Dear Doctor:

Two questions about Rogaine application:

  1. In addition to taking finasteride daily, I’ve been applying Rogaine foam for a few months now, mainly the frontal third of the head. That area alone takes more than the recommended half a capful. Although it is the frontal third that is my main concern right now, I’m somewhat miniaturized pretty much on the N5 area, albeit, to the naked eye, I have a pretty good head of hear at the moment (I’m 29). I just don’t see how it is possible to treat the entire area with less than three times the recommended dosage (which makes the treatment prohibitively expensive and fraught with side effects).Is there any residual benefit to the vertex area through general scalp circulation at all, if the application is on the front third?
  2. Since Rogaine absorbs into fingers rapidly, does it make sense to apply it with a medical rubber glove, to ensure that more goes into the scalp, not hands? For some reason this issue hasn’t been addressed by Rogaine users.

  1. Overdosing Rogaine for the entire scalp application is a real concern, but the best I can offer is to just watch out for side effects. Any Rogaine you use will be absorbed into the body before it works its way around the scalp where it is not applied, so if you use it on the crown, do not expect benefits in the front of your scalp or visa versa.
  2. The photo below (click to enlarge) shows the result of Rogaine Foam (minoxidil) on the hand that applies the medication to the scalp when compared to the other hand. Although this patient’s hands are quite hairy to begin with, clearly, the right hand has more hair than the left. This patient has been using the Foam for 3 months. It is up to you whether you want to use a glove when applying it.


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

Dr. Rassman,
Sorry that I write you all the time. Have you read the news about the man who regrew his whole finger tip using a drug called ACell which vets use on pets. Why couldn’t this be used on humans to regrow our original DHT resistant donor supply after it is transplanted. My request might be a little far fetched but I believe someone is willing to be your guinea pig for an experiment like this. Thanks for everything you do.

I did a Google search on the subject and found this article from the Associated Press and posted to FOX News last year —Scientists Regrow Human Fingers. However, I don’t know any more than you do by reading such an article. There is no breakthrough that I can surround from the medical releases. Everything is experimental. The photos in that article showed the pulp of the finger on the palm side is what regrew. This is not a regrown finger like the examples that they gave on salamanders that grew limbs.

Like you, I read this material with great anticipation that someday we will see such breakthroughs available to us all, but I couldn’t say when that might happen. Note that the focus is not on hair, but rather on body parts and spinal injuries. That will become the first and second application that will be approved… not hair.

Tags: fingertip, finger, hair, hairloss, hair loss, regrow, acell, science

you answer most topics, however I cannot find any information about CELIAC DISEASE and HAIRLOSS. It is scattered all over the web, however the link, to me, is not clear. I am 20. and have diffuse hairloss, my doctor told me to take omega 369 and jarodophillus. and to not drink beer, or eat wheat. is this good advice, considering the link between cleliac disease and hairloss?

Hair loss associated with celiac disease can be related to its link to alopecia areata, and can also be a result of the nutritional deficiency caused by the disease itself. The treatment for celiac disease is to remove gluten from your diet and to address the malnutrition caused by the disease. It sounds like your primary care physician is right on track with his recommendation for treatment. Once this has been addressed the question will be whether your hair loss was caused by alopecia areata, a nutritional deficiency, or both. A good source of information on this disease is the Celiac Disease Foundation. Good luck.

Tags: celiac disease, gluten, hairloss, hair loss, celiac, nutrition

Dear Dr. Rassman,

Thank you in advance for reading this question. I am a 19-year old male with MPB, NW II. I am currently on propecia to combat this.

I have recently started taking a nutritional supplement called forskolin, at half the daily recommended dose, as I am worried about the possible effects on testosterone levels. A study was done and can be found here: Body Composition and Hormonal Adaptations Associated with Forskolin Consumption in Overweight and Obese Men.

My question is, if this product does legitimately increase serum free testosterone levels significantly, is this a cause for concern?

Thank you in advance

I looked at the abstract of the study that you referenced. It seems that it does increase your serum testesterone levels, although not significantly. Time frame wise, the study only looked at the effects of this supplement at 3 months. It is possible that at 6 months or a year both the placebo and the Forskolin group may have no difference in serum testosterone levels. Who knows? With an increase in testosterone levels in the blood stream you always run the risk of having more testosterone converted to DHT, and thereby having increased hair loss.

Tags: hairloss, hair loss, forskolin, testosterone, dht, obese, obesity

Hey doctor, love the site. thank you for your time and effort in maintaing baldingblog and all the help you’ve given to everyone who reads it.

quick question. i’m wondering what your opinion is on patients taking propecia temporarily (immediately before ht and for a certain time after) in order to protect against shockloss from a transplant. Many doctors advise this to patients who refuse to take propecia or cannot from side effects. i wonder if you think this is a good idea, or should patients completely avoid finestaride if they’re not going to continue with it? Thanks.

I generally advise men to take Propecia (finasteride 1mg) before and after a hair transplant surgery indefinitely. If a patient is completely resistant to taking Propecia for long periods, I generally advise them to take it at least one year post surgery. It may aid in preventing shock loss and the patient may even see some benefits from the medication and decide that they will continue taking it.

Tags: propecia, finasteride, hairloss, hair loss

Hello Dr. Rassman,

I’m a 19 year old male, who has a very oily scalp. I’m suspecting that it contributes to my hairloss by clogging the follicles. I have used a lot of dandruff shampoos (including Nizoral and tar shampoos), but nothing seems to work. Do you know any stronger treatment which can effectivly remove the oil on my scalp?
Thank you

An oily scalp will not cause hair loss by clogging the pores of the hair follicles. Just use a good shampoo.

Tags: oily scalp, oily, hair loss, hairloss, shampoo

Hi Doc!

What if I want to “repair” a small, round scar on the top of my head, say about 1 x 1 cm wide… Will I still need propecia to prevent shock loss? That is, is shock loss even possible when transplanting such a small amount of grafts?

If you have active male pattern baldness (MPB), then yes, it could impact your hair and cause hair loss.

Tags: hairloss, hair loss, scar, repair

I had two transplants at NHI over the past 5 years (last one was 3 years ago) and the results are fantastic. Whenever I get a haircut I will tell the stylist that I had the transplant procedure done just so they are aware of the line scar in the back and don’t cut my hair too short back there. I find that as long as I tell them before they get started, its no big deal and the scar is never visible, even with a $15 Supercuts haircut that I get. BUT, I usually end up spending the 10 minutes I’m getting my haircut explaining to them that yes, this is a hair transplant and no, I’m not just joking around. Nobody believes me! Outside of getting a haircut, I never mention it anyway… but the one time I tell someone, they don’t believe it. So that just goes to show that you did a damn fine job. Really incredible work and as you can probably tell I am thrilled with the end result. I’ve included a couple photos that you can use for your blog.

Thanks, doc. I’m very, very, very pleased.

I’m glad to hear that nobody believes you — that means we were successful! In all seriousness, this is how any good hair transplant should be. We never want patients to be easily spotted as having had a hair transplant. The end result should always look natural.

This patient had 1,737 grafts transplanted over two procedures.

Update Dec 2008: [Photos removed by request]

Tags: hairtransplant, hair transplant, haircut, supercuts, hair style, photos, hairloss, hair loss

Hey Doc Rassman, great site. I’ve been hooked onto it since I started losing some hair myself- and of course, the fact that you’re called one of the pioneers of hair surgery just increases the blogs credibility.

I’m an 18 year old male, and I’m a serious teen bodybuilder. I’ve been competing, and recently, I’ve started using a fat burner (Nutrex Lipo 6) which contains a lot of caffeine, synephrine, yohimbe and some other stuff to get into my final competition stage. Now regardless of these ingredients, what concerns me is that all fat burners constrict blood vessels to increase blood pressure, and in turn increase metabolism to burn calories faster. That’s alright, fine with me. But it’s the hair loss I’ve been experiencing since I’ve started using this product that’s causing concern!

Just taking a shot in the air, would you say that the fat burner is causing poor blood circulation due to the high BP (a case associated with cigarettes too as I’ve read), and in turn causing this balding? Would this then mean that people with high blood pressure (something I have a family history of) have poorer quality of hair?What are your views,doc?

I can’t really comment on a specific fat burner as the cause your hair loss. Many medications report hair loss as a side effect, so even this ‘substance’ may have similar side effects. If you have hair loss it is most likely related to genetic male pattern baldness (MPB), otherwise known as androgenic alopecia (AGA)… particularly in a young man of your age. You may consider an examination by a doctor and possibly starting finasteride as a treatment option.

With regard to any connection between blood supply as a cause of hair loss, it is not ABSOLUTELY the cause of hair loss. The fat burner you are talking about can not possibly reduce the blood supply by constricting scalp blood vessels. There is also no connection between high blood pressure and hair loss either.

Tags: fat burner, hairloss, hair loss, blood vessel, blood pressure

Well doc, I’ve got to hand it to you. You’ve solved all my problems. I’m 20 years old, and had been losing hair for over 2 years now. I was worried,stressed,depressed.. dreaEverything you can imagine.

I also tried all the products on the market that claimed to stop hair loss- creams,oils,herbal ‘remedies’. I didn’t use propecia though,it required a prescription which would mean I’d have to tell someone I was losing hair. No product seemed to work. Suddenly,long after I stopped using these products, my hair loss stopped.

Finally, I realize that my hairline was just maturing. All thanks to your site. I never knew such a thing existed!

Anyways, the point I would like to put across is to teenagers, who seem to be flooding your site with questions. The point is, your hair will be there till you are in high school, and till you graduate from college(assuming you arent unusually old for school). These are the two places where girls would superficially judge you (and where you’re just looking for thrills). After high school and college, its a different world. Girls turn to women, and they’re looking for more than just arm candy then. Your hair would NOT matter as much as you’d think.

So don’t worry about your hair too much; even if it’s rapidly falling,it would take a while for you to bald completely. And by then,you’d be through the superficial stages of life. And remember, nothing really causes hair loss apart from your genetics, which you cant change. So don’t worry about things that are not in your control.

Otherwise,there’s always Dr.Rassman ;).

Thanks for the comments! For those that still don’t know what a maturing hairline is, you should certainly read Maturation of a Hairline — Moving From Juvenile to Mature.

Tags: teenager, teen, hairloss, hair loss, hairline, maturing, mature

Dear Dr,

Please help me! I have been suffering from hair loss since Ausgust 2007. I have been diagnosed with Telegon effuvuim , I came off the pill to concieve in august after being on it for 12 years. I am now 7 months pregnant and am so depressed with what is happening. In Dec 2006 I was in hospital due to a hemorage that happened after an infection too so maybe this has something to do with it. My iron stores are pretty low so I’m now on Ferrous Sulphate 200mg and also Spatone Iron Supplements. The loss has happened for 8 months and I’m now losing hope, is there anything I can do? Will this ever stop and most of all will it all grow back? I feel so helpless at the moment, I dread washing and brusing my hair and just hope this will stop. Any advice would be much appreciated.


Your history shows a great deal of stress and many of the contributing factors for hair loss, like taking birth control pills some time ago, your pregnancy now, infection, bleeding, and low iron. The hair loss has gone into its telogen phase (sleep phase), but this should abate once you deliver your baby and correct the low iron. I am sure you are being followed by your doctor. I would expect that the hair should regrow some 4-6 months after the birth of your child. I am keeping my fingers crossed for you.

Tags: pregnant, pregnancy, women, woman, female, hairloss, hair loss, telogen, iron

Hi Dr Rassman,

I need some help with storage of propecia. I live in an area where the weather usually goes up well above 30C (sometimes up to 42C). On the box of propecia, it says it must be stored below 30C. I cannot keep it in the bathroom anymore as its too hot. Should i keep it in the fridge or is that too low of a temperature?

how low can the temperature be for storing purposes? thanks heaps!

In your case, I would store it in your refrigerator, as the temperature in there is going to be below 30C unless it is broken (considering a fridge is normally around 5C). I would wrap it in an insulating type cover, because you would want to avoid condensation.

Tags: refrigerator, fridge, propecia, finasteride, store, storing, celsius, temperature, hair loss, hairloss

my dermatologist has me on propecia for hairloss. i am 55, female and have read that avodart may give better results. my dr. says she has not heard of avodart. i didn’t mention this was not the intended use of the drug. anyway, i think i may need to find another doctor. do you have anyone in orange county you might recommend?


Go seek out another dermatologist. I personally would not treat a 55 year old female with Avodart (dutasteride) unless they had Polycystic Ovarian Syndrome (PCOS) or a similar problem.

Tags: dustasteride, avodart, hairloss, hair loss, female, women, woman

Hi there-

I’ve surfed through past entries, and was unable to find a post specific to the problem I’m having.

I began noticing the signs of MPB in my late teens, and a more prolific loss in my early twenties. I’m 24 years old now, and have been on a Propecia/Rogaine regiment since visiting a dermotologist last year.

Within two weeks of consistent Propecia use, I began to have painful ejaculations and the consistency of my semen became clumpy/very gelatenous. I was told that sexual side effects usually subside with continued use, and indeed, ejaculation is no longer painful. My semen consistency is mostly normal now, but it occasionally reverts back to that of the initial months of taking the medication.

Ever heard of a similar experience?

I have been aware that the consistency of the semen changes in some men, but I have not heard about painful ejaculation. Talk to your prescribing doctor about this issue.

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

In your opinion, if there is no miniaturization does that mean there is no hair loss? I recently had my hair mapped for miniaturization by Dr. Pak in San Jose, CA. He found no miniaturization beyond what is normal. It is possible that I have experienced a telogen effluvium, I mistakenly took a testosterone booster for a month about 8 months back, I also had 4 surgeries this past summer. I know for a fact that my hair has changed some in the past year, but I don’t show any miniaturization upon examination. Should I be worried?

In the interest of patient confidentiality, I will keep the answers generic. If you have specific questions or concerns you can call our office at 800-NEW-HAIR (800-639-4247) for a personal consultation / discussion.

Having no significant miniaturization should indicate that your hair loss state at that point in time was stable. You may have lost your hair in prior months and may have even experienced telogen effluvium, but there is no way to tell with a miniaturization study, which just shows hairs that are in the process of being lost.

If you take testosterone or anabolic steroids, you could “kick start” the genetic balding process, but as stated above, if you do not show signs of miniaturization at this point, it indicates things are stable. Most people will undergo changes in hair texture with age, but frankly there is no way to tell. I would recommend watching the hair over time with repeat miniaturization studies in the hope that your hair will become more full.

Tags: hairloss, hair loss, miniaturization