2% Minoxidil Worked Well, 5% Worked Better — Should I Try 15%?

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

A while back I began using Rogaine 2% and found after a number of months that it worked well for me. I have always have very thick dense hair in my youth. I then tried the newer 5% Rogaine and found that it worked even better, including additional hair growth of the hairline, though not a great deal. Going on this premise that the higher concentrations offer myself additional hair growth I am interested in trying even higher concentrations. I hear that they are available up to 15%. What would you advise, should I attempt it and how high a concentration can I use safely. I have not had any adverse reactions in the year that I have used these products. I am a male 50 years old.

Some doctors regularly formulate 15% minoxidil. I am sure that if there are no side effects you experience (such as blood pressure drop manifested by light headed feeling), then it would probably be more effective. Just a guess on my part and it would require a doctor’s involvement.

Tags: hairloss, hair loss, minoxidil, rogaine

Stress Caused Body Hair Loss

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

I lost my hair because of bad nerve and stress. i lost my hair in spots. what do i need to do to make it come back? I lost my hair on my stomach and face.

For a very short and brief description and without the luxury of a physical exam, I cannot offer much help, but I can suggest that you visit your primary care doctor or a dermatologist to make sure you do not have any other medical causes of hair loss. It sounds like you might.

Tags: hairloss, hair loss, body hair, stress, nervous, body, facial, face, moustache, beard

Are Neck Pain, Hearing Loss, and Itchy Scalp Related to Hair Loss?

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

(female) I was in a car accident a year ago and have been suffering neck pain since. I also have noticed in about the last 5 months severe itchy scalp and some hair thining. I noticed the loss by my forehead at first but within the last month noticed that I can put my hair in a small clamp. I never have been able to do that before. Also I have noticed some hearing loss, could this all be related? Thank you

Neck pain is not related to hair loss. Itchy scalp is not related to hair loss. Hearing loss is not related to hair loss. Itchy scalp with neck pain and hearing loss in any combination are not related to hair loss.

You may just have a lot of separate medical issues going on that needs to be followed by a doctor. Hair loss can be a result of stress (physical or mental), which you may have.

Tags: hairloss, hair loss, pain, neck, hearing, itch, scalp

Female Hair Systems in the UK?

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

Dear Dr Rassman,
Your blog site is very interesting and I came upon it by chance.

I’m a customer of Farrell systems and was wondering where else I can buy as good a unit with that natural front. Can you direct me to another similar company, preferably in the UK? It seem hard to find systems as natural, am I right?

I am sorry, but I am in California and my network to wig makers in the UK does not extend to the one-on-one associations I have here. If there are any suggestions from those that are reading this, please feel free to post a comment. Thanks.

Tags: wig, hairsystem, uk

Any Adolescent Hairline Transplant Photos?

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

Can you post a before & after photo of someone who you’ve lowered their hairline to an “adolescent hairline”. I know you’ve said in the past you usually only do this procedure on someone who makes their living by their looks & I wanted to see how much of a difference it would make. Thanks, great blog!

These three patients had their central hairline brought down to the childhood hairline position:

Also, please take a look at the hundreds of patient before and after photos on my website in the Patient Photo Galleries.

Tags: hairtransplant, hair transplant, hair loss, hairloss, photos, hair restoration, hairline

After Years of Taking Propecia, I Finally Experienced Side Effects

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

Hello Dr. Rassman,

I am a 21-year-old male student who has been taking Propecia 1mg daily for almost 3 years. When I began taking the drug, I experienced both maintaience and regrowth, and I love my new hair. I have, however, in the last 6 months or so, experienced problems. After several years, side effect free, I experienced the loss of morning erections and the inability to perform in the bedroom. Could it be that the side effects “snowballed” over time? I really like the meds; they have served me better than expected. Have you ever heard of this happening before? Also, I am a heavy smoker.

I doubt that finasteride side effects have accumulated or “snowballed” over time. The side effects may NOT be related to Propecia (finasteride 1mg) and could be associated with your smoking (which does impact blood supply to small blood vessels) or even something else entirely (I don’t know your medical history, so I can only make assumptions). One of the many side effects of cigarette smoking (aside from lung cancer and death) is impotence. You can experiment and find out the cause by:

  1. stop taking the Propecia for 2 weeks and see if the sexual problem goes away, as it should if it is Propecia related
  2. stop smoking

You should seek the help of the doctor who has prescribed Propecia to you.

Tags: finasteride, propecia, smoking, cigarette, hairloss, hair loss

More on Rogaine Foam

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

In a previous post, I discussed Rogaine Foam when it just came to market. There appears to be good information now that the foam delivery system for Rogaine seems to increase the effectiveness of the medication by a factor greater than two. With greater effectiveness as measured by increasing blood levels, one could and should assume that the delivery into the skin is more effective than the traditional oil or alcohol base of the ‘old’ standard product. Greater skin delivery will almost certainly bring better benefits. Time, of course, will tell us what it all means, but for the moment, I would recommend using this product and sticking with it for a full 8 months before drawing conclusions one way or the other.

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

Hair Falling Out — Lighter Color Near Bulb

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

I am a 21 (about to be 22) year old male and I am currently in between a NW 2 and 3 on the balding scale. I’ve been taking propecia for about 4 months with decent results.

My question is, when I examine hair that has fallen out of my head, it appears that the hair is lighter colored at the base of the hair (near the bulb) than up around the middle and tip. Is this a sign that the hair has thinned or is it normal for hair to be lighter near the base?

You did not state your hair color. In blonde, gray or white haired people, the bulb is lighter. In hair that is near the end of its life, the pigment changes may be lighter in color as is hair that is about to go into telogen. If you are worried about balding, then get your hair mapped out for miniaturization to determine what is actually going on in your hair.

Tags: pigment, change, hairloss, hair loss, miniaturization

Mystery Rash on Scalp

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

I’m a 19 year old male whose hairline has been steadily declining since I was about 15. Hair is thickest at the back of the head, and thinner towards the forehead. There are no balding spots; but I’m noticing that V-shape with regards to the temples. I figured this was typical hereditary hairloss, except since my early-to-mid teens I’ve experienced a slightly rough-feeling rash around my scalp, which seems to pop around it in spots at random from day to day – particularly towards the front of my head towards the forehead. It looks like a sunburn, but it’s there year-round and there are some small pimple-like sores scattered about wherever the rash is. They don’t hurt when pricked, though I’ve avoided this. I’ve seen a dermatologist (roughly two years ago), whose best guess was acne (which was on my face at the time), so I was given Accutane for three months – my face is great, but the scalp problem persists. I’ve also been on tetracycline occasionally. And I know a Accutane causes hairloss, so I’m sure it hasn’t helped the problem. But over the last few months the hairloss has been socially noticable, though before I took Accutane some would still wonder where my hairline is. So, I guess my question is…can you guess the mystery rash? Two doctors and a dermatologist have had no idea, since I’ve no symptoms of Sebhorrea (sp?) and the like, and well, am completely confused with what’s going on. Few are bald in my family, and those that are weren’t balding before 30. And the rash is unique. I can’t think of anything unique to my environment to cause it, though I have an affection for coffee and started smoking recently (cigarette a day). Any idea?

After two doctors who have actually examined your scalp, I doubt I can guess what your mystery rash on your scalp may be (especially via the internet). If you are thinking that you are developing frontal balding, please read the following reference article: Juvenile vs Mature Hairline — Am I Going Bald?

Tags: hairloss, hair loss, rash, scalp

My Earliest Dermatology Appointment Is Months Away

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

hi doctor
I took steroids and now its been over 3 months since I stopped and my hair still keeps on falling out. I am trying to make an appointment with dermatologist and I cant get an earlier day than january 10th. In my opinion if I will wait that long my hair will be totaly gone by that time. I wonder is my DHT will ever get normal on its own. I dont know what to do. its very sad that I just turned 23 and I am going to be bald.

Try to see a good family doctor then. If you are a young man and have stopped the offending steroids, then a good doctor can easily prescribe Propecia for you. If you are in California, the wait for seeing either Dr. Pak or myself is not more than a couple of weeks.

Tags: hairloss, hair loss, steroid, dermatologist, appointment, doctor

How Did I Get Fungus On My Head?

/by William Rassman, M.D./16 /,

I recently discovered a patch of my hair is missing in the middle of my head, the area is very tender and itchy. I went to a dr and he told me it was a fungus. Other than taking the meds I don’t know what type of fungus it is or how to keep it from happening again. Or if my hair will even grow back.All I was told was he saw that there was a black head in it……Iam confused

The appearance of a fungal infection may reflect:

  1. other diseases that you have (example could be HIV positive people)
  2. conditions on the scalp that change (wet conditions, sweat, gels or topicals)
  3. certain medications may make you prone to these like those which treat heart and kidney transplant patients
  4. a change in climate (people who travel may come back with these infections)
  5. poor hygiene
  6. injuries and wounds
  7. unknown causes (see: MedlinePlus – Tinea capitis)

If you are confused, I suggest that you ask your doctor to clear up the confusion for you.

Tags: hairloss, hair loss, fungus, ringworm, fungal

Oily Skin or Acne a Factor in Male Pattern Baldness?

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

Is having really oily skin or acne a risk factor for Male Pattern Baldness? My dermatologist didn’t see any miniturization. I’m not shedding. I’m 22 years old and there’s no visible recession. I still have a teenage hairline. But I do have really oily skin. My dad is a Norwood Class 7. I figure if I was going to be a class 7 I’d have recession by now. What do you think?

Acne is common in young men, and really, it’s common with any man with oily skin. That being said, there may be an association, but not a cause and effect (balding does not produce acne). Likewise, oily skin and acne will not cause balding. The acne problem is more common in the young patient, when hormones seem more volatile. I am sure you remember the days in high school when the zits seem to pop up at the worst times. In these situations, the appearance of the beard in the young man compounds the problem.

Tags: hairloss, hair loss, baldness, acne, oily skin

No Hair Growth Months After Chemical Burn

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

Hello,
I have 2 scars on the top of my head from a chemical burn. During the healing process I noticed hair underneath the skin that looked like stubble. I was wondering if there was a chance of my hair growing back because of this. It’s been 2 months and my wound is healed but no hair. I have been looking into tissue expanders and hair transplants but wondering if I should wait to see if my hair grows. Friends are saying that the hair might not grow until the wound heals. Is that true? and if it is do you think I should wait because it has only been a week or two since my wound completely closed?

This is not an easy question to answer. If the burn was second degree, then the hair loss will probably return by the end of the induced telogen cycle that the burn may have caused. A second degree burn does not go through the entire skin below the dermis. Some elements of the hair shaft remains and these often grow new hair, to a varying degree depending upon the depth of the second degree burn. The less deep, the better the hair growth will be. If the burn went through the entire skin below the level where the bottom of the hair follicles are, then the hair will not regrow. Full thickness burns are relatively easy to diagnose as the skin is very tight and tissue like. Most full thickness burns form large wounds (sounds like what you are talking about) and the growth of the skin comes from the healthy skin around the burn. It takes months for such wounds to close on their own and some require surgery to get them closed. I do not know how big this burn was (size is very important), if it is really uniformly third degree or not, to what depth it went, and whether it is combined with a second degree component to it. I will assume that it must be eary serious if you are looking into tissue expanders. As you are in Los Angeles, I would be pleased to give you a second opinion if that suits you. You can call my office at 800-NEW-HAIR if you’d like to setup a free consultation.

Tags: hairloss, hair loss, chemical, burn, degree, hair growth

7 Year Old Daughter Has Telogen Effluvium

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

My daughter’s hair has been falling out since mid July. She is 7 years old, and other than her hair falling out seems perfectly healthy. Her pediatrician referred me to a dermatologist who said it was telogen effluvium. I cannot think of any event that could have triggered this. She had the flu in mid April and the hair started falling out in mid July. Could this be a cause? Does hair typically grow back? Do I have any options for her other than just waiting it out?

Sincerely,
A very worried Mom.

There is much written on the subject. You need to understand that there is much we do not know. The acute phase of the disease entity may disappear in about 3-6 months from the time of onset. If there is a chronic form present, it may last a great deal longer. Read the material below. Good luck!

Tags: telogen effluvium, telogeneffluvium, hairloss, hair loss

Any Update on Lasers for Hair Loss?

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

I’ve read all of your posts on LLLT and the article on the NHI website. I noticed that the NHI article was written in AUG of ’05. Is there any update on that situation? I was thinking of buying a laser comb and was wondering if you had any suggestions?

Thanks

My experience is increasing with the large units. Many patients using it regularly have reported improvements to me. It is totally subjective, though. As I do not charge for these treatments (only for existing patients who have had surgery at one time or another with us), there is more objectivity in this type of report than in patients who have other agendas. With these patients traveling up to 3 times per week, braving the Los Angeles traffic, it tells a great deal about the value these people seem to infer. The final story is still officially out.

Tags: laser, hairloss, hair loss, lllt