This Blog Is Biased And Distasteful!

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

Do you think you might be biased because you are a Hair Transplant Doctor? Anybody interested in HM knows you are overplaying health risks. as everyone knows this is a different process altogether than most “experimental drugs” because it is not a drug. It is borderline tissue engineering. it is distasteful to lie to people about HM to sell transplants, please stop.

Dolly the cloned sheepNote: This question / statement was actually posted as a comment to the recent Intercytex and Hair Cloning post, but I’m replying to it here. Also, I believe that the above mentioned “HM” means “hair multiplication”.

I am always open to new ideas and new criticisms. I am also aware some may consider my answers to be biased. However, the posts on this site are my opinions (or that of my M.D. editors). As clearly stated on the homepage, the goal of BaldingBlog is to educate — not to sell hair transplants.

If you have been following this site, more often than not I have recommended a medical approach to hair loss, such as finasteride. In fact, I do not recall a post where I have recommended a hair transplant directly. Twice before, I have even been accused of working for or being paid by Merck (the company that makes Propecia). That simply is untrue. I do not get paid when a patient takes finasteride (Propecia), nor do I own stock in Merck. I recommend finasteride (Propecia), because it is the only medically proven pill for the treatment of hair loss approved by the FDA.

Hair multiplication or cloning is an experimental process. You may want to participate in it, but it is my medical opinion that it may not be safe and it is clearly not effective today (nor will it become a solution in the short term). That is the essence of the BaldingBlog — medical opinion for hair loss from a medical doctor’s point of view.

As you didn’t provide a legitimate email address for yourself, I am inviting you to write once again with the hope that this time you will include a list of your qualifications for your medical insight, aside from perhaps reading company press releases and marketing jargon. I would be happy to discuss this with you further, as long as you can promise to keep the conversation civil and any insults to yourself.

(Photo source of Dolly the cloned sheep: BBC)

I Am Convinced A New Diet Will Regrow My Hair

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

Trying to research (and in the process, bypass all the websites advertising products claiming to be the “answer” for hair loss) a solution for my thinning spot. There has to be a biological reason this happens and, thus, a biochemical solution. In other words, I’m seeking a connection between foods I eat and regrowing the hair – a natural way that involves my diet rather than expensive pills or surgery. Are you aware of any research in this regard? Where can I find information about their findings?
Thank you!

There are many causes for hair loss and it is well understood. To date, the only “biochemical solution” they have found is a drug called finasteride (Propecia) which is approved by the FDA for the “biochemical” treatment of male pattern hair loss or male pattern baldness (MPB). You are also correct in stating that certain diets (such as poor nutrition) can lead to hair loss. Unfortunately, the only medical solution to MPB is either taking finasteride or getting a hair transplant. Nothing is guaranteed, and you can find out much more about Propecia, here.

You are under the impression that you are what you eat, and there is clearly truth to this concept, but the complexity of the thousands of vitamins, nutrients, protein, sugars, and other things in our diet weighted against the things that are wrong with us is a daunting task. Just above, I discussed the drug finasteride, but did you know that this substance we call finasteride was actually found in the diet of some mountain villagers? It was naturally in the food staple of their daily diet. Because they ate so much of it, the explorers that first found the village noticed that there were no young boys — just what appeared to be girls. On further examination of this situation, they found many, many hermaphrodites in the population that came from ingestion of this ‘natural food’ substance. This later turned out to become finasteride, a drug used for men with prostate problems and/or hair loss. So here are some important lessons for the natural minded herbalist readership:

  1. Not all natural foods are safe. Arsenic is natural, but it can kill.
  2. There are many good things in what we eat. A good healthy diet will make us healthy.
  3. If we eat anything that is not well understood, then we should take the time to learn and understand the issues of safety and effectiveness if we expect some outcome from what we eat.
  4. There are many substances that work to produce effects we might want. Some natural substances have steroids in them and they may make us feel better, healthier and look more muscular, but the question that must be asked is what is the real costs of such substances? Steroids are harmful in the long term and are not good things to take whether it be natural or in pill form.
  5. Even things like Vitamin A which is healthy in low doses, can cause hair loss in high doses.

If you are concerned about your hair loss or thinning, you should first be evaluated by a hair transplant doctor to map your scalp for miniaturization and the pattern of your hair loss.

Finally, if you find this elusive “cure” to hair loss, please come see me. I would love to be your business partner!

Noni Juice

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

Can saw palmetto and niacin or other capsules help accelerate hair regrow on top of using propecia and minoxidil…What other natural products would you say can help the regrow? what about NONI juice…. (TahitianNoni.com)

I’ll paraphrase something I read on BerkeleyWellness.com about saw palmetto that applies to most of the products people write in about. The dietary supplements market in the US is largely unregulated, so you can’t be sure what you’re getting when you buy something like niacin or Tahitian Noni juice or a saw palmetto product (or any supplements, for that matter). There’s many preparations on the market, and because they do not contain the same amounts of the supplement, they may not have the same effects. There is just no way of knowing how much of a particular supplement is actually in a tablet/capsule/juice, even when a specific dose is written on the bottle.

Noni juice sounds exotic (it’s Tahitian!), but it is just a dietary supplement like many others. To be fair, I can’t find anything on their site that even claims to regrow hair.

Propecia Can Result in More DHT Production?

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

Hello Dr. Rassman

I apologize if you have already answered this question, but I have heard that propecia can actually stimulate hair loss via negative feedback pathway. I’m a biochemist, and this somewhat makes sense. According to the details, as propecia lowers the DHT levels, it causes more transcription of 5-AR genes, resulting in more DHT production. The body senses the reduced DHT levels, and attempts to compensate by creating more of the enzyme. Have you heard of such details? Any help is appreciated. Thanks so much.

Your question may best be answered by a neuroendocrinologist, but being a biochemist yourself, you should realize that as much as we know about the biochemical process, we also do not know all its intricacies. We are taught to simplify it by drawing feedback loops, but the pathways are often influenced by multiple factors.

I am not certain that 5 alpha reductase enzyme blockade (by finasteride or Propecia) will necessarily increase more of its production by a feedback loop. It is a reasonable hypothesis, but I do not think this has been proven. Perhaps it can be your research project.

Hairpod

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

I saw this article today on the internet. What are your thoughts on it?

Hairpod photo

“Hairpod … stimulates the user’s scalp with low frequency electric current”.

There will always be devices, potions, creams, shampoos, and other such creations for “magically” restoring hair. I am not aware of the Hairpod or its results, though I am familiar with the iPod (though unrelated to this).

I’m only posting this to show the readers this … uh, interesting… new hair device.

My Hair Splits Into Two

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

I’ve noticed that one hair follicle, on my head, can be split into two. In other words, a piece of hair at the end, I see are two pieces, but connected to one. Is there something wrong with my hair?

In the styling industry they call this ‘split ends’. I suspect that the hair becomes drier and more brittle as it grows longer and longer. Hair grows for 2-7 years usually at about 1/2 inch per month. That means that the hair that can last for 7 years, will grow to about 42 inches in length (two year growth will bring it to 12 inches in length, etc.). Women often grow hair to the fullest length that their hair will tolerate and when the hair reaches the final length, the ends often split. The split ends are often what precipitates the stylist to cut the hair back. There is nothing wrong with your hair, but it is possible that your hair is very dry and you may want to use wetting agents, (e.g. shampoos or conditioners for dry hair) or just check with your stylist about recommendations to deal with the split ends.

Scarring in Recipient Area After Transplant

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

I wanted to know if there is any scarring on RECIPIENT AREA…and this scarring as bad as that in donor area….i mean does recipient area scarring heal fast?? Thanks

The recipient area rarely shows scars. That is because the wound where the hair is put in is made with a fine needle and a needle does not leave significant tracks. Donor scars usually measure a width of about 2mm, but with a trichophytic closure, that width can be hidden inside hair that grows through the scar. Scarring in the recipient area is very rare. When it occurs, it occurs for two reasons:

  1. When the hair is coarse and the healthy coarse hair has a wider shaft exiting the skin, it may create a very small dimple.
  2. Infections in the area where the hair was transplanted, which will disappear when treated.

With the old techniques, the recipient area had a series of problems that made them quite detectable. That was because the grafts were larger than the follicular units themselves and this older style batched a series of follicular units together into the recipient area. These older graft techniques moved considerable amounts of skin with the grafts and the skin created an obvious whitish disc which: (1) could be higher or lower than the surrounding skin producing a phenomenon called ‘cobblestonning’, (2) would be depigmented make the grafts ‘whitish’ in appearance, and (3) they often clumped the hair within them together producing a stalky appearance, rather than the delicate normal follicular units with the modern technique. With the pure follicular unit transplants, on the other hand, the recipient area should be undetectable in most people within a week, unless there is persistent redness . The abnormalities I discussed above should not be seen with these small follicular units.

Taking Propecia and Procerin Together

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

Hello, I am 23 and I have a receding hairline. I started taking Propecia and Procerin together about 3 months ago. I feel like my hair in the front is falling out even faster! Is there a possibility that taking both in conjunction with one another might actually be speeding up the process?

I do not know anything about Procerindirectly. However, I would suggest stopping the Procerin and focus upon Propecia first. Then with one of the substances gone, watch for what is changing. Accelerated hair loss does occur in genetic balding in phases. You may be going through one of those phases.