Follicare and Avacor

/by William Rassman, M.D./2 /

Hello Dr. Rassman. I’m 31. Family history of hairloss on the male side. What is your opinion or take on the hair loss products: “Follicare” and “Avacor”. I was thinking about trying them. Tried Rogaine in the past, didn’t like the itchy scalp as a result. Also tried Propecia, but got tired of waiting and was worried about the side effects. I would appreciate your opinion.

Your fortune cookie should read: “Patience is a virtue”. Propecia is the only FDA approved drug that grows hair. You need to wait 6 months to 1 year to see its effects. If you tried Propecia and experienced no side effects, stop worrying. If you are concerned about hair loss, you should be evaluated by a qualified doctor.

Avacor has minoxidil in it as your active ingredient, which probably grows the hair that is reported. You can buy it for much less money under the generic name minoxidil.

As for Follicare, it supplies a topical spray, shampoo, and minoxidil. Seems like you’re paying lots of money for the pretty packaging. At least they sound honest about what is included in their products, and provide a buyer beware page on their site.

Generic Propecia?

/by William Rassman, M.D./1 /

I ordered generic propecia from a website that seemed to be the cheapest. They claim to be FDA approved, so i was wondering if infact there generic propecia is the same as regular propecia.

I have been taking generic propecia for about 2 weeks now. Since ive been taking it I have been getting alot of acne and i was wondering if propecia may be causing it

It is a buyer beware market. I am not aware of a generic Propecia available in the United States, since it is still under patent protection. Some other countries who do not respect patent laws may attempt to copy a drug formula, but I do not believe the FDA would approve of such practice. There is no way for me or anyone to tell if your side effect is a direct result of your generic drug. Finally, you need a qualified doctor to prescribe Propecia, so I would certainly be nervous about ordering prescription drugs like this online from a website you are not familiar with.

Trichup Oil

/by William Rassman, M.D./52 /

Dear Sir,
I came to know about this website thru one of the search engine. I am 52. I was getting bald because of stressful life. One of my friend in London recommended me one very interesting product. The name of the product is Trichup Oil. It is a special kind of hair oil I used for a month and I found my hair loss stopped. In the second month I saw new hair growth. It was really surpriced for me but now I am regularly using this oil and my hair is very healthy.

Thanks for including my letter on your website. Best wishes.

I don’t know much about the chemical in this product. It does not have the science I like to see, so I can not recommend it. If it works for you, then that sounds good. Those interested can look at: VasuPharma.com

Avodart and Female Genetic Hair Loss

/by William Rassman, M.D./0 /,

One of my friend’s doctors has prescribed Avodart for her thinning hair. Is this effective? If so, why do I not hear more about it? Can I get your to prescribe it as I am in Los Angeles?

See Effective treatment of female androgenic alopecia with dutasteride

One case does not say much about this process, but it may provide a little hope. There is no significant documentation for breast, ovary, or uterine cancer predispositions with DHT blockers. That is worrisome without a good controlled study in hand. We know that one side effect of this medication in men is breast enlargement (one in about 300 men), so the question of safety is paramount in the decision to provide this drug to women. Even for men, there are no long term studies to suggest that this drug is safe for the younger men. Any woman taking this medication while pregnant runs a high risk of producing a hermaphrodite baby (without a normal penis or vagina). This tells you a great deal about what we do not know. I will not prescribe this medication for women, and I have been very forthright against using it without adequate safety issues addressed in the proper way. I worry that articles like this, which show a single example that could be a chance occurrence having little to do with this medication, can be ascribed to the drug. Please don’t rush to your doctor or the internet and use this as a panacea for your hair loss problem, for it could just open a Pandora’s Box. I would be happy, on the other hand, to have you visit me for a diagnosis and an opinion.

Skin Different Color Under Widow’s Peak?

/by William Rassman, M.D./1 /

Hey when i get a haircut my barber shaves my widows peak off but for some reason it doesnt show my skin it shows like this blue stuff. Do you know how i can solve this problem. Thanks alot.

If you are talking about the ‘blue stuff’ meaning the freshly growing look of a shaved area (stubble), then you could use make-up to cover it. Bad turn of the cards — there are many out there that would love to have a natural widow’s peak. You, on the other hand, don’t like it. Seems to apply to many things in life, right?

Hair Loss Lotions and Creams

/by William Rassman, M.D./2 /,

dear Dr rassman
iam 26 years old and have been losing hair steadily since last few years. No one in my family is bald for that matter and now i guess my loss is pretty prominent. my question is do these hair loss creams really help.If so which one can be beneficial
thanks

There are only two medications that are known to work and to be safe for the treatment of hair loss. Propecia (finasteride) is a wonderful medication (oral pill once per day) for men only. Younger men or those with early hair loss in the back of the head often get reversal and hair regrowth. In most men, it prevents or slows the hair loss process. Rogaine (minoxidil) is the second medication and works in men and women, although it is not predictable. It is a topical medication and must be applied twice daily to get any effect.

There are hundreds of products sold over the counter and over the internet that make magnificent claims, but few if any of those claims can be backed up with any good science. Claims of FDA clearance are rampantly fraudulent. There are so many people looking for a magic cure and so many others looking to take advantage of them. Buyer beware!

10 Months Since Chemo And Hair Has Still Not Fully Regrown

/by William Rassman, M.D./0 /,

My son who is 21 completed a 4 cycle chemo treatment in May 05. Today his hair is still very thin, fine and spots of balding. I have left a message today with his doctor for some advise when I saw your web page. Any suggestions? I know hair growth takes a while but it is going on 10 months now. Thanks!

Hair loss during and after chemotherapy is one of the most distressing side effects. Hair loss occurs because chemotherapy targets all living cells in the body including hair follicle cells. Simply put, chemotherapy is poison to all living cells. It is a medical balancing game where the cancer cells are killed before the chemotherapy kills you.

Hair follicle cells have three phases of growth:

  1. Growth phase (Anagen phase) which lasts anywhere from 2 to 6 years. This is the phase where your hair is actively growing at approximately 10cm per year. 85% of hair is at this phase at any given time.
  2. Transitional phase (Catagen phase) which lasts about 2 weeks. This is the phase where the hair follicle shrinks and prepares to enter the resting phase.
  3. Resting phase (Telogen phase) which lasts about 1- 2 months. This is the phase where hair does not grow but stays attached to the follicle. Some hairs are shed at this phase, but at the end the hair follicle re-enters the growth phase to start the cycle over again. 10-15% of hairs are at this phase at any given time.

During chemotherapy, hair in the growth phase is most affected due to the active nature of the hair follicle. Ideally, hair lost during chemotherapy should start to grow after 3 to 6 months. Unfortunately, new hair may grow thinner, slower, or with different texture or color.

Your son’s hair growth seems to be returing, but at a much slower rate than you have anticipated. This may be due to the 4 cycles of chemotherapy. This may also be due to the fact that your son’s body is recovering at a different rate than expected. It may just be a normal recovery pace for your son. Ultimately, if your son is healthy and is in remission, that is the most important priority. Neverthess, hair loss is certainly the most visible and distressing side effect of chemotherapy and a stigmata of cancer. There are a number of support groups and wigs available to chemotherapy patients, which are sometimes even covered by insurance companies. Finally, topical creams or Propecia would not be of benefit for hair loss from chemotherapy.

By Dr. Jae Pak and Dr. William Rassman

[Note: This blog entry has been answered by Dr. Jae Pak, who has been working with Dr. Rassman for the past 9 years developing new surgical instruments and hair transplant procedures.]

Propecia and Facial Hair

/by William Rassman, M.D./0 /

can propecia effect facial hair growth? Is it all right to take a detoxifier and vitamins while taking propecia?

Propecia has not been linked with facial hair growth although in theory, as DHT is one of the causes for bringing on facial hair, there may be a link.

By Dr. Jae Pak

Can I Eliminate The Greasy Feel After Rogaine Use?

/by William Rassman, M.D./0 /

I have been using Rogaine unsuccessfully for a number of years. One problem I have with it is that I only apply it after taking a shower and never do a second daily application. The reason for this is that unless I dry it with a hair dryer the Rogaine always makes my scalp look greasy.

Is the hair dryer detrimental to the Rogaine working? What can I do to eliminate the greasiness?

To get real value from it, you must use it twice daily. Change to Rogaine for Women, as it has an alcohol base which is not oily.

Taking 1.25mg of Finasteride Daily

/by William Rassman, M.D./0 /

Dr. Rassman,

I have been taking finasteride for 1 month. I have quartered proscar tablets. Given that the doses are therefore 1.25 mg of finasteride each I have been taking the pills for fours days straight and then taking one day off. This way I receive 5 mg in my body over five days just like with propecia. Can this skipping a dose have an effect of the drug’s effectiveness? Also, I plan on switching to the regular 1 mg dose of propecia every day once my 30 tablet proscar supply finishes (so roughly five months). I assumed the transition will be smoother with my current dose technique then if I was taking 1.25 every day and then switched to 1 mg per day. My main reason for skipping the 5th 1.25 mg dose is to reduce the chances of side effects. After two weeks of use I experienced some tenderness in one of my breasts but thankfully that passed after one week and I feel perfectly fine now. My worry is that an increased amount of finasteride in my body would increase the chances of such effects returning. Any thoughts you can give in regards to my concerns would be appreciated.

Thank you.

You need to have it on board every day. Don’t worry about side effects if you do not experience any now at the dose you are taking. The breast pain is a rare side effect (1 in 300 patients), so if it has passed, just count your blessings.

Norwood Class 4 at Age 20

/by William Rassman, M.D./0 /,

Hello,
Well i am a 20 yr old guy. I started losing my hair since i was 16. By now i am a Class 4 patient with receded hairline from the front and at the top of the head. Many people have told me that hair transplant is not safe for a 20 yr old male. Is it true? ANd does it have any side effects. Kindly let me know on that.
Regards

At the young age of 20, you are experiencing accelerated hair loss. Your final pattern may be reflected in your family, so probe the entire history of hair loss amongst the men from both your mother’s and father’s sides. Having a hair transplant at this early age may lead to further hair loss, called shock loss, from the trauma of surgery itself. Thus, the net benefit of hair transplantion may outweight the hair loss experienced from shock loss and most (not all) 20 year olds are asked to wait for more time to pass. We can not determine the true pattern of your hair loss until you’re later in age. Hopefully, you have been using Propecia since the beginning of the balding process and this finding reflects a failure of the drug. If not, it is prudent to go on Propecia for now and wait for a response (in about a year). The drug can stabilize or reverse the hair loss in someone of your age. If you bond with a doctor and have been on the Propecia for a year or so, then you can discuss a hair transplant. Going forward along the surgery route requires that you develop a Master Plan for your future hair loss management taking your worst case scenario and balancing it with the worst case ‘donor’ hair availability (that is what is meant as a Master Plan for your hair loss).

Accutane Caused My Hair Loss — Will a Transplant Fix This?

/by William Rassman, M.D./1 /,

First, let me tell you how wonderful and informational your website is. Never have I seen such an informative site that so clearly tells a customer what they might be getting themselves into if they undergo such a surgery. You should be commended!

Here is my situation…

When I was 22 years old (I’m 31 now), I took the Acne drug Accutane to clear up a moderate problem with Acne. My little brother took it and had no permanent side effects, so I figured it was safe enough. One of the rare side effects listed on the container of the drug is hair loss. Well, as you can imagine, I experienced this side effect. Within 3 weeks of taking the drug, the hair on front part of my head, the “juvenile” hairline, started to rapidly fallout to the point where it was clogging the shower everday. I didn’t realize how bad it was and kept taking the drug for a couple more weeks. After it became apparent that the hair was falling out and not growing back, I stopped taking the drug. The hairloss stopped within a couple of days of stopping the medication. I went to several dermatologists complaining of this because the hair never grew back! They all told me I was crazy and that I had plenty of hair and that they saw nothing wrong. Basically, they were defending their drug!

So to make a long story short, it never grew back but I still have plenty of hair left and have not lost any more hair since. So I do not have the typical male pattern baldness (at least not yet) but would like to fix the minor loss and restore it back to the way it was. I am concerned about the success of the procedure due to the fact that the Accutane changed my skin such that occassionally, the skin in the area where I experienced the Telogen Effluviam is dry. I am in Miami Beach now, so the humidity keeps it pretty healthy, but I am hoping that if I go through this procedure that there is not something else that might cause the newly transplanted hair to not grow there. For example, what if the Accutane changed the skin such that the blood flow is lessened there and hence, the transplanted hair would experience the same event?

I see this as the only risk for me right now and would like your comment on it. If I come in for an evaluation and it is determined that this should not be a problem, I will do the procedure without looking back.

Please advise.

Accutane may have had the side effect you describe. It is difficult to say that it only caused your frontal hair loss, as I would have expected a more diffuse hair loss pattern. It may have been just coincidence, but either way you should be evaluated by a good hair transplant surgeon to map out your hair loss pattern for miniaturization and then develop a Master Plan to ascertain what and when you can address this surgically with a hair transplant. At 22, the mapping I am talking about is critical, for if you do not know what you might look like when you are 30, 40, and 50, then starting before that evidence is in may not be in your best interest. Generally, I can see the pattern emerging on most men by the time that they are 25 with good mapping performed.

By Dr. Jae Pak

[Note: This blog entry has been answered by Dr. Jae Pak, who has been working with Dr. Rassman for the past 9 years developing new surgical instruments and hair transplant procedures.]

Cloning Hair in the Future

/by William Rassman, M.D./1 /

hey doc, thanks for answering my previous question.
Now I gotta question about hair cloning. Lets say that this becomes possible in the next 10 years or so. Don’t you think that due to the ethical issues it will raise, this procedure might be introduced as a cosmetic procedure first before it is used as a body part/organ replacement option? Or maybe, 10 years from now, due to the desentisizing of society by mass media and the acceptance of change, this advancement of mankind may be welcomed with open arms.

The FDA will take a very long time to approved any cloning issues. Add up to 5-10 years after the breakthroughs are in hand. My five year estimate is based on the drug cures that are expedited through the FDA when human lives may end before the ‘cures’ are processed, not something as unimportant as hair cloning. I say unimportant in terms of a comparison for saving or extending lives, or reducing pain and suffering. This is a count backward assessment, for one must now add a solid set of breakthrough to the calculation. At this time I have seen no such breakthroughs introduced into this industry.

My Hair Started to Regrow at Age 80

/by William Rassman, M.D./1 /

i just turn 80 years old and started to grow new hair. please let me know why? thank you

Either God or medications, I suspect. Count your blessings! Most people at 80 lose their hair just by getting to that age. My grandfather had a full head of hair at age 102. How much hair did you grow, how obvious is it, and where is it growing?