Dear Sir,
Do you have knowledge of the effectiveness of Phyto Thinning Hair? This brand has a strong reputation, however I’ve yet to find any in-depth reviews of this particular product.
I can’t find much information on it, except that it contains ginkgo biloba and grapeseed extracts. There is no proof of efficacy with this shampoo.
This is a follow-up of the blog entry from the other day, What Happens When a Doctor’s Car and Mansion Payment Is More Important Than You?
First, lets get to the photos. The photo on the left was taken this week in my office. The photo on the right was taken 18 months ago, also in my office (forgive the quality — it is scanned from a Polaroid). Click the photos to enlarge.
The above photos are of a man in his mid-50s. Note that the progression of his hair loss has been very significant. Some of the medications he uses may be promoting hair loss rather than saving his hair. He tried Propecia (finasteride), but he had wiped out his sexual drive from it. He went to another doctor for a second opinion and then came to see me with that second opinion. He was a good note taker and is fastidious about medical records. His father had prostate cancer. The doctor who offered him the second opinion suggested that he have 3000 graft placed all over this head. He would then have a “full head of hair”. Even though he saw a doctor, it was the salesman inside the doctor who was talking. That has to be the worst recommendation he can get, because shock hair loss is almost a certainty and this patient would be like the fellow I showed you the other day. To make matters worse, his donor supply was low so that the probability of getting 3000 grafts would have failed.
This patient did the right thing — he got a second opinion. In this case, he checked up on me. Transplanting the corners and making a hairline is an option, but he should stay away from transplanting into the thinning area. Because of the steroids he is taking, I advised him to stop some of the medications and try to take a smaller dose of Propecia, for if he undergoes a hair transplant (or even if he does not) and would want to see his hair loss stop first. Propecia may be the only good option for him and worth a try again at half of the dose. With the family history of prostate problems, Propecia is a good medication to reduce this risk. The other doctor only talked about selling him 3000 grafts and the benefits of such a procedure for him. Why am I alarmed? Simply, this man is losing hair in ‘gangbusters’ and as he is in his mid-50s — that is not supposed to happen. He is clearly an exception to the rule that men over 50 don’t usually go through accelerated balding. With low densities, any doctor who put hair into his crown will deplete his donor supply. He is also losing frontal hair now, so what is the Master Plan when he runs out of donor supply and money?
I showed him photos of his hair, and explained how the miniaturization of the hair was throughout the top and crown and if this area was transplanted, the hair he would lose would be more than any benefits he would have if he was transplanted. I am personally appalled at the desire of a doctor to try to push him into getting thousands of grafts and to make matters worse, he was never told that he may accelerate his crown loss with a transplant. Patients have every right to know such potential side effects and the probability of that happening. Doctors are legally obliged to inform patients of such risks. My only place to vent this frustration is on this site. I don’t mean to scare you and I don’t want you to think that every doctor out there is trying to screw you. There are many good and honorable doctors that do hair transplants, but again and again, I tell patients, Let the Buyer Beware.
Hello,
Im 24 years old and have been taking Propecia 6 months prior to my surgery and have been doing so ever since. In which now I am 4 months post op. I had 1500 grafts done, 500 in each temple and 500 in the crown.
I still have some mild numbness since the surgery directly on the top of my head in the non recipient sites. This area was very dense and now is very thin and I believe it is due to the numbness. Can you tell me generally when the numbness starts to subside. As well will that density come back or is it safe to say my hair will continue to be this thin?
Thank you.
It sounds like you have two different things happening. At 24 years old, if you thinned after surgery, you probably experienced ‘shock loss’. Do you know if the hair you lost was miniaturized? Miniaturized hairs are the ones at risk for shock loss. Propecia has wiped out most of the hair loss caused by the surgery that we experienced prior to Propecia’s availability on the market, but there is (of course) no guarantee that it will wipe out all of the risks of shock loss.
As for the numbing you’re feeling — all numbness should be gone by now. You need to go back to your doctor and ask these questions or get a second opinion if your doctor does not give you satisfactory answers.
I know you probably will not reply, but thought I’d give it a try. Do the topical minoxidil plus tretenoin sprays actually get through the hair onto the scalp? I’m very interested in Lewenberg’s formula, but do not see how a hair spray can get to the scalp. I would really appreciate your opinion – someone with expertise. Thank you
The use of Retin-A with minoxidil is commonly used. Retin-A produces irritation of the skin, a sort of light burn which increases the circulation as the body tries to repair the burn. As a result, the blood supply to the scalp increases and any medications such as minoxidil (which is in Lewenberg’s formula) gets better absorbed. I do not like the burn effect and would rather use a higher concentration of minoxidil and even Rogaine Foam 5%, which also has better absorption. The use of a spray is impacted by any hair that gets in the way, so you have to apply the spray carefully, parting the hair so the spray gets to the scalp.
I was recently told that if the grafts from a hair transplant were out of the body for more than 4 hours, they died. Is that true?
This was studied in the past. Dr. Bob Limmer did this study and kept one group of grafts out of the body for up to 8 hours (studied them each hour for growth), and then studied the graft survival after 8 hours on another group, then 24 hours, then 48 hours, and finally 72 hours later. There was no difference in graft survival in the first 8 hours, but after that, the death rate came out at about 1% per hour for grafts out of the body above 8 hours. I hope that this answers your question.
I am 37 and had a transplant done to try and fill in a thinning area on my crown. It does not seem to have done anything and it was about a year ago. Have you heard of this? Is there anything I can do?
You should certainly speak with the doctor who did it and ask that doctor this very question you posed to me. The crown generally takes a great deal of hair grafting to see significant benefits. If you did not lose your original native hair with the transplant and had a significant number of grafts, then maybe the transplants failed (quite unusual in the hands of a good doctor).
Hi Dr.,
I plan to get a transplant in the future and have been reading on this site about shock loss. I have been on propecia for about 4yrs, i am 28 white male, i also take dutasteride & minoxodil. Does shock loss happen at the area where you put the hair or take the hair from or anywhere on the scalp? How long after surgery can you go (time) until its safe to assume shock loss wont happen? Thanks
If shock loss happens, it hits the miniaturized hair, not the healthy hair. Propecia (finasteride) seems to protect the miniaturized hair from shock loss in young men.
I am 19 years old and male pattern baldness runs in my family. I was prescribed finasteride (propecia) to ward off male pattern baldness and have been taking it for 5 months. I recently stopped taking it, however, because I have not yet fully developed my facial hair and fear that the DHT-inhibiting effects of finasteride will delay or completely cancel my full development of facial hair. So far, I have upper lip hair, chin hair, and sideburns, but little on the cheeks and under the chin. Please let me know if my concerns are valid or if finasteride does not affect the development of facial hair and I should continue taking it. Thank you
I have answered a similar question question before here — Will Finasteride Harm My Growing Body?
There is a theoretical possibility that Propecia might suppress facial hair development, but I can not be sure of it. The actual dose of finasteride might be too small to impact facial hair development, but as facial hair takes years to evolve, I do not know of any way to be sure.
Hello Dr,
Thank you for taking the time to respond to so many of these questions. It provides untold comfort for those of us who are plagued with hair loss problems.I am quite certain I have seborrheic dermatitis-induced telogen effluvium. I have all the characteristics, long dark hairs with tiny white bulbs at the end (TE), and my scalp is red and itchy with noticeable scaling (SD). I have been inflicted with this condition for 7 months now, when can I expect for it to stop falling out? Will I see my hair return to the way it once was?
Thanks in advance.
If you have telogen effluvium, it has nothing to do with seborrheic dermatitis. You should see a good dermatologist to make the diagnosis of TE.
Sir, as a friend and ally of your fellow countrymen, I fully understand and respect the term “freedom of speech”. However, what I do find moronic at times, are the extreme ways in which people abuse this right, by asking the most stupid questions via professional, well informed internet sites and blogs etc.
For instance,and I quote “whilst sleeping, my leg hair fell out, please help me Dr Rassman as I’m desperately seeking answers – what would you recommend I do in the mean time?”
How the hell do you find time to answer up to a stupid question like that?
How about wax them and then you won’t have to worry!!
I understand the desperate plight of hair loss sufferers in search of need of reassurance and hope, but for God’s sake, some people just take the biscuit!!
Thanks anyway for your site – I do enjoy reading it.
Sometimes the other writers for this site (Dr. Pak or Dr. Mohebi) will make a somewhat sharp reply with a humorous intent. Since I edit all of the responses before they are published, some of their barbs are quite pointed and we all get a good laugh out of these creative comments. My job, when the other editors write the answers, is to keep a general respectful spirit on the site. At times the questions can be…. not very intelligent… and at times some of the writers of these questions must be challenging my patience. As an expert in this industry though, I find that many people are hair obsessed and do not apply rational thinking about the subjects that they toss at me. With my obvious answers to obvious questions, these people may learn to think this through rather than believe all of the hype that is generated by vendors who just produce lots of marketing material that confuses issues and make any clarity more and more difficult to consumers (by design).
I recall a very bright professor of engineering who was convinced that all of the hair that grew out after a hair transplant 4 1/2 months earlier just appeared one night while he was sleeping. On first blush, one would not expect an intelligent person to think that he grew an inch long hair overnight, but that was what he was convinced had happened. I believe that when we are emotionally caught up in something like our health, we lose perspective and rational thinking at times. I just call it like I see it, as directly and as gently as I can. I try to think the best of the person asking the questions, but you are right, it does frustrate me a bit.
As for how I find the time — well, I make time. I generally spend a few hours each day (including many weekends) answering emails and writing responses for posts that make it to the blog. Somewhere in there, I find the time to run a business, invent new technologies, perform surgeries, eat food, and even sleep. If I didn’t enjoy it, I wouldn’t do it. Judging from the amount of email I get, this site helps many, many thousands of people from all over the world, so that makes it worthwhile for me. I can’t be the doctor for everyone, but I can provide general insight and opinions that hopefully will help many people. As always though, this is just a blog and not intended to be a replacement for your doctor.
Hi Dr, I started using hair dye at 22 years old.before using hair dye i never used to lose hair.But once i start using hair dye,there was a lot of dandruff on my scalp and hair started falling. In my family history no body is having bald head.Do you think that is it heriditaory..? what kind of treatment do u suggest? does rogaine works for me..? Thanks in advance
There is no direct connection between dying your hair and losing hair unless you are using dyes that are dangerous and out of the mainstream of commercial products and their proper application. Instructions on the commercial dyes suggest that you test your skin against the dye to anticipate any skin reaction or allergies. I have also seen people who use high concentrations of dyes that damage their hair, so be attentive to the directions on any commercial product you use. The fact that you had dandruff might be an indication of seborrheic dermatitis that can precipitate the process of baldness if you scratch your scalp often. Constant scratching can produce traction alopecia.
Before developing a lifelong master plan for your hair loss, you need to be thoroughly evaluated by a good hair specialist. Depending on the degree of your hair loss, you may or may not need medical and or surgical treatments. At 22 years old, if the loss is mild, there are rarely indications for surgery unless you want to make a doctor richer. Seriously, when you start the transplant process too early, you must know what might happen if the hair loss progresses faster than you anticipated, develop shock loss from the surgery, what your donor supply will be as it is used up by multiple hair transplant, how bald you might become and the costs for multiple surgeries if you estimated wrongly what your future has in store for you.
If I take Jintropin, will it impact my hair loss?
Jintropin is manufactured and distributed by GeneScience Pharmaceutical Co., Ltd. It is a potent brand of Human Growth Hormone (HGH) and will accelerate any hair loss in men who are genetically prone for hair loss. It is worse than steroids for hair loss. There are many dangers in taking HGH, particularly without a doctor supervising the process. This has become a big business for baby boomers who feel extra vigor when they take this medication. Many good, responsible doctors feel that HGH raises the risks of stroke and heart attacks and the aging process may also be accelerated on it, even if the person taking it feels better.
In related HGH news, actor Sylvester Stallone just plead guilty to bringing Jintropin into Australia without a permit. From the Associated Press — “Stallone was accused of bringing banned substances into Australia after a customs search of his luggage during a Feb. 16 visit to Sydney revealed 48 vials of the human growth hormone product, Jintropin.” Ouch.
I am a 38 year old male from the UK and i’ve noticed hair on my pillow in the morning. furthermore when my hair is wet or gel’d thinning can be noticed. However during what would be a normal day to day e.g. not wet or gel’d, all appears normal. My concern is if i start propecia will this make matter worse? Hence it is important for me to ascertain what percentage men suffer hair shedding while beginning the course of propecia? if shedding does occur does this mean the shedded hair will be replace during the next regrowth cycle? if so under normal conditions how long would the hair loss be noticeable before recovery? sorry for so many questions! regards
I have had a few patients claim that they go through a shedding phase after starting Propecia (finasteride). This lasts only a month or two and is followed by the expected decrease in hair loss. I believe that this is a small number, but I can not put a figure to it for you as there have been no studies that I’m aware of that reference a percentage to answer your question. There are theories that suggest acceleration of cycling as a cause of temporary shedding, but I do not know much about this other than what other doctors assume could be the cause.
Patients start taking Propecia because they do not want to lose hair. Most people notice an immediate slowing of the hair loss on Propecia.
From the BBC — Gene find triggers baldness hope
Hair loss in humans might not be irreversible, suggest scientists who have helped create new hair cells on the skin of mice.
We have all hoped that we could make new hair from stem cells or gene manipulation. It looks like we have moved one step closer to that goal.
More articles about this here —
Have there been any test results that showed products such as Propecia or Rogaine can actually cause MORE hair loss? Both products after several months caused me to lose more hair more rapidly and I’ve read other people’s accounts of this happening, on this blog, as well as other sites. It seems that the FDA should study this if they’re going to license products. Thank you for your time!
There are no long term hair loss events reported from either drug, except for the people who have local allergic reactions to minoxidil. The short term loss of hair is thought to be the results of accelerated hair cycling and it reverses.