A World Of Coincidences – It Is A Small World After All Dr. Rassman Finds

This is an email I received from a doctor in Brazil: “Today I had a consultation. The patient told me he was buying tickets for Phantom of Opera in New York (around 1996). Someone behind him realized he had had an alopecia reduction and a bad hair transplant (that someone was you). You talked to him and suggested to go to your office in L.A. to have a better result. Two years later he was in your clinic and had the surgery done by you. You fixed it for him.

Other coincidence: newhair.com was opened in my computer when he came to my consultation room and so was the e-mail you sent me. I showed him all the coincidences!!! I took a Picture by his side and am including it for your pleasure. It is a honour to have you as a mentor, colleague and friend.”


2015-01-08 14:14:57A World Of Coincidences – It Is A Small World After All Dr. Rassman Finds

I Had a Propecia Shed Within a Few Months of Starting The Drug, But It Never Regrew!

Hi Doc,

I have been taking Finasteride for about a year and a half now and within a few months of starting the drug I noticed that the hair on top of my head was getting thinner. I am 37 and have extremely slow hair loss since the age of nineteen, so after research I figured it was the “propecia shed” amd that it would grow back within a few months. Well, that was eleven months ago, and it still has not been restored to what it was before starting finasteride.

Anyways, I was hoping you could give me some advice on what to do. My doctor just basically said that all I can do is try Rogaine, but there are many reasons I don’t want to use it. Is there anything you could recommend by chance?

Thank-you

The only medicinal treatments I recommend for treating hair loss are minoxidil and finasteride, as they are the only ones proven to work.

I’m not sure what I can offer you advise-wise, considering you’re already under the care of a doctor and I don’t know anything about your medical history. You took finasteride because your hair was thinning — so is it possible that you were just a non-responder and your hair loss would’ve been progressing to this point even if you hadn’t taken finasteride? Did you have any additional stress in your life that could’ve caused it to occur?

Would Increased Minoxidil Absorption from a Scalproller Be Safe?

I’m considering purchasing the Scalproller but i’m concerned as to the safety of the increased absorption of minoxidil. In your opinion do you think it is safe if the increased absorption is so much greater? And would using the Scalproller lead to a shed similiar to the shed when switching from 2% to 5% minoxidil?

The following response is by UK-based physician Dr. Bessam Farjo:


Response by:
Dr Bessam Farjo, United Kingdom
Dr Bessam Farjo
United Kingdom

5% minoxidil is the safe limit. More may cause systemic side effects such as dangerously low blood pressure. It is speculated that the absorption of minoxidil in a lot of people is not as efficient as it could be. This is most likely due to method of application which can be influenced by the amount of hair present. I have prescribed 6% in the past without side effects and I know of a clinic in the UK that gives a 12.5% preparation! I don’t have any data with regards to their side effects. One possible side effect of too much minoxidil is a lowering of blood pressure and resultant light-headedness.

I don’t know if the scalproller will cause any shedding, but it will be one of the observations I will make when I start a clinical trial. I emphasise that at this point I see the scientific basis of such a device but cannot actually endorse the scalproller itself or support any claims that it will help with hair loss.

Learn more about the author of this article, Dr. Bessam Farjo, on his BaldingBlog profile or at his website.

I Have a Consult With NHI Next Month…

Hi there,

I have an appointment to come and see you guys in about a month or so (combining it with a California adventure) but I had a question that I wanted to send you in advance.

I started proscar 1mg/daily last September, but cut down the dose (and also took it irregularly) this summer. Over that time, I started to notice a lot of shedding – which I never observed before, even before the starting propecia.

I had cut down the dose at the beginning of the summer because I felt that I’d put some fat on my midsection and in my breasts – I’m in pretty good shape, so the change was noticeable – that I thought was due to the propecia. Since I didn’t know if it was even doing anything, I cut it out. And then brought it back! Since September, I’ve started again at 0.5 mg/day. But I’m still shedding.

What I’m wondering is if I should just stop taking the medication again so that I can establish a non-propicia’d baseline with you when I come for my consultation, which I neglected to do before starting the drug in the first place and which I regret. Or, should I stay on the 0.5 mg/day and then increase it to 1.0 after seeing you to see if there’s improvement?

Hope that’s not too confusing. I’m just trying to have something clear established so I can figure out what hair I’m losing and at what rate. I like the idea of having an empirical baseline. I guess I don’t mind the minor chubbification if I know that the propecia’s doing something. But I want to know that it’s doing something!

Just wondering if you had any thoughts. Anything you could offer would be appreciated. Thank you so much for this resource.

First and foremost, lets discuss the facts. Propecia is a brand name for finasteride in 1mg. Proscar is a brand name for finasteride in 5mg. For the treatment of androgenic alopecia (AGA) the recommended dose is finasteride 1mg (Propecia) taken orally once a day. Some take 1/4 pill of Proscar (finasteride 1.25mg) once a day. Ideally, you should cut it in 5 pieces, but that is difficult to do with a small pill. Taking more than 1mg of finasteride will not be of benefit with respect to your hair loss issues. More may just cause increased incidence of negative side effects. Taking less (finasteride 0.5mg for example) is about 70 to 80% as effective as the full 1mg dose.

In general, Propecia does not cause shedding. I realize other websites and forums state this (and we’ve published emails about this), but it is not something I usually see in my practice. If you are seeing shedding and you think it is from Propecia, then I will take your word. But you should also note these important facts:

  1. Propecia does NOT stop hair loss forever.
  2. It takes 6 to 12 months of taking Propecia before you see any effect with consistent use.
  3. Your genetic predisposition will always win over Propecia in the long term (which could be years).
  4. When people start taking a medication to do something, such as taking Propecia to stop losing hair, you will generally be more astute to any changes in your hair (that you would have never noticed).

That all being said, I can’t tell you what you should or shouldn’t do with your prescription medication dosage, as I didn’t prescribe it to you and I’m not your doctor. Talk to your prescribing physician to help figure out what you should do next and then when you come in for your visit to my office, we can go from there.

Wouldn’t Hair Cloning Put Transplant Docs Out of Business?

Dr. Rassman,

Fist let me say I love this blog and think you are do a wonderful thing by informing people about the many dynamics of hair loss.

I noticed you mentioned and have recently posted about hair cloning as a future treatment for hair loss. I was wondering, let’s say in the next 5 years, there is a big break through with hair cloning and it becomes widely available as a safe treatment for hair loss. What then will happen to hair transplants? Wouldn’t that be bad for the NHI or would your practice just shift to hair cloning and stop doing transplants?

The specialty of today’s hair transplant surgeons can become tomorrow’s hair cloners. Who else would be sitting at the cutting edge and wanting to make the market happen?

When the flying car becomes commonplace like everyone has been wishing/hoping for 50+ years, I’m sure the major automakers will be right there at the forefront. As the industry evolves, those that blazed trails aren’t likely to just disappear.

You Changed My Life By Repairing My Plugs — But Can I Remove a Donor Scar Completely?

Dr. Rassman,

I had many strip procedures in the early 1990’s that left my hair looking very “pluggy”. People would immediately look and my forehead at first meeting and continue to stare as though I was not even present. I wore a baseball cap everyday to cover up my hair everyday for 9 years (all the way through college, graduate, and PHD school). Luckily, I took a chance and made an appointment with you. You completely changed my life and helped rebuild my self-esteem.

After many corrective surgeries and reaching an amazing result due to you experience and craftsmanship, I have one last question regarding “reducing donor scar left from the strip harvesting.” Are there any other new options out there that could eliminate the donor scar through Trichophytic closures coupled with FUE, laser surgery, or tissue expansion that would allow me to shave my head if needed?

Thank you for the kind words and I’m glad I was able to help.

With respect to the donor scar, there are scar revision surgeries and even Scalp MicroPigmentation (SMP) to disguise the scar. I don’t know that you’ll be able to completely eliminate the scarring, but masking it or revising it would possibly be doable. With that said, everybody’s situation and needs are different, and I cannot give you a detailed personal consultation over the Internet without an examination.

Please call my office at (800) NEW-HAIR or (310) 553-9113 and we can set up an appointment to discuss your options.

I Have Found That A Doctor Is Offering 50 Cent per Graft for FUE. What Do You Think?

Hi Doc, I read on a website that a doctor is offering FUE surgery at $0.50 that is 50 cents a graft in Pakistan. What do you think?

 

Your guess is as good as mine. I really can’t validate this claim.

There was a sarcastic remark made about the Taliban and how it may relate to prices. Apparently it offended a few readers. We apologize for the insensitivity to those who were sensitive to the comments.

 

I have Peyronie’s syndrome, can I take finasteride?

I just got diagnosed with peyronie’s. I’m in very early stages but started finasteride 3 months ago. Can I continue using it?

Peyronie’s syndrome reflect a deformity of the penis reflecting the development of fibrous scar tissue inside the penis that causes curved, painful erections. Penises vary in shape and size, and having a curved erection isn’t necessarily a cause for concern. Finasteride should have no impact on this sundrome


2020-02-04 13:11:14I have Peyronie’s syndrome, can I take finasteride?