Finasteride and Semen Quantity Reduction

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

Hello Doc..
What is the exact mechanism of finasteride to reduce the semen quantity? Does everyone who is taking finasteride face the problem of reduction in semen quantity to some extent or are there people who do not have any reduction in semen quantity??

People react differently to certain medications. There is a small percentage (1-2%) that sees a decrease in libido, however, there are others that see an increase. Along the same lines, some may have a decrease in semen volume (not uncommon), however, according to an article from October 1999 in the Journal of Urology titled “Chronic treatment with finasteride daily does not affect spermatogenesis or semen production in young men“, the authors concluded that, “Treatment with 1 mg. finasteride daily for 48 weeks did not affect spermatogenesis (sperm production) or semen production in young men.”

A more recent study does report two patients with decreased sperm counts.

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

Does This Sound Like Natural Balding?

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

Hi,

Im 34 and I have been experiencing hair loss (gradual) for more than 10 yrs now.

Things observed during these yrs.

  1. Hair loss, thinning of hair etc.
  2. Hair falling out from the root/base.
  3. Lack of natural oil secretion from scalp
  4. Itchy scalp (flacking)
  5. Oil massage has not helped me.
  6. Very thin new hair – at the areas of hair loss

Just wondering if its fungal etc or just natural balding. Pls let me know what you think about my case.

Thanks much in advance.

Without examining you it is impossible to say much from your listings above. Is the hair thin all over the head, including the back and sides? As you are not clear about this, I can not tell if you are changing hair character or are experiencing genetic thinning/balding. Some of the items on the list, like reduced oil secretions and itchy scalp, go together and may reflect changes in genetic balding.

Tags: hairloss, hair loss, oil, itch, scalp, balding

Will a Trichophytic Closure Still Leave a Noticeable Scar if My Hair Is Cut Short?

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

Would you generally advise transplanting hair to the temple area where no hair is currently there? I’m thinking this can maximize the chances of a fake look? Am I right?

I read about the trichophytic closure technique — if it only covers 1mm of scar area, then would that leave a NOTICEABLE average of 1-2 mm of scar area still visible if hair is cut short (2 with guard, that is)?

Yes, it may. Scarring is highly variable with different individuals. You can have a doctor with poor surgical skills perform a procedure without a trichophytic closure and still have a great 1mm scar. Or you can have the best surgeon using a trichophytic closure and have a wide noticeable scar. 1-2mm is considered a great scar and it may still be noticeable with a very short hair cut. A #2 guard may hide the 1 to 2mm scar, but this also depends on your hair color, scar color, scalp color, hair coarseness, hair waviness, etc. As you can see, there are many variables.

Tags: hairloss, hair loss, hairtransplant, hair transplant, trichophytic, closure, scar, scarring

My Dermatologist and My Hair Doctor Disagreed About Propecia

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

I’m 33. About 6 months ago I went to see a ht doc, and my doctor and dermatologist. The ht transplant doc prescribed propecia and told me to come back in a year, but my doc and the derm would not. My doc said you could see a little of my scalp on top but nothing out of the ordinary. The derm said, along with my family history, that “there are no signs of mpb and your hairline is strong.” But I had bad imflammation, he prescribed Luxiq, a topical steroid, but I have been feeling like I was losing more than normal/thinner than normal. About a month ago, I started the propecia, just to see how it went, because I was nervous about losing anymore.

The inflammation has only gotten worse, and now in the last few days, I am shedding like crazy! My head does not itch, it is just a dull pain/feeling on the vertex. The last few days I lose up at least 50 hairs so easily when styling my hair for just a minute – much, much more than ever before. I’m afraid to even touch it.

So – can you shed on propecia if you arent actually actively losing hair? Does the shedding hint that I actually am losing hair? Also, if I decide now to stop the treatments and follow up again with my derm, will the hair that I’ve shed come back, even after stopping the treatments?

Thanks

I would assume that the hair transplant physician did a miniaturization study to come to the conclusion that you have male pattern balding and that you need Propecia. Eyeballing someone’s scalp is not the equivalent of this. I would make make an appointment with your dermatologist and have him/her recheck you since you are having more problems. I can not tell you what is going on without knowing what your dermatologist is treating with the steroids. Having said that, I would doubt that Propecia is causing your hair loss.

Tags: propecia, finasteride, dermatologist, dermatology, doctor, physician, hairloss, hair loss

I Get White Hairs When Stressed

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

Im 27 yrs old female and when I get stressed I get White hairs not gray. But sometimes I get striped black and white hairs I dont think I have a brain tumor like one blog said and I dont have any med. problems so whats up with the striped hair?

Very interesting. Unfortunately, I have no experience with a person whose hair turns white or gray and is stripped. I have seen stripes of white hair mixed with dark hair. Maybe what you are reporting is something that I should have observed in some of my patients. I don’t have all of the answers and am often humbled by my ignorance.

Tags: stress, white, gray, grey, hairloss, hair loss, stripes, striped

Actor Joe Penny Shows Off His Repaired Hairline (with Photos)

/by William Rassman, M.D./22 /, , , ,

Joe Penny, perhaps best known for his starring roles in hit 1980s television series Riptide and Jake and the Fatman or more recently his guest spot on the popular TV show CSI: Crime Scene Investigations and the Hallmark Channel’s Jane Doe TV movies, has agreed to let me show his results from a repair job started years back. Due to a variety of professional obligations, we were unable to schedule more work until about a year ago. When his old, ugly plugs from another doctor showed, I was reluctant for him to tell people that I was his doctor (even if only for repairs, because I did not finish the repair job)… but now things are very different as these two month old pictures show.

He tells me that on many occasions he’s overheard fellow actors talking about hair transplants, expressing fear of taking charge and doing something about their thinning hair. As Joe puts it, “It takes a great deal of courage to make the decision to get a hair transplant, especially when you see so many bad jobs out there in Hollywood. You get gun shy after making a bad decision and it took me some time to make the decision to fix my bad hair job. But now, when people talk about a hair transplant for their balding and struggle with the hair loss problem, they don’t look at me as an expert any more”.

Update 2/1/08 6:00 pm:

Joe just wrote to me. He did not know that I put him on the blog today, even though he gave me permission to do this over a month ago. This is what he said: “I want to thank you again for your kindness and your generosity in my case. The last procedure I had..even after seeing you a couple of months ago..has still continued to grow and thicken. Also the donor area…because of the expert surgical job you did… is so loose I cannot believe it! It is truly astounding to me. I mean…I new you were good but WOW! The results speaks louder than words. I have recommended several people to come and see you. I know that some of them have already come. They called me and were very angry at me, meaning…well the dialogue went something like this…”Why the hell didn’t you tell me about the NEW HAIR INSTITUTE BEFORE” My response was “I DID…YOU WERE NOT LISTENING”. They are extremely satisfied, as I have been for years. So I will keep spreading the word about the fantastic work you and you Doctors are doing at NHI.

After I received this email, I wrote to him asking for permission to use the above email. His response came in at 9:00pm and this is what he said: “Yes, you have my absolute permission to post my email. Please consider this communication as my acknowledgment that it is absolutely OK with me to post it. Not a problem Dr. Rassman. If there is a group oif men or if there is an open house going on at the office with people who are considering it and might feel a little shy or afraid of a surgery, just let me know and IF I, AM…AND IN TOWN….I WILL DO MY BEST TO ATTEND AT AN OPEN HOUSE!

Thanks You Doc,

Sincerely,

Your fan forever, Joe Penny
God Bless You And Keep You

Joe is not atypical for someone who has gone through a type of hell with the old type of hair transplant plugs done years ago. I am absolutely humbled by his comments. For as long as I have been in this industry, I have been pleased to be able to help men like Joe and there have been hundreds of them, but it is even better to put hair back on a new patient who would never have to experience Joe’s type of pain.

Click photos to enlarge.

After repair:

 

Before repair (scanned photos):

 

Tags: actor, hollywood, celebrity, csi, joe penny, hairloss, hair loss, hairtransplant, hair transplant, repair, plugs, photos

10 Days After Surgery, My Doctor Pulled Off My Dry Scabs

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

Hi! Thank you for taking the time for answering my question. I had a Hair transplant 10 days ago. My doctor did not really brief me about the swelling and shampooing my hair post op. I was scared to shampoo my hair. I shampooed it on the 3rd day, on sixth day the scabs became really hard i couldnt resist to to rub hard but i didnt pull, some came out though no blood just scab attached with hair. I went to see him on my 8th day he said everything looks fine and that the grafts are secure. He started breaking up the scabs on my head i was not comfortable at all i told him that i read on the internet that pulling dry scabs moves the graft. He’s like this is not the first time i do it i’ve been through thousands of heads. I’m on my 10th day now the scabs are all gone. My new hair is there i still have the strong urge to rub my skull.

Did he ruin my grafts by pulling the crushing and pulling dry scabs? does rubbing the new hair effect the growth?

Let me get this straight — you trusted your doctor for his expertise and judgments to have him perform a hair transplant surgery, but now you don’t trust these very same things because you read things on the Internet about post-operative care and scabs?

I highly doubt your doctor ruined your grafts. We did do a hair pull study and published the results of it with The American Society for Dermatologic Surgery in 2006 (see Graft Anchoring in Hair Transplantation PDF) and we found that the grafts were not totally secure if there was scabbing present. Each graft was pulled out day by day to get the results that we published. With that said, I would assume that your doctor knew this and was very careful in cleaning you up. What we generally recommend is washing your hair daily to keep the scabs down. Most of our patients are scab free within a day or two.

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

Broccoli Inhibits DHT?

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

Hi Dr. Rassman,

While this study is from 2003, I never saw it on your blog, and thought the readers (and you, if you have not seen it already) might be interested:

Chemical in Broccoli Blocks Growth of Prostate Cancer Cells, New Study Shows

Apparently, Broccoli contains a substance which this UC Berkeley study showed “acts as a powerful anti-androgen” and “inhibits the actions of dihydrotestosterone (DHT).” Based on your reading of the study, do you think consuming Broccoli may help prevent/slow hair loss?

Thanks for the great blog!

BroccoliJust another benefit from eating broccoli. Not only does it have high amounts of vitamin A, C, and K, according to this review, it may also help in preventing prostate cancer. You may be able to reason that since it blocks the effects of DHT on the prostate, then it can also prevent/slow hair loss.

However, based on the article, and without rigorous research, the conclusion that broccoli can prevent or slow hair loss is yet to be determined.

Tags: broccoli, brocolli, hairloss, hair loss, dht, prostate, cancer, food, vitamins

Did Chemical Relaxers Permanently Damage My Hair?

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

I am a 25 year old African American male and I have been relaxing my hair since I was 15 now my hair is very thin and I know its because of the relaxers because baldness does not run in my family, I have been wearing my hair natural for the last 4 months and i’ve bought Rogaine and have been using it for the last three days do you think it will work for me in any way or have I permantly damaged my hair? If there is anything I can do and what products do you suggest? Because i’m so afraid of being bald or keeping my hair this thin.

Thank you for reading
God Bless

Although chemical relaxers can cause damage to hair, you need to be examined by a properly trained physician to make sure you do not have another reason for your hair loss. With your long term use of chemicals and heat, there is a high probability that you have damaged your hair. A miniaturization study would definitely help to understand the role of MPB in your hair. Without knowing the true cause of your hair loss it is hard for me to recommend a treatment.

Tags: hairloss, hair loss, chemical relaxer, damage

Had a Hair Transplant 4 Weeks Ago and My Donor Area Still Hurts When I Lay on a Pillow

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

Hey doc, first of all I would like to say that your website is excellent and very helpful. I tried to look up my question but unfortunately couldn’t find the answer.

I had a transplant on the 2nd of Jan 08 (this month) every thing is in order except that my scalp above my donor area hurts if it gets in contact with any thing, even if I put my head on a pillow. I was wondering if this is normal as the surgeon has to pull the scalp in order to stitch it up and the scalp is obviously not at the old location. How long will it take before I get rid of this problem? I thank you for your time.

I would strongly recommend that you make an appointment with your hair transplant surgeon to make sure that everything is alright. Since we did not perform your surgery I can not tell you if this is normal or not (I don’t know how the surgery was performed, the number of grafts, the doctor’s techniques, etc). Certainly some pain after a surgery is possible even after 4 weeks, but it should be quite minimal.

Tags: hairtransplant, hair transplant, hair loss, hairloss, surgery, procedure, pain

Prescribed Capex and Topicort for Itchy Scalp — Still Experiencing Hair Loss

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

Dr. Rassman,

For over a year I have been experiencing hair loss. It started with a great deal of hair falling out in the sink and shower and has progressed to include a sharp itch (or sometimes general itch) to the scalp with an immediate loss of a few hairs in the area it itched. These “itches” are not limited to any part of my scalp. I was on Propecia for about 8 months which seemed to have no effect. At that time I was prescribed Capex and Topicort which seemed to just help temporarily. Do you have any suggestions on controlling the inflammation and hair loss? Thank you.

Capex is a shampoo containing fluocinolone acetonide and is sold without a prescription for itching of the scalp. Topicort contains the active synthetic corticosteroid desoximetasone and this can cause hair loss. I have no doubt that a topical steroid will reduce the itching, but at what cost on the issue of hair loss?

Tags: topicort, capex, corticosteroid, shampoo, hairloss, hair loss, itch

Years After My Transplant, I Shaved My Head — How Can I Make the Scar Less Noticeable?

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

Hey Doc,
I just shaved my head about 7 years after having transplant sugery and everyone loves how it looks. I just want to know what the best solution is to make the scar in the back (middle) of my head and behind my right ear less noticeable?

Depending on the size of the scar and its location, you may be a candidate for a scar revision surgery or hair transplant directly into the scar.

Tags: hairtransplant, hair transplant, scar, revision