I am constantly asked for information and news on what is coming down the pike on hair cloning. The following link will take you to a news release from the Associated Press, published yesterday. Please read through the lines; nothing is about to happen tomorrow.
In a recent news article from Central Florida’s Local 6 News, the relationship between hair loss and dieting was emphasized. Although I have always included weight loss as a contributing factor in hair loss, I was reminded by this article of the obesity problem that is confronting the American population and the degree to which people are willing to go to lose excess pounds. Sometimes, starvation diets are employed and are just not a subject that anyone wants to talk about (short of bulimia in a movie staff), but the problem is real and weight loss can accentuate any hair loss that may be present, if not precipitating its onset if it is not present but within the genetic cards of that person. For more info, see the article link here.
Hello Dr. Rassman
You are really doing a great job in this informative blog, thanks a million for that. Have had a recent HT procedure for about 1500 grafts by strip excision method that were implanted along my temples in addition to the frontal hairline. So far everything seems to be going fine as i approach my 8th week post-op except for one slight problem. Just like any other HT, the grafted hairs begun to shed within the first 4 weeks & i was left with only about (20-30)% of the total amount, now i started seeing new hair growth of very fine hairs but the problem that these little stubbles-like hairs are easily fallen as i wash/shampoo my scalp, are the implanted follicles intact? will new firm hairs grow later?
With Regards
Thank you for your kind words.
Now that you are in your 8th week post-procedure, I would not worry about losing the transplanted follicles, as they will regrow over the subsequent 2-5 months. In general, a small percentage of all normal hair comes out when you shower, when you walk along a windy path, or when you comb or brush your hair. The same number of hairs start into anogen (growth) so that the total population stays the same (about 100,000 hairs). When your transplants grow, they will behave as your normal hair does and cycle the same way, some falling out while an equal amount will regrow. In the normal, full haired adult, about 100 hairs per day come out that way. If you have hair loss for any reason, be gentle with brushing and washing, as vigorous handling will negatively impact genetically ‘fragile’ hair.
Dr. Rassman, I have read on HairLossTalk, the following:
“It’s been firmly established that male pattern baldness is initiated by DHT attaching to the receptor sites on the hair follicles. Genetically, only the follicles on the top of the head are encoded with the receptor sites, which explains why hair along the side of the head and in the back of the head is not lost with age. The attached DHT on the receptor site is perceived as a foreign body and the immune system begins to destroy the hair follicle, shortening the growth phase and causing the hair shaft to become progressively finer in texture. In extreme cases, only a vellus hair remains. The good news is that the follicles have the inherent capacity to mature to their former size.
Encouraged with the success of Propecia (Finasteride) to reduce the amount of DHT in the scalp of patients with male pattern baldness (MPB), doctors and scientific researchers took another look at existing medications that are known to act as anti-androgens.
However, there have to be stringent criteria for an anti-androgen that can be used to combat or even reverse pattern alopecia. The ideal anti-androgen should have the following properties:
(1) It has to have potent anti-androgen activity (2) It should selectively prevent or successfully compete with DHT without changing testosterone levels (3) It should be effective topically, so it can be conveniently applied with minoxidil solutions and (4) Even though it’s easily absorbed into the skin, it should not have any systemic effects.
That’s a tall order. Surprisingly enough, there is such a medication: Spironolactone. For over thirty years Spironolactone has been used as an antihypertensive and a diuretic. More recently, it has been used to treat hirsutism (excess body hair) in women. Using Spironolactone to treat hirsutism may sound contradictory, but body hair (e.g. chest, face, axilla, pubis, etc.) is promoted by testosterone and since Spironolactone is a potent anti-androgen, it’s successfully used to eliminate unwanted hair on the body.
On the top of the head, where the hair is adversely affected by DHT, Spironolactone has just the opposite effect. Spironolactone exhibits anti-androgenic effects in both males and females. Taken orally, it is such a potent anti-androgen that, although it is an effective anti-hypertensive drug, it is rarely used to treat men with hypertension because of its feminizing properties, including painful gynecomastia.
However, applied topically, Spironolactone does not have any systemic side effects. Among its other properties as an anti-androgen, Spironolactone also effectively prevents DHT from attaching to the receptor sites on the hair follicles. As a result, the follicles no longer atrophy and can mature again to their normal size. And it does so without decreasing the circulating levels of DHT in the body. By comparison, Finasteride inhibits the formation of DHT, causing troublesome side effects in many patients.”
What do you have to say about Spironolactones?
Spironolactones have been used for hair loss for decades. Early in my career, I had asked well respected dermatologists about their experience with spironolactones and the results for the treatment of hair loss. The consistent story I got from them was that they were not efficacious and patients who used them, with or without other injectable medications used in the head, had no significant demonstrated benefit. With that knowledge, the written material that you’ve sent me seems to fall flat, missing some elements of science in the practical world of clinical medicine.
I got a prescription for Avodart here in the states.I will start today.I have read on the internet that there is a 12.5% minoxidil lotion and a 15% minoxidil cream that are better than the 5% you can buy over the counter.I want to start a new hairloss program but i want to make sure that im doing the best possible treatment for my hair.Are these stronger creams better or should i use the over the counter 5%.I have been depressed but i can not give up on my hairloss.Your input on this email will be very helpful!
You can try higher strength minoxidil, but just be wary of the drug’s side effects like dizziness or skin irritation. I have no particular experience with 15% minoxidil, but if you want to try it, I have not heard anyone saying it is bad.
Update: November 15, 2006
To comply with a letter I received from this product’s lawyer requesting that this review be removed, I will simply direct your attention to Google if you wish to find more information.
Hi Dr. Rassman,
I have a couple questions to ask you regarding my hairloss situation. First of all, im 21 yr old male. I recently began losing a lot of hair suddenly throughout my whole head at about 8 months ago. I have been on propecia for 7 months now. However, the majority of hairs that fall out(about 75%) has a white hard mucus substance that can be scraped off from the end of the hair. I lose about 150ish hairs and they are basically always all the same size hair. I also seem to have a lot of dandruff (im assuming, white mucus-like flakes) that fall off also with the hair.
I just went to a dermatologist the other day and had him look at everything. He looked and sifted through my temple region hairs with just his eyes but didnt really look closely at anything else (no magnifying or anything). When i asked him about the white mucus stuff, he said it was normal to have that. (For the record, i know that hair has little white bulbs on the end of a hair, but this isnt the case here. it is real scrapable stuff, NOT the bulb)I then asked him about taking a scalp biopsy and he told me that that wouldnt really show anything. I then asked him about measuring my level of DHT in my body to see if its really high and he said that also wouldnt show anything because it doesnt matter how much DHT we have in our system, it only matters how much the hair follicles react to that DHT. He then gave me a form to get my thyroid, iron, and blood glucose? tested, which i will do now.
He then concluded that the acne on my face that is deep down inside my skin (never been able to get rid of it) could have something to do with my scalp and the flakey-ness as well as the mucus on the hair pieces so he prescribed me Nizoral 2% shampoo as well as Nizoral pills to get deep down and clear out my face and anything in my scalp. He also believed that milk could be playing a part in my hair loss because of the hormones milk has and how it bypasses the DHT blockers in propecia. (I do consume a lot of dairy products) He was very adamant about it and said how americans are much more balder than other countries and how the US drinks much more milk than others, etc. and how he is planning on doing a research project on it with candidates, etc. So he told me to stop all intake of milk, cheese, ice cream, etc. and see if it improves in the 2 months when i see him for a followup appointment. I asked about the loss of calcium etc. and he said that i would be fine without it and the loss of dairy products wouldnt have that big of an effect. (i could get it from other food products, etc.)
What im wondering is if what you think of my situation and about the dermatologist. I was just a little taken back about how he didnt give me a scalp biopsy, or look in a magnified glass to see deep down in my scalp. I dont doubt his intelligence because he told me that he was one of the doctors that got the creation of Nizoral, etc. and he is very well known and popular. (takes 3 months to get an appt.) I was just wondering if you agree and what your thoughts are on what he said about the different tests and if the examination of me seemed correct because i really wanted a biopsy and DHT test since i heard it worked well. Also, what are your thoughts of the acne issue and besides the thyroid, iron, and blood glucose tests, are there any other tests or procedures done to see if my hair loss is normal. And lastly, what is your opinion on my hair loss situation and is this normal? If that white mucus stuff isnt normal, does that mean that as each one of those hairs falls out, does that mean that particualr hair will never grow back? (is that the hair follicle or something meaning permanent loss?) I will send you a picture of my hairs and of my scalp.
Thank you so much for your time in reading and replying to this, it means so much to me. Im really having a hard time trying to deal with this.
The tests that your dermatologist told you about are always a good idea, so he can be sure that you do not have other causes of hair loss (other than genetic male patterned balding, which is the most common). We generally lose 100-150 hairs per day, so seeing the hair come out does not bother me. If you are picking because of the scaling, then more hair loss with bulbs may be detectable. What I always do and think is important to do, is a thorough analysis of your scalp by region, looking for miniaturization, which is the hallmark for genetic balding and some other forms of balding as well. Any good long-term plan, which is critical for someone of your age, must have periodic follow-ups of the scalp, quantifying the degree of miniaturization and any changes over time. Without that step, there is no possibility that a diagnosis of genetic male pattern balding can be made. Hair falling out is normal, provided that your body replaces the same amount (usually between 100-150 hairs per day).
With regard to the milk focus that your dermatologist is referring to, I am not familiar with it, nor have I found that others in the hair restoration community have developed such focus. I was a dairy farmer many years ago, and I do not believe that we are allowed to use the type of hormones in these cows that would produce more hair loss, but it’s been many years since I’ve last milked cows. As for Nizoral, I’ve discussed this previously here: Nizoral Shampoo.
It sounds to me like you need some real assessment of the balding process by a hair specialist, like me. On the east coast, Dr. Robert Bernstein in New York (phone – 201-585-1115) would also be able to do such an examination for you as well.
My hair has been thinning for some time now, right in the temple areas, but especially on my right side. I do, however have some fine hair in these areas but it will not grow long, and also in these areas some spots are just simply bald, clean, bare skin.
Will hair every grow their again, and how can I get the short hair that is there to grow long again?
Hair transplants work well for this problem, but first a diagnosis must be in hand. Assuming that you do not have an autoimmune cause of the hair loss or some problem that will cause a hair transplant to fail, then the transplant option is a good one. Some examples of temple hair transplants can be seen in the NHI ‘other’ photo gallery, which contains before and after photos of crown, temple, sideburns, eyebrows, and female transplants.
Hello Doctor,
Thank you for your blog !
I have a few questions. I am 24 yr old male with no history of hair loss/thinning. But my dad started balding at 34. I have a full set of hair as of now but the chances seem high that I will eventually start losing/thinning. My brother is only 21 and he is already thinning. I was wondering if I should be proactive and start on propecia/minoxidil so as to delay/avoid the hair loss? What are the downsides to this (if any)? Will the fact that I take minoxidil or propecia even though I have full set of hair affect my hair in any negative way or initiate the process of hair loss ? Even if any of those medications grow further hair .. will I lose all that hair or even my original hair if i discontinue taking them? Please advise. Thanks!
There is an old American saying “If it ain’t broke, don’t fix it”. That fully applies to you. You are correct to be slightly concerned at this time, so the best way to find out what will happen to you is to obtain a good hair doctor’s examination and get yourself followed yearly to detect the very first signs of miniaturization. You should not start treating it now, but if or when the process begins, then Propecia will probably be the best approach to preventing or slowing the process down, that is, unless another better drug comes on the market by then. It is not infrequent for generations to be skipped, so please do not obsess over the balding prospect.
Hi I used propecia 3 years ago & it was very good for my hair growth, but for one year I couldnt find propecia and I lost my regrown hair. then I found propecia in my country and now I use it again, but it does not work for me. why?
Once you lose your hair, getting it back is difficult. In your case, it sounds like Propecia caught the hair loss early in the hair loss process. By the time you had resumed using Propecia, you’d already lost the benefits you gained by using is early in the hair loss process. You probably resumed where you would have been had you not started it at all so you now have a new baseline. In your case, you could not go back to where you were after the first course of Propecia. Transplantation sounds like your best option now, but a proper diagnosis needs to be made first.
Think about a car that rusts with time. If you keep it from rusting, it will stay rust free, but if you let it rust, then the rust is there and you just can’t take it away as if it never happened. In this metaphor, the rust is like your hair loss; you are the car. Now that the car is rusty, all you could do is to repaint it (or in the case of hair, transplant it to get it back). That is why I always tell people who I start on Propecia that they must never stop it, or they will experience what you experienced.
Too many men, after taking Propecia for a year, stop it thinking that it is not working, even though it stopped their hair loss. They come to see me a year later, crying over what looks like more hair loss than they had ever experienced, even dating back to the time they had started to take Propecia. It looks worse because they lose what benefit they got in a few months, then on top of it all, they continue on the march of progressive hair loss.
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