Coloring Hair After Chemotherapy

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

How soon after chemo is it safe to dye the hair??

If the hair has not fallen out and you have passed that critical phase where it would normally fall out, then you can use a gentle semi-permanent dye to color your hair. Semi-permanent dyes that are acidic are made of small molecules which can pass through into the cortex of the hair. As all of these dyes are water soluble, they can be easily washed out. They may last for between 1-6 weeks depending upon what dyes are used, but they lose their effectiveness with frequent washings. These are generally safe and can be used at home. Since these do not contain bleach they can not lighten the hair, but darkening gray hair is reasonable.

Tags: hair dye, chemo, chemotherapy, cancer, dye, hairloss, hair loss

Did Hypothyroidism Cause My Gray Hair?

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

Dr Rassman and staff,

I am a 26 yr old male from NYC.. I took a routine blood test and the doctor told me I may have some thyroid condition, possibly hypothyroidism.. I started getting gray hair since I was young, like 14, 15. Is it possible the thyroid condition can be the cause?

Also if I take medication for the thyroid condition is there any chance I can get my black hair back??

I would think that your graying is the result of some genetic process that does occur in rare cases for young people, but the presence of hypothyroidism may cause premature gray hair. See Thyroid Foundation of America for more info. You should consider using hair dye to color your hair black.

Tags: thyroid, hair, gray hair, grey hair, hypothyroidism

Eradicating Baldness

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

Hi Doc!

Don’t you think male-pattern-baldness will be extinguished over time, without proper medication? I mean, the society we live in tend to get more shallow each year, and for that reason the percentage of women choosing balding men over non-balding men seems to decrease significantly. Since genes are playing a big part in determining one’s final balding pattern, I guess “bad genes” will be replaced with “good genes” over time if women are giving birth to children conceived mostly by non-balding men.

Assuming that you are right (women choose non-balding men), it would take many, many generations to wipe out the balding gene. I really don’t believe that women will choose only non-bald men anyway. We are, as a society, not so shallow!

Tags: hairloss, hair loss, genetic, gene, baldness

Japanese Patient Hair Transplant Results (with Photos)

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

Hi Doc,
I’m a 32 year old male of Korean (dad) and French (mom) descent and have been obsessed with my hair loss for years. I got my dad’s hair, including his balding. It looks like I’m a Norwood category III or IV. I have light skin and dark straight hair so I think that would be difficult to make a successful transplant and haven’t seen many photos of Asians with hair transplants. Anything you can provide? Thanks so much.

Well timed! I just had a Japanese patient in my office this week that stopped by for a follow-up, so I’m glad I could promptly oblige your request quickly. He had a Norwood Class 4 hair loss pattern and we transplanted 1836 grafts in a single procedure about 3 1/2 years ago.

Click the photos to enlarge.

Before:

 

After:

 

For the record, it’s not that we avoid posting results photos of patients from certain ethnicities, but I can only show the results of patients that sign a photo release, and not everyone wants to do that (which is completely within their right, of course). I always appreciate when patients allow me to show their results, though!

Update — June 16, 2008: More photos added from the top view.

Tags: asian, japanese, hairloss, hair loss, hairtransplant, hair transplant

What’s Up With Hair Transplant Surgeons That Make a Low, Straight Hairline?

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

Dr Rassman,

I have always been a fan of yr ‘Master Plan’ approach to dealing with hair transplant surgically. However, recently, through some hair transplant blogs, I managed to find a few patients undergoing ‘dense-packing’ method up front the hairline area and crown.

This very well-known and highly-regarded hair transplant surgeon seems to be a complete opposite of what you are doing. A look at this patient’s photo gallery, one can only be flabbergasted (more than impressed) by the transformation the patients went through. This is especially so in the hairline constructed – usually thick, low and virtually straight. Also, per hair line procedure, grafts from 1500 to up to 3150 grafts are usually used. Leaving only aother 2000-3000 grafts avaialble for future transplant. I am an advocate for careful hair transplant Master Plan, but seeing such amazing hairline done, one can only be moved and inclined to doing it with this surgeon.

Did you think this surgeon would have considered the impact of future hair loss in these patients or it is simply an amazing surgeon at work?

I can probably guess who this surgeon is, though I won’t do that here. If I am correct though, this surgeon basically does 3000 grafts on almost everyone that he sees (even those who are not balding very much). I would assume that he has loaded the very front of the hairline with very dense packing of the hair amongst other existing hairs that have not fallen out.

In my experience, some patients with fine hair just don’t get those densities. I would question if he’s cherry-picking the patients that he wishes to show. You are correct in your analysis, as many of these patients will not have much hair left after he finishes his first one or two sessions. Maybe there is a Master Plan, but it may not be in the interest of his patients.

Tags: hairtransplant, hair transplant, surgery, surgeon, hairloss, hair loss, hairline

What Are the Chances That My Hair Loss Has Stabilized at Age 35?

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

Hi Dr. I love this site, been reading like crazy. Thank-You. I first realized that I was developing some balding at the right front side area when I was 29. I didn’t pay much more attention until about 32/ 33 because my hair covered up okay and frankly I had never heard of propecia as an option. As I type this I’m now 34 and have been on propecia for just 10 weeks (no side effects) as my hairloss is more noticeable in the front. My hair is full in the sides / top and back with virtually no balding at the vertex but if you look at me from the front I have the shape of hairloss in and upside down U with the centre still intact at the original hairline . I’m taking the propecia as a defense measure against any further balding and because I NEED to keep this middle centre portion to have any chance of styling at all. My question is …. At nearly 35 is there a good chance I have stabilized ? I am committed to propecia for life because a pill a day is no big deal….is there a chance I could turn those “thinned” out hairs into better coverage hairs in the ” upside down u”. Thanks.

P.s the generosity of your time here is very appreciated.

Genetic hair loss is progressive, and although it does generally slow down, that may not apply to you. From your history, you did not really lose enough of your hair to notice it until you were in your early 30s. That means that you were a late starter and that your hair loss will be progressive later in life than the general rule in the majority of young men.

Get your hair mapped out for miniaturization ASAP so that you can compare the impact of finasteride 1 year after you started taking it. Between the two measurements and the degree of miniaturization that is there now, you and your doctor may be able to predict what will happen to you in the future.

Tags: hairloss, hair loss

Propecia Baseline

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

Hello, I hear a lot about how a majority of men maintained or improved hair counts compared to the baseline measurement on Propecia. However, I can’t seem to find when this baseline measurement is taken. Since Propecia takes about 3 months to “kick in”, is the baseline measurement the hair count at that time or the hair count at the beginning of Propecia treatment?

Thanks for your help!

I suggest that you get a baseline count when you start taking Propecia and repeat it yearly, as it does take a while to see the medication’s benefits. I personally prefer miniaturization studies, because it is the miniaturized hairs that benefit from the Propecia, not as much the increased hair count. To get a very accurate hair count, you would have to tattoo a spot on the scalp, so that same spot that you first counted will be the same spot you count a year later. Most people would be unable to find that exact spot without a permanent mark of some type on it. Miniaturization studies will look at sections of the scalp, not just one spot.

Tags: propecia, finasteride, baseline, hair count, miniaturization

Possible Alopecia Areata, Plus Hair Loss from Prednisone?

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

Hello Doctor,

I’ve been treated for alopecia for about 3 years – mostly on the back of my head. After taking prednisone for the first time, large areas of back scalp balded, instead of just the typical circles. I was then given a larger dose and hair grew back – but very fine, white color, and short – like baby hair. Is there a chance I will get “real” hair back or may my follicles have been damaged.

Thank you

Prednisone is known to cause hair loss, but based on your description, I would guess that you also have alopecia areata (you mentioned alopecia, but also said that you used to have “typical circles” of hair loss). Have the circles of hair loss regrown in the past?

This is a complex problem with many presentations and many progressions. However, guessing so blindly is not what doctoring is about unless I am treating you and I have all of the facts. You need to present these questions to your doctor, who can examine you in person and hopefully diagnose your problem.

Tags: prednisone, hairloss, hair loss, alopecia, alopecia areata, female, women, woman

Site Software Upgrade

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

We’re doing an upgrade of the blogging software this morning, so there might be some intermittent problems. Things should be back to normal ASAP (if they leave the “normal” state at all)…

In the meantime, feel free to email us with any ideas for the site that you may have. This site would be nothing without the support of our readers, so I’d love your feedback. I’ve had a few readers ask for a full message board, for example. Do you want a full message board, where you can create your own topics and discuss them amongst yourselves? Let us know!

Update: Software upgrade complete. No major hiccups.

You’re Losing Hair — What Do You Do Next?!

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

Im sure these are some basic questions you’ve answered before, so feel free to direct me to a previous answer. I’m 42, and my hair is starting to both thin and recede, It bothers me quite a bit.

  1. you say very often get examined by a professional. where do i start? is this my regular doctor, or i need to go somewhere else.
  2. What is the difference between rogaine and propecia, and who would be best to recommend what would make the most sense for me?

thanks very much for any help you can provide.

DoctorYou should go to a good dermatologist with an interest in hair loss. Call his/her office to find out if they are the best one to treat you. Alternatively, you can see a hair transplant doctor (they have an obvious interest in hair), but don’t get yourself rushed into surgery. I see quite a number of men with problems like you describe.

There are huge differences between Rogaine (minoxidil) or Propecia (finasteride). For starters, Propecia is an oral prescription medication and Rogaine is a topical over-the-counter medication. They each have their own set of possible side effects and they both are currently the only FDA approved medications for treating hair loss. I usually recommend Propecia for early hair loss, but as it is a prescription medication, your doctor will be able to give you all the proper information about it. I wrote about this briefly before — “The two drugs work differently. Propecia is more predictable than minoxidil, but they could work together. I have seen hair come back with minoxidil, however I have seen more patients show great benefits from Propecia.”

For more, Wikipedia has good info about minoxidil and finasteride.

Please note: the above image is not an endorsement of child doctors.

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

Type I and Type II DHT

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

I don’t understand the difference between Type I and Type II DHT. Why does finasteride only block Type II? DHT is DHT right? Also, if you’re going to lower DHT levels by blocking it from forming, why not just block all of it?

In the clinical trials for Propecia, I heard they tested finasteride at 20mg and its effects on hair loss were marginally better or more or less the same. And if Propecia is great but not perfect, there must be something else causing hair loss, perhaps another enzyme acing on type II or 5AR or another enzyme acting on Type I DHT.

Is it possible for Propecia to cease hair loss where it is forever?

Cheers for your time.


DHT is DHT. It works on different receptors in the body and these are discussed on RXList.com. Essentially, “The type 2 isoenzyme is primarily active in the reproductive tissues, while the type 1 isoenzyme is also responsible for testosterone conversion in the skin and liver.”

The last question in your message is not clear. If you are asking if taking Propecia forever will keep the DHT blocked at the same level forever, then the answer is no. There is no forever anti-DHT treatment. Your body will eventually start to produce more DHT than Propecia will be capable of combating, and you may begin to see hair loss again years and years down the line. Some doctors actually increase the dose of Propecia to combat at progressive ineffectiveness, but there is no proof that a higher dose works, but it may be a logical direction to go if the drug is less effective after years.

Tags: dht, dihydrotestosterone, hairloss, hair loss, propecia, avodart

Pretoxan

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

Dear Dr.,

There is a new product called Pre Toxan, (or Pretoxan) containing L-Arginine, the website is: www.pretoxan.de

Could you please let us know your opinion, is it safe?

Thanks

PretoxanI looked at their site (thanks to Google’s translatation service) and the “science” they mention just makes no sense. From what I gather, Protoxan is a shampoo that mixes the ingredients in Procapil with L-arginine. The site mentions that it, “boosts the synthesis of important components at the epidermal junction where the hair anchors to the skin.” And that Procapil, “has active compounds that help to anchor the hair follicles more firmly in the scalp, allowing hair follicles maintain their youth. By stimulating cell communication and metabolism, follicle anti-aging is promoted and anchoring molecules are rejuvenated. This helps prevent premature hair thinning, hair loss and MPB (male pattern balding).”

Excuse me if Google’s translator didn’t turn that into perfect English, but I think I see what they’re trying to say… and there is no science here. There is a poorly documented clinical trial on a limited number of men which is designed like a double blind study, but just does not cut it. The product may work, but there is no clear cut evidence that it does what is says.

Tags: hairloss, hair loss, pretoxan, pre toxan, procapil, l-arginine, shampoo

Capsaicin for Treating Hair Loss?

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

Hi Dr. Rassman,
What is your take on using capsaicin for hairloss? It’s my belief that Zhang Guang 101, a Chinese “herbal” product that is popular overseas, contains only capsaicin as its active ingredient. Having used a few bottles myself, I’m fairly certain that this simple molecule found in chili peppers is responsible for any hair growth effects that the product claims. I’ve only been using it for a couple weeks, so I can’t give a definitive testimonial. There has been research done on the effect of capsaicin on hair growth. It supposedly promotes the release of IGF-1, which is crucial for hair growth. It also stimulates pain receptors and releases substance P. Can you take a look and tell me what you think? Thanks.

Administration of capsaicin and isoflavone promotes hair growth by increasing insulin-like growth factor-I production in mice and in humans with alopecia

PeppersFrom the article:
“These observations strongly suggested that combined administration of capsaicin and isoflavone might increase IGF-I production in hair follicles in the skin, thereby promoting hair growth.”

Capsaicin is found in chili peppers and even in pepper spray. I don’t have any experience with this, though I read the article and will wait to see if it may become a treatment modality. I’m not opposed to new treatments by any means, but I will need to see actual proof before I throw my support behind it. At any rate, I’d think it would cause incredible tingling in your scalp, just as eating a very spicy pepper can numb your lips.

Tags: peppers, chili, capsaicin, hairloss, hair loss

Eat Rice and Get Scalp Massages Daily to Make Hair Regrow?

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

I was at the hair salon yesterday and overheard another customer telling his stylist to keep the top a little longer because he was starting to bald. The stylist told him “my father was losing his hair until he started eating rice every day and my mom massaged his scalp. Then his hair grew back and although he’s 72, he looks like he’s in his 50s”. Now I know enough to realize that this sounds like just a cheap way to get your wife to massage your scalp on a daily basis, but is there ANYTHING to the rice thing? In Asian countries, there is still hair loss and rice is a dietary staple, so I am guessing that right there dissolves the theory. I wanted your insight though. Thanks, doc!

RiceWell, Asians do have less hair loss than Caucasians, but I don’t believe that anyone has connected it to rice. The dietary differences may play a role, but how? I don’t have the answer to that.

I used to massage the scalps of my children when they were younger. It was a bonding experience of sorts and I joked that my magical fingers surely kept them healthy! Maybe I should’ve added a bowl of rice at the same time as the massage so that my oldest son wouldn’t have lost his crown hair! While a scalp massage might feel nice, it won’t regrow lost hair.

Tags: hairloss, hair loss, scalp massage, massage, rice, asian

I Started Losing Hair Before I Hit Puberty!

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

dear doctor,

PLEASE HELP ME!
i am a 16 year old male teen. the hair on the top of my head has been thinning since age 9-10, and i fear that at the rate i will not have hair on the top of my head by this time next year. this has been 6 long years that have been devastating to my self-confidence and i dont know if i can deal with being bald at age 16.

i did plenty of research on my dilemma, and i didnt find any record of a case that is similar to mine. i have been to a doctor, and have been tested for things such as thyroid, but it always come out negative. my doctors dont really seem to care much to help me. they tell me its just hereditary, but i dont understand how it could be. i started losing my hair before i hit puberty, and also my my whole family still has there hair. even my grandma and grandpa who are in his 70’s have nearly all there hair.

at age 12 i was told to start using rogaine, but stopped because i know that there is something else wrong that is not being found. every day i wake up and look in the mirror to see that i have lost more hair. it getting harder and harder to hide it from my friends. and everywhere i go im constantly reminded of it because my hair shows up everywhere like in my sink, or on my desk at school.

anyway, please please please answer me back. you’ll be the one person in the world that cares enough to truly help me find out the problem and hopefully the answer. thank you for listening.

I wish I could offer you some solid advice or anything of substance, but you really need to be examined, as your case is quite unusual. I couldn’t do you any justice by just guessing at your problem via the web. As you indicated in your email that you’re located in New Jersey, try to arrange a visit with Dr. Robert Bernstein (with offices in Fort Lee, NJ and Manhattan, NY). He can examine you and offer suggestions.

Tags: puberty, hairloss, hair loss, age, teen