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my hair has been rapidly shedding since March within two months of being sick. I noticed little white bulbs at the end of the hair. The hair on top, sides and back become difussed, now all of my neck hair has receded. The Derm says I have TE. does it sound like TE? Derm explained hair cycle phases. Am I in the Telogen phase.. Hair stops growing and shedds? when does it stop shedding.?

Thank you

Telogen effluvium (TE) can occur after a stressful illness. It does sound like that’s what you’ve got, but without examining you for myself I couldn’t really say one way or the other with certainty. People with RE will often have a positive hair pull test. If you are going through TE, it will usually stop within 6 months after you are fully recovered from your illness. Learn more about TE at eMedicine.

My doctor implanted hairs over my existing hairs. The result of what he did destroyed my hair and my donor area. He told me that he had to do this because I was going to lose it anyway. I’m a mess now and am ashamed of what I allowed him to do on me. Now what to do?

Some doctors take advantage of young men who are scared to death about losing their hair. Some doctors are like predators and look for men who will fill their pockets with money. You need to find a good doctor who can assess your situation and give you a plan on what to do. Most good doctors can help you but a second mistake is not an option so be careful in finding a doctor.

Hey doc, there is a new hair laser on the market. What do you think?

This space age design and the small case “i” in-front of the name does not add value. The FDA clearance means that it is safe. I really do not understand the FDA as effectiveness has not been proven in the one example mentioned in the article. I have not seen any definitive clinical research that proves that these lasers have any value at regrowing hair. Even the recent article in the Dermatology journal stated “further study is needed”.

I started recently (I’m thirty) and have been on it for about six months with great results. The only side I felt so far is the mild ache in the testicles from time to time. However recently the ache has come back and is pretty persistent. And I might be paranoid but i read somewhere that propecia even the 1mg one can led to shrinking of the testicles.

If you are having testicular pain with finasteride, see your doctor and get examined. If the two are related and it doesn’t go away with stopping it for a few week, or using a smaller dose, then it might not be the drug for you.

I am a medical student and was wondering how finasteride works to give people a fuller appearance of hair.

In the Journal of the American Academy of Dermatology July 2006, Volume 55, Dr. Vera Price summarized the action of finasteride as follows:

“Long-term finasteride treatment led to sustained improvement in hair weight compared with placebo. Hair weight increased to a larger extent than hair count, implying that factors other than the number of hairs, such as increased growth rate (length) and thickness of hairs, contribute to the beneficial effects of finasteride in treated men.”

This is important, because what she implies is that the miniaturized hairs reverse. That is why it is so important to map out the scalp for miniaturization and to perform bulk measurements with the HAIRCHECK instrument. These two approaches used prior to starting finasteride (Propecia) gives us a baseline metric to determine the value of the treatment. I have seen people with miniaturization in the 80% range, reduce substantially to almost normal levels (under 20%). This is why everyone taking finasteride should be evaluated prior to starting the treatment by a doctor who understands this process clearly.

Too many finasteride (Propecia) users do not get evaluated prior to starting the treatment. They depend upon their memory of what they looked like after being on the drug, the appearance of hairs falling out and found in the drain, and even photography. Considering the investment of emotion (and money) in treating hair loss, every person should be a HAIRCHECK done for bulk measurement. After a year on the drug, you will know if you are gaining, losing or just staying put. This is the critical first phase of a Master Plan for hair loss that everyone using it should undertake. These measurements along with the first visit check-up, is free at the New Hair Institute. For women, the HAIRCHECK measurement is also important for knowing where the hair loss is going.

I am a medical student and was wondering how finasteride works to give people a fuller appearance of hair.

In the Journal of the American Academy of Dermatology July 2006, Volume 55, Dr. Vera Price summarized the action of finasteride as follows:

“Long-term finasteride treatment led to sustained improvement in hair weight compared with placebo. Hair weight increased to a larger extent than hair count, implying that factors other than the number of hairs, such as increased growth rate (length) and thickness of hairs, contribute to the beneficial effects of finasteride in treated men.”

This is important, because what she implies is that the miniaturized hairs reverse. That is why it is so important to map out the scalp for miniaturization and to perform bulk measurements with the HAIRCHECK instrument. These two approaches used prior to starting finasteride (Propecia) gives us a baseline metric to determine the value of the treatment. I have seen people with miniaturization in the 80% range, reduce substantially to almost normal levels (under 20%). This is why everyone taking finasteride should be evaluated prior to starting the treatment by a doctor who understands this process clearly.

1. Is initial shedding experienced with minoxidil the same as loss due to trauma? That is, does the initial shedding often experienced from a topical solution represent permanent loss (like loss from surgery or medications), or is it simply the start of a new hair cycle, with potentially thicker hairs growing back. Or is this the same as traumatized hair that, once it falls out, regrows weaker and smaller? I ask because I began adding liquid Rogaine on weekends in addition to the foam during the week (it is just too greasy otherwise), and I am hoping that maybe some of the most recent loss might have been caused by the liquid formulation.

Minoxidil is known to cause shedding in the initial use. It is not comparable to trauma. The hair should come back and start reversing from the short term loss within 2 or so months.

2. We discussed formula 82M. So, in addition to 5% minoxidil, it contains retinoic acid, tretinoin, 0.01% topical steroid fluocinolone, and oleanolic acid. I am just curious if you would expect to see any real difference in response to treatment between 82M as opposed to Rogaine. I have not felt any irritation from the 82M upon application, but my scalp has become extremely dry with a tremendous amount of skin flaking (when I wake up in the morning, my pillow looks like it has been sprinkled with confectioner’s sugar). I never had a problem with scalp irritation from either liquid or foam Rogaine. If there is no reason to expect different results from 82M versus regular minoxidil, I do not know that it will be worth using in the long run.

The various acids in the 82M or other similar medications generally cause the scalp irritation, dryness and flaking. The basic theory behind the extra ingredients is to irritate the skin to absorb the minoxidil better.

3. Many doctors promote PRP treatment, and I know you remain fairly skeptical without good clinical evidence, but have you actually seen positive results in any patients anywhere? Is it a hit-or-miss type of treatment, where some people respond and some do not, or is it purely nonsense?

PRP has not shown any value. This came up at the recent international meeting for hair restoration surgeons and after review, it was my conclusion from that meeting (as well as many of the respected doctors who where there) that PRP has little value, if any in the various balding or hair transplant scenarios.

I have not seen positive results or met anyone who claimed positive results.

4. There are no solid studies regarding the effectiveness of LLLT on hair growth. Despite the question of efficacy of LLLT, I wonder if it is still possible to determine which device may be the best choice for the end user. I was considering trying a new laser, if only for better coverage and convenience of use, but is there any reason to think that the hair cap, for example, is any better than other laser products?

I have tried LLLT on patients over the years and I never saw any value and that is my belief. One doctor I respect, told the meeting that of the various devices, the Laser Hair Comb might be the best. I ask the best of what?