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Are These Side Effects from Propecia or Stress?

Dr. Rassman,
I am 23, and have had diffuse thinning for the past three years. I am currently taking propecia and minox and have been for 15 months. During that period, I have not noticed any significant regrowth, but the appearence of my hair has seemed to maintain to some degree. I am also a law student and in December I had my first set of finals. During that time, I can honestly say that I was more stressed then I have ever been in my life. Since december, I have noticed that my hair has appeared to thin significantly.It used to be thin only in the back, now I can see a thinning pattern in the front. Additionally, in the month since finals ended my libido and sex drive have significantly increased. I do not know whether that increase is due to my lack of stress, however I am speculating that the propecia has stopped working for me. I was wonding if these are typical effects if it does stop working; i.e increased thinning and greater sex drive or perhaps I can attribute both the my level of stress and current lack there of. Any help would be greatly appreciated. If propecia has stopped working for me, then I really don’t know what else I could do

Stress impacts everything in our lives. Your hair loss and thinning is certainly (assuming you have genetic hair loss) being made worse by stress. Propecia sounds like it has slowed or stopped the present hair loss, but as male genetic hair loss is a progressive process, it is only a matter of time until you notice more thinning/recession. The sex drive issue relates to many things. Men can find sex to be a good outlet for frustration and hiding from problems. Propecia can initially cause an increased sex drive due to the increase in testosterone levels, but the sex drive of a man your age should already be high, so perhaps your body is just learning to deal with the stress better. Could it be that your normal sex drive is what you are now experiencing?

With regard to your thinning and possible genetic hair loss, you should get your hair mapped out for miniaturization to determine if the hair loss is genetic and to what degree it is progressing. You need a Master Plan for your future hair loss. As you are in Los Angeles, I would be pleased to see you myself at no charge in my LA office. If you are interested, please call my office at 800-NEW-HAIR to set up a free consultation with me.


2006-01-30 10:36:12Are These Side Effects from Propecia or Stress?

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Medications for Diffuse Unpatterned Alopecia

Hello. I am 24 year old male, who believes I am suffering from diffuse unpatterned alopecia. My hair is thinning evenly over the top and the side of my head to from the classic horseshoe pattern of a Norwood class VII. I have been taking Propecia since January and i do not believe its working as the thinning has progressed. My dermatologist did not seem to concerned and told me to continue taking it for the full year before asking for any other options. Are there any other effective options available? I have read about Avodart and minoxidil, or the possibily of a chemical imbalance, but I do not know if they are effective for this condition.

I believe that DUPA can be reversed with Propecia. I see this in about half of the patients who are taking it. For those like you, it may be worthwhile, after trying Propecia for a year, to consider Avodart, but I have said many things about this drug which you should review.

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Article on scalp blood flow has it wrong

The authors show that the blood flow in the scalp with less hair is less than with more hair. This is because the hair requires a great deal of blood because it has a high metabolic rate. The body pumps blood to the scalp to meet the need to support the high metabolic hair organ system. The reduced blood flow, long held as the cause of hair loss, has never been proven. This is an issue of cause and effect, less hair produces less blood supply not the other way around.

Subcutaneous blood flow in early male pattern baldness

Under an Elsevier user license
open archive

Abstract

The subcutaneous blood flow (SBF) was measured by the 133Xe washout method in the scalp of 14 patients with early male pattern baldness. Control experiments were performed in 14 normal haired men matched for age.

The SBF in the scalp of the normal individuals was about 10 times higher than previously reported SBF values in other anatomical regions. In patients with early male pattern baldness, SBF was 2.6 times lower than the values found in the normal individuals (13.7 ±9.6 vs 35.7 ±10.5 ml/100 g/min?1). This difference was statistically significant (p ? 0.001). A reduced nutritive blood flow to the hair follicles might be a significant event in the pathogenesis of early male pattern baldness.


2020-04-19 09:35:58Article on scalp blood flow has it wrong

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Men should be comfortable being bald

The point is there’s no need to reinforce this belief that everybody needs to have hair. That mentality obviously benefits the hair loss industry. Some guys can’t get over the fact that they’re losing their hair and will go to far lengths to preserve whatever they can. But there’s no shame in being bald and if your hair is a main source of self esteem, I recommend taking steps to fix that because nice hair won’t get you that far in life.

Hair loss has been important throughout the ages. From a historical perspective, hair loss was very common in the cities when TB ran wild. That was why a woman looked for a hairy man to qualify a man as a prospective husband. If a man lost his hair, the presumption was that they had TB and would probably die from it, not living long enough to provide family support for the long term. This created a lot of myths that have stayed with us in one way or another today. It is also imporant to know that the hair restoration business will hit $30 Billion for 2025, now at something like $6+ Billion and the hair cosmetics industry is today over $20 Billion and growing fast to make you WANT to not be bald. This is the power of money today because if you retain the bald look, no one can make money from you, its free!


2021-01-23 10:38:22Men should be comfortable being bald

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Association Between Early MPB and Prostate Cancer?

Snippet from the abstract:

Results: Our study revealed that patients with prostate cancer were twice as likely to have androgenic alopecia at age 20 [odds ratio (OR) 2.01, P = 0.0285]. The pattern of hair loss was not a predictive factor for the development of cancer. There was no association between early-onset alopecia and an earlier diagnosis of prostate cancer or with the development of more aggressive tumors.

Conclusions: This study shows an association between early-onset androgenic alopecia and the development of prostate cancer. Whether this population can benefit from routine prostate cancer screening or systematic use of 5-alpha reductase inhibitors as primary prevention remains to be determined.

Read the rest — Male pattern baldness and the risk of prostate cancer

I was recently asked by a reader of this site about a link between developing early genetic balding and having prostate cancer somewhere down the road, so I researched it a little and found the above article. I don’t think we wrote about it before, but this study was published in the Annals of Oncology a little over a year ago.

The MPB / prostate cancer connection seems to be present, but what to do about it, if anything, remains to be seen. The suggestion that the 5 alpha reductase inhibitors like finasteride, may have a role in reducing the risk for prostate cancer, but that process is not well understood and the long term risks of such drugs are presently under a cloud of controversy.

There were 669 patient studied, of which 388 had a history of prostate cancer. There was no association on the degree of balding, just the presence of genetic balding patterns earlier in life. Men under the age of 30 and those who have developed vertex (crown) balding seem to have a higher prostate cancer risk. The study was taken in many countries and each patient answered questionnaires, from which the data was extracted.

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MFG, MUG, and FUT

I have been reading about Multiunit Family Groups (MFGs) and Multi Unit Groups (MUGs) which are felt by those who do them to be as good as Follicular Unit Transplants. These claims are very confusing. I met with a doctor last week who does MUGs and he stated that they are essentially the same as Follicular Unit Transplants. Is that true?

The reason that many people use MUGs or MFGs is that they can not or will not put the effort in learning or mastering the Follicular Unit Grafting techniques which are clearly more difficult and more expensive to deliver. There is a great movement to show equality between MUGs and MFGs and the golden standard Follicular Unit Transplants, which is absolutely not the case. At the ISHRS convention these past few years, some doctors showed off patients with MUGs and MFGs. They were at the same session as patients with final results from Follicular Unit Transplants and they are clearly not as good on close inspection. Like the “Emperor’s New Clothes’ , the MUGs and MFGs proponents want to believe that it is something that it is not.

Clearly, the use of MUGs and MFGs are better, much better than the old large plugs of yesterday. But they are just smaller plugs made up of groups of Follicular Units which when placed into MUGs and MFGs, tend to become compressed and look ‘stalky’. Real Follicular Unit Transplants are more difficult to do, but the quality on close inspection with Follicular Unit Transplantation can not be told from God’s work in the best of hands, most of the time.

William Shakespeare said, “A rose by any other name would smell as sweet“, but the MUGs and MFGs doctors might modify this famous quote by declaring that a synthetic paper rose with perfume on it is exactly the same as a real rose for all practical purposes because it may (from a distance) look like a rose.

I think that Shakespeare was talking only about real roses and I am talking only about what God had designed in his original plan for us. We are naturally put together with Follicular Units, not MUGs and MFGs. Sorry if I offended anybody here.

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Microneedling and minoxidil

Do you apply minoxidil right after dermarolling? If so, why? Is it more efficient or just personal preference? Also what is the perfect derma roller size? 1.5mm or less/more. And how do you clean your derma roller? Sorry for all the questions, im just cautious

If you apply the minoxidil immediately after dermarolling, then the medication may go through the skin directly making it more effective

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Bad beard transplant

This young man rushed to get a beard transplant. He should have asked the surgeon to show him other patients who had it done in that surgeon’s hands. Unfortunately, that didn’t happen. Now he work in a public position and every asks him what is wrong with his face? He wants to get rid of the transplants, all 2500 of them. This will possibly produce scarring even when they are out. The use of a very small punch by the surgeon and test removals is the way to go to see what is outcome will be. There is clearly a balancing act, the removal process and the possible scars left behind, or leaving it the way it is.


2020-08-28 12:37:58Bad beard transplant

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Microneedling needle depth

What in your opinion would be the ideal needle depth and frequency? Every two weeks?

I am not an expert on microneedling; however, it makes sense that needle depth should be 1-1.5 mm to reach through the epidermis and impact the stem cells which are found high in the dermis. The frequency is purely an intellectual guess. I am seeing that many of the Reddit posters are doing it weekly which sounds ok to me. I am certain that once a hair cycle has passed, the growth from microneedling will be undone unless more microneedling is performed.

 


2021-01-26 18:01:30Microneedling needle depth