Putting Retin-A on My Scalp Is Causing Hair Loss

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

Hi,
I am using retin A for acne and because my skin is very oily it gives a very good effect. So i decided to use it on my scalp because i also have a problem of very oily hair. So it give me good effect on my oily hair. they are producing less oil now but after four or five days i noticed my hairs are falling a lot. So i dont know if i should carry on retin A or stop it but i really want to get rid of oily hair.

Well, the answer should be obvious. You put retin-A on your scalp and started seeing hair loss… so stop taking it. Retin-A is an acid and is probably burning your scalp. See a good doctor who cares about your problem, will take the time to examine you, and will render you an opinion on what is happening. I wish I could offer more, but the Internet it not the proper venue for this.

Tags: retin-a, hairloss, hair loss, tretinoin, acid, scalp

Can Propecia Regrow Hair Behind the Hairline?

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

I know Propecia won’t work to regrow a hairline but can it help regrow hair behind a hairline like 1cm behind it? Since my hairline is still intact but behind it is where the drama lies.

It can, but each person will react slightly different to medication, so regrowing hair there might be rare. It has a better chance of maintaining hair that is left, though regrowth isn’t completely out of the question. The younger you are and the shorter time since the hair is showing the impact of balding and thinning, the better the chance of reversal.

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

Severe Female Hair Loss Specialist in Los Angeles?

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

Please-I would like a recommendation for a dr. that can do a scalp biopsy and who also takes an interest in severe female hair loss? Thanks so much.

Dr. Richard Strick at UCLA specializes in this and would, of course, do a biopsy and read the pathology himself if he felt the indication to do so. His contact info can be found at the American Society for Dermatologic Surgery.

Tags: hair loss, hairloss, los angeles, ucla, richard strick, strick

If You Could Block 100% of DHT, Could You Never Have Hair Loss?

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

Dr. Rassman, if more Finasteride blocks more conversion of testosterone to DHT in the 5-alpha-reductase Type II, then why would it not be better for preventing more hairloss? I heard of people who up their dosage if it starts to lose effectiveness and it works for a period of time. Also, what would happen if 100% of DHT is blocked and you had no side effects, in theory could you never have hairloss? Lastly, why cannot Saw Palmetto be used in conjunction with Propecia to block more DHT?

Regards

To make DHT, your body must have the enzyme 5-alpha-reductase. We know this because some people are born with this enzyme missing and when that happens:

  1. They do not develop sexual differentiation and become hermaphrodites
  2. They do not become bald
  3. They do not develop prostate cancer

That suggests that DHT is the cause of hair loss when interacting with a person’s genetics. I can not be sure that DHT and 5-alpha-reductase type I or II are totally responsible for genetic male pattern balding, but it is highly suggestive. It may not be as simple as blocking one hormone, so we may not really be sure of the science.

Lastly, I do not believe there is good scientific evidence of saw palmetto blocking DHT the same way Propecia does. I reviewed this subject fairly completely and could find conflicting discussions from good scientific sources that show evidence that saw palmetto may work on blocking DHT… or it may not. Saw palmetto is a herbal medicine that has been traditionally used for prostate (not balding) problems in men, so studies on balding are not very complete or scientifically studied with good double blind clinical research projects. Finasteride is a medication that has been used in high doses (5mg) to treat prostate enlargement in men with a unexpected side effect of growing scalp hair in balding men. The value of both Propecia and saw palmetto will probably give more side effects, particularly the negative impact on libido.

Tags: propecia, finasteride, dht, saw palmetto, herbal, hairloss, hair loss, libido

Hair Loss from Thyroid… and Inaccurate Lab Work?

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

(female)
This is not so much a question but another thing to think about. I have suffered with hair loss for about the last 6years. I also suffer with itchy scalp and was told that it must be ezama. I have lost so much hair that you could see my scalp. I now am suffering with mood swings, fatige, night sweats and several other symptoms. I have been taking vitamins, iron, rogain 5% drinking pom & mangosteen juice along with expensive hair products,shampoo and so forth, for the last 4 to 5 years. Yet I still have hairloss.

I say all this to give hopefully some hope. After MUCH research I found that your thyroid (overactive & underactive) can cause hairloss alot of the time, also because of my age 49 hormones can also cause hairloss. Now for some that don’t know this, in 2003 the thyroid range has changed from 0.5 – 5.0, to 0.3 – 3.0, my range in 2006 was 2.80. I was told that my thyroid was perfect, but what I found out is on my lab work, the lrange was 0.5 – 5.0. I now believe that my range is high based on the new range. I am going to have my thyroid & hormone checked by a specialist. most lab work does not give very accurate results, that why we are told our blood test are normal. I found out that about 89 to 95 percent of people (both men & women)suffer with an imbalance thyroid, and don’t even know it. Something to think about.

I’m not sure where you are getting your facts, but to say that most lab work is inaccurate sounds… well, inaccurate. Different laboratories have different ranges of values they work with so your levels may have been fine. In other words, you cannot compare your lab results from one laboratory with the standards of another laboratory.

I do not know why you are losing hair. There is probably many factors affecting including thyroid or genetic or hormones, etc. I would follow up with a doctor and discuss your concerns and issues with him/her. Fatigue and night sweats are non-specific signs for possible serious illness.

Tags: thyroid, lab, hairloss, hair loss, female, women, woman

In the News – Men Would Rather Remove Spider Veins Than Have Hair Transplants?

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

Snippet from the article:

Sclerotherapy has seen a 226.3% increase in males over the past five years. A drastic comparison to the 3.5% increase in females since 2002.

On the opposite end, males have strayed away from hair transplants. Cost is likely to be a cause of this decline. Over five years, the price of hair transplants increased by $1,296, while sclerotherapy decreased by $103.

Read the full article at ScienceDaily

I realize this article is a few months old, but somehow I missed it. It is, however, still interesting and worth posting about. My commentary on the article is that it is probable that the increased cost reflects the higher number of grafts being performed by today’s modern hair transplant surgeon. From what I hear amongst the transplant community, the doctors have been following the “more grafts is better” trend and is more profitable as well. More grafts means more hair in less surgeries, which drives the fees up. A fuller head of transplanted hair may not be better for the hair transplant surgeon’s wallet though, as the higher fees may drive patients away.

Tags: hair transplant, hairtransplant, surgery, news, hairloss, hair loss

If Propecia Shedding Occurs, How Noticeable Is It?

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

I been reading about the shedding that may happen with Propecia in the beginning of treatment in the blogs and on the Propecia site. If it’s gonna happen, will the shedding be noticeable or I’ll just lose a little more hair a day then I should? Also is it a rare or common thing to shed with Propecia? Right now my thinning ain’t visible to people but I know it’s there I would really be upset if Propecia will make my hair thinner in the beginning.

In the many years in practice and being one of the largest Propecia prescribers (according to Merck) in California, I do not remember one case of shedding reported by my patients. I do believe it does happen because of the large number of people who report it to me on this blog, but I suspect it is far less common than the reports you can find on the Internet seems to suggest it is. As I have not seen it in my patients, I really do not know the answer to your question, but I suspect it may vary all over the place from minimal to substantial.

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

Does Dr Rassman Have MPB?

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

Dr. Rassman

If you were to judge from your own picture (the one shown on the website), would you say you have genetic hairloss? If so, to what degree?

I had a bald crown measuring about 3 inches round. This is classified as a pure vertex balding pattern. I originally made a mistake and had scalp reductions in the early 90s, which left me scarred. Since that time, I have had hair transplants and the scars and balding spot is largely gone. My hairline is natural.

Tags: rassman, hairloss, hair loss, hairline, crown, scalp reduction

If There’s No Irritation After Coloring Hair, Can I Assume Dye Isn’t Accelerating Hair Loss?

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

Hi Doc

I dye my hair after a cut, about every 4 or 5 weeks. If there’s no scalp irritation is it safe to assume an accelerated hair loss isn’t from the dye? Can dye increase hair loss if there’s no scalp reaction that I’m aware of? I noticed the increase about the time I started the dye over a year ago. I started Propecia about 2 months ago.

Thanks

Safe dying should not produce or accelerate genetic hair loss. By safe, I mean that the bleach is not driven into the hair follicle below the skin to cause chemical injury.

Tags: hair dye, hair color, coloring, chemical damage, chemical, hairloss, hair loss

Lack of Leg Hair

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

(male)
Hey guys im hoping you can help me. I’m 18 i have a problem, now i dont know why i dont have hair on my legs, 1 could it be becuase i dont eat the right food, 2 i dont excersie enough or is it just that my DHT level is low, and why would it be low? i have bvery little hair, only around my ankles not alot but a little, over the month of June last week i was on Vacation, i noticd that i had a little more hair growing then it stopped am i imagining this or is there something wrong

This is a maturing process and body hair increases as one ages. At 18, you may be on the left of the bell curve, which means waiting it out. Leg hair increases in the 20s in most men.

Tags: hair, leg hair

Kevis Reps Told Me There was a 90%+ Success Rate, But I’m Still Losing Hair!

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

Hi Doc!

I have been losing my hair for about 4 years now. I have used a number of products already including Avacore, Rogaine and most recently Kevis. I have been using Kevis now for about 6 months with no results. I have been losing more hair then I have ever lost on the other products though the people at Kevis had told me that I would not lose any hair and that the success rate is over 90%. They also said that I will see results within 2-3 months and when I told them that I dont see anything they said that I will have to wait 6-9 months before seeing any results and that I will have to double the dose. I am now completely bald at the sides- in the front and the middle is thinning terribly. I really want to stop using Kevis but I’d like to know if there is anything you recommend doing as an alternative hair loss program.

Thank you so much for your help.

KevisWhat you are telling me is that you believed what you were told by salesmen who profited by giving you advice. Bad advice that ended up putting more money in their pockets. That is a shame. The ingredient in Kevis that the company promotes as HUCP is hyaluronan (hyaluronic acid), which is a supplement commonly used to treat joint pain — not hair loss. That is just one of a handful of ingredients listed, including water, alcohol, sorbic acid (a food preservative), and biotin (which is also known as vitamin B7). Although the product packaging and website certainly look slick, there is no science here. I can’t even find any before / after photos on their website, which should tell you something about the product right off the bat. All I see there are stock photos of happy people with full heads of hair.

Although I don’t know your age, I’m going to assume you are in your early to mid 20s. You should have seen a doctor and instead of wasting your money and the precious hair that you may have lost forever because of the delays, you should have been put on Propecia (finasteride 1mg). Propecia is the only oral FDA approved treatment for hair loss and it would’ve almost certainly halted the loss a 20 year old (again, just guessing on your age). It’s still not too late to do it right, so see a good doctor (dermatologist or hair transplant surgeon who is ethical) and get on the track to the correct treatment. The other treatments you mentioned (Avacor and Rogaine) are minoxidil, which apparently does not work on you.

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

Any Difference Between the Various Laser Combs Offered?

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

Hi,

For a while now Ive been looking into buying the Lasercomb and finally came to the decision of doing so. However, I am confused if not a little uneducated. There seems to be NUMEROUS versions of the lasercomb manufactured under many companies!!! Hairmax Lasercomb, Rezultz LaserComb (sold by Medical Hair Restoration), Bosley LaserComb and the list goes on …

Is there a significant difference between the different manufacturers???

Thank you!

I am not a fan of this technology, but the HairMax, Rezultz, and Bosley LaserComb models are all made by the same company — Lexington International. So it is one manufacturer and likely the only difference between each is the logo and the price the reseller charges (all well over the price they’re worth, in my opinion). Note the photos below (found on the sellers’ websites), and see how Bosley and HairMax are the exact same image with different logos on the unit, while at least MHR’s Rezultz marketing folks bothered to take their own photos from a different angle and lighting:

LaserCombs
Tags: hairmax, rezultz, bosley, lasercomb, laser comb, laser, lllt, lexington, hairloss, hair loss

Antibiotics, Soy, and DHT Levels

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

I’ve heard antibiotics can effect DHT levels i.e. get rid of any gut bacteria that has DHT under control, esp. in the case of soy/equol. Any truth to this?

See a previous blog post about Equol. I don’t have much to add to this reference. The DHT block is about 70% efficient with finasteride and 90% efficient with dutasteride. What the added value of soy is… well, I don’t know if it has any further value. Of course one wonders if there is an effect where it could work instead of the drug approach. My general comment is that someone who might try it with known genetic balding would run the risk of losing hair that could have been saved with a more conventional approach, so I would not recommend soy as a substitute.

Certainly any bacterial impact from antibiotics would be short term.

Tags: antibiotic, bacteria, dht, soy, equol, hairloss, hair loss

Minoxidil and Sexual Side Effects?

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

hello Dr…

I used Minoxidil for a while and stopped as i feel it created some problem in my erection.i need to know how long it will take for me to get rid of the side effects.

I could guess that maybe you have ED and that a small drop in your blood pressure, which is a side effect of minoxidil, is helping it along (meant to be negative). Honestly though, I couldn’t tell you based on the info you’ve supplied (none).

As I do not know your age and have not examined you, I generally think that some doctor might be able to help. If I knew more about you, maybe I could help. With that said, minoxidil is not known to produce erectile dysfunction (ED) or a libido drop like finasteride does. See a doctor for a complete examination.

Tags: minoxidil, libido, ed, hairloss, hair loss, sexual, rogaine

14 Year Old Losing Hair — Student Sitting Behind Him In Class Sees Hair on His Desk

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

(male)
hey. im only 14 but for about a month know i have been very worried about my hair. it started right about summer and my hair has been falling out rapidly. i have medium long hair and wash it daily. every time i step out of the shower and comb my hair the comb is completly filled with hair. at school the person behind me would complain about the hair on his desk.

this has never happend to me and im scared i might be going bald very early. please help

First, at 14 years old, you should have a parent or guardian involved in the process. See an expert on hair (a good dermatologist) and get that doctor to evaluate you for early genetic hair loss. Most people lose 100 hairs a day and when the hair is long and the summer is upon us, there may be shedding from the heat. Still, get a doctor to look at your scalp and hair to tell you one way or the other if you are balding at a young age. Get your hair mapped out for miniaturization, as that will tell you the status of genetic balding if you have it.

Tags: hair loss, hairloss, teen