Gynecomastia and Finasteride

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

Hi, Is there any conclusive evidence that the regular use of Finasteride (Propecia) for hair loss can result in Gynocomastia as a side-effect?

The Physician’s Desk Reference does not list this drug as a possible cause of Gynocomastia, but I have heard mixed stories from individuals.

Results of any known conclusive studies in this regard would be appreciated.

Gynecomastia is a known side effect from the use of Propecia. I do not understand the mechanism of action for it, but when it does happen, most men usually find it as a reason to stop using Propecia. Fortunately, I believe that the incidence is well below 1 in 300 men. I don’t know of any studies off the top of my head, but if any blog readers happen to have a link to any studies posted online, please feel free to post the link in the comments.

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

Propecia and Testicular Pain, Follow-Up

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

I saw the post today mentioning the testicular pain when on Propecia. I’ve been on Propecia almost 5 months now. I did have intense testicular pain after about a week or two on the drug. But right when I was about the quit, the pain went away and I haven’t noticed it since. Hope this helps.

I generally tell patients not to overreact to things. This is a good example where a little patience solved the problem. Thanks for sharing it with us.

Tags: propecia, finasteride, testicle, testicular, pain

Doctor Charges Per Procedure, Not Per Graft

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

Thank you for taking the time to maintain this website. I met with a hair loss consultant last week for the first time. He recommended that I have 2500 grafs on my forehead area and a second transplant a year from now on the top of my head. Why not just have it all done at once? He claims that they dont charge per graf, but a flat fee regardless of how many transplants they do. Is this just a opportunity to make more money for a second procedure?

If the consultant you spoke with was not a doctor who does the surgery him/herself and is trained in hair transplantation as a specialty, then he/she is practicing medicine without a license and I would run for the hills. There are some clinics that promote consultants to recruit patients and I have seen some people get recommendations that are way out of line with their need. Doing more than 2500 grafts depends upon:

  1. The size of the bald area being treated
  2. The donor density
  3. The looseness of the donor area skin (laxity)
  4. The skill of the surgical team (only some teams are capable of performing 5000 grafts at one session)

Fees are generally priced per graft, but that is not a hard and fast rule. Whatever the basis for the charge, it should be both competitive to what a quality medical group would charge and show value for what you are going to receive (result focused of course). Selecting a doctor should follow the science I have outlined in How to Tell if You’ve Found the Right Hair Transplant Doctor.

Tags: hairtransplant, hair transplant, hairloss, hair loss, surgery

Taking Propecia Before the Sun Rises

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

SunriseHey doc, I need this question answered ASAP, if you wouldn’t mind. As you may know, Ramadan has begun and many Muslims will be getting up in the middle of the night to eat and drink, for eating and drinking aren’t permitted until the sun sets.

So if I take Propecia before the sun rises, like around 4 AM or so, would it have the same effect as taking it later on in the day? Thanks

You can take Propecia (finasteride) at any time. Just take it about once every 24 hours (day). I generally recommend taking it when you wake up in the morning, when your testosterone is highest and if that is 4am, it will work as well at that time.

Tags: hairloss, hair loss, propecia, finasteride, ramadan, muslim

Can You Explain Hair Loss from Amphetamines?

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

On a molecular level, how do ampetamines cause hair loss and how can this drug induced hair loss be halted or reversed? Thank you for you time.

I really do not know the answer to your question. My previous posting reflected what is known by the manufacturers of the various amphetamines and from others that have suffered from this hair loss side effect. I am sure that the answer is intricate and related to many other factors in those particular people taking the drug.

Tags: amphetamine, hairloss, hair loss

Olive Oil and Aloe Vera on Scalp

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

I’ve read about testestorone which produce DHT causes hair loss. I would like to know if lifting weights causes hair loss. I lift weights(heavy) almost 5 times a week. Also, I check out some website and they recommend using olive oil and aloe vera which I took from my back yard. Applied it on my hair and massage it for about 30 minutes. So far it help with getting rid of my sometimes smelly scalp and my dandruff problem. I would like to know if that really work. Thanks.

Aloe VeraI know that aloe vera is the magic plant that cures almost everything. It is used extensively in the tropics where it is grown as a herbal solution to a wide variety of skin problems and I know that it works in many. Reading that it helped your dandruff is not a surprise. Adding olive oil is a wetting agent, which should stop flaking. It would not benefit you in the treatment of hair loss, however. For more info on aloe vera, you should check out the Wikipedia entry.

Oh, and weightlifting does not cause hair loss.

Tags: aloevera, aloe vera, hairloss, hair loss, dandruff, oliveoil, olive oil, herb, weightlifting

Very Irregular Periods a Cause for Female Hair Loss?

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

Hello there….I am a 29 year old female experiencing frontal and temporal hairloss. I am upset and not sure what to do. I have VERY irregular periods. I may have one 1-2 times a year. Will this cause hairloss? I know a decrease in estrogen will cause it, but I am young and wonder if a very rare period would contribute to it. I have had my thyroid checked and it was ok. Not sure what causes the irregular periods either. I would greatly appreciate a reply to help my questions. I am a nursing student who will be graduating this coming May and would like to look nice for pictures. Thank You

There may be no relationship between your hair loss and your periods. There are conditions like Polycystic Ovarian Syndrome (PCOS), where infrequent periods and hair loss go together. You can see this at 4woman.gov or PCOSupport.

I am not suggesting that this is what is wrong with you, but the diagnosis of female hair loss is complex and requires a complete examination by someone who can evaluate your periods and your hair loss in partnership with you.

Tags: hairloss, hair loss, female, woman, women, period, menstruation, pcos

Can Any of These Supplements Cause Hair Loss?

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

Dr.
I wanted to know, since I have been taking creatine, animal m stack and muscle milk I have noticed my hair has been falling off, I also take ocuvite, fish oil, and korean ginseng, do any of these supplements contain anything that may make my hair fall faster, I mean im just concerned since I am only 20 years old.

It is a cruel fate of nature for some of us to lose hair at such young age. While I cannot comment on every supplement and their efficacy on hair growth or loss, sometimes the cause of hair loss can be related to increased androgens (example: testosterone) in your body. Drugs like finasteride (Propecia) work by addressing this fact. It is my general opinion that no one source of food or supplements are a cause of hair loss unless it has steroid type of activities (of which there are probably a few natural type of substances out there on the market). If you are losing hair then it is likely you may have a genetic component of hair loss. To be certain, you should have your scalp hair examined by a doctor and if possible have you scalp hair mapped for miniaturization.

Tags: hairloss, hair loss, supplement, ginseng, ocuvite, creatine

Losing Eyelashes

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

do some balding/thining men lose their eye lash hair too, i noticed my dad has some hair there left, but not much, it seems like im losing some eye lash hair too

The loss of eyelashes in men can be a genetic characteristic. It could be unrelated to male patterned balding. From what you wrote, that is what it seems like. Are there other men in the family line that also have loss of eyelash hair?

For a near complete review of the subject see: ISHRS – Eyebrow & Eyelash Hair Restoration Surgery

Tags: eyelash, eyebrow, hairloss, hair loss, eye lash

Restoring the Moustache

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

MoustacheA few years ago i had some stiches places on my mustache area and it left a scar and now hair doesnt grow in the places that the stitches were placed.

I was wondering if you know of any product, surgury or any other possible solution that could allow hair to re-grow in the spots that the scar is or in other words where the stitches were placed?

Hair transplantation is an ideal procedure to address the scar on your mustache area. At NHI we have even done entire beard/chin areas and recently for a patient who wanted to grow a goatee.

[Note: photo above is of the World Beard and Moustache Championships world champion, Willi Chevalier. Photo used for display purposes only, and not to imply that Mr. Chevalier had any restoration to his facial hair.]

Tags: moustache, facial hair, hairloss, hair loss, hair transplant, hairtransplant

Removing Chest Hair Permanently

/by William Rassman, M.D./3 /

Hi, I’m thinking of removing my chest hair permanently. To be frank i’m a bit scared of laser treatment. What i’m thinking of is waxing, will the hair be permanently removed after multiple waxing sessions? Or it would grow thicker and darker???

Thanks

Chest hairIn the movie “The 40 Year Old Virgin“, the main character (played by Steve Carell) has his chest hair waxed to do a little grooming for the ladies. Your question reminded me of this scene — which I read was not movie magic, but was really the actor having his chest waxed for the first time in his life. Can you remember what he was saying as they ripped off the wax from his chest? His facial expression in the picture on the right has a subtle hint.

If waxed regularly for many months or possibly some years, traction alopecia (permanent hair loss from pulling hair) may develop, but the problem with chest hair is the growth cycle, as less than 40% of the hairs are growing at any one time. To get traction alopecia of those hairs you might take more frequent treatment and over an 8 month period, you might get one hair pull per hair. Put that into a formulae and if you have 8 cycles over a five year period, is that enough hair waxing to get traction alopecia? Lots of pain, my friend.

Lasers are still the best way to do it, but you can count on at least 5 sessions. Be sure that the doctor uses the best and most up-to-date laser, as many of the ones being used are older style lasers that just do not work well. Sorry to bring you back to the thing that you did not want to include in your considerations, but it would be the fastest way to come to the solution you’re seeking.

Tags: chest hair, chesthair, hair removal, laser, wax

Problem with Wig Leads to Heart Attack

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

Sounds like a hairpiece can be stressful, in more ways than just worrying about it falling off. Here’s an interesting case of man that felt he was wronged by a wig maker, and it ended up causing him much more emotional and physical distress than a wig is worth.


Milford man counter-sues in hairpiece lawsuit

A city man claims in a lawsuit seeking more than $15,000 in damages that he suffered a heart attack after refusing to pay for a hairpiece that was not only the wrong size but also the wrong color.

Paul Lewis filed the counter suit in Superior Court after Paula’s Wig Boutique in Orange filed a small claims action seeking $1,200 in payment for the hairpiece.

Lewis says in the lawsuit that he suffered a heart attack in December 2004 after Paula Wood, the owner of the Boston Post Road wig shop, threatened to call police because he refused to pay, court records state.

You can read the rest of the article at Connecticut Post Online.

Tags: hairpiece, hairsystem, hair system, wig, hair piece, toupee, lawsuit, legal

1 Week After Transplant, I Accidentally Hit My Head

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

i had 1200 graphs put in one week ago. after reading your blog, i wish i had done them with you. i was planning on another 1500 or so in my next procedure and i will come see you first for sure. so you will be seeing me about 12 weeks from now. unfortunately, today i was getting into my car and hit my head on inside part of my car door. ( again i am one week post op) i hit it relatively hard…when i reached to see if there was bleeding( i hit in the area of my recepient site) it was bleeding. I did not stop bleeding for about 35 minutes. Did i likely dislodge new transplanted graphs as well? The cut is about 2 inches long, not very wide not too deep. After one week am i likely to have dislodged graphs? i did not see any follicles, but you never know? your opinion?

It is difficult to answer your question without examining you in person (you’re in Los Angeles — we’re in Los Angeles). That being said, the hair grafts are generally considered permanent after the first couple of days. It is very, very difficult to dislodge a graft after they get set-up and I have seen people get lacerations of the scalp from accidents at about 1 week and when I examined them, all of the grafts were intact and in place (unless they were inside the laceration itself). If you did not see any grafts, you probably did not do any significant damage. However if you have a cut on your head, you will get an inevitable scar and hair may not grow on the scar.

If you do decide to make an appointment to have your injury looked at, please mention this blog entry to me (or to Dr. Pak, who is a contributing editor to this blog).

Tags: hairloss, hair loss, hair transplant, hairtransplant, injury

Itchy Scalp, Hair Loss from MS?

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

I am a 45 year old female who is diagnosed with M.S. (relapsing & remitting). My scalp has, over the last few months, become itchy followed by overall hair loss (no patches) and there is no dandruff – could it possibly be linked to the M.S.? Is there anything I can do to help the situation. I mentioned it to my doctor who said it was probably my age and there was nothing I can do about it.

ChickenThis could be a chicken and egg situation. We know that Multiple Sclerosis causes paresthesia (numbness, tingling, or burning) and this may cause you to scratch it. Scratching it can cause hair loss. So in one of the scenarios, the MS can be the underlying cause of a process that leads to hair loss. There are many other things that can cause thinning hair, so you might want to see a dermatologist for an assessment of the hair loss.

Tags: multiple sclerosis, ms, hairloss, hair loss, paresthesia

Early 20s, Desperate for Hair Treatment that Works

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

I’ve just recently discovered your website but have found it very informative. I am 23 and have a family history, on both my mother and father’s side, of male pattern hairloss. I too have been suffering, and in the last three months my hair loss has accelerated to such a degree that the hair on the front and top of my head is becoming increasingly thin, and my hair line is dramatically rising. I have recently started using Kirkland minoxidil (having used Rogaine whilst at university but then stopping as I couldn’t afford it) but not only is my scalp flaking a lot, but I am also losing a lot of hair on a daily basis. As I’ve only used it for under a month, do you think I should persist with the treatment as I have a years supply?

I have also recently bought dutasteride on the internet, having used propecia for 3 months but with no affect, only spots on my forehead. I realise that it takes longer than three months for the tablets to work but do you think I should see if the Dutasteride works as I am awaiting a two month supply in the post, or go back to propecia? Ultimately my hair loss is getting me down a great deal and being that I am so young and as this treatment is quite expensive, would it be better to save up for a hair transplant, and if so do you have any contacts in the UK that are not only reliable but might also be able to give me some impartial and helpful advise. Thank you so much in advance for your response as you can see my hairloss has left me really sad and I would really appreciate any advise you can give me. Many thanks again

There are many, many young men in a situation similar to yours. I can’t say for sure what you should or should not do, as you are not my patient — but my general advice would be to give the Propecia more than 3 months (8 months is my minimum trial period) to see any benefits. Especially at your age with early hair loss, Propecia tends to work better than minoxidil. I do not recommend dutasteride, not only because it stays in your system far longer than Propecia, but also because there have not been enough studies (to my satisfaction) that show any long-term effects the drug may have in a younger person, such as yourself. To find a doctor in the UK, I’d suggest looking at the ISHRS site’s physician search. Good luck.

Tags: hairloss, hair loss, propecia, finasteride