What About Aderans?

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

Dear Dr.,

Now that Intercytex have moved into Phase II trials has aderans given up on their research for hair multiplication? Are they still pursuing with their version of the treatment? If so, do you know the status of their development? I thought you may have heard from ome of your contacts at the IHRS meeting in October. Many thanks for a very informative blog.

From attending the ISHRS conference last month and also being present at the Aderans presentation, there is nothing groundbreaking to report here. Aderans is continuing on with their research.

Tags: aderans, hair cloning, hair multiplication

Undescended Testicle and Propecia

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

Is there an increased rick of testicular cancer from finasteride? The product literature says something like that, although I don’t completely understand it. Would finasteride be contraindicated in someone born with an undescended testicle?

Undescended testis is a congenital disorder that is seen in male infants. Most cases will spontaneously improve within the first 4-6 months. If it persists untreated after this age, it will increase the chance of infertility and testicular cancer in adulthood.

Propecia is not indicated for use in pediatric patients, and women should not handle crushed or broken Propecia tablets when they are pregnant or may potentially be pregnant due to the possibility of absorption of finasteride and the subsequent potential risk to a male fetus genital system. Your question may be referring to the animal studies on finasteride. Exposure of pregnant monkeys has shown to cause genital defects in their male fetuses.

After complete development of testicles and when they descended to their final location, finasteride should not cause any problem.

Finasteride is not related to testicular cancer in any way that is documented in the literature that I can find.

Tags: finasteride, propecia, testicle, testicular, cancer

Finasteride Graph – Comment Needed

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

Check this out- https://baldingblog.com/finasteride-competes-with-dht-at-the-receptor-graphic/https://www.geocities.com/bryan50001/GRAPH8.GIF

You can very easily see what the graph indicates, PLEASE comment why this could be like this? Is finasteride effect still “active” despite the fact that it’s out of your body (half life) after a couple of hours?

Another question, is it possible to develop more breast tissue due to suppressed testosterone levels as an direct cause of finasteride use?!

Take much care doc!

  1. The effect of finasteride is through inhibition of the enzyme, 5 alpha-reductase. This enzyme is responsible for conversion of testosterone to DHT, which is the active form of hormone on hair follicles. Although finasteride gets eliminated from plasma in a few hours, its inhibitory effect on the enzyme remains for a long time, so you don’t need to take it more than once a day and that is probably why a once a day dose is recommended. What this graph shows is DHT levels, not effect of the drug over time. The recommended dose reflects the results on controlling hair loss, not DHT levels.
  2. In the study of finasteride in men, the incidence of breast enlargement was not significantly higher than the patients who were just given placebo. Less than one percent of the patients may experience breast tenderness and enlargement, which may be simply related to the placebo effect of the medication on some men. I have seen direct effects on breast tissue stimulation with finasteride at the 1mg dose and these man are clearly very sensitive to this drug. Please note that finasteride actually increases testosterone levels by about 15%, not decrease those blood levels as suggested in your question.
Tags: finasteride, enzyme, testosterone, dht

Topical Hair Thickener and Propecia

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

Hello,

I am 33 years old and have been gradually thinning, a diffuse thinning… since my mid twenties. I did not pay much attention to it because my hairline was always strong, but recently that has began to thin. I am trying propecia and it has seemed to halted the hair fall, but no new regrowth to speak of. I was wondering if using a topical like prothik can hinder hair growth while experimenting with propecia?

You can use a topical like Prothik or DermMatch to camouflage your balding scalp while using medications, or even after hair transplant surgery, before your own hair is thick enough to cover the thinning area. DermMatch is best to use when there is still hair to cover the scalp and does not work well in frank balding. In some patients with diffuse thinning who are not candidates for hair transplant surgery, this might be the only solution.

Tags: hairtransplant, hair transplant, hairloss, hair loss, propecia, prothik, dermmatch

Why Do Hair Loss Treatments Not Work in the Frontal Hairline?

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

Is there a reason why rogaine and finasteride only work on the vertex but not the receding hairline/frontal area?

Many aspects of the mechanism of action of Rogaine and finasteride (Propecia) are still unknown, and for that same reason we do not know why they work on the vertex better than the temple and frontal area. I can guess that reversal of frontal hair loss is very rare, because by the time the treatments are started, the balding has gone too far as it starts earlier. Crown balding is slower and from the time it is first recognized, it often early in the thinning process. As such, reversal of crown loss is much more common with these medications, particularly in the young man under 35 years old. However, finasteride does work to slow down or stop hair loss in the frontal area, particularly if caught early enough.

Tags: finasteride, propecia, rogaine, hairloss, hair loss, frontal, hairline

Dry Scalp and Minoxidil

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

Dr, i just read a reply of yours saying that the dryness sometimes caused by minoxidil can cause hair loss. i am currently 21 and noticed thinning at 18 and have been taking rogaine/generic minoxidil for about 2 years with no success (hair is still thinning) and just started taking propecia 4 months ago. i’ve always had a probelm with having a dry scalp but if minoxidil could worsen this do you recommend that i stop using it and just continue with the propecia? thank you for your response and all the help your site has already provided.

Dry scalp will not cause hair loss in itself. A small number of people who use minoxidil have told me that they experience drying of the scalp secondary to the inactive ingredients that may irritate the scalp. Those users generally stop using the medication.

Minoxidil is a topical drug used for the treatment of hair loss so it should not cause hair loss. Furthermore, there is talk among clinicians indicating that using minoxidil in conjunction with finasteride (Propecia) may have a synergistic benefit. Finally, for those who may have dryness of the scalp secondary to the generic spray on minoxidil, there is a new foam/mouse formulation of minoxidil (Rogaine Foam). It is reported to be easier to use with less irritating effects.

Tags: rogaine, minoxidil, foam, scalp, dry

Did Johnny Depp Have a Hair Transplant?

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

Doc, Johnny Depp totally had a hair transplant. Compare this pic of him wearing a tuque or beanie or whatever Americans call it:

https://www.johnnydepp-zone.com/deppartment/nocolor/13.jpg

to this pic in the same head-gear:
https://www.johnnydepp-zone.com/deppartment/nocolor/09.jpg

Those photographs seem to show slight differences in the corners of the hairline. Could this be a hair transplant that caused this difference? Possibly. I’d guess that it’s probably the photography leading the viewer astray.

Tags: johnny depp, depp, hairtransplant, hair transplant, hairloss, hair loss, celebrity

When Can I Get My Hair Transplant? I’m 22 Now!

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

I am only 22 and started losing hair at around age 20. I have been on propecia for roughly 4 months and it has already completely stopped my hair loss. I would rate my hair coverage about a 7 now. Given the fact of my age and great propecia results would a hair transplant be a viable option now given the fact that I dont think I will get the growth I am after from the propecia drug alone? Cheers

Taking Propecia for only four months is a relatively short time. I would wait out a full year before concluding what will happen to you. Get your hair mapped out for miniaturization to get detailed metrics for what is happening on your head. When this is done before and after starting Propecia (after 12 months or so), then you will get an idea what nature has in store for you. Do not rush to a hair transplant now. Give the drug a chance to become effective first. Even though you’ve already started the Propecia, it’s still not too late to get your scalp mapped! It’s better to get the mapping done now, rather than not at all.

Tags: propecia, finasteride, hairtransplant, hair transplant

Hair Multiplication Won’t Give a Full Head of Hair

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

Hello Dr,
I have been looking at articles in relation to hair cloning recently and something caught my attention. Researchers are warning that the first available hair multiplication procedures won’t give a full head of hair. If this is the case do you think hair multiplication will be able to give a full head of hair in the near future? Do you think these kinks will be ironed out? Your views on this would be much appreciated.

The solution where one hair can make many, is years away. We really do not understand the process and can not replicate it at this time. Too much hype, in my opinion and years away from a solution. When ever I report this, I get many emails that knock my pessimism — but I can’t please everyone.

Tags: hair cloning, hair multiplication

I Am Getting Confusing Advice From Doctors

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

I have done my research on hair transplant for about nine years now. I have always had thin hair but it seemed to progress durring my early twenties. I am 29 now I ahve never had any proceedure. I have had 4 consultations with Dr. Bernstein who has repeated to me that I am not a good candidate for a proceedure. Dr. Bernstein proscribed propecia to me. I have taken it for 4 years (proscar actually) and it has really slowed my hair loss if not completely halted it for teh last 4 years. I do have thin hair all over and thus not great donor area and it is thinner up top and especialy in front.

Yet I still just want some more hair in the frontal area to just look better if even for a couple of years. I have had numerous consultaions with many other surgeons and I have a scheduled appointment to have it done by another doctor.

After reading many things online and reading your blog I am starting to have doubts.

I know I will never have a strip surgery but I am wondering about the validity to any of these proceedures. there is so much garbage out on the internet. i do not know what to believe anymore or who to believe. i just want someone who knows that i want to look better but at the same time cares about who i am and does not want to suffer. i rather be ripped off but i dont want to be deformed or anything.

I really wanted to have this done by Dr. Bernstein but at the same time he tells me to just cut my hair short and i look fine. Every other Dr. I ahve met has said the same thing about Dr. Bernstein – he is ultra conservative. The doctor who wants to do my surgery this week indicated that he did not undertsand why Dr. Bernstein did not want to perform FIT or FUT on me. He suggested that Dr. Bernstein’s techniques are not very advanced. Another doctor was pushing strip surgery and saw me for about a total of 30 seconds.

I already have been financed for $7,000 for 900 grafts. Not sure if I should do it anymore because I am so confused – yet I really wold like to have more hair in the front.

Please, Please give me some advice. should I go through with this. I was 100% ready and then i started to surf around on the net and suddenly i am worried and paranoid. Some of the doctors seemed very professional and honest about the results especially long term. Other than losing my money are there any cons. I figure I will just shave my head in a couple of years if I lose everything anyway. Is there any way to find out who are the bad doctors out there to help me focus on what to do?

As I have said time and time again, this is a buyer beware business. I have edited out the many doctors you asked about, because my job is not to slander anyone. I left Dr. Bernstein’s name in your questions, because I know him and he is honest and always professional at making decisions that are in the patient’s interest. Remember, Dr. Bernstein did not make any money in this case and will not make any money when he is telling you to hold off on a surgery. He, like myself, is a hair transplant surgeon and when an honest doctor is telling you to hold off, he is going against his short term financial interests. In the long term, being protective to patients is always good business; trust and reputation are things that have no price for us, for a good reputation is really invaluable. It is clear from your question that you are not sure about what to do, so I would always tell someone like you that a good decision today is a good decision tomorrow.

There are a number of websites worth looking at for doctor recommendations, including IAHRS and HairTransplantNetwork.com. Also, please read my previous blog entries for ways to select a doctor, learning about pricing of transplants, and cheap tricks some doctors pull to get you to have a surgery —

Tags: hairtransplant, hair transplant, doctor, bernstein, hairloss, hair loss

FUE vs FIT — Which Technique is Recommended?

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

Overall what would be your recommendations for a procedure that would better serve the interest of the patient the FUE or the FIT?

The difference between FUE (Follicular Unit Extraction) and FIT (Follicular Isolation Technique) is essentially in a name. The originators of the technique called FIT, in my opinion, could not get credit for an inventive breakthrough, so they simply changed the name. With that said, the FIT doctors use what they think is a different instrument (a sharp punch with a depth guard), something I used in the early days when I was originally exploring the technique and found no real advantage because any alteration in the angle of a sharp punch will cut through the graft and kill is. I believe that the use of a sharp punch of any type causes too much damage, so I rarely use it except for special cases where my biopsy shows that it has value and will not damage the hair. The best interest in patients is served by the least damage in the extraction process when these procedures are selected. There is enough difference between the tissues of one patient vs another patient that fine tuning the instrument (which instrument will be best for that particular patient) is critical (my opinion).

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

Taking Expired Propecia, Transplanting Spikey Hair

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

Thanks for your very informative blog.

Two questions: I’m 35 – MPB runs in my family. I’ve avoided using anything and think I’m ready to try propecia. I actually got a prescription for it about two years ago – just didn’t take it. Is there any harm in taking expired propecia?

I few years back I saw a transplant doctor in San Antonio, TX. He said I would not be a great candidate for a transplant because the hair in the back of my head is kinda spikey and the scar would be noticable. How do you deal with folks with spikey hair to minimize that?

Thanks so much!

If the Propecia was in a sealed bottle, it would probably be ok. I won’t recommend taking it, but I do recommend reading this article from Newsweek published a couple weeks back — Do You Take Expired Medications?. Contact your prescribing doctor for the final word on what you should do.

With regard to your question about spiked hair, I’ll assume that the doctor you saw was saying that your hair was very straight and strong in character. That should not be a problem for transplantation. Asians have strong, straight hair and I do such surgeries on this type of hair quite often with no problems.

Tags: hairtransplant, hair transplant, spike, expire, expired, propecia, finasteride, drug

Hair Loss Potential from Prescription Drugs

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

Hello,
I Have a question regarding prescription based drugs and thier potential to cause accelerated hair loss. For many years I have had a very mild thinning throughout my crown and front (not very noticable). I never really considered going bald, as it is not in my family.

I work out a lot and started using phentermine as an energy booster and to help keep me on a very strick diet. I ended up going a few weeks only eating a small portion of vegetables, rice, and nuts (very little). I was also taking Xanax to help me sleep at night.

During this time I noticed an incredible loss of hair just at the top of my head. Picture a skunk, that is kind of like the very thin line of hair I have right down the top (form front to mid section).

Could this be the drugs? Now that I have stopped, will this possibly grow back?

Thanks

You described some of the causes of hair loss — diet and weight loss, drugs possibly with androgenic bents, drugs known to possibly contribute to hair loss, and stress. You may also have turned on the switch for male pattern hair loss with a thinning pattern on the top of your head. If you triggered the genetic switch, then you should have your scalp hair mapped out for miniaturization. Once your diagnosis of male patterned hair loss is in hand, consider starting on Propecia. If the genetic switch was turned on, you may not get your hair back, but Propecia might help with that agenda. In any event, if you do nothing you will know in less than a year if the hair will grow back by just watching it.

I’m Not a Drug Taker, But I Want to Maintain My Hair

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

I am having a 2200 graph transplant next month. What in your opinion is the best way to maintain what I have on my head. I am not a big drug taker and I feel like if I dont take something, I am wasting my time because my hair is going to continue to fall out.

The only way I can recommend to minimizing your progressive hair loss — and yes, it is progressive, because that is the nature of the beast — is to take finasteride 1mg (assuming you are a male). If you do not take this medication, you will most likely continue to bald, because that is what happens to men’s hair if they have genetic hair loss. I do not know if you are wasting your time, but you aversion to taking a pill once a day makes no sense to me. By taking finasteride once daily, you are not becoming a drug pusher, just a smart patient.

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

Dry Skin and Hair Loss

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

Hi Dr., I recently had a consultation and I think I was told that retin A caused hair loss. I believe the doctor sai that it dries out your skin and this causes hair loss. I have recently began using minoxodil on the sides of my head and for some reason it causes my face to dry up and I was wondering even though minox. is prescribed to treat hair loss, can it cause it by drying out my skin.

Is that correct? Thank you.

Rogaine FoamMinoxidil (Rogaine) can be a skin irritant for some patients and Retin A is an acid which burns the skin and will cause dryness. Some patients have told me they stopped using minoxidil because of this side effect.

BUT… there is a new form of minoxidil that just came to market called Rogaine Foam which should not cause the dryness that other topical minoxidil may. I do not have personal experience in using it (I take Propecia), but some readers of this site have written to let me know that they do like the foam better due to ease of application and less of a skin annoyance. Reports by experts indicate that there is better absorption and better blood levels with the foam whihc should translate into better results over time.

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