Propecia and Sensitive Testes

I’ve been using Propecia for about 3 months now and my testicles are extremely soft and sensitive. Should I continue using it? Will this condition worsen to where I may become impotent?

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Although testicular pain and tenderness are sometimes reported by patients who are on Propecia (finasteride 1mg), the rate of this side effect is the same as those on the placebo. Impotence is not one of the documented side effects of this medication and I would doubt any permanent side effect like this would occur from taking Propecia. My advice to you is to stop Propecia for a few weeks and see if the pain goes away. You may also cut the dose of medication to half a pill each day (after stopping it for a week or so to see if the symptoms go away). Some of our patients had good results by cutting the dose of medication. If you continue to experience the pain, stop Propecia and discuss it with your doctor.

Tags: finasteride, propecia, testicle, teste, pain, tender, hairloss, hairloss

Permanent Make Up on the Scalp?

Hi Dr. Rassman. I recieved two hair transplant procedures in the late 90’s with micro/minigrafts. I just recently had them removed with lasers. It took me 11 sessions but i got there. I proceeded with 3 micropeels. I’m sad to say that I’m really not satisfied with the results. I want to know what your opinion is on permanant make up on the scalp? I really don’t want to proceed with anymore surgeries…You’re feedback would be greatly appreciated. Please note if you’ve ever seen permanant makeup on a hair transplant recipient ..thanks so much

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I have seen quite a few people who had their scalp tattooed. I would suggest that this may not be the best approach for you. I will assume the the peals left you with discolored skin and the transplants that were lasered also gave you a less-than-normal looking scalp. Your situation is a complex one to solve since you have gone through all of the things (number of surgeries) you had. I would be happy to see you, but a face to face meeting is the only way I might be able to help you or anyone in a situation similar to yours. I have always said that the good and the bad news about scalp and hair surgery is that these are permanent procedures. You can try to undo what was done, but the results will never quite be 100% to where you once were. This is why researching your doctor is important and this is certainly why understanding what you are getting into is extremely important — before you ‘dive in’ and that goes for any procedure, cosmetic or otherwise.

Tags: scalp, tattoo, makeup, hairloss, hair loss, hairtransplant, hair transplant

Salve of the Comfrey Root Stopped My Hair Loss and Regrew My Hairline!

I’ve been using a salve of the comfrey root and its flowers on my head for the last four years, it has stopped my hair loss and has regrown hair in my residing hairline. I did this experiment on myself based on the fact that comfrey contains a chemical compound called allantoin which is a cell rejuvenator. My barber will testify.

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This appears to be a product with extensive claims that run the gamut — gum disease, hair care, hair damage, hair growth, hair loss, halitosis — and have no basis. If you believe in this product, I would suggest that the readers take notice of my slogan. Let the buyer beware.

There is generally interesting information about comfrey root, its history and much about its growth and use at Wikipedia. Many, many herbs are used for various conditions and when they work for one of these conditions, the person becomes an advocate. This type of advocacy is not scientific. We only know the successes and not the frequency of failures, because advocates do not talk about the failures. For the advocate, it may reflect their pride of authorship and an individual’s need to contribute to the welfare of fellow human beings, but as a clinician, if I recommend something (even an herbal type of product like comfrey root) I want to have evidence of its effectiveness and its safety.

Tags: hairloss, hair loss, comfrey, root, herb, flower


I am just wondering if you have heard of Adenogen, a hairloss product by Shiseido, one of the biggest cosmetic company in Japan. What are you thoughts on it? Do you think it is likely to work?

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Here’s yet another product that costs quite a bit ($85) for a 5 oz supply and is claimed to be a “quasi drug” for some possible benefits of treating hair loss. My guess is that for that kind of money, I would think that it better work. I did find this forum topic on that discusses Adenogen, if that helps any.

Anyone out there that has tried this product, please feel free to comment or let me know via the Contact page.

Tags: hairloss, hair loss, adenogen, shiseido, japan, cosmetic

Seborrheic Dermatitis and Minoxidil

I have had patches of sebhorrheic dermatitis on my scalp since I was little but since I started using Monoxidil for my hair loss it has spread over my entire scalp. My doctor perscribed the strongest medication that she could prescribe (clobetasol propionate) and it isn’t working at all. I just started using the monoxidil 3 months ago and was wondering if my scalp will eventually adjust and stop itching and flaking as bad?

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It sounds like you are reacting to the minoxidil, which can increase the flaking of the scalp. You are probably not a candidate for minoxidil, so try stopping it for a week or two and see if the problem goes away. When people react to this medication, it usually does not get better and may actually get worse. Long term use of topical steroids are risky, so be careful.

Tags: dermatitis, minoxidil, steroid, hairloss, hair loss, clobetasol

Hair Damage from Dirty Hair Brush?

Can you lose or damage the hair if using a hairbrush that hasen’t been cleaned for a long time?

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Have you heard the old saying that cleanliness is next to godliness? Are you asking if you can damage your hair using a brush that has been in the drawer for a long time and then used on your hair without the brush being cleaned? Well, the answer is probably not. The question I’d wonder might be how old the brush really is and how long it has been since you used it last.

Tags: brush, hairloss, hair loss, damage

Transplanting Asian Hair (with Photos)

I am Asian. I lost all of the hair in the front. I understand that black hair and white skin (my situation) is more difficult to get good results. True or false?

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True. Asian hair, which is often straight and black, is contrasted with a light skin color making the hair transplant less forgiving if it is done improperly. So while it is more difficult to get great results, it is not impossible. We have transplanted hair for many Asian patients over the years.

Here’s an example of one Vietnamese patient that has a Norwood class 6 pattern of hair loss. The photo on the left is before hair transplantation, the photo on the right is after 1 procedure of 1,852 grafts. Please click to enlarge.

Tags: hairloss, hair loss, hairtransplant, hair transplant, asian, asian, vietnamese, vietnam

Which is Better — FUE or Strip Harvesting of Follicular Units?

Does follicular unit extraction (individual follicles are removed from the back of the head creating a tiny round punctate scar) and FUT (follicular unit Transplant – where by a strip of hair is removed creating a line scar) produce better grafts? In your experience, what procedure out of these two causes the least amount of damage and would better serve the interest of the patient at the end of the procedure?

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Both techniques should give you real follicular units, but often the FUE in many doctor’s hands do not give real follicular units because they are transplanted as they are taken out (complete follicular units, more than one follicular unit, or parts of a follicular unit). Strip harvesting is better in most people, simply because the strip is highly efficient and very controlled in most doctors’ hands to prevent damage. FUE grafts are not always of the same quality as strip follicular units. The reason for that depends upon the particular patient and the particular method used for the extraction. In many patients, the grafts are extracted and devoid of fat and supporting infrastructure (very skinny grafts), which makes them more vulnerable to the environment and more easily damaged when transplanted.

Tags: fue, hairtransplant, hair transplant, strip, hairloss, hair loss

Reversing Stress Hair Loss in Men and Women

Hi Doc, Happy Thanksgiving! I have read recently in some of your blogs that stress is one of the major causes of male pattern baldness (MPB). However, I have also been lead to understand that stress would normally induce a diffuse form of hair loss all over the head; and is reversible once the stressful period has subsided. So does this mean that an individual’s MPB can stop naturally in the same manner, if its primary cause is in fact due to stress? Would taking medications like Propecia or Rogaine help? Thank you so much for this clarification!

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When a balding man develops accelerated hair loss from stress, then that hair loss is usually not reversible on its own without some medical intervention. If the hair loss is recent and the man is young (generally under 30), then it may be stopped or reversed with Propecia (possibly Rogaine, although less likely). Reversals is a hit or miss thing, but if the hair loss has been less than 2 years, the reversal is more probable than not.

The diffuse pattern hair loss you referenced and its association with stress is more with women and this may reverse on its own when the stress subsides, often without the use of medications but helped with such medications such as minoxidil. The woman’s reaction to stress hair loss is quite variable and may reflect the cause of the hair loss, the age of the woman, the use of medications that have participated in the hair loss, the existence of a variety of diseases that are known to produce hair loss (e.g. Thyroid), and the existence of any long term female genetic hair loss that may be present.

Tags: stress, hairloss, hair loss, men, women, woman, female, male, pattern

Skin Still Red Months After Hair Transplant


I’ve recently had hair grafts on my temple areas for my male pattern baldness. This was just under 2 months ago. My recovery went as expected, with the graft scabs dropping off after a week. However the skin at these sites is still slightly red (on one side more than the other) and not back to its normal condition. According to all articles I’ve read on recovery, the graft sites should now be back to normal. I’ve spoken to the surgeon about this, and he assures me there’s nothing to worry about. I’m struggling to get an appointment with him to take a look. I’ve also noticed some of that my original hair at the graft sites is thinner than before the operation. I was assured during the pre-op consultation that my existing hair wasn’t at risk from the operation. Any advice for me? Is this something I should be worried about?


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Occasional redness that lasts beyond 2 months is seen on men who are histamine positive to a scratch test. This person will eventually see the redness fade, but it could take up to 6 months to get there. With regard to shock hair loss (that sounds like what you experienced), in men this hair does not usually come back, but hopefully the new hair will be enough to compensate for the shock loss when it grows in. I am frankly surprised how many people tell me that they can not get help from the doctors who transplanted them. I have never had that complaint and even those of you who are not my patients that write to me via this site get timely, responsive answers.

Tags: redness, histamine, hairtransplant, hair transplant