Balding Blog – Page 1776

July 13, 2006

Propecia and Androgenicity – Hair Loss Information by Dr. William Rassman

I have been on propecia for the last three month. I am bout to end month three and have noticed that my temple hairs have become noticably thinner than before I started propecia. I have increased sex drive and more morning erections. For a while I was having some scalp irritation which has gone away. Is it possible I am being affected by androgenecity? Prior to taking propecia I had my total test. checked and it was at about 250. I am 24 years old. I am hoping that my temple hairs have been pushed into telogen and this is why I have thinned in these areas. I have a good amount of hair on my head and want to maintain it. What do you think? Also, many of my hairs that have been falling out look to have a white type of pulp on the end near root.

Your report of an increased sex drive is a well known side effect of Propecia (most people seem more concerned and worried about the decreased sex drive which occurs in 1/100 to 1/200 patients). Men generally get an increased testosterone level of about 18% on Propecia in the initial month or so. This often returns to normal after 1-3 months. Testosterone is a far more potent that DHT as a male hormone for sex drive.

Your hair loss may just be a normal progression of your male pattern hair loss and Propecia may actually be slowing its progression (even if it seems you are losing hair). If you are concerned about hair loss, you may consider visiting a hair specialist who is able to quantitatively record the miniaturization of your scalp hair and perhaps even determine the degree of future hair loss.

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July 13, 2006

Patient Letter to Dr Rassman – Hair Loss Information by Dr. William Rassman

Every now and then I’ll receive an email from a patient years after seeing them and it brightens my day. I thought I’d share this one I just received…

Dear Dr. Rassman,
I am [name removed for privacy] and I had a procedure for almost 2 years now (2280 grafts).

WELL!!! By looking at every single FOLLICULAR UNIT you had transplant onto the front of my head, I couldn’t tell that I had a hair transplant. Man, that is how good you are. I am so glad I got you as a Doctor. It changed my life forever because I feel more comfident about myself now and a lot more of the man I know I am because of you, Dr Rassman.

You know what my dream is Dr. Rassman? My dream is to have another TRANSPLANT from you but my girl friend doesn’t let me because she witnessed what I been through and she was so scared. To me I feel great and I would do it over and over again. I guess she just cares for me too much and I thank you GOD for that. Who ever reads this, please bear with me. It sound like I am a super pussy. Maybe, I will do it again without letting her know. If you do my surgery, that would give me more motivation to convince my girl friend to let me have another procedure.

Thank you for all the staff. You are part of my life.

What a nice letter. I can not tell if you are worried about pain from the surgery or from your girlfriend who may not be backing you for a second surgery. If you are worried about any pain, since your last surgery, we have made substantial changes in the anesthesia protocol we use with the use of a medication called Versed. This medication is a type of narcotic which does make the local anesthesia far less painful if you had trouble with it before. We have also added a stronger narcotic for the first night when the muscle spasm hits so that the first night is more tolerable for those who experienced pain. With these changes, you should think twice about any pain fears that I think you are expressing here. With regard to your girl friend, well most men either have wives, girlfriends or significant others and these folks do get involved in decisions we make like undergoing still one more transplant.

For the blog readership: this patient has agreed to let me post his photographs and he will be coming to see me shortly so that we can not only discuss the email posted here, but also take recent post-surgery photographs so that we can all know just what he is sooooo excited about.

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July 13, 2006

Anabolic Steroids, Propecia, and Rogaine – Hair Loss Information by Dr. William Rassman

I was wondering Dr if you take steroids at a young age (19) (I know certain steroids are more harmful to your hair than others), and you do start to loose your hair but after 4 years you still have very thick hair but you do have mild hair loss and you still have enough thick hair to cover up bald spots, what does that mean? Are you predisposed to loosing all your hair or the hair you lost while on steroids is that it, has the hair loss stopped? Mind you, I have been on propecia for close to 2 years but I did stop for close to 6 months and none of my hair in the back fell out but my frontal line receded a bit.

Also, can rogaine cause hairloss? Because I was using rogaine and I did get some growth but I also felt I had some hair loss so I went off of it (I was on for about 6 months) then I have started to lose more hair. I am on propecia, so what is going on? PLEASE HELP ME.

Steroids, especially anabolic steroids (the kind bodybuilders use), may cause hair loss. Unfortunately for reasons not clearly understood, once you start losing hair it seems to continue as if a “switch” has been turned on.

Finally, the hair loss you are noticing may just be your natural course of hair loss indendent of Rogaine or Propecia. Propecia and Rogaine may have slowed down your hair loss to a certain degree, but we will never know the degree of how much of gain or loss you had because you did not continue the drugs for an extended period of time. My opinion is that you may want to continue the Propecia and/or see a hair specialist who may better assess the degree of your hair loss and its balding pattern, hopefully by mapping our your hair for miniaturization to obtain measurements on what is happening to your hair.

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July 12, 2006

Using Straight Razor to Shave Head Stimulates Growth? – Hair Loss Information by Dr. William Rassman

My hair has been thinning since I was about 18. But it seems to have accelerated in the last year or so since i grew my hair long. (I am now 23) I decided to shave my head, and boy did that reaffirm my receding hairline. When it grew back it looked a little bit odd to me. My left side had no border; it has basically a 2 1/2 by 2 1/2 inch patch of thin hairs (with more density towards the top) with hugh gaps between them from my “peak” in front to the side areas. On my right side it is thinning but there is a border and it is a lot thicker and less receding. There is a major difference. How many years could have stress and growing it long accelereated my hair loss, if what I described is normal. Secondly, I used a straight razor to shave my head thinking that would stimulate hair growth, eventhough i was told about it scarring and or killing the follicles.

I do not believe using a straight razor will stimulate hair growth. If that is true, I would be in the hair shaving business!

You make an interesting observation of being able to see the pattern of hair loss with the short shaved head. What you are seeing is the miniaturized hair, which has less bulk than normal hair. This is fairly difficult to see in patients with average men’s hair lengths. That is why I often write about mapping your scalp for miniaturization with the densitometer that we routinely use at New Hair Institute. Alternatively, if you can not find a doctor able or willing to map your head for miniaturization, you can get a very short hair cut and see with the eye where the miniaturization is.

July 12, 2006

Saw Palmetto for Women? – Hair Loss Information by Dr. William Rassman

What course of action do you recommend for women with thinning hair? I have low thyroid and take medication for this condition (.75 mg levoxyl)

Should women take Saw Palmetto, or any other product that reduces production of DHT? I am nearing menopause and my estrogen levels are reading very low: >.32. Would HRT help?

Does a completely bald father and mother with thinning hair compound a child proclivity toward hair loss in middle age in women?

My hair loss started 10 years ago mainly in the forhead area and temples. It has now progressed into a triangular pattern stretching toward the back of the head. Luckily I had a thick head of hair to begin with or I’d be wearing a wig by now.

Any advice would be greatly appreciated.

You should discuss these issues with your regular doctor — especially with respect to HRT. HRT may help with your low estrogen levels and overall well being. However, there are breast and cervical cancer issues that your doctor needs to discuss with you before starting HRT.

Saw Palmetto has been implicated with DHT reduction (correlations not based upon good clinical science) however if your hair loss is not DHT related it would not work. Women rarely have such a connection. You should be evaluated by a good specialist who can correctly diagnose the cause of your hair loss. Please note that just because there is a diagnosis, it does not mean there may be a solution, as is the case in many women with genetic hair loss.

July 12, 2006

Rogaine After Hair Transplant in Woman – Hair Loss Information by Dr. William Rassman

Thank you for your forum…. it is so helpful. My question is I had a HT of 1480 units about 2 weeks ago. How long should I wait to start using Rogaine again? As a female can I use any oral medication to help maintain the hair I have?

You can start using topical Rogaine after about 1 to 2 weeks after a hair transplant, and it may be a good idea to use it at least for the first 4-5 months after surgery. To date there have been no FDA-approved oral medications available for female hair loss. Propecia is not recommended for women.

July 12, 2006

Propecia and Working Out – Hair Loss Information by Dr. William Rassman

Hi.

I’m 35 and loosing hair. It’s likely that Propecia could be one good solution. However, from what I understand Propecia blocks DHT by limiting the creation of testosterone which is why it can stop balding process.

Now, I am working out seriously 4 times a week and trying to add on muscle. Muscle growth is due to testoterone. My question: how can my work out be still beneficial in terms of muscle growth if the testosterone is lowered because of use of Proprecia.

Thanks for your time.

Propecia does not decrease testosterone. It decreases the byproduct of testosterone known as dihydrotestosterone (DHT). DHT is what is implicated in male pattern hair loss. Taking Propecia increases testosterone by about 15% and benefit (although not proven) muscle building. Propecia can also apparently be used to mask muscle enhancers. You may recall from the recent Olympic games the controversy surrounding Propecia — Olympic Athlete Banned from Competition for Propecia Use.

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July 12, 2006

I’ve Experienced Severe Diffuse Thinning in Just 4 Months – Hair Loss Information by Dr. William Rassman

I am a 22 year old who has experience fairly severe diffuse thinning over a period of just four months. I first noticed the problem in March eventually going to see my doctor in April. He said he could see nothing wrong with my hair but noted that I have two patches of Alopecia Areata and some form of dermatitis on my scalp. My hair continued to thin and in June visited a dermatologist who was similarly distracted by the patches of alopecia and inflamed scalp and also said he could see no sign of MPB. However I feel my hair has continued to thin rapidly since then so I have booked another dermatologists appointment for two weeks on Wednesday but fear I will have little hair left by then.

Is four months considered rapid progression?
I have had an extremely stressful year so far but feel I can rule out T.E because I read you can not have A.A in conjunction with it.
My diet is admittedly poor but a blood test in April turned out to be fine.

Do you have any thoughts?

Thanks

I am assuming that you are a male. Men with genetic hair loss do, at times, develop alopecia areata. There is no connection between the two. With that said, if your hair thinning is diffuse and reflective of some other form of hair loss like diffuse telogen effluvium or diffuse unpatterned alopecia, you should have your scalp mapped out for miniaturization to find out if you have an early subtle patterned genetic hair loss. A hair pull test would also have value for you. Has your doctor done both of these things? Have you had blood tests for endocrine abnormalities such a thyroid disease? The stress you are having can accelerate genetic hair loss or diffuse unpatterned alopecia. If you get the idea, you need a doctor to make the differential diagnosis here.

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July 12, 2006

I Stopped Propecia for a Month, Then Restarted — It’s Not Working the Same! – Hair Loss Information by Dr. William Rassman

I am only 18 but I have been noticing hair falling out since I was little, and it only became more pronounced a couple of years ago. Last year, I began taking Propecia and I was on it for about four months. It was so expensive that I stopped for one month but decided that I really needed to continue with it. I have now been back on it again for just over a month, but I’m still noticing a large number of hairs falling out daily. After stopping treatment for a month, will I never experience the previous effects of Propecia, or do I just need to be patient for it to start working again?

Other men, older and wiser than you, have come to me almost in tears about the same experience they had when they stopped using Propecia and experienced an accerated hair loss. Usually, they stopped for longer than a month. In theory, the drug should remain in the hair follicles to some level up to a month or so, but the blood levels disappear in a day. It is unfortunate, but if you are losing hair from stopping the drug, your hair loss may be permanant, though it is possible that much of it may reverse because of maintained tissue levels. It is probable that some hair may come back if you go back on the Propecia immediately to replenish the tissue levels of the drug in the hair follicles. On the brighter side, Propecia may prevent further hair loss.

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July 12, 2006

I Don’t Have The Kind of Money to Spend on Treatments – Hair Loss Information by Dr. William Rassman

Hello!
I recently had a free consolt at the Hair Club for Women to discuss options for my thinning hair. I was disappointed with the options I was left with, which were: use the hair care products their company sells for $2400, or do nothing and continue losing hair. Since I have nowhere near that kind of money to spend, I was unable to purchase their product. Now I am left trying to find another option. They talked to me about taking vitamins, but I was never told what kind would be helpful. I am only 25 years old and it makes to sick to think that I may be close to blad by the time I’m 40. I have been losing hair for the past 10 years, and I have probably only half the hair I had as a child. Is there anything you can suggest for me to take or do that will help regrow my hair, or at least stop from further hair loss, that will not drain my bank account?

I would suggest that you should be evaluated by a medical doctor to find any medical causes of your hair loss. Once you have been evaluated for any treatable medical causes of hair loss, you may want to be evaluated by a hair transplant surgeon or dermatologist that can map your scalp hair for hair loss patterns that may shed more light into the cause and the prospect of future hair loss. I agree that $2400 is a significant amount of money to spend on hair loss, but consumers spend billions of dollars on hair loss products each year. Vitamins, special shampoos, and hair loss supplements all promise hair growth, but it is a buyer beware market. Good luck.