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    Oral Minoxidil has a rare cardiac risk on a very low dose of 0.25mg/day

    Aug 12, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    A recent report out of South Africa showed a healthy woman placed on 0.25mgs of oral minoxidil developed cardiac and other systemic swelling.  This situation could have been life threatening, but it was picked up early and the medication was stopped.  The problems went away. 

    Up until this point in time, I, like most of my colleagues believed that dosing oral minoxidil of 2.5 mgs/day or lower did not expose the risk of cardiac complications.  This is the first such reported case of what may be thousands of people, but this post is here to let you know if you are on oral minoxidil that this is a risk.

    Of significance, this patient had signs of a problem with swelling of the legs, hands and face and her doctor was quick to discontinue the drug with reversal of all side effects 

    finasteride, minoxidil and microneedling

    Aug 12, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    The effect of the second picture could be the results of longer, curly, coarse hair alone. Such results in 6 months are too quick as normal terminal hairs usually grow at a rate of 1/2 inch/month. Maybe we are seeing a combination with some results from your treatment and a good quality coarse wavy hair. I wouldn’t suggest that you shave your hair, but from such a picture, the results of the treatment would be evident.

    18 months on finasteride and microneedling (photo)

    Aug 12, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Nice result, but the ultimate question is what will happen when you stop the microneedling? If any readers know the answer to this question, please write to me

    Actors who have thinning hair don’t have it on camera

    Aug 12, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    One never knows what it is that you are seeing. Hair systems are commonly used and good make-up artists can add additional hair to almost any man’s head for the big screen. 

    5400 grafts to frontal balding (photo)

    Aug 11, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    If you only had frontal hair loss and used up 5400 grafts, that means that you would have used up 2/3rds of your entire usable donor supply. Did you know that if you progressed to more balding, you may not have enough donor hair to cover the rest of your head? In building a Personalized Master Plan, 5400 grafts doesn’t fit any frontal hair restoration strategy I know of. What it fits is either the ignorance of the surgeon or greed to make more money off of you.

    Oral minoxidil side effects?

    Aug 10, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Doses of 1.25 or 2.5mgs have to my knowledge, never seen the severe cardiac effects such as cardiac tamponade. It still is a blood pressure lowering drug but at these doses, lightheadedness and allergies may be the most prominent side effect

    I use a 1.5mm microneedle for my weekly microneedling

    Aug 10, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    I would suggest that you reduce the size of the needle to 1mm. If should be just as effective possibly producing less bleeding

    Will TRT make my thinning worse?

    Aug 10, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Will testosterone make my generalized thinning worse even if I take finsateride?

    If you have the genetics for balding which your generalized thinning suggests, testosterone supplements will accelerate the timeline to balding even if you take finasteride to block the DHT

    Unnatural hairline (photo)

    Aug 9, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    This picture shows a harsh looking hairline with only 5 single hair grafts in the frontal leading edge of the hairline (arrows point to them). Clearly, this hairline is easily detected as a poorly performed hair transplant.  It can be fixed by placing a transition zone of single hair grafts in front of the existing hairline (at least 300 of them) so that one can’t see the hairline but will see a transition zone from forehead to full hair.

    Article looks at Finasteride use over years

    Aug 8, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    https://www.oatext.com/Long-term-(10-year)-efficacy-of-finasteride-in-523-Japanese-men-with-androgenetic-alopecia.php

     

    Shock loss and finasteride

    Aug 8, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Everyone is shitting on this guy for not taking fin but then. Dr. William Rassman writes a lot about successful transplants with no finasteride. What are your thoughts

    Hair transplants can be done without finasteride; however, native miniaturized hairs often fall out (a condition called shock loss). The older a man is, the less the risk of shock loss. This condition can be predicted by analyzing the amount of miniaturization that is present.

    Finasteride and minoxidil taken for 9 months (photo)

    Aug 6, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    This young man had a Class 3 pattern with a persistent forelock. Note the hairline around the forelock. These forelocks, if they last past 35, generally hold for life.  He had a great results in just 9 months from finasteride and minoxidil alone.

    Comb-over No More (From WSJ today)

    Aug 5, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    https://www.wsj.com/articles/comb-over-no-more-why-mens-hair-transplants-are-flourishing-11659725418

    Microneedling and minoxidil for 3 months

    Aug 5, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Looks good. Hair grows at 1/2 inch per month so much of your native hair grew out to that length. If you have new hair growth which is suggestive in the fullness in the picture on the right, the new hairs will be much shorter than the native hairs at 3 months. Still, enough to increase the fullness

    Lichen Pilinoplaris

    Aug 5, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Hey, Dr. Rassman. Thank you for checking in. Unfortunately (or, perhaps, fortunately, in that I have an answer) I was diagnosed today with lichen planopilaris. It seems worst case in a way, but again, I’m relieved to have an answer. Starting injections soon. I’ve finally found a good dermatologist that was willing to take a biopsy and didn’t just prescribe finasteride at the first mention of “hair loss.” Thank you for perusing this subreddit and helping people out. If we’re here, we’re miserable, and it’s good to have someone here who will listen and give actual advice. All the best, and happy holidays to you and yours

    This is becoming more and more common in younger men and men of all ages. We used to think that this was a woman’s scalp disease and now we know better. You must get a good doctor when you treat hair loss, as this man struggled to get the proper diagnosis. If he was to be transplanted by some over-zealous hair transplant surgeon, it would have failed because the disease that took his hair away would have done the same thing to his hair transplants. 

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