Category: Uncategorized

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BaldingBlog Tip: Email Questions that Contain Actual Information

Just this morning, I received a reply from a reader that didn’t like a previous reply I had given him via email. Here’s what he said:

Wow, you’re a lot more helpful on the e-mails you display on your site than the ones you actually send. What a big surprise.

Dr RassmanFor every one email I post on the site, I probably answer 10-15… and even then, I can’t get to all of them. There have been a high number of people writing in asking for my opinion on this or that, and their email usually focuses on just one thing. In some cases, what that ends up doing is raising a lot of questions for me to ask back to them so I can help get them an answer. To render an opinion and help those that email the site, I must have lots of information and sometimes even good photos (and permission to publish them is encouraged). All too often there is nothing of the sort. I don’t want to be rude by simply saying that “you” need to see a doctor, but this is not a guessing game for me and while I do want to help, reason must prevail. Bottom line… if you are writing to BaldingBlog, make your case as concise as possible with as much relevant information that you can provide. It might sound like a contradiction, but I’ll try to clarify if you need more help. I enjoy writing the blog, but I can only answer what I’ve got to work with, so keep that in mind if you don’t get the reply you were hoping for.

Also keep in mind that I’m not diagnosing people online, but just providing general information. Please don’t write to me upset that I’m just trying to pass you off to your doctor. I can’t legally do what you want me to do, and most times an in-person examination with a doctor is the best way to go anyway.


2009-06-04 21:51:25BaldingBlog Tip: Email Questions that Contain Actual Information

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Minoxidil Dependence

Dear Dr. Rassman,
How long does it take for minoxidil dependence to occur ( once use has been started)

I do not know the definite answer to this, as there are no studies published about it (to my knowledge). First, the hair must be responsive to minoxidil for it to become dependent upon it and that means that the hair is thin and not normal. This generally takes many months, to a point where the drug is making a difference.

If you put a non-balding person on minoxidil, I believe that the hair would not develop a dependence upon it.

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Before and after Finasteride (6 months)

These pictures are highly suggestive of value; however, had this man has a HAIRCHECK instrument test, he would have an absolute measurement of the gain or lack of gain from the drug finasteride. This is why I always do a HAIRCHECK test on all of my patients who are put on finasteride, (see here: https://baldingblog.com/haircheck-test-how-it-is-done-video/)


2019-05-01 08:05:26Before and after Finasteride (6 months)

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Minoxidil Is Making Me Hairy!

I started minoxidil 2 months ago and it is working miricles on the back of my head. The problem is that it is now hair growing on my back and the hair on on my arms and legs is getting thicker, much thicker. I am growing hair all over my body, even the chest is hairier. When I looked at my arms, there is probably no new hair, but the hairs on my arms are definately thicker. Could I be imagining this? Is this possible?

Yes, this is a known, but rare side effect of minoxidil with topical applications. It was a finding that was more consistent when the drug was given in a pill form for the treatment of high blood pressure (that was its original use). I suspect that you are absorbing considerable amounts of minoxidil into your body through the skin. Skin applications of medications are not new. Testosterone is administered as a patch and so are many other medications. The skin is an excellent route for bringing drugs into the body. Your dilemma is simply to accept the new body hair along with the benefits in the crown of your head, or stop the drug and wait for it to back to your original, normal state.


2006-08-22 14:58:13Minoxidil Is Making Me Hairy!

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Best Dermastamp to buy?

Derma-rollers are something I’ve overlooked but seeing as how they’re so popular here I think I’ll give it a try. Thing is, I’m not quite sure how to tell if one is good or not. I did read that 0.5mm is the ideal starting size, used once a week, but other than that is there anything else I should know about? I’ve heard the titanium ones are better than stainless steel. Also, are the rollers better or worse than the derma stamps? I have large diffuse thinning, not just a local spot.

And does the brand matter? Any brand or model recommendations?

Microneedling is best done with a reciprocating needle device like the Dr. pen device, which has 36 needles and a depth of 1.25mm. Using once a week is the best way to go. You can hold it in a single area for a defined period, like 10 seconds, which delivers a known injury. This injury starts a healing cascade that brings in or activates the stem cells found in the upper part of the hair follicles or in the upper part of the dermis at a depth of about 1 mm.

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Minoxidil put dark circles under my eyes

Hi doctor I am a 26 yo French guy who has been taking minoxidil & dutasteride for 6 years now. I am a special case because I have an identical twin who is not taking the minoxidil . I have developed hypertrichosis and dark circle from minoxidil . Does someone who develop hypertrichosis should get scalp result from the minoxidil? the dark circle and hypertrichosis under eye are 100% from the minoxidil because my twin doesn’t have those. Will it last if I keep taking the drugs? thanks a lot doctor

Stop the drug and the side effects should go away in time.


2020-12-23 08:56:44Minoxidil put dark circles under my eyes

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Beta Blockers, Shampoo and Female Hair Loss

(female) Hi my question relates to the previous question you received regarding hair loss and the use of head and shoulders shampoo. I have used this product for about 10 years now and have over the last month or so noticed my hair thinning. I have switched to the Loreal Elvive Anti Dandruff shampoo now but the volume i once had to my hair does not seem to be returning. My hair used to be very thick and wavy now it is limp and lacks volume. I also am currently taking the medication beta blockers, would these be contributing to what is happening, rather than the shampoo?

I clearly can not tell you what, if anything, will help you. Too many changes at the same time confuses the issues. Go back to do what you were originally doing and then after some months, make one change at a time to see if there is an effect and note what that effect is.

Be sure that you have a medical work-up for the diseases that impact women (first choice) before jumping to conclusions that this is a simple matter just involving shampoos. Hair loss in women can sometimes be caused by underlying medical conditions, so it is important for you to be evaluated by your own physician. If clinically appropriate, the following disease processes should be considered: anemia, thyroid disease, connective tissue disease, 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. The following laboratory tests are often useful if underlying problems are suspected: Estradiol, FSH, LH, SHBG, Prolactin, T4, TSH, ANA, Iron, TIBC, Ferritin, Free and Total Testosterone. It might help to print this page out and show this to your family physician.

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Minoxidil with No Propylene Glycol?

Doctor,

What do you think of minoxidil products sold by doctors with little or no propylene glycol? Do you think they’re still effective as long as minoxidil is the main active ingredient? (Tried Rogaine foam, very hard to apply through hair to the scalp)

It appears on the internet a large number of people are only using minoxidil once a day. Usually at nite. Do you see that at your practice? Are they having results or developing dependency?

Also, it appears I can only handle .5mg of Propecia due to side effects. I think you’ve stated it’s about 80% effective at that dose. Have you seen that 80% result in your clinical practice?

Thanks for taking the time everyday to answer everyone’s questions. I’ve learned more than anywhere else on this blog.

Rogaine FoamI don’t see why the lack of propylene glycol would make minoxidil ineffective. The propylene glycol is supposed to help the minoxidil penetrate the scalp better, but it isn’t used in the Rogaine Foam or in the Women’s Rogaine liquid (which is good for those that may have allergies to propylene glycol), so I’d expect that other delivery mechanisms, such as alcohol, work relatively well. I really have no opinion on the various ways the doctors make their minoxidil formulas. The recommended use is twice a day, but many people do use it once a day. I can not tell if once a day works across the board.

My comments on the 80% effectiveness of 1/2 mg of finasteride came out of a conversation I had with Dr. David Whiting (and might’ve been in something I read), not my own clinical study.

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Biotin

Hi Dr. How much biotin should I take a day for hair loss???

Biotin deficiencies can cause hair loss, so many people may include biotin in their vitamin regimen. However in healthy people it is almost impossible to have a deficiency of biotin. A biotin deficiency is therefore extremely rare in the United States. When it does occur, it may be associated with disease conditions of the gastro-intestinal digestive tract. An adequate daily dosage for biotin is 30-100 mcg for the adult male.

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More body hair, from finasteride or minoxidil?

Hair lengthening/thickening in arms, legs, eyebrows, and even ears. Is this because of DHT, or minoxidil? I am NOT on Fin.

Minoxidil can do this when it is absorbed systemically or administered orally. Finasteride has occasionally these side effects.


2020-09-15 12:24:20More body hair, from finasteride or minoxidil?