My Doctor Refused to Give Me a Proscar Prescription

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

Hi Dr. Rassman

My doctor refused to give me prescription for proscar telling me that the drug will minimize my prostate and that long term use will cause me permanent libido problems. Now i consider buying the drug from internet. What’s your opinion? Thanks.

Male 24, NW2.

I would see another doctor. Finasteride 1mg will not give you permanent libido problems.

You need to be followed by a doctor and have a doctor’s prescription for taking this medication. More importantly, you need to have a good diagnosis of what you are treating before you start any medication. I do realize you can buy many medications without a doctors prescription over the Internet, but that is not a smart thing to do, nor is it exactly legal.

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

My Daughter Had a Bad Chemical Burn on Her Scalp When She Was Hours Old

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

I have a 11 year old daughter who has a bald spot in her head. She received this chemical burn when she was about a few hours old when she stopped breathing and they had to put an IV in her head. She has really dealt with this situation for the past few years but now she complains because she can only wear her hair one way. I have taken her to a dermatologist and they said that her follicules were dead and that she would have to have a hair transplant. I have been researching about microscopic follicular hair transplants and I think I want to have it done for her this summer. I really want to know if you think she is to young for this surgery.

Depending upon the size of the area, the treatment should be customized for that size and location. Some children develop very large areas of balding from such events and these may require more than a hair transplant. I would have to see photos of her to tell you what could be done (you can send them here and please reference this post in your email). Photos will remain confidential unless permission is granted to use them.

Tags: hairloss, hair loss, chemical burn, chemical, burn, child

Corrective Hair Implants

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

I’ve recently come across the concept of hair implants https://www.hairloss.com/. I was wondering if you see any viability in this procedure, or is this another tactic of some money making company basically blowing smoke where the sun doesn’t shine?

You have to always beware of such advertisements, particularly when it sounds too good to be true. At first glance, the site reads as if it is a hair transplant with hair from another person, and without surgery! But then, the website interestingly discusses some bonding of human hair (not your own) to the skin with some bonding material.

My conclusion — it is just another type of wig.

Tags: hairloss, hair loss, corrective hair implants, implant, hair

Will Propecia Work for the Top of My Head if I Have DUPA?

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

I have recently been diagnosed with DUPA. I have received a prescription for Propecia and will be using it as instructed even though I am aware that it is not always effective for someone with my condition. If Propecia is effective for me will it have an effect for thinning areas throughout the scalp or only at the top of the head where the balding is usually restricted to.

Propecia is the only drug that MAY work for DUPA. It is worth a try, but you won’t know for a good year or so. No one really knows if and how it works, when it works.

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

How Long Does Propecia Take to Dissolve in the Body?

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

Upon taking propecia, how long before it dissolves and enters the bloodstream? Better yet, how long will it be before it is safe from urination or involuntary regurgitation of food?

Thanks doc

Propecia (finasteride 1mg) will go through an empty stomach in under an hour, but if the stomach is full of food, well that relates to the emptying time of the stomach which will vary based upon so many factors that there is no real answer to that part of your question. It will last about 24 hours in your body, dropping blood levels at about 50% for every 4-6 hours after it is absorbed. If you were to vomit, it would depend upon what you had in your stomach when you took it. An empty stomach will absorb it very quickly.

I don’t quite understand the uriniation part of your question, but you will not pass it through your kidneys as finasteride, but rather as the metabolites of that drug. Wikipedia says the excretion of finasteride is feces (57%) and urine (39%) as metabolites, but I do not how accurate that is, nor do I quite know what that means, since the drug is metabolized on its pass through the liver if it does not get absorbed as finasteride directly from the blood stream. Long story short, I don’t believe you should worry about passing it through your bladder if that was your concern.

Tags: finasteride, propecia, hairloss, hair loss, dissolve, bloodstream, urination, urine, medication

Woman Losing Hair on the Sides (with Photo)

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


i have been having a problem with my hair falling off at the sides for a very long time. im 27 years old so that should not be a problem of age and i have not given birth. the problem is that it grows but keep falling off. i’m short of tricks to do and the worst thing is that its really hard to style my hair. i never had tight pig tails and i have always had this thought that its hereditary as my mom has also that problem and i experienced it early im teenage. and i have tried some creams but they have not worked and been to the doctor. help

The photo appears to show traction alopecia, but it could be an autoimmune process as well. There is a condition called triangular alopecia, where the hair at the temples may be lost on both sides, but I am unaware of reports of it being this extensive. Perhaps a biopsy would help make the diagnosis. You need to see a good dermatologist who should be able to let you know what you have. Thank you for permission to post your photo.

Please click the photo to enlarge.

 

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

Is It Likely That I’ll Lose Hair After a Facelift and Brow Lift?

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

I am considering a facelift and brow lift with a trichophytic incision due to a slightly high forehead and bald areas above my ears. I have been losing hair like crazy from menopause-common in the women in my family. I am afraid of more hair loss as my hair is already thin at the front,sides and recedes at the place men usually recede on the sides of my head. The surgeon doesn’t seem to think this is a problem. He cuts along the front of the hairline then back into the hairline and then down to the ears. What is your opinion of the likelihood I will lose more hair since I lose hair where ever I am cut? Thanks

Hair loss around the facelift / brow lift scar is a risk and while your hair will likely hide any scar or hair loss, it is still a risk you should be aware of. My opinion and observation is definitely skewed, because I only see the worst cases when hair loss occurs after a facelift/brow lift in which time they come to me for a hair transplant. If you are already losing hair or are actively having thinning of your hair, there is also a small possibility that surgery (as a stressor on your body) may precipitate more hair loss. As stated, these are small risks, but something you should consider to weigh out when looking at the risks versus the benefits of these procedures.

Tags: hairloss, hair loss, facelift, face lift, brow lift, plastic surgery

Will Blocking DHT Make Me More Feminine?

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

  1. If MPB is not about blood flow and DHT blocking blood flow causing hair loss, then what the hell is Minoxidil for? Isn’t it a vasodilator, which has to do with blood flow?
  2. Regarding DHT…if I’m taking Propecia and/or Saw Palmetto, and DHT is essential for men and to differentiate between men and women, by blocking DHT will this cause me to have more feminine characteristics? Also, I’ve read DHT may (emphasis) affect facial and body hair growth if taken at a young age (I’m 20), but will it affect height growth, muscle growth (bodybuilding), or any other hormone related things?

Thanks, I appreciate it!

  1. A side effect of minoxidil is that it causes hair growth. When the drug was originally released, it was an oral antihypertensive drug that did not work well, but they noticed that women grew mustaches and beards from systemic use. The connection between being a vasodilator has nothing to do with its hair growth side effect.
  2. Blocking DHT will not make you more feminine. Propecia will not make you feminine. You are asking questions about your medication management and I can not take those questions on without being your doctor. Discuss these with your prescribing physician.
Tags: minoxidil, dht, propecia, finasteride, feminine, hairloss, hair loss

Has Propecia Turned My Semen Brown?

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

Dear Dr Rassman

Your site is a fantastic resource for men suffering from ongoing hair loss. Based on your advice and other research I have conducted, I have been using a combination regimen of Propecia and Minoxidil with some success over the last year, and as yet have noticed no significant side effects.

But recently I have experienced two instances of discoloured semen on Propecia. Rather than the usual milky white colour, on two occasions in the last 6 months my semen has turned a dark brown colour. On both occasions I stopped the Propecia and the colour returned to normal after about 2 weeks. I then started the regimen again but the same thing happened after around 6 months. Again I stopped the medication and the discoloration stopped.

Could you give me some advice on this? It would seem that the Propecia is having some effect on the prostate and causing bleeding of some kind to discolor the semen. Is this a common side-effect of Propecia or Finasteride, and most importantly, is it safe for me to continue taking the drug?

Many thanks

I do not know why your semen is changing colors. You need to go to your doctor or a urologist for a good history and examination. The issues is not about how safe it is to take Propecia. The issue is about finding an underlying, undiagnosed medical problem you are now aware of. Please see your doctor.

Tags: propecia, finasteride, hairloss, hair loss, brown, blood

I’m Afraid I’d Sweat Out the Minoxidil

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

Dear Mr. Rassman,

I am a loyal reader on your blog and would like to revert a question.

I am 26 years old using propecia since 1 year and I would say I am having good results from it, meaning my hair loss came to a stop. So far I still have most of my hair, but hairline (temple area) is still receding and I would like to tried out Minox 5% topical solution which I would rub in on my temples. Since I am Caucasian and living in a tropical country I am sweating quiet often and therefor would be afraid of sweating out all the topical solution which I would rub in.

Do you think my fears are appropriate or will Minoxidil be absorb by my scalp after a few minutes?

Thanking you in advance for your answer

best regards

I suppose your concern is valid, but after you apply the medication to your scalp it should be absorbed fairly quickly. I don’t know exactly how sweat will affect its efficacy, but I suppose it would depend on how much you are sweating. You may consider applying it mostly at night before you sleep when the temperature is cool (assuming you’re not sweating at nights also) and in the morning after a shower.

Tags: minoxidil, rogaine, hairloss, hair loss, sweat, heat

Propecia Has Halted My Hair Loss Since 1997

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

Just wanted to let you know been on propecia since 1997 and it has totally halted my hairloss. So you are right get on it right away and stay on it.

Thank you for the sharing of information. It seems from all the emails I receive patients are so focused on the small possibility of the side effects of Propecia that they often lose sight of why they are taking the medication. Only about one to two percent of men will have a negative sex drive side effect.

Tags: propecia, finasteride, hairloss, hair loss

Taking 1/2 Dose of Propecia and My Dermatologist Now Says I Have No MPB

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

Dr. Rassman,
I’ve been taking finasteride .5mg for 6 months. I hate to say that I cannot handle the side effects. I didn’t have much thinning except for a slightly receding hairline. I’m 38 and a dermatologist thought that I had very little chance of MPB and advised me to stop finasteride with a small chance losing alot of hair. Have you had experience with people like me who get of the drug? What happens? Thank you very much!

Unless you approach the diagnosis scientifically, you will never know if you have genetic hair loss. If the 0.5mg of finasteride showed you benefits after the 6 months, those benefits will be gone — any retained hair will fall out.

Tags: finasteride, propecia, hairloss, hair loss

Does Propecia Block 100% of DHT?

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

My question is if Propecia blocks DHT, does it block 100% of DHT?

Thanks.

No. Propecia (finasteride 1mg) blocks around 60-70% of DHT at the hair level. The varying numbers depend on the source.

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

Hair Loss After Using Lye Hair Relaxer

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

Hello,

I am a 26 year old black male and I recently put an s-curl in my hair. I have since cut it out, but now they are patches that aren’t growing as fast as others and some are even bald. Will these go away with time? Or should I see a doctor?

No more LYE for me!

S-curlI’d never heard of this “S-curl” style, so I had to look it up. Assuming I’m not the only one that didn’t know what it is, here’s a description from Wikipedia —
Depending upon the strength of the application, an “S-curl” hairstyle has hair texture either only slightly less kinky than natural tightly coiled African hair. Similar to a woman’s permanent, an S-curl is applied using relaxers containing lye, and, like a jheri curl, requires continued use of specialized shampoos and conditioners to keep the chemically altered hair from becoming dry, hard, and brittle.

The relaxer contains lye, which is known to kill hair if it gets below the skin edge into the hair follicle. However, even if you use a “no lye” relaxer, you still need to use it with caution (see FDA warning). The products that soften the stiff and kinky nature of African hair often have significant limitations on their applications, so be sure to read the insert and the warnings on the packaging. Patches of balding areas may signify damage caused below the skin edge into the hair follicle itself. This type of damage may not disappear. See a good doctor!

Tags: hairloss, hair loss, african american, african, lye, relaxer, chemical

Reader Wants Everyone to Know That People Do Lie!

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

I am a firm believer that Finasteride works, and works well! I always question people on these forums who say otherwise. An analogous case in point. I was looking at this bodybuilding forum recently talking about this Arnold Schwarzenegger Encyclopedia of Modern Bodybuilding, and people were saying some negative things about it. I use it as my bible so to speak, and I can promise it works, regardless of people who says it didn’t help them gain any muscle — they didn’t try hard enough. That said, people reading this should know that other people say all sorts of crazy stuff and lie, so take everything with a grain of salt.

Sorting through all of the BS on the Internet can be a difficult task. Sometimes it just comes down to plain old common sense. If it sounds too good to be true, it probably is. If you think a secret “miracle hair cure” is going to be available off the Internet for the low, low price of $100, you’ve most likely just flushed that $100 down the toilet. Look for proof, not for fantasy.

And to add to the point you were making, people need to also remember that many claims found on the Internet are unsubstantiated. For example, just because Joe Schmo says that a medication made his hair fall out and his fingertips turn black doesn’t mean it really even happened!

Tags: hairloss, hair loss, claims