Category: Uncategorized

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One Year and Finasteride Failed Me

I am 24 years old guy who started losing hair 2 years ago I remember not long time after the girl I loved left me for another guy, anyways I’ve been obsessed with my hairloss for a long time, it was killing me mentally everyday, and making me depressed and sad, losing will and motivation to do anything in life. I have been using Finasteride since 07.08.2018(exactly year ago). and I missed a dose or two over a whole year. Final review? It didn’t work for me unfortunately . I’ve lost a lot more hair then I had exactly a year ago. I have always seen comments on this site, over this year for how long I’ve been on it, comments like “I never saw a thread from some guy saying he still lost hair on Finasteride, everybody halts hairloss or even regrows, Finasteride works like 100%”. Well then I didn’t make it brothers, sadly…. Maybe I should consider Dutasteride?

You have to have a good doctor to discuss this with. Dutasteride is something that many doctors don’t prescribe because it is not FDA approved for hair loss. Have you considered what you would do if dutasteride didn’t work? A good doctor can keep hair on you, one way or the other. Hair transplants always work as an option that many take.


2020-06-15 06:55:07One Year and Finasteride Failed Me

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Classic Case of DUPA

This is Diffuse Unpatterned alopecia (DUPA) which shows only 5 normal thickness hairs which are labeled in the photo (1-5) and the rest are miniaturized. This comes from the donor area which almost certainly is see-through. Note that this is best seen when the hairs are cut short because they can be easily counted as you can see on the long hairs on the left of the photo. Anything over 20% miniaturization is DUPA if it is the donor area.

 

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Oral minoxidil 2.5mg for one year (photo)

This is a wonderful response to Oral Minoxidil 2.5mg daily that I prescribed for one year use. Most of his frontal hairline had disappeared but returned with the oral minoxidil.


2021-09-17 11:25:37Oral minoxidil 2.5mg for one year (photo)

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Cognitive Impairment from Finasteride

I’ve done my due diligence on the side effects of Finasteride, but I’m really worried about the potential side effects of cognitive impairment. As someone who is really susceptible to the side effects of drugs, I’m afraid to take Finasteride as I have just started medical school and I cannot imagine a worse time in my life to be experiencing some kind of cognitive impairment. Have you had patients complain of cognitive impairment? If you were in my situation, would you even take that risk?

Yes, I had a few patients who reported some cognitive impairment, more however stated they just did not feel good on the drug. The decision to take finasteride is a personal decision. I advised my son to take it, and prior to having his first child, he took it for 15 years and the only thing he noticed was an increase in his sex drive. Unusual, but that happens probably way more than cognitive impairment. He started on the drug when he went into Orthopedics.


2019-03-19 07:37:14Cognitive Impairment from Finasteride

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Over 40, should I focus on my hair loss?

Most posts I read on various hair loss forums like Reddit, seem to be from guys who’re in their late teens/early 20’s who were probably going to be able to grow beards anyway, but for whom the minox may have just accelerated the process. Any success stories from older guys? I’m nearing 40 myself and looking for some inspiration. Much appreciated.

Men react differently to hair loss at any age. The most common reactions involve opting for very short haircuts or even shaving their heads. This trend is noticeable in places like airports or shopping centers. Some men embrace this change and never look back.

Others take a different route, seeking ways to regain their hair. Many of them share their experiences and seek solutions on platforms like Reddit or various forums. Some younger men might become fixated on their hair loss due to familial experiences.

Then, there’s a group who prefer not to rely on medications and choose the hair transplant route. They seek an immediate solution, despite the significant cost involved. I’ve performed hair transplants on men as old as 92, driven by various reasons like wanting to appear younger for dating purposes. Typically, men between 35 to 55 years old make this decision. With today’s technology, unlike older methods, about half of men can restore their hair in a single transplant session.

The crucial question here is personal: Does hair loss bother someone enough to (1) commit to lifelong medication (assuming it works), or (2) opt for a hair transplant despite the cost?

There are numerous success stories addressing hair loss, many of which are shared on platforms like Reddit. Are you bothered enough to go through treatments such as daily medications or a hair transplant. Only you can answer this question.

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Comment oin a young man in his early 20s who had a hair transplant.

Well you should never have had a transplant that young especially with this much hair loss. Any good doctor would never do this because the potential for you to keep going bald is too high. In other words, you only have 6000-7000 transplantable grafts total. You may not have grafts to cover future loss later. The sad fact is the best age for a hair transplant is in the 30s. Now you may be faced with shaving your head and if you have fut, you will have a scar. It’s possible you can have scar revision if it’s bad. You can also have what’s basically a hair tattoo where they take a shaved head and place tiny dots to simulate hair follicles as well as hide the scar. You have other options but not everyone has the correct head or hair for a transplant.

This man is right on!

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Hair Loss InformationHair Loss in Teenage Female – Hair Loss Information – Balding Blog

I am an active 17 year old high school cheerleader and my hair which used to be thick, is now falling out and becoming thin, like my mother, my grandmother and two of my aunts. They tell me it is in the family, but not when they were my age. What should I do? If I go to a doctor, how do I find one?

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Genetic causes of hair loss in a 17 year old female, is unusual. You were correct to ask your female relatives at what age the condition first appeared with them. I would first have a good doctor see you and look for medical causes of hair loss (there are many). The following problems are amongst those that should be considered: anemia, thyroid disease, connective tissue disease, various gynecological conditions and emotional stress. It is also important to review the use of medications that can cause hair loss, such as oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin and prednisone if you are taking any of these. Many other medications can also contribute to hair loss so if you are taking any drugs of any type, then that should be looked into as well. The following laboratory tests may be useful if underlying problems are suspected: CBC, Chem Screen, ANA, T4, TSH, STS, Androstenedione, DHEA-Sulfate, Total and Free Testosterone.

It is possible that a medical condition may be the cause of your hair loss, so before you jump to conclusions that you are following your female relatives’ fate, I would have you checked out for these conditions. Also, please read my previous blog entry, Female Hair Loss.

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Computer Imaging for Balding Patients

Dr. Rassman:
Do you use computer imaging with your patients, to manipulate a current patient picture into a “target goal” picture? I did not see any info about this on your website, but it certainly seems to me the best way to ensure both patient and doctor share the same vision. Thank you.

We have been offering open house events for 14 years so that prospective patients can see, first hand, what the actual results are from hair restoration surgery. The use of computer imaging is frequently misleading, just as photography can be, because it shows what the operator wants to show and does not take into account the real elements that make ‘coverage’ for hair replacement surgery. Things like hair thickness and hair character can not accurately be portrayed with computer imaging. The view can also be misleading. Frontal views, for example, are often better than top views for showing more fullness.

Setting patient expectations is at the core of what I do. I have written extensively on the artistic elements in the hair restoration process and published these observations in prestigious medical journals and text books. I do not believe that correct expectations can be set by the imaginary world created by computer images. As a side note, although many doctors do computer imaging, few will give the patient a picture of what they might look like from such imaging systems. The reason is simple: such a picture is like a contract, which can be used in court against the doctor if the result in that picture is not obtained. If the correlation between computer generated images poorly defines the differences between projected results and the actual results, then this tool does not set proper expectations for the bald buyer. It is clearly better when you examine a person up close, who has actually had a surgical hair restoration procedure and holds his ‘before’ picture for you to examine with his ‘after’ presence in person.

This computer imaging is vastly different for a nose job where a nose is altered in length, or taking out a bumb. A breast augmentation is also a simple computer image to demonstrate because size and location with support or poor support is easly altered on the computer as it would be in surgery. Most patients who show at the open house, will let you feel the thickness of their hair and then you can compare your thickness with theirs. In addition, the hair character (curly vs straight) will be evident. You can look from many views, even the worst view so that you absolutely know what will happen to you. What you see is going to be what you are going to get.

Hair is very different and that is why we rely on the open house format. I do not want to mislead anyone.

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Hair Loss InformationProcerin – Hair Loss Information – Balding Blog

Hello Doc,

I’ve wrote once before. I appreciate your reply. My question is I now have been using propecia for 1 1/2 months now. Sincerely, my hair thickness has degraded significantly. It has shed to a point where my scalp is visable in many areas. Maybe I am one of the small % of the crowd, but definate loss is more since AFTER initiation of treatment. Also, with reading in many different sites and encyclopedias, prostate cancer % is decreased in men, but tumors or certain cancers are more agressive. Also toying with testosterone and estrogen levels is not recommended. There are tons of products out there, I think most are scams fishing for suckers. I found this product called Procerin. It sounds safer to me. I value your professional feedback. If you don’t recommend this product, and I feel propecia isn’t the answer for me, please tell me the best product to use without scary sounding side effects? Thank you for helping…

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I originally commented on Procerin a few months ago (found here).

I have read various articles about Procerin on the web, and there is an unsubstantiated claim that it is a DHT blocker. It might be right, but I can’t say for sure, as it is not FDA approved for that claim and good science for Procerin is just not there to give me comfort that claims can be substantiated. Your problems may not be related to Propecia, but you can always stop the drug and see what happens. I suggest that you take (whatever you do), one step at a time. Stop the Propecia if you want to see what happens. I would hope that any ill effects will be reversible in a month or two if you go back on it. Do not bind yourself to a medication you are not comfortable with. If you believe in Procerin, then try it after being off Propecia 6 weeks or so. Then see what happens. There may be competitive inhibitors to the DHT production sites that Procerin might impact (if it is a DHT blocker, that is), competing with the likes of saw palmetto and other DHT blockers at the actual active site in the body. I have written much about Propecia in this blog, so you can find out other things I have said about it by clicking here. I frankly do not know and do not know how to find out the answers to your questions, however.

Good luck.

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Considering Future Hair Loss

i am 56/m, bald at the crown. with general thinning on the top and front. because my hair is still falling out i would expect to be compleatly bald in the norwood 6 area in 1 to 2 years. my hair is very fine. can i get a transplant that will also take into consideration my future hair loss, or will i have to repeat the process as my natural hair reduces to zero. if this is a stupid question please forgive my ignorance.

p.s. can you recommend a surgeon in the u.k. who is of your standard both ethically and medically. also i am a blue coller worker, so i would need a to get a loan, can you give me a estimate of a average price for a norward 6 transplant.

p.p.s. GREAT SITE.

At 56, it would be unlikely that you will complete your expected Class 6 pattern, because at your age, the hair loss is often very slow (almost to a stop) in most men. If you want to fill in the frontal and top areas, that would be the best place to start. The crown often takes a great deal of hair to fill in. With regard to a hair transplant surgeon in the UK, consider the physician search at ISHRS.org for a place to look and be sure to read The Truth About Cheap Hair Transplants as a buyer’s guide to selecting a doctor. Both the NHI site and my book also cover different aspects of the buyer’s challenge. Loans vary with the doctor, where some have arranged credit sources. Many of our patients put the hair transplant on a credit card.


2006-01-05 10:57:43Considering Future Hair Loss