Taking 1/4 Proscar Daily For 15 Months — Now I’m Noticing Breast Tenderness

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

Dear Dr. Rassman,

I am 42 yo. I have been on Proscar 1/4 pill daily for the last 15 months (& prior to that for 6months every other day).

I have just noticed increased breast tenderness, very slight swelling, and a small lump under my left breast. Can proscar be a cause of this? I Have not had this issue with Proscar to this point or any other side effect.

Could this be caused by other factors such as work/stress related? – I have had a gruellling couple of months and have been drinking quite a bit of beer after work – Something I normally don’t do. I am also quite slim so it’s probably not a body fat issue

I’m thinking of reducing proscar itake to every other day. Should I do this, or if it could be stress related take other appropriate action?

Thanks in advance

One might suspect breast response to 1/4 Proscar pill (finasteride), but there are many male breast problems that must be ruled out first. You really need to be examined. See your doctor. If your doctor concludes that this is finasteride induced, you will probably want to reduce the dose to 1/2mg or even less. As I am not your doctor, I can not give you such advice.

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

Anything New on Procyanidin?

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

Hi again, Dr. Rassman. The blog is great and useful as always! Congratualtions. My question is in regards to Procyanidin. After all the stories and comments since October, 2006 it now looks like the promises did not become anything solid and real, correct? I suppose more research would have been done if this really showed true potential, correct? Thanks!

I have no further insight than the last time I wrote about procyanidin B-2. That does not necessarily mean nothing has happened with it, but any new information hasn’t been brought to my attention. For those that want to read my past blog entries about procyanidin, see here.

If anyone has any new information, please don’t hesitate to send it.

If I Drink a Lot of Water, Will This Make Propecia Leave My Body Quicker?

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

i have heard that vitamins in high quantity pretty much wash right through your system. I have (safely) really upped my daily water intake. Will this make propecia leave my system quicker via urination and sweating?

thanks, love the site!!

Nope. Drink all of the water you want. Just be weary of water intoxication.

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

HairGenesis Clinical Studies

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

Hi, I used the search and see you have only replied to 1 question with regards to the hair “Hair Genesis” product. I am quite aware of the products “claims”, but I wish to get your opinion on the studys that they have posted on their website. Links marked Clinical Study 1 and 2, and your input on the published report in The Journal of Alternative and Complementary Medicine. I’m in my mid 20’s and my hair is thinning and the front of my hairline has been receeding. So I have been researching potential products to try. Not interested in the mess associated with rogaine, and the merck drug can have those sexual side effects.

While I agree with you that anyone should be wary of a product that touts the FDA, however their website is much more proffessional than other, similiar all herbal products.

Ultimately my question is: If you could review the study’s they claim to have done, do these studies apear to have been legit? Also, since your last question/post on this product was in 2005, has anything changed since?

HairGenesisHairGenesis, like some other botanicals, may have DHT blocking effects, but why play games? Any DHT blocker has the potential to depress the sex drive, but the frequency with finasteride is defined and it is relatively low. I certainly don’t believe that these HairGenesis products are “Proven DHT Blockers! With no side effects.” If you want a DHT blocker, I’d think you’d want one with known value like finasteride (talk to your doctor about Propecia, as it is a prescription medication).

I read the studies and I am afraid they do not meet the type of criteria I find statistically valid. For starters, I can’t find any information relating to who conducted these studies (who knows if they are even independently researched). Secondly, the photos presented in the studies are very poor quality with bad lighting. It is also worth noting that a professional website may give an appearance of a professional company, but it isn’t too difficult to find a good designer to make a great site nowadays. I don’t see their site as looking all that great, but beauty is in the eye of the beholder. You probably shouldn’t base your opinions simply on the look of their website, though.

Tags: hairgenesis, hair genesis, dht, hairloss, hair loss, finasteride, propecia

Critical of the LaserComb’s Claims and FDA’s Rulings

/by William Rassman, M.D./5 /

Dr Rassman

Thanks for your excellent blog. Much has been written in your blog about the LaserComb, with various degrees of advocates (and distracters). As a physician, I’d like to amplify on a previous blog, which emphasized that detailed data on the benefits of the LaserComb is not available and thus makes it difficult to evaluate its benefit beyond anecdotal experiences. In addition, the manufacturer makes claims likely to be criticized as unsupportable if similar claims were made for a drug and, to me, employs classic marketing techniques designed to give as little information as possible.

The data supplied to the FDA in support of the LaserComb, which is publicly available at FDA.gov (PDF File) is scant for 4 main reasons: (a) approval was based on use as a device rather than a drug, (b) the threshold of evidence was not the usual superiority of controls required of drugs but “equivalence” to “predicate” devices, (c) a single, controlled study involving a small number of patients was conducted (rather than the usual minimum of 3 studies required of drugs), and (d) unlike studies supporting drug approval, detailed data for the LaserComb is not shown on the aforementioned FDA site. Basic information, such as patient entry criteria, number of patients participating, participating centers and investigators, statistical analysis, etc is absent.

When the manufacturers of the LaserComb report their claims in peer-reviewed, scientific journals where the data can be evaluated by the public, it will allow me to better evaluate the risk/benefit is. In addition, claims made by the manufacturer (“greater than 90% user satisfaction reported!”) are the type of marketing statements that are impossible to evaluate without context. The site also speaks to the single study used to approve the device but fails to mention the number of patients used (likely very small), duration of baldness of patients, or what the placebo response is. Photos of successes are also shown on the manufacturer’s site, with no timeframe to let the reader appreciate how long the patient used the device.

Finally, a previous blog noted the 20-week return policy, which gave readers an impression that money will be refunded if the device does not work. This policy, as stated in the manufacturer’s site, is that a partial refund (60%) will be given if the device is returned within 20 weeks. As the site suggests using the device for more than 20 weeks if no growth is seen, (“many of our users report that even in this time frame, with continued use, they slowly start to notice a thickening of their hair, and even show signs of re-growth”), one wonders how many patients with no growth truly send the device in before the 20-week cut-off.

You make many great points and perhaps the manufacturer of the LaserComb (and other manufacturers of similar products) will see your post and address the points you brought up. I know they’ve read this site in the past, as I’ve received correspondence from them when I disputed claims made on their site over a year and a half ago. We’ll see.

Whatever the case may be, thank you for your comments!

Tags: lasercomb, laser comb, hairmax, lexington, hairloss, hair loss, fda

In the News – Love Cured Complete Alopecia in Young Woman

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

Perhaps I’m just an old romantic, but I really enjoyed this story. Maybe balding people should look for love to cure their hair loss? Likely not, but the story is entertaining for sure.

Hayley BurtonSnippet from the article —

Love has been a hairraising experience for Hayley Burton – in the nicest possible way.

The pretty 20-year-old student had been TOTALLY BALD for seven years before meeting and falling in love with boyfriend Don Timson.

But now her locks are growing back despite her extreme form of hair-loss disease alopecia.

Full text — People.co.uk – The Lock of Love!

In Hayley’s own words — Pick Me Up Magazine – Love made me hairy!

Tags: hairloss, hair loss, alopecia, love, female, women, woman

Doctor Warned Me Not to Pop Scalp Pimples After Hair Transplant

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

hello doctor

i’m three months post a hair transplant operation, i started to note a scalp pimples appeared stating from the second month after the operation, i had told by the doctor who did the operation to me don’t burst these pimples as this could lead to follicular death!, but sometimes i got to burst the white head of the pimples spontaneously. is it true what he told me about damaging the FUE???? this could happen when combing or whatever i do actions to my scalp by mistake.

also i read on the internet that this is normal and a very good sign to hair regrowth underneath the scalp.

another question please, now and after the third month hair density is very thin, is it normal ? and what is going to happen in the next 3 months, can i really got 5 or 6 times the hairs which i got now ? or it depends on something i don’t know it ?

thank you so much

Many of your questions should be asked of your surgeon. I do not know enough about your case to address most of your questions. Some people do develop cysts after surgery and they tend to ‘pop’ by themselves with warm compress soaks. If you develop folliculitis, then you could lose a graft under the skin, but folliculitis needs to be treated, again by your doctor, not me over the internet.

Tags: hairtransplant, hair transplant, pimple, cyst, hairloss, hair loss, aftercare

Psoriasis

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

Hi Dr. Rassman. When I was younger I had what I think was diagnosed as a form of psoriasis which was mostly on my scalp. I would have quarter size patches of dry flakey skin and if i tried removing the patches large clumps of hair would also come out. Although I’m sure I was experiencing MPB as well, I feel like this was something that increased the amount and rate of hair which was being lost. I had visited the dermotologist and Nizoral was prescribed at the time.

Just wondering if this is a condition you’re familiar with?

Thanks

I am more than just familiar with it, as I have a very aggressive form of psoriasis myself. When I was young, it impacted my scalp along the ears and frontal area and looked awful and felt painful as well. Psoriasis will not cause hair loss unless you pick at it enough to develop traction alopecia. If your dermatologist has his/her hand on it, then there is nothing to do unless you are not in control of it. If you have male pattern loss at this time then probably you should be on Propecia (finasteride 1mg).

Tags: psoriasis, hairloss, hair loss

If They’re Going to Show Up, How Long Until Propecia Side Effects Are Present?

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

Hello Doc,

I have been on Propecia (1mg/day) for 2 months the first time and then stopped it for a couple of months and started to take it again and its been about 3-4 months now.

My questions is how long does it take for someone to notice the side effects of Propecia like the sexual side effects, etc? And once we notice it and decide to quit Propecia, are the side effects reducable?

If they are going to appear, sexual side effects from Propecia usually come in within the first month or so. They will go away after another month or so upon stopping the pill.

Tags: propecia, finasteride, side effects, hairloss, hair loss

Existing Hair Falling Out In Transplanted Areas

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

Hi, I’ve had 2 hair transplants to the front of my forehead where i still had a substantial amount of hair. The reason i did it was to thicken the area up. I noticed that after the surgery, my current hairs fell out next to where the implants were put, and a lot never grew back. The surgeon said that was because they were going to fall out anyway, but that was 8 years ago and it is still obvious where my hairs fell out, the other ones near them havent fallen out. My question is, Is it true that the trauma DOES make existing hairs die?

For people who do not take Propecia (finasteride 1mg), they run a higher risk of shock hair loss or an accelerated hair loss pattern after a hair transplant. Your doctor is correct, but the acceleration is usually about a few years worth, unless you are taking Propecia (by prescription and for men only).

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

Hair Loss from Accutane — What Is It and How Can It Be Treated?

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

Hello and thank you for reading my questions. For reference, I am a 21 year old male. I am wondering if you could provide some information and statistics regarding accutane-induced hair loss. I am one of many accutane users who has experienced substantial hair loss due to the drug and have yet to find any reliable information about what to expect and what to do. I am specifically interested in any statistics you might be able to provide, or simply what you’ve observed yourself. What percentage of patients who experience hair loss from the drug end up getting their hair back? Do you have any information about the success rate of products like rogaine for treating this problem (I saw a hair loss specialist who recommended using it)? I’m really just looking for some information about this issue that I can trust, as the internet is riddled with personal testimonies and contradicting accounts.

In addition, I am interested to know if this subject (accutane hair loss) has been raised at any hair loss or dermatologist conferences or other events when those in your profession communicate? From the research I’ve done, it seems that many dermatologists still don’t believe that accutane can cause hair loss. My own dermatologist told me “that’s weird” when I first told her about my hair falling out after starting accutane. Moreover another dermatologist I saw immediately diagnosed my hair loss as genetic and put me on propecia. It wasn’t until I met with a hair loss specialist that a doctor agreed with me that accutane was the culprit.

From the accounts of people who have posted their own experiences online, I’ve gathered that some dermatologists consider it to be a form of tellogen effluvium while others diagnose and treat it as a form of diffuse alopecia areata. The logic behind the diffuse AA theory is that accutane causes an autoimmune response in some patients, resulting in hair loss. Considering that accutane has in rare cases caused lupus and other immune disorders, I found this to be a reasonable explanation. I have read some accounts from individuals stating that dermal kenalog shots seemed to help stop or slow down the hair loss. Have you heard any of these ideas before? If not, could you try and find out the next time you’re at a conference?

My major source of information is coming from what is turning into an online community of accutane hair loss victims at
acne.org

If you take the time to read through some of the accounts posted on here, you’ll see a variety of peoples experiences with accutane-induced hair loss. The prevailing opinion among some is the alopecia areata theory which I previously mentioned. I’d really appreciate it if you could provide me some additional insight into this issue. Also, do you know of any doctors who have experience treating patients with this problem who might have some of the answers i’m looking for if you’re unable to provide them? Thank you very much for your time and I’ll look forward to hearing back

AccutaneI wish I could spend the proper amount of time researching your question to do it justice, but dermatology isn’t my strong point. I have personally only seen this problem a couple of times, but I hear that it is not uncommon amongst Accutane (isotretinoin) users. The only medications that I believe may be effective in treating this is minoxidil. The use of powerful steroids may make the problem worse, but I do not have much personal experience with Accutane, as I am a surgeon, not a dermatologist.

I forwarded your question to a number of highly qualified dermatologists and those that have responded stated that they don’t have an answer as to why hair loss occurs with Accutane use. The only treatment modalities suggested were minoxidil and finasteride. Again, I wish I could be more helpful to you, but at this point I’m kind of at a loss.

Tags: isotretinoin, accutane, acne, hairloss, hair loss, minoxidil, finasteride, rogaine, telogen effluvium

PCOS and Hair Loss

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

I am a 27y/o female I have been dealing with hair loss for about 3yrs now. I have been diagnosed with pcos. I am being treated for that with birthconrol pills. the last time i checked my hormone levels were close to normal as well as my thyroid levels. so why is my hair still falling out? my family have no signs of baldness mother and father,grandparents, both have full hair. everybody but me. please help have you ever heard of thymu skin does it work? I also seem to have a lot of grity white stuff on my scalp my hair if very thin on top. please help

To answer your questions about the management of your PCOS and hair loss, I would need to examine you as I would anyone I was treating. PCOS tends to act like male patterned hair loss and I would want to know if that was you situation. I’d first map out your hair for miniaturization and then get a diagnosis.

See previous posts for more:

ThymuSkin is a shampoo. The science is weak and I have no working experience with it.

Tags: female, women, woman, hair loss, hairloss, pcos, polycistic ovarian syndrome, thymuskin

In the News – Stress from Being Bullied Causes Teen Girl to Go Bald

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

From the article:

A teenage girl who was the victim of disgraceful bullying for three years has been left so traumatised that her hair has fallen out.

Faith Hawley, 14, said she was verbally abused, punched and even had her hair set on fire after starting at secondary school.

After three years Faith was diagnosed with alopecia, which doctors say was down to stress.

Bullied girl - before and after

 

Wow. This is a horrible case of stress, and for a 14 year old girl to lose all of her hair, it must’ve been quite extreme. Read the full article at the UK’s Daily Mail — ‘I was so badly bullied my hair fell out’: Girl, 14, reveals ordeal at hands of school yobs

Tags: stress, hairloss, hair loss, alopecia, teen, girl, female, women, woman

If I’m in My 30s And Have Early Hair Loss…

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

In a recent response you wrote: “It is in the 20s (pretty much from age 20-29) that men are most likely to see most of their hair loss.” What does that mean? I am 33 and I started to notice some minor thinning in the last year and a half. My derm has said it may be “very early MPB” or the result of inflammation I had – and he would not prescribe propecia as he said “You’re not there yet”. If most men see most of their hair loss in the 20s, and my dad and older brother (38) have no thinning, should I assume since I am older than 20s and dont have that pattern in my family, that the thinning will be mild or stabilize soon or is caused by something else(though it is on the vertex)? Again, I was not prescribed propecia because “I’m not there yet” – but I thought it was best early. Just wondering about my age, and what it means if most see most loss in the 20s and my family has none.

The hair loss in the 20s is a statistical thing. Some men start balding in their 30s, less in their 40s, and some even in their 50s and 60s. There is no hard rule, but whenever you start balding, the drug finasteride is effective at slowing and/or stopping it. I do not agree with your dermatologist, as once you know you have genetic balding, the earlier you start the drug the better it is.

Tags: finasteride, propecia, hairloss, hair loss

I Want a Hair Transplant to the Crown and Front

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

I am considering a hair transplant. My crown is nearly bald and my front is thinning to the point you can see scalp. I’ve been on Propecia for 4 months and hair is still coming out. THe loss doesn’t seem as rapid, but I’m still seeing hair in my hand after shampooing. What’s your opinion on getting a transplant to cover the crown and thicken the front. Thanks

I would want to know your age, see your photos, determine your density and laxity, and map out your hair for miniaturization so I can understand where your hair loss is going. I would want to know what your expectations are and be sure that they are realistic — and most important, I want to know more about you, as a person. With all of that behind us, then a discussion of a hair transplant may be appropriate.

Tags: hairtransplant, hair transplant, crown, hairline