After Stopping Propecia, I Feel Very Depressed

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

hi – i have been on propecia since it was first introduced (fall of 1998) – so about 10 years now – i stopped taking it abruptly about 6 weeks ago because i just decided to stop taking a chronic medication and wasn’t sure what kind of potential side effects there were – a few weeks after stopping, i started feeling very depressed and anxiety ridden – something i’ve never felt before – a few stressors WERE present in my life at the time but nothing more than what i’ve experienced before – any chance this is linked to my abrupt termination of taking propecia? – i’ve restarted it recently in the hopes of mitigating my mood but has anyone heard of this?

It is very difficult to answer your question. There have been reports of finasteride causing mood changes. You need to see your doctor for help. Were you also taking other medications that you abruptly stopped? Are there other stressors in your life (independent of stopping Propecia)? Could this be coincidental? There are many unknowns here and BaldingBlog is not the appropriate venue to discuss all of your issues. The only thing I can tell you is that after a few months of stopping Propecia you may find that your hair loss will accelerate and this may add to your depression.

Tags: propecia, finasteride, depression, stress, stressor, hairloss, hair loss, mood

Do All Transplanted Hairs Grow At the Same Time?

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

Hello,
what is the maximum time that it takes for hair to grow after a hair transplant surgery? 6-14 months? please give me a range.

do all the transplanted hair grow the same time?

It generally take 6-8 months for 80-90% of the hair to grow. About 95% of the growth should be seen in 12 (rarely 18) months.

The transplanted hair do not grow at the same time. They grow out in waves. I have personally seen complete hair growth as early as 2 months (in less than 5% of patients) and as late as 18 months for complete growth. Most fall within the 6 to 12 month range. This variability has to do with the individual and not the surgeon or technique itself.

Tags: hairtransplant, hiar transplant, surgery, hairloss, hair loss, growth

Does Niaspan (Niacin) Contribute to Hair Growth?

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

have you ever heard of the cholesterol drug niaspan helping with hair growth. It is prescription niacin which helps increase blood flow thus the flush in the skin you get from it. In theory could it be positive? I love your site. Thanks for all the good info.

Niacin is a supplement and not a drug. I don’t think that it will help hair loss or promote hair growth in a normal individual. With that said, I will refer you to a site which references a source on the value of niacin for hair loss — TheBeautyBrains.com.

Tags: niacin, niaspan, hairloss, hair loss, hair growth, growth, vitamin b

Cleft Lip Scar Growing Hair That Is Different Color from Rest of My Beard

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

I have a very nice beard, But my cliff lip scar has very fine hair that is not long or same color as the rest of my beard. can I see if Rogane is alright to use there? Can I Get some help?

I would think that it is alright to use Rogaine on your facial hair, however, I do not think it would do much to change the color. There are many products to change the hair color with a brush. Go to your local pharmacy and ask for them.

Tags: rogaine, facial hair, beard, moustache, mustache, cleft palate, cleft, lip

Charging for Transplants Per Graft vs Per Hair

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

Hi i am quite confused about charging by graft and by per hair.I recently met up with a doctor and he told me that i would need about 1700 hair for the transplant.The transplant will cost me around $4500.The doctor told me that there will not be any side effect and that the new hair will look very natural but i was told by a friend that transplant might cost swelling face and that the new hair will look different.Is theis true.Overall is FUE method effective?Thanks

In the United States, surgeons generally charge per graft (follicular unit). One graft contains anywhere from one, two, three, and sometimes 4 hairs. In general, one graft averages 2.2 hairs. Some doctors add to the confusion about pricing by switching to a charge per hair, to make it appear less expensive. So if 1700 hairs were placed at surgery, it would be like a 773 graft surgery. At our NHI standby rate of $5/graft, the surgery would cost $5 x 773 = $3,865.

Hair transplantation has many risks along with the many benefits, and they should be discussed in detail between the doctor and the patient. Some of the risks include (as you stated) post-operative swelling and shock hair loss, just to name a few. FUE is a great method when done correctly (with an experienced doctor and experienced team, as it is very labor intensive).

For more on ethics and hair transplantation, see How Do I Know I Am Getting the Number of Grafts I Am Paying For? — and be sure to check out the links at the bottom of the post for even more reading.

Tags: hairloss, hair loss, hairtransplant, hair transplant, graft, charge, ethics, ethic, doctor, physician, price

I’m Allergic to Propecia

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

Dr. Rassman, I urge you to post this account of my allergic reaction to Propecia. Approx. 5 weeks ago I started on daily use of Propecia. In the first 2 weeks I didn’t notice any significant effects except mild loss of libido. Around week 3 or so I started to develop what I thought was a normal Winter time stuffy nose. I also started to hear strange little sounds like crickets and thought that was odd. What were crickets doing out in the Winter ? My so called stuffy nose continued to get worse until on day I was so stuffed my mucous would not drain out of my ear and I developed a severe case of Tinnitus. I also started to experience what I thought was overly sensitive ears.

I went to 2 Dr.’s and both diagnosed me with upper viral infection and eustachian tube dysfunction. I was given oral/nasal cortisone to help open my eustachian tubes, had a audiogram which was o.k. My throat was a little tight and as I continued to take the cortisone oral tabs and spray my symptoms would temporarily get better. I was told that Upper Viral Infection would take as long as 2 weeks so I just kept taking the meds. I noticed late at night my symptoms seem to get a little better and in the morning they would get worse.

This morning I took my Propecia and within no time my Tinnitus had gotten worse. I took my Cortisone and got a little better. I finally made the connection after 2 weeks of this that I was having an allergic reaction to the Propecia, causing the inflamed throat/ETD/Tinnitus and upper viral infection. I also found one other person on the net with identical symptoms. I also experienced a strange pressure in my head as though my head were being inflated and deflated slightly and “brain fog”.

Please help get the word out.

Thank you for sharing your experience, but it is hard to make a direct correlation. Based on what you’ve described, it sounds like an viral upper respiratory infection, as your doctor pointed out. Perhaps you should stop taking Propecia to see if your symptoms go away. I suspect if it is a viral infection, your symptoms will go also away. If you feel that you are allergic to Propecia, check with the doctor who prescribed it and consider stopping it.

Tags: propecia, finasteride, allergy, allergic, reaction, viral infection, hairloss, hair loss, tinnitus

Does FUE Destroy Follicles? Does FUT Traumatize the Scalp?

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

i wonder what size instrument you use and do you do FUE and not FUT as a preference. i am over 50, auburn curly hair, very fine, i think miniaturized; loss on top and front. i read one article which tells me FUE is not reliable and destroys follicles; then i read another which says FUT traumatizes the scalp; i am stuck! which is safest and produces good results? can cortisone injections cure pattern loss in women? thanks

Actually, you are correct about the follicular unit extraction (FUE). Please see the post titled, What Doctors Don’t Want You to Know About FUE. As you see, there are always the pros and cons of any type of surgery, but you must weigh these out before making a decision.

I do not agree that FUT (strip procedure) traumatizes the scalp, though. FUT is considered a minor outpatient surgery.

Cortisone injections are sometimes used by doctors for female hair loss, but in my opinion it generally does little to help hair loss.

Tags: fue, fut, strip, hairtransplant, hair transplant, hairloss, hair loss, cortisone

I Am Vegetarian and Dutasteride Capsules are Made from Gelatin

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

Hello,

I take one 0.5mg generic dutasteride capsule (Duprost) daily for hair loss purposes.

The capsule is made from gelatine, an animal product, and as I am vegetarian would there be any negative effect on the effectiveness of this product if I bite down on the capsule to release and swallow only the contents but do not swallow the gelatine capsule?

Thank you

Honestly, I don’t know for sure. The contents of the pill can likely be ingested without the gelatine capsule — I can’t say how good or bad the taste is, though. I’d ask your prescribing doctor, however. I’ve prescribed this very few times and the pills I’ve prescribed aren’t in a gelcap, as far as I know (though they might not be generic). I’m not ready to recommend dutasteride yet in treating hair loss, as you would probably have more negative side effects from dutasteride over something like finasteride.

Update:
The official Avodart labeling I found on the FDA site specifically says, “The capsules should be swallowed whole and not chewed or opened, as contact with the capsule contents may result in irritation of the oropharyngeal mucosa.”

Tags: hairloss, hair loss, dutasteride, finasteride, avodart, gelatin, capsule, vegetarian

Applying Toppik or DermMatch with Rogaine Foam

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

Hello Dr. and thank you for this website, it is incredible the amount of information here displayed. I have 2 questions:

  1. I will start using Rogaine Foam as I used ScalpMed in the past and I had mild results (better than not using anything at all), but I wish to use a hair concealer after the topical application of the drug. I am not sure if I should use DermMatch (that had worked wonders on me) or switch to Toppik. DermMatch has to be applied on wet hair and that is what makes me doubt about using it (I might wash away the Rogaine). What do you think?
  2. Toppik announces a “fiberhold spray”: Toppik.com
    do you believe it could affect the effect of the toppically applied drug, or once the Roagine Foam is dried I can pretty much put anything on my hair?

Thank you again!

FiberHold Spray

  1. Apply the Rogaine Foam first, then use the Toppik after the foam has worked its way into the skin. You can experiment with both the DermMatch and the Toppik and see what works best for you.
  2. I don’t know more about the FiberHold Spray than what is already in the link you sent, but I do not believe it will produce a negative impact on Rogaine after it has been absorbed. It seems to be just a fancy hair spray for Toppik users.
Tags: toppik, dermmatch, rogaine foam, rogaine, minoxidil, hairloss, hair loss, fiberhold, spray

Hair Loss Worse After Going from 0.5mg to 1mg of Finasteride

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

Hi Dr Rassman,

After taking 1mg propecia/day for about a year, i dropped my dose to about .5mg/day due to side effects I was having. I recently jumped back up to 1mg/day, but have noticed an increase in acne and hair oiliness. Also my hairloss seems to have gotten much worse. Could this be due to a case of reflex hyperandrogenicity? My sex drive/body hair hasn’t changed, but im worried that continuing finasteride could make my hair loss worse – is this possible?

While your theory seems possible, I really do not have a good idea if that is what is really going on. You have two options:

  1. Go back to the 0.5mg finasteride dose
  2. Continue with the 1mg finasteride dose

Either way, you should discuss the plan with your doctor.

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

I Think ScalpMed is Working After Just a Week

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

I just wanted to say that I have tried Scalpmed and I think it is working. I just bought it a week ago, but I feel I am already seeing results. I am not using it twice a day like it says because I don’t like how the product leaves my hair feeling like I have gel in it and it really weighs my hair down considering how fine my hair is already. I wear it only at night. But so far so good. I also thought it was going to me a scam but its good so far.

Good for you! I highly doubt anything works in just a week for treating hair loss. Could this be like a placebo effect?

Tags: scalp med, scalpmed, hairloss, hair loss, placebo

24 Year Old Using Propecia and Minoxidil for Years is Still Balding!

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

Hi doc! I’ve been on propecia for about 4 and a half years now and i’ve also been using minoxidil 5% for about 3 years but I’m still balding! I’m only 24 and I’ve been balding since the age of maybe 16-17. I always see you answering to young people that they should try Propecia or Rogaine, but that stuff doesn’t work for me. What should I do?

I would love to have a hair transplant so that I can at least enjoy a “normal” haircut for the next 5 years, instead of waiting for my hair loss to stabilize (going completely bald) and THEN have a transplant and still look pretty bald.

While Propecia and topical minoxidil are great medications for male pattern baldness, they have their limitations. Your genetic predisposition will always win. Nevertheless, while you are still losing hair, I am sure the rate of your hair loss is slower than if you are not taking the medication at all. In short, these medications are likely working for you, but your genetic fate is winning the battle.

If you were to stop taking these medications, I am fairly certain you will accelerate your hair loss.

It seems your next step might be a hair transplant surgery. Of course, I couldn’t say for sure as I haven’t examined you, but options are limited if your loss isn’t stopping with medications. If you would like a private consultation with me either directly or by phone, please call our office at (800) NEW-HAIR (800-639-4247) and my staff will be happy to arrange it.

Tags: hairloss, hair loss, minoxidil, rogaine, propecia, finasteride, hair transplant, hairtransplant

Reader Encourages Others to Send In Their Success Stories

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

Hi there Baldingblog team! First and foremost Id Like to thank you for your outstanding site. Losing your hair causes such panic and as the internet is where most of us look for help,Sifting through all the rubbish takes time,and is frustrating, type “hair loss” in google and reams of pages trying to take your money will come up, claiming cures, 98% success etc. People in this world really do pray on the weak! I have found this site an amazing source, and think i’ve now educated myself pretty well! I have been coming here for almost a year and this is one of my first posts.

The reason why i’m writing is because I noticed a lot of negativity and criticism coming from obviously frustrated balders,this is also because I dont think many people with propecia success stories/great hair transplants come here to post. only paranoid,frustrated, critical people who are looking for someone to just tell them it will all be fine…. the fact is guys, there isn’t a cure…yet. But there are things you can do,educate yourself…and just have the guts to try the treatments available. there is no harm in that.they wont be instant at working, and they might not even work at all for some, but dont be that much of a skeptic that you wont even try. just be patient.

I personally was losing my mind over my stupid hair… got propecia a few months ago (3) and my hairloss has stopped, and I can even see a few little baby hairs, getting a bit more coverage! Alas I havent covered my bald spot completely in a week as many of us would like! but thats just not where todays science is at. Id also just like to encourage readers with success stories to post, because the scale at the moment is just too unbalanced. anyway take care!

I agree. It certainly seems like I post a lot of emails from people with negative responses from Propecia (or those that believe they’re having negative responses), but that is not a good sample of people, statistically speaking. I also post messages from those that are seeing results, but it may seem that the bad far outweighs the good. As I’ve pointed out before, I think more people are just ready to make their complaints known than those that just silently enjoy the benefits of the medication. So to all readers of this blog — if you have a success story you’d like to share about your hair loss treatment, please send it in!

Tags: hairloss, hair loss, propecia, finasteride, hairtransplant, hair transplant

If My Hair Loss is Due to Drinking Alcohol — Will It Grow Back if I’m Sober?

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

Hello Dr. Rassman.
After reading about the 26 year-old who had questions about his hair loss, possibly due to drinking & smoking. I am a 32 y/o white male in the same boat, except I don’t smoke. My hairline over the past year or so seems to be receeding more now than ever. I am wondering if indeed one’s hair loss is due to their drinking, if they stop drinking, would the hair possibly grow back, or is it too late? Thank you!

AlcoholDrinking alcohol should not produce hair loss unless your diet is deficient. I would look for genetic causes for hair loss by getting your hair mapped out for miniaturization to determine the cause of your hair loss.

Generally for a male, if the hair loss is precipitated by poor diet, it is most likely accelerating the genetic process and probably will not reverse. That said, for females, there is a good possibility that correction of the diet will help with the hair loss.

Tags: hairloss, hair loss, alcohol, drinking, drink, sober, sobriety

I Made a Foolish Mistake in Experimenting with Anabolic Steroids — Now I’m Losing Hair!

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

Dear Dr. Rassman,

I am not 28 years old and made the foolish mistake of experimenting with anabolic steroids a few times a few years ago. My first two attempts, I had zero hair loss and then all of the sudden the third time I had quite a bit of hairloss in the diffused pattern all across the top. My question is was there a chance that I was not going to bald at all or was not balding at the time and the steroids started mpb that might not have started for another 10 years or not at all?? Just curious to if I would be losing any hair had I not experimented with the anabolics. Does it have the power to start mpb if you weren’t going to bald and can it start it up to 10 years earlier? I am asking this because my dad didn’t start to bald until his 40’s.

Thanks for the time.

Anabolic steroids can accelerate hair loss if you have the gene for male pattern hair loss. Even without taking anabolic steroids, you probably would have had hair loss at some point in your life. Anabolic steroids are illegal unless prescribed and managed by a physician and only for special health purposes. Anabolic steroids can not only accelerate hair loss (that is usually not reversible), it can also cause other medical problems such as liver damage, etc.

Tags: steroid, anabolic, hairloss, hair loss, liver