Blood Pressure Medication and Hair Loss

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

Which other BP medications don’t cause hair loss and coughs like Lisinopril does?

Any medication can potentially cause hair loss as one of the side effects. However, the most common cause of hair loss is not due to medications. If you are losing hair you should have doctor who specializes in hair to examine it for signs of miniaturization in specific pattern or distribution. To answer your question more specifically, there are no studies to compare the hair loss effects of a particular blood pressure medicine against another. That is the type of research I would love to see, but a research project that is unlikely to happen. More importantly, you should always consult with your doctor before stopping or changing any medications.

Tags: blood pressure, medication, hairloss, hair loss

Shedding From Minoxidil and Propecia

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

Dr Rassman:
I started using Monixidil 5% two times a day combined with Nizoral shampoo 3xweek about two and a half months ago. I also added Propecia to my thinning hair treatment about a month ago. I started experiencing shedding about a month and a half ago and still I am shedding; my dermatolgist did not see anything wrong with my scalp by the time she Rx propecia. Is shedding normal under treatment for this long? The Monoxidil has irritaded my scalp which also seems to be part of treatment but I decided to take a 10 day brake which ends today (11/18/06) so I started using it again. The irritation has ended…so far and the Nizoral definetly helps.

I started the treatment as prevention, I am 43 and thinning but now I am questioning my decision because of the excessive shedding.
May you please offer some advice? When should I expect improvement on the shedding? Are those follicles still intact? My biggest fear is that I have caused more damage than good. Thanks for your help.

Shedding is occasionally reported when starting minoxidil or Propecia (finasteride 1mg). You must wait out the period until the shedding stops (about 3-4 months). This appears to be an acceleration of the hair cycle before the better growth kicks in. Your reaction to minoxidil indicates that you may not be able to take it. Some people get considerable irritation from it.

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

Happy Thanksgiving from BaldingBlog!

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

Thanksgiving

Happy Turkey Day! It’s time for family and a feast. The long holiday weekend is upon us, so there won’t be any new posts here until Monday. So fill up on that turkey and stuffing and take some time with family to enjoy the holiday! We’ll see you here early next week.

I Have Very Patchy Facial Hair (with Photo)

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

I’ve got some horrific facial hair coverage. From the jawline up it’s just atrocious, very thin coverage of hair, and it’s very patchy. however from the jawline down, I’ve always thought I had really nice thick coverage. Not that I’m really thrilled about it, I’m not too fond of the “amish beard” look. Is there any way to fix patchyness in facial hair? And what would cause this to happen? I didn’t have any injuries to this area as a child (no scarring or burns or anything that i remember that might prevent hair from growing there). I have attached a photo which you may use on your site. I’m 25 years old. Thanks

Some people have uneven facial hair distribution and others are delayed in their beard growth, which may develop well into their 30s with more uniformity. You should wait and see what grows out as your beard matures.

Alternatively, you may consider transplanting hair from your head to the beard area, assuming the caliber of the hair is similar (it must be close to the same texture). If it is not, then you might have two types of hair which may be obvious and another type of problem. Even though beard to beard transplants would work, I would not recommend this approach, because it would thin out the beard you have in other areas (where you are happy with it) — unless you take the hair from below the chin where it is not easy to see. This may be a bit extreme and costly, but it would work beautifully. Although the transplantation may be an option, I actually think that this may be overkill and would ask you to wait until you fully grow out your beard. If it continues into your 30s and you still want to do it, then go for it. I will take you on as a patient.

Here’s the photo that the email included (with permission to post it here):


Tags: facial hair, hairloss, hair loss, bald spot, baldspot, beard, neck

Months After Transplant, Hair Became Thinner

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

Dear Dr Rassman
First of all i would like to thank you for the great support you have been providing.

I am 27 year male. I had my hair line done(1400 grafts) 5 Months ago in LA. Around 4 months after the surgery i had good number of hair on the left side. But with in last 1 month i have noticed that my hair have become thinner in this region. Is it possible that i have lost few newly transplanted hair. And also i do not see much hair (not even baby hair on the right side). I am a social smoker i smoke between three or five cigarettes a week. Does this has any thing to do with poor hair growth .

Thank you very much for your advise.
Regards

Patients react differently to their newly transplanted hair. In some people, the transplanted hairs completely fall out before regrowing after a few months. In rare times, they grow and keep growing after a hair transplant. The final results of a transplant must be assessed no sooner than 8 months from the time of surgery, because you want styling length to about 1 1/2 inches to see the benefits of the new hair. Your thinning may have been part of the initial shock loss and may grow it back (I recommend that my patients use Propecia to reduce the risk of shock loss). With a good surgical technique more than 90 percent of your grafts are expected to take.

Smoking, as we discussed several times here before, is bad for your overall health and decreases blood micro-circulation in tissues, possibly contributing to poor wound healing. Proper wound healing is essential for the transplanted grafts to ‘take’. Smoking may potentially stop the growth of implanted grafts and in your case you may have lost some of the grafts as a result of that. Again, most patients who have less than targeted results from transplant are smokers. Maybe it is a good time for you to quit smoking. See the doctor who did your hair transplants and hold him accountable to give you the direct answers to your questions with you in the same room. If I were your doctor, I would want you in front of me at about the 8th month after the surgery.

Tags: hairloss, hair loss, hair transplant, hairtransplant, shock loss, shockloss, smoke, smoking, cigarette, healing, propecia, finasteride

Would Hair Multiplication Work After an Existing Hair Transplant?

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

Hello,
If hair multiplication becomes reality one day, can it still be performed on hair where strip transplantation has been done before? Thanks. Regards !

The way the research is going, hair follicular units that have intact stem cells will be taken out of the scalp from the permanent zone. One hair will make many hairs and therefore, as long as you have some donor hair left, hair multiplication, when it is available, will be able to be done on people who had previous hair transplants. Just don’t hold your breath for the technology to come about anytime soon.

Tags: hair multiplication, hairmultiplication, hairtransplant, hair transplant, hair cloning, cloning, hairloss, hair loss

Any Comments on False Research Findings?

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

Interesting article report!

Dear Doc, please take a look at this article and comment the content.

This is a very interesting article. I tend to remain skeptical and I am dubious of research that is poorly executed. Unfortunately, we have a tendency to want to believe certain things, and such desires will impact our own objectivity. For example, there are many lotions and potions in the marketplace that claim the ability to reverse or treat hair loss. Many of them use poorly designed research to push a commercial agenda and many hair loss sufferers want to believe that herbal and naturopathic medications can address their hair loss agenda. The research that I have reviewed since starting this blog is overwhelming and the findings of many of these products are in fact, unsubstantiated and false. This article may be of interest to some of our readers, so I did put it into the blog as a way of sharing it with my readership.

Tags: research, false, hairloss, hair loss, drug, medication, herb

Humidity, Bacteria, and Itchy Scalp

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

I notice that my scalp itches more when the relative humidity outside is high. On cold winter days when the relative humidity is lower than usual and we rely on artificial heating, I have no scalp itch. Since relative humidity is a measure of the amount of water/moisture in the air, this correlation would make sense in that the extra moisture is a catalyst for bacteria and other organisms that cause itchiness. Can you explain doc?? Thank you very much for your time.

While your theory is certainly plausible, I doubt bacteria are causing your scalp to itch. Maybe your skin type does not agree with the higher humidity. Conversely, others may find lower humidity may cause more scalp itching and skin drying. Get a dermatologist to examine you, as a starter.

Tags: humidity, bacteria, scalp, itch, hairloss, hair loss

Miniaturized Hair Shape Under Microscope

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

Hello Doctor,
For a while now I’ve wondered: does miniaturized hair have a conical shape when viewed under a microscope?

What prompts my question is the larger consideration of whether hair miniaturizes while a cycle is in process, or whether it miniaturizes from one anagen phase to the next.

I suspect that both factors are in play here. The increased hair count seen in 12 months clearly indicates a change from one cycle to another, but as I see changes in patients in an 8 month time frame when I examined the hair and observed less miniaturization, I would suspect that some increasing girth probably occurs as the hair grows out from the scalp.

Tags: miniaturization, hairloss, hair loss, hair

Lead Acetate in Hair Dye

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

I have been utilising a progressive hair colouring agent to gradually eliminate my grey. The product contains lead acetate would this chemical result in hair loss. I am 40 years old, male, and just today noticed a tiny bald spot on my crown. I have been using the colouring product for only 4 months and worry it has resulted in permanent hair loss.

I would imagine that the use of lead acetate must be safe in the products that use it or there would be a real problem considering its use in many of the hair dyes. I can not comfortably comment on this query. I did find this article from a year ago about lead acetate in hair dyes being banned in Canada — CosmeticMagazine.com.

Tags: hairdye, dye, hair dye, lead, acetate, hairloss, hair loss

Large FUE Session Risks?

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

Hi dr.
I have been looking into hair surgery for the last 3 months. It is clear to me that I opt for FUE because I want to wear my hair short in the summer and long in the winter.

I have been offered a 2500 graft session in 1 day, using FUE. Although this dr. claims to perform such large sessions I can not find any information about large FUE session.

Are large FUE sessions safe or are there risks involved ?

Thank you for an honest answer

A 2500 graft FUE procedure would require a real expert, so anyone that claims this type of result should easily prove his capability to do so by showing patient results. I would be skeptical — very much so, actually. Doctors claim whatever they want to claim, but do you want to put your future in someone’s claim if they can not really pull such a session off with 100% predictability? One doctor reported to me that he does 2000 graft FUE procedures all of the time, but from what I understand it is a follicular holocaust. Safety and integrity go together for the doctor’s claims. Let the buyer beware!

With regard to what you have to lose:

  1. money
  2. valuable, irreplaceable donor hair destroyed if yields are not in the high 90% range
  3. folliculitis from buried or transected grafts
  4. scarring

I am sure many more risks will come to mind as I think back on this question.

A large session FUE (in the 2500 graft session in one day) in theory can be done safely. I would strongly suggest that you ask the doctor to allow you to speak or even better, meet a patient or two that had 2500 grafts in a single day done by FUE, then observe the results and check with the patient who had it done about the results meeting his expectation.

Tags: fue, follicular unit extraction, risk, hairtransplant, hair transplant, hairloss, hair loss

16 Days Post-Procedure, I Still Have Scabs

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

Hello,
I am a 34 year old male and it’s been 16 days since my Hair Transplant of 1200 grafts. I still have scabs. I have been very gentle with washing, but am currently allowing the full pressure of the shower head. I have not scrubbed my scalp the way I normally would prior to surgery. Today, I lightly rubbed and picked a scab with the hair attached. It came off pretty easily. Was this the graft? Did I lose the future hair?

Can I start scrubbing my scalp at this point? My doctor recommended waiting 1 more week (3 weeks total) before washing and combing my hair as I did prior to surgery. What is your recommendation? And did I lose my hair graft? I am eager to get back to normal life. Thank you for any help.

Patients may generate scabs after surgery. It is best to wash them off before they get ‘rooted’. When they are not washed off immediately, they may last for days. I have even seen patients who do not wash well and have their scabs last for weeks. Pulling off scabs during washing and styling is one of the most common causes of losing a graft after transplant, although I would doubt that it would occur 16 days out. We did a careful study to determine when the vulnerability of graft loss ends and we found out that the existence of scabs parallels that risk. Study shows that pulling grafts can remove the whole graft any time during the first 10 days, at which time the scabs usually fall off with reasonably vigorous washing.

When fully healed, the follicle becomes part of the recipient skin and will keep its ability to generate new hair. You are well beyond day 10 and it is unlikely that you will lose your graft at this point in time. Let shampoo stay on your wet hair for 10 minutes or so, then rub the scabs gently with your fingers and the scabs will fall off.

Tags: scab, hairtransplant, hair transplant, aftercare

60+ Year Old Female — Hair Transplant Possibility?

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

I’m a 66 year old female taking thyroid and blood pressure pills for an underactive thyroid and high blood pressure. Would having hair transplantation be successful at this age? How much would it cost? My hair has become thin and brittle, as well sparse. Please let me know what is the possibility of a successful transplant without complications.

To answer the question, I would want to understand the quality of your donor area and the degree of miniaturization you have in the hair of that permanent zone. Then I would want to know the extent of the hair loss and the size of the area that you want to treat. I would want to map out your scalp for miniaturization as I would need to know that information in order to ascertain if you will be helped or hurt by a hair transplant. Evaluating women for hair transplants is a real art combined with science. I met a doctor at the recent annual International Society of Hair Restoration Surgeons meeting that told me that their medical group did surgery on better than 95% of women who came to them. I would suspect that the doctor has terrible results and many unhappy patients. Get a good doctor who knows about this and get yourself evaluated properly.

Tags: hairloss, hair loss, hairtransplant, hair transplant, female, woman, women

What is Diffuse Unpatterned Alopecia (DUPA)?

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

Hello!
I have seen many dicussions related to Diffuse Alopecia or DUPA, but I have never understood the causes. Is it genetic hair loss expressed in a diffuse pattern, or is it a kind of disease caused from something else?

Thanks a lot for your time!

Diffuse Unpatterned Alopecia (DUPA) is a condition where the hair has miniaturization throughout the scalp without a particular pattern to it. Women who have genetic hair loss have something that acts and looks like the male patient with DUPA. It is generally believed that in men, DUPA is genetic and hormonal. At times, it will respond to Propecia (finasteride 1mg) in slowing down its advancement and in about half of male patients it does get better (slightly) with Propecia.

Tags: finasteride, propecia, diffuse, alopecia, dupa, hairloss, hair loss

Dandruff Getting Worse on Propecia

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

Ever since I started Propecia I noticed that my dandruff was getting worse. I have had nice results with stopping my hair loss from Propecia and I think that it may be regrowing my hair, but the increasing dandruff has become an embarrassment for me. Any suggestions?

I have had a few people complain of increasing dandruff. There seems to be a benefit with using a mild steroid (1/2% hycrocortisone) a few times a week. I generally tell people that three applications, 12 hours apart would be ok, but not to use it heavily or too much steroid can be absorbed in your system through the skin. The use of Nizoral shampoo has worked for many of these people.

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