Balding Blog – Page 1830

April 6, 2006

Propecia Questions, Part 1 – Balding Blog

Note: I’m just going to post my answer under each question to make it easier for everyone to understand. The email I received from this writer was well researched and quite long, so I’m breaking this into 2 parts. Enjoy part 1 below, and check back for part 2 tomorrow…

1. Is it easy to fake or re-create the standard Merck packaging of Propecia and/or Proscar? I’m asking because of concerns over the legitimacy of these products when purchased from online pharmacies.

Anything is possible. It is always a buyer beware market. Furthermore, you should be evaluated by a qualified doctor before beginning any medications. Propecia can only be precribed by a doctor.

2. The patent for Proscar & Propecia is expiring on June 19th of this year. Have you heard of any developments with regards to other companies wanting to manufacture the generics? Does Merck itself plan to deliver a generic version?

If you remember few years back when Prilosec (omeprazole) became generic, it became less expensive, but the company who made Prilosec then made Nexium (esomeprozole) which is basically the same class of drug and it was marketed successfully as a replacement. I assume something similar may happen, but that is just a guess. I am not in the know and I don’t have inside knowledge. I believe the patent for Proscar runs out this year, but the patent for Propecia (same drug, just 1mg) is still valid for a few more years.

3. Does DHT serve a valuable purpose in the body that is being negated by use of finasteride?

DHT plays a key role in the development and progression of benign prostatic hyperplasia (BPH). Blocking DHT is actually beneficial in preventing prostate cancer according to recent scientific papers which have been published with the 5mg does of finasteride (Proscar).

4. It has been stated that blocking the reduction of testosterone into DHT actually increases the amount of testosterone in the body.
a. Do these raised levels persist or does the body adjust?
b. Given its effects on the hormonal system, I often regard finasteride in the same light as certain steroids even though the action of finasteride on the hormonal system is indirect. Nonetheless, should I be concerned with things like HPTA shutdown, normally an issue for steroid users?

Testosterone is converted to DHT which is then converted to other metabolites. Thus, one may argue that blocking DHT formation may increase testosterone. But there are other biochemical pathways for testosterone to be broken down. It has been said that blocking DHT may slightly increase normal estogen levels (yes, men have estrogen hormones which is normal), but there have been no adverse side effects associated with taking a DHT blocker such as Propecia. Finasteride is not a steroid.

5. Should we be concerned with the effects of finasteride on the liver? I mean, if the drug is to serve its purpose, it must be taken for life.

Finasteride has been approved by the FDA and it does not have adverse effects on the liver. DHT blockers like Propecia will be less strongly metabolized if your liver is functioning poorly, so please check with your doctor for dosing instructions if you have known liver disease.

Stay tuned for part 2 with more questions and answers, which I’ll post tomorrow…

April 6, 2006

Problems from Fincar (Generic Finasteride) – Balding Blog

Dr. Rassman: Fincar Caused Bizarre Problems for me-please advise. I have used 1/4 proscar daily for 8 years I decided to try Fincar for a while. Supposedly Fincar is identical to Merck’s proscar. After starting Fincar my left testicle started aching. I had read numerous about such a paid although I had not experienced it.

In 30 days of Fincar use, bare spots appeared in my beard and the hair on my left arm diminished significantly. The outer third of both eyebrows have thinned drastically and my skin has gotten dry and wrinkly. I know this all sounds crazy but it’s scary.

I went to my family doctor and he just blew me off and said Im getting old since I’m 48.

Doctor-What did the Fincar do to me? I’ve been of Fincar 3 weeks. No testicle pain. Will I return to normal? I’ve resumed the Merck proscar daily but am scared. I wish I had never touched Fincar. Please tell people to never touch the non-Merck finasteride.

Thanks

From my understanding finasteride formulations like Propecia and Proscar is still under U.S. Patent protection thereby restricting the manufacturing of this drug in companies which are under patent treaties with the United States. Generic versions of finasteride like Fincar are made by a pharmaceutical company called Cipla in India and is not available in the U.S. (although I suspect internet sales makes this possible). I am not familiar with International Patent laws so I am not qualified to comment on patent issues. I do know that foreign manufacturing of drugs are not governed by US FDA regulations, so I do not know if the formulation meets the same criteria. There is real no way for me to know if your symptoms are a direct result of taking Fincar. I also do not know about the additives and other inactive ingredients in the formulation. I am not aware that the official, U.S. brand of Propecia is associated with aching testicles or thinning eyebrows or dry, wrinkly skin. I am curious to know why you took the medication if you had read “numerous” reports that such drug will cause these problems.

Fincar may have caused your symptoms, but it may also have been coincidental. I suspect you do not want to take another chance. It is always a “buyer beware” market. Seek competent medical advice. I hope you return to “normal”

April 6, 2006

Post-Op Questions About Redness – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,
Thank you for having this site and thank you for taking our questions.
I had hair replacement surgery a month ago. I received 2700 grafs. I still have redness on top of my head as well as an itching from time to time.
How long will the redness remain and how long for the itching to go away?
Also, is it okay to scratch my scalp in the area where the transplants were placed. I currently scratch with the tips of my fingers, very, very lightly? Is that okay?

Thank you.

Redness is generally minimal for most people. For those few individuals with a tendency to get red (having histamine positive skin), the redness may take weeks to completely go away. There are no straight rules. Topical steroids work to minimize redness or to treat it if it appears, but minimal use should be encouraged (speak with your doctor). Scratching vigorously is always a bad idea, because it tends to produce trauma to the delicate areas where the transplants were placed and increases your risks for infection at the hair follicle level. What you described sounds ok, as that is not scratching. Make sure your fingers are clean, that you do not pick your nose and then go to scratch your head, because the bacteria from the nose will seed the transplanted area for infection (don’t laugh, as this happens frequently).

April 6, 2006

I’m New to Hair Loss – Hair Loss Information by Dr. William Rassman

Sir,
I am 27 year old from Bangalore, India. I have lost most of my hair due to male pattern baldness. You can say i am almost bald. I would like to get my hair back. Is there any way I can? I am not sure who to concact for this. Please advise.

I do not know where to start. First, please review newhair.com, as I believe it is as a fairly complete directory for hair loss and hair restoration information (possibly the largest and most complete site anywhere on the internet). Then review this blog site, which now has over 1300 questions and answers to various problems people have experienced with their hair. Then with that education, seek professional help. You can use the physician search at ISHRS.org to find a doctor in your area. You must exercise your brain and do good research to avoid the scams that are widely promoted around the world. Many of them are identified on this blog site, by people like you who do good research and share that research with me. This is a buyer ‘beware business’, but there are many good things that can be done for the average person with hair loss (which impacts almost 50% of all men and women in their lifetime). Good luck with the research and target me with questions once you are more informed.

April 6, 2006

I Think I Am Going Bald – Hair Loss Information by Dr. William Rassman

Hello,
I am a 21 year old male who seems to be having rapid hair loss. My hair has always been very thick and within the last 8 months my hair just began been falling out. My hair is beginning to become very thin and noticeable. I can run my hand through my hair and have 20-30 hairs in my hand. Both sides of my family still have alot of hair. I am just wondering if it is just genetics or maybe because of a desease. What do you think I should ask my doctor???

It is normal to lose up to 100 hairs per day. You can quantify it by collecting the hairs in a bag for 24 hrs and then counting them, but unless you stay home and follow yourself around catching every hair that comes out, you will not get them all. We generally lose hair with the wind and just walking around doing the normal things people do. To better evaluate for your hair loss, you should have your hair mapped out for miniaturization to get a diagnosis in hand. Don’t panic quite yet, but be smart on what you do now.

April 6, 2006

Hair Loss Treatments and Cures in the Future? – Hair Loss Information by Dr. William Rassman

What hair loss treatments and cures can we look forward to in the future? When will these treatments be ready for use?

There are many drug presently working their way through the FDA. I have become aware of two of them recently, but have signed non-disclosure agreements so I can not identify them. The mechanisms of how they work out seem to be different than the drugs that are available today, but great clarity in their mechanism of action will take time to define. Drug testing can take between 5-10 years.

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April 5, 2006

Hair Loss InformationIntercytex / Hair Cloning, Follow-Up – Hair Loss Information – Balding Blog

I agree with you that cloning is not going to be available anytime in the immediate future, but why do you say 10 years just for safety issues? According to Intercytex, they have already completed the phase I safety trial. Also, isn’t the fact that scientists have successfully transplanted hair into mice and are now putting it into humans a breakthrought? According to Intercyted Seven human individuals from phase I trial currently have “cloned” hair on their heads. Isn’t that pretty huge?

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Mouse If a doctor thinks that he can find a stem cell on you and move it to your head in the hope that it will grow hair (it actually might) then the doctor may be allowed to do this if he does this in his office. He has to pay attention to the medical licensing board’s rules on human experimentation, but he will not be going through a hospital-certified facility.

If he takes something out of your body (or even worse, from a mouse as you suggest) and then does something to it, following that by reinjecting it into you, then he is using a ‘drug’ which would then be covered under FDA regulations. Safety and effectiveness for a drug takes many years (15 on average) and cost about $800 million. Thousands of people must be tested and safety and effectiveness must be confirmed according to FDA rules and under FDA guidance. That is why I said 10 years. A cloned mouse hair on a human head fits that timeline for me, but if that happens on your head, be sure to stay away from cats.

April 5, 2006

Wife Refuses Sex If I Take Propecia – Hair Loss Information – Balding Blog

I used Proscar in the past and it worked well in stopping hair loss and improved hair growth. I stopped it a couple years ago when I got married because my wife thought she would or could get cancer if any of my semen got inside her or even touched her (because of Mercks disclaimers about potential affects on a male fetus). She is very paranoid with tremendous anxieties, so I stopped using it. My hairloss increased greatly. I want to use it again but she is very stubborn and says “no sex if I do.” Can you tell me if there is any potential that my semen can harm her in anyway if I am taking Proscar or Dutasteride or any other Alpha blocker?
Thank you.

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There is no evidence that women are at any risk from men who take Propecia, Proscar, or Avodart. This includes any fluid pass through from sperm (intercourse) or saliva (kissing). With regard to Propecia, the drug company has already cleared the drug for young men and the FDA would have never released it without appropriate warnings if any of the medication passed from man to woman.

Now with that said, what I am suggesting is that taking medications that impacts your wife to such a degree as you outlined above, is probably not worth the therapy that it may require or the potential to ruin your marriage. If you push on this, then you may create an unhealthy marriage.

If you find the balding option not acceptable and the medication something that does not work for you and her as a long term couple, then hair transplants are worth exploring. You are not alone, as many men find it unacceptable to take medication on a long term basis (even with my belief and the FDA assurance that the drug is safe in the long term for women who have sex with men taking Propecia). Hair transplants are good options for someone like you, assuming you qualify.

April 5, 2006

Only 50% of My Hair Grew Back After Chemo 6 Years Ago – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I had a chemotheapy in 2000 and lost all my hair. Then it didn’t fully come back and now I still have diffuse alopecia. I can say only %50 of my hair came back. I also had lots of grey hair but they are now replaced by black colour hair, my original hair colour.

Do you think if I use Pantogar Capsules 3 times a day, will I get any results? If not, which medicine do you suggest to use?

Thanks a lot!

Hair loss from chemotherapy usually grows back without any supplements. I am not aware of any supplements or medication that will accelerate this process. The only treament I know of is “time”. I realize chemotherapy has the stigmata of cancer and is often devastating and depressing for your morale and self image. You must be sure that you do not have other systemic causes of hair loss and your treating doctor should advise you on this.

The time you are taking to grow your hair back appears much longer than most. This may indicate that you will not return it all. If you are disease free and you have what we call a positive nitrogen balance (good diet adding calories to you), then you are doing the most that you can do. There are many organizations or some hospitals have great hair piece or wig programs for their chemotherapy patients.

As I have written in a previous blog entry, I am not familiar with Pantogar, but did find this site which mentions it: EHRS.org

April 5, 2006

My Hair Doctor Told Me To Wait For Transplant – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,

I’m a 22 year old male. In the last two years I’ve noticed more hair falling out in the shower and if I run my hands through my hair, as well as a decrease in volume and more visible scalp. Although others haven’t said the same, I feel like I know my hair pretty well. I have mild temporal and frontal recession, a widow’s peak that was never there before, but most worryingly I noticed that individual hairs falling out are much thinner.

I saw a transplant/hair loss doctor and he took global photographs, but told me I have to wait. He said my small recession is just called ’sculpting’ and that looking at my head you can’t see any pattern of loss.

My question: Why do I have to wait until its clear I’m losing my hair visibly to take action? My father has lost some of his hair (class III?), my mother has pretty severe hair loss, and one of my uncles as well (father’s side).

You always refer to miniturization, and I understand this process, but the doctor made no mention of mapping it in my case. Does every good hair doctor map for miniaturization? Is it right to pursue in my case?

What should I do?

Please respond, my hair is my confidence!

Thanks and all the best

Good measurements are the heart and soul of good science. That is why I map out the scalp in all of my patients. I generally do not like to transplant a 22 year old, but if you are in the early balding process you do need your scalp mapped out for miniaturization to understand what is happening to you. The science of measurement (metrics) is the back bone to diagnosis in your case. Where are you now with regard to miniaturization and where will you be in a year? If your hair is miniaturizing, why are not not taking Propecia? You need to have some good solid measurements to define where you are and where you are going. Then, with those good measurements over time, it will be easy to answer your questions. Please remember that what you do now will impact you for the rest of your life, so timing is critical.