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Propecia Beyond 5 Years – Hair Loss Information by Dr. William Rassman

Can you please tell me what the latest information is on Propecia beyond the 5 year mark ? There was a hypothesis that a plateau might be reached at the 5-6 year mark as hairs entered a new growth phase and the hair counts might improve. Is this the case?
Thank you

The formal Propecia study only goes out 5 years, and I can’t seem to find any official published data beyond that (even from Merck, the manufacturer). The suggestion from what I have seen in the 5 year study is that the number of hairs will probably drop off slowly, possibly more slowly than it would without the medication. It is also the experience of many that this is not just a ‘number of hairs’ game, but it is also one which reflects hair quality. The thickness of the hair shaft in those treated with Propecia gets better and will probably stay better while the drug is maintained. But your question is asking for the difference beyond 5 years, and I am afraid that a solid answer would only be speculation on my part.

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Herbal Combination for Hair Loss – Hair Loss Information by Dr. William Rassman

There is an alternative therapy to propecia. Try this: Strong Green Tea Extract, Soy Isoflavones, and Evening Primrose oil. I also, would like to challenge any doctor that believe that is quackery. This combination will work much better than Propecia and there are no sexual side effects. Don’t believe me try it and you will begin to feel your hair stems getting stronger and you will slowly start re-growing hair.

There are many herbal suggestions for alternative treatment for male pattern genetic balding. I have no experience with this, but clearly you have. I have stayed with traditional, known treatments for hair loss like Propecia and Minoxidil as they have predictive results that are scientifically well documented. I stay away from experimenting on my patients with unproven herbs or poorly defined drugs with benefits. I am also not aggressive when it comes to the unapproved FDA drugs for hair loss like Avodart. If the herbal approach works for you, then that it good for you. If it does not work, a person experimenting with these herbs run the risk of losing hair that may never come back. As hair loss is a progressive process, the pattern for hair loss in each man with the genetic predisposition for it, they may lose valuable time and valuable hair moving them further down the balding pattern scale.

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Thinning on Sides and Back of Head – Hair Loss Information – Balding Blog

i’ve been using propecia for about 3 yrs now & minoxodil. for the first 2 yrs my hair stopped thinning & stabilized, but just this yr & more specifically the last 4-6 months. but heres the thing, im thinning on the sides & back corners where your usually not supposed to go bald or lose hair. this started right around the time i started using minoxodil & something from hair club for men on the sides cause before that i wasnt, so i stopped doing that, do you have any suggestions, thx for your time

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You need to be evaluated by a good doctor that specializes in hair loss. Loss of hair from the sides and back is unusual in men and common in women. There are too many possibilities here to discuss and there is no substitute for a good doctor to evaluate you. You can contact a dermatologist that specializes in hair loss, or has an interest in this field. If I were to guess on your problem, I would have to make a list of possibilities and that may do more to confuse you than to help you.

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Generic Plan for Hair Loss – Hair Loss Information – Balding Blog

Could you send me a generic plan…I have been using propecia for two yrs.. might try avodart down the road but not until I hit the 5 yr mark. I would like to know what else I can do maximize .. keeping my hair… THANKS

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If you’ve followed the many questions and answers on this blog, you will see that there really is no ‘generic master’ plan. The doctor must create a full map of your scalp loss status, the degree of miniaturization of the hair at each point on your scalp showing the balding and thinning area so that the progression will be clearly defined. As you move from class of hair loss to another, you need to have a good doctor who UNDERSTANDS exactly where you are and where you are going. Then and only then, can you have a plan customized for you and modified as you get older and progress with the hair loss that is a certainty in the years to come.

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Hair Transplant Repair – Hair Loss Information by Dr. William Rassman

can you correct a hairline transplant already done? I have had a hair transplant done and had the hairline move down and now i don’t really like it and it does not cover the area i want it most. Can you help me?

Frontal hairlines that were transplanted in a manner that you do not like, usually can be fixed. I personally have many patients who have had old type of plugs, where I have repaired the hairline and now enjoy an undetectable, normal hairline. I have also moved hairlines up or down. We have published many articles in this area. Please see the following links for more info:

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How Young Will Balding Start? – Hair Loss Information – Balding Blog

What is the % of white men that eventually go completely bald, and partly the worry about the male baldness is my son’s best friend is almost completely bald with very thin follicles on top at age 27, how young does one start to experience MPB to have this stage of loss by age 27, he’s literally NW 6 1/2 if that’s on the Norwood scale

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The statistics are that about 45% of men will have some clinical balding by the time they are 45. I have seen the process start at 16 years old and some reports have placed it as early as 12 years old. Most of the really bald men see some sign of balding by the time they are 21 (clearly evident on high magnification views with miniaturized hairs with thin shafts). The real question still unanswered is can this all be stopped when the advanced balding young men start Propecia early enough. At the age of 27, the pattern in the man you are talking about will probably be a Norwood Class 7 balding pattern. Class 7 on the Norwood scale.

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Hair Loss InformationBody Hair Transplants – Hair Loss Information – Balding Blog

Can you use body hair (like from my back to graft into my head??) All I have left is straight black hair. The brown reddish wavey hair is elsewhere on my body. What about if I want my once wavy hair back?

Does one consider using grafts from the other body areas such as pubic area hair?? As a former Physiology major and Chemist, this in theory seems possible considering the technology being used at the moment yes? Thanks — I’ve many questions, appreciate your bearing with me.

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Hair can be transplanted from most parts of the body to other parts of the body. Some of the best work in this area was done by a Dr. Kim from Korea, who transplanted head hair to his leg as part of his PhD project where he tried to get more than one hair from one hair. He succeeded to transplant these hairs to his leg but failed to get more than an one for one yield.

Today, there is much human experimentation in moving hair from legs, abdomen, back, chest and beard to the scalp. It appears to work, but the question is one of value. Is the hair valuable enough to achieve the goals of the patient. How long will it last? How long will it take to grow? What are the growth cycles of these hairs when moved to the scalp or eyebrows? There are many unanswered questions and some answers are appearing to show that these types of transplants work.

All of these body hair transplants are done with the FUE technique. There is not a mystery as to how to do this, but the problems I see are more in the many unknowns for routine clinical use.

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Hair Loss InformationAvodart – An Update – Hair Loss Information – Balding Blog

I would like to know what you found out in regards to Avodart at the hairloss convention. Please get back to me when you get a chance.

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There is a strong suggestion that Avodart will work better than Propecia from what I heard at the meeting. There are, however, many questions not answered such as:

  1. What is the appropriate dose considering that there is a half life of 6 weeks for the medication in your body? Nobody seems to have a good answer to this question.
  2. Some think that Avodart may stay in the tissues for over 6 months, so what effect could this have on your system?
  3. What is the long term safety of Avodart taken by young man? All of the documented studies are on men over 50 (old-‘farts’ like me)

These are the reasons that most doctors do not want to prescribe Avodart ‘off label’ (not FDA approved for hair loss treatment). From a medical-legal point of view, as well as a licensing issue, I can not really prescribe it. Also, my expertise is in surgery, not medications (although I try to use medications I command and know forward and backward). There are some dermatologists, internists, urologists and family doctors that would prescribe this medication, and if you want to go that route, you should try to find one of them to prescribe it for you. With an off-label use, the issues of safety are risks that you must take.

The preliminary studies that were presented indicate that it works to grow hair when Propecia fails to do so. Still, Propecia should be the first line for the medical treatment of hair loss. What does concern many doctors, however, is that there may be a Vioxx type of hidden side effect in the young man that is not known. Will it produce cancers or heart disease or some other problem that is not yet identified? This is the reason we look to the FDA, to define safety and effectiveness for us. So far, the safety is not clear and the effectiveness appears to be coming into view through unofficial channels.

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Lost Leg Hair – Hair Loss Information – Balding Blog

i have lost the hair on the front of my lower leg below my knee. the rest of my legs have hair except this part. can you tell me why this is and ways to get the hair to grow there again. i am a 35 year old male. thank you.

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This is unusual. You should start by checking your Testosterone and DHT levels. Body hair is a ‘benefit’ of DHT. That includes leg hair (and the appropriate target genes), nose and ear hair, and body hair. Many men in our modern society do not look forward to the increase in these hairs!

Checking with a good dermatologist would be a start for leg hair loss. Is this a pattern in your family?

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Hair Loss InformationMaximum Number of Transplanted Hairs – Hair Loss Information – Balding Blog

HI DOC, what is the average number grafts a person has to transplant from the donor area???

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This is a difficult question, because it depends upon donor denity and donor laxity (assuming the strip method of harvesting). On average, I would suspect that the total number of transplantable hairs is between 15,000 – 20,000 assuming an average density and average laxity. Those with high density and laxity may push these numbers to double (30,000-45,000 hairs). I gave this answer in hairs not grafts, so based upon an average of two hairs per follicular unit, that number may be half in grafts.

If the FUE technique is perfected, then this number might change, but without more clinical experience, I could not answer this part of the question as the technique changes.