If Rogaine / Regaine Is Working, Would I Still See Daily Hair Loss?

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

Hello Doctor Rassman

I have a few question, I hope you can help. I have been on Regaine for 3 months and half now,my doctor has recommended me to use it after checking my scalp, he said im suffering from MPB. I have not seen much improvments or results, I still have a good hair density though..my hair line is still fine but its kind of receding.

At first and as stated on the regaine web site I knew that hair loss should be stopped by the 6th week of use, otherwise it may not be working. I still see hair loss every day and my doctor who prescribed me the regaine believes and as he told me on our last meeting that im seeing results and should keep on it. I dont know, Im confused.. my doctor believes I should not stop because its working and losing some hair everyday is normal and doesnt mean its not working. Therefore I have the following questions:

do you have any suggestions about my condition doctor??
do you really think I should not stop and keep on it??
and do you think losing some hair everyday is normal even if regaine is really working??

Bye

RegaineUnfortunately, I do not have suggestions about your condition, because I have not examined you and I do not know the condition of your hair or the miniaturization state. If you are already under the care of a physician, you need to see your doctor and ask him/her these questions. You need a Master Plan to understand what is happening to you and where you are in the process. This plan will take into account the way you respond to the medications and what medications to use.

So if you’re looking for me to give you direction, I really can’t tell you to stop taking it or even to continue taking it, because I have not examined you to know if there are improvements or not. You should never stop or start any medication without consulting your prescribing doctor. What I can tell you is that you will likely continue to lose hair if you have male pattern baldness (MPB). You can slow it down with drugs such as finasteride (Propecia) or topical minoxidil (Rogaine — now marketed in the UK as Regaine), but to see any results, you need to continue using it at least 8 to 12 months so you can not tell where you are in the hair loss process.

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

Exercise, Alcohol, Sunlight, and Hair Loss

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

Hi Doctor,

Although my hair is thinning, I still do have a relatively full head of hair. I have three questions:

1) I realize that it is not proven research from a credible source like the AMA, but I wanted to know what you thought of the following: (Prostate Problems)

“Changes in the level of several hormones are involved with prostate enlargement, but the key one is a version of the testosterone, known as dihydrotestosterone (D.H.T.). Reducing levels of D.H.T. reduces the size of the prostate. D.H.T. levels go up with alcohol (especially beer) consumption and with stress, and come down with zinc and Vitamin B6. Zinc also cuts down the rate at which testosterone is converted to D.H.T.”

Thus, can regular consumption of alcohol (including beer) contribute to MPB in your opinion?

2) Several anecdotal studies have found a relationship between aerobic exercise and hair loss. Do you think regular aerobic exercise could prevent MPB, or at least prolong it?

3) Is moderate exposure to sunlight a positive or negative if you have short hair (i.e. direct sunlight goes right through to your scalp) and you are concerned about MPB? Should I wear a hat to prevent sun damage or have my scalp exposed in order to soak up that natural vitamin D?

DHT is partly responsible for prostate enlargement… and the prostate will often shrink by taking DHT blockers. Anything that increases DHT levels will probably increase testosterone levels as well, since DHT comes from testosterone and is a breakdown product of it in the metabolic pathway.

I found the link you sent quite interesting and probably true, but I do not believe that exercise can prevent or slow down male pattern baldness (MPB). As well, there has been no connection between sunlight and balding, but based upon all of the claims with using a laser to stimulate hair growth, if that was true then sun exposure would have at least the same benefit.

Tags: alcohol, sunlight, exercise, hairloss, hair loss, laser

I’ve Been Taking 2.5mg Finasteride Daily for 3 Years

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

Dear Dr. Rassman,

I started using Proscar (5 Mg. divided into 2, 1 part daily) about 3 years ago. 6 months ago I added the use of Minoxidil just once daily (every morning), opposed to the recommended 2x daily, since it is only to aid the Proscar. Am I doing the right thing?

Best

The recommended dose of finasteride is 1mg for treating hair loss, sold under the brand name Propecia. Taking 5mg or 3mg or 2mg will not grow more hair, but will produce more negative side effects. Changing doses from 5mg or 2.5mg to 1mg will not likely affect hair growth. Merck’s research has shown that 1mg is as good as a higher dose, so if you are taking a higher dose and then bring it down to the normal 1mg does, there should be no negative effect.

Tags: merck, finasteride, proscar, propecia, hairloss, hair loss, growth

A Week After Transplant, I See Small Hairs Falling Out With the Scabs

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

Hi, I had 500 grafts to the temples 12 days ago. I have been washing the recipient area almost every day, and gently dabbing the shampoo on and off but some scabs still formed. I began very gently running my fingers over them when dry (but certainly not pulling them) by about day 7 and noticed some easliy fell out but with small hairs attached. Is this my grafts coming out?

We all worry about losing hair grafts after the surgery and that is the basis of your question. It is an important question; so important that NHI did a major study on the subject and the best answer to this question is for you to read our article on this subject — Graft Anchoring in Hair Transplantation (PDF file).

Tags: scab, hairtransplant, hair transplant, graft, anchor, hairloss, hair loss

With Minoxidil, My Hair Got Thicker, Then Thinner Again

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

Hi doctor.
I have been using Minoxil (only minoxil, no Finestride ect.) for about 11 month now because I loss a lot of hair in the bath ect. The first 7 month went really well, and i stopped loosing hair, and my hair was also getting thicker. But after the 7 month, i started loosing hair again, and have done that for 4 hole month, while still using minoxil twice a day. My hair is now really thin. Why? And what should I do to stop this thing before i’ve lost all my hair? Please help me. thx

You need to see an expert to understand what is going on with your hair. I can not tell very much from your question. Minoxidil is not a hair thickener, so I am not sure what you have been observing. If the hair got fuller, then you should expect that the effects would be maintained on the medication.

Tags: minoxidil, hairloss, hair loss, thicker

Using Minoxidil Once a Day?

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

Hi Dr.

I have been on Propecia for six months with good results and have been using minoxidil as well for the crown and that has seemed to improve thing even further.

My question is that I find I can only practically use the minoxidil once in the evening. To put it on in the morning is just too difficult. Is there a negative to only using Minoxidil
once a day instead of twice or is it just a matter of it not being as effective?

Thanks

The best response for minoxidil has been shown to be twice a day use. You can try the Rogaine Foam and see if that works easier for you in the morning. Some people use it as a styling agent.

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

Managing Hair Loss By Yourself — Not a Good Idea

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

Hi Doctor

I’m 21 and my experiences with meds that lower DHT like Propecia for a year, and Dutasteride for 5 months have been bad, very bad, in fact it didn’t just not work for me, it made matters worse. like my body was rejecting it. Propecia made things worse, and Dut made things a LOT worse…seems the higher the anti DHT the worst it got which is the opposite affect. Im not gonna complain and say lifes not fair! but I am curious as to what went wrong… if 9/10 can maintain their hair with propecia, what goes wrong with that 1/10. what are the possibilities. just very curious. Thanks a lot in advance!

The blocking effect of finasteride on DHT formation is only one factor that impacts hair loss; your genetics are another and they are completely independent from each other as separate variables. At your age, if you were going to be very bald by the time you reach your mid-20s, then your genetics are far more powerful in producing hair loss than finasteride (or dutasteride) is for preventing it. I am fairly sure that the drugs are slowing down the process, but when the impact is not dramatic, then the user often thinks that the drug treatment is a failure.

If you got your hair measured and mapped for miniaturization, the impact of these drugs could be established and followed over time. You need a Master Plan for your hair loss management and should find a good, caring, competent doctor who will establish this with you. It sounds like you are trying to be your own doctor and are not being scientific about managing your hair loss.

Tags: hairloss, hair loss, genetic, gene, dht, finasteride, propecia, dutasteride, avodart

Angry Reader Points Out — Lamisil Does Cause Hair Loss!

/by William Rassman, M.D./14 /,

A Google search brought me to the question and your answer from a man who was experiencing dramatic hair loss following a two month usage of Lamasil. Your reply discounted Lamasil from being a cause, citing the drug’s use for infections that in and of the condition cause hair loss.

I am sorry to tell you I find your reply specious. Look, the drug insert slip detailing the side effects CLEARLY states that hair loss is a DIRECT side effect of terbinafine hydrochloride usage. You can bet the drug company would give much not to have to include it, or any other in a list of side effects, but after 33 years of patient use, I’m fairly certain that it’s had substantiation. Hair loss is a real unpleasant and tremendously visable side effect, and tons of money is spent by men and women to counter baldness. No drug company wants to have to tell users “this could happen to you”.

Now, I am a 45 year old woman prescribed and dutifully taking on schedule terbinafine hydrochloride aka Lamasil. I have had HUGE, by the handfuls, hair loss. I am in perfect health, substantiated by my age 45 health screening, except for normal stress, the effects of aging, and toenail fungus.

Please note: I received the prescription of Lamasil for TOENAIL fungus, not fingernail fungus, not ringworm or anything else that would cause hair loss, and hair loss is NOT a result of toenail fungus, doctor. So, when you post a sincere and concerned question (which unsurprisingly you did NOT answer) with a reply disdaining and discounting the legitimacy of the issue with an answer that supports an obvious agenda on your part, you discredit yourself and your profession.

AND I still need to know if MY hair will regrow. That guy was almost certainly loosing his hair from the Lamasil. Drugs are special, doctor, and many are needful, but those side effects ARE real.

LamisilMany drugs can cause hair loss, but my position has always been to explore other, more common causes of hair loss before blaming the drug. More importantly you need to discuss starting or stopping any medication with your physician.

Lamisil is often used in the treatment of fungal diseases of the skin, such as ringworm or toe fungus. If left untreated, some fungal diseases of the scalp by itself can also cause hair loss. I stand corrected with your reference to the drug insert warning of hair loss as a complication, but many times, just because a person is on a drug that has hair loss as a known side effect, it does not mean that it is THE cause of the hair loss. Diagnosis is just not that simple.

If you believe the drug you are taking is causing your hair loss, please address these issues with the prescribing doctor. There’s a disclaimer at the bottom of every page of this site that can be summarized to say, “This site is intended to educate the public on hair loss topics and should not be used for the purpose of medical diagnosis or treatment recommendation.” Please remember that I am not your doctor.

Tags: lamasil, lamasil, hairloss, hair loss, toenail, scalp, fungus, female, women, woman, terbinafine hydrochloride

Does Hair Loss Take a Vacation?

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

hey doc, ive asked you questions before and your answers are very helpful for me. i was wondering if hair loss ever took ‘breaks’. For example have it progress to a certain stage and stabilize for a few years then continue where it left off. how big a role does stress play in mpb as well, i feel like i’m losing so much more hair during my school semesters than during the summer months.

CalendarNot exactly. Unfortunately, hair loss doesn’t take a vacation for veterans on Veterans Day, for fathers on Father’s Day, nor for fools on April Fool’s Day…

In my practice, I find that hair loss sometimes occurs in spurts and is not necessarily a constant phenomenon. Stress can precipitate genetic balding, so it would not be a hard to reach a conclusion that the stressful times at school are causing you to lose hair. See a hair specialist or a dermatologist to discuss this phenomenon more in person.

Tags: hairloss, hair loss, holiday, vacation, stress

In the News – Controversy About Actors with Hair Playing Bald Roles?

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

HitmanClearly, some people know how to exploit balding in the Hollywood setting. The San Francisco Chronicle looks into actors that are shaving their heads for movie roles, instead of going with the naturally bald actors. From the article:

Timothy Olyphant plays Agent 47, the bald assassin in the new action movie “Hitman.” The controversy? Why have the well-coiffed Olyphant shave his head when there are so many bald actors who are perfect for the role?

Full article — Hairless fakers, take note. Bald is in charge.

Tags: olyphant, hitman, hairloss, hair loss, bald, shaving, shave, sfgate, controversy

Treating DUPA with Dutasteride?

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

has there ever been a case in which somebody with DUPA (Diffuse Unpatterned Alopecia) has responded to dutasteride after trying propecia (finasteride)?

I have very little experience with Avodart (dutasteride), but I have seen some patients with Diffuse Unpatterned Alopecia (DUPA) respond somewhat to finasteride. In theory, dutasteride should be better than finasteride, but clearly the side effects are substantial with dutasteride (decreased sperm count, impotence, decreased libido). Unfortunately, we do not know a great deal about DUPA and what causes it.

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

T-Gel Shampoo and Hair Loss

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

I have a question about coal tar shampoo (neutrogena t/gel) and hair loss. I have used t/gel extra strength twice a week for years for my scalp condition (either seborrheic dermatitis or psoriasis, i don’t know) because it is the only one that completely rids the scales. I never responded well to Nizoral or other prescription anti-fungals. Recently, I came across a lawsuit online where a woman was suing Neutrogena for hair loss allegedly caused by T/gel. This hair loss was accompanied by a severe allergic reaction. Knowing that I am not allergic to the shampoo, do you think it is ok to use it without causing more hair loss? By the way, I am aware that they used T/gel in the Propecia trials, so Merck must not be too concerned about its potential to cause hair loss. Thanks for your help!

What are you asking me? It seems you already know the answer, by the way you posed the question. If T-Gel works for you, great! If you don’t have an allergic reaction, even better!

If you are losing hair, you should see a doctor for a diagnosis including a miniaturization study. If you have psoriasis, then a dermatologist will be the best referral for you.

Tags: t-gel, tar, shampoo, hairloss, hair loss, neutrogena

Inderal and Hair Loss

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

I know Inderal can cause hair loss, but I only use it when I perform on stage. So I go weeks without using it, then maybe have 20mg at a time for performances. Would this limited usage still cause hair loss? Thanks

I doubt that the schedule in which you are using Inderal (propranolol) would cause hair loss, but you should speak more with your prescribing doctor about your concerns.

Tags: inderal, propranolol, hairloss, hair loss

One Year of Propecia Use (with Photos)

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

This is not an atypical response to Propecia on a man in his mid-thirties with a great deal of miniaturization throughout the top and crown. Click and enlarge the photografts and you can easily see the change in miniaturization on a macroscopic view.

The photo on the left is before taking Propecia; the photo on the right is after 13 months of daily Propecia (finasteride 1mg) use. Click the photos to enlarge.

 

Tags: propecia, finasteride, hairloss, hair loss, patient, photo

My Hair Is Very Fine — I Had 2 Procedures, Should I Try Laser or DermMatch?

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

Dr. Rassman, I have completed 2 NHI transplant procedures. However, because of my very fine hair, my scalp is visible, especially under bright overhead lighting. I am considering a third procedure, but would like to first try the X5 HairLaser or DermMatch. Any thoughts? Thanks

A hair transplant procedure has limitations, in that it simply can not restore all the hair that was lost, since there is a limited supply and usually a relatively large area to cover. Individuals with very fine hair often have see-through coverage, even with normal (birth) densities. As hair transplants rarely produce over 50% of the original density in one or two procedures, I am never surprised when there is a see-through look and I tell my fine haired patients that this is what they must expect. There has to be realistic expectations and if the desire is to increase the fullness and let less light through (making it less see-through), then more grafts are necessary if the supply of good donor hair lasts and the use fits into a good Master Plan.

If you had surgery with NHI, please give my office a call (800-NEW-HAIR) and I will review your file and would be happy to discuss your situation. We offer free in-office laser treatments for all of our patients, but I can not tell if it works yet. Before any lasers or other alternative treatments, I would strongly recommend finasteride (Propecia / Proscar) as an option if you are not using it already.

While products such as DermMatch and Toppik are great cosmetic adjuncts to disguising thinning, it should be noted that these products do not grow hair.

Tags: dermmatch, toppik, hairtransplant, hair transplant, finasteride, propecia, proscar, laser