Category: Uncategorized

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Taking Propecia Before the Sun Rises

Hey doc, I need this question answered ASAP, if you wouldn’t mind. As you may know, Ramadan has begun and many Muslims will be getting up in the middle of the night to eat and drink, for eating and drinking aren’t permitted until the sun sets.

So if I take Propecia before the sun rises, like around 4 AM or so, would it have the same effect as taking it later on in the day? Thanks

You can take Propecia (finasteride) at any time. Just take it about once every 24 hours (day). I generally recommend taking it when you wake up in the morning, when your testosterone is highest and if that is 4am, it will work as well at that time.

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Fungus on Scalp

i had to move out of my home due to fungi spores outside home was over 5000 and was consuming the inside of new home also. i am very allergic and had to be put in hospital, i have been on flagyl for 3 wks now and i still have bacteria,and fungi internally and on scalp. is it normal to constantly pass black and red dots from scalp and is this scalp fungus? going bald,and intense itching for 6 months now. please give any suggestion. thank you so much

It sounds like you have some serious issues. I would follow the recommendations from the doctor who is treating you. It is impossible for me to give you any medical advice over the Internet, as I am not your doctor. I can only give general opinions as a doctor. I do not know what “black and red dots” you are passing on your scalp, and I would have to see them to get an idea of what you’re talking about. It certainly does not sound normal.

Again, you need to ask these questions to your doctor who can actually examine and see what those “black and red” dots are. Sorry.

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Tapering Finasteride

I have a question about Finasteride tapering (I seem to remember something about this on your website, but can’t access the link now). Basically, is there any recommended dosage regime to slowly taper yourself onto the usual 1mg/day dose? i.e. working your way up from 0.5mg once a week, then up to 0.5mg EOD, then 1mg EOD, then 1mg daily, over a period of a couple of months? Or could this kind of slow tapering actually be harmful?
If you are having side effects from this drug, you can just stop it. Tapering it will not alter the “catch-up” hair loss that many people who stop the drug experience. Catch-up hair loss reflects a loss of all of the hair that did not fall out or was gained from the drug, and the person who stops the Finasteride will see this effect within 3 months.


2018-05-18 08:32:28Tapering Finasteride

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General Anesthesia for a Hair Transplant

Why can’t the procedure be done under general anesthesia, to avoid the shock loss associated with the local anesthesia and the epinephrine used with the local anesthesia?

General anesthesia has risks that local anesthesia doesn’t have (the death rate is about 1:20,000 people). In addition, hair transplants are very long procedures, and general anesthesia would cost a lot of money for 8 hours and put you at more risk than needed.


2020-06-04 20:08:40General Anesthesia for a Hair Transplant

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How do you tell the difference between a receding hairline and a maturing hairline?

Almost all Caucasian males develop a maturing hairline. When recession occurs, it usually is associated with hair loss elsewhere on the head and scalp and that is why I perform a HAIRCHECK if I have any doubts on the distinction between a receded hairline and the appearance of a maturing male hairline. The HAIRCHECK instrument will show hair loss behind the hairline which always occurs when the hairline is receding. The picture of me below shows a V Shaped mature hairline that is 100% mine since it changed from the rounded hairline of my youth. This hairline was not transplant but my entire crown was transplanted with 2700 grafts. The second picture shows early hairline recession that was transplanted along with a replacement of the temple peaks. You can see that this hairline was ‘ratty’ in appearance which is essentially what often happens when the hairline starts eroding.

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Temporary SMP?

Hello, I read your blog everyday and wanted to thank you for the information you provide. I am a 40 year old male and been on propecia and minoxidil for over 15 years with pretty good results. I find now my crown is getting pretty thin and wondering if SMP would be an option for covering up the crown for my hair which is a light brown/sandy blond .Is there such a thing as temporary SMP that might only last a few years?

Thanks

Scalp MicroPigmentation (SMP) should be considered permanent. If you want a temporary solution, I would suggest you research topical camouflage products such as DermMatch or Toppik.

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Given my family pictures, should I get a transplant?

When I was 17 the temples of my hairline had receded and I now have very minimal crown loss . I’ve been using minoxidil with dermarolling for the last 3 months on my hairline but all I can see are very tiny vellus hairs along my hairline. However for the past couple days I’ve been having day long migraines and I suspect it might be the minoxidil so I’m stopping use until around next week.

Hair transplants are personal decisions. Knowing what you might look like by looking at family members might help you understand better, especially if you can speak with those that are still alive and ask them if they could get their hair back (an completely undetectable hair transplant) would they have done it. You need to sit down with an expert in this field (hair restoration) and get a Master Plan worked out for your future hair loss problems if your hair loss should occur.


2019-04-08 13:11:02Given my family pictures, should I get a transplant?

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Chemo After Lung Cancer 2 Years Ago – I Lost Most Of My Hair

I had lung cancer and my last chemo treatment was in July of 2012. I finished radiation in October December 2012. I had some balding prior to the Chemotherapy that you might classify as a Norwood Class 6 pattern, but there was still hair throughout the head. It was just thinning. It has been almost two years and now my hair loss pattern is very clear and all of the thinning hair has not come back. I have a few sparse hairs all over my head, but they are very sparse. I am off my medications at this time. Will my hair come back and what can I do to help it. I have used Nioxin for two years and just recently started uses minoxidil. Are there vitamins to help? Just what can I do?

I do not know how to help you. You clearly had male pattern balding that was not complete and the chemotherapy stressed your fine, miniaturized hairs and finished the balding process in them. One of our patients had used the ‘Cold Cap’ when the took Chemotherapy and lost less than half of the hair. Few doctors are aware of this treatment. At this stage, I believe that you can expect that hair regrowth will not occur. We have a treatment that may be worth looking at, called Scalp Micropigmentation (scalpmicropigmentation.com). Many patients convert from a Class 6 or 7 pattern to a full looking head of hair by taking on a shaved look. Just like the star of Breaking Bad, many men look great with the shaved look and your case does parallel the main character’s appearance. This is something to consider. Many times I ask myself if SMP was available when I started to treat my hair loss, would I have chosen this option. The answer is yes, but at my age, this is not something that I would do considering that my hair loss is gone and my hair transplants were 100% successful in addressing by large crown loss.