Using Styling Products with Toppik

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

I’m a 25 years old male, been losing some hair (in the front part of my scalp) over the last few years, but started taking propecia about 4 months ago and it seems to be working really well! Was wondering if using Rogaine as well would improve or accelerate the results…what would you recommend?

Also Toppik was just launched here in Mexico and I think I’ll give it a try to help the spots with thinning hair look thicker. However I’ve been trying to find information on whether I can use styling gel or wax after applying Toppik and I don’t seem to find anything. Do you think that would work?
Thanks a lot!

I generally do not recommend both Propecia and minoxidil at the same time in a young man. Start off with Propecia and wait 8 months or so before giving up. If it does the job, you have no need to use minoxidil. I don’t recommend using both at the same time, because then if you do see results you will not know which of the two gave you the results. Its just a matter of cost then, as you will end up staying on both just to keep what you have regrown. If you know which one works by trying them separately, you’ll save money in the end.

Topical scalp coverings like Toppik are great to accomplish the appearance of fullness behind hair that already exisits. Use any styling aid that works for you.

Anything New with Alopecia?

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

what’s new in the world of alopecia? I am a 34 year old woman and have had alopecia universalis (alost 100% hair loss) for 10 years. Should I get laser treatments? What about DPCP – is it even safe? What immune system enhancements could I do to boost hair regrowth? Or should I just be content to live without hair for the rest of my life?

Why does this happen? Is anyone doing research?

The last question is the easiest, as it is purely a genetic process now being mapped out by the science of genetics. When the research advances with a solution to the genetic defect, then you and many other people (even those without the complete loss of hair) may benefit.

For those of you interested in the subject of alopecia universalis, see: AlopeciaAreata.com or BaldingBlog – Alopecia Universalis

There is nothing now on the horizon though, sorry.

A Chair to Grow Hair, Follow-Up

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

Hello Dr Rassman,
I read your blog on the “Hair Chair” and you seem to focus on electro-magnetic therapy for bone growth. From my understanding, this is electro-static therapy. Low intensity pulsating static energy to be exact. I called the company that makes the chair www.current-technology.com and they referenced me to an oncology study that’s posted on their website. There was a lot of medical jargon but the general gist is that 12 of 13 women undergoing chemotherapy retained their hair…quite impressive. Also, their chair is medically approved in Europe for hair regrowth. Current Technology referred me to a Dr Morris Westfried in NY who referenced me to an article in DermatologyTimes and pointed me to a salon in NY with a chair:

DermatologyTimes

I’m convinced that this technology holds some merit and promise. I’ll let you know the results if your interested.

I’m definately interested, so please do give me a follow-up. I think that I learn as much from my audience as I teach on this site. Thanks for the information.

Is Hair Transplantation a Slippery Slope?

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

hi there . my question is why every time i have had transplant work done it has caused the hair around the transplanted hair to permantly go to sleep or fall out. i have even met doctors over the years who stopped doing tranplants for this reason.it seems like a slippery slope getting transplants done. thanks

I do not understand what your situation is, so before I dive in, let me make some general observations and pass on particular messages that I feel are relevant.

  1. I don’t like the idea that you used the term ‘every time I had transplant work’. Why is there so many times? That is not the modern approach used today and something that I would not want to hitch my wagon to. Was your work started many years ago? How many procedures did you have?
  2. Hair loss in previously transplanted hair is very, very unusual. Generally its incidence is 1 in 500 people who may temporarily lose previously transplanted hair. For men, hair loss in non-transplanted hair often does not grow back if it is well along in its miniaturization process. In women, it usually grows back when it does happen and it is present in less than 10% of women transplanted.

What you are describing in non-transplanted hair is a well known phenomenon called shock loss after a transplant. In men, it only happens once, usually after the first transplant on young men not on the drug Propecia. This can be minimized by taking Propecia and it does not happen to all patients who undergo hair transplants, particularly men over 40. Hair loss may also have occurred even without a hair transplant if there is an accelerated phase of hair loss, or the hair transplant may have just accelerated it (again, more common in young men not on Propecia). It is very troubling to me that the doctors you met have stopped doing transplants for this reason, because it signifies that they do not know the intricacies and the physiology of the hair transplantation process. Or there is possibly other factors that you’re not mentioning.

I Want To Buy Your Products

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

I have been to a couple places and cannot probably do a hair transplant because my donor area has receded. I tried minoxidil (5mg.) and prostar but quit. Give it to me straight, your product will regrow hair on neckline and bangs beside crown, and its money back gaurentee. I just hit 50 what are my chances and my brothers are worse than I am.

I get emails like this every now and then, but I just wanted to point out that I do not sell any non-FDA-approved products for treating hair loss and what I do sell (Propecia) I sell at cost only to my patients as a courtesy for them). I am a physician taking great interest in my patients and in this field of hair transplantation. I make my living moving hair around from one part of the head (donor area) to other parts of the head (parts that are bald with the state of the art hair transplants that I pioneered) and I do it artistically. If you want frontal hair, filling in a bald area, or just a touch up, I might be able to help. See my website at: newhair.com

Warfarin and Hair Loss

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

will warfarin cause my hair to come out ?

Warfarin is one of many drugs that may cause hair loss. The important point is that you are most likely on warfarin for a very serious medical condition and you should not stop taking warfarin because of a possible hair loss. You should first seek out other causes of hair loss. Follow up with your doctor or follow up with a hair transplant surgeon to map your scalp hair for miniaturization and pattern of hair loss.

Desperate for a Transplant But Low on Money

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

I have been loosing my hair for about 8 years now but did nothing due to lack of finance. I went to a hair transplant facility and they said that they could help me for about $8000. With that in mind i throw in the towel because i could not afford it. Recently i had a free cosultation at another clinic in Manhattan and i felt they were more honest with me for less. The team said that i could get about 1,000 grafts but i also had a limited supply of donors. He suggested that i tried monoxydil at this time before considering the grafts. My hair is still thinning in the top of my head and i’m still low on funds but desperately need to do something fast. He said the 5% monoxydil would be better than the 2%. Please reply with helpful advice. THANK YOU

Be wary of doctors who are willing to transplant hair, matching their recommendations to your budget. I do not like your desperation, because you are a set-up for being taken advantage of. Hair transplantation in women, such as yourself, rarely works as well as you’d hope and putting money into such a procedure for a female without good cause and a solid diagnosis is just plain foolish. Your first stop should be your primary care doctor or your dermatologist to possibly find a medical cause for your hair thinning.

Regenix, Avodart, and Minoxidil

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

i’m 22 and have been thinning in the crown/back/top for about 3 years. i’ve used minox 5 % and propecia for a couple of years, switched to dutasteride 10 months ago…with no results.

i am going to continue the avodart…but i’ve recently started a regimen from Regenix out of LA. i was wondering if using minox 5 % once a day is enough to avoid a major shed? regenix took some hair samples and ‘formulated’ a treatment just for me. do you know if Regenix is worth my time and money? also, could it be that the avodart takes a while to start showing results? any advice is much appreciated.
thanks.

I am assuming that you are a male, not female. With that said, if you have genetic hair loss and it is progressing rapidly, then it sounds like you have real problems. I may sound like a broken record here, but you need your scalp mapped out for miniaturization and then get a working diagnosis.

Avodart, in theory, is as good or more potent than Propecia. Minoxidil must be used twice daily to get any reasonable effect. I do not know about the special formulations of Regenix you asked about. To me, it sounds like you are playing with fire with a blind-fold on. Please get a working diagnosis first so you will know what is really happening.

Happy 34 Year Old Taking Propecia (with Photos)

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

I wanted to share these photos with the blog readers. This 34 year old man came to my office in late 2003. He has short hair and when he let his hair grow out, it was puny looking, without bulk or body (see first photo). He went on Propecia and one year later, his hair grew out thick and full (early 2005 – see 2nd photo). I had asked him to cut his hair short when he came in again for a better assessment of his balding pattern (early 2006 – see 3rd photo). His miniaturization partly reversed with the Propecia, and he is one happy guy!

I apologize for the quality of the 1st photo. It was taken with a Polaroid camera, and the photo came out slightly blurred. However, the photo does still show the sparseness of his hair, which is the only point I was trying to make by showing it.




Removing Transplanted Hair for Corrective Procedure

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

What are the options in dealing with transplanted hair that you no longer want-is there any procedure that would remove the transplants but still athestically feasible?

The second related question is what is the effectiveness of corrective procedures that thin down some transplanted areas, moving the hair to other parts of the scalp that now need it.

As you can guess, I am dealing with a transplanted “head” of hair that is actually mostly comb-over because I have lost so much hair behind my orignal transplant. I can fake it at the present time but I am getting tired of being the world’s biggest user of hairspray and worrying about the wind

I have written extensively on the subject of repair and have many patient examples of repairs on our website. Also see Dean’s Story for a good example of things that can be done and how it was done on this particular patient. Removing grafts is usually the best thing to do if the grafts are in the front.

Heavy rows of grafts may be best removed just like a ‘brow lift’ surgery and then 2-3 months later, you can transplant the area and create a completely normal frontal hairline like the patient example above. I have also found the FUE / FOX Procedure to be very effective in thinning out transplanted hair and moving them to other locations to produce better coverage. However, not every patient can be a candidate for this procedure. I would need to see you first (or you can send photos, which will be treated confidentially). For FOX redistribution, I need to test each patient to be sure that this approach will work.

Smoking Cannabis After Hair Transplant

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

First off let me say I find your answers to be very informative.

My first question is: Will cannibus affect my hair transplant I had on Feb 08/06? I don’t smoke cigarettes but cannibus helps me deal with my occasional back pain.

Secondly when can I resume my normal jogging of a couple miles in the morning? As well as doing chin ups and push ups? I have been told exercise of these sorts will only expand the the donor scar.

Thank you and i appreciate your advice.

Cannabis Medically speaking, smoking cigarettes (even the cannabis / marijuana kind) promotes poor wound healing by decreasing blood circulation. It may have an impact on your hair transplant, however, I do not know how much of an impact it will have.

Exercises such as sit-ups that may have a potential to stretch the back of your scalp will also have an impact on your donor scar. Running 1 week after surgery is not a problem. Although you can probably resume most of your regular activity after one or two weeks post surgery, the scar takes about 6 months to a year to completely set and in the first 3-6 weeks, the wound structural elements that make for good solid healing change and build. I generally tell my patients not to do the type of exercises that stress the neck muscles like body press or sit-ups for up to 6 weeks. A few of my patients even ran marathons a few weeks after surgery without any negative effects.

Taking Propecia with Saw Palmetto

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

Is it safe to take propecia and saw palmetto together, and if so how much saw palmetto? Can either of these effect facial hair growth or acne?

BerkeleyWellness.com states: “Because dietary supplements are essentially unregulated in the U.S., you can’t be sure what you’re getting when you buy a saw palmetto product (or any supplements). There are many preparations on the market (with different amounts of fatty acids, for instance, and some in combination with other ingredients of questionable benefit). They may not have the same effects.”

For the same reason, there is no way of knowing how much saw palmetto is actually in a tablet even when a specific dose is written on the bottle. Furthermore the exact mechanism of how and why saw palmetto works is not well understood. It may have an effect on DHT like finasteride, but nobody knows for sure as the science has not defined the actions. It has been sold in natural food stores for the treatment of benign prostatic hypertrophy (BPH), treating men who can not urinate well. One may argue that it may also help with male pattern baldness (MPB), but there are no medical studies to support either claim.

There is no way to tell you if it is safe to use saw palmetto with finasteride (Propecia) or if it will affect facial hair growth or acne. If saw palmetto is really a blocker for DHT as some feel is the case, then you could be increasing the dose of DHT blocking to the point of decreasing your libido (a bad trade). I do not recommend saw palmetto for MPB for the aforementioned reason.

ScalpMed Causing Shedding?

/by William Rassman, M.D./14 /, ,

I am a 38 year old mail in good health and good physical condition, however like most men my hair has begun to thin. I saw the infomercial for “ScalpMed” and it looked promising, so I thought…what the heck, i’ll give it a try. Now, my question is this, it appears that I shed more hairs in the morning when I wash my hair (using a a ph balanced DHT reducing shampoo) after using this product. Can minoxidil cause one to shed more hair since I know this product contains this? If I don’t use scalpmed at night, the next morning when I wash my hair I have fewer hairs in the tub– about 14 without Scalpmed, and 20-40 with Scalpmed).

I also would like to make a comment to the medical industry. If one wants to try and find a cure for baldness, maybe they should research the italians or greek bloodline and see why the majority of those men have their hair way into their 40’s, 50’s, if not later years. Maybe they should research those genetics???

Thanks for your time and insight.

It is normal for one to lose 100 to 150 hairs a day. It is also normal for one to be concerned about hair loss and be proactive as you to try with products such as “ScalpMed”. Unfortunately there is no way to tell if these products actually work. That is why most are not sold as medications or FDA approved products. If ScalpMed is causing you to lose hair, I can not comment on it for there is no real information on the issues of safety or effectiveness.

Minoxidil has been studied as a topical treatment and shows good promise of hair growth in some individuals. To date, there are only two medically proven ways to treat male pattern baldness where it is not really ‘hit or miss’.

  1. Hair transplant, which works 99.9% of the time
  2. Propecia drug regimen (which may or may not work for you but it met strict FDA requirements) is more reliable, the earlier the hair loss is seen. In men under 30 with thinning and not recession, the reversal in my experience is significant. Reversal of a receding hairline, however, is highly unusual (even in the young man). The key to this drug is to start on it early if you have genetic balding and get to the hair while it is miniaturizing and before it falls out.

To more specifically answer your question, counting 14 vs 20 hairs lost per day seems insignificant (at least from a medical perspective). As stated, we normally lose on the average 100 to 150 hairs a day. ScalpMed may be contributing to the extra 6 hairs that you are losing, but there is no way to really tell.

Finally, the hair loss gene spans all races and cultures. The study of Italians and Greeks has already been done and there it still almost 50% of men in these ethnic patterns that have hair loss.

My Homeopathic Doctor Treats Me For Hair Loss

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

My homeopathic doctor is treating me for hair loss. Iv been losing my eyebrows lately…probably due to the medicines. Someone said that this can be due to steroids. Is there some test i can perform to find if there is any steroid content in my body/blood?

You need to see a medical doctor who can draw your blood and send it to a laboratory to measure the various steroids in your system and look for exogenous steroid (just like they do for athletes). A homeopathic doctor is not licensed to prescribe medication or conduct medical tests in the United States and if he/she is giving your steroids, there would be some serious licensing issues for his/her license to practice. There is no way for me to know what is in the “medicine” you are taking or what is the true nature of your hair loss but your doctor can have what you are taking analyzed.

Propecia and Frontal Hair Loss

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

I heard from one of the hair transplant surgeons that I spoke with that Propecia doesn’t necessarily prevent the hair loss in the front of the head, but often helps in the back.

I’ve been taking Propecia for almost two years now, and have noticed that the hair loss in the back of my head has stopped, and perhaps sligtly improved. My hair has been gradually falling out in the front — I’d love to hear your thoughts about this. Is it true about the front vs. back loss?

In general, Propecia is more effective in the vertex (crown) area than the frontal area. I have seen it reverse hair loss in the front in a small percentage of young men (under 35) so I know that it does impact both regrowth (less common) and prevention (more common), but the results are statistically far more impressive in the top and back of the head. I recommend that you continue to be on Propecia.