FDA Warns About Hair Loss from Total Body Mega Formula

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

I read that the FDA has issued a warning about the oral supplement Total Body Mega Formula being unsafe because of high selenium and chromium levels. So my question is why does the FDA not have control over the sale of these supplements, but they do have control over the recall of them?

FDAI saw the official FDA warning and the Center for Disease Control advisory (PDF file). Apparently it took the Florida Department of Health to send reports to the FDA about the potential toxicity of Total Body Mega Formula and Total Body Formula before they were actually looked at by the FDA. The reason for this is because as dietary supplements, there isn’t a requirement of the FDA’s approval processes for safety or effectiveness. This is quite unfortunate, and just goes to show that you really don’t know what could possibly be in these supplements. So for these particular products the FDA found that, “In all cases, the reactions included significant hair loss, muscle cramps, diarrhea, joint pain and fatigue.” Yikes.

The FDA itself didn’t recall the product — after they issued their warning, the manufacturer voluntarily recalled the toxic products to avoid lawsuits and more bad press.

Tags: fda, hairloss, hair loss, toxic, warning, total body, total body mega, supplement

Propecia and Testicle Pain

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

First of all, I am a big fan of the site. As such, I know your first response will be to “see my doctor,” which I may do soon, but I wished to hear your input as well. I’m a 22 year old male with a small/moderate amount of hair loss. I started taking propecia 5 months ago. I’m not sure if I have had any hair regrowth, but I certainly have not had any more hair loss (which is fine by my standards). However, as many others, I have noticed the sexual problems, mostly that my erections are sometimes soft and not as large as normal. Also, I seem to have acquired an on/off again dull pain near my left testicle.

I’m not sure if the testicular pain is related to propecia. As such, I am not sure whether to see a urologist or the dermatologist first. Also, in regards to sexual problem, I have thought about taking half the dosage (.5) myself and observing whether these things go away before consulting a doctor (my budget is small as it is). Thank you for any input.

I’m concerned that you’re talking about taking a prescription drug (or altering the dosage) without consulting a prescribing physician.

I’ve written about groin pain and Propecia (finasteride) before —

You are your own man, and if you already have Propecia and decided to half the dosage, that is ultimately up to you. Legally, as I am not your doctor, I can’t give you suggestions like what you’re asking about. However (you knew this was coming), you really should meet with your doctor sooner rather than later. A urologist is a better choice when it comes to the diagnosis for testicular pain.

Tags: pain, testicular, testicle, hairloss, hair loss, propecia, finasteride

Can’t Take Finasteride, But Is a Hair Transplant Still an Option?

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

Dr Rassman,
If one has been evaluated by a urologist and undergone a variety of tests for problems and finasteride has been single out as the cause. Can one still undergo restoration work? Or should one simply forget it?

You are asking for a medical opinion without my ability to find out details about you, something that I do when I perform a consultation. Things like family history, age, miniaturization (where it is and how advanced it is) will tell me much. One can have a hair transplant without taking Propecia. I do this in older men and in men who I can predict what will happen to them over time. Everyone is different. My job is to protect you from over-enthusiasm, bring you down to reality, and then try to accomplish your goals (which may or may not be a hair transplant).

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

Hair Scarring from Bleaching?

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

Hi doctor,

I have heard that hair follicles get scarred if you have had extensive bleaching done for coloring. Could you please explain what exactly happens because I am confused. Does the hair just fall off, or the entire mechanism shuts down ie, the dermal papilla cells get destroyed and the pores close?

Also, say one had his hair (black) bleached three times so that he could have it toned white (I did it 5 years ago, don’t ask why, it was college). Would you notice hair scarring within the year or is it possible that hair will gradually fall off because of it even five years later.

Thank you in advance for your help in the matter.

BleachBleaching can become permanent if it went down to the bulb of the hair follicles and impacted the granules of melanin that produce color. Bleaches can also damage the production mechanism of the hair-producing part of the hair follicle. That is why bleaching should be done by professionals who know how far to push it without going overboard. I would expect that the damage would occur quickly and not be delayed. See a good dermatologist and get your hair examined.

Tags: scarring, bleaching, bleach, coloring, dye, hairloss, hair loss

I Am Bald at 78 Years Old — Is There a Solution for Me?

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

I am a male and started to loose my hair when I was 18 yrs old and now I am 78 yrs old and have male pattern horseshoe shape baldness. I hate being bald. is there any solution for me? thank you

It’s never too late! I have performed hair transplants for men in their 70’s and 80’s. Here are two patients off the top of my head that have had surgery in their 70s:

Tags: senior, older, balding, hairloss, hair loss, hairtransplant, hair transplant

Phera-Plex and Hair Loss

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

I took an anabolic steroid called Pheraplex(progestin), and believe my hair has thinned a bit. My scalp is feeling inflamed today (2 months down) so I’m curious what I can do now?

Steroids can accelerate hair loss, so if this is an anabolic steroid…

You need to see an expert. You should get your hair mapped out for miniaturization to see where and to what degree your hair loss is occurring.

Tags: anabolic, steroid, pheraplex, phera-plex, hairloss, hair loss

I See Some Almost Invisible Hairs at My Hairline

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

Hi doc,i just have a question,I am almost 21 and I think I have a mature hairline,my hairline started to change when I was 19 years old.I have a widows peak and in the widows peak I noticed that there are like some vellus hairs that are almost invisible between the terminal hairs,the rest of my hair is thick and healthy but the thing that worries me is that they can be miniaturized hairs.You said that it is normal some miniaturization at the beginning of the hairline.

Yes, vellus hairs are normal. You will have them everywhere on your body. Some miniaturization is normal at the very front at the beginning of the hairline.

Tags: vellus, hairloss, hair loss, hairline

Dr Rassman, Your Reply About Femara and Hair Loss Was Dismissive!

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

Dr. Rassman, with all due respect I found your response to the poor woman who asked for help re Femara and Hair loss, to be incredibly insensitive and dismissive. Didn’ t you read her history? Obviously her priority has been and continues to be, cancer, but doesn’t she deserve to look and feel good about herself, with a FULL head of hair?! Because to date, Femara has been so effective in preventing breast cancer recurrence, I am sure you’ll be receiving more requests for help to reverse or ease, the hair loss side effect. I suggest you do some research yourself and try to help us, rather than lecture us on priorities and then pass the buck back to oncologists. Believe me, as a 54-year old woman who has also gone through surgery, chemotherapy, radiation, Tamoxifen and now Femara (9 months) all with a great deal of hope and grace, what an insult it is, to be losing my hair AGAIN, along with a host of other debilitating side effects, that are destroying my quality of life. Good information from you or your colleagues, would be most welcome.

You’re referring to my post from a couple months ago, Femara and Female Hair Loss.

I do not treat cancer and certainly do not have direct knowledge of the various chemotherapeutic drugs that are used. Hair loss is usually a secondary consideration when treating a cancer. Of course, most doctors would love to find an equally effective anti-cancer drug that has no hair loss as a side effect, but that does not seem to happen very often.

Quality of life is often balanced in the treatment of cancer with the effectiveness of the drugs used to control recurrence. Doctors are very focused on the cancer and feel that side effects like hair loss are less important in the “war against cancer recurrence”. I do understand where you are coming from and my heart does go out to you. I recently reviewed a drug that was designed to treat hair loss associated with cancer chemotherapy, but I signed a non-disclosure agreement, which means I can’t speak about it because the company was concerned that:

  1. The drug was not FDA approved yet
  2. The effectiveness was yet to be proved scientifically (they started down that path)
  3. Any release of information could risk their FDA approval status

I liked what I saw and knew well how this type of drug would impact people like the woman on the referenced blog post. I would welcome the chance to become a source of good, reliable information if I had it. Unfortunately, although I care a great deal about this problem, my practice is not focused on the treatment of hair loss from cancer chemotherapy. I’m sorry if you feel that my answer was insensitive, but I did not intend it to be as such.

Tags: cancer, chemotherapy, chemo, hairloss, hair loss, female, women, woman, femara

I Want Great Density Up Top and In Front — Not Too Concerned About How the Back Looks

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

I have a hypothetical question:

I know, that in general you don’t transplant more than a certain ratio of hairs available in the donor area to the transplanted area. What i was wondering is if i wear my hair in a certain style (in this case a bald fade) it would’t be as important for me to have thicker hair in the back, but of course, i would want good density on the top and front. under these circumstances, would you transfer more than usual to the top and front?

I generally develop a Master Plan with each patient, unique to that patient. What I feel my job is, is to do what is in your best interests and that includes combining what you want and what I feel is ethical. Many patients have different priorities, so my job would be to come to some conclusion about your hair supply and then lay out a plan that is worst and best case possibilities to address your desires at this time.

Since your question is hypothetical, I will say that hypothetically what you’re asking for is possible under the right conditions. Also, if you were to want to do a fade hairstyle in the back (donor area), a linear scar could be visible with a strip procedure, but you’ll probably be alright with follicular unit extraction (FUE).

Tags: hairtransplant, hair transplant, fue, strip, hairloss, hair loss

Seborrheic Dermatitis or Psoriasis?

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

Hello Dr,

I am a 29 year old male who developed scalp flaking problem last year. My doc diagnosed it as seborrheic dematitis but didn’t rule out psoriasis also. At that point there were no symptoms on my joints.

For the last 1.5 months I’ve again developed the flaking problem. I went to the local physician and he gave me Fluocinolone acetonide to apply locally. It aggravated my condition (lots of itching and more flaking). I discontinued the medicine but around 2 days back I noticed red spots (small swellings) on my left elbow and knee. Is this a sign of psoriasis? Do the shampoos that work for seborrheic dermatitis also work for psoriasis? Any other treatment or self care that I should be doing?

I am going to visit a dermatologist soon. The current situation is causing a lot of mental anxiety within me.

Thanks a lot

I really couldn’t tell you what you have without an examination, but psoriasis may start off with red areas on the skin leading to flaking and eruptions. These red areas, when they impact the scalp that is covered by hair, may not show up well. There is a fine line in the diagnosis between seborrhea (also known as dandruff) and psoriasis at times. I realize you are looking for help and anxious about your problems, but you are doing the right thing by making an appointment with a dermatologist.

Tags: psoriasis, seborrheic, dermatitis, dandruff, hairloss, hair loss

Weaves Pulled Out My Hair — Can I Use Steroid Cream to Regrow It?

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

Can you use Steroid Based Ointments to help grow the sides and back part of your head that has thinned from Weaving? I pulled out a lot of my hair over years of weaving and left my weave in for over three months most times. My hair is originally thick, tough, bulky and curly and I think I used weaves because of anxiety and low self esteem, kind of like self harm as I abused my hair with weaves for years. Anyway, I didnt realise the weaves were slowly pulling out my hair and the last weave was so tight I lost bulk from the middle and the front was so thin you could see my scalp after it came out.

Ive now stopped that. My immediate family including both pairs of grand parents have absolutely no balding or hair loss problems. My twin sister also has thick curly hair. I am now 32. Will my hair grow back to its natural state and remain like that and can I use anything to help?

Thanks

No, no, no steroids! They are generally bad for your hair. Steroid-based ointments, creams, lotions, or potions will not regrow the hair you lost.

Hair loss from years of using tight weaves is usually permanent. The constant pulling from the weave in your hair likely caused traction alopecia. You should see a hair transplant surgeon to find out if you can be helped. For more on traction alopecia, please see eMedicine.

Tags: hairloss, hair loss, steroids, weave, wig, traction alopecia, traction, female, women, woman

Propecia Shedding Started Within a Month

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

I began taking Propecia, 1 mg QD a little over a month ago. Right after one month of treatment, I noticed more hair in the shower than usual and also what seems to be more thinning than ever in the frontal area. I’ve read about a shed that can happen when taking Propecia, and I understand that it’s rare and usually a good sign. However, from what I’ve read I understand that a propecia-shed (telogen effluvium?) would happen more into at around the three-month point in the treatment. Is it possible I’m having one of these rare but ‘harmless’ effluvia after only one month? I understand you would more medical info from me to be certain, but if I’m experiencing this too early in the treatment, what steps should I take from here?

After just one month of taking Propecia (finasteride 1mg), you will know very little about its process in your body. You must wait a reasonable time period (3-6 months) to ascertain what is going to happen to this ‘shed’. Chances are you will be better and what you are seeing is the acceleration of some cycling in your hair cycles.

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

Ringworm on My Stomach — If It Spreads to My Scalp Will I Lose Hair?

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

I have ringworm on my stomach. I am kinda freaking out about it! Every little itch I have, I think it’s going to be a new spot of ringworm. I have a really dry scalp as it is, but my main question is, if the ringworm has spread to my head, will my hair fall out? Does this happen in every single case of ringworm on the scalp, or can it possibly not cause hair-loss and continue to grow?

If you have ringworm on your abdomen, it can be treated and it will not necessarily spread anywhere if it is under good treatment. Ringworm is not really a worm, but a fungus. See a doctor about this soon so you can stop freaking out!

Tags: stomach, abdomen, ringworm, fungus, hairloss, hair loss

Worried Sick About Propecia Side Effect Stories!

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

Dr. Rassman,

I’ll try to keep this as short as possible.

I started Propecia in Summer 2007 as it was prescribed to me after a dermatologist visit in which the doctor diagnosed me with MPB. I took the 1MG 1x daily up until December 2007. I discontinued the drug because of the cost as well as a couple of close friends’ stories of libido loss and worries about impotence.

As I’ve now learned is common upon stopping the pill, I began losing my hair again and it has now become visible and very depressing. I want to get back on Propecia to help curb the hair loss as well as try any other supplements that may help the battle. However, I’m worried sick about some of the stories I have heard/read about concerning long-term use of Propecia and sexual/Prostate problems that are irreversible. How do you feel about these stories? There are multiple websites dedicated to getting the word out about permanent semen reduction, watery semen, ED, depression, etc. Is there evidence to back these stories up that you know of besides the hearsay? What is your professional opinion on these stories and the fact that the drug has only been out 10 years so no long term studies have been conducted?

Also, if I do begin the Propecia again, is Nizoral a good supplement to combine into a regimen? I have heard good things about Zinc supplements as well. Any recommendations?

Thanks so much for your time and help,
It is much appreciated

6 FingersNizoral is a good shampoo, but it won’t do anything to regrow your hair. I’ve addressed the side effects questions many, many times before on the blog — the most vocal are the ones with complaints. There are hundreds of thousands of men that use the drug that don’t spend all day on forums discussing it in a positive or negative way. Also, the complaints are unsubstantiated — I could say that Propecia grew a 6th finger on my left hand and made my skin turn silver, and how are you going to disprove that? The FDA published that the side effects occur in less than 2% of men.

You already have experience with the drug and if you did not develop side effects in the 5+ months you took it, it is doubtful that you see them when/if you restart Propecia. We are in total control of our decisions, but unwise choices may lead you further down the course of more and more hair loss.

(Note: The above image is Photoshopped, and it was not caused by Propecia. I hoped I wouldn’t have to point that out, but I don’t want any emails about it.)

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

I Think My Donor Scar Is too High and Will Show Soon

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

I’m concerned that one of my donor scars is too high and that eventually it would show as well as the grafts taken from the area will die. I’ve had three procedures. The first was in 1997. I had 800 micro/mini grafts. Then in 1998, I had another 1000. This time the doctor seemed to place the incision in the donor area high. My third procedure was in 2007. I had 2000 FU’s placed. I think I’m a class 5 or 6 (not completely sure). During my last consultation before my procedure, the doctor told me that the scar from the previous procedure looked high.

It is 2″ above the bump at the base of my skull – about the height of my eyes and the top of my ears. I’m not sure if it was higher before my last procedure. Is it possible that it now appears a little lower given that 2000 FU’s were taken below it? Does this sound too high? Would hair mapping help me to know with greater certainty? If so, where can I go to have my hair mapped?

I appreciate your time in reading and responding to my question. I’ve read several of your blog comments, etc. and I’m considering using your services in the future.

Thanks again

Perhaps your donor scar is higher than normal, but this can be a normal thing as the doctor will make subtle judgment calls during the procedure. It may bother you cosmetically, but there is not much you can do other than to grow your hair long enough to cover the scar. From a long term point of view, if the donor hair was taken too high, it may not be in the area of permanent hair, in which case you risk losing the hair that was transplanted from that area.

You should start off with a good examination and consultation for a second opinion. That will address your concerns above. You must have a worst case scenario managed with a Master Plan for future hair loss, as you are suggesting in your questions. I don’t have a list of every doctor that will map your scalp, but you can find a transplant doctor in your area by using the physician search at ISHRS.org.

Tags: hairtransplant, hair transplant, scar, donor, hairloss, hair loss