I’m a Woman and Not Having Children — Can I Use Propecia?

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

I am a woman in my late 40s and have thinning hair and a hairline that has receded somewhat due to menopause and discontinuance of HRT (I think).

Would you recommend Propecia for me? I will not be having children — is there data related to breast cancer and Propecia? Or, what is your opinion of the new laser combs or devices–specifically the X5 Laser from Spencer Forrest which appears to be superior to the Laser Max comb? Also, do you know anything about “virtual hair” — a membrane similar to your scalp custom-created for the client, with real hair attached, and glued onto the scalp? Of course, as the hair grows, the glue becomes dislodged, but it was featured on “Good Morning America” and looks terrific — so natural. Please, any help you can give me would be greatly appreciated

I would not recommend Propecia (finasteride) for a woman unless there were high androgens present on her blood testing, and even then I would have to think about it. This is provided that she could not get pregnant and there was no breast cancer gene present.

With regard to Virtual Hair, anytime you attach something to your scalp, it can produce traction hair loss… which could become permanent. And I’d rather not comment on special customized lasers.

Tags: laser, propecia, finasteride, women, woman, hairloss, hair loss, virtual hair

Using Procyanidins with Minoxidil and Propecia

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

Dear Doctor Rassman,

I am considering taking procyanidins sold from applypoly.com along with minoxidil and propecia. I started on 5% minoxidil then later also started taking 1mg propecia as part of my hairloss treatment(been using both for over a year). I was wondering if adding procyanidins in both topical and pill form to my regime would have any impact on my current treatment. Do you see any potential harm if I take them all simutaneously? Your advice on this matter would be greatly appreciated.

Regards

AppleI do not see potential harm by exploiting all of these options. The procyanidins have been discussed on this site before (see search results). For those of you who do not know what this is, please review Applypoly.com.

Keep in mind, I’m not suggesting you order this stuff (yes, I realize it is for sale on the page I just linked to), but to do your own research.

Tags: apple, procyanidin b-2, minoxidil, rogaine, propecia, finasteride, hairloss, hair loss

Can Donor Hair Be Regrown?

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

I would also like to know whether in the future it would be possible to replant hair follicles in the donor area (that was previously used for an FUE surgery), in order for hair to grow again in the donor area, in other words will it ever be possible for the donor area to grow hair again?

When hair is moved from one place to another, the area that was the donor area will have lost those hairs forever. They do not regrow and can not be stimulated to regrow. If you move them back (I don’t know why anyone would do this), then yes, they will regrow in the original donor area.

Tags: hairloss, hair loss, donor, hairtransplant, hair transplant, regrowth

Hair Loss in 74 Year Old Woman

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

Hi, I am a 74 year old female and my hair has started to fall out. My scalpe is itchy red and flakes alot. I have had this condition most of my life but have always had a good head of hair, only recently has the condition got worse and the hair started to come out. Is this just old age ???

I wish I could give you a clear answer, but I honestly have no clue! You need an evaluation by a physician in-person who can ask pertinent questions and conduct a proper physical examination. I suspect if you had this condition most of your life, it probably is not related to your age.

Tags: hairloss, hair loss, female, woman, women, senior, age

Will Whey Protein Thicken My Hair?

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

Sir, i have started consuming WHEY protein supplements after my workouts to thicken my hair. Is it safe and will it work?

Good protein in your diet will keep you healthy, but it will not thicken your hair.

Tags: whey, protein, hairloss, hair loss, thicken, health

Hair Transplant Results After Just 1 Procedure (with Photos)

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

This Norwood Class 5 patient had just one transplant of 3684 grafts about two years ago. He recently came in for a Propecia prescription renewal and allowed me to take updated photos and post his results. He had a wonderful, big smile for me and said everyone he meets knows he looks different, and so rather than explain these changes, he made a point to lose weight and show off his newly trim figure. No one suspects that he has had a hair transplant.

Click the photos to enlarge.

After

 

Before

 

Tags: hairtransplant, hair transplant, hairloss, hair loss, patient, photo

Why Is It That If I Stop Propecia or Minoxidil, All the Benefits Go Away?

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

Just a question about how when someone uses procepia or minoxidil and then stops he loses whatever hair he would have lost if he didn’t use the drugs, why does that happen? does all the DHT that was blocked by the medication get back all at once to take revenge and kill the hairs? or is it something else?

Your explanation, although unscientific, is as good as any explanation I might come up with.

Simply, any hair growth or thickening with minoxidil is a direct result of this medication. It is completely dependent upon the medication for the benefits. Take away the medication and the hair growing side effect goes away with it. Regarding Propecia, this medication has stopped or slowed down the hair loss. Again, like minoxidil, it is holding off the progression of the balding process, so although from a different mechanism of action, the medication must be present. With Propecia, however, I believe that it works on the gene of the hair follicle. As you may know, every cell in the body has telomeres at the end of the DNA which determine cell death timing. Somehow, the hair cell’s death is delayed with the drug. Enough of my rambling and metaphors…

Tags: propecia, finasteride, minoxidil, rogaine, hairloss, hair loss, medication, drug, gene, dna

Scalp Had No Sensitivity After Brain Surgery

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

Hello Doctor,

Im male 30yrs. I had a brain surgery 3 yrs ago. After surgery, I had no sensitivity in mid or top of head. The hairs on that part started shading/ thinning slowly and then turned like baldness. Now Im getting sensitivity in that parts of head. Can I expect the hairs i lost or thinning be converted into thickness or hair growth? Can you pls advice me on how can I grow the hairs back/thickness on my crown/central head part?

Thanx in advance

I am not sure that I can help you evaluate your problem without examining you. The brain surgery may have cut critical sensory nerves in the scalp to cause your numbness. If the temporal vessels and nerve was cut on just one side, then you might have a sensory defect to cover the top and the side of your scalp. If both were cut, then you would have complete numbness, some of which could reduce over time as other nerves from the back of your head may take over. Any vascular damage could produce hair loss as well. Either your brain surgeon could/should tell you why you have this problem or any good doctor examining you will know what to look for. I would be happy to evaluate you if you are in or near California and would like to pay me a visit.

Tags: surgery, brain, numb, sensitivity, hairloss, hair loss

My Transplant Doctor Suspected an Infection After Surgery, Now I Have Dead Skin Areas

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

Hi, after recent hair transplant, I had severe swelling in my donor area and the Dr had to cut off a some of the sutures on the 7th day as he suspected an infection. Antibiotic ointment and medication has helped heal the donor area, but I am left with an area of dead skin, where there is no hair! This is on an area about 2cms wide and 5cms long, just on top of either ear. My Dr says that he can fix it by re-doing the scar in a few months or optionally by transplanting some hair in these areas, again after a few months. In your opinion, which is a better option? Your advise will be sincerely appreciated. Thanks and regards

You describe an unfortunate, but a real and relatively rare complication with the surgery. I am not clear if what you refer to as “dead skin” is really “skin necrosis” or hair loss seen around the donor wound on the scalp that is not necrotic. Small areas are easy to treat, large areas can produce problems. You should bond with your doctor on what is going on and get comfort from him/her on the plan for you over the next month or two. I suspect all hair transplant doctors have had some scalp healing problems at one time or another. Assuming that the problem is minor and you have bonded with your doctor, the best advice I can give you is to be patient and let time work in your favor. While it may be an inconvenience, if this is just hair loss in the donor area and it is not too extensive, the hair you lost may come back after 6-10 months. If you really have a wide necrotic area, then clearly waiting without adequate physician management is not the correct course. Without seeing you I can not make a firm recommendation other than for you to connect with your doctor and follow his/her advice, or get another opinion if you can not or do not wish to continue the relationship with him/her. In discussions, you should ask about healing, timelines, a worst case scenario, etc..

Tags: hairtransplant, hair transplant, infection, dead, scar, scarring, hairloss, hiar loss

My Hairline Matured at Age 17, Now It Started Changing Again At Age 36

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

Hi Doctor,
I asked you a question a few months ago and recently saw your answer posted on this blog. I’m afaid my question was misunderstood. I am 36 years old, and have been worried about my hairline since the age of 16. I had no idea about a mature hairline which I developed between the age of 15 and 17. Now at 36yrs old, I notice a very slight change on one side of my hairline. Do our hairlines change slightly as we get older? My hairline has been exactly the same for twenty years, and only recently do I see a slight change. My hair is very thick, and my hairline looks as good as the patients you’ve given transplants. Could it be that my hairline didn’t finish maturing yet?

I can imagine that some further changes in hairlines in non-balding men does occur with age. If it bothers you, it can most likely be fixed with hair transplants, but if you are just curious, you can follow any further changes and act when and if it does bother you.

Tags: miniaturization, hairline, hair loss, hairloss, maturing, mature

Experiencing Chest Pains from Generic Finasteride?

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

Dr. Rassman

I am 25 years old and very healthy. I recently purchased generic propecia offline (finpecia). I have been on this finpecia about 7 months. For the past month, I have been experiencing slight chest pains. Is this serious? Would brand name propecia give me different results?

If you are having chest pains, you need to see a doctor. Cardiac pain or epigastric (stomach) pains must be evaluated. I doubt, however, that the finasteride is the cause.

Tags: finasteride, stomach, chest, hairloss, hair loss, pain

Balding in Professional Sports — Rare?

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

Hi Dr. Rassman! I have a pretty weird question for you.

I just read a comment you made about most politicians having lots of hair compared to the average man. As a big fan of european soccer, I have noticed that almost all of the games biggest stars have a full head of hair (Francesco Totti, Ronaldinho, Kaka, Fernando Torres, David Beckham, Luis Figo and more). The only superstar who is balding is Zinedine Zidane from France. Very few choose to shave their head and those who do aren’t balding (ronaldo). For example, Englands national team does not have one bald guy in the starting 11. The same goes for Italy. And a lot of other big soccer teams don’t have much bald guys. Is this a coincidence?

There seems to be a good number of balding men in tennis. I can’t make a case one way or the other on your observations on soccer, but do think that it is interesting to note. Thanks for sharing.

Tags: balding, hairloss, hair loss, sports, athlete, tennis, soccer, football, pro

With the Death of Kanye West’s Mom After Plastic Surgery, I Wonder How Dangerous a Hair Transplant Is?

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

How dangerous is a hair transplant? The news about Kayne West’s mom dying after surgery has me scared. What happened to her and could it happen to me after surgery?

Kanye West, Donda WestThis is certainly a big news story this week, but for those that haven’t followed it, please read the following links:

What is there to say that the above references did not already say? Crossing the street can put you at risk of death, but the risks will go up if you’re running across the street with your eyes closed. Good planning, thorough research and common sense is central to the lessons here.

The presence of heart disease, by itself, may not be a contraindication for elective cosmetic surgery, but the heart disease risks must be defined and appropriate steps must be taken to minimized these risks. I have done surgery over my career on many patients with heart disease and these surgeries were done safely. Clearly from the references here, there is a strong suggestion that these risks were not defined for Donda West’s heart condition.

The doctor is ultimately responsible not to do surgery when risks have not been mitigated. I would ask if there was a rush to the surgery. Decisions that are made before surgery, during anesthesia, and even after the surgery is completed, account for most of the risks. Donda West doctor’s legal problems (medical board history, history of DUIs, and court appearances for malpractice) are suggestive of a problem for this doctor. It has been reported that the plastic surgery (tummy tuck and breast reduction) was performed by Dr. Jan Adams, who is probably best known as the host of the Discovery Health channel’s show Plastic Surgery: Before and After, or from his appearance on the Oprah show, or even from when he co-hosted a daytime talk show with Dick Clark a few years back. So here we have a doctor performing cosmetic surgery that has been on TV for a number of years and is known to many viewers. Does he promote himself as a “Doctor to the Stars” due to his Hollywood connections? Did Kanye West’s mother research the doctor’s history and credentials adequately? Did she have heart disease and if she did, was it adequately evaluated. I don’t know the answers to these questions.

To my knowledge, there has been only one death from a hair transplant anywhere in North America, as previously reported (see Death During Hair Transplant Surgery). This death reflects what appears to be completely incompetent medical care. The clinic where this death occurred, known for bargain basement prices, is still performing surgery and it appears that the patients that go there do not focus on risks of death or complications from a hair transplant or they would not be so popular. One might ask those who continue to even consider this place for surgery, “Why try to save a few dollars and place your life on the line?”

Tags: kanye west, kanye, donda west, donda, hairtransplant, hair transplant, jan adams, doctor, physician, plastic surgery, surgeon, danger

What Does a Doctor Do If a Big Percentage of Grafts Don’t Grow?

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

Having read a number of postings and messages concerning transplants, the question arose as to what percentage of the transplants actually survive and grow. If, say, 25% of the transplants do not grow, does a typical doctor deal with the situation by trying more transplants? Or is the patient stuck with having paid for something he did not get?

Ben Franklin“…in this world nothing can be said to be certain, except death and taxes.” – Benjamin Franklin, 1788

Typically, the success or growth rate of a hair transplant surgery should be in the low to mid ninety percentile, although there may be variability with different clinics. Furthermore, the success of a hair transplant surgery is dependent not only on the doctor, but also on the transplant team and technical staff. That is why the reputation of the entire medical group is just as important as the surgeon. If you feel your hair transplant was not within the acceptable range for survival or it did not meet your expectations, you should meet with your surgeon and address your concerns. On the few cases where yields were less than ideal in our hands, we offered additional transplants at no charge to the patients.

Tags: hairtransplant, hair transplant, graft, percentage, rate, hairloss, hair loss, graft

Can Hair Transplantation Damage Surrounding Follicles?

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

Hello,

Great informative blog. I have a question about future density after transplanted hair. Does your thinning hair follicles around where transplanted hairs gets inserted die from having that area worked on? In other words, say you still have some hair left on you hairline or mid section and you use transplants to help fill that area. When you use Propecia or Rogaine to help thicken your original hair follicles does that hair get “damaged” from having transplanted hair around them?

Thank you for your time and keep up the great site you have.

You raise a very important question. Yes, you can potentially damage the existing surrounding hairs with a hair transplant procedure. Thus, you must consider the risks versus the benefits of the surgery. Most of the time, hair transplantation near normal hair should not damage the normal hair, but if the surrounding hairs are weak (miniaturized) you may precipitate a “shock loss” phenomenon where you will experience loss due to the trauma of the surgery. Although drugs like Propecia work to minimize the shock loss risk, your doctor must not talk in generalities with you and should specifically address your risks. You must discuss this risk with your physician before a hair transplant surgery.

Tags: hair transplant, hairtransplant, damage, follicle, hairloss, hair loss, shock loss