Female Hair Loss After Taking HGH

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

I was going out of town to work on a strenous work project. I decided to take hgh when I started the job. While I was away, my hairline began receding and itching. I didn’t realize it was the HGH until too late, ten weeks of use. I am female and now must hide the front of my head with scarves and wraps. I’m using rogaine. Is there anything that can reverse hgh hair loss?

You may have done permanent damage, but you will not know for a full 8 months from the time you stopped the HGH (which can cause hair loss in some people). A hair transplant may have some value if you do not recover. Unfortunately, you’ll just have to wait and see.

Tags: female, women, woman, hairloss, hair loss, hgh

Double Follicular Unit Grafts (DFU)

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

Why don’t you offer double follicular unit grafts (DFU)?

Double follicular units (DFUs) are 3-4 haired grafts that have a slight gap containing skin between the hair follicular units (the natural growing anatomical units). Some people claim that if they use them, they can get more density per square cm and that the advantage is that more density can be created with fewer incisions… which means less grafts/cost to the patient.

DFUs are essentially the old type of minigrafts and the problem with them is not only a slightly pluggy look (for those people with dark hair and white skin), but also that there is skin transplanted with the follicles. This skin becomes depigmented and forms a whitish plaque on the scalp on close inspection, particularly noticed if you have a tan or olive skin. So while it is true that this can provide more density at less financial cost, the price is in a lesser quality transplant. The older large plugs had the highest densities, so if one takes the logic that DFUs are less expensive than follicular units and are the way to go, you can also look like you have doll’s hair for about a tenth of the cost of a fdu. You get what you pay for; do not lose sight of the fact that this is a surgical procedure on your head.

So to answer your question about why we don’t offer DFU, to be blunt, it’s because we don’t offer grafts that can be detected as a hair transplant, even on close inspection. The question should be, would I do it if someone specifically asked me to do it, to which my answer would be that I would consider it if there was complete informed consent present at the time the decision was made.

Tags: dfu, double follicular unit, follicle, hairtransplant, hair transplant, hairloss, hair loss, plugs

Rogaine Foam Response Time?

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

Dr. Rassman,
I am confused as to why you said it would take 1-2 years to see results with Rogaine 5% Foam versus the 3 to 4 months that is usually mentioned for any results. I thought the cycle of hair growth is generally a four month turnover process and am wondering why you said I would need to wait 1-2 years. Again, I am a 48 year old female with androgenetic alopecia. Thank you.

It takes time for the hair to grow out, so any benefit of minoxidil that is obtained in the 4-6 month hair cycle, needs to grow to styling length to see value. Sure, you might see tiny baby hairs sprouting up, but those aren’t at a length that is manageable. Hair grows at the rate of 1/2 inch a month, so by adding the numbers together, we get to the estimates I gave before —

+ 4 months (growth cycle)
6 months (to grow a three-inch hair length)
= 10 months

Then add to this the reality that it may take up to a year for the full benefit of the minoxidil to be realized.

Tags: rogaine, foam, minoxidil, timeframe, time, results, hairloss, hair loss, math

In the News – Bexarotene 1% Gel to Treat Alopecia Areata

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

From the article:

Topical bexarotene 1% treatment produced a 30% hair growth response among patients with alopecia areata (AA), according to research presented here at the American Academy of Dermatology 66th Annual Meeting (AAD).

“Currently, there is no cure for alopecia, and it is often refractory to treatment. So new treatment possibilities are especially welcome,” said lead investigator Rakhshandra Talpur, MD, Instructor, Division of Internal Medicine, University of Texas M. D. Anderson Cancer Center, Houston, Texas.

Full text — Bexarotene 1% Gel Shows Efficacy for Alopecia Areata: Presented at AAD

Tags: alopecia, areata, alopecia areata, bexarotene, gel, hairloss, hair loss, treatment, targretin

Mederma and Transplanted Hair

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

I had a FUTH in india but there are white spots/ dolls head appeance on the recipeient area where hair were inserted. If i use mederma, would it result in loss of the transplanted hair?

Please reply.

You’ve described the older technique of a hair transplant, where pieces of skin are transplanted with the grafts and the grafts are not typical follicular unit grafts. FUT (follicular unit transplantation) should not give you the results that you describe. While Mederma is used for minor scars, I doubt it will do much for the white spots on your scalp, as this is probably the result of depigmentation of the skin edges in the transplanted grafts. I do not know if it will result in the loss of transplanted hair either, since there are no specific studies on the subject.

Tags: hairtransplant, hair transplant, mederma, plugs

Difference Between Generic Finasteride and Proscar Formulations?

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

Dear Doctor Rassman,

I have been reading your blog for months and I have found always straight forward and interesting answers to (often) tricky questions.

I have been taking proscar (prepared as 1mg pill by my pharmacist) for 4 years (I am 26) and had slowed my hair loss thanks to it. Unfortunately,I had some erectile and libido problem But as it was not that serious so I decided to continue taking it.

1 month ago, My doctor prescribed for a generic finasteride (manufactured by sandoz) and since then I have no more erectile problem but I have the feeling that I am losing my hair again. Is it possible that the generic drug is actually working fine but give me less side effects (different resorption,… which would be great)

or the fact that my erectile problems are gone and the feeling that I am losing more hair really indicates that the generic drug is less efficient.

Thanks a lot for your future reply

There should be no difference between cutting Proscar into quarters or fifths and taking a generic 1mg finasteride pill, though the 1mg generic is not legally available in the United States. If you’re having less side effects but less results in protecting your hair, I’m not sure what to tell you. Think about why you’re taking the pill to begin with — for your hair. If you’re not getting the same results for your hair, I’d consider going back to what worked better for you, perhaps even cutting the dosage to see if the side effects go away. Talk to your prescribing doctor about this.

Tags: finasteride, propecia, proscar, generic, side effects, libido, hairloss, hair loss

Desloratadine to Treat My Itchy Scalp

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

Hey,
I just wanted your readers to know of a change ive had to my scalp. Alot of people have itchy and flaky scalps coming with hair loss. I had this too, and I thought both were linked together because they came at the same time. Well I was wrong but I did manage to fix my itching by taking desloratadine 5mg. Apparently my itching came from an allergy and it fixed the problem completely.

So for all your readers having itchy scalps they should check they might be allergic! Thanks alot for the site

Desloratadine is a drug that is used to treat hay fever and allergy symptoms. When one uses a medication for symptomatic relief, it does not get down to what you are allergic to and will only be a temporary solution until you solve the cause of the itch.

Tags: itch, scalp, desloratadine, clarinex, hairloss, hair loss, allergy, allergic

Side Effects from Propecia — I Can’t Cut This Pill!

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

Dr. Rassman – my doctor prescribed proscar, quartered, which I can afford. My problem is I can’t handle the side effects. And it is nearly impossible to cut any further! So, would taking 1.25 every other day still be effective and lessen the chances of side effects?

Thanks!

Every other day is better than none at all, but you should speak with your prescribing doctor about dosing.

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

High Prolactin Levels, Masturbation, and Hair Loss

/by William Rassman, M.D./4 /

“An abnormally high level of prolactin (hyperprolactinemia) is a condition characterized by elevated serum levels of the hormone prolactin in non-pregnant individuals. Hyperprolactinemia may cause progressive pattern hair loss due to an indirect effect on increasing free testosterone level.”

I’ve read this in one of your post…So you say high prolactin levels are responsible for some degree of hair loss.Prolactin levels are usually very high after masturbation,yet you said masturbation had no effect on hair loss.

Any connection between masturbation and prolactin levels can not possibly have an impact on hair loss (if that is where you are taking this question).

It has also been shown that prolactin levels after sex are 4x higher than prolactin levels after masturbation (see PubMed). So I suppose you’re suggesting that:

  • Having sexual intercourse will lead to a 400% greater chance of hair loss over those that masturbate
  • Masturbating (instead of sex) results in a lesser chance of hair loss

I realize the two bullet points are the same thing just worded different ways, but I really want to make sure your points on masturbation were clearly outlined. There is simply no connection between hair loss and masturbation, as many of these hormonal changes are very short term.

Tags: masturbation, masturbate, sex, intercourse, prolactin, hairloss, hair loss

I Have a Limited Amount of Propecia — Should I Split the Pill or Take It Until It Runs Out?

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

hi there again balding blog team

just a quick question… I have been on propecia for the last 6 months and have had good results. the clinic that I got the medication from (london’s best apparently) suggested going on minoxidil, and propecia, and azaliac acid, and they would have thrown in a lazer comb! ..but after doing a lot of my own research (mostly on your page) I decided to just go with the simple one pill a day. the thought of medicating and lazering, applying lotions was all to much for me. needless to say i am more than happy that propecia is doing its job great and im happy.

However im out of town at the moment for a month on business but just realised I only have a 2 week supply ! I dont want to mess with my regime to much, but had an idea that if I split the pill into 2 it would last a month, as ive read it is almost as effective (70%)? or do you think i should just take the full dose, then miss a couple of weeks …. ??

also how effective can propecia be at arresting hairline recession? the clinic said “it would halt hairline recession” and I know its not known to work well in that area but read different things in different places! it seems to have stopped mine ! in your experience with the drug what would you say about it?

Thanks for a fantastic site !

It sounds like you’ve done your research and are very well informed to make good scientific decisions. For example, if you started Propecia, minoxidil, azelaic acid, and laser therapy all at once, you would never know which one worked (or which ones didn’t work) and would likely end up spending thousands of dollars unnecessarily. Plus, you’d be stuck with the fear of stopping any therapy without knowing which provided the results.

With respect to limited quantity of Propecia, why is it so difficult to get a refill of the medication? A refill would be your best bet, as it is available in most countries. If you cannot get a refill, I would take 1/2 pill a day to extend the limited quantity you have left, as a half pill is about 70% as effective as a full pill. This ensures that you have the effects in your system consistently.

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

LaserComb and the Probability of Success

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

I have not had any growth due to long-term use of the LaserComb. As with many drugs and devices, some people benefit, others don’t. The real issue is: what is the probability of technical success? Unfortunately, the manufacturer has not published articles or studies in peer-reviewed journals, and thus has not enabled prospective users to evaluate the risk/benefit and answer this question. In addition, the regulatory designation of the LaserComb as a medical device also precludes finding the level of detailed information on the FDA web page that is usually reserved for drugs/biologics. In the absence of such information, one can only rely on anecdotal observations and your (Dr Rassman) experiences have been helpful in raising the prospect of questionable cosmetic improvement with this device. One also has to have a skeptical eye for any drug or device claiming benefit where detailed data usually available to evaluate is either missing or difficult to locate.

Thank you! I couldn’t have said it better myself.

Sometimes these products can be muddled in with the financial gain of selling a product and media hype and not have much to do with actual results (i.e. “buyer beware”).

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

I Wasn’t Losing Hair Before I Started Taking Propecia

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

i have been taking propecia, and generic propecia for about six months. i have a lot of hair but since i have been taking this, my hair seens to be thinning. why? the reason i started to take this product is, because my father is bald, and my mother has hair loss. what should i do. im going to a dermatologist to se what caused this so fast. it seem since i stared taking this its making things not work. my hair was alot thicker before i started taking this product and i have had a rash on my leg four month now. please, help me

If you were NOT losing hair, then why in world did you start taking Propecia? This drug is not to be used as a preventive treatment when there is no hair loss present. Propecia is a prescription medication used for the treatment of androgenic alopecia. Please follow up with the doctor that prescribed you the medication. You should also follow up with a dermatologist about the rash on your leg, which is probably not related to Propecia.

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

Sarcoidosis and Female Hair Loss

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

I am an African American female who has been diagnosed with Sarcoid of the skin. I have since lost 85% of my hair and it is NOT growing back. When I was first diagnosed, I would see these scaly flaky spots which would peel away (along with my hair). By the way, I am also taking Prednisone to treat my Rhumatoid Arthritis. I would however like very much to have my natural hair as the wigs are hot, unnatural and unattractive.

There is no cure for sarcoidosis. Treatments sometimes exploit the use of systemic and topical steroids. Local steroid injections into specific lesions sometimes help; the use of methotrexate (an immunosupressive agent) also helps in some people. I have little experience in this awful disease. You need an expert in this arena for treatment, but don’t blame your doctor if the treatments do not work.

Tags: sarcoidosis, sarcoid, hairloss, hair loss, prednisone, steroid, female, women, woman

Hypersensitive to Minoxidil? — I Experienced Heart Palpitations

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

Hello-

I started using Minoxidil 5% twice a day in January or February of 2006. I didn’t experience any side effects, so a year later, I substituted the 5% Minoxidil with 12.5% at night. I still didn’t feel any side effects. I switched to Xandrox 5% (minoxidil with azaelic acid) last December since I have PCOS and it was recommended to help stop the miniaturization of my hair. Within a couple of weeks (maybe even a week), I experienced heart palpitations. Is it possible that people can become hypersensitive to Minoxidil after a period of time (for me, 2 years)? Or could it be coincidental and related to something else?

Thanks

I would never recommend 12.5% topical minoxidil, as it can have serious systemic side effects (just as you described). More importantly, heart palpitations can be a harbinger to a serious and life threatening condition. I strongly recommend that you follow up with a physician for an examination. Minoxidil can cause a drop in blood pressure in a limited number of people.

Tags: minoxidil, rogaine, hairloss, hair loss, female, women, woman, heart, cardiac

Cool Laser

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

I have seen advertisements, and have listened to radio advertisement raving about the cool laser for the treatment of baldness. Are there any statistically valid studies that have shown that they work to either stop hairloss or grow new hair?

There are studies, but they were done by people connected with the business, so I will not believe them until they are done by a completely independent source. See my prior posts on lasers here.

Tags: laser, cool laser, hairloss, hair loss