Epididymitis and Propecia

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

At ~18 yrs old I underwent surgery due to a severe case of Epididymitis (left testicle). As a result of that condition and surgery (removed damage tissue), my left testicle decreased in size, to a point where only my right testicle remains functional. I’m 37 yrs old now and just recently started taking Propecia to treat mild hair loss. After only two days I felt a difference in my sex drive and decreased ability to achieve an erection. I immediately stopped using propecia but my symptoms continue after a week. Should I expect everything to go back to normal or could this be aggravated by my medical history?

Propecia is cleared from your blood stream after a day. Any Propecia side effect should have resolved, especially after a few weeks. One testicle should be as good as two testicles, as the output of testosterone from the one testicle goes up to compensate for the missing one. You may have an underlying medical problem or a psychological problem. Men are very suggestive when it comes to sex and if you feel like less of a man or are sensitive about it, that in itself could be responsible for your loss of libido or erectile dysfunction. Please see your doctor for further evaluation.

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

Doesn’t Every Man Have SOME Degree of Hair Loss?

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

Hi Dr Rassman, congratulations on your blog which I find very useful. I am almost 29yo and I have been experiencing hair thinning for a couple of years. I am using minoxidil which has cause my hair loss to stop (or slow down). I have become obsessed with people’s hair and noticed that most people my age have a much worse hair problem than me. I would say that hair loss affects almost everybody, but people usually won’t notice a slight hair thinning as I did. Am I right? I mean, when you look at people about 35-40yo they almost always have some degree of hair loss or thinning.

Bill ClintonGenerally about 50% of men have some degree of balding or visible hair loss by the time they are 45 years old. Some men outside this statistical group also develop senile alopecia with aging. If you are noticing thinning to a point where it is socially noticeable, you may have the gene(s) for male pattern balding (MPB). If you are thinning, you should have your scalp hair examined for miniaturization.

To answer your basic question, some men never experience hair loss at any level. Ronald Reagan was, I believe, one of them and Bill Clinton is another one.

Tags: hairloss, hair loss, reagan, mpb, gene

Equol

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

Dear Doctor:

Have you heard anything about the availability of Equol on the market? I understand equol binds to dht, essentialy deactivating it as it can not bind to the androgen receptor and cause hair loss. I have heard that there are “equol producers” that are able to create natural equol through a unique gut bacteria that converts soy into equol. I have heard that there are many that are not producers. Do you know if equol is being synthesized in the lab for use? Thanks very much!

Equol is a nonsteroidal estrogen that is made in human intestines from soy foods. Its DHT blocker function is documented, but in practice it has never been completely studied as a replacement for conventional DHT blockers such as finasteride. See Equol Is a Novel Anti-Androgen that Inhibits Prostate Growth and Hormone Feedback.

Tags: equol, hairloss, hair loss, dht, prostate

Isotretinoin and Hair Loss

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

I had a bad case of acne earlier due to which i had to resort to Isotretinoin treatment. now wherever i’ve read it says that alopecia is a known complication even after discontinuing isotretinoin therapy and i have been experiencing the same. i have a strong family history of baldness and am experiencing an increasing low hair density with slight temporal baldness for the past 8 months or so. i even had to shift to a new city and have noticed hair fall only after that. see any connection? Also could you advise me a suitable solution to the Isotretinoin complication?

Although hair loss is a documented side effect of isotretinoin, I could not find any study to prove that this is a permanent phenomenon. Having said that, the hair loss due to the side effect of medications could be irreversible if you had a lot of miniaturized hair and were about to lose them anyway. In this case, medication has only acted as an accelerator, not originator of this phenomenon.

Tags: isotretinoin, hairloss, hair loss

In the News – Red Meat and Vegetables Can Beat Hair Loss

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

DailyMail.co.uk – Red meat and two veg can beat hair loss

There are hundreds, if not thousands of articles on diet and hair loss and health — we have to use common sense to interpret its practicality and validity.

This article basically talks about low ferritin levels being bad for hair health. Nothing new here. Another article on that site says “A tomato a day keeps cancer at bay”. If we agree that a tomato is a vegetable, we can beat hair loss and cancer!!! Yes, I know a tomato is technically a fruit, but it is classified as a vegetable in cooking. Let’s not split hairs now.

Tags: red meat, meat, vegetable, hairloss, hair loss, iron, ferritin, diet

Fatty Breast Tissue Risk with Propecia?

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

Dear Dr. Rassman, I have a question regarding the side effects of Propecia. Does a man who already has a lot of fat tissue in the breast area have a higher chance of experiencing an even larger breast size when he takes Propecia, than a man who doesn’t have a lot of fat in the breast area?

The short answer is no.

Are you overweight? That could be the cause of your breast tissue buildup. If you have that much fat in the breast areas it may be more difficult to detect gynecomastia, but people who develop gynecomastia usually have pain in the breasts. You should see a doctor before starting any medication and express to him/her your concern.

Tags: gynecomastia, breast, propecia, finasteride

Steroid Shots Under the Scalp

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

I heard that steroid shots under the scalp may work to help revive the hair growth. Is this true?

No. Some doctors give steroid shots under the scalp if they believe the hair loss is due to an inflammatory cause. I have seen a patient who actually lost hair because of the steroid shots.

Tags: hairloss, hair loss, steroid

Realistic Expectations of a Transplanted Hairline

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

I am trying to find great hairline work. The pictures on your site can’t get me excited. What can I do to get to a realistic expectation and become comfortable?

For the readers that are not familiar, the photos that are being referenced are located here — New Hair Institute – Patient Photo Galleries.

You are looking for a perfect hairline. I would love to know what your problems are with the posted photos. If it is that the density is not what it originally was, it is possible that we did not try to get to the original density (most patients require more area to be transplanted so achieving the original density is not in the cards). Some patients have their own mind made up as to what they want and I almost always do what they want, not what I think is best. I am not super selective on the patients I show on the site, for if I were, I would not show so many patients and only show those who had their original densities restored. All of the posted patients were happy with their hairlines and they allowed us to show off their photos (even for those that do not allow their face to show). I try not to pick out just the best of the best — I want to be honest and give a clear idea of what is possible. If the patients were not happy, they wouldn’t sign the photo release to allow us to show off their hair.

The posted photos may give you an idea of how a natural hairline looks after hair transplant, but the pictures lose the impact of the difference in hair textures that people have. There are a subset of patients who I would challenge anyone to detect anything but a natural appearing, non-transplanted hairline (even to the experienced eye), and some of these patients routinely show up at our open house events. They come to challenge even the most discriminating prospective patients who attend. If it is feasible for you, you can attend one of our monthly open house events at our Los Angeles office. This will give you the chance to meet with some of our previous patients and will allow you to examine our results very closely. I strongly suggest you do this, because pictures just don’t tell the whole story. It is not unusual for us to have 10+ patients show up to demonstrate their results in our Los Angeles open house.

If you have any other questions I will be glad to answer them by email or in person. I look forward to meeting you soon.

Tags: hairtransplant, hair transplant, hairline, nhi, open house, event

I’d Like a Career in the Field of Hair Loss

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

Doctor Rassman,

Two years of immersing myself in your blog and other medical literature has cultivated in me a real passion for the study of hair loss. I am still a college student and would like to know what academic decisions would be important for me in laying out a career path in hair research.

To be in the field of hair loss treatment and hair transplantation, you can either be a nurse, technician, or be a doctor. To be a hair transplant doctor you need to go to medical school (4 years). Afterwards, you need to finish residency (3-6 years). You can choose any residency such as dermatology or surgery. After the residency you would need to finish a fellowship (1 year) specializing in hair transplant surgery. If you wish to get into the field after college, send us an application. We train technicians, which can earn you a very good living when you are good at it. If you are considering pure research, you can major in biological sciences and pursue a graduate degree and specialize in the stem cell research and cloning.

Tags: doctor, physician, technician, nurse, career, job, hairloss, hair loss, hairtransplant, hair transplant, research, cloning

Dark Circles Under My Eyes While Taking Propecia

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

Dr. Rassman,
I took Propecia for two years and had seen great results with my hair loss when I began to notice dark circles around my eyes. This made me stop taking the drug three months ago, and the dark circles have virtually disappeared. However, immediately after stopping to take the drug I developed puffy nipples and I can actually feel the enlarged glands under my nipples. I’ve read about gynecomastia and Propecia, but the side effects seem to appear when taking the drug, and not after stopping it. I wonder if you might have any insight on the matter. I’m hoping that this is my body’s reaction to the hormonal change and that over time my nipples will return to normal (there’s no fat accumulation, only gland enlargement).
Thank You

I highly doubt that dark circles under your eyes are from Propecia and this is not a reported known side effect. It may be a coincidence or the fact that you were tired and not getting enough rest, so look for external causes of dark circles.

Gynecomastia is one of the rare side effects of Propecia, but you are correct in stating that it occurs while you are using it (not stopping it). You need to see a doctor for further evaluation and physical examination. Gynecomastia is often the result of hormone manipulation. Are you taking steroids?

Tags: gynecomastia, dark circles, eyes, propecia, finasteride, hairloss, hair loss

Best Hair Product Combo to Use?

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

Can I for instance use:
Propecia pills
Hairmax
Organic shampoo

All at once? What is the best combo? Your advice is appreciated. Thanks!

There is no “best combo”. I do not endorse any products. I only prescribe medication such as Propecia (finasteride 1mg), because it works. All others are “buyer beware” as far as I’m concerned. With respect to the Hairmax laser, I have written extensively on that topic (here).

Tags: hairloss, hair loss, product, drug, lasercomb, hairmax

Testing for MPB Gene?

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

my brother is two years older than me and has had a receding hair line for a few years he is now 23 my hair is still very thick will i follow the same pattern or could i have been skipped by this gene. Are there any tests that can tell you if you have male pattern baldness genes.

DNANo one has identified the MPB gene(s). I would suspect there is more than one gene responsible for hair loss. The only test available is a miniaturization study which shows the progression of the balding pattern and the degree of hair loss.

Family inheritance seems to evade the logical mind and that alone shows that the responsible genes are probably multiple.

Tags: mpb, gene, genetics, hairloss, hair loss

Can Propecia Prevent Hair Loss from Stress?

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

Hi Doc.
Can propecia prevent hairloss from stress? Can it stop stress from affecting my hair?? And can It bring back hair that was lost due to extreme stress? Not too much was lost, and since the stress ended right before starting Propecia, do you think that the med has enough time to kick in and save those poor lil old hairs??? (At the hairline.. the left corner has lost a bit of hair, I think beyond the mature hairline, about half an inch. There’s still hair but VERY low density, I can practically count them with my fingers.) Thanks Alot.

I’ve asked many questions before, and I’m sure they weren’t answered since you had similar qs before. But I would REALLy appreciate it if you answered this one :) .
Thanks.

Propecia (finasteride) treats hair loss from genetic male pattern hair loss. It works for hair loss due to stress in those who have the genetic predisposition to hair loss and have miniaturization of the hair. That being said, stress can accelerate genetic male pattern hair loss.

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

Ringworm Treatment

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

i was diagnosed with having a ring worm on my scalp. I was prescribed Ketoknonazole shampoo, Lamisil and 5mg tabs of Biotin Forte. Since then I have lost my health insurance so OTC I purchaed Biotin 300 mcg tab. How many tabs should i taken to reach the 5mg dose?

You should take medications as prescribed by your doctor. There is no shortcut to treating a fungal infection (ringworm). If you don’t take the medication as directed, your ringworm may get worse! The loss of medical insurance should not be a reason for taking a second class approach to your problem.

Tags: ringworm, hairloss, hair loss, medication

Transplanting Hair Where Mole Was Removed?

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

Hi Dr. Rassman,

I have a mole that has been revealed as my hairline has receded and I am thinking about getting it removed. However, I may transplant hair into the area in a few years. Will hair be able to be transplanted into the area where the mole was removed?

Yes, you can transplant hair into the area where the mole was removed. You should monitor that area to see if there is a recurrence of a mole or any skin changes.

Tags: mole, hairtransplant, hair transplant