Category: Uncategorized

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Hair Loss Product Warning Labels

Why do hair loss products say “do not use if you have no family history of hair loss”? By using these products if you don’t have a history of hair loss cause one to start losing hair? Please answer this question instead of telling me to get a miniaturization done or to use Propecia.

I do not know the reason why they have the warning label you mention, nor do I even know what product you are referring to. If you are concerned, you can call or write the manufacturer and find out. Or perhaps you can try the product and test your hypothesis.

I often advise people who are concerned or worried about their hair loss to at least get a screening for miniaturization of their scalp hair, because you need to know WHAT you have BEFORE you treat it. Blindly buying hair growth products would be a waste of your money if you don’t know the cause of your hair loss or the degree of hair loss that is actually present. Likewise, blindly taking any of these products may leave you ‘not knowing’ if they are actually working. The same is true for taking Propecia or minoxidil when you do have androgenic hair loss because it could mean that you would also be throwing your money away if it does not work on you. This is why I recommend that miniaturization tests are done to grade the hair loss (if you have it) and then measure it (as it responds or does not respond to whatever you are treating it with) over the time that the treatment is being used. If it seems like I do make this recommendation too often on this blog site, well, that’s just what good medicine and good science is about and this is ‘my’ personal blog site and the way I like to run it. I try like hell to focus on objective things and I am not emotional about products that ‘claim’ but can not ‘prove’ value. This is why this site has become very successful in just a year.

For the record, the decision to take Propecia or any drug should be a decision made between the patient and his doctor. If I seem to advocate the efficacy of Propecia, it is due to the fact that it is the only FDA approved and well studied medication that has been shown to grow hair or slow down androgenic hair loss with any reasonable predictability. I am not a spokesperson for Propecia (nor do I have any financial interest in the success of Propecia). As a medical doctor, I base my medical opinion on safe and ethical medications and I require that all claims and issues of safety and effectiveness meet FDA approved guidelines.

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Trichoscopy for Dx of LLP and FFA

Trichoscopy, the examination of the scalp with magnification for diagnosis, is critical to be able to detect the presence of diseases that might be a contra-indication to hair transplantation. A hair transplant done on a person with FFA or LLP will fail. A biopsy of the scalp confirms the diagnosis.

The first picture on the left, shows a patient with genetic hair loss and a disease called Lichan Pilnopilaris (LLP). If this patient is not examined with a Trichoscope to make this diagnosis and had a hair transplant, it would fail. Note the crusting around each of the terminal hairs that are typical of LLP. This is an autoimmune disease of the scalp.

The picture on the right shows a man who is 33 years old, and had corner recession typical of a genetic Norwood Class 3 pattern of balding, but Trichoscopic examination showed Frontal Fibrosing Alopecia (FFA) which is highly unusual in a 33 year old male but if he had a hair transplant, it would fail as the former patient with LLP. The picture shows the absence of vellus hairs which is typical of FFA. This is an autoimmune disease of the scalp that killed off all of the vellus hairs.

 


2021-04-02 07:26:56Trichoscopy for Dx of LLP and FFA

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Hair makes a difference (transplants 5 months growth – photo)

There is no doubt that a hair transplant puts hair on the balding head and does it in a timely and predictable manner, in this case in just 5 months. I would expect that more length and possibly more hair is yet to grow in this man. If you are over 25, it is a very good option.


2020-12-02 07:05:57Hair makes a difference (transplants 5 months growth – photo)

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Trying to Keep Looking Full

I am working harder and harder to keep my hair looking fuller and it is progressively getting more difficult. Been on Propecia since it first came out and in the past year or so, I spend more and more time in the morning trying to maintain my look. God forbid, the styling gel does not hold it! Should I switch to Avodart? If it is safe enough for prostate disease, why Avodart be safe for me, age 31?

Avodart is safe and approved for prostate problems which only occur in men over 50, most often over 60. If there were a Vioxx type of problem to come about after taking this medication for 20 years in a 70 year old man, I doubt that we would ever see it. In someone your age, I can’t say that. There are trials underway for treating hair loss, however.

Thank you for coming into the office after sending your email. Examining you (see pictures below) showed the following:

  1. You still have your childhood hairline.
  2. You do not look bald or thin from any angle.
  3. When we separate your hair, is is clear that you work hard to keep this full look.
  4. There is 50% miniaturization.
  5. With styling in a dark hair, light skin person, 50% is almost as good as 100% density with any reasonable styling. Your hair is medium-fine thickness and has a slight wave to it. Many men would be happy to be where you are now and with 50% miniaturization I would not consider you a transplant candidate. Drugs (DHT blockers) like finasteride (Propecia) or dutasteride (Avodart) are the best way to maintain where you are.

The photo on the left is this man’s hairline from the front. The photo on the right shows the miniaturization in his parted hair. Click the photos to enlarge.

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Hair Problems from Wearing a Hat 10 Hours a Day, 6 Days a Week?

Hi i’m a 27 year old male, I am currently undergoing a hair growth/maintenance program through a hair clinic in australia. Although not really receeding much, my hair has become thinner than before. I started the program and saw some significant results, but then stopped after six month and picked it back up again but now using only 1/4 tablet a day of PROSCAR and a topical solution (prescribed by them) applied daily to the scalp. I have not seen much difference at all and still experiencing slight shedding of my hair, noticeable because it gets stuck on my body after showering and occasionally falls into my mouth. I do however miss a day or two of use throughout the course of 1-2 weeks, as i don’t come home for a few days when i go out on weekends. I am thinking about dropping the program as it is quite costly and time consuming to apply topical solution daily and am experiencing slight to mild stomach discomfort (don’t know if it is related to the PROSCAR). I’m comfortable with the state of my hair is at the moment as it is not too different from when i first started the program (Mostly slight thinning of frontal and mid region of scalp, no receeding so far).

What i’d like to ask is if i was to take just the proscar or propecia alone, how effective would it be to retain the conditions of my hair at the moment, and would it help prevent receeding of my frontal hairline? Also i’d like to ask although hat wearing has does not cause hair loss, does wearing a hat head for almost 8-10 hrs a day, 5-6 days a week for the last 3 years (due to laziness of grooming while out or working, on many occasions my hair/scalp would be drenched in sweat) have a direct affect on the health and growth of my hair?

Propecia (finasteride) should help halt hair loss, even in the frontal hairline. If you abandon the program outline by your doctor, I’d still keep up with the finasteride, for if you have genetic balding, that is the best thing you can take to treat it. Finasteride works differently for different people, so I can’t say with 100% certainty whether it’ll maintain your hairline. As I don’t know what topical solution you were using, I can’t be sure if stopping it will make a difference. If it was a minoxidil-based topical and you saw results, stopping it will result in a loss of those benefits (hair that grew will fall back out).

The use of hats 10 hours a day or even 24 hours a day are neither positive or negative, providing that they are not tight enough to rub and produce traction on your hair.


2008-11-18 12:49:52Hair Problems from Wearing a Hat 10 Hours a Day, 6 Days a Week?

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Hair Systems at 23

I’m 23 and it’s happening. I’ve always had a poor hairline but now it’s thinning. And quickly (6 months and it’s gotten worse). Money is no object. Are these crappy hairpieces or are they indiscernible from the real deal? Do you shave the rest of your head for them? How do they work? How do you clean them? I want to do it early enough with my current hairstyle so no one can tell. I’m not keen on the medication or rolling.

Be aware that hair systems need to be attached, so most use glues to hold them to your shaved scalp. This causes traction alopecia and more hair loss so most men who make the switch to hair system end up on them for life as their hair loss always gets worse, often from the hair systems themselves.


2021-01-23 10:48:38Hair Systems at 23

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Undercover Videos Made in Turkey – See What Really Happens

This is clearly a production line business. The doctor is not particularly important other than for the marketing, recruitment, and conversion. It is clear from what the interviewer found out, that the doctor does not do the surgery. If not the doctor, who does it? I know that there have been deaths associated with hair transplants and even dental work in the western world, but at least in the US, Asia, and Europe, you have licensed MDs performing the surgery and who are trained on how to treat you if something goes wrong. Everyone going to Turkey should see this (Taken from https//www.hairtransplantmentor.com and the brilliant Joe Tillman).

Here are the videos:

Joe gave me permission to display the links to his Undercover Videos


2019-02-20 06:24:32Undercover Videos Made in Turkey – See What Really Happens

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Hair Transplant at Early Stage of Hair Loss?

hi doctor,
in your earlier blog you said that best time to do a hair transplant is when the hair loss becomes unbearable and you(doctor) has something to work upon.however in your recent blog you said that it is better to have hair transplant in early stage. what exactly in your view is the better option?

For starters, you need a Master Plan to understand what is going to happen to you.

Hair transplants work well early in some men if there is obvious balding, but just having miniaturized hair and some thinning may be better treated with medications like Propecia (finasteride) before considering a surgical approach. Frontal areas, as they bald, work well with hair transplants, while crown areas may take huge amounts of hair that will not meet your needs in the supply/demand ratios of your hair density and scalp laxity.


2009-03-19 12:23:58Hair Transplant at Early Stage of Hair Loss?

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Updated Propecia Info Says There’s Erection Difficulty After Discontinuing Treatment

Dr. Rassman

You have always been against the idea that propecia side effetcs may be permanent, and I saw you telling many people that the side effects as released by Merck are temporary and have been approved by the FDA. now it seems that there is an updated Prescription Information for Propecia. you can check it yourself at this link

among the most important changes are (in section 4, “Possible Side Effects”): “Persistent difficulty having an erection after discontinuation of treatment.”

Anything to comment? Thanks

Interesting, but the information lists that under the heading “Frequency unknown“, which leads me to believe it must be extremely rare. I have no information on this and have never seen it in my practice. I wonder about psychological impact on those that are affected.

The PDF you linked to appears to be for the Austria, Denmark, Finland, France, Germany, Greece, Iceland, Italy, Luxembourg, Netherlands, Portugal, Spain and Sweden markets… and Merck doesn’t seem to have the same information in their US pamphlet. I really could only speculate as to why that is the case, though.