Category: Uncategorized

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Do I Need to Worry or Is It Just My OCD?

Hi Doctor,

I’ve sent a few blog questions through, so I do apologise for the influx of emails you’ve probably received from me.

I’m 21. I suffer from OCD, and I’ve recently been extremely worried about my hair. I’ve posted numerous pictures on various different forums to try and get an analysis of my hair, and I’ve been told my hair is fine. However, I’m still worried, but am unable to afford an appointment to go to a trichologist. So, I was wondering if you could take a look at my album of photo’s. There’s a fair few in here to get a decent look at my hair.

At first I was worried about my crown area/top of my hair, but was told that I’ve got a natural parting coming from my crown. Then I was, and am worried about my hairline, but was told I have a ‘mature’ hairline. Still, I was wondering if you could take a look for me and tell me how you think my hair and hairline is? What Norwood do you think I am. I also have seborrhoeic dermatitis so my scalp is quite inflamed/red.

Basically, do I need to worry, or is it just my OCD?

Oh, and feel free to post the picture album of my hair if this question get’s published. I don’t mind. Thanks.

Click the photos to enlarge:

 

Nothing I can say online is a substitute for a medical exam or seeing your doctor in person. As you state you suffer from obsessive compulsive disorder (OCD), I think you need to have that under control. Since you’ve posted these pictures on numerous forums and have gotten a reply that your hair is “fine”, I do not know how much more I can add. Your hair looks very good to me, but there’s only so much I can tell based on photos. Base don the pictures, the hairline looks strong and thick, as does the crown.

If you are still worried and your OCD is under control, make an appointment with a doctor you trust, especially one who can perform a HairCheck bulk analysis which gives a metric for the presence of hair loss. I’m not going to be able to assuage your OCD and hair loss paranoia, but I do thank you for letting us use your photos.

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Prostate Cancer Treatment Associated with Higher Risk of Heart Failure

Men with early-stage prostate cancer who receive androgen deprivation therapy are at significantly higher risk for heart failure, according to a study published in the British Journal of Cancer. After following a cohort of 7,637 men diagnosed with localized prostate cancer between 1998 and 2008, researchers found androgen deprivation therapy was associated with an 81 percent increased risk of heart failure in men without pre-existing cardiovascular disease (CVD).

SOURCE: https://www.cardiovascularbusiness.com/topics/heart-failure/prostate-cancer-treatment-associated-higher-risk-heart-failure?utm_source=CVNW&utm_medium=6c47c50623&utm_content=article&utm_campaign=newsletter_referral

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Do Vellus Hairs Turn Into Normal Hairs from Finasteride?

Is is safe to assume that vellus hairs turn into normal hairs on finasteride?

Vellus hairs stay as vellus hairs. In every follicular unit, there are one or two vellus hairs (short like stunted hairs). Miniaturized hairs, on the other hand, are terminal hairs (normal hairs) that lost their bulk and these are the hairs that get positively impacted from finasteride by increasing their shaft thickness when they are miniaturized.


2012-06-12 14:30:38Do Vellus Hairs Turn Into Normal Hairs from Finasteride?

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Psoriasis and Hair Loss

Hi,

I have male pattern baldness. it started at age 18 from my temples and has been receding terribly over the years, and more esp over the last 5 years. I am now 43. I used to have severe psoraisis on the face and scalp and was told the hair loss was because of that. Now the psoraisis has gone down considerably, alomost completely but the receding continues. i also have thick scabs on my scalp on and off that do not look like psoraisis scabs, i think it could be symptomatic of systemic yeast/eczema?

I used to have a very thick full head of hair, more than the average person so the hair loss over the years was more apparent to me than to others. Now, it is apparent to everyone. i just have a strand or two to cover my unnaturally high forehead, the hair on top is very thin, weak and sparse, there is more at the back but that too has recently thinned a lot.

In the last 3-4 months, my hair has been falling out in clumps, and is extremely coarse, dry and brittle. Please dont tell me it is age because this has been happening throughtout my adult life , but has has gotten much worse recently and esp since my first ever perm a year ago. But the frontal hair has been receding steadily since age 18. It has been very distressing and depressing for me, and nowadays, i dont even like to look in the mirror and see my unkempt hair. No matter what i do – hair oils, etc, it is as dry n weak as ever and receding all the time. help would be very welcome and appreciated.

This is an area where I have first hand knowledge, with the worst form of scalp psoriasis one can have. Mine, like yours, burned out in the scalp and I have almost none of if at this time. But I never lost hair because I was careful about not pulling off the plaques which would have almost certainly produced traction alopecia. Psoriasis does not cause hair loss unless the plaques are pulled off and the hair comes out with the plaques regularly.

With regard to hair transplants, I am frequently asked by people with psoriasis, if the psoriasis can be moved from one part of the scalp to another. In my experience, psoriasis can not be transplanted from the affected area to an unaffeced area, but any surgery done on active psoriasis, can make it worse, unless it is treated topically prior to the surgery.

You may have a skin condition and this must be defined by a good dermatologist. The rest of your needs are easily dealt with through traditional hair transplantation, which is extensively discussed in my book, The Patient’s Guide to Hair Restoration.


2005-11-10 13:35:41Psoriasis and Hair Loss

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Do you think that finasteride will reverse this hair loss? (photo)

You have a Class 3 pattern of hair loss with a persistent frontal forelock. These forelocks may hold for a long time depending upon your age and your family history. I wouldn’t expect that finasteride would reverse this unless you were under 22, then there is about a 30% chance of reversal.


2019-05-19 10:34:05Do you think that finasteride will reverse this hair loss? (photo)

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A quality hair transplant frames the face

If you look at the face as a picture, the top of the frame is the hairline. A picture that has a frame missing on top, is not a good picture. This man has a normal, mature hairline which is 100% transplanted. Nobody ever knew by looking at him, nobody.

Screen Shot 2018-12-19 at 1.45.32 PM

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Doctor Rassman, there is evidence that Saw Palmetto works, see below

http://www.ncbi.nlm.nih.gov/pubmed/12006122

http://www.ncbi.nlm.nih.gov/pubmed/8142312

http://www.ncbi.nlm.nih.gov/pubmed/7577710

http://www.ncbi.nlm.nih.gov/pubmed/3218455

http://www.ncbi.nlm.nih.gov/pubmed?term=prager%202002%20saw%20palmettohttp://www.ncbi.nlm.nih.gov/pubmed/12477490

http://www.ncbi.nlm.nih.gov/pubmed/8922564http://www.ncbi.nlm.nih.gov/pubmed/6708534

http://www.ncbi.nlm.nih.gov/pubmed/8876706http://www.ncbi.nlm.nih.gov/pubmed/8922564

http://www.ncbi.nlm.nih.gov/pubmed/8876706http://www.ncbi.nlm.nih.gov/pubmed/20300369


2019-05-19 10:26:00Doctor Rassman, there is evidence that Saw Palmetto works, see below

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Questions about finasteride from a young man

(1) I know it can take up to a year to see results and possible regrowth. In terms of shedding however, will I immediately begin to see less hairfall upon taking the drug? (2) I know side effects are rare, but if I do get any how long should I continue to use finasteride before I should stop? I’ve read that quite often side effects disappear through continued use of the drug. (3) Although finasteride effects beard growth and development, if I stop taking the drug will my beard develop as normal or will it be permanently damaged?

Answers to your questions.
1- I tell my patients to wait a full year to see real benefits but if you do not get a shed when you start the medication, you will see the hair loss slow down or stop in a month or two
2- If the sexual side effects hit you, wait a month or two to see if it goes away, you can cut the dose to one pill every other day which may help
3- Usually, when you stop finasteride, beard hair goes back to normal


2017-08-10 08:52:45Questions about finasteride from a young man

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Doctors, Crooks, or Con Men — How Do You Tell the Difference?

I just met a patient who, while doing comparative shopping, came to me as the fifth doctor on his shopping list. He was 46 years old and had some thinning in his crown. He lost the first inch of his hairline, but his hairline did not bother him and therefore was not his focus. He was fine with where the frontal hairline was. He was able to see through the crown for the first time in years. Below, is the spirit of what he told me his experiences were, I simulated quotes of a conversation to demonstrate what he described to me —

Doctor #1:
“You are going bald in the crown”, he was told. He was quoted a surgery cost of $12,000 for 1400 grafts.
“Will I lose any hair from the transplant?”, he asked.
“It happens sometimes,” the doctor answered, “but if it does happen, it will grow back”

Doctor #2:
“I can fix it with 800 grafts for $3,000 and if you do that now, I will throw in another 100 free grafts”.

Doctor #3:
The man had researched this doctor and found that there were reputation problems evident through industry-specific bulletin boards and in internet reference sites. He felt that the visit to this doctor reeked of sleaziness.

Doctor #4:
On the visit, he met a patient in the crowded lobby. The patient (who already had surgery) warned him to stay away for his own good. When he visited the doctor, he was told that for $12,000, he could get 2000 grafts into the crown and it would make his crown appear full.

Dr. Rassman (Doctor #5):
I mapped out his scalp for miniaturization and found that less than 50% of the crown hair was miniaturized (no other doctor did this). The frontal area had 80% miniaturization just behind the balding area, suggesting that his hair loss will continue in the frontal area. I told him that with only 50% miniaturization in the crown, a drug treatment would be the best approach, not surgery. When the hair is 50% miniaturized, there is usually reasonably good cover and surgery runs the risk of causing irreversible hair loss (which usually does not grow back in men). If this happened, it could make his crown more see through than it was now. I recommended against any surgery.

I was personally frustrated with my colleagues in the hair transplant field, particularly for what appeared to be a lack of moral fiber in managing this man’s problem. I have always believed that doctors should put their own welfare behind the patient’s welfare. What the above cases clearly showed me was that the first four doctors were behaving like used car salesmen, selling this man the car driven by that little old school teacher who never abused it. I have no difficulty condemning the opinions of these other doctors and their behavior. Every one of the four wanted to take this man’s money and preyed upon his vanity.

Of interest, when he first started talking with me, he was at first baffled by the wide discrepancies between the recommendations and the pricing, but after receiving my explanation of the miniaturization assessment (something that none of the other doctors did on his examination), his confusion cleared up. His initial question to me was why was there such a wide descrepency between the estimates of work and price. That was not his focus after the consultation with me. In his case, good comparative shopping saved him from being victimized by doctors who behave like crooks and con men. They are still out there.

Again and again, I warn people, ‘Let the Buyer Beware!’


2006-09-05 20:31:06Doctors, Crooks, or Con Men — How Do You Tell the Difference?