Category: Uncategorized

I just received a prescription to start taking Propecia. I am still very young, 21, and have only mild hair loss. This is more of a proactive attempt to make sure things do not get any worse. My question to you is at my age, and with only mild hair loss, does it make sense to maybe take a smaller dosage each day? Maybe taking .5mg instead of 1mg. I have been reading many opinions online but would love to know yours. Thanks for your time.

Assuming you really do have genetic hair loss (without a good solid diagnosis, you really do not know), why would you take less than a fully effective dose that is proven to be effective? It makes little sense to me. Some people do suggest taking lesser dosages and even on this blog I have referenced such information. You are in command of your own destiny and that is what separates the men from the boys.

I’m a 52 year old male in good health. I had a series of small transplant sessions – first 3rd of the head with last one being 8 years ago. Was completely satisfied until the last year when hair throughout scalp has become thinner and crown more “shiney”. Could propecia reverse some of this change over the last 18 months or so?

Finasteride (Propecia) is well known to slow down or even reverse thinning of hair in the crown area. While I have seen patients with (as you call) ‘reversal’ of balding in the crown area, it is patient specific. Every patient is different and results will vary.

In a previous post, we have shown such a patient who maintained the full reversal of his hair loss for 10 years on Propecia. Of interest, this patient still has 40% miniaturization in the crown hair even though it is not visible with the naked eye.

I am a 31 year old Caucasian male. My facial hair is most prominent around the mustache and chin areas of my face.

I am concerned about what I perceive to be irreversible “damage” to some of the hair follicles on my face from shaving. I now seem to have small “bald” patches from improper shaving techniques (shaving against the grain, shaving without allowing enough hot water to soften the beard).

These bald patches in my beard show up pretty well as my facial hair is dark and I seem to have 5 o’clock shadow even after shaving.

Will these hair follicles ever repair? Can I use Rogaine to revive them? Are there any other suggestions you can offer me (besides being more careful with my daily shaving routine)? Help!

Unless your shaving technique involves cutting into the skin by 5mm and shaving off the the top skin layer, you cannot damage your hair follicle.

The bald spots on your face were likely there before and you are just noticing them or you have a disease like alopecia areata that is causing these bald spots to appear.

I have used laser to remove body hair. Can laser have an effect on DHT levels in the body?

I do not believe that a laser that was used to remove your body hair will have an effect on your DHT levels.

hi, i have been using proscar and minoxidil 7% for over 4yrs. while the results have been satisfactory, i have been told that there is no such thing as minoxidol 7%, and i should just use the 5%. I would like to know if i am getting scammed by paying $250 a bottle for 100mls of minoxidil 7%. and should i just go to my pharmacy and buy minoxdil 5% which is so much cheaper? by the way my bottle claims to have retinoic acid 0.01% which is suppose to make a difference. One other thing i was considering having surgery done on the front hairline, as there doesn’t seem to be any other solution. thank you for your insight. i am also 28yrs old male. thank you

I do not know of a minoxidil 7% solution that is commercially sold, but it may be privately labeled. I am more familiar with the standard minoxidil 5% solution. This does not mean the 7% solution does not exist. Moreover, a stronger concentration (such as the 7%) does not necessarily mean you will have more benefit and grow more hair. Higher and higher doses may produce negative side effect such as dizziness, fatigue, and dangerously low blood pressure as your body absorbs more of it into the blood stream. The use of retinoic acid essentially causes irritation to the skin (it is an acid and produces a low burn) which, in theory, is supposed to increase the blood supply to the scalp and hence the absorption of the minoxidil. I am not a proponent of this approach. Producing a burn just does not seem like the right thing to do.

A couple of years ago, I noticed a bald spot in my head and got shots for the hair to grow back. I just got another one, but not as big. What is the cause of this? Can I prevent it from happening again?

What kind of shot did you get? Did your hair grow back after you got a shot a few years ago? I would hope a doctor gave you this shot. You should ask him/her these questions and ask him/her what they were treating so that you have a working diagnosis. Doctors have the obligation to educate their patients and communicate with them so that they are able to understand that is going on with their bodies. I would strongly suggest that you go back to your doctor and ask what was he/she was treating. I cannot diagnose your condition or even give you advise on your treatment since I do not have the advantage of examining you in person.

My 62 year old wife had heart valve replacement surgery over a year ago. Since that time she has been steadily losing hair — not in clumps, but rather over her entire head. Her dermatologist advised that this may well be due to the stress of the surgery.

a) Do you agree? if so

b) then what can she do about this,and how long should it last before the hair
grows back?

Thanks

I agree with the dermatologist that the stress of the surgery may be causing your wife’s hair loss. We know that those people who carry the genetic hair loss genetics, can precipitate hair loss from stress. Furthermore, certain medications that your wife is probably taking (after the valve replacement) may also be contributing to the hair loss. There is not much you can do about this type of medication induced hair loss if these medications are critical to your overall health. Explore the medications with your dermatologist. You should never change or stop any medication without discussing it with your doctor first.

There is a good chance that the hair will return after the hair goes through its sleep (telogen) cycle. That generally takes 3-6 months. Minoxidil may help as well.

Dr. Rassman,

I have noticed an increased amount of shedding which started at the very end of summer till now. Is there such a thing as increased shedding during the change of season (specifically summer to autumn)? I am also approaching my fifth month on propecia, so I suspect that the increased shedding can be attributed to the medication? I remember you writing that you can experience increased shedding during the first 6 months. In any case, I was wondering if you could provide some insight into my situation. I appreciate your help Dr Rassman; your blog is extremely helpful!

I have heard some of my patients reporting that they lose hair during certain seasons. Humans have asynchronous hair cycling, which means that we generally shed uniformly over the entire hair cycle of about 36 months. We lose about 100 hairs per day and replace that number each and every day. Animals have synchronous hair loss, which means that they molt once a year, usually in the Spring when their hairs go into telogen (the sleep part of the cycle) and in the Autumn when they go into anagen (the growth part of the cycle).

Does propecia effect blood test in anyway.Also I have had a scalp biopsy and was told I have anadrogenic alopecia.So now I have been on propecia for 11 months and now I’m losing hair all over my head like D.U.P.A or something.Also for the last month or so I have been losing my eyebrow hair and eyelashes. I have been to the doctor so many times and they cant find out whats wrong with me.Please help I’m so scared of waking up one day with no hair on my entire face.

It has been long thought that finasteride 5mgs can reduce an elevated PSA (prostate specific antigen test for cancer of the prostate). For this reason, we always ask men over 50 (over 50 because they are at risk of prostate cancer) to get a PSA test prior to starting Propecia. As cancer of the prostate is almost unheard of in a man younger than 50, we do not require a PSA test before starting Propecia. With that said, recent publications indicate that Propecia (1mg dose of finasteride) does not impact the PSA test, even if it is elevated. To my knowledge, only the PSA blood test has been associated with Propecia.

It is impossible to diagnose your condition over the internet. BaldingBlog is not a place to make a medical diagnosis (which you may need). Aside from a scalp biopsy, you may benefit from a scalp hair miniaturization study so that a good doctor can put a listing of possible diagnoses before you. You should get a focused answer. If you are not satisfied with the information your doctor has provided you, see another doctor.

Dr. Rassman:
I’m a 32 y/o physician and have had a high temporal hairline for as long as I can remember. Unfortunately, over the course of the last few years it has gotten higher. I’m thinking about doing something about it but have concerns about transplantation. My concenrs include the durability of transplantation and the potential need for more and more procedures as time goes on. I also wonder about the variability in outcomes from physician to physician, even in your group. Do you keep track of graft yield/take statistics within your group, do you know who the best is as far as the above is concerned, and do you share this information? After deciding on proceeding with transplantation, can one ask that you specifically be the one to do it and, if so, do you charge more? Thanks.

Wow, that would require a long dissertation to answer it all. Yes, there are differences between medical groups in the survival of grafts and the yield of hair as it relates to different procedures. As you may know, there are many techniques being used today. The golden standard is Follicular Unit Transplantation, a process which we pioneered. See Follicular Transplantation: Patient Evaluation and Surgical Planning? and The Aesthetics of Follicular Transplantation for more.

Hair transplants, once grown out, are quite durable and they should last your lifetime. The issue you should be concerned about is the progressive nature of hair loss in the balding man. Propecia (finasteride 1mg) is a good way to address this problem and in most men with a good Master Plan, they (in conjunction with a good doctor) should be able to define what will happen to your hair situation over time. Good miniaturization studies are critical to the development of a Master Plan for hair loss and treatment.

The average clinical doctor does not keep records on graft survival, but the different doctors have learned over time that they must have graft survival if they are to survive in the competitive marketplace. So what they have done is modify what they can do effectively. Some doctors do not do Follicular Unit Transplants (FUT) and instead have developed modifications of this technique so that their survival will be high. But, in my opinion, the FUT standard is the Golden Standard and has been so since the day we first published the article on it 9 years ago. The reason that it is the golden standard is simply, it produces the best and most natural results possible.

Pricing does vary between medical groups and even within my medical group by doctor (my price being higher than the other doctor because of availability issues). I suspect that the quality of work in any one medical group should be consistent with doctors in that medical group. Dr. Pak, for example, does as fine work as I do as he uses the same staff and the exact same techniques. As you should realize, the crux of the quality of the work you get is tied to the staff as much as the medical group, something we proudly show off at our monthly open house events, where our patients come to meet with prospective patients.

For further reading, here are some past blog posts that I’d recommend:

• Doctor Availability
• The Truth About Cheap Hair Transplants
• How Do I Know I’m Getting the Amount of Grafts I Paid For?