, thanks for writing. The question you posed is a good one.

Minoxidil was a poor anti-hypertensive when they produced it for that purpose in pill form. As a topical medication for hair, the absorbed dose rarely produces an effective drop in blood pressure. Controlling blood pressure is a science and it is critical for your overall health. Best to stick to medications that are known, have been tested in you and are reliable in you. Then, adding another drug will only lead to more risks for you, but with that said, topical use of Minoxidil should not impact your blood pressure when used as directed, twice a day.

Posted on

Early 20s with High Hairline – Hair Loss Information – Balding Blog

Hi, My son, who is 23, has very thin hair on top of his head and a high forehead. He tried avacore and it’s hard to say if it helped or not. He has very thick hair on the sides-we are prone to high foreheads in our family but the thin hair on top of his head is distressing him (which I’m sure doesn’t help). Is there someone he can see to access his problem-we live in New Jersey and are a train ride from Manhattan. Thanks so much for your help.

Block Quote

Is your son balding now? I would guess from what you are describing is most probably genetic hair loss. Avacor is overpriced and has minoxidil as its active component; I would have been surprised if it would have worked. The marketers of Avacor do a hell of a job promoting the ‘benefits’ of their product and as a result, they have one of the most popular sales efforts ever and it appears to be priced over 10 times that of minoxidil. Propecia, which is made by Merck (pharmaceutical company), is under FDA and FCC regulation so Merck can not promote claims that are ill defined or vague. In a 23 year old male, genetic hair loss comes from the ‘workings’ of DHT on the growth center of the hair follicle. Propecia is the only substance that has been clearly documented to block the effects of DHT on the hair follicle. It has documented benefits on retarding, stopping or reversing hair loss. A competent doctor would make the diagnosis and appropriately manage the problem for you. To answer your request for a doctor on the east coast, I would recommend Dr. Robert Bernstein at 201-585-1115, who has offices in Fort Lee NJ and Manhattan NY. He is as good as they come and I would not hesitate to have my son treated by him.

Posted on

Hair Loss InformationBalding on Mother’s Family Side – Hair Loss Information – Balding Blog

Dr I am 26, My father is 64 with a full set of hair, how ever on my mums side they are all totaly bald (males only) im just strating to lose my hair were my crown is. I dont have alot of faith with all these product as i have tried plenty in the past. Im hoping you can regain my faith to my hair loss problem. My hair is thin and very curly i do have alot of hair exept were for the top of my crown.

Block Quote

At 26, you should go on the drug Propecia as it should slow down, arrest or reverse the hair loss you are experiencing. You should be evaluated by a good doctor. Sounds like you will follow your mother’s family line, but the drug may forestall the balding or stop it from happening. After 8 months on the drug, you should be re-evaluated.

Posted on

Hair Loss InformationHair Potions and Lotions – Hair Loss Information – Balding Blog

What do you think about all of the vitamins and other things sold in the health food stores that claim that they reduce or reverse hair loss?

Block Quote

The word ‘claims’ in this usage, reflects the lack of scientific proofs for naturally produced substances sold in heatlh food stores. Many of the items sold are sold on their potential and a ‘hipe’ that is created by word of mouth. There is little regulation for natural food additives, so there is no way to determine the proof of the claims that are made. Some of the natural substances may have DHT blocking abilities, as claimed, but there is no proof of such activities.

It is common to find substances sold in health food stores that claim DHT blocking properties. There is no way to confirm or deny this, so it again becomes a ‘buyer beware’ issue, leaving the final action in the hand of those willing to spend the money on it. At least Propecia is a proven DHT blocker and we know that because it has been thoroughly investigated by the drug company to meet a high standard of FDA regulations. We also know about the side effects (very low) and long term use statistics. A large company behind this medication tells us that someone is accountable if things go wrong. I can not say that for most of what is sold in the health food stores.

For example, Saw Palmetto, is thought to be a natural DHT blocker, and there are various articles that purport to prove it is an effective DHT blocker. But, a recent article that I read in a well respected medical journal indicated that it was a very weak DHT blocker. Did you know that Saw Palmetto was added to the GI’s food in World War II battle zones to suppress the soldiers sex drive so that they would not get distracted? Now if you link these two (weak DHT action and sex drive suppressant), why would anyone want to take it?

Posted on

Hair Loss InformationRegenix – Hair Loss Information – Balding Blog

Dr.Rassman,
Have you heard about this hairloss product called Regenix? The actor Matthew McConaughey was on the David Letterman show and he said that he was losing his hair until he used Regenix, and now he has as good a hairline as when he was 18. What do you think?

Block Quote

Regenix has been around for years and they can make the hair thicker appearing (therefore fuller) with many of the things they use. The change that our actor shows suggests that either he has an unusually good result from Propecia or he had a good hair transplant surgeon in conjunction with what Regenix is doing. Two pictures of him on the web (see links below), show what appears to be a remarkable turn-around. I tend to be skeptical in believing everything I see or read about celebrities. If Matthew should read this blog, please come in for a private consultation. I will not post about the visit, I promise.

Here are links to two photos that display the dramatic change in Mr. McConaughey’s hairline:

Posted on

Scalp Psoriasis and Transplants – Hair Loss Information – Balding Blog

Does a history of scalp psoriasis (assuming it is under control with treatment) rule out using minoxidil or transplants to offset hair loss?

Block Quote

Psoriasis is an autoimmune disease that has a genetic preference in its victim selection. It comes in all degrees of activity. Simple dandruff may be a very low active state of psoriasis and as it becomes more severe, it takes on more of the characteristics of the disease state, where scaling of the skin and red areas in the affected area can become painful. Flaking of the skin can be easily seen when psoriasis affects the scalp. Baldness is also a genetic process but it is unrelated to psoriasis. Both processes can co-exist in the same person and both can be treated independently at the same time.

People with psoriasis often ask about transplanting the disease from one area of the scalp to another. Can, for example, skin taken from the area where psoriasis is active, move the disease to areas in the recipient area that are not showing signs of the disease? The answer here is no, as the disease seems to be localized in the area where the scaling exist and moving the hair from the scaling area does not impact the normal recipient area, assuming the recipient area is normal. Psoriasis can be aggravated in the area where the disease is active by any trauma and surgery is a trauma. Some people who tend to pick at their skin and hair can develop traction alopecia (hair loss) if they persist on picking over a prolonged period of time.

I generally tell my patients to use a topical treatment (steroids) on any active area of psoriasis prior to a hair transplant so that the scaling that occurs will be less bothersome during the transplant process. I try to get good control of any scalp psoriasis prior to a hair transplant.

With regard to minoxidil, if this medication does not produce skin side-effects, then one can use it with psoriasis. If side effects should appear or the psoriasis should become worse with minoxidil, then the medication may not be a good choice.