Can Hair Transplants Just Take Longer to Grow For Some People?

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

I had a hair transplant of 1200 grafts about 6 to 7 months ago and I am not really noticing any hair growing in yet other than what i already have is this normal? and does it take longer to grow in for some people than others? I am currently taking Propecia with Minoxidil and the EXT Extreme Hair Therapy From Hair Club.

A hair transplant can take as long as a year to completely grow. It is not unusual to observe growth at 6-8 months. I usually tell patients that by the 8th month, 80-90% of the new hair is usually 1+ inch in length and you should see the value by that time. In 1 out of about 20 patients, the hair grows immediately without going through the sleep phase that delays the growth normally. Different parts of the scalp may produce hair at different growth rates initially (e.g the crown may grow faster than the front or visa versa). If you have specific issues or concerns regarding your particular transplant, I would follow up with your doctor who performed your surgery.

Tags: hairtransplant, hair transplant, hair loss, hairloss

In the News – Vitamins and Nutrigenomics

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

While it isn’t hair loss news, I just came across this very interesting bit of news which links our genes to our vitamin needs. We are not all the same, so our needs are different. This is a wonderful insight into where we are going with GOOD scientific research that will eventually prolong our lives.

Snippet from the article:

Newly discovered genetic variations can impair an enzyme whose malfunction has been linked to birth defects and heart disease–but added nutrients can reverse the effect, according to new research. The findings could signify a step forward for nutrigenomics, a growing field examining how our diet and genes interact to affect our health.

Read the full article at TechnologyReview.com

Tags: genetics, genes, nutrigenomics, health, vitamins

Nizoral (Ketoconazole) and Minoxidil

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

Hi Dr Rassman,

If one was to take the information on this article below which you have probably read and any of the other articles online in reference to ketoconazole and hairloss would you consider the following? Nizoral (PDF file)

Compounding minoxidil and ketoconazole? I have seen solutions being compounded of 5-6% minoxidil and 0.3% ketoconazole. Or using a product like extina?

Keep up the good work

I read the article with interest, but I don’t really have any comments on it. The study mentions, “The clinical significance of the results awaits further controlled study in a larger group of subjects.” — and I agree with that comment. If someone will produce good data that shows us that when put together in the concentrations proposed is safe and effective, I would vote for it.

Tags: ketoconazole, nizoral, minoxidil, rogaine, hairloss, hair loss

Taking Propecia At Different Times Each Day

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

If I take Propecia on a Monday i.e. at 9 PM, and then take it on Tuesday at 11 AM, then I’ve taken Propecia both days. Is this an ideal scenario for getting the best results from the drug,
or should the times I take Propecia each day be separated by about 24 hours?

There is no point to do this. It probably does not make a difference. The drug has a half life of 5 hours or so, which means that in 24 hours, it is out of the blood stream. I usually tell people to take it in the morning when testosterone levels in men are the highest, but that is an intellectual analysis, not based upon any comparative study that I know of.

Tags: propecia, finasteride, hairloss, hair loss

Working Out Accelerates MPB?

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

I’ve read on this blog mixed answers as to whether working out with weights (which increases testosterone leves apparently) can accelerate MPB. I thought in one blog answer you said working out does not contrbute to MPB but in another you said the presence of increased testosterone may be a risk factor for faster MPB development. What’s the story here?

Exercise (working out) does not accelerate male pattern baldness. Genetics cause male pattern baldness. I am sorry for any confusion.

Tags: exercise, workout, working out, mpb, hairloss, hair loss

Hair Transplant and Cigarettes

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


On June 2nd i had my procedure done, a total of 3000 grafts divided between the frontal area and back. My question is after day 14 i started to use minoxidil, and every time i use it and rub it into the scalp a large amount of hair falls out into my hand as i am rubbing it in. Is this normal? Can the minoxidil be doing more harm than good?

The other question i have is the fact that i am a smoker has me worried sick that the grafts will not grow because of this. My doctor never asked me if i was a smoker, or warned me not to smoke because it may harm grafts. However after doing some research it seems like i should have stopped prior to surgery and at least 10 days after, is this true? I am now 3 weeks post op and trying to quit, i definatly have cut down, is it to late?

CigaretteIf rubbing minoxidil on your transplants causes hair to fall out, stop the rubbing process. Although it is usually safe to use minoxidil two weeks after a hair transplant, in your case it may not be good. Minoxidil is a known irritant in some people.

With regard to smoking and transplants, it is thought that there is a connection between hair growth from transplants being less for smokers than for non-smokers. The scientific evidence on this is not substantially strong, however. I do have patients that refused to cease their nicotine habit before or after their procedures and the results still turned out great. I’m certainly not suggesting you continue on with smoking as normal though (not to be preachy, but quitting should be something to consider with or without a hair transplant).

Tags: smoking, cigarette, nicotine, tobacco, hairtransplant, hair transplant, minoxidil, surgery, hairloss, hair loss

Doctor Won’t Prescribe 18 Year Old Propecia

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

I recently turned eighteen years old and have noticed a recession of my hairline in the corner’s of my hairline. My grandfather’s father and father both have hair loss and my mother’s father as well, though not as significant.

I recently went to see a doctor(after a long wait, grr) and he wouldn’t give me a prescription for Propecia because of the effects on hormone’s for someone my age. But as I recall, reading through this site, Propecia ought to be most effective for someone my age.

He referred me to a dermatologist, whom is booking for November(my god, about 5-6 months…).

My question is ‘What are the effects on the hormone’s on someone my age taking Propecia and is it worth the successful hair regrowth which should come from someone my age?’

Thank you.

It is not unreasonable for an 18 year old with proven genetic hair loss to take Propecia (finasteride 1mg). You’re likely past the age of puberty, so I don’t understand what problems your doctor has with the medication. Propecia does work best when the genetic hair loss is caught early.

To prove that you have genetic hair loss (and not just a maturing hairline), then you should get your hair mapped out to see if there is any substantial miniaturization behind the mature hairline, and if so, then this drug will be effective and generally indicated. Your doctor will make the final determination on prescribing you this medication, however. Also, you might consider asking your doctor to refer you to a different dermatologist — one that doesn’t have you waiting half a year to see him.

Tags: finasteride, propecia, hairloss, hair loss, teen, age, hormones, puberty

My Family Tree Shows No Signs of Hair Loss Anywhere, But My Hairline Changed At 20 Years Old

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

Hey doctor, thanks for keeping this blog.

I was just curious about genetics and hair loss… I’ve read multiple blog posts, but still confused.

About seven months ago I realized that my hairline had changed some. Since then, it hasn’t changed at all. Looking at a picture when I just turned 18 (I’m a 20 y/o male), my hairline looks similar in the front but not quite as high on the sides (I also have a naturally large forehead). However, as I said, for at least seven months my hairline has not changed at all.

My question for you is this: My father, mother, grandparents, great grandparents, uncles, cousins… all have full heads of hair. I’ve even asked my parents about their great grandparents, their cousins and uncles and aunts, and they all had full heads of hair as well. So, basically, in my entire family tree–both vertically across 4+ generations and laterally along each generation–there was no hair loss. I still have very thick hair on both the hairline and all around the scalp…people just tell me that I’m paranoid. Can I safely presume that my hairline is just maturing with my large forehead, and that I am not genetically predisposed? (Many in my mother’s family have large foreheads).

Thanks for your continued assistance.

I haven’t seen what you’re talking about, so I couldn’t tell you whether anything is safe to assume about your hair loss (or lack thereof). As you are in Beverly Hills, you could come by my office (no charge) and let me determine if you are really balding or just developing a mature male hairline. I will also perform a miniaturization mapping of your scalp hair to determine any possibility of early balding behind that frontal hairline.

Even if you were across the country… or across the planet, I would still suggest that you get such an opinion. If not from me, then from any competent doctor that is willing to examine your scalp.

Tags: hairloss, hair loss, family, genetic, hairline

Tambocor (Flecainide) and Hair Loss?

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

Dr. Rassman,
I have been using Proscar (cut in pieces) for years with good results. I am 55, by the way. I felt that it had totally halted my hairloss. In fact, the last couple of years, my hair’s texture seemed so much better. However, I feel that my hairloss has now returned. I feel that it may be because I am taking the drug flecainide for heart arrythmia. I have taken this drug for a couple of years because of occasional bouts of atrial fibrillation. Now, my doctor wants me taking it daily because I have had recent episodes of A-fib.

My question is how often is this drug indicated for hair loss? I don’t know if it’s this drug or perhaps Proscar is not working any more, but it seems coincidental that as I’ve started taking this drug daily that I feel my hair is falling out. Thanks for your time.

flecainideThis drug flecainide (marketed as Tambocor) has hair loss as a side effect (see Patient UK). Speak with your heart doctor about this and maybe there is something else he could prescribe. At your age, hair loss with finasteride is generally stable so you are correct to suspect the flecainide drug’s side effect.

Tags: flecainide, tambocor, hairloss, hair loss

Rogaine and Pregnancy

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

Me & my husband have been using Rogaine 2% & 5% for about 5 yrs now, my question is when do I need to stop the Rogain before I get pregnant? How about my husband?

Your husband does not have to stop taking Rogaine (minoxidil), as there should be no impact on the pregnancy. As for you, that is a conversation you should have with your obstetrician. I generally do not like any pregnant woman to take any drug, but this is a decision between you and your doctor. See DrugSafetySite.com for more.

Tags: minoxidil, rogaine, regaine, pregnancy, pregnant, hairloss, hair loss

Minoxidil, Vitamins, and Shampoo for $3000?!

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

I purchased a package where it contains solutions such as minoxidil 5%, shampoos, scalp cleanser, conditioner and vitamins. Along with that comes a once a month hair spa as well. Total of $3000.00. I have canceled and requested a full refund because i believe i can purchase these solutions elsewhere. I can do all this at home, with out that hair spa which i dont think is a big deal for A LOT less. Your opinion, did i do the right thing? The main thing here is the minoxidil 5%. The others are vitamins/herbs,etc where i still can purchase elsewhere such as rite aid, etc. Am i correct????

It sounds like you made a good decision. I am careful about my pennies as well. The minoxidil is FDA approved to treat hair loss, and is proven to work in some men. Although I don’t know which vitamins and scalp cleansers were included in your $3000 package, I know that none of them will regrow your hair like minoxidil or finasteride.

Tags: minoxidil, vitamin, shampoo, cleanswer, conditioner, hairloss, hair loss

I’m Using Androgel for My Low Testosterone Levels — Will This Increase My DHT?

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

Dr. Rassman,
My family doctor did a blood test and it revealed I had low Testosterone Levels. He prescribed Androgel and I apply this daily. My question is will this increase my DHT/hairloss? Thank you.

Possibly yes, and I suspect that it should not make a difference with regard to hair loss if you are taking finasteride (Propecia), because of the competitive inhibition that occurs at the site where the enzyme is made that converts testosterone to dihydrotestosterone (DHT).

Tags: testosterone, dihydrotestosterone, dht, androgel, hairloss, hai rloss, finasteride, propecia

Can Finasteride Cause a Woman to Grow Facial Hair?

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

(female)
I was prescribed 5mg of Finasteride per day for hair loss. I was told that it could cause hair to grow on my face, ears, and body. Is there any data on this side effect? I am concerned about this, and no one seems to be able to give me an answer.

PropeciaThere’s a few key bullet points I need to make here:

  • I do not believe there is much data for women taking finasteride to show that it is effective in treating hair loss.
  • Finasteride is not FDA approved for women, as it can cause unknown side effects (this includes birth defects if a woman takes it during pregnancy).
  • The normal dose of finasteride is 1mg for the treatment of androgenic alopecia (male pattern balding). 5mg of finasteride is used to treat prostate issues.

I would seriously discuss your concerns with your doctor or obtain a second opinion. If you were told by the doctor that prescribed you this drug that it can grow facial hair, ear hair, or body hair, etc.. why (as a woman) do you want to take this risk as a side effect? I’ve not heard of facial hair growth for women taking finasteride (again, there is not a lot of data for women on this drug), but I do know that minoxidil (Rogaine) can cause facial hair as a side effect.

With all that being said, for women who are not going to get pregnant or can’t get pregnant and who have too much androgens in their body (like those with polycystic ovary syndrome), Propecia may help. For more info, see WomensHealth.com – PCOS.

Tags: female, women, woman, hairloss, hair loss, finasteride, propecia, proscar, pcos

Early Stage Hair Loss (with Photo)

/by William Rassman, M.D./6 /,

I thought I’d send you the picture of my current hair situation for use on your Blog because it’s hard to find pictures of men who are truly in the early stages of balding. And not just a maturing hairline or are in the more advanced stages. It’s also hard to find any good pictures on the internet because of camera quality, lighting and such.

This is a picture of me three and a half months ago when I went to Dr. Bernstein for a consult. He put me on Proscar and said to comeback in a year.

So far, I’m starting to see small hairs growing out above my temples in the 1/2″ area of my hair above my temples that I lost about two and a half years or so ago when I was 22. This loss caused a more pronounced widows peak and moved me from a NW2 to a NW3. You can also clearly see the thinning in the anterior mid-scalp. I’m not sure when this started because I used to use gel and leave my hair wet which made the loss undectable. But you can better explain what is going on in this picture, so I’ll let you do it. Do you normally see a good response from Proscar with this type of thinning? Thanks for all the great help this Blog offers!

 

Thank you for allowing me to publish your photo. Click it to enlarge.

It is difficult to assess your hair loss from the photo you provided, but if Dr Robert Bernstein found miniaturization during an in-person exam, then it is there. Since your hair loss is quite early, finasteride should do wonders for you. I should note, however, that if you were prescribed Proscar (finasteride 5mg), you are only to take 1/4 tablet a day to treat your hair loss. After a year on finasteride, another miniaturization exam will show whether the medication was beneficial for you in halting your hair loss. I suspect that it will be.

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

Recurring Seborrheic Dermatitis

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

Dr Rassman,

I often hear that Seborrheic Dermatitis does NOT cause permanent hair loss, and that any loss is temporary and usually regrows. However, I have been suffering from persistent recurrent SD now for 8 years, and a thick head of naturally curly hair has all but vanished. Indeed I now suffer from very diffuse hair loss.

My Doctor prescribes me Cocois Ointment but I find that when you rub it on the area of SD, then wash it off, that the hair previously present in that area becomes noticeably thinner. This has been the pattern for 8 years. repeating over and over like a vicious cycle until hair loss is severe.

You are providing a fantastic service via your site across the world, and I would be extremely grateful for your views and advice. Thank You.

Seborrheic dermatitis (SD) does not cause hair loss unless you scratch it. Sometimes the treatment may impact the hair. Cocois Coconut Oil Compound contains contains coal tar, salicylic acid, and precipitated sulphur. These types of treatments are usually used for advanced SD and psoriasis, but they are not as effective as steroids when they are judiciously applied under the care of a physician. You did report loss of hair or thinning of the hair from Cocois ointment, so maybe it’s time to review this treatment with your doctor.

Tags: seborrheic, dermatisit, cocois, coconut oil, hairloss, hair loss