Xalatan (Latanoprost) For Growing Eyelashes

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

I received the following from a patient:

Guess what I’ve discovered? Indirectly, of course :) Turns out that THIS stuff had an odd side effect (it’s a glaucoma medication) it grown hair and has become RevitaLash. There’s more to the story (possible lawsuit, etc) about the product… how interesting! Anyway, I would like to buy the Xatalan (if you can/will write a prescription) and test it on my hairline. Does that sound interesting to you?

Xalatan is the brand name that Pfizer uses to market the generic drug latanoprost.

This is interesting, but upon looking up the drug for risks and potential side effects, I am not sure about safety. My one and only real caution is the safety issues. For example, if you accidentally got this into your eye, then there are pressure changes in the eye that might damage your vision — and there are verbal reports from doctors experienced with this drug that have told me it can change eye color. The medication is normally used to drop high eye pressure under the direction of a physician, but if your eye pressure is normal, it can drop to below normal levels and possibly cause injury.

As far as hair growth, it would be interesting to see if anyone has tried it, but the cost is high on a per drop basis so you would have to be quite wealthy to put drops of this stuff on your scalp.

Tags: latanoprost, xalatan, xatalan, hair growth, eyelash, eyelashes, pfizer, lashes

Starting and Stopping Propecia Multiple Times

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

Dear Dr. Rassman,
Thank you very much for maintaining this very informative and detailed website. I would sincerely appreciate your advice regarding my propecia therapy. I am 21 years old and have been taking propecia since July 2007. After the first 6 weeks on the drug, I noticed a complete cessation of hair loss. I subsequently discontinued the drug on the very poor advice of my father, an internist with little experience with finasteride treatments for MPB. I then restarted the drug about 2 months later, and again noticed complete cessation of hair loss within several weeks. I stopped taking propecia a second time, again on the advice of my father. Once again the hair loss returned within a few weeks.

I went back on propecia in late December, and have been taking it for the past 8 weeks. Unfortunately I have not noticed any change in the amount of hair I am losing. I am wondering if you would kindly explain the mechanism of this phenomenon. Have I induced resistance or tolerance to propecia in my hair follicles? Have I upregulated the expression of DHT receptors on the follicles? Is it possible that my estrogen levels or testoterone levels are relatively higher than they were when I started treatment several months ago?

I realize that I have committed a very grave error in discontinuing my propecia on two separate occasions. Have I irrevocably lost my responsiveness to the drug, or will it likely prevent further hair loss? Fortunately my hair loss is still not noticeable, and I would be happy simply to retain what I have.

With best wishes,
A stressed-out medical student.

It is often surprising how little doctors tend to understand about hair loss and its treatment. If you are playing with this drug, you allow the hair loss to continue its downhill course each time you stop taking it. The hair that you lose when you stop taking it may be lost forever, so stopping the Propecia intermittently may just set you up to a progressive lower hair count over time. Perhaps you were just in a rapid state of hair loss. Whatever is the cause of your situation, from a mechanistic point of view, you MUST continue on this drug for life. Stopping it allows you to play catch-up hair loss and eventually you will just progress further down the balding road.

Tags: finasteride, propecia, hairloss, hair loss

In the News – Eyebrow Transplants

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

There’s a new article about transplanting eyebrows, and features quotes from myself and my colleague Dr Bernstein, and contains before and after photos of an eyebrow patient of mine. Here’s a snippet from the story:

Throughout the country, follically-challenged and over-tweezed women (and some men) are discovering a new solution to their eyebrow woes that does not involve tattoos or makeup pencils.

Eyebrow transplants accounted for just 3 percent of all hair transplants in 2006, according to the International Society of Hair Restoration Surgery, but they grew by 35 percent over the previous two years and appear to be gaining momentum

Read the rest of the article here — Transplant perks up fading eyebrows

Tags: eyebrow, eyebrows, hairtransplant, hair transplant, eyebrow transplant, rassman, bernstein, hairloss, hair loss

I Met an Old Man That Had Estrogen Injected to Treat Stomach Cancer — Now He’s Got Hair!

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

Today i met a fascinating old man in his 80’s. We got talking and he remarked that being a builder for many years was stressful and then joked it made his hair turn grey. I replied “At least youve got your hair!, i dont think im gonna even gonna get to grey” (im a NW3 and have recently made and informed decision against Propecia after 6 months of intense research talking to 3 doctors.)

He then informed me that he was previously bald with a ring around his head,( sounds like a NW7). He got stomach cancer a few years ago and was forced to take estrogen. It sounded like it was a massive amount of estrogen and they put it straight into his stomach, he also said its about 1300 a pop and that he had it three times. The Doctor warned him that this treatment would either grow hair on his head or give him breasts.

His hair, now white was probably a Norwood 2. Just wondering if you could share some light on this fascinating story.

We know that estrogen protects women against hair loss and when they go through menopause, they lose their estrogen and many times their hair. I have been aware that estrogen may help in hair loss, but at what cost for the men (breast, libido, and feminization issues)?

Tags: estrogen, hairloss, hair loss

I’ve Been Off Propecia for 8 Years, But Want to Restart

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

I have been fighting the effects of MPB for 10 years now and am 36 years old with good results and a lot of dedication. Ten years ago I started using Propecia when it first came out. It worked very well for me. Five years ago I noticed that it did not have the same effeciveness. I started to use Minoxidil along with Proscar split in to two. This worked well for three years but a year and a half ago we started to try for a baby and I did not want to have Proscar broken up around the house. I stopped using Proscar and just used Minoxidil which worked untill about two months ago when I started to see thining at the front. This is the same thinning I saw 5 years ago. Do you think this is a 5 year pattern that my hair goes through and not to worry? Have you seen somebody use Propecia for 8 years get off it and get back on it a year or so later with good results? What would you recommend?

It isn’t too late to restart the drug, although what hair you lost may not come back. It will likely slow down or stop what you are losing now. Some people think that Propecia works only in a 5 year cycle, but that is not true. The official Merck study was limited to 5 years and that is what people seem to remember.

Tags: propecia, finasteride, hair loss, hairloss

Revivogen vs Finasteride/Dutasteride

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

Hello,

What do you think of Revivogen and this recent study, comparing it to Finasteride and Dutasteride: study (PDF File)

The science looks interesting, but it is not clear from this study that there will be actual hair growth. If you want a known DHT blocker, finasteride is safe and proven to work. Nonetheless, I appreciate the link and thanks for sending.

Tags: hairloss, hair loss, revivogen, finasteride, dutasteride

I’ve Seen 3 Different Dermatologists with 3 Different Views on My Hair Loss

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

I have seen 3 dermatologists with 3 different views.

The first derm i go to does the pull test and says the ease of hair coming out might make it seem like a non genetic thing. The second derm wants to give me corti shots…which i received, we were to meet for 2 more sessions, but he suddenly quit the office. The 3rd derm , in replacement of the 2nd, says it is genetic and prescribes me Propecia. I feel like these docs aren’t taking the time to study things case by case so I come to YOU for some experiences advice.

HISTORY:
Started to notice hair loss in senior year of college. It has been many months since start of serious hair loss. Mother’s side all good…father’s side, hair loss beginning in 40’s and 50’s.

MY CONDITION:
Itchy scalp, most noticeable when in contact with a brush. Flaking, now very few, prob due to few uses of Nizorol. Oily…in fact, my pillow smells and in the morning it is oily and a mess. Back, side and front very good condition, the hair loss is diffused amongst the top portion of my scalp.

HAIR CONDITION:
When examining the fallen hairs, they usually have a bulb but it is small and dark. Sometimes there is a oily/flaky substance attached to it. Also, some hair I notice have a wave to them and the tip is very thin and pointed.

I have thought the possibility of a seborrhea condition, is my case something a scalp biopsy can figure out? A blood test has already revealed normal ranges in all except some hard to decipher words in the hermatology report which my physician did not deem notable.

Thank you very much in advance.

I do not agree with cortisone shots in the scalp for treating genetic hair loss. Seborrhea should be treated by any good dermatologist or family doctor. The use of topical steroids are often overkill. Pull tests are part of the work-up of a patient with hair loss. Mapping out your hair for miniaturization gives me a great deal of knowledge on what is going on in the hair of a person with balding or thinning.

Doctors don’t all agree and that is a fact of life. When you are caught up in the middle between doctor’s advice, make a judgment on who you like, who treats you with respect and who has a caring manner, then stick to that doctor. A good doctor/patient relationship is important, and trust in your doctor is significant. I can be the 4th doctor to look at you, but I’m in Los Angeles and you indicated you’re in New York — so if you don’t mind the travel, I’d certainly invite you to my office for a consultation. Or more convenient for you, my colleague Dr Robert Bernstein has an office in New York.

Tags: hairloss, hair loss, biopsy, dermatologist, dermatology, doctor

Reshaping the Temples with Hair Transplants

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

Dr. Rassman, thank you and your team for always having a very informative blog and website.

My question is about transplant to the temples… is it a good idea to reshape the triangle part of the temples? Or is it better to use the grafts for the hairline, etc? Do you have pictures of patients you’ve done temples to that you can share with us?

Thank you very much for your help.

Yes, we can reshape the temples! In fact, my surgery case today was reshaping a patient’s temples and sideburns. Here is an example of a patient with temple transplants. He had about 1100 grafts placed into his front hairline and 150-200 grafts placed into each temple.

The before photo is on the left, after on the right. Click the photos to enlarge.

 

To see more of this patient (including other angles), check out his profile in the NHI Patient Photo Gallery. Even more temple hair transplant patients can be seen here.

Tags: hairloss, hair loss, temple, hairtransplant, hair transplant, photos, patient

Dr Rassman Quoted in Boston Globe

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

Boston GlobeMy initial thought was that a quote by yours truly in the Boston Globe would be a really great thing. Then I realized that the writer of the article only found three words of mine (relating to DHT) to be worth quoting. Check it out:

Am I the “shrivels hair follicles” guy now? Is that going to be my claim to fame? Wow, I hope not! But hey, at least it gave me something funny to mention on the blog.

Tags: boston globe, hairloss, hair loss, rassman, boston, globe, shrivels, follicles

My Hair Loss Seems to Have Stopped Over Time — Is It Likely Stabilizing?

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

Hi Doctor,

thanks for great blog full of questions and answers gave me lot of information.

I have few questions. I am today 22. I Started loosing my hairs i guess around when i was 18, it was very bad, i was on minoxidil for few months but then i stopped it. since till few years back i was loosing hairs falling out etc. but since 5-6 months now i am not loosing hairs. nothing much is falling and even though my hair fall started at 18 my hairline is not recessed that much but hairs front of my crown have thinned but hairs on and below my crown are too thick.

so is it the case that my MPB is slowed down now and here is around i will find my stabilization or (Worse fear) as my thinning etc started too early and it will continue rest of my life till i get my IV or IIV NW like my dad ? and this period is just a bit slow resting phase.

also i want to know if start taking 5% Minioxdil from now on , is minoxidil something i can continue all my life without any problem, few people think it worsens the hair root after few years and the scalp really gets more and more worse longer you keep applying it.

Hair loss occurs in spurts and it is in the 20s (pretty much from age 20-29) that men are most likely to see most of their hair loss. The drug Propecia (finasteride 1mg) works to slow or stop it and in your case it might continue the stabilization. You need to get your hair mapped out for miniaturization, which will tell you what may happen to you over the next few years, and then speak to your doctor about Propecia.

I have seen no negative reports related to what you mentioned after long term use of minoxidil, and I have seen many patients who have used it in excess of 10 years.

Tags: hairloss, hair loss, minoxidil, stabilization, propecia, finasteride

Browlift Scar Repair with Hair Transplants

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

I have a scar from a brow lift on both sides of my head. I wear my hair short(military style), so you can see the scar. The scars have healed (6 yrs ago since browlift), and both sides of the scar have feeling in them. I can feel something touching, scratching them. The scars are pretty flat. I want to know about the procedure to transplant hair into the scar (including associated costs, timeframe, etc.) I have very thick hair that grows quickly. I am 34 years old.

Hair transplants work very well in the scars of brow lifts by transplanting them directly into the healed wound. We do these with some frequency, as well as neurosurgical scars, which are often larger. The costs are generally between $3000-4000 for such repairs as it takes 400+ grafts depending upon length and width of the scars. Most of these surgeries take about 3-4 hours and the hair will grow within 6-8 months.

Tags: browlift, scar, repair, hairtransplant, hair transplant, brow lift

What Happens to Hair When You’re Stressed?

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

What happens EXACTLY to your hair when you are stressed?

Although hair loss can be stress induced, simply having stress will not (in most people) impact your hair unless there is a balding process going on at the time of a prolonged stress. We do not know the mechanism for it in those that are impacted. Men rarely see it, women frequently will see it if they have a hair loss problem.

Tags: stress, hairloss, hair loss

Paxil CR and Female Hair Loss

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

I am a twenty-three year old woman taking 37.5 mg of Paxil CR and have experienced substantial hair loss. Could this have something to do with this medication which I’ve been taking for the past 5 year? Also, my hair doesn’t seem to be growing. I eat well- get plenty of protein and take calcium supplements with magnesium and vitamin d. What might I do to trigger hair growth?

I do not know the mechanisms for this side effect, but Paxil (paroxetine) is on WebMD’s list of medications that can potentially cause hair loss. You should discuss this with your prescribing doctor.

Tags: paxil, paroxetine, depression, hairloss, hair loss, female, women, woman

The FDA is Corrupt and Mismanaged

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

Hi Dr. Rassman,

Check out this article on the Wall Street Journal: FDA Chief Is in Budget Bind.

With all due respect, why do you put so much stock in the FDA? It is clearly a horribly mismanaged government agency. President Bush and Congress have declined the FDA’s request for a budget increase due to the system being “badly broken” and even though it is still considered the “gold standard” (as the article states), it is obvious that there is much corruption. So why can you so easily disregard every product that hasn’t made FDA approvals and even some that the FDA have cleared (like the hair lasers)? I get that you’re hesitant to recommend anything beyond the FDA approved drugs because you are a physician and you do not wish to do any harm, but I’m open to new ideas and you seem to be coming from this old school mentality of just believing what the government tells you and disregarding everything else.

I love your site and I know you’re writing by far the most honest hair loss site on the web, but this is just something I have a problem with and I hope I can shake your tree a little bit to find out your thoughts on the FDA as a regulatory agency and their actual ability to act in the best interest of the public or in the best interest of the drug companies.

FDAIf I had to judge safety and effectiveness, I am afraid that I would be doing only one thing with my life and that thing would be to become an expert in possibly only one drug. It would take years and a massive effort to perform the same types of studies that the FDA requires. Every civilized country has their own FDA or equivalent with the same mission — to judge safety and effectiveness of various products before they come to market.

Governments build bureaucracies and much like the Katrina disaster in Louisiana, our government did not do a competent job. I am not a fan of bureaucracy or incompetence, and upon reading your referenced Wall Street Journal article, I know it speaks clearly about the problem. I am afraid, however, that I must use whatever sources are available to determine safety and effectiveness and other than the FDA, there are not any other substitutes.

Tags: fda, food drug administration, government, hairloss, hair loss, drug, medication, congress, bush

Injecting Finasteride and Minoxidil Into the Scalp?

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

Hi Doctor,

I came across a doctors site which supposedly has a procedure for balding in which they actually inject a small amount of fines. and minox. along with vitamins and trace elements via computerized mesogun into the mesoderm of bald areas. The site is www.msi-medspa.com, under hair restoration tab, in the “Is there any other solution for hair loss other then surgery”.

Does this technique seem feasible? I have been on propecia for a month now. My question is, would using the above technique assist in preserving the current stage of my hair until the propecia begins working (assumingly in 3 months now)? Could it be used in conjunction, and would injecting fines. directly in bald areas prevent side effect?

Thanks for your help.

Guinea pigOral Propecia (finasteride 1mg) starts working immediately, but it takes months to see the effects of it (a good 8 months to see the impact on hair growth). I can not imagine injecting either minoxidil (which will drop your blood pressure, as that what it was designed to do) or finasteride (not shown to be effective here).

The site you referenced says: “Tiny amount of active ingredients of minoxidil, finesteride together with all vitamins and trace elements are injected via computerized mesogun into the mesoderm of bald areas It gives an excellent results in both Androgenic and pseudo androgenic alopecia.”

I would like to see the proof that this procedure provides “excellent results”, for it sounds like you’d be experimenting with yourself as the guinea pig.

Tags: finasteride, minoxidil, propecia, proscar, rogaine, injection, mesoderm, mesotherapy, hairloss, hair loss