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Nizoral, Milk, Cows and Hair Loss

Hi Dr. Rassman,

I have a couple questions to ask you regarding my hairloss situation. First of all, im 21 yr old male. I recently began losing a lot of hair suddenly throughout my whole head at about 8 months ago. I have been on propecia for 7 months now. However, the majority of hairs that fall out(about 75%) has a white hard mucus substance that can be scraped off from the end of the hair. I lose about 150ish hairs and they are basically always all the same size hair. I also seem to have a lot of dandruff (im assuming, white mucus-like flakes) that fall off also with the hair.
I just went to a dermatologist the other day and had him look at everything. He looked and sifted through my temple region hairs with just his eyes but didnt really look closely at anything else (no magnifying or anything). When i asked him about the white mucus stuff, he said it was normal to have that. (For the record, i know that hair has little white bulbs on the end of a hair, but this isnt the case here. it is real scrapable stuff, NOT the bulb)I then asked him about taking a scalp biopsy and he told me that that wouldnt really show anything. I then asked him about measuring my level of DHT in my body to see if its really high and he said that also wouldnt show anything because it doesnt matter how much DHT we have in our system, it only matters how much the hair follicles react to that DHT. He then gave me a form to get my thyroid, iron, and blood glucose? tested, which i will do now.
He then concluded that the acne on my face that is deep down inside my skin (never been able to get rid of it) could have something to do with my scalp and the flakey-ness as well as the mucus on the hair pieces so he prescribed me Nizoral 2% shampoo as well as Nizoral pills to get deep down and clear out my face and anything in my scalp. He also believed that milk could be playing a part in my hair loss because of the hormones milk has and how it bypasses the DHT blockers in propecia. (I do consume a lot of dairy products) He was very adamant about it and said how americans are much more balder than other countries and how the US drinks much more milk than others, etc. and how he is planning on doing a research project on it with candidates, etc. So he told me to stop all intake of milk, cheese, ice cream, etc. and see if it improves in the 2 months when i see him for a followup appointment. I asked about the loss of calcium etc. and he said that i would be fine without it and the loss of dairy products wouldnt have that big of an effect. (i could get it from other food products, etc.)
What im wondering is if what you think of my situation and about the dermatologist. I was just a little taken back about how he didnt give me a scalp biopsy, or look in a magnified glass to see deep down in my scalp. I dont doubt his intelligence because he told me that he was one of the doctors that got the creation of Nizoral, etc. and he is very well known and popular. (takes 3 months to get an appt.) I was just wondering if you agree and what your thoughts are on what he said about the different tests and if the examination of me seemed correct because i really wanted a biopsy and DHT test since i heard it worked well. Also, what are your thoughts of the acne issue and besides the thyroid, iron, and blood glucose tests, are there any other tests or procedures done to see if my hair loss is normal. And lastly, what is your opinion on my hair loss situation and is this normal? If that white mucus stuff isnt normal, does that mean that as each one of those hairs falls out, does that mean that particualr hair will never grow back? (is that the hair follicle or something meaning permanent loss?) I will send you a picture of my hairs and of my scalp.
Thank you so much for your time in reading and replying to this, it means so much to me. Im really having a hard time trying to deal with this.

The tests that your dermatologist told you about are always a good idea, so he can be sure that you do not have other causes of hair loss (other than genetic male patterned balding, which is the most common). We generally lose 100-150 hairs per day, so seeing the hair come out does not bother me. If you are picking because of the scaling, then more hair loss with bulbs may be detectable. What I always do and think is important to do, is a thorough analysis of your scalp by region, looking for miniaturization, which is the hallmark for genetic balding and some other forms of balding as well. Any good long-term plan, which is critical for someone of your age, must have periodic follow-ups of the scalp, quantifying the degree of miniaturization and any changes over time. Without that step, there is no possibility that a diagnosis of genetic male pattern balding can be made. Hair falling out is normal, provided that your body replaces the same amount (usually between 100-150 hairs per day).

With regard to the milk focus that your dermatologist is referring to, I am not familiar with it, nor have I found that others in the hair restoration community have developed such focus. I was a dairy farmer many years ago, and I do not believe that we are allowed to use the type of hormones in these cows that would produce more hair loss, but it’s been many years since I’ve last milked cows. As for Nizoral, I’ve discussed this previously here: Nizoral Shampoo.

It sounds to me like you need some real assessment of the balding process by a hair specialist, like me. On the east coast, Dr. Robert Bernstein in New York (phone – 201-585-1115) would also be able to do such an examination for you as well.


2005-11-14 16:01:22Nizoral, Milk, Cows and Hair Loss

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Can I talk about sexual side effects if my doctor is a woman?

My doctor is a woman and I’m 18 years old. If i ever experience sides from finasteride, i’ll feel weird to ask my doctor about it. Does it matter about what gender doctor is? I just feel more comfortable in talking to a guy about sides if they ever show up.

Women doctors are just doctors and they often speak about sexual problems with male patients without embarrassment. Focus on your needs, not the sex of your doctor.


2019-01-21 14:43:44Can I talk about sexual side effects if my doctor is a woman?

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Non-FDA Approved Products

Dr. Rassman,

I realize as a doctor you must take the given data to insure your patients are given the “right” treatment for their condition. I do however, wonder how you can comment on products you yourself admit to know very little about. I do not know much about the product either, but a friend has used it and has had very real results with it within 12 months. I am not here to blast your opinion, but as a doctor you are compelled to research things/products that may very well put some doctors out of business. Heart disease for expample, may be a thing of the past in a decade. There are great prescriptions for heart-related conditions, but there are also great things such as diet and herbs that greatly reduce the risk of heart disease. My father was a surgeon who always put the patient first even if it was not the most lucrative choice for him. I am a bioligist with a very firm understanding of biochemistry as well. I agree that nothing is side-effect free, especially if it has any real efficacy, but check closer on some things to make sure you are not missing something out there. Something that may have potential. I am sure I don’t have to remind you that your patients are always first. You know your science works, but remember the light bulb was ignored at first also. oh yes, as far as the FDA works, I have no real comment on that. They have their own job and I am not certain how they work. They do real good things, and it has also been proven that they do real crooked things also.

This sounds more like a statement than a question. Your points are well taken. In my formal capacity, I do not recommend medications/herbs/potions/lotions that I do not know to work. You are correct in that not every medication is good and safe (just look at Vioxx), but the tradeoff between benefits and risks just need proper informed consent for each person using it. I know that Vioxx helped many people handle the pain of crippling arthritis, but some of them paid for that benefit. The issue really is, did they know what the risks were? We all know that the drug Thalamide caused babies with no arms or legs when their mothers took the medications while pregnant, but did you know that this drug was a miracle drug for many problems today in the non-pregnant female? The drug was taken off the market, so some people with particular types of bone cancer go through hoops and loops to get some to help them. It is now being considered for people with advanced HIV infection and body wasting, yet to pass FDA safety and effectiveness clearance. The drug has many uses in the third world.

I believe that we all have the right to know and balance (1) the benefits and (2) the rewards of taking a medication or herbal remedy that is heavily promoting its products. There are two sides of that equation. I do not know if some of these products are safe or effective, so I read the material supplied by many of these companies. When I see poor photographic representations, or scalp coloring agents used to promote benefits which are only created by a ‘can of spray paint’ on the scalp below the miracle new hair (or something similar), then I can not endorse these products. They may be great products, but they burned their bridges with me as a product endorser.

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Can I use a tooth brush to take off the scabs one week after my hair transplant?

Using a tooth brush to get rid of the crusts is a bad idea as it may actually pull out the grafts. Place the shampoo on your head, leave it there for 10 minutes, and then using your fingertips, gently rub the grafts. Repeat this twice a day until the crusts come off easily but do not be rough about this?


2017-11-09 21:14:36Can I use a tooth brush to take off the scabs one week after my hair transplant?

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Norwood Class 3A Patient — 10 Days After Surgery (with Photos)

This Norwood Class 3A patient came in for a check-up 10 days after his hair transplant procedure of 2,000 grafts. The scabs are gone and the recipient area is very clean with no visible redness. I wanted to show this patient because I’m constantly asked, “What will I look like after surgery?” — and with proper washing techniques, this is a typical result. Please click the photos to enlarge.

10 days after hair transplant surgery:

 

Before:

 

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Not Hair Loss News – Exercise Slows Dementia and Alzheimer’s Disease

At the Alzheimer’s Association International Conference (AAIC) 2014, it was reported that use of computer activities and exercise reduces cognitive decline associated with Dmentia and Alzheimer’s Disease. At the Mayo Clinic, 1830 people at risk for Cognitive Decline were were studied in different groups, with a control group and a group that participated in a variety of exercise routines from mild to advanced. The patients were studied for 2.3 years.

“Any level of physical activity in midlife may help keep cognitive decline and dementia in late life at bay, new research suggests.”

The range of exercises include: “mild exercise was defined as leisurely walking. Moderate exercise included engaging in activities such as brisk walking, cycling, and swimming, and vigorous exercise included participating in activities such as mountain biking and downhill skiing.”

There is definitely protective effects from exercise, even as simple as taking your dog on a brisk walk. “The investigators found that only moderate midlife physical exercise was significantly associated with a decreased risk for incident dementia”.

I summarize these important reports, because we all have parents and family that need to avoid the inactive lifestyle and we have a responsibility to them to see that they stay healthy and mentally active so we can enjoy their senior years with them.


2014-07-24 08:11:31Not Hair Loss News – Exercise Slows Dementia and Alzheimer’s Disease

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Can You Take Finasteride Propecia for Diffuse Patterned Alopecia (DPA)?

1. Have DPA young patients (Early 20´s) more oportunities with finasteride in comparasion with a MBP who have a normal patron (NW 6).
2. Have you ever seen a early 20´s with DPA who have a good response to finasteride for a long time (10 years)?

I am a 21 years old and I have taken finasteride since I was 18 years.. My dermatologist prescribed it to me.

Here you have photos of mine when I start the treatment (2012) and now
(2014).

You have my permission to publicly use it.
dpa

Diffuse Pattern Alopecia (DPA) is basically the same as Male Pattern Balding otherwise known as Androgenic Alopecia. DPA, as the term implies, shows up as diffuse hair loss that occur in a “pattern” such as you see in male pattern balding but the permanent zone on the back and side of your head not impacted.

Finasteride (Propecia) is used for the treatment of this condition (DPA, AGA, MPB – they are all the same).

There is another condition called Diffuse Unpatterned Alopecia (DUPA), which may be genetic, but does not respond to the drug finasteride (Propecia). DUPA is uncommon; however, it is critical to have your doctor make this diagnosis before being considered a candidate for hair transplant or medication. These DUPA male patients often get a failure of the transplant, even if on the drug finasteride.

I cannot make a diagnosis with your photo and this blog is not a place for making diagnosis. I also cannot predict what will happen in 10 years. I am not a fortune teller. I have seen men in their early 20’s start finasteride for male pattern balding and has kept most of their hair. I have also seen them lose their hair rapidly despite being on finasteride as their genetic predisposition overtook the drugs ability to slow things down. It doesn’t mean that the drug didn’t work.

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Not Hair Loss News – Tylenol Poisoning

Snippet from the article:

During the last decade, more than 1,500 Americans died after accidentally taking too much of a drug renowned for its safety: acetaminophen, one of the nation’s most popular pain relievers. Acetaminophen – the active ingredient in Tylenol – is considered safe when taken at recommended doses. Tens of millions of people use it weekly with no ill effect. But in larger amounts, especially in combination with alcohol, the drug can damage or even destroy the liver.

Davy Baumle, a slender 12-year-old who loved to ride his dirt bike through the woods of southern Illinois, died from acetaminophen poisoning. So did tiny five-month-old Brianna Hutto. So did Marcus Trunk, a strapping 23-year-old construction worker from Philadelphia.

The toll does not have to be so high.

The U.S. Food and Drug Administration has long been aware of studies showing the risks of acetaminophen – in particular, that the margin between the amount that helps and the amount that can cause serious harm is smaller than for other pain relievers. So, too, has McNeil Consumer Healthcare, the unit of Johnson & Johnson that has built Tylenol into a billion-dollar brand and the leader in acetaminophen sales.

Read the rest — Use Only as Directed

This is a really informative and lengthy article you should read if you have some spare time. In a nutshell, the article says — the FDA isn’t perfect, around 150 people die every year from Tylenol misuse, and restrictions exist in many countries that aim to prevent overdose.

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Can’t Doctors Remove Old Hair Plugs One By One?

Hi Doctor. Thank you for having this great site!!

About 25years ago I had a HT using the hobby drill method. Now I have 3 rows of white plugs. I am like most of the others on this site and want to shave my head. I was wondering if you have ever considered a procedure to re-drill the plugs and suture them closed similar to the way you show it being done to patients for the top of their heads. I have spoken to other doctors and they want to cut the entire area out and suture it closed. They also state that it would take two or three procedures. Why can’t someone just re-drill and suture shut the area?

We have done what you described — taking each of the old style hair plugs out one-by-one and suturing each wound closed. We have also cut out the entire row and sutured it all closed. And we’ve even done a combination of both. Here’s a step-by-step story of the process one man took to repair his pluggy hairline. It took multiple surgeries to complete his repair, with the first procedure being a removal of a row of plugs, and the second procedure being individual removal of some of the remaining plugs.

My point is, everybody is different and every treatment plan for each individual is unique. In the end, find the doctor that you trust and ask to see some before after results of these repair procedures. You may even ask to speak to their former patients or meet them. Good luck.