Category: Uncategorized

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Diffuse patterned or unpatterned thinning?

Is it the occurrence of shedding all over the top of the scalp? From what I understand there are two major camps of hair loss suffers, the diffusers and the miniaturizers… and sometimes both. But anyways what exactly is diffuse thinning? I get mixed answers all over the place

Thinning comes in two types (1) Diffuse Patterned thinning that fits into confined areas and it is often related to genetic balding and the thinning is a precursor to it, and (2) Diffuse Unpatterned Alopecia (thinning or DUPA) which occurs throughout the entire scalp, even in the back of the head which is usually immune to genetic hair loss. Some women get DUPA when they pass menopause. There is a new term just pioneered by Myself and Dr. Robert Bernstein which is Age Related Thinning (this occurs when the entire population of terminal hairs become uniformly thinner.
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Propecia and Tinnitus

Hi Dr. Rassman,

i am following up on a previous message i sent. I am wondering if you know of anyone who after taking propecia(finasteride) found the following symtoms- tinnitus with an overall feeling of pressure in the head. I only took the drug for two weeks and then stopped after these symtoms appeared. I am still suffering with this six months later. I had these same symtoms five years ago, (but was not taking propecia at the time) which lasted for one year and am wondering if the propecia could have triggered this again as it is used as a blocker, or might it just be a coincidence.

Hope you can answer this for me, thanks!

I do not know what may be the cause of your problem. While many drugs can cause tinnitus, it is relatively rare. More importantly, tinnitus can potentially be a sign of serious medical problems and suggests to me that you have some medical issue which needs to be addressed by an expert in middle ear problems. I personally have not seen any patients in the last 10 years with tinnitus as a side effect of Propecia. I’ve been asked about this once before, a couple of years ago — Propecia Causing Tinnitus?


2008-07-22 09:58:40Propecia and Tinnitus

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Discussion between two men on Reddit about finasteride

Below is the conversation I had with another reddit user in this post regarding finasteride. I would greatly appreciate your feedback regarding what he said. Is it true?

Me: I’m 7 months with no noticeable improvements. It may take up to 2 years for improvements, but we’ll see

Him: Thats not true the peak at 2 years mark , but thats only if u saw any improvment by 6 month mark

Me: At year 2, almost 20% more saw regrowth according to the FDA-supported study. So yeah…it may take 2 years to notice improvement. Never heard of the 6 month statement. How do you know that?

Him: Lol trust me the brother. I have no reason to let you down. If u got nothing by now. You are not gona get any after. I mean if you are stable be happy.

Me: The research contradicts you

Him: U clearly didnt understand

Me: Please explain then and where you got that info from. I want to learn

Him: There a huge missleading about the fda reaserch. They mention that the the peak of the result were on 2 years mark. But those ppl kept improving since day one up to 2 years. Its not like after 1 year the regrowth start to accure. After 1 hair cycle u should see some results if u respond with regrowth.

My opinion is:

  1. finasteride may reverse hair loss (rare)
  2. finasteride may slow hair loss down (common)
  3. finasteride may stop hair loss (common but you don’t know this unless you stop the drug)


2020-04-03 12:40:12Discussion between two men on Reddit about finasteride

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Propecia, Hair Removal, and Travel Discount?

Hi Doc,

Couple questions:

  1. Is 37 too late to take propecia (I hear its less effective as we get older)?
  2. I suffer an ironic twist of fate – have too much body hair (back, shoulder, chest, etc) and thinning head hair (MPB). Can I use FUE to remove the body hair (even if I dont want to use it on my head – i.e. just want to permanently get rid of it).
  3. Finally, if I am travelling to visit your clinic for a procedure from an international location, is there any rebate/discount?

Thx!

  1. 37 years old is not too late for finasteride use, but you are correct, the drug tends (not always) to work better in the younger man in his 20s, rather than older men above 40.
  2. Taking out body hair with FUE instrumentation is expensive and unnecessary as there are good hair lasers that accomplish this better, faster, and less expensively.
  3. Yes, we do offer travel reimbursement for all patients coming from out of town. See details here.


2009-06-02 09:29:06Propecia, Hair Removal, and Travel Discount?

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Do Cowlicks Lead to Thinning or Will It Just Stay the Same?

Cow licks (actually called widow’s peaks when they are central) are actually remnants of your juvenile hairline. Many women think that they are attractive in men and in women-over half of them actually have some for of widow’s peak present. I wrote an article on this here: https://newhair.com/wp-content/uploads/2018/11/phenotype-article-published.pdf. There are some good photos of widow’s peaks in men and women in the article.

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Propecia Raised My Testosterone, So I Switched to Avodart

since taking propecia for 6 months my testosterone had been raised quite high, so i decided to switch over to avodart as i heard it is better. my testosterone is still high. my question is, is it worth me taking these medications for my hair loss as its raising my testosterone in turn producing higher amounts of DHT and higher amounts of DHT will cause more hair loss. in a sense im taking a drug to stop DHT but at the same time the drugs making higher amounts of DHT so im in a confusing paradox. should i continue with either one of these medications if all there doing is creating more DHT, even though there getting rid of it. please help Dr. Rassman and NHI team. thanks

It sounds like you are buying these drugs on your own without being followed by a doctor. There is a reason why these medications require a prescription from a doctor. In general, Propecia should not raise your testosterone levels to a significant amount over the long term, but testosterone levels have been found to be higher in those men on Propecia. There may be other issues special to your particular case. If Propecia raises your testosterone levels, Avodart will also increase the levels (certainly not decrease). If you’re indeed under the care of a physician, you need to ask these questions to him/her.

Without going into the biochemical aspects, there is no paradox that you are referring to. The real paradox is taking Avodart (dutasteride), because Propecia (finasteride) raised your testosterone level.

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Do I have DUPA

I took these photos of my donor area. I can see though my donor area which worries me about having DUPA

Diffuse Unpatterned Alopecia (DUPA) is determined when the hair in the field of view substantially exceeds 20% miniaturization. I generally like to cut the hairs in the view so that it is easier to count. One of these views is hitting up against the 20% number suggesting that better photo are ideal to pin down this diagnosis. The middle photo suggests that the miniaturized hairs are more than 20% but the other photos don’t back this up.


2018-12-26 09:05:14Do I have DUPA

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Propecia, When to Start

Lots of Propecia questions this week…

I am 21 and notice that my hairline is going. Should I start taking Propecia?

There are many important elements to your question and like all good questions, the answer may be more complex than you were expecting. There are many reasons for the hair line to move, the most common reason is the transition from having a youthful hairline to acquiring a mature hairline. This frontal change in the hairline occurs in 95% of young men and it is not reflective of the balding process. I can not tell you if Propecia will stop or slow this process down, but I suspect that it might considering that this is probably a DHT induced manifestation.

With regard to early genetic balding, I would get a good doctor to examine your hair looking for miniaturization of the hair shafts. The finding of miniaturization is an absolute sign of genetic hair loss, If you have it, Propecia is recommended to be started at the earliest appearance of genetic hair loss in the post pubescent male. Since genetic hair loss is a progressive process, the earlier you get a good diagnosis, and begin Propecia, the better your chance is to keep your hair for a longer period of time.

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Do I Need to Apply Minoxidil to Every Single Thinning Spot?

Hey doctor,

I have been using propecia and minoxidil for nearly 10 months now and seen almost excellent results on the hairline but not on the crown (I know it is supposed to be vice-versa). I have two questions for you:

1. Because my hair is somewhat long, I use a dropper to apply minoxidil. Do I need to apply minoxidil on every single thinning spot (massage my scalp to distribute the medicine) or does it get absorbed on a wider area? For example, if I miss the thinning spot by half an inch, will I still benefit from the drug?

2. I have used this treatment called the Nanogen Serum VEGF. However after around 9-10 months of using it I thought it didn’t have any effect at all and quit. I have seen light shedding after quitting the medicine but so far it is acceptable. My question is, they published some sort of trial results regarding their product. I couldn’t make a lot of sense and therefore wanted to ask you before being skeptical about it. Here is the link to the study.

Thanks in advance!

1. First and foremost, you should read any instructions that came with the product. Many minoxidil packages come with some “how to” info. What you usually would do is apply topical minoxidil (Rogaine) to the areas you want to grow hair. If you put it on point A, you probably will not see growth on point B.

2. As with all products that claim to grow hair, my mantra has always been “Buyer Beware!” If you tried a product and it didn’t work, what makes you think a fancy study or a website will make a difference? It just means they used the money that they’ve made for better a marketing presentation.

As for that Nanogen study you linked to, it’s not published in a peer-reviewed medical journal and looks to be just a small test of hairs in petri dishes that sat in different solutions. There’s nothing in the study that shows the product is safe or effective.


2014-03-17 18:26:01Do I Need to Apply Minoxidil to Every Single Thinning Spot?

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Proscar Warning Label and Possible Birth Defects

Dr. Rassman,

Thank you for continually answering questions on this forum. I am amazed how I routinely learn about hairloss by just reading the answers you post in response to other readers.

My question is about proscar. I’ve decided to switch to proscar over propecia because quite frankly, it is much more affordable to buy and split proscar into fours. I read in the past on this forum how you stated that Merck removed the warning about possibly passing Finasteride to a female through semen. My information leavelet that came with the Proscar had the following on it (women should not) “be exposed to the drug through sexual contact with a man taking Proscar”. It suggests that you should use a latex condom during sex. Does this mean that you should not try to have children while taking Proscar/Propecia? Does the fact that the dosage in split Proscar/Propecia is significantly lower than that of regular Proscar eliminate or reduce the risk for “birth defects” in a baby’s sex organs?

Also what you heard or know about a product advertised on TV by the name of Procede? They claim it is once every three months treatment.

Thank You

What is known about finasteride is that if a baby in the womb is exposed to this drug (dosage is not understood) that the development of their sex organs and possibly the way their brain is wired (female vs male) may be influenced. Genital abnormalities can be created by the influence of this drug in the first trimester of pregnancy. These abnormalities, when associated with finasteride, had been observed when the natural form of finasteride was ingested in very, very large doses (based on the research of a mountain village in the Dominican Republic).

The warning by the drug company reflects that knowledge and that a risk may be present. These are clearly warnings that are meant to protect the drug company, but to my knowledge, even with the widespread use of Propecia in young men (over a million men) there are no reports that I know of that show that there is a link between women who got pregnant with their men on Propecia and the creation of genital abnormalities in any of their children. I have one of my sons on Propecia and when he is ready for a family, I will not recommend that he change his usage of this medication. He likes the hair that is now strong in the frontal area and was thinning before he started to use it.

A little bit of history (though having little to do with your exact question) — One of the untold stories in medicine are about the hermaphrodite whose sex is misdiagnosed at birth. The absence of a penis may cause a baby to be classified as female or the presence of a large clitoris, may cause the baby to be classified as male. These children are then raised according to the original sex designations from the birthing room. These situations lead to great tragedy. For those of you wanting to learn more about hermaphrodites, I suggest that you Google the term hermaphrodite. Also, I have recently read a best selling novel titled Middlesex by Jeffrey Eugenides (a Pulitizer Prize winning epic that follows many generations in a family that had a hermaphrodite inheritance pattern in the family line). It puts a face on this tragedy and is a recommended read.

With regard to Procede, please see past responses here.


2013-06-18 11:56:30Proscar Warning Label and Possible Birth Defects