WHY Does Shedding from Hair Loss Medications Occur?

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

Hey, Doc. I’ve been taking Avodart for the past 3 months and have been experiencing what can only be described as a “shed”. While I’ve seen other posts and answers here regarding shedding, I’ve never seen you delve into why it actually happens. Can you enlighten? Thanks.

I do not know why it happens. It seems to happen more through the reports on this blog site than I have seen in my own practice. As I do not have experience with Avodart (dutasteride), I can only assume that any ideas I might have will be a common thread to Propecia (finasteride). It has been suggested by some doctors that shedding can be explained, because acceleration of a hair cycle occurs. Hairs in the growth phase are pushed into a telogen phase (which means that it will have some shedding). The suggestion then is that the growth phase comes in stronger. This is the idea of others, so I am just passing what I hear, not what I know as fact.

Tags: hairloss, hair loss, medication, drugs, avodart, propecia, finasteride, dutasteride

My Hairline Is Diagonal

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

Hi, I am 19 years old and have a thick head of hair. There is no thinning present whatsoever. However, when i pull my hair back to look at my hairline, i notice that it goes in diagonally, not quite at 45 degrees but still noticeable diagonally (perhaps the mirror exaggerates how diagonal it is), the right side more so than the left as well. I have shown my mum, grandma and sister, and they have said that my hairline is normal and not receding. I know its hard to tell without seeing it, but are they right and is this type of hairline normal or is it a receding hairline. Like I said, when my hair is not pulled back, I have a thick head of hair and you would not notice that I had this type of hairline.

This clearly bothers you. I suspect that there is some maturing of your hairline at 19, which is common in men. You could send me pictures with your eyebrows lifted high (a good digital photograph) and I will give you an opinion. Please reference this blog posting when/if you send photos. Thanks.

Tags: hairloss, hair loss, hairline, diagonal

Propecia and Hair Count

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

This is a reader response to my blog posting from way back in May, 2005 — When Will I Go Bald?

My question to you is the following: Per your last line [note: “There is no doubt that the hair loss will still pick up again (even on the drug) but it will be a slower process.“], even if i take Propecia, and stay on it forever, then at some point I’ll begin losing more hair anyway? Is that what you mean by your last line? Thanks.

Let’s say that you start off with 100 hairs prior to the Propecia (finasteride). Then with the Propecia you go up to 130 hairs after year one. You also have an identical twin brother (100% exactly the same as you), but he decides not to take Propecia. Now let’s see what happens to the hair count for the two of you…

  Hair Count – You
(with Propecia)		 Hair Count – Twin
(without Propecia)
Start 100 100
Year 1 130 98
Year 2 127 95
Year 3 120 89
Year 4 112 85
Year 5 106 82
Year 6 101 78
Year 7 98 74
Year 8 93 70
Year 9 88 68
Year 10 85 64
30 years later 75 62

 

Note that you may be coming closer together. Maybe not. Obviously, this is just an example to illustrate a point, but I hope that makes things a little more clear. Simply, Propecia does not stop hair loss completely or forever, but it does modify the course of the hair loss over time.

Tags: propecia, finasteride, hairloss, hair loss

Aderans Says Follicle Neogenesis Will Likely Be Available Before 2010

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

I found this quote on the Aderans website. You have probably read this before.

“Follicle neogenesis, a bio engineered hair loss solution, is not many years away; in fact, it is likely that before the end of this decade patients will have access to hair multiplication technology.”

Do you belive that before 2010 we will likely have hair regeneration?

Thank you!!!

I have not heard much about the progress of Aderans from my sources in the industry in recent months. I imagine I might learn more at the International Society of Hair Restoration Surgery (ISHRS) meetings next month. A number of years ago, I was told that it would be out in 3-5 years, and now that time has passed. Optimistic views are the way new businesses fund themselves and justify the research. There is a tendency to be aggressive when predicting timelines. I will try to report to the readership on this blog after the meetings next month.

Tags: hair cloning, hairloss, hair loss, neogensis, aderans

Microdermabrasion for Pits in the Skin

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

Reference the blog you put on your website from Sept 13, 06 “Transplant Scars in Donor and Recipient Area“.

If you don’t recommend microdermabrasion for getting rid of the “pitting” look from the old micro/mini graft HT’s, how might I get rid of that?

Thank you.

Honestly, if what you want do is worse than doing nothing, why do something at all? Here’s an article from HowStuffWorks.com about microdermabrasion that explains, essentially, how it works.

I do not have a good solution to the pitting problem in many situations. I would have to evaluate you first-hand to see if I had a solution for you. There is no clear-cut answer for everyone in this predicament.

Tags: microdermabrasion, dermabrasion, pit, hairloss, hair loss, hair transplant

Revivogen vs Propecia

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

I stopped using propecia about 4 months ago because, after about a year, I started to experience sensitivity in my testes. I will say that my hair loss totally stopped, but I couldn’t handle the pain. So, about 2 1/2 months ago, I started the revivogen/tricomin pack, and I had been experiencing large amounts of shedding! Every morning in the shower there’s hair everywhere. Revivogen states that some shedding is expected for the first month and that it’ll stop, but the future doesn’t look promising. Should I get off of it? If propecia worked exceptionally well as a DHT inbitor, shouldn’t revivogen do the same?

Propecia (finasteride) is a known DHT blocker while Revivogen is not main stream for DHT blocking and there is minimal science to back up the claims for DHT blocking in that product. I have heard about pain in testicles just recently with Propecia. Sounds to me like you are going to lose a lot a hair by the choices you’ve made. Four months is about ‘no man’s land’ with regard to going back to your state from before you stopped the Propecia. If I were you, I would go back on the Propecia and then if the hair loss reversed, consider reducing the dose if the pain in your testicles continued. You are (I believe) right that the hair loss “future doesn’t look promising”.

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

A View of New Rogaine Foam

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

A note from a blog reader:

I just tried the Rogaine Foam and found that it dries very fast and helps makes my styling easier. I don’t particularly like the lemon smell that they put to it, but the odor does go away in a few hours. I think that you need more of it than with the recommended dose that is used for regular Rogaine.

I thought this might be interesting for those that have used minoxidil in the past, but do not like the mess of the topical liquid. I have no experience with the foam, but if others out there have used it, please feel free to post your thoughts about this product.

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

Propecia and Testicular Pain

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

I have had pain in my testicles after I started Propecia. Is there a relationships?

There have been occasional reports of testicular pain on Propecia (finasteride). I have had thousands of patients using this medication and this has never crossed my path as a patient complaint, but some other doctors in the community have reported this as a suspected rare side effect. One doctor reported that the pain came on with the drug and disappeared when the drug was stopped, suggesting a relationship. It could have been coincidental. Most causes of testicular pain are caused by athletic stresses and for the young men, it may have something to do with puberty.

I would stop Propecia, wait a month and start it up again. If it happens a second time, then assume that this is a side effect of this drug for you.

Tags: propecia, finasteride, testicle, testicular, pain, hairloss, hair loss

I’m a Dermatologist and I Say Rogaine/Propecia Are Worthless

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

Does Dhea cause hair loss? If it does, when it is discontinued can the hair grow back or is it too late. Also can Retin A be used by itself to regenerate hair loss? Also can topical melantonin have any value. As a dermatologuist, i can tell you that rogaine and propecia are close to worthless.

DHEA can cause hair loss. When it happens in men, it often triggers or accelerates the genetic hair loss and in men, this is often not reversible. Retin A can not regenerate hair, nor can topical melatonin.

Your comment about the value of both Propecia (finasteride) and minoxidil does not reflect my thinking nor my clinical experience. I have seen people completely reverse on Propecia — see Propecia Patient Results (with Photos) for one example.

Tags: propecia, finasteride, hairloss, hair loss, hair growth, minoxidil, dhea

Estradex for Androgenic Alopecia?

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

I have just been diagnosed with AGA and given some Estradex. This is very costly and i’m wondering if I could get the same effect by using Minoxidil and taking a high oestrogen pill, or a pill that helps inhibit Androgens? Also, do you believe Estradex to be more effective than using Minoxidil alone? My fear is that it may just be an overly priced lotion. Thankyou

I do not understand or appreciate what Estradex is, so I can not comment on it. As you were prescribed this by a doctor, ask that doctor. Androgenic alopecia, also known as AGA (female genetic hair loss), needs to have an extensive evaluation. Have you had it? See previous Female Hair Loss posts for more.

Tags: hairloss, hair loss, androgenic alopecia, estradex

Did Jamie Fox Have a Hair Transplant?

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

I would like to know the difference between FUE and FUT and scarring between them. Also, looking at the actor Jamie Foxx, it seems like he has had a hair transplant. I see him having really short hair or shaved head, so his scar would be visible. What would you recommend to reduce the scar? Also, looking at this website, there is a difference in his hairline. It is low and perfectly lined so would you do a procedure on someone to give them that exact perfect symmetrical hairline or would you say no because it does not look natural? Is it the doctors decision or patients choice??

ConcreteLoop.com

Jamie FoxxFollicular unit transplantation means that the grafts occur in their natural unit anatomy and are transplanted that way into the recipient area. FUE is a harvesting mechanism and should be taking out the grafts as follicular units so that they are completely natural (that may not happen, however). Strip harvesting is the second harvesting mechanism and may or may not yield FUT, depending upon decisions by the surgeon and his team.

With regard to Jamie Foxx and hair transplants, the site you sent me does present some very interesting photos. There is a difference in his hairlines over time so it is possible that he did have a hair transplant. If these photos are to be believed (I am not disputing them, but I do not know the source), then it does appear that his hairline is quite a bit lower now than it previously was. Maybe there’s another explanation — his hairline could naturally be very low and he shaves it higher to achieve a different look at different times. I really don’t know, though. The perfection of his hairline may be the result of styling control that he exerts, but as a good hair transplant is undetectable, I can not tell from these photographs.

An interesting thread about this was on HairLossHelp about a year ago (found via Google) — here.

Tags: hairtransplant, hair transplant, hairloss, hair loss, hairline, jamie foxx, jamiefoxx, actor, celebrity

4 Years After Hair Transplant, I Am Still Numb

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

I had a HT from another surgeon about 4 years ago. The numbness area has still not gone away after 4 years. I was told it would take 3 months to a year. Is there still hope for my nerves to reconnect on their own? If not, is this correctible by surgery or any other methods?

Thanks.

Numbness after a year reflects some nerve damage. I would want to know where you are numb. There are nerves in the back of the head than can be damaged from surgery. They are the greater and lesser occipital nerves, temporal and third occipital nerve. The following image shows the major nerve distribution and it may correspond to the area where your sensation is impacted:

As you can see from the picture, these nerves specifically cover different areas of the scalp. If any of these nerves are injured, a sensory defect will reflect the nerve’s distribution. We are fortunate that these nerves overlap in most people, and if one is damaged, the other has a distribution that covers the damaged nerve. It sounds like your back-up system did not work.

After 4 years, the nerves usually are dead, so that surgery (which is very difficult anyway) will not work. If there is pain in these nerves, then there are things that can be done to alleviate the pain, but usually after 4 years, all pain should have gone away.

(image source: eMedicine)

Tags: hair transplant, nerve damage, nerve, numb, surgery, hairtransplant, hair restoration

Any Advice on How to Ween Off Avodart?

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

dr. rassman,

i’m a 23 year old male with MPB. i’ve been on avodart for about 18 months (0.5 mg/day) and have noticed little results. i’m not sure, however, if the medication has slowed my hair loss and to what degree. i want to swap back to propecia for health/safety reasons..but i’d like to avoid a huge shed. any advice for how to make the swap? should i ween off the avodart?

I am using judgment, not experience in answering this question. As Avodart (dutasteride) has a 5 week half life and stays in your system for months, I would stop it cold, and start taking Propecia after a month. You can actually start Propecia (finasteride) earlier and as long as you do not get side effects (sexual side effects in particular) the double dosing should have no negative effect.

Tags: finasteride, propecia, dutasteride, avodart, hairloss, hair loss

Smart Hairbrush

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

The Kao Corporation of Japan is developing a “smart hairbrush”, which can assess the damage caused by hair treatments such as dyes and bleaches.

The article about this hairbrush is halfway down the page, but worth a read — NewScientistTech.com.

Read the full damage-sensing hairbrush patent application, here.

Such a device (if easy to use for the consumer) could give you a way to get miniaturization mapping done on your hair. Innovation shows how well the human brain can tackle problems.

Tags: hairbrush, hair damage, smart hairbrush, smarthairbrush, kao