The Internet Rumor Mill Says Dr Rassman Was Paid By Merck

This is part of a comment someone posted that I wanted to address:

I was disheartened last night to read that Dr. Rassman was paid to present to a Merck Committee which could perhaps explain his bias. I don’t know how much he was paid, how often it occurred, or if the company used any psychological manipulation on him, but I am starting to feel he’s lost for good. It is a very scary world in which we live, if one can trust their own animal instincts over the educated and experienced opinions of doctors.

To clarify, I was never paid by Merck. Anyone can post comments on forums, but this is bordering on slander.

Over the years of writing my BaldingBlog, I have come across a select group of critics who have an issue with Propecia and I address those issues here without censorship. To clarify again, I prescribe Propecia, the only FDA approved oral medication for genetic androgenic alopecia (AGA) to my patients who have been diagnosed with AGA. The risks and benefits are explained to them as an optional medication.

I do not make money from selling Propecia, as I sell it in my office for almost my cost (just enough extra to cover stocking costs). In fact, most of my patients go to a drug store to get the generic finasteride 5mg, which they cut in quarter doses. I have nothing financially to gain from recommending Propecia (finasteride). Since I make most of my income from hair transplant surgery, it would actually be advantageous for me NOT to recommend Propecia. So where is my bias?

I Am Taking Hormones And Losing Hair

I started to lose your hair this July. About that time I also went on hormones, DHEA, and antibiotics. Could these medications have caused my hair loss. I recently stopped taking these medications and think that the loss may have slowed and some reversal may be going on. Is this possible

I believe that considering the short period of use and the known relationships between DHEA and hair loss, it is reasonable to expect that the hair loss you had might be related to the medication. You think that the hair loss is reversing upon stopping the medication so it is reasonable to expect that your progress will continue. You need to determine the status of your hair in and around your head, get the hair and scalp mapped out for miniaturization and if this is normal, that would make the process most probably reversible.

The “Sean Connery” of Hair Restoration?

Hello, doctor. I do not mean any disrespect in my question, but I do believe it is an important one. I am considering surgical hair transplantation, and I’ve heard that you are one of the better surgeons in Los Angeles. My concern… my question is, how old are you? I ask this for two reasons. (1) Have you passed your surgical peak? (2) Will you be there in a couple of years when I may conisder another procedure?

Thank you. Again, no disrespect intended, but I am looking for a relationship with a physician who is not only qualified but who will be there when I need them.

What crystal ball does anyone of us have? Do you know when you cross the street that you will make it to the other side and not get hit by a car?

I am 63 years young. I have performed surgery on a couple of billionaires this past year and a number of top celebrities, one head of state, many CEOs of large companies, four patients from the TV show Extreme Makeover, construction workers, a bus driver, a grandmother and a mother of 7 kids, and many others who asked similar questions. My health is good, my maternal grandmother lived to 114, my maternal grandfather died at work when he was 102, my father’s grandmother lived to 99, and many uncles and aunts lived into their 80-90s. Like Sean Connery, I like to think that I get better with age. Mr. Connery turned 75 a few months ago, so he’s got many years on me yet.

I received the hair restoration industry’s equivalent to the Acadamy Award for Best Actor, called the Golden Follicle Award in 2004 at age 62, published the FUE technique when I was 59, and am probably one of the few doctors world-wide who does it well today. The FUE technique has to be the most taxing surgery in hair restoration that there is. I wrote chapters in text books and published scientific and other papers in the past 18 months numbering about a half dozen. I can not run the marathon (nor could I when I was 23), bench press some 500 pounds (also not able to do it when I was 23), or sprint the 100 yard dash (no comment is needed here but for that I am clearly out of shape). However, I ski regularly, scuba yearly to depths of 100 feet, ride my bike about 16 miles a day when I am not over-working and can play the piano for hours (my fingers, at least, hold up well). I can work longer hours than any of my staff and can get along on 3 hours of sleep per night if I must. If you get a younger doctor, ask to see patients of his/her which were done this year. I can show off many of my patients (which we do monthly) at our open house events and have done it for 14 years consistently. I tend to take my responsibility seriously, and have often helped my patients through many personal health crisis that were unrelated to their hair transplant. One patient of mine stands out (age 44) when he discovered that he had John Ritter‘s vascular diagnosis (actor known best for his role in “Three’s Company”). Mr. Ritter died just a few days from his 55th birthday from a rupture of his ascending aortic, so I became involved in the diagnoses and open heart surgery decisions that saved my patient’s life from Ritter’s fate. There is no doubt that had this patient not had a hair transplant, his diagnosis would probably have not been made and as his cardiac surgeon told him, he probably would have died in a year or so. If you would like, I can ask this patient for a reference that would back up this claim.

When you get to my age, you appreciate people for their value, hopefully gain wisdom, and with wisdom should come temperament that allows an artist to perform finer work, perfect his art, and refine and hone judgments that generally take years to define (just like Sean Connery has done for acting). I believe that what I bring is judgment and wisdom to my patient’s problem and potential surgery, and provided that my vision holds out and my hands remain as steady as they have for the past 35 years of doing surgery (from war torn Vietnam, to orthopedic, vascular, and general surgery), I fully expect to be doing hair transplants for some time, at least, on a selective basis.

Come meet with me and judge for yourself:

  1. if you like me
  2. if you respect me
  3. if you trust me
  4. if you think that I will be around for the duration of your needs

Your call, of course. When and if you come, please refer to this blog answer as I would love to connect with you, see the smile on your face and understand your motivation for writing this question to me. At the least, I enjoyed writing this answer, and at the most, maybe we will have things in common. I have made many friends amongst my patients, including many who did not ask traditional questions when they met with me.

Good results from SMP (photo)

I had just my first of four sessions of SMP. Look how great it came out?

These results are exemplary of the value of SMP (see here: https://scalpmicropigmentation.com/gallery/thinning-hair/ ) We have a break-through at two levels in this field: (1) a new laser tattoo system that allows the process to be done in a single session ( https://newhair.com/wp-content/uploads/data/docs/pubs/Tattoo%20Pigment%20Delivery%20with%20a%20laser_final.pdf ) and (2) a totally new ink which is encapsulated and is not free to spread once it is placed into the scalp. Spreading of the ink is the #1 problem with today’s SMP. The new ink can still be removed with a laser but it will be much more stable in the scalp. At this time, our group will be the first group in the world using this new ink in the next month or so.


2020-04-25 12:54:49Good results from SMP (photo)

There appears to be a risk for type 2 diabetes for people who take finasteride in the treatment of Benign Prostate Enlargement

https://www.bmj.com/content/365/bmj.l1204

Conclusions The risk of developing new onset type 2 diabetes appears to be higher in men with benign prostatic hyperplasia exposed to 5?-reductase inhibitors than in men receiving tamsulosin, but did not differ between men receiving dutasteride and those receiving finasteride. Additional monitoring might be required for men starting these drugs, particularly in those with other risk factors for type 2 diabetes.


2019-12-02 14:23:23There appears to be a risk for type 2 diabetes for people who take finasteride in the treatment of Benign Prostate Enlargement

Grafts and an Insufficient Donor Supply For A Class 7 Patient

This week I saw a man who had a transplant of 3000 grafts… and did not look normal. His examination showed a very low donor density and very fine hair, yet the doctor who did the surgery had placed these 3000 grafts uniformly around his entire, very large Class 7 balding area. The patient regretted his decision to do this surgery. Unfortunately, his options were limited and his doctor should have given him the information to avoid this terrible mistake.

Had I seen him before his surgery, I wouldn’t have been able to help him; however; today because of Scalp MicroPigmentation (SMP) there is an obvious solution. To help him make his decision, we decided to first address his large wide scar with SMP. Then with his scar taken care of, he can shave his head very closely and see what he would look like if he decided to have SMP all over his head. This would be an incremental decision for him, giving him the time to judge this last step.

What failed him was his previous doctor who never told him that he did not have enough hair to reconstruct his extreme balding pattern, nor was he told about scarring risks. The doctor painted a good picture and like most patients who believe in their doctors, he wanted to believe that his doctor was addressing his best interests. As there is no going back now, the solution of SMP to the entire head would give him the look of a buzz cut (see scalpmicropigmentation.com)


2014-08-14 18:58:41Grafts and an Insufficient Donor Supply For A Class 7 Patient

What Do You Think About This Article Which Discusses the Value of Low-Level Light Therapy?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944668/#!po=14.7887

I have read the article. There is a great deal of speculation about the use of light therapy in certain areas, like graft growth after hair transplants. I know that grafts grow after a hair transplant when the surgery is done correctly and can’t be accelerated by using such a modality. The author speculated on the use of infra-red light, but there is no evidence available for this use either. Most of the studies on LLLT therapy are written by people who have something to profit by pushing this technology. Laser hats and other devices cost up to $3,000 retail. Almost half of the money goes to the doctor selling it, so do you think that a doctor can be impartial when bringing you this technology? I don’t sell them because I refuse to make money from my patients without giving them value.

 

Great results by sticking to the treatment (from Reddit.com)

My husband began balding at 24. He is epileptic and a switch to a different anticonvulsant exacerbated what doctors say is genetic hair loss. Within a year, he lost 50% of his hair. Because he lacked health insurance, his doctor refused to allow him off the medication. It was not until it stopped working that we again switched.

Although he stopped taking the medication, his hair never returned. It continued to shed in tremendous amounts. Along with it went his self-esteem and all the things he liked about himself. In June of 2018, we met with a dermatologist that suggested finasteride and Minoxidil 5%. The first photo is from then, when he first began taking 1 mg/day. It is still his current dose. In addition, he uses Kirkland Minoxidil twice a day and Nizoral shampoo three times a week. In addition, he does microneedling once a week. He sure has come a long way and I am proud of him.

Nothing like staying the course

Thinning hair after menopause

Menopausal induced hair loss is common (50% of women experience this condition) and the single best treatment of this is Scalp Micropigmentation (https://scalpmicropigmentation.com/smp-for-women/).

 


2019-10-18 07:21:25Thinning hair after menopause

Gynecomastia and Finasteride

Hi, Is there any conclusive evidence that the regular use of Finasteride (Propecia) for hair loss can result in Gynocomastia as a side-effect?

The Physician’s Desk Reference does not list this drug as a possible cause of Gynocomastia, but I have heard mixed stories from individuals.

Results of any known conclusive studies in this regard would be appreciated.

Gynecomastia is a known side effect from the use of Propecia. I do not understand the mechanism of action for it, but when it does happen, most men usually find it as a reason to stop using Propecia. Fortunately, I believe that the incidence is well below 1 in 300 men. I don’t know of any studies off the top of my head, but if any blog readers happen to have a link to any studies posted online, please feel free to post the link in the comments.