Balding Blog – Page 1439

July 15, 2008

Will Propecia Grow Hair for Me? – Hair Loss Information by Dr. William Rassman

Hello Doctor,

I am a 36 yr old black male. I am totally bald in the crown area and the top of my head, as well as my temple area. My hair only grows on the side of my head and the bottom of the back of my head. Will propecia help me grow hair so I am at least not bald and have some hair on the crown and top of my head.

I don’t know enough about your medical history to make any assessments. If your loss is early, Propecia will work best for you, but you may be describing extensive balding so without a set of good pictures, I can not advise you. If you’re still experiencing hair loss, Propecia will likely slow or halt the loss and if you should have miniaturized hairs in the crown, it might even grow some hair. If you’ve been completely bald on the top and front for 10 years, Propecia probably won’t regrow hair there, but I couldn’t say for sure as each person reacts differently to medication. Best to send pictures if you can not come in to see me.

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July 15, 2008

Why Can Some Men Have Less Grafts and Still Have a Fuller Look? – Hair Loss Information by Dr. William Rassman

I am 36yrs old and am considering getting a HT. I need a little in the front and some on top. What are the risks of shock loss in males over 30? I would also like to know why some men receive less grafts and their hair look fuller than some who receive more.

Risks of shock loss following hair transplantation occurs in young men, but Propecia/finasteride usually prevents it.

The value of a hair is not equal amongst all hairs. A fine hair may have 1/4 of the bulk of a coarse hair, so a transplant in a coarse haired person will be fuller (hair for hair) than on a fine haired person. A good character wavy hair will cover better than a straight hair. A kinky hair will have even better coverage. Also, the difference between the color of the hair and the scalp (contrast) has a lot do to with the result of a transplant. Add to that, the artistic skill of the surgeon and the distribution of the transplanted grafts and one patient can have a very different result, all things being equal, from one surgeon to another.

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July 15, 2008

We Want Solutions, Not Lectures!!! – Hair Loss Information by Dr. William Rassman

I find your responses to be irritating. Specifically, they take on a condescending tone, are pointless as most recommend seeking medical advice. What is the point in this forum if that is the pat answer. Of course they should seek medical advice.

Sometimes people just want encouragement and hope. Not a …”you should do this… you need to do that… Not helpful at all. Sorry, that is just my observation.

I have not been able to find many (if any) articles on the internet that indicate relief of symptoms and offering a solution.

We just want a solution, not a lecture.

Soapbox Your point is well taken, but please recognize that many people who write to me want a medical opinion on their condition, something that I can not give without examining a patient and without being able to ask questions. Also, many times my hands are tied by legal restrictions (I am a doctor, but not the doctor of those writing in) and therefore the best suggestion I can give is to visit their doctor. 95%+ of patients seen by the doctor can have a diagnosis by taking a careful history with good observation. This is particularly the case in diseases of the skin and hair where x-rays and blood tests are generally not needed, just experience and skills in the art of diagnosis. Telling me in an email that “my scalp itches” does not tell me much that I can use in diagnosis or offering relief. For example, last week I posted a question from a reader that said it felt like something was crawling around his scalp and I suggested that he might have head lice. In a situation where I could do a face-to-face examination, I would have seen the head lice crawling around his scalp had that been the right diagnosis.

You asked for solutions that bring relief. If that was so simple, then the doctor’s role of history taking and examination would have no value. I offer 2-3 hours a day to the blog to help when I can (sometimes more, sometimes weekends), and many, many emails are screened. I wish it was an easy task, and if only life were simple! As you can see, I volunteer my services on this blog and do not make my living from doing it, but what I do get from the effort was a way to stay in touch with people and a reason to research many of the questions that had great value to my learning experience. Even at 66 years old, I am still a student.

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July 15, 2008

Stopping Propecia After a Month – Hair Loss Information by Dr. William Rassman

I am 27 yr old male. Slight thinning in crown for 1 yr. So I took Propecia for 1 month but decided to stop since my thinning process is rather mild. My concern is will my thinning condition worsen with the stopping of propecia after 1 month of consumption. Is my hair already dependent or addicted to the medication? Will my hair thinning process goes back to original speed or end up with accelerating thinning speed?

I doubt that one month of Propecia will have caused dependency. Before you stop it, you should discuss this with your prescribing doctor (as with any prescription medication), and you should be getting your hair mapped out for miniaturization to find out a baseline for genetic hair loss. Maybe you don’t have it, maybe you do. Be smart with the decision and find out.

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July 15, 2008

Showering After Applying Minoxidil – Hair Loss Information by Dr. William Rassman

Im 29 and have just started a course of quarter proscar daily to hopefully halt my receding hairline and thinning crown. I was considering complimenting this with 5% minoxidil as the 2 together appear to give good results. I dont think the twice daily application of minoxidil would be a problem but my question is, if i were to take a shower and wash my hair around 3-4 hours after an application would this decrease the effects of the minoxidil?

Thanks

The minixodil will have been absorbed by the skin within an hour or so. Showering and washing your hair four hours after applying the minoxidil should not be a problem.

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July 15, 2008

I Think I Lost Hair Because of Exercise – Hair Loss Information by Dr. William Rassman

I have lost most of my hair because of exercise. I stopped exercise for couple of months & retrieved almost 30% of my hair loss. but the problem is I am a fitness professional and cant live without a workout but as soon as I start my workout which includes weight training I start losing my hair. can anybody help me? whats the relation between exercise & hair fall? if you see, most of the body builders are bald but why?????

There is no connection to exercise and hair loss unless you have a telogen effluvium that is caused by stress. Are you stressed when you exercise with your clients? Even this scenario is far fetched. I would have to examine you and take a careful history to understand your problem better. I would be venturing a guess without knowing more.

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July 14, 2008

Worse Case Scenario — I’m Allergic to Minoxidil and Propecia Makes Me Slow – Hair Loss Information by Dr. William Rassman

I’m allergic to minoxidil and Propecia makes me stumble over words. I’ve been off Propecia for 8 days now and I’m pretty much back to how I was before Propecia, wit wise. My hair was thinning before and it still lookes the same now.

The only other real options I have are this saw palmetto and soy/equol. If this equol does inhibit DHT from working, does this mean we have to consume soy everyday? What if we go on a month safari to somewhere in Africa where soy is not prevalent? WHat then?

I am not sure if soy/equol actually inhibits DHT. For that matter I am not convinced that even saw palmetto inhibits DHT, but there are some suggestions that it does impact the prostate and may impact the hair. It might be a good gamble to use this provided that saw palmetto does not produce the same effects on you. I have not seen any good scientific literature pointing to these claims. Here is a seemingly unbiased summary I found from a simple Google search regarding saw palmetto: Pharmacology of Saw Palmetto.

You, the consumers, drive this industry as we are all trying to find the next best thing. The cure for balding, the cure for aging, etc. We latch on to loose associations and circumstantial evidence. We read things on the Internet which are not all true. We like to believe in commercials and promotions (”looks good, sounds good, must be a true” type of attitude).

That’s my two cents worth of rambling, but if you are asking for my personal opinion as a physician, my answer is: I suppose it won’t hurt, but it probably won’t work. I always say “It’s a buyer beware market,” but maybe I should rephrase the last comment as “It’s a price is right market…”. For a few dollars (or euros, pounds, etc) we seem to think it may be worth it.

By the way, who says there is no soy in Africa?

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July 14, 2008

Where Are the Published LaserComb Trial Results That Lexington Promised? – Hair Loss Information by Dr. William Rassman

Has Lexington fulfilled their promise (that they made over 3 months ago on this very site) by publishing their FDA lasercomb clearance study in any peer reviewed medical journals?

You’re right. A rep for Lexington posted in the comments back in March of this year stating, in part –
“We are currently drafting a medical review of the study to be submitted to a peer-reviewed journal. We have every intention of publishing the study and making the full results available for public scrutiny.”

I’ve yet to see anything of the sort. We are all waiting…

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July 14, 2008

Propecia Costs Per Year – Hair Loss Information by Dr. William Rassman

how long does one need to use propecia to witness the benefits, and does it require continued usage-as in ad infinitum? how much does a yearly prescription cost on average?

Propecia runs between $700-900 / year, plus there are rebates offered by the drug company Merck. Cutting Proscar into 4 pieces will reduce the costs to about 1/3rd, but your doctor will need to be willing to prescribe that to you. Proscar is a prostate medication (finasteride 5mg), while Propecia is the same drug, but in a 1mg pill and FDA approved for the treatment of genetic male pattern hair loss.

There is a generic Proscar available, which also helps cut the cost. A generic Propecia is yet to be available legally in the U.S. due to patent laws.

July 14, 2008

Inherited Father’s Oily Scalp — Will I Also Have His Hair Loss? – Hair Loss Information by Dr. William Rassman

Hi Doctor,

Just a quick question. My cousins and I are curious about the likelihood of us inheriting our fathers’ hair. Our curiosity was piqued after we (all three of us) had sebaceous cysts removed from our scalps in the last year. My father and uncle have also had cysts removed from their heads several times over the decades. Despite the presence of all this sebum (I understand an over-production is related to high-levels of DHT), and the not-so-clinical removal scars, the two men have full heads of jet-black hair – not bad for guys in their seventies!

What we’re asking: we’ve obviously inherited the oily scalps. Is there any relationship between this and a resistance to the effects of DHT with regard to hairloss. I’m 26 and have the same hair-colour and widows-peak hairline as my father. My cousins are in their early thirties and similarly show no sign of baldness. Just curious. Thanks.

These are probably related to different genes, but your probability of inheriting it from the male side of the family may be reasonably expected. I don’t know of any way to tell for sure, so you may just have to wait it out.