Category: Uncategorized

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Propecia and Fertility and Sperm Count

I am 27 year old Male. I have diffuse thinning of hairs. There is no bald spot yet and i can hide my thinning with thickening shampoo. But thinning became quite visible when my hairs are wet or oily. I have been using 2% Rogain for past 2 years and it helped in hair loss. But thinning continues.I want to move on to Propecia but recently i read about articles of its effect on semen. I will be getting married in a year and want to have kids in near future. Will it be advisable to start Propecia? Is any of your patients became father even on Propecia ? Any advise will be helpful. Thanks

There have been questions raised on the relationship between low sperm counts or fertility issues and the use of Propecia (finasteride 1mg). While there is no clear evidence that there is a direct relationship, there are reports you may find on the Internet that may justify such concern. The best advice is to speak with your doctor about your concern before starting any medication and consider your risks and benefits.One thought is to have your sperm count and your fertility tested before you start the medication. This is what is often missing in all the case reports. I do not know of any of my patients with this issue and I’ve known many patients (on Propecia) who married and had children.

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Difference Between Shampoos?

What kind of shampoo would you recommend and product to use. I use gillette and softee indian hemp hair & scalp treatment. But it doesn’t seem it’s helping at all. I looked on the internet found that Nisim can help keep your hair natural. What do you think?

It does not make a real difference. In my book, Hair Loss and Replacement for Dummies, I discuss the ingredients of various shampoos in detail. There are many good shampoos, but none of them will prevent hair loss. If a company makes that claim, they will be violating the FDA guidelines which define what can and can not be said. If they make false statements that can not be proven with appropriate FDA scientific studies, then their business will be shut down. But just because there are rules, it does not mean that companies will not misrepresent themselves.


2009-12-01 10:29:53Difference Between Shampoos?

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Propecia and Sensitive Testes

I’ve been using Propecia for about 3 months now and my testicles are extremely soft and sensitive. Should I continue using it? Will this condition worsen to where I may become impotent?

Although testicular pain and tenderness are sometimes reported by patients who are on Propecia (finasteride 1mg), the rate of this side effect is the same as those on the placebo. Impotence is not one of the documented side effects of this medication and I would doubt any permanent side effect like this would occur from taking Propecia. My advice to you is to stop Propecia for a few weeks and see if the pain goes away. You may also cut the dose of medication to half a pill each day (after stopping it for a week or so to see if the symptoms go away). Some of our patients had good results by cutting the dose of medication. If you continue to experience the pain, stop Propecia and discuss it with your doctor.

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Should Diffuse Thinning Be Treated with Hair Transplantation? (from Reddit)

Although some hair transplant doctors offer hair transplants for diffuse thinning, I consider this an issue of malpractice because, if it is really diffuse thinning, there is little value of a hair transplant to correct this. Sometimes, a hair transplant for thinning in the frontal area can work in women. For men, it takes a good honorable surgeon who is not in a rush to take your money. So, be careful about hair transplantation to solve this problem. Patterned thinning is often a precursor to balding. If you are a male, have a doctor evaluate you for this then build a Master Plan for your future balding which almost always happens.

Hair transplant for diffuse hair loss from tressless

 


2018-09-14 09:06:55Should Diffuse Thinning Be Treated with Hair Transplantation? (from Reddit)

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Propecia at the 10 Year Mark

Hi Dr Rassman I have a question regarding long term efficacy of Propecia in older men who have been using it for an extended period of time.

I am in my mid fifties and have been using it for 10 years and I’m happy with the results it seems to be maintaining fairly well. However I see posts on other hair sites (by users not doctors) who say it stops working. I tend not to trust some of these people as it sometime seems they are freely expounding personal experience rather than hard facts.

Can you shed some light on this for me?

I’ve written about this before, but if the benefits of this medication eventually becomes less apparent and if you should stop it, then you’ll surely find out if it was still working when you begin to lose more hair. In other words, it is best to continue it even if you think it isn’t working anymore, because it likely is still working and stopping the medication may cause you to lose any hair that it was holding onto.

As an aside, there is great evidence that this medication will reduce the risk of prostate cancer in men over 55 years old.


2010-01-05 13:52:44Propecia at the 10 Year Mark

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Distilled Water and Hair Transplants

You state in this article that distilled water solutions are harmful to grafts during surgery. However, my surgeon’s office told me to rinse my grafted area with distilled water to avoid the impurities found in tap water.

Will this damage the grafts post-surgery?

Distilled water and normal water are harmful to grafts DURING surgery if you are using it to soak and store the grafts that have been cut, but distilled water after the surgery is fine to wash the scalp as part of the cleaning process. Always check with the doctor/surgeon who performed your surgery if you have concerns, as you should have established a good trusting relationship with him/her.

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Propecia is One of the World’s Most-Faked Drugs?

Hi
I sent you the fake Propecia press release a month ago. Here is another short article dating back to 2007 about people stopping finasteride thinking it didn’t work for them when they were taking a placebo after all.

Thousands Of Men Sold Fake Propecia

The article states, “Propecia is one of the world’s most copied drugs and it is an extremely easy drug to sell online as many men to feel embarrassed to go to a doctor to speak about their hair loss problem. The Propecia drug works for about 90 percent of men.”

And it continues, “It is estimated that thousands of men around the world have stopped using Propecia believing that it doesn’t work for them when in fact if they had used a real version of Propecia made by the drug company Merck they would have experienced good results and possibly hair regrowth.”

I’m not sure where those estimates came from, and seeing as how the article is a couple years old by now, the problem might even be worse, regardless of attempts to thwart it. Thanks for sending this in, along with the previous article you sent.

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Do East Asian Women Have a Greater Chance of Developing Hair Loss?

Is female genetic hair loss/hair thinning more likely to start in early 20s if you’re of Asian (Korean) heritage? I’ve read that East Asian females have a greater chance of developing diffuse thinning than Caucasians.

No. I’m not aware of any good scientific studies that investigated women with hair loss by ethnic groups. We generally believe that hair loss does not discriminate race, sex, or ethnicity. In other words, it is mostly the same for all populations. You’re not at any greater risk than a Caucasian woman is if the genes are present.

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Propecia Stopped My Hair Loss Immediately, Then Started It Again Months Later

Hi Doc. Thanks for a great website.

37 year old male, been on Propecia for three months now. Prior to Propecia, hair was falling out of vertex at a steady rate. Started Propecia and loss stopped immediately and completely within three days. One month later after continued Propecia use, hair begins falling out at same rate as before Propecia and continues falling out now.

I know that I can’t “build up a tolerance” to Propecia, so am I in a shedding phase? If so, how long will that last approximately? And is it a good sign that my loss stopped so dramatically at the outset of my treatment? Is that a sign of things to come after this shedding?

Any information would be appreciated. Thanks!

If this is not a short term shedding process, you could be in for trouble. I don’t have any idea if it’s a temporary thing or how long it’ll even last. Stick to the treatment and then work with your prescribing doctor. You might start to ask yourself if its time to consider adding minoxidil to the treatment plan.

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Do I have DUPA? (photos)

These photos are better and I was able to zoom in on them. There is no significant miniaturization present. You have what appears to be a lower than average donor density, not miniaturization. To have DUPA (Diffuse Unpatterned Alopecia) there must be significantly more than 20% of the hairs that are miniaturized, which is not the case in your donor area as shown in the photo below, a zoomed in section of the photos you sent to me.


2020-02-06 09:04:22Do I have DUPA? (photos)