I’m Taking Propecia, But I’m Not Convinced I Am Balding

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

Dear Dr.,
I have been taking propecia for three days and I’m now not convinced that I am suffering from male pattern baldness. If I stop taking the drug and wait to see if my hair starts thinning or falling out would starting propecia again work? In other words, would propecia still be effective after taking it briefly and then starting again in the future? i want to see if my hairloss is attributable to other factors. Also, I have no history of male pattern hair loss in my family. Many thanks for your thoughts.

If you are not treating genetic balding and have only been taking Propecia for 3 days, stop it now. If you ever need it, you can start it then. Follow the old adage: If it ain’t broken, don’t fix it.

Tags: propecia, finasteride, hairloss, hair loss

How Do I Know I’m Getting the Amount of Grafts I Paid For?

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

Here’s a question I’m sure many prospective patients have asked before: How does a patient verify that he’s getting exactly the amount of grafts he’s paying for and that they aren’t being divided to artificially bump up the count and thus increase the cost of the procedure? Are we just going on blind trust or what?

Most important to ask, “Does the count of grafts correspond to what you are buying?”

  1. There should be an accounting system in place at the doctor’s office and you should have the opportunity to ask to see it. Any honest doctor will be proud to show their graft accounting system working in your situation. I just had a patient the other day who had surgery and wanted to know just what you asked. He came in to the surgery of another patient (with permission of course) and was shown how the accounting system worked to guarantee that what he was quoted was actually given. I also showed him his count sheets. Although he was shy to ask, he clearly felt better after seeing it.
  2. Is the number of grafts artificially inflated to make money for the doctor? Some doctors divide their grafts into sub-follicular units. For example, a 4-hair graft could be divided into two 2-hair grafts, and a 3-hair graft or a 2-hair graft could be divided into 1-hair grafts. In this situation the graft count would climb while the hair count would be the same. This is a problem in my industry, unfortunately. I have been quite outspoken about this problem in the past.

It all boils down to trust. If the doctor is open to questions posed by his/her patients, then this builds a trusting relationship. To be as completely blunt as possible, if you don’t think you can trust your doctor to not ‘screw you over‘ with the amount you’re paying for, you probably shouldn’t trust that doctor on almost all counts, let alone to give you the results you’re looking for. This is just another reason why doing research is very important in making your doctor selection. Also, see The Truth About Cheap Hair Transplants for more.

Tags: hairtransplant, hair transplant, hairloss, hair loss, procedure, count

Xandrox, Revivogen, and Other Non-FDA Approved Products

/by William Rassman, M.D./5 /

I am using xandrox for a while quite effective. However my hair has started again and have added spironolactone and revivogen to my regimen. I am uneasy about the revivogen i believe its making my hair loss worse, is this possible ? Apparently there is a shedding period for the product. And if it is making my hair loss worse will those hairs that ive lost grow back once i stop the product ? Do you believe its an effective or snake oil product ?

Appreciate any advice. Thanks

The enthusiasm for these products is hard to put into objective terms. I always want a good piece of science to form opinions. Many such products just do not have such science behind them. You ask me questions about how these products may interact, and I say I do not know how these products work, let alone know how they interact. If these products had FDA medication value, then the way they work and how they interact with other medications would be clearly documented for everyone to see. I always use the point that a natural product does not infer a safe product. Arsenic is natural, but not safe. It is always a buyer beware market.

Tags: arsenic, fda, xandrox, revivogen, hairloss, hair loss

Nutrition and Hair Loss

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

Dear Dr Rassman,

This is a great blog and have really learned a lot about hair loss from this site.

I am a 36 year old male experiencing MPB but I have lots of healthy body hair on chest and back.

My question is regarding nutrition and hair loss. Is the nutrition needs for scalp hair any differnet from nutrition for hair on the sides of the head or the rest of the body? After a hair transplant should one be worried about nutrition?

Would really appreciate your response.

Good nutrition is important for healthy hair, just as it is for a healthy body. Nutrition should not be a cause of hair loss, unless there is malnutrition present. Transplanted hair, like hair from the top, sides or back of your head, will do what your genetics dictate. Hair on the sides and back should grow for your lifetime and even if they are moved into the balding area, they will grow as if they were in the sides or back. After you have a hair transplant and you have reasonably good nutrition, your hair will grow and grow and grow in its new location, pretty much for the rest of your life. There is nothing that a reasonable man can do to stop the growth of the transplants.

Tags: hairtransplant, hair transplant, hairloss, hair loss, nutrition, malnutrition

Tonic or Shampoo with Procyanidin from Apples?

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

Dr. Rassman… I have come in to your clinic been mapped for miniturization and soon I will be coming in to re-supply my stock of Propecia. I continue to enjoy the info you provide on this blog… thank you!! I believe that the fight against hair-loss is a noble fight where one needs to try the things that might work. The recent posting on Apple procyanidins really peaked my interest. I would be willing to try procyanidin tonics, supplements, or shampoos etc. would you know of a reputable vendor for such product… also which form would be best a topical solution or a vitamin supplement for ingestion? I’m not getting my hopes up here just wanting to see if this is something that might work for me in addition to what I’ve already done. Your help and advice is very much appreciated.

I found the following forum thread that lists sources for Procyanidin:
Hairsite.com – Where to buy apple polyphenols or procyanidin B2?

I don’t have any experience with these products, but please let me know if any of them help.

Tags: apple, procyanidin, hairloss, hair loss, product

Ammonium Chloride in Toppik

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

Hi there. Is the Ammonium Chloride in Toppik safe for us to use? To be honest, I don’t ever wash the stuff out. I just leave it in and keep adding more. I have much less hair than it appears. But, I worry about this ingridient seeping into my bloodstream from my scalp.

It seems that Ammonium Chloride is part of the formulation for many shampoos and some hair loss products, like Toppik. I would assume that it is safe, as product safety is under the auspices of some governmental agencies that would have restricted the use of Ammonium Chloride had any major negative reports come in. But, as I can not answer you with any authority, I would suggest that you write to the manufacturer of Toppik and ask them. Many people who use Toppik do not regularly wash it out. If you are concerned about the safety of the product, then stop using it, or at the least wash it out every night.

Tags: toppik, ammonium chloride, hairloss, hair loss

I Feel Terrible Pain When I Lose Hair

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

Im a 20 year old male, and Ive noticed about 3 months ago ive started to shed my hair along my frontal hairline as well as my scalp. The thinning is gradual, but I can tell that the more I mess with it, touch it, shampoo or comb it it gets much worse. My concern isnt going going bald, my concern is that I feel terrible pains when I do in fact lose hair. It feels as if someone is yanking on my head. Also, afterwards my hair feels very oily, and has a smell to it. Is this normal shedding? Im concerned this isnt male pattern baldness Im being faced with. Thanks in advance for your time, dedication and help.

I’m not making light of your pain, but it sounds like you are overly obsessed with your hair. The pain you feel may be from the emotional roller coaster that you are riding. Do you have someone close that you can talk with? You should try to get some emotional counseling.

Many men experience pain when they lose control over their lives or their health. Hair has been known to reflect such a loss of control. One patient told me, “I have control over everything in my life, what I do, how I feel, how much to work out, who I am friendly with and who become my friends. When it comes to my hair, I know that I have no control over it.”

Tags: hairloss, hair loss, pain, emotion, control

6 Year Old Developed Very Smooth Bald Spot

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

My 6 yr old son has developed a small, oblong bald spot around 3 months ago. The spot has no signs of hair growth and is very smooth as if no hair was ever there. What could be the cause and should I take him for blood work?

You should have it look at by a good dermatologist. The possibilities are extensive, and infections are not uncommon. Ringworm (a fungal infection) is one of the more common causes in a six year old.

Tags: hairloss, hair loss, bald, child, ringworm, infection

Pulled Out My Hair Around a Bump

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

During August I went out with a friend to a fireworks show. When I came back it was pretty late and after a while, the top of my head started to hurt. There was a bump on the top of my head and my guess was that it was a pimple (because it felt oily). I’m 17 so it’s common. Anyways, it never stopped hurting for a week and during that week I started pulling out my hair out of the area where the bump was. Now there’s a bald spot of maybe 1.5-2cm in diameter. It is now October (about 2 months passed) and I only have a tiny bit of hair growing back in the center of the bald spot. Will hair ever grow back or is this permanent? Thanks in advanced.

If there is no active infection and the ‘bump’ is gone, then leave it alone and it will probably grow back.

Tags: hairloss, hair loss, infection, bump

I’ve Been Feeding My Hairless Cat Propecia

/by William Rassman, M.D./5 /,

I’ve been feeding my Sphynx (aka Canadian Hairless) cat propecia and rubbing it with minoxidil on a daily basis to see whether hair can be grown. So far there’s been no response, however, I’m hopeful.

Hairless catI honestly hope this is a joke, but you’d be surprised at some of the emails I receive that are completely serious. Most people would think that the funnier notes I receive were sent to just mess with me, but either way, I’ll answer it seriously…

Cats lick their fur and will ingest these medications. I suspect that the minoxidil may drop your cat’s blood pressure, if nothing else. Silly things like what you are doing to your cat, may make discoveries where no man has gone before. I don’t recommend experimenting on your pets though.

At least you made me smile, something that your cat may not be experiencing.

Tags: animal, pet, cat, hairless, hairloss, hair loss, propecia, finasteride, minoxidil

Will You Give a Patient a Juvenile Hairline?

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

hi dr… will you give a pt a juvenile hairline if they want it and promise to stay on propecia and are 40 yrs old and do not have a lot of balding??? please let me know .. thanks

I have to be encouraged to produce juvenile hairlines in 40 year old men. Included in my criteria are:

  1. emotional maturity
  2. good, solid thinking
  3. a good reason for wanting it
  4. some assurance (by examination and from taking a careful family history) that the person does not have advanced genetic balding

The need for Propecia (finasteride) is only critical if there is balding present. I have done hairlines on actors whose youthful hairlines are critical to their professional careers. I have created these juvenile hairlines in other people too, but these men usually bond with me and develop a relationship with me that convinces me that it is the right thing for them to do. Sometimes, when older men want a lower hairline and their balding is stable, I will move it down to a lower position (lower than a mature hairline but possibly higher than the juvenile hairline).

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

Can I Get a Hair Transplant If I Have Fine Hair?

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

Hello Doctor,

I’m currently a 21 year old male with some signs of MPB. I would say that I currently am between a NW II and III and I do have a family history of MPB on my mother’s side.

My question is more for future reference as I know you advise against most people under the age of 25 to get hair transplants.

Now for the question, I’ve always had “fine” hair (much like my mother and her father). Would this affect my ability to get a hair transplant in the future since my donor area’s hair would be much finer and not cover as much as personal with “full” hair? Have you ever turned away a patient because of this?

Also, which technique of hair transplantation would you recommend for someone with “fine” hair? The FUE or the Strip procedures?

A transplant with fine hair will produce coverage that you have always had. The transplants bring you your hair, with all of its characteristics. Most people with fine hair have a see-through look when they at 12 years old, so a hair transplant will bring you back to the see-through appearance you had all of your life. Fine hair is not a contraindication for hair transplants. The harvesting mechanism should be up to you and your budget, the supply of the donor hair you have, and the size of the bald area you are transplanting. FUE is not a good surgery for extensive hair transplants in a very bald man, just because of the number of surgeries you have to go through to achieve the numbers of grafts.

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

Hair Loss Due to Porous Hair?

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

Hello Dr. Rassman,
My hair is extremely porous, yet certainly not over-processed. I colour the gray roots once every 4-6 weeks and do not blow dry or straighten. No matter how expensive the salon or the hair product, it’s always porous. In the Summer it loves the humidity and in the Fall and Winter it looks like string.

I am also at 6 months post-hair-transplant, and I am hoping for the best hair possible. Is there a relationship between female pattern baldness, which began in my teens, and porous hair? Can you recommend anything at all for my hair, which has been treated very carefully all my life. Thanks a million, and God Bless you! xoxo

I generally do not like to make recommendations for daily hair grooming and hair management. There is clearly dry and moist hair and the difference does reflect the porous nature of the individual hair shaft for that person. The transplants should behave as it did when the hair was located in their original ‘home’ in the back of your head. I would stick to the recommendations of a good stylist who works with individuals with different hair characteristics (porous and non-porous) every working hour of their lives.

Tags: hairloss, hair loss

CT Scan and Hair Loss

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

Hello Dr – I read with interest your answer about MRI scans and how there is no link from them to hairloss as they use magnets. What then, would be your opinion on CT Scans? Could these cause hairloss and if so over what time period? i.e – a few days after the scan or a few years? Thank you for your time.

The amount of radiation that a CT scan (also known as a CAT scan) will administer is not sufficient to cause hair loss. It takes much, much more radiation to cause radiation sickness and have the side effects to cause hair loss.

For more information about CT scanning, please see: Wikipedia – Computed tomography

Tags: hairloss, hair loss, ct scan, cat scan, radiation

Removing Hairs from Scalp Pimples

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

Hi,

Im 22 and I have noticed some wierdness around my scalp. What happens is I develop pimples on my head and removing the hairs that grow out of the pimple have a very wierd end. They have a short white film on the bottom with the bottom of the hair showing a black dot. The difference is tat normal hairs come up fine with no black dot and no white film. Is this a type of disease?

From your brief description, I do not think you have a “disease”. If you have pimples on your scalp or skin, the white material is just dead white blood cells, cellular debre and bacteria that have accumlated that caused your pimple. The tiny black dot may just the end of your hair root. Unless you see the black dot crawling with tiny legs, I wouldn’t worry.

Tags: scalp, pimple, hairloss, hair loss