Success Story — Finasteride and Minoxidil Worked!

/by William Rassman, M.D./9 /

Here’s some positive feedback:

I’m 28, been losing hair since I was 22. I started out taking herbal supplements (saw palmetto, stinging nettles, etc.) and I feel they did work to a degree. The hair loss slowed a little, but not enough to keep me satisfied. I tried Revivogen during this time but wasn’t satisfied at all.

A year and a half ago I met with a great hair loss doctor near Toronto. He immediately dismissed me as a candidate for surgery, which I find refreshing. It shows he isn’t just after a quick dollar and actually cares about his patients.

He started me on Proscar (1mg/day) and I’ve seen AMAZING results. Six months ago I started adding Minoxidil formula at night (6% I believe) and now I’m seeing a lot of new growth. My hair looks fuller and more natural, too.

My expectations are pretty reasonable. I know I’ll never have the same head of hair I did 10 years ago, but for a guy pushing 30 I’m doing alright. I’m 100% satisfied with the results I’ve had. It seems that if you catch it early enough and are dedicated to your Dr.’s plan, most people can stop hair loss.

Have faith, gents.

The above letter is from a reader in response to Reader Encourages Others to Send In Their Success Stories.

I’m glad you’re seeing amazing results! It just goes to show that surgery is not always the answer to treating hair loss. Congratulations!

Tags: proscar, finasteride, propecia, minoxidil, rogaine, revivogen, hairloss, hair loss, success

Could Finasteride Be Affecting My Sperm?

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

Dear Doctor,
I have been taking Propecia for years. My wife and I are trying to have our first baby. She has gotten pregnant twice, however both have resulted in her getting a D & C. There have been problems with cell growth after conception in that an empty sac forms with nothing inside. Could finasteride be affecting the genetics of my sperm?

There are many potential reasons why your wife may have trouble conceiving. There are two issues that are known with regard to sperm while taking Propecia —

  • Reduced semen volume is very common, but usually the presence of sperm is good.
  • A recent report in the medical literature suggests that Propecia may cause reduced sperm counts, so I would have your sperm tested for this.

I would think that Propecia is low on the list of many more common possibilities.

Tags: semen, sperm, propecia, finasteride, hairloss, hair loss, pregnancy, baby

I Have Hairy Shoulders, Back, and Chest — Will I Have MPB?

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

Hi Doc. I have a few questions regarding male pattern balding and hormones.

  1. I obviously have a lot of DHT as I am 22 and have hair on my shoulders, back and chest and had bad acne growing up. Does this mean that I will be more susceptible to MPB?
  2. I have a widows peak that I inherited from my father. He is in his 50’s and the only extent of balding happened before his mid twenties that resulted in a pronounced widows peak. Does this mean That I will probably follow his pattern? if I have more DHT that he does is there a greater chance that I will have more balding…or is your pattern of balding predetermined…regardless of the amount of DHT you have.
  3. I have noticed miniaturized hair falling out every once in a while, they are thin but still as long as the rest of the hair. Does this always mean MPB or does some hair naturally miniaturize. (could other scalp conditions cause this, such as dermatitis)

I appreciate any info you can offer regarding these questions. Excellent site, keep up the good work.

  1. Having “lots” of DHT does not necessarily mean you will have MPB. You need to have the gene for MPB. Just having hairy shoulders, back, and chest does not necessarily mean you have “lots” of DHT either.
  2. You may or may not follow your father’s hair pattern. There is no way to tell for certain.
  3. Miniaturized hair does not necessarily mean you have MPB. Men with MPB have miniaturized hair in certain “patterns” — thus, the term male pattern baldness (MPB).
Tags: chest, back, shoulder, hairloss, hair loss, mpb, gene

Why Was I Born with a Bald Spot?

/by William Rassman, M.D./12 /,

Hi,
I am a 28 year old woman that was born with a bald spot in the middle of the back of my head. Do you know what may have caused this? And do you know how I may be able to fix this? I never wear my hair down because of it and it’d be nice to. Thanks!

I really couldn’t tell you why you have a bald spot on the back of your head. The bald spot may just be a birthmark or it could have been a result of trauma when you were a baby. I do not know. If you want to address or fix the bald spot, you can consider a hair transplant.

Tags: hairtransplant, hair transplant, bald spot, birthmark, birth mark, women, woman, female

Gastric Bypass Surgery Coming Up — What Can I Do to Keep My Hair?

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

(female) Hi. I am a pre-op for gastric bypass surgery. I understand that hair loss is a common effect of gastric bypass surgery. Is there anything that I can do now to get ready for this? I have thin hair to begin with. Is biotin helpful? Thanks.

Hair loss and weight loss go hand in hand. Speak with a dietician to come up with the best balanced diet for you. You may suffer from hair loss as long as the weight loss continues, and as this is a consequence of the surgery there may be little for you to do once you focus on your best diet through professional help.

Tags: gastric bypass, hairloss, hair loss, diet, surgery, weight

Success Story — A Reader’s Hair Transplant Experience

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

I am writing this message as a way to convey my personal experience thus far with a hair transplant. I would like to offer hope to people considering this route. One caveat is that everyone is a different case-regarding donor supply, pain tolerance, how far along the Norwood scale, etc. Without naming physician-I will tell you of my experience. I researched for over 5 years who to go to and kept coming back to the surgeon I chose.

I had tremendous trepidation about whether I should do this-people would tell me I look fine but I knew I was kidding myself with my hairstylist working with me to cover my completely eroded hairline and front as well it made me a 4A on the Norwood scale. I was given 2 valium to relax me. We discussed the hairline that would be age appropriate for now and the future. Then we were ready to get started.

OK-here is the answer everyone wants to know- does it hurt?

Well I can tell you that I have a low pain tolerance and definitely dreaded the needles for the anesthesia and rightfully so-they did hurt especially the forehead-but the good news is you felt nothing after that. None of the cutting/suturing nor placement of grafts into the receptor sites. I was pleasantly surprised. Based on my personal experience the surgeon was able to place 2502 grafts. He even told me that he was sure I would be happy with the results something he refrains from saying. He knows that I am very particular and I believed him. It is all a waiting game. say 6 months to a year before you see real results at least this is what I have been told.

The surgeon used the latest technology-the tricophytic closure a double suture process-to assure a minimal scar provided you do as your told.

We are all adults and clearly must be responsible for our own welfare. Therefore if you follow exactly the direction for maintaining post op procedures I am sure it will minimize infection chances and limit scar size. You must treat these grafts as if they are fragile like glass-they can be destroyed accidentally and through not following directions. I am on day 5-one third of the way through the post op.

I myself am very sad to say that I had a violent reaction to the pain medication with Codeine. Between the antibiotics and the pain meds it really did a number on my stomach. I see that as the worst part for me. Amazing the procedure was easier than the recuperating time-I never would have guessed. I am just getting over this gas pain/vomiting caused by the medication. It was a tough couple of days.

Would I do it again?

Absolutely yes-the small/moderate pain you feel in the few days is nothing compared to a lifetime of happiness. The bottom line is I was unhappy with my appearance-depressed, self-conscious, lack of confidence you name it. Being a 46 year old male who has been told he looks like he is in his late thirties is Great-but for how long can I pull that off what with the way my hair was going south.

My advice is simple-do your research. check out hair transplant on youtube-they show actual surgeries-do not let that put you off. do not shop around for cheap. this is your future. my cost was $10,000 for 2500 grafts from a surgeon rated the top 100 in Manhattan. Do not go cheap-you will pay for it in the end.

Good Luck!

The above letter is a response I received after posting Reader Encourages Others to Send In Their Success Stories.

The experiences outlined above are common and even the response to codeine is not atypical and can easily be managed. Codeine has an impact on the stomach as an irritant. I appreciate that you took the time to write this eloquent history to share with our readers!

Note to everyone out there, please keep sending in those success stories!

Tags: hairloss, hairloss, success, codeine, hairtransplant, hair transplant

Steak Accelerates Hair Loss?

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

I have seen certain studys that show hormone polluted meats such as mince meat and steak can accelerate MPB causing more hair loss. Is there any truth to this?

SteakI found an article with a quote that suggested there was something to this: “If you look at Japan, male pattern baldness was almost unheard of prior to World War II. The Japanese diet is now far more fatty and Westernized, and Japanese men are going bald everywhere. It’s clear that a high-fat, meat-based diet raises testosterone levels, and that may adversely affect hair follicles. I’m not sure eating low-fat foods will stop hair loss, but it might slow it down.”

The above quote is attributed to Dr Michael Klaper, a vegan health advocate that focuses on the perceived dangers of consuming meat and dairy. The problem is, there is no modern science to back his hair loss claims up. While there are many suggestions that “we are what we eat” and that diet does influence the expression of genes, I am unaware of good statistical or scientific studies that accurately report balding prior to WWII in Japanese men or that meat contributes to hair loss.

Tags: hairloss, hair loss, steak, meat, ww2, japan, western

When Will My Donor Scar Not Be Visible?

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

I have had a recent HT in Nov 2007 and now having problems with haircuts. I have tried a number 2 shear and number 3 shear haircut with both showing the donor area scar for weeks. I was told that a number 2 was fine but obviously not. How long will this donor scar be visible for males that like to wear their hair shorter.

I do not know how wide your scar is or where your donor scar is. You may have a wider than average scar. You may or may not be a candidate for a scar revision surgery if the scar is wide. You may have temporary telogen effluvium on your donor area that may make the scar more visible and if that is the case, it should reverse in 4-6 months. There are many variables that I cannot readily answer without examining you. You can send me photos of your scar with a ruler next to it so that I can appreciate the degree of scar widening (please reference this post when sending). You should see your surgeon who performed the hair transplant surgery and discuss your concerns with him/her.

Tags: hairtransplant, hair transplant, donor, scarring, scar

Fluocinonide Topical Prescribed for Female Hair Loss?

/by William Rassman, M.D./15 /, ,

Hello Dr.(40 year old African American female) I was told on the 8th of Jan 08 by a Dermatologist in a county hospital that I have scaring in the crown of my head and very few follicles left because of the way African-American women process their hair, and then as he exits the room he says, there’s nothing we can do. A more sympathetic intern stayed behind and offered to prescribe Fluocinonide Topical Solution USP,0.05% 60ml,will this have any benefit at all? and am I a candidate for anything else transplant or otherwise. P.S., know any good specialist in Houston, TX.?

Fluocinonide is a potent steroid medication and I do not like to second guess another doctor’s recommendation. You should probe your doctor’s opinion on just what benefit he expects to see and over what period of time. My personal feeling is that it is sometimes more difficult for a doctor to do nothing — and sometimes when a doctor feels compelled to do something, medications prescribed may have little or no value. I do not have recommendations in TX at this time.

Tags: fluocinonide, steroid, hairloss, hair loss, doctor, female, women, woman

Scalp Indentations After Cortizone Shots

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

What causes the indentations to the scalp after the cortizone shots?

Anything injected into your body can potentially cause a reaction and scarring (scalp indentations). When steroids are injected into the dermis, it may cause loss of dermal fat, which could cause the indentations you are talking about. I have seen such indentations in people who have had scalp injections by doctors who believe that steroids have value for balding patients.

Tags: scalp, indent, indentation, cortizone, injection, shot

Does Warm Water Followed by Ice Cold Water Shock Hair Growth?

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

2 questions:

  1. when showering using warm water and finishing off with ice cold, will the cold water stun/stock hair growth or enhance it?
  2. Can pimples where one has had a transplant be popped?

Water

  1. No, but I suspect it would stun / or shock your body. It will not contribute to hair growth, though.
  2. Yes, but use care. Warm compresses will speed up the process. See Scalp Pimples Weeks After Hair Transplants for more.
Tags: hot, cold, water, ice, stun, shock, hairtransplant, hair transplant, hairloss, hair loss

Could Applying Minoxidil Cause Traction Alopecia?

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

Hi Dr. Rassman,

I use minoxidil twice a day, and was wondering if the rubbing in of the product using my fingers could cause traction alopecia. Sometimes the areas I rub become a bit sensitive, and while
I dont think I am rubbing too hard, I was wondering if this constant, twice a day rubbing could contribute to hair loss.

Thanks.

No. Traction alopecia does not occur from rubbing product into your hair; it occurs from constant pull on the hair for many weeks or months.

Tags: minoxidil, alopecia, hairloss, hair loss

I’m Going In for Knee Surgery — Do I Need to Tell My Doctor I’m Taking Finasteride?

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

Hi,
Thanks for offering such an objective viewpoint on the subject of hairloss where many others seem to offer empty promises and such skewed opinion. I may require surgery on an ACL injury in about 6 months as that is most convenient time for me to have the surgery. I am 22 and started taking propecia about 3 months ago, but I did not go through my doctor and just did my own research and bought off a reputable website. I don’t want to damage the relationship between my doctor and tell him that I did not even consult him before starting with propecia, but I was concerned that I might have to tell him I was taking this medication for my own safety given the ACL operation. Is it necessary he knows this information if I have surgery. Also, you talk alot about young men obtaining better results with propecia, but I couldn’t find any statistics apart from the study for men between 18-41. What is the exact benefit for under 25 compared to 30 year plus.

Thanks for your help

PropeciaThank you for your kind words.

I would recommend that you come clean with your doctor and tell him everything about your health and medications that you are taking. After all, if you are trusting your doctor to perform surgery on you, I am sure you would want your doctor to trust you. It makes for a good doctor-patient relationship.

With respect to Propecia statistics, the scientific data comparing one age man with another is not available. From the extensive experience by many physicians in the field, Propecia works best when hair loss is more recent and that implies younger men. The practical answer is that it is never too late and I have seen it work in men from 18 years old to 70 years old. And all the research and statistics go out the window when YOU are the one taking the medication, because if it works… it works! You should only worry about statistics if you have a wager on how well it will work on you, because even if the statistics are low, I am sure you will take it since you have nothing to lose (but hair).

Tags: acl, knee, surgery, finasteride, propecia, surgery, doctor, hairloss, hair loss, age

Giraffe Poop Decreases Hair Loss?

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

This sounds like an urban legend. Thoughts?

“Scientists at the University of Sydney have discovered that giraffe shit will decrease hair loss and at the same time increase existing hair on balding men. The study was carried out over a two year period with 50 balding men. Group A, the control group consisting of 25 men, were given falafel to apply on their head and group B…”

GiraffeHa! If you want to rub animal droppings on your scalp, that is entirely up to you, but if you’re trying to stop your hair loss with these droppings, you’re going to wind up pretty disappointed (and smelly).

There is nothing published from the University of Sydney, and the only reference I can find about this oh-so-scientific study is the source article. I can say with certainty that it’s just a joke. If you prefer, you can even call it a hoax, a satire, or even a fake. Plus, if you stop and consider that the source is a website called Turd On A Stick and the article was written by “Bill O’Turdly”…

The full article can be found at TurdOnAStick.com

Tags: giraffe, turd, poop, crap, hairloss, hair loss, parody, humor

Evolutionary Reason for Hair Loss?

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

I know this may sound ridiculous and maybe hypothetical, however i find it reasonable to ask. Hypothetically speaking, who ever the first person was on the planet to go bald, what scientific REASON did he? I know you may answer by saying they would have had DHT-sensitive cells,but that isnt really explaining what chemically or otherwise is making the follicles sensitive to DHT. People have DHT yet dont go bald, so what makes the cell sensitive to it? The usual answer i get given to why am bald is because the balding ‘Gene’ has been passed down. Well who ever was the first person to bald, What specific reason did his cells become sensitive to DHT?

Sex, Time and Power: How Women's Sexuality Shaped Human EvolutionThis is a great question. For those readers who believe in evolution and not intelligent design, I gave one reasonable answer to why hair loss occurs in a previous post — Why Does the Back and Sides of the Head Not Lose Hair?

After having read Sex, Time and Power: How Women’s Sexuality Shaped Human Evolution by Leonard Shlain (referenced in the above link), I became a believer, as it was the only explanation for balding I’ve ever found.

The book is available at Amazon.com.

Tags: hairloss, hair loss, evolution, balding, shlain