Magnetic Helmet for Hair Re-growth

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

read in the news yesterday that a ‘helmet’ had been launched in the UK which uses electromagnetic waves to combat balding.It costs £750. Have you heard about this latest ‘baldness cure?’

Also – if someone has hair miniaturisation – does that indicate that those hairs will definitely be lost or is there a chance that they will just stay thin?

Thanks again Dr!

I have heard that electromagnetic waves can have a positive impact on hair re-growth. In fact, I was approached by a company wanting my endorsement on this type of therapy, but as there is no science behind these claims, I did not agree to what they were asking.

Miniaturization means that the hair shafts have a reduced diameter. In the balding process, the hair diameter generally gets thinner and thinner, eventually disappearing. Without doing something, this process is progressive. There is never any guarantee that these miniaturized hairs will all fall out. Many people who can profit from claims of producing hair re-growth and companies pushing such products are hopeful that the hair looks fuller. If that happened, one might think that miniaturization is reversed.

Tags: hairloss, hair loss, magnet, helmet, miniaturization

Spironolactone and Minoxidil Dependence

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

Dr. Rassman,

I am a 27 year old latino male who a couple months ago noticed my hairline was receeding at the temples. 2 weeks ago I started aplying minoxidil 5% solution (2 x day) and spirolactone lotion 5% (1 x day). After ONLY 2 weeks, I`ve noticed no sheding on adjacent areas (or very little) but I have noticed an increase/thickening of vellus hairs (on the bad side, also drier scalp and incipient dandruff in adjacent scalp areas). I only apply these products to my temple areas and inmediately adjacent scalp. My questions are:

1.- Should I expect sheding if I continue use?
2.- The dependence on minoxidil, is that only for regrown or thickened hair or does healthy hair (inmediately beyond my temples) become dependant too?
3.- (a) Is it possible to avoid dependance on minoxidil by using cycles (2 weeks on, 2 weeks off, or monthly)? … (b)and still gain some benefits if done like that?
4.- Does Spirolactone topical lotion cause dependence too?

In case you are wondering, I think I`ve had a “mature” hairline for some years now and I acted only when I noticed slight but definite further receeding on my temples. Oh and I can’t get my head mapped for miniaturization yet, as I am quite poor at the moment, but I will when I can… I hope your answers help me decide on what to do at the moment.

The use of minoxidil should not cause shedding, nor I expect Spironolactone medications. Normal hair (not genetically weak) should not be affected by either Spironolactone nor minoxidil, but the dependencies that are built from these medications for genetically impacted hair is well documented. Cycling these medications may just cause them to be less effective if they are working. Although I do not have direct knowledge of Spironolactone topical lotions, I would think that it too (if working) will produce dependence. The androgenic blocking impact of Spironolactone, when administered orally, can produce impotence and breast enlargement, two side effects that are not what you may bargain for. Just because Spironolactone is in lotion form does not mean that you will not absorb it through the skin. It is a potent medication and should be used only on a doctor directed treatment plan.

Tags: minoxidil, spironolactone, hairloss, hair loss

Is DHT Produced in All Men?

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

So DHT is the hormone that causes male pattern baldness? And that hormone is produced in all men who will experience from male pattern baldness after puberty? So is DHT only produced in men who will experience male pattern baldness or is it produced in all men? And if DHT is produced in all men after puberty do they only start experiencing baldness when another gene triggers it? How do you tell if you are genetically going to have male pattern baldness? My dad does and so did his dad and so did my mums dad but my uncles (on my dads side and my mums side) dont and both have full sets of hair at 55 and 58? So how do i know if i too will experience it ?

All men produce DHT, unless they are born with a genetic defect and missing a particular enzyme that makes DHT. There is no way (at the moment) to tell who has the gene for hair loss and if they did know, they wouldn’t know if or when it will be expressed in the lifetime of any particular man.

Tags: hairloss, hair loss, dht

Propecia and Follicular Neogenesis

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

Hello Doctor and thank you for this your answers on this forum. I was curious about two things. First, is it true that taking Propecia will SOMETIMES help maintain the other areas of hair you are not taking the medication for? In this, I mean if I were to take Propecia for very minimal vertex thinning, but my hairline and frontal hair are perfectly fine the way they are right now, will propecia help keep those hairs in perpetuity? (in general of course, I know there are no guarentees in all of this). Second, do you keep up on the latest information regarding the process currently being worked on called follicular neogenesis (the elusive “cure all” for baldness? I’ve heard from many sources (including Bosley reps) that within 8-10 years, all the kinks MIGHT finally be worked out of this, thus hopefully ending and curing baldness. I know the key word is “might,” but I was just curious how much you’ve heard about it and your thoughts. Thank you so much.

Divide the term follicular neogenesis into three words and you get:

  • Neo: New
  • Follicular: Refers to hair unit of growth
  • Genesis: A biblical term suggesting source, creation, derivation of something, birth, the beginning or origin

Put them all together and you get a new technology — or at least the name of one. Sounds like a good name to me. There are many people working on technologies that will create new hair follicles from the source (possibly the stem cells that generate hair follicles) once we learn to control the stem cells. The success of forcing stem cells to create hair follicles is about 10% now with a great deal of randomness to the process. I have heard the same estimates of time (10 years) for the resolution of things related to cloning, etc…

Your first question has a problem with it. If the hair is thinning in the back, then there is genetic balding possibly in other areas as well. Thinning either means miniaturization of the hairs or loss of density. Propecia works better in decreasing the miniaturization (increasing the thickness of the hair shafts) than it does with restoring the density (growing new hair). I do not believe that Propecia (finasteride) will prevent the loss of either hair shaft thickness or loss of density, but I do believe that it will prolong the period of loss for years.

Tags: hairloss, hair loss, finasteride, propecia, follicular neogenesis, follicle, hair cloning, cloning

Sexual Side Effects Months After Propecia Use

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

Dear Dr. Rassman,

Last year I had a hair transplant done at the New Age Hair Clinic and along with that the recommendation of taking propecia to help prolongue losing more hair, which makes sense obviously. Propecia really worked for me and I was pleased with its results combined with the transplant, however, after six months I noticed those sexual side-effects I had been told about. I never worried about it because it had such a small percentage tagged to it so I figured I wouldn’t have to. But now I have no sex drive and difficulty achieving and maintaining erection…but others as well. There is no orgasm for me anymore and most of the time a loss of ejaculate and when something does come out, it’s almost like a gel… My penis has lost feeling and almost in a way “detached” shall we say from the body because i really can’t feel it that much anymore. This worries me because I have been off the drug for six weeks now. My real question is have you ever seen these adverse effects permanent in a patient? It’s really starting to scare and depress me… I figured it would take a few days to get out of my system and once I saw it was only temporary go back on it because I don’t want to lose what I worked at with the transplant, as is what my doctor recommended, but the effects seem worse now than when I was on it… Can you help me at all? Should I go back to using it or keep waiting till I see improvement and then perhaps use it? I would really appreciate any information you can give me… The dilemma of choosing between hair and sex drive is a hard one being I am only 23… I want both. My doctor can’t help me at all so maybe you can, I’m hoping. Also, have you ever heard of a hair-loss product called scalp-med? I saw it on tv and checked out their website at scalpmed.com and it looked good because they say no sexual side-effects because it’s applied directly to the scalp, but it all seems too good to be true so I was wondering if you knew if it was legitimate or not. Thanks for taking the time to read and respond to this. I appreciate it.

Propecia, hair loss, penis detachment, orgasm, ejaculation… OH MY! From the tone of your writing, I can see that you are very concerned about hair loss and sex. Worry not, for I would say you are like most men. If you obsess over something like your hair loss and image, you can produce impotence. Your sexual problems might be related to the Propecia use, but the problem should go away soon after discontinuing Propecia. Propecia certainly does not stay in your system for 6 weeks after stopping its use. Your sexual problems may be psychological or you may have an underlying medical condition that you have not been diagnosed with. If it continues to be a problem you should see a medical doctor for a formal evaluation. With respect to Scalpmed, there are numerous posts on the product here.

Tags: propecia, finasteride, side effects, penis, hairloss, hair loss

What DHT Level Am I?

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

I read this on one of your posts: “…but what about the young man with a stronger Type I and Type II DHT blocker”

Is there any such test to find out what type of DHT type / level / category I am? Cheers!

I think that you misunderstood what I was talking about (see Regrowth – Phase II FDA Hair Loss Study Results for Dutasteride). Each of us is the same with regard to the way these drugs work on us, so you don’t need to check yourself out to categorize yourself (as you asked). Dutasteride is more effective at blocking both type one and type two receptors, making it superior to finasteride, at least in theory. As what studies there are have incomplete clinical trials, we can not be sure what this all means and certainly we do not know enough about safety in the young man taking this drug for his lifetime.

Tags: hairloss, hair loss, avodart, dutasteride, dht

I Want to Lift Weights 2 Weeks After Hair Transplant Surgery

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

Weightliftingregards doctor, my question is i have had a my surgery 2 weeks ago and have my staples removed I am going to wait a month to lift heavy waits but I am still concerned that it might be too soon and will stretch the scar and if so how much will it stretch or bleed. Really worried about that. and will working out heavy affect my grafts?

Working out will not impact graft growth, just the risk of scarring in the harvested donor area (assuming you had strip harvesting). I tell my patients that they can run a marathon in 7 days, but hold off anything that works the trapezius muscle as it might potentially stretch the scar in the back of the head.

Tags: hair transplant, hairloss, hair loss, activity, scar

Increased Scalp Testosterone with Dutasteride

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

Hi Dr. Rassman,
I have seen the results of the study that has shown significant increases in scalp testosterone with dutasteride (104% for 0.5 mg). Could this major increase in scalp testosterone contribute to further male pattern balding, since testosterone can also bind to the androgen receptors in hair follicles? Basically, is there any possibility that the decrease you get in DHT from dutasteride could be overwhelmed by this increase in testosterone? thanks very much.

What you are talking about is as much science as speculation. From what I have learned from doctors who use dutasteride in those patients who do not respond to finasteride (Propecia), the report is that it is stronger and more effective. I have addressed the scalp testosterone levels with dutasteride before here. More insights may be obtained by looking at pubmed.gov.

I only have a limited understanding of the pharmacology here, so I would rather just refer the readers to better authorities.

Tags: hairloss, hair loss, testosterone, dutasteride

Thinning Runways an Indicator of Further Baldness?

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

RunwayHello,

Thanks very much for answering my previous question. I thought of another question that I can’t find the answer to in previous posts. I know from your posts that recession at the temples and some recession in the frontal hairline is the sign of a “mature” hairline and will not necessarily lead to genetic baldness. Is slight thinning in the “runways” along the sides of the head or on the crown always an indicator of further baldness to come, or can thinning happen in these places as part of a normal mature hair pattern, without leading to further baldness?

Thinning in the runways or anywhere in the crown usually reflects miniaturized hairs. This is often the precursor for balding. Sorry if you don’t like that answer. Few do!

Tags: hairloss, hair loss, thinning

Ibuprofen and Hair Loss?

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

In November 2004 I took Ibuprofen for a knee injury and by the end of the week my pain was unbearable; the Ibuprofen did not help with the pain at all, but all of my hair fell out. Well, I used Nioxin and have been taking one Biotin and 3 Hair, Body, and Nail pills a day.

My hair on my head is growing back (finally) It’s very short and I can see differing lengths…. But I have also noticed very fine hairs growing on my face and not just where my eyebrows used to be. Is this the normal fuzz that was probably there before that I didn’t notice or are my vitamins trying to make me look like a man.

I’m 37 years old. Please help me.

While many drugs may cause hair loss, I suspect your hair loss may have been coincidental or from the physical stress caused by your knee injury. With respect to the fuzz you notice on your face, it is most likely that was there before and you had not noticed. You can see this in everybody. We’re all fuzzy!

Tags: hairloss, hair loss, ibuprofen, pill

FUE Technique of Dr James Harris

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

Dear Doctor,

I have recently read about the supposedly “improved” version of FUE called Surgically Advanced Follicular Extraction (SAFE) System invented by Dr. James Harris.

How does this differ from the FUE that you and your team are offering (is it better, the same, or otherwise?)… Would be very useful to read your opinion about this technique and added benefits, if any, of this technique vs. other FUE products currently offered in the marketplace. Many thanks.

Dr. Harris has added a valuable insight into the FUE process with the use of a dull punch which he correctly identified as a better instrument for many people having an FUE. We use his tool (amongst other tools) when we perform an FUE procedure. In some patients, his two step procedure is superior to the one step procedures we had used prior to his insights. You may be confusing his terminology. His invention incorporates a tool for performing FUE and a technique for doing the FUE that is performed in two steps.

This technique is an important part of the arsenal that most good doctors performing FUE should be doing. His technique may work in certain patients who I have classified as FOX negative patients (with the biopsy technique I published in 2002, before he invented his tool). Prior to his contribution, I might have excluded some patients from candidacy for an FUE procedure. Even with this advance, the matter of efficiency of the procedure is still an important element in performing the technique and selecting patients. In some patients, the two step technique is not as good a techniques as one done with alternative tools. [The graft yield per hour, for example, can make the procedure so laborious in some patients to make it impractical (e.g. a 50 grafts per hour extraction rate) when targets of 1000 grafts might require a patient surgery that could run in excess of 20 hours GOD forbid one that is 1500-2000 grafts where a surgery can exceed a full working day without resting (illustrative example only).] To have a successful FUE surgery, the surgeon can not be fatigued to the point that slop or carelessness comes into play as fatigue mounts. Like any good medical advance, great contributions often require the talents of many people and Dr. Harris’s insights with his SAFE two step system clearly made a valuable contribution to today’s state of the art FUE technology.

Tags: fue, fox, hair transplant, hairloss, hair loss, harris

Onion Formula

/by William Rassman, M.D./7 /

Doc,

Is there anything to this Onion Formula phenomenon? Thanks!!

OnionI found some herbal info at MyHairLossAdvisor.com. Creative ideas never cease to end and here is another one. Apparently, you rub your hair with an onion before washing. I have also heard of hanging from your feet for 20 minutes three times a day to get more blood flow to your head. I would suspect that putting the onion to it prior to hanging upside down may be one step closer to the solution, from the ground up, that is. Or maybe if you just love the strong odors, you should add some garlic and hot sauce to it. Oh boy.

So is there anything to this onion stuff? No.

Tags: hairloss, hair loss, onion, remedy, herbal, treatment

Injecting Saline Into Scalp To Transplant Higher Density?

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

Dear Dr. Rassman,

A couple of years ago I remember reading an article about a hair transplant doctor at UCLA (I believe) that was able to transplant a higher amount of hair into a site by first having the scalp injected with a solution (possibly saline) to actually swell or enlarge the scalp area so more hair could be transplanted into the area. Later when the swelling receded the results would yield a higher density.

Can you comment on this. Is this something that you would recommend? Why or why not?
Thanks!

Many hair transplant surgeons will inject saline into the scalp to accomplish just what you are talking about. The important thing to focus upon is graft survival. Are the grafts packed so closely that the blood supply may be compromised? It is possible. I recently saw a patient done by another doctor who had the skin in the recipient area develop gangrene from a decision to put too many grafts too close together in skin that could not tolerate dense packing of grafts. The details of what the surgeon does is not a simple one thing vs another thing. A good hair transplant is the result of a complex series of decisions and takes into account not only the size of the grafts and the nature of the skin, but many other judgments. I have heard doctors focus on one thing that makes them unique, but ask yourself, “Am I being pitched a sales line here?”

Tags: hairloss, hair loss, hair transplant, scalp, saline, density

Chemical Castration Effects on Hair

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

hi dr, ive read some on chemical castration, is there any way to produce the effects of castration that it has on your hair without actually doing it and so avoiding the other effects

Castration prevents hair loss because without testosterone, one can not make DHT and without DHT, balding does not occur. It is well known that removal of the testicles will prevent hair loss, but I have not seen anyone willing to take up this cure. Castration will not reverse what hair loss has already occurred, but it is the ultimate DHT blocker for preventing what may yet unfold. I do not know of a way to do what you’re asking though.

Tags: hairloss, hair loss, dht, testosterone, castration, chemical