Taking Propecia at 18 Years Old

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

Hello doc. my family comes from a background of hair loss. Both my brothers experienced this as well at thiis age. I am 18 yrs old and have recently been in fear of hairloss as ive seen more and more hair in the bath and comb. i was wondering if it would be ok to take propecia at such an early age and if it would have long term effects. thanks

Propecia (finasteride) best started early if you are diagnosed as having genetic hair loss. You should first get a diagnosis by having your hair mapped out for miniaturization and then if you do have early balding, by all means, start the drug. Propecia is available by doctor’s prescription only.

Tags: finasteride, propecia, hairloss, hair loss

Hair Loss, Skin Rash, and Excessive Pubic Hair Sweat

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

It appears no one has helped me with my current condition. Approximately two years ago, my hair started shedding drastically. My doctor thought it was my hormones because I just had a baby. A thyroid test has been performed but test came back normal. Now I have a rash on my leg which looks like I’ve been burned. The derm said it could be a fungal infection but the culture came back negative. I don’t have a clue what the problem is but very concerned as I haven’t gotten a diagnosis yet. My pubic hairs sweat just like underarm sweat. I have to use deodarant down below because its very strong smelling which its coming from the pubic hairs. Any suggestions on what other test could be performed?

Hair loss after having a baby is a common problem. Hair should grow back with time.

It is virtually impossible to tell you what your rash is without an examination. It sounds like you are doing the right thing by seeing a dermatologist.

With respect to your pubic hair and the strong smell, I would also suggest that you discuss this problem with your dermatologist. There are a number of conditions that will cause excessive sweating and a smell (frequently an over-growth of certain bacteria in the gland itself) can be caused by such bacterial growth. Like bad breath is a bacterial growth problem, our sweat glands ‘breathe’ (metaphorically speaking)

Tags: hairloss, hair loss, pubic, sweat, rash, female, women, woman, pregnancy, pregnant

Age and Hair Loss

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

Hello sir,

I really respect your advice and in the past your forum has been very helpful for me. I do have one question however, and that has to do with regard to age and hair loss.

Currently I have a full head of hair, but for the past 2 years now, i have had some frontal recession and a thinning of the crown. Neither of these has progressed for the past two years. Since I am 22 however, does that mean with absolute assurity that I have inherited aggressive balding since I am only 22, despite the fact my hair has not gotten any worse?

Male pattern balding (MPB), androgenic hair loss, and genetic hair loss are terms used to describe the SAME thing. If you have miniaturization in the crown, then I suspect you have genetic patterned hair loss, and that means that it will probably kick in to another phase of the hair loss process sooner or later. Finasteride (Propecia) may slow down the appearance of the next hair loss cycle, but first get a good doctor and then a diagnosis before you commit yourself to a lifetime of this medication.

Genetic hair loss can start as early as the teenage years. The degree of hair loss — from small frontal recession to full baldness — is difficult to predict at such early age. There is no way for me to diagnose your hair loss without a proper exam, but genetic hair loss at the age of 22 is a good possibility. With regard to your frontal loss, be sure you understand the difference between the progression of a mature hairline and balding.

Tags: hairloss, hair loss, baldness, balding, age, teen, mature, hairline

Top of Scalp is Thinning, but Hair Still Grows Very Slowly

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

Hi Dr., I am a 23 year old black male. My texture of hair is curly (soft). About 5 years ago I was dying my hair alot and putting relaxers in it as well, for different styles. I then cut my hair very low. Now that i’m trying to grow my hair out again, the top of my hair is starting look alot thinner than the rest. I can see the little holes on my head, but the hair grows very slow from them. What do I do?

It is difficult to answer your question without a good physical exam and medical history. While trauma from chemicals may cause some hair loss, it should generally grow back unless the chemicals you used worked their way into the hair follicles below the skin of the scalp. Furthermore, if you have a very short hair cut, the thinning or hair loss is more readily noticeable and any hair that is genetically impacted with miniaturization will see slower hair growth. You may have a component of male pattern hair loss and a miniaturization analysis will show that. If you suspect such a scenario, you should see a doctor to establish a diagnosis and have a miniaturization study of your hair to see the pattern of thinning.

Tags: hairloss, hair loss, chemical, trauma, burn, relaxer

Creatine and Hair Loss

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

I was wondering if there was any correlation between hair loss and creatine usage. I’ve been working out 6 – 7 days a week for the six weeks while taking creatine every daily, and have noticed increased hair loss.

Although as far as I know, creatine does not cause hair loss, I found a couple of sites that tell stories that would dispute that. Remember, just because you read about it on the internet, it does not necessarily make it true. Take these with a grain of salt:

Tags: creatine, hairloss, hair loss, supplement

Hair Is Thinner After Taking Finasteride for 6 Months

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

Been on a 1mg Proscar for 6 months, and i’m noticing more receeding hair lines and the crown area has less density. Is it normal ? I’m not seeing any improvement as a matter of face, it worse now than before. Proscar is the only medicine available where I live that has Finasteride. and doctors are clueless when it come to hair loss treatments and diagnosis.

If what you are taking is really finasteride, then it should be working unless your hair loss is in rapid loss mode. You will know this if you stopped it, because the hair loss and thinning may accelerate. Mapping our your scalp for miniaturization would give you a clue as to what is happening. I can not tell you where to go to find a doctor to do the miniaturization analysis other than looking to ISHRS.org to find a doctor in your area.

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

Losing Eyelashes

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

I have noticed that my eyelashes are not only thinning out but on the lower lashes they are gone. My hair is thinning as well. I have made no changes in my lifestyle. The only change concerning my eyelashes is that I started using Estee Lauder mascara. Any suggestions to stop the loss and will the lashes grow back?

Best to leave it alone for a period of 6 months, not applying anything to them. It could be the gentle pulling of the brush or the mascara itself. Give it time to go through a hair cycle and then re-evaluate your situation.

Tags: hairloss, hair loss, eyelash

Estimated Efficacy of Taking Propecia In Morning vs At Night

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

Hey Doc, great site, very informative.

I know you’re not into guessing and speculation, and the question is not as simple as it sounds at face value, but if you HAD to give an estimate as to the percentage difference in efficacy when it comes to taking propecia in the morning (9:30am) as opposed to in the evening (7:30pm), what relative percentages would you assign to each? Let’s say that all other lifestyle factors are equal and the timing of dose is the only variable here. I work a regular 9-5 day, Mon-Fri.

Would you expect taking it at 9:30 am would be x% more effective than 7:30pm?

Again, just an educated guess on your part (since I value your experienced opinion). And by the way, what time do you take it?

Thanks a lot, and congrats on the awesome site! I’ve been reading almost daily since last spring :)

Morning vs evening use of Propecia should not make a huge difference. It just makes sense to me to take it upon awakening in the morning when the testosterone levels are highest.

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

Baldness Trends Through History

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

Doc,

Are there any trends in the amount of bald people we see in the population over time. For example, is there a higher percentage of bald people now than say 100 years ago? Just curious.

I have no way to answer your question. Good studies 100 years ago were not done to my knowledge. I would think that the incidence is the same considering that this is a genetic problem.

Tags: genetic, history, hairloss, hair loss, gene

Propecia and Sperm Count

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

Dear Dr. Rassman.

What current info do you have on the possibility of finasteride reducing sperm count? Are there any scientific studies out there on this subject? I will be planning on starting a family in the next year or two and fear such side effects will greatly harm my chances of conception.

You have stated that finasteride in a dose of 0.5mg is around 70-80% as effective as 1mg. Can you give an answer as to how effective you think a 0.25mg dose would be in comparison to 1mg? After only 5 days of taking a quartered proscar pill, I’m experiencing some side effects such as increased libido and problems in maintaining an erection. I have no problems getting an erection (due to the increase of libido), just maintaining it.

I’ve heard that taking zinc in high doses can significantly lower DHT levels. Can you shed more light on this subject?

Warmest Regards

PregnancyFinasteride (Propecia) may cause a decrease in volume of semen, but there is no evidence that the medication causes low sperm count in men. In animal studies, mature rats treated with very high doses of finasteride (488 times the usual human exposure) for up to 12 weeks did not demonstrate any adverse effect on fertility or ejaculate volume. However, when treatment was continued for 24 to 30 weeks, fertility rate decreased significantly in those animals. Diminished fertility was entirely reversible within 6 weeks of discontinuation of the medication in all animals.

The above mentioned study was performed with very high doses of finasteride. The occurrence of decreased fertility should be much less if any in usual doses in human. If you are still concerned about fertility, stop finasteride and the potential adverse effect of the medication should be eliminated in days.

About the effect of lower doses of finasteride, there is not enough evidence on lower doses to absolutely confirm value. We suspect the lower doses may still have a good effect based on animal studies. I can not give you an exact number for this until it is proven by scientific studies on humans. There is no evidence that fertility is impacted by finasteride so this woman on the right could have been your wife.

Regarding the last part of your question; treatment with zinc has been studied in 37 patients with infertility. Administration of zinc has increased DHT with no effect on testosterone or fertility. The mechanism of this effect is not clear. And we don’t have any evidences that zinc supplement can increase hair growth in people who are not zinc deficient.

Tags: hairloss, hair loss, sperm, fertility, proscar, propecia, finasteride, zinc

Widow’s Peak and Hair Loss

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

Hello doc, I’m a 24 year old white male.

I’ve read a lot of people refer to MPB as starting out with a “widow’s peak” but here’s a question for you sir: all of the females in my family have a natural widow’s peak shaped hairline, they aren’t flat but have that M shaped curve to them. The trait is dominant and I got one as a kid as well. I rarely see any older men out there that have low widow’s peak shaped hairlines, all of the men that have low hairlines as they age seem to have flat hairlines with just some hair loss at the temples.

My question is this: when a boy gets the widow’s peak hairline as opposed to flat, does that more commonly or always lead to a higher mature hairline as an adult? I am currently 24 and my hairline has some definate hair loss at the temples, but it still hasn’t gone back at all in the middle and very slightly on the sides. Does the fact that I have a widow’s peak shape mean I am destined for a high hairline on the front/sides?

David LettermanGood question. I believe that the frontal juvenile hairline has different genetics than the hair behind it (the mature hairline) and that includes the widow’s peak. I have seen men who maintained the juvenile hairline and lost all of the hair behind it (just 1/2 inch of hair present that is normal for that man). Also, the central forelock has a distinct genetic pattern in some family lines (that forelock will last into old age even if all of the hair around it is lost). Nighttime talk show host David Letterman has a persistent forelock which on close examination looks like a round patch of hair isolated from the hair on the sides and behind it. Sometimes the forelock is connected to a widow’s peak and sometimes it is connected to the surrounding hair.

Tags: hairloss, hair loss, widows peak, forelock, hairline, juvenile, mature

Pseudopelade and Hair Loss in Women

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

I am a 47 year old female with a very strong history of family baldness.Initially(for 1 1/2 years) i ignored the hair loss.Putting it down to the very stressful period in my life.However when the bald patches couldn’t be ignored anymore I went to see the doctor. Was first diagnosed as areata alopecia and then cicatricial alopecia.Another docter then diagnosed it as pseudopalade. What is the differerence between these alopecias and what is the treatment for pseudopalade? What can be done to cover the bald patches.

Many of these autoimmune diseases are related to each other. Pseudopelade is another type of scarring alopecia. This is the world in which the dermatologist is supreme. Look at what dermatologist and world-class hair transplant doc Robert Bernstein said about the various diseases that are related: BernsteinMedical – The Diagnosis of Hair Loss in Women.

Tags: pseudopelade, alopecia, hairloss, hair loss, female, woman, women

Propecia or Alcohol — Which Caused My Breast Enlargement?

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

Dr. I came in for a consultation at your LA office in mid August. I saw Dr. Pak, and had my hair mapped for miniturization. The follow up e-mail said I was “very early Class 3, possible Class 4A balding pattern.” I was actively losing hair and it was suggested to wait on a surgical procedure, I agreed. I had already been taking propecia with no results. It was recomended I continue for possible results. About mid september I noticed a large decrease in the amount of hairs on my hands in the shower. Unfortunitely for me a friend pointed out I was kinda growing a chest. I had not noticed this. Here is the thing. I drank very heavely for about four years, I know alcohol abuse can cause this. My question is, is it more likely the propecia or the past alcohol abuse that is causeing this, and what do you suggest I do. I don’t drink heavely anymore I had stopped before this was pointed out to me. It’s noticable enough that I’m self concious about it, and if there is no other option except surgical removal I may have to consider it. On that note, can you recomend a good surgeon to see for a consultation. It’s causeing me some greif in the work place, I’m a Marine so I’m sure you can imagine the comments. I lost 15 pounds since I stopped drinking so that helped, but not enough, I fear the rest may be breast tissue. I would have called your office with these questions however I am deployed to Iraq until April. Thank you very much for your time!!

First, I would try stopping Propecia to see if your problem resolves in 2-4 weeks. That will show if the cause is Propecia. You should see your Army surgeon (it is kept private) who will be skilled in assessing the breast enlargement. Any good general surgeon back home can take care of this for you if it does not get better with stopping the Propecia.

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

Saw Palmetto, Seborrhoeic Dermatitis

/by William Rassman, M.D./4 /, ,

Hi doctor,

Does Seborrhoeic dermatitis causes thinning of the hair on the frontal and temporal areas or it just causes the hair to fall without thinning? I have noticed an increase in acne production in my scalp in addition to my noise and behind my ears and i am noticing a major thinning of my hair, so i am concerned if Seborrhoeic dermatitis is causes of these side effects. Also does DHT trigger the increase of acne production of the sebum glands, which are similar to the consequences of Seborrhoeic dermatitis? I currently stopped the use of propecia due to a severe sexual dysfunction and I am taking saw-palmetto and monoxidil 5% without any significant positive results but a major thinning all over my head. What is your comment on using saw-palmetto as a DHT inhibitor? Shall i wait till my hair sheds and then transplant some hair instead of taking a risk and play with my hormones? I am in a dilemma please help me. Thanks a Lot Doctors

Young men with genetic balding are best treated with finasteride (Propecia). Saw palmetto does not work for preventing hair loss and contrary to some promotion, there is no evidence that it is a DHT blocker. Minoxidil is less effective in genetic hair loss, but it may work. Seborrhoeic dermatitis does not cause hair loss nor does acne, provided that you do not pick on your hair. Acne medications do cause hair loss. If you get infections, then that could cause localized hair loss unless it is treated by a good doctor.

Tags: dermatitis, hairloss, hair loss, sawpalmetto, saw palmetto, finasteride, propecia, dht

Doctor Suggested Rogaine, But Should I Ask for Propecia?

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

I’m an 18 year old male and was recently told by my dermatologist that I am starting to bald. My dermatologist told me that I should just take Rogaine, since I was able to catch the balding early. However, the thinning is happening in spots just behind the hairline, and I know that Rogaine has not been proven to work in that spot. Should I go back and ask for Propecia?

If your only concern is hair loss at the hairline and the immediate area behind it, you should be aware that most of the studies, which documented positive effects of Propecia, were done on crown and vertex area. This is also true about Rogaine. With that said, Propecia is the best medical treatment for genetic balding, but you need a diagnosis by mapping out your scalp for miniaturization to determine if this is indeed genetic balding or just the maturation of your frontal hairline. One reason I usually recommend finasteride (Propecia) to my male patients, because of its ease of use (one pill a day rather than applying Rogaine solution to the bald area twice a day).

In the office yesterday, I saw a young man who was started on Propecia a year ago. He responded well in the frontal area, reducing the miniaturization from 70% to 30% and he had more hair in the frontal area from picture comparisons we had of him and his own assessment. What this means is that just because the official line is that Propecia may not work in the frontal area, clearly we all respond differently. He was smiling (certainly not complaining) about all of that new hair in the frontal area.

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