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    I Have OCD And Didn’t Wash My Hair For a Long Time

    Aug 28, 2006/by William Rassman, M.D./0 /Hair Loss Causes

    I am a 20yr old male who didnt consistantly wash my hair from the age of 14-18 because of suffering OCD. Its hard to estimate but its possible I went a month without washing my hair in that 4 yr period. Although I did take a shower everyday and even sometimes twice, so my hair did get wet daily.

    I was wondering if its true sebum buildup causes hairloss? IF so is this hairloss permenent or should we assume once the problem is corrected, any loss would grow back.

    I also have oily scalp which makes me assume, I might have had sebum buildup.

    Is the sebum builup story about causing hairlos true or false?? Please respond as your response will really relieve my worries and anxiety, since I do suffer a few mental problems and have been worrying about this for some time. Also if the sebum buildup applys to my case, would a dermatologist be able detect that by observing my scalp??

    Thanks

    Sebum buildup does not cause hair loss. What may happen is that if you brush or comb you hair and the hair is stuck to your scalp, you may pull it out. Wash with a good shampoo and use a conditioner as well to prevent pulling the hair out.

    Tags: hairloss, hair loss, sebum, ocd

    Take Propecia With Food or Empty Stomach?

    Aug 28, 2006/by William Rassman, M.D./2 /Drugs

    I was wondering if it is better to take Propecia on a empty stomach.I take it in the morning with my breakfast.Do i get the same benefits taking it with my food in the morning?

    It’s best to take Propecia when you wake, before breakfast. The empty stomach is best for absorbing 100% of the value of the pill.

    Tags: hairloss, hair loss, finasteride, propecia, proscar

    Severe Dandruff So Itchy My Head Bleeds

    Aug 28, 2006/by William Rassman, M.D./0 /Other

    i have a lot dandruff,and it’s so bad that i itch so much and some times it bleeds and have clogs on certain areas of head…and..secondly…sems like right side of my head has less hair than left…and losing hair too.

    It sounds like you scratch it a lot. If that is that case, of course it will eventually bleed. Stop scratching it and use a good dandruff shampoo. If you are concerned about less hair on one side than the other, see a good dermatologist. It sounds to me that you are pulling hair from the scratching and if you keep doing that, you will eventually make the thinning you are seeing, permanent hair loss.

    Tags: dandruff, scalp, hairloss, hair loss

    I Have Thick Hair, But Not As Thick As 10 Years Ago

    Aug 28, 2006/by William Rassman, M.D./0 /Age, Hair Loss Causes

    Hi Dr. Rassman, I am a 43 year old musician and I am very lucky to have thick shoulder length hair. However, although still thick, it is certainly not as thick as it was 10 years ago, and I am beginning to notice some slight thinning at the crown and although my hairline is still low, some very slight thinning there too. My question is, should I use Rogaine preventatively? Is it better to start Rogaine at the very beginning of what might be a problem? Will I see benefits from Rogaine if my hair is still thick? Or at 43, have I likely escaped a serious hair loss problem and just take some vitamins or something? Thank you so much for your help.

    To me, thinning hair either represents a change in hair thickness (possibly aging) — something we see when a baby becomes a young child, and then often when a young man takes the turn into puberty –or localized miniaturization in the areas where you notice the hair being not quite as thick as it previously was. To make that diagnosis, as I have said before, you need to get your hair mapped out for miniaturization and then the microscopic analysis will be clear as to what you are seeing with your eyes. In men, miniaturization is best treated with finasteride (Propecia), not Rogaine (minoxidil) as the drug of first choice. I now have an office in Newport Beach, and since you indicated that you are in Orange County, why not get your hair mapped out and find out that is happening to you?

    Tags: hairloss, hair loss

    Patients After Hair Transplantation (with Photos)

    Aug 25, 2006/by William Rassman, M.D./0 /Hair Transplantation

    What will I look like within a week or two after a Hair Transplant?

    Here’s a collection of recent patients. Please note that the amount of redness is different for each person, and all of these patients had these photos taken pretty soon after surgery (between 3-10 days, as noted below). Click the photos to enlarge.

    This first patient is 10 days since he had 2150 grafts. He has white skin and dark hair and wants to keep his hair pulled back. He would do better to hide the transplants by combing it forward, but this is his choice, of course. What you are looking at is a new beard from the transplanted hair which is about 1/8th inches long, just below the hair that he had prior to the transplant. The transplanted hairs were placed between his longer hair.




    The second patient has 1661 grafts and had no cover at all. This is his bare skin on the 7th post operative day. Good washing and small surgical wounds are the key to fast recovery of hair transplants almost immediately after surgery. Most people who are bald worry about detection of the transplant. By about two seeks, the faint pink glow will not show. If his skin color was anything but ‘very light’ not even the pink appearance would show.




    The third patient had 1794 grafts and is 3 days after his hair transplant procedure. He had short hair in the front and the transplanted hairs was placed between his short hairs. He did form very small crust that did not immediately wash off in the first day, as is often the case.




    Steroid Use with Propecia Makes Hair Loss Worse?

    Aug 25, 2006/by William Rassman, M.D./0 /Drugs

    Dr. Rassman

    I have recently read an article stating that the combination of steriod use and propecia can enhance hair loss rther than protect it and that they should not be used together. Is this true?

    Many steroid users want to protect their hair from loss and steroids are known to increase the hormones and byproduct DHT that promote hair loss. There are more body builders using steroids with hair loss than those who work out but do not use steroids. Many body builders ask me if Propecia will help them keep their hair. The best thing to do is stop taking steroids, but using Propecia can not hurt. There is logic that any DHT block will help and Propecia (finasteride) can accomplish this in theory. The key question to ask is: Will the negative impact of steroids on my hair be offset by the positive impact of a good DHT blocker like finasteride? The answer here is a theoretical, “probably”.

    Tags: hairloss, hair loss, steroids, propecia, finasteride

    If Propecia Stops Working, How Bad Can Hair Loss Get?

    Aug 25, 2006/by William Rassman, M.D./0 /Drugs

    Dr. this question has been asked before but there never seems to be a clear cut answer from anyone I have asked.If I am a good responder to propecia if and when the benefits do decrease will my hair get worse than at my starting point or go back to my starting point and maintain. This is all if I keep taking it. Thanks Dr.

    The 5 year data from Merck shows that after 5 years, the average patient comes close to his starting point. There is a suggestion that after 5 years he will be worse off than his starting point. This is a bell curve statistic which relates to the average person in the study. You are not average, nor am I. Some people will do better (good responders) and some worse (bad responders).

    I hope that answers the question for you.

    Tags: propecia, finasteride, hairloss, hair loss

    Taking Minoxidil at 15, Dermatologists, and Miniaturization

    Aug 25, 2006/by William Rassman, M.D./2 /Age, Drugs

    Hey Doc, once again your site is freakin awesome. I sent you mail a few weeks back, and you asked what I meant by recession at the sides. I’ve changed the mail I sent so I’m more clearer:

    I am a 15 year old Indian male, and I recently discovered my receding hairline. For a week or so I thought it was a mature hairline since everyone in my family has one (noone is bald though). Anyway I went to see a dermatologist and she said it’s male pattern baldness because of the recession on the sides (on your miniaturization diagram at https://baldingblog.com/2006/08/04/miniaturization-2, the areas I have recession in are T1 on both left and right). She
    prescribed Minoxidil 5 % for 12 months. I just wanted to know if you think I should take Minoxidil at such an early age or get another opinion. BTW, when I raise my eyebrows my last fold of skin is 3/4 inch away from my hairline. And the recession of my left and right sides are an inch away from my hairline.

    Another question, I talked to my dermatologist about having my hair mapped out for miniaturization, and she had no idea of what I was talking about. Do all dermatologists have machines for minaturization or do I have to see someone else. THANK YOU for taking the time to answer my question…your site is more helpful than the dermatologist I visited.

    You may be experiencing the appearance of a maturing hair line. That would correspond to the “T1” area in the diagram in Miniaturization: Critical to the Master Plan for Hair Loss. Minoxidil is therefore not appropriate for you.

    With regard to the question about miniaturization, print out the reference article in the link above and show it to your doctor. In addition, I just wrote another piece worth reading, How Propecia Works on Hair and Why Miniaturization Mapping is Important.

    Tags: hairloss, hair loss, minoxidil, hairline, miniaturization

    Menopausal Woman Losing Hair

    Aug 25, 2006/by William Rassman, M.D./1 /Age, Female Hair Loss

    Dear DR. I’m suffering with great deal of hair loss, I’m a 53 yr old woman who is currently going through menopause, I went to my family Dr. and showed him the amount of hair that had fallen out of my head for 3days and he said it was way to much for menopause so he did some blood work on me and everthing came back ok. So I know its not my thyroid…. This happened about last yr as well, and I went to my hairdresser and he gave me some shampoo that seemed to help. But I haven’t had to use again until now..Why is my hair falling out like this? I also notice that even after washing my hair, if I sweat that my hair and scalp really smell bad. Please help if you can. Thanks

    The cause of hair loss in women is not as straight forward as it is in men who usually follow a specific male pattern balding. Over 50% of women going through change of life homone fluctuations experience significant hair loss. All women need to be medically evaluated for a variety of causes of hair loss reflecting medications that they take and conditions that are known to produce hair loss, best reviewed by your doctor. There are many potential causes of hair loss in women and most are not readily treatable. If the cause is genetic, treatments are not very effective. Minoxidil is one of the few drugs that work for some women.

    If you have seen your primary care doctor and have ruled out medical causes of hair loss, you may want to have your scalp hair evaluated for a specific pattern of hair loss by getting a miniaturization study. I often sound like a broken record when I talk about miniaturization, but it may provide a clue or help monitor your hair loss/gain. With respect to menopause, it is often a contributing factor that may have started a cascade of events for your hair loss, which may be irreversible.

    Tags: hairloss, hair loss, menopause, women, woman, female

    Minoxidil Applications, Pantovigar

    Aug 25, 2006/by William Rassman, M.D./2 /Drugs

    Dear Dr Rassman
    Two questions please: first, it is recomended to apply Minoxidil twice a day, in the morning and evening. Does it matter if I apply it later, around midday?

    Second: what do you think about Pantovigar?

    Many thanks.

    Many doctors feel that if minoxidil is not used twice a day it has substantially less value. Generally, twice a day means as close to 12 hours apart as is socially reasonable.

    Everything I researched on Pantovigar seems to be in German — I do not speak or read German. No further comment can therefore be made by me at this point in time.

    Tags: minoxidil, rogaine, hairloss, hair loss, pantovigar

    Thinned Hair From Continued Stress

    Aug 25, 2006/by William Rassman, M.D./0 /Hair Loss Causes

    I have gone through a period of very high stress and very poor nutrition, and my hair has thinned dramatically from the full head of hair I had. I am 58. My Father and Mother both had full, thick hair when they died. Will this come back as long as I have stress in my life, and is there anything I can do to help my body repair. My nutrition has improved. Thanks.

    I know nothing about your sex (male or female) or if you’ve had any medical tests that may indicate disease, and on and on. See a good doctor and be sure you are completely healthy first. Then a hair expert will have value for you.

    Tags: hairloss, hair loss, stress, nutrition

    I Experience Bald Patches, But Don’t See Hair Falling Out

    Aug 25, 2006/by William Rassman, M.D./0 /African American, Female Hair Loss, Hair Loss Causes

    Im a 34 black women for the past year I have seen bald patches in different parts of my hair, the good news is the hair grows back, but takes about 3 months. The only thing is there is no evidence of hair comming out of the head, no hair on my bed, just wake up in the mornig to find bald patches but don’t see where that hair disapeared to.

    If it was there when you went to sleep and not there in the morning, and there was no hair anywhere in the bed, no hair in your fingernails… hmmm.

    I’m sorry, I don’t know what to tell you.

    Tags: hairloss, hair loss

    Email Response from Managing Director of HairMax LaserComb

    Aug 24, 2006/by William Rassman, M.D./0 /Other

    Earlier this month, I posted an entry titled Analyzing the Results of the HairMax Laser Comb. The extensive email that I received (posted below) shows the great care that the HairMax folks went through to try to be objective. I do not doubt that objectivity was the intent, but upon reviewing the images that were presented, my counts came up differently than the counts of the researcher(s). I know how to count, and since densitometry was my invention (so to speak), I think that my expertise in counting hairs stands for itself. The conclusions of my previous writing still stand (see link above). Nothing written below changes that. The scientific study was put together properly, but it failed on the simplest level, counting hairs. All is wasted if the counts (which our readership can do) failed to be what the researchers counted. I will present the impressive piece written by David Michaels of Lexington International (makers of HairMax LaserComb), because it is fair to do so. Remember, there is no substitute for good marketing, but the success of a product should not infer that the product does as represented, nor does it make counting numbers different than what they are.


    Greetings Dr. Rassman,

    Firstly, I would like to thank you for taking interest in low-level laser therapy and fielding questions on your blog about our device, the “HairMax LaserComb.” Open discussions like this one can only help to further the advancement of LLLT. I spoke to our chief medical advisor, Dr. Matt Leavitt, about your remarks regarding the LaserComb on your blog and Dr. Leavitt spoke very highly of your professionalism, commenting especially about your intellectual brilliance.

    We reviewed your blog page that contains comments about our clinical study’s macro photos and we encourage you to post this message as a follow up to your comments.

    We would like to outline some of the background about the clinical study we concluded.

    Our experience with using low-level laser therapy for hair dates back to the mid-80’s in Sydney, Australia. Our founder operated a laser clinic where he successfully treated thousands of people. I was one of these laser patients and had significant results. We then worked closely together to develop a hand held laser device for the international market that can assist individuals suffering from problem hair. The HairMax LaserComb has been on the market for five years and is in use in over 74 countries.

    In 2005, we concluded a clinical study protocol entitled “A RANDOMIZED, DOUBLE-BLIND CLINICAL TRIAL TO EVALUATE THE SAFETY AND EFFICACY OF THE HAIRMAX LASERCOMB FOR THE TREATMENT OF ANDROGENETIC ALOPECIA IN MALES”. The primary efficacy endpoint was: Change in terminal hair counts, which are non-vellus hairs, in the target region between baseline and endpoint, utilizing macro images.

    This is our second clinical study; unfortunately, we had bad professional direction for our first study as it was only a single site without a control. Despite this, we used the results of this initial research as a pilot study to help develop our new protocol.

    Our goal was to conduct this study scientifically and in accordance to Good Clinical Practices (GCP). We utilized four clinical research facilities, three of which participated in many of the Minoxidil studies. Each facility had a primary investigator with extensive experience in Androgenetic Alopecia. All study protocols were approved by an IRB. Professional independent site monitors were employed to verify all case report forms and data managers were used to ensure that all recorded data complied with the protocol and with all applicable section of 21 CFR as required by the FDA. A biostatistician was retained to independently analyze the resulting dataset.

    The equipment in use was a Fuji S2 6 megapixel digital camera with a Canfield epilume attachment. The same location was photographed every time, marked by a tattoo and the hair counts, centered around this tattoo, are well documented using Canfield Mirror DPS 6.0 software which stores a image on each individual hair counted over the original macro image for verification.

    While conducting our study, we sought to show that the HairMax LaserComb had an effect on the number of non-vellus hairs present on the scalp. In an effort to eliminate any potential bias, independent medical professionals were commissioned to perform the hair counts. These professionals were blinded to the treatment assignments thus removing any bias towards the subjects’ treatment. The data from these medical professionals was then monitored and sent directly to the data management team removing and potential for us to review the data or interact with it.

    All terminal hairs were marked and registered in Canfield’s Mirror DPS software using a 19 inch computer monitor. They were evaluated and counted by two independent hair professional reviewers. We are sure you can appreciate that counting many hundred macro images is a laborious task and can be very tiring on the eye. For this reason, we ensured that all hair counts were not performed consecutively. The counts were split up over a reasonable period of time in an effort to eliminate any uncertainty introduced from reviewer fatigue. Although the reviewers may have missed one or two hairs, we are confident that our macro counts represent a fair and accurate assessment of our study.

    Our macro images were carefully reviewed by numerous professionals including many of your peers; all have complemented us on our fair evaluation of the data and our methods used in the study. We are unaware of what standard Dr. Rollins and you used in reviewing these images and where the difference exists in our hair counts. However, all the hairs that were counted are marked and we consider these counts to be an objective evaluation.

    We will be bringing our clinical images with us to the ISHRS conference in San Diego; we invite you and Dr. Rollins to further review our images up close and hopefully once you see the standard of the images and documented counts you may have a different assessment of our macro images.

    Kind regards,

    David Michaels, Managing Director
    Lexington Int LLC
    Developers and Manufacturers of the HairMax LaserComb

    Tags: hairmax, lasercomb, laser comb, hair loss, hairloss, hair growth, photos, hair max, lexington

    Tribulus Supplement and Hair Loss

    Aug 24, 2006/by William Rassman, M.D./1 /Drugs

    I am 41 year old with a history of succesful treatment of MPB with Propecia. Over the past 6 months I was taking a supplement (tribulus) to help with working out and muscle gains. It is a herb which is reputed to increase testosterone. It seems to me that my hair is losing some weight and thickness during the past 3 months or so. I am wondering if you think that such a supplement could negatively impact on hair?

    TribulusIt is difficult for me, as a physician who understands the classic drugs, to comment upon such substances which are not reflected or reported in standard PDRs (Physician Desk References are used for full disclosures of all FDA approved drugs). Based upon what I read in BodybuildingForYou.com, there is a clear suggestion that this botanical is stimulating hormone modification, some of it steroid like. That would mean that this supplement could caused hair loss.

    I did not feel good after looking at USDA – Tribulus terrestris. Maybe I am just old fashioned. I try not to take anything that has such varied and powerful effects. I always point out that arsenic (another herbal) is very toxic. A single bubble of arsine (the hydride gas) can be fatal and it is this herbal that was promoted as the cure of syphilis by doctors some 100+ years ago (may have also killed some of the patients). It was a classic poison in many classic writings, and at the least, entertained thousands of readers of great literature.

    Tags: tribulus, hairloss, hair loss

    1mg vs 5mg Finasteride for Hair Growth

    Aug 24, 2006/by William Rassman, M.D./0 /Drugs

    Has there been any studies that have shown any increased hair growth taking proscar 5mg daily vs propecia 1 mg daily.

    The 1mg dose is just as good as the 5mg dose for treating hair loss. This was determined when the drug company (Merck) did effectiveness testing. I am sure you can get it from the FDA. For urological problems, the 5mg dose is more effective. The question is really about how much finasteride binds to the hair follicles themselves. We know for prostate problems, that there is different binding dynamics than with hair follicles. I am not familiar with any study that directly compares the 5mg dose to the 1mg dose, but I would suspect that like any bell curve, the 1mg recommendation applies to those individuals in the center of the bell curve and that some people most certainly would be better with a higher dose, possibly worth trying if the 1mg dose is not adequate to meet the needs of the patient’s problem. See Pattern-Baldness.com for more.

    Tags: propecia, finasteride, proscar, hairloss, hair loss
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