My Doctor Tried to Sell Me a Laser and Didn’t Put Me On Propecia – Hair Loss Information – Balding Blog

Hi there,
Firstly let me say it’s great to have a reliable doctor to look to for information, this site is the only one of it’s kind not trying to sell something. A few details first. I’m 26 with some recession on both temples about 1-1+1/2 inches. Very little to no movement in the centre where i’ve always had a widows peak.

Today i had a consultation with a “hair specialist” in Toronto who performed a microscopic analysis. As i had expected he advised i had some miniturization on my temples but he also advised i had same on my crown. He went on to try to sell me a laser comb on the spot, for $500. At this stage i began to feel something was a little off. My hair loss is minimal (so far !) and from what i understand if there is any use from the LaserComb it’s to thicken existing hair rather than prevent further loss. I’m a little doubful about crown recession as my dad, brothers and uncles either suffer at the temples or escape altogether. It certainly looks ok to the naked eye.

Anyways, in your opinion should i begin using a Finasteride based drug given the frontal loss or should i look for a second opinion? I’ve heard the drug only really works on the crown is this true?

Cheers

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At 26 years old with early hair loss, the Propecia would most likely be your best bet (I can’t say for sure without examining you myself and determining the degree of miniaturization in the frontal corners and the crown). The drug does work in the front. I’ve found that it works to halt the hair loss in the front often (regrowth happens for some). It might work better in the crown, but I’ve definitely seen results in the frontal hairline. I’ve even posted multiple patient results of Propecia working in the hairline over the years of doing this site -–

As for the laser, I’ve yet to see results as the product manufacturer claims. I suppose the only thing you have to lose is money, time, and more hair.

Hair Loss InformationSeeing Results a Month After Using a DHT Blocking Shampoo – Hair Loss Information – Balding Blog

I wanted to ask you a question regarding the DHT component of male pattern baldness. Four weeks ago I began using a shampoo and conditioning system which blocks the production of DHT and 5AR in the scalp. I have noticed a significant amount of hair growth from a point in the rear portion of my head leading to a point just over one third of the way towards the front of the scalp. the rest of my scalp has little hairs similar to a man’s shaving stubble except at a point in the middle of my forehead which has a long patch of hair which I can comb or brush down as bangs. My question is this: It’s already been four weeks with these results and how soon should I expect to see the full results?

I am using Nioxin System 3 Scalp Cleansing Shampoo and Conditioner along with a daily multivitamin supplement designed for healthy hair, healthy skin, and healthy nails. As I said, I’ve had some definite results thus far, and am wondering at which point I should expect to see the full results?

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NioxinI was not aware that Nioxin System 3 Scalp Cleansing Shampoo contained a DHT blocker, so I looked to their website. The company states that it is a “vitamin-enriched, daily leave-in scalp treatment – delivering essential botanicals, nutrients, antioxidants and vitamins onto the scalp skin and hair to help safeguard against environmental residue and DHT buildup on the scalp.

I don’t know how to prove that it does what it claims, and the FDA isn’t required to clear these types of products before they make it to market. It certainly is not approved by the FDA for claims of hair growth or as a DHT blocker, and as a physician I will not endorse it for that purpose.

The sebum containing DHT and requiring some blocker type of topical shampoo to manage it makes no sense. The sebum is not the problem. I would not expect to see any significant benefit in days or in a month, because the hair that grows out only grows at 1/2 inch per month and therefore there is no time for benefits to show. I am not sure what you are seeing, but it is not the result of blocking DHT.

Topical DHT Inhibitor? – Hair Loss Information – Balding Blog

Are there any topical DHT inhibitors? I know that Propecia blocks DHT and I have tried it in the past, but the sexual side effects were really severe. I’m curious why no company has tried to market finasteride in a topical solution…will it not absorb through the scalp?

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There are some doctors and many companies that claim that they have a topical DHT inhibitor for sale, but to my knowledge, there is no such thing on the market at this time that has proven blood levels in any meaningful date. I would want to know how much has to be applied to the skin to get a comparable blood level to the oral counterpart. Again, I have not seen this. Logic does not tell you anything about effectiveness of a drug and that is what we must know. Claiming effectiveness and proving effectiveness are two different things.

It would be nice if there was one that was FDA approved and proven effective, like a Propecia shampoo. That might solve the side effect issue that seems to frighten so many men and cause them to not use the oral form of the drug.

Hair Loss InformationNecrotic Tissue After 3rd Transplant – Hair Loss Information – Balding Blog

I had several hair transplants that went well, so I decided on a 3rd which led to necrotic tissue damage. The doctor told me it well be ok. i had 3 holes w/ necrotic tissue, which i would treat for several months getting worst. fortunately after 3 months, the holes got as big as a quarter and black. went to the emergency room, when they said this is your lucky day after removing the black. and 3 years and 4 surgeries later, i finally got everything corrected. now i have 3 bald spots in the front of my head. i use the dark particles to hide it. any recommendations. what to do besides surgery ??

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Necrosis causes the skin to turn black (it is called gangrene). I would love to know more details, like who was your surgeon and what did he/she tell you caused this? I might be able to help, but I’d need to examine you first. As you are in Los Angeles, you should consider paying me a visit in my LA office (no charge for the consultation). You can call my office at 800-NEW-HAIR (or 310-553-9113) to setup the consultation.

Necrosis was not uncommon in the early days of megasessions when the surgeons used large punches and too many of them. This did devascularize the scalp and parts of the scalp died. There were numerous reports published that condemned the procedure because of this risk, but as the world was trying to make up its mind on the risks, I had published large series of huge megasessions with not one case of necrosis in the recipient area. Eventually the doctors learned that small holes were critical to getting not only good growth, but no damage to the skin of the scalp.

There are non-surgical solutions, including Toppik, DermMatch, Couvre (all are concealers)… and of course, hair pieces.

Hair Loss InformationCan Nizoral Cause Hair Loss? – Hair Loss Information – Balding Blog

Hi Doctor Rassman!

Thanks for your great and informative site.

I am an 18 year old male with no signs of hair loss and a very thick head of hair. However I recently have noticed that I may have a very mild case of dandruff. I want to begin treating it right away in order to catch it before it gets worse and I have heard the great effects of Nizoral 1% on treating dandruff and even speculation that it may actually help with hair loss.

I just want to know if there is any chance that using the recommended dose of Nizoral 1% for my dandruff will ACTUALLY CAUSE HAIRLOSS? because of the chemical ketoconazole in it? Or is it perfectly fine to use for the recommended period of time?

Thank you I value your opinion and look forward to your response!

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I would doubt that Nizoral would cause hair loss. I’ve not heard/read any reports of actual loss from this shampoo. Some believe that ketoconazole, the active ingredient in Nizoral, helps stimulate hair growth, but I’m not convinced until I can find more scientific studies on this.

Omega Fish Oil and Hair – Hair Loss Information by Dr. William Rassman

Hello Doc,
I have recently incorporated Omega 3-6-9 fish oil pills, Multi vitamins and Vitamin B12 into my supplement routine for working out, and was wondering if any of these pills will have any negative impact on my hair. I take the supplements as directed, without “pushing the limits” of them. I have also heard that Omega Fish Oil pills can actually be good for your hair, and was wondering if there is any truth to this?

Fish oil pillsOmega 3-6-9 fish oil pills, multi-vitamins, and vitamin B12 are all ok and may help you maintain your general health and perhaps your hair health as well. I do not know of a good scientific paper discussing these benefits on hair loss or faster hair growth, though.

Balding Forum - Hair Loss Discussion

Paid advertisements (not an endorsement):


Alpha-GPC (GlyceroPhosphoCholine) and Hair Loss – Hair Loss Information by Dr. William Rassman

I am inquiring to if you are familiar with the a newer supplement called Alpha-gpc? It is also referred to sometimes as GPC (glycerophosphocholine). Supposedly it improves neurological capacity and a few other health benefits listed such as those listed at this web site

However, I am concerned with the claim that this supplement “naturally increases HGH levels”. The main reason I am even considering this supplement is because it was recommened to me by my trainer (and teammates) and I am an NCAA athlete basically looking for an edge in training. I do suffer from MPB and have been taking Propecia 1mg daily for the past two years (along with Rogaine) with excellent results thus far. To sum things up, do you really think that this supplement would raise HGH levels high enough to increase hair loss? Or am I being over-cautious and this supplment is safe for me to use without risking increased shedding?

A response would really be appreciated because I have been going back and forth on this decision recently. Sincere thanks to you and your associates for creating this website.

I have reviewed the website you mentioned and I have no way to prove or disprove the claims made by the company. The claims of increasing HGH as the agent for the change is without proof and because it is a natural ingredient, the FDA does not get involved in the regulation of such products. However, with claims of value and medical benefits, the line may have been crossed with FDA labeling requirements, which does control all products with medical claims. I am sorry, but I don’t have the answer to this and unfortunately, I don’t think this is a question that can be answered.

One thing you should check out though is that as an NCAA athlete, I believe finasteride (Propecia) is on the list of banned substances. There are medical exceptions though, and I hope you’ve gotten clearance to use the medication when competing. See NCAA Medical Exceptions (PDF file) for more info.

In the News – X5 Hair Laser Clinical Trials Begin – Balding Blog

Spencer Forrest, the makers of Toppik, Couvre, and other masking agents, has entered the home laser market with the X5. The device has been available for months, but now they’re looking for a nod from the FDA with the clinical trial. As regular readers of this site may know, I’m not a fan of this laser technology (because I haven’t seen great results), but let’s read a snippet from the press release anyway:

The trials will determine the efficacy of the X5 in stimulating the re-growth of hair in men who are balding. If proven effective, the X5 will become only the fourth product ever to gain recognition by the FDA for treating male pattern baldness.

Note that they’re aiming to gain recognition from the FDA, and not approval. In other words, they’re not looking for the FDA to say it will absolutely regrow your hair — they’re just looking for the FDA to say it won’t harm you (the same clearance that the LaserComb has).

Full press release here — Spencer Forrest Begins Clinical Trials On The X5 Hair Laser, Sets Sights On Beating Genetic Hair Loss




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Balding Forum - Hair Loss Discussion

Hair Loss InformationDeceptive Marketing, Questionable Ethics, and the Hair Transplant Network Lawsuit – Hair Loss Information – Balding Blog

I read that [name removed] is suing the hair transplant network since they expressed their reservations about him and his questionable ethics, deceptive marketing practices, as well as issues with his hair transplant technique both FUT and FUE. I also believe that you are the person who invented the FUE technique. Is that right? Do let me know since I would want to know if this doctor is as good as everybody says he really is.

Regards

[Editor’s note: The above question has been changed to omit the names of the doctors and to avoid adding fuel to the fire]

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FightYou ask a loaded question, but I will keep this as simple as possible, even though it will get quite lengthy.

FUE and the doctors that use this method:

Yes, I introduced the follicular unit extraction technique (FUE) back in 2002 at the International Society of Hair Restoration Surgery (ISHRS) conference in Chicago and published the classic article on the subject in the Journal of Dermatologic Surgery that same year. FUE as a new procedure had many people interested, but when the doctors actually began to use the technique, they quickly realized that it was tedious, difficult, and required a real change in the way the surgery would be delivered, so in the long term it was not welcomed by most of the surgeons. Even today with the attention to detail required to minimize damage from the technique, it is not routinely offered by many doctors. However, with increasing demand by the consumer, more and more doctors seem to claim “expertise” (even if they can’t do it well) since there is a lot of money to be made in offering this service. Putting 2000 holes into a person’s scalp does not mean that 2000 viable grafts will be produced that will eventually grow into a nice head of hair. So some doctors offer a service and simply can’t deliver the goods. Being a “minimally invasive” surgery, FUE is certainly a great procedure and it sells well so marketing it is not difficult. It is virtually painless in the post operative period and it leaves virtually no detectable scarring (small punctate scars) unless the head is shaved, but most patients do not realize that there are also limitations and problems with the FUE procedure itself, such as how you will not know if it worked for a good 8 months after it is performed and if the surgeon could not perform the procedure as promised, the check will have cleared his bank account. Unfortunately, there are deceptive marketing practices everywhere you look and as I always say, let the buyer beware.

At the recent ISHRS physician meeting in Montreal last week, many doctors were claiming to do FUE in numbers that boggle my mind. I would say that some of the claims I heard by some of the doctors were unbelievable, and as that is my personal opinion (as the inventor of the procedure), it is an opinion that needs to be shared with you. In the next week or so right here on BaldingBlog and on the NHI site, I will publish an extensive discussion on FUE, which I’m presently writing with the goal of educating consumers about spending thousands of dollars on a procedure that could fail. I want to provide tools that might help them avoid getting trapped into deceptive practices that may be relatively commonplace. Stay tuned for more on that.

Legalities and understanding how these Internet marketing sites work:

With regard to the litigation, the sponsoring agency central to the lawsuit is the Hair Transplant Network (HTN) and they have been fairly open about the problems as they see it. Although it is no secret, I must point out that HTN levies fees to doctor members for their participation in advertising and promotional activities. They maintain the position that they have a responsibility to judge the value of the doctors’ services and the doctor’s ethics. They restrict their membership only to doctors they feel are worthy, ethical, competent as well as those doctors who are willing to pay them their monthly participation fee for their services. You can imagine that such a set of activities can not only rub some of the doctors in the field the wrong way, but could be frankly damaging to the doctor’s worldwide reputation. The damage comes from either comments that might be made that denigrate the doctor’s skills by directly discussing his/her practice, services, or ethics, or by excluding specific doctors who are not paying the monthly marketing fee when the site’s contributors discuss the best doctors in the field. It is like saying, “to be a great doctor, you have to be willing to pay the monthly fee”. An omission of a doctor from the “best doctor list” itself can be perceived as a statement reflecting the unworthiness of a doctor to potential buyers who are shopping for hair transplant services. HTN is a privately held business and will do what its owners believe are in the best interest of HTN, their audience and readership, the consumer, or their participating doctors. The doctors involved in this particular litigation also have their own self-interest and self-preservation focus. What claims are made about a doctor’s ethics or skills may or may not be true, so how this particular litigation unfolds will tell us much about the facts as the legal process goes forward. For those interested in reading more from the HTN’s side of things, follow the thread on their forum and draw your own conclusions on truth and justice.

Conflict of interest:

There are three words that trouble me with regard to all of the “consumer advocacy” sites and web forums — “conflict of interest“. As stated above, doctors have to pay HTN and other such sites to be included among the list of recommended doctors. Promoting member doctors can be costly and the crux of any business is to have income that exceeds expenses (therefore producing profits), and I am fully in favor of the capitalistic business model. There is no doubt that I am very much into free enterprise, provided that fairness, honesty, and truth remain central to the business process where conflicting interests and the profit motive do not outweigh the integrity of the process.

So there’s my 2-3 cents, and I hope it gives everyone something to think about.

Hair Loss InformationRecommended Dandruff Shampoo? – Hair Loss Information – Balding Blog

Hey everyone!

Well, I’ve been basically dealing with very heavy dandruff and mild scalp itching for the past year or so. I was wondering if there were any particular shampoos which would help my condition. And Im also wondering if it is okay to scrape the scalp with my finger nails lightly when im washing my hair, to remove some of the dandruff.

P.s I am a 19 year old male.
THanks !

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Dandruff (pityriasis capitis) is present in about half of the human population. There is an associated small yeast cell associated with it called pityrosporum ovale which multiplies as the dead skin in those with dandruff is higher than in those people without it. The pityrosporum ovale yeast form a cake of sorts with the dead skin cells that cause the classic dandruff flake. You can nudge off the flakes when you shampoo your hair, but be careful not to pick too much on them as you can produce hair loss from picking them.

There are many dandruff products out there and some work in different ways than others. For example, there are shampoos that contain zinc pyrithione, selenium sulfide, ketoconazole, salicylic acid, and tar. CNN has a nice list towards the bottom of this page — Dandruff. I do not recommend any particular dandruff shampoos. More popular shampoos include Selsun Blue (with selenium sulfide), Head and Shoulders (zinc pyrithione), Nizoral (ketoconazole), and Neutrogena T/Gel (tar). You should try a few (or all of them) and pick what suits you the best. As each person is different, one type of shampoo may work better for you than another.