I wanted to ask you a question regarding the DHT component of male pattern baldness. Four weeks ago I began using a shampoo and conditioning system which blocks the production of DHT and 5AR in the scalp. I have noticed a significant amount of hair growth from a point in the rear portion of my head leading to a point just over one third of the way towards the front of the scalp. the rest of my scalp has little hairs similar to a man’s shaving stubble except at a point in the middle of my forehead which has a long patch of hair which I can comb or brush down as bangs. My question is this: It’s already been four weeks with these results and how soon should I expect to see the full results?

I am using Nioxin System 3 Scalp Cleansing Shampoo and Conditioner along with a daily multivitamin supplement designed for healthy hair, healthy skin, and healthy nails. As I said, I’ve had some definite results thus far, and am wondering at which point I should expect to see the full results?

NioxinI was not aware that Nioxin System 3 Scalp Cleansing Shampoo contained a DHT blocker, so I looked to their website. The company states that it is a “vitamin-enriched, daily leave-in scalp treatment – delivering essential botanicals, nutrients, antioxidants and vitamins onto the scalp skin and hair to help safeguard against environmental residue and DHT buildup on the scalp.

I don’t know how to prove that it does what it claims, and the FDA isn’t required to clear these types of products before they make it to market. It certainly is not approved by the FDA for claims of hair growth or as a DHT blocker, and as a physician I will not endorse it for that purpose.

The sebum containing DHT and requiring some blocker type of topical shampoo to manage it makes no sense. The sebum is not the problem. I would not expect to see any significant benefit in days or in a month, because the hair that grows out only grows at 1/2 inch per month and therefore there is no time for benefits to show. I am not sure what you are seeing, but it is not the result of blocking DHT.

Tags: nioxin, shampoo, dht, hairloss, hair loss

Hi Doc,

You are an impressive personality, I have been reading and making my decisions about my hair loss through the research on your website.

My wife is pregnant and and I want to start taking propecia, I am thinking about start taking it after the baby is born which is due on mid Nov. But I would like to know if breast feeding and propecia can create complications to the baby or wife. I think I am a norwood class 4 and have almost good coverage, I am 25 year old male.

Your reply would be a great help.

Keep up the great work.

Nope. Unless you have found a way to create milk from your own breast and are breastfeeding your baby, there is no danger to your wife and your baby as Propecia does not come over to the woman from sexual intercourse. It is not known if Propecia can be found in the breast milk of mothers that are taking Propecia themselves, but Propecia is not approved for use in women anyway. It will not affect your wife or unborn child even if you are having intercourse with your wife while she is pregnant. The pharmaceutical company Merck’s statement on this is, “Available data indicate that the level of PROPECIA in the semen of a man taking PROPECIA does not pose a risk to an unborn child. Accordingly, a man can take PROPECIA while conceiving a child with his partner, or have sexual intercourse with his partner if she is already pregnant.

If you are still worried, use a condom.

Tags: breastfeeding, pregnant, breast milk, propecia, finasteride, hairloss, hair loss

(female) I have been using Ambien for about 4 years. I am losing my hair and get tingling feelings and sometimes my scalp feels sore in places. Can Ambien cause this, it seems to have gotten worse since June when I had an MRI done of my head to rule out MS. What can you tell me. Thanks

AmbienI’ve not read anything that says Ambien (zolpidem tartrate) can cause hair loss. There are a couple of unverified reports I found online, but nothing in the official literature.

I can not comment on your other symptoms. Sounds like you already have an expert working with you, but based on the information you stated, your doctor must think there is something going on (since you were screened for multiple sclerosis) and you need to have a down to earth discussion with your doctor on the differential diagnosis here.

Tags: ambien, ambien cr, zolpidem tartrate, hairloss, hair loss

Hi doctor and a big thanks to you and your team. Im very interested to know at least to tell me how many hair cycles there are. i read somewhere there are 14 in another place there are 25-30 and i like to know not the exact number but for something close. where is the truth because i have been doing a little experiment. i had a single hair divided from the others, i mean theres not another hairs around this one and it keeps falling and falling and it has surpassed the number 20 of cycle and it keeps showing after some months before being full mature it will fall off again and im so confused. pls help. i will be glad for ur response and thank before very very much

The answer is not so simple. If you average 4 years for a cycle and there are 30 cycles per human (as an example) that would mean that your hair will last 120 years. Unfortunately, our cycles get shorter as we get older. How much shorter depends upon your genetics, so you see, nothing I just said is solid enough to hang your hat on. We tend to preach that hair has a 3 year cycle, but how do we really know that? The answers are illusive. Sorry!

Tags: hair cycle, cycle, hairloss, hair loss, genetic

Recently my wife became pregnant. I currently take minoxidil and am wondering if I am putting her (and the baby) at risk by sharing the same bed, incidental contact, etc.

Thanks for your help.

Twin bedsYou can use minoxidil even if your wife is pregnant. So go ahead and push those beds together and be near your wife.

Your wife (or any woman) should not use minoxidil directly while pregnant, though. See Minoxidil and Pregnancy for more on that.

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

I have a severe scar beginning at my ( receding ) hairline. It is a prominent scar, probably 1 1/2″x 1/2 inch. Obviously no hair grows there and I cannot completely cover it. The injury that caused the scar also took a little “tissue,” meaning there is a slight indentation.

My question is this: Is there a procedure where someone could “reconstruct” the damage? Perhaps by taking a mold of the scar, a piece could be made and have hair implanted. And if so, could this “piece” be safely adhered to my head? I am open to suggestion as well. Thanks.

It would be best for me to see what you look like by sending photos of your hairline and the scar (reference this page). Scars at or just behind the hairline are relatively easy to fix with hair transplants. Sometimes the scar can be partly excised as well (though unusual), but without seeing it you have tied my hands. I have repaired many frontal hairline scars.

Tags: hairloss, hair loss, dent, scar

Hi Doctor,

Is there a relationship between Aminexil and ovarian cysts? I had an ovarian cystectomy last year and I started using aminexil recently which greatly improved my hair loss situation. However, lately, I’ve been feeling that the cyst may have returned.

I didn’t get it checked yet but I need to know whether to stop Aminexil or not.

I can’t blindly recommend taking or stopping a medication to someone other than my own patients. While many women with polycystic ovary syndrome (PCOS) use this drug, it is the condition that tends to produce ovarian cysts, not the aminexil. You’re already under the care of a doctor, so I’d ask him/her what you should do next.

Tags: aminexil, ovary, ovarian, cyst, pcos, hair loss, hairloss

Hello doc,

I found this text on a website recently “If you look at Japan, male pattern baldness was almost unheard of prior to World War II. The Japanese diet is now far more fatty and Westernized, and Japanese men are going bald everywhere. It’s clear that a high-fat, meat-based diet raises testosterone levels, and that may adversely affect hair follicles.”

– Do you have any information about this? Could this be true?

CheeseburgerWhile it is true to some degree that we are what we eat, hair loss comes about because of four components. Our food intake (if normal nutrients are ingested) is not one of those four. They are:

  1. Genetic elements for balding
  2. The male hormone in adequate quantities for healthy men
  3. The time the hormones and the genetic defect interact
  4. The amount of stress in the life of the person

I have a problem when someone is comparing early 20th century assessments of hair loss and modern 21st century assessments of hair loss. I also have a problem with the comment that ties healthy diets to hair loss in any way. The “authority” seems to originate from a talented man and nutritionist, Michael A. Klaper, M.D. He does not cite any evidence for his opinions and uses the term “may” when commenting on the connection between meat in the diet, testosterone, and hair loss. In my opinion, a statement like, “male pattern baldness was almost unheard of prior to World War II,” really can not be based upon any reasonable scientific observation and if I am wrong, I would want to see it. Who would be making such an assessment in a closed, almost feudal society like pre-war Japan? Balding is big business in modern Japan, which supports the largest hair wig manufacturer in the world. Many of the people of Japan still maintain the more traditional diets (they are not hamburger freaks) yet they lose hair. Studies have shown that there is little difference in balding statistics between races.

The website which originated these comments appears to be MotherNature.com and it does not show any convincing evidence to support the posted statement. Show me the science and I would be willing to change my mind.

However, it is documented that daily vigorous exercise (like endurance training) and lower fat/total calorie intake will decrease the free testosterone and DHT levels, and you can assume that this can decrease hair loss (see Relationship between stress hormones and testosterone with prolonged endurance exercise). Does a low fat diet alone decrease the levels of testosterone and DHT? That is not clear.

Tags: diet, hairloss, hair loss, fat, japan, western, dht, testosterone

Hi doctor,
Does taking sexual stimulant tablet or testosterone booster, prevents finasteride to work full?

Ask the doctor that is providing you sexual stimulants or testosterone boosters before starting or stopping any medication (including finasteride). Generally, what do you mean by a sexual stimulant? Viagra? Or some pill you buy from the back of a men’s magazine? There are many items that could qualify as a sexual stimulant.

Testosterone is an anabolic steroid that is generally illegal to use without the supervision of a prescribing doctor due to many side effects, such as liver damage. It can also cause increased androgenic alopecia (AGA) so if you are taking testosterone (or boosters), clearly that will ‘pull’ in the opposite direction of finasteride on your hair loss, thus defeating the purpose of using finasteride at all.

Tags: testosterone, steroid, hairloss, hair loss, sexual stimulant, viagra, propecia, finasteride

dr rassman,,, shame on you as a medial professional to encouge people to use rogaine,, a drug only desighned for for high blood pressure… even the FDA banned minoxidil for all its sideeffects,, rogaine,,, ie ,, minoxidil is certainly absorbed into blood stream, from topical solution, which can cause heart enlargment amounst many other side effects,, rogaine itself admits they dont event known to how this drug reacts,, therfore cannot say for certain all the posiable sideffects,,what is ceratin that many people have complaine about the side effect ,, even to your site,, why take the parachical evidence and not the prof of the people,,

Thank you for your concern, but where are you getting your information?

It is true that minoxidil is a high blood pressure medicine when taken orally. Some of it may even be absorbed through the skin. When minoxidil is applied topically (Rogaine) it can also have many side effects when absorbed by the skin including a light head feeling, irritation to the skin, etc, but is not banned by the FDA and some patients have good results with their hair loss. In fact, it is only one of two FDA approved medications for genetic hair loss in men, and the only medication that is FDA approved for treating genetic hair loss in women.

Tags: minoxidil, rogaine, hairloss, hair loss, fda

Hi Doc,

I have been suffering from seborrheic dermatitis for the last 1.5 years. I read somewhere that yeast containing food aggravate the problem. Is it true? Are there any specific food items that I should avoid?


There appears to be an association between yeast and seborrheic dermatitis. There’s a great article on the American Academy of Family Physicians website that says:

Pityrosporum ovale, a lipophilic yeast of the Malassezia genus, has been implicated in the development of this condition. It has been suggested that seborrheic dermatitis is an inflammatory response to this organism, but this remains to be proved. P. ovale is present on all persons. Why some persons develop seborrheic dermatitis and others do not is unclear. The colonization rate of involved skin by this organism may be lower than that of uninvolved skin. Nonetheless, the fact that seborrheic dermatitis responds to antifungal medications is strongly suggestive of the role of yeast in this disorder.

Read the rest of the text at American Academy of Family Physicians

Tags: yeast, seborrheic, dermatitis, food, skin

Is it possible say after 4 months of the procedure to damage the hair grafts if you are kinda compulsive and don’t really like to even show that you are losing hair as in my case i didn’t have to much hair loss in the first place but don’t like to show that i am losing any at all by styling the hair downwards. spending like 10-20 minutes doing so basically what I am saying is that if the hairs are inplanted after the immediate post op 1-3 months is ok to be less careful after this period and is there any adverse way to affect the growth. Also when is ok to buzz ones head after the FUE technique is performed.

thank you very much

Your hair transplant doctor should have told you this. Hair that was transplanted is considered permanent after a week or two.

Either you are an obsessive compulsive or have not been told the right information. You do not have to be so careful 4 months out from surgery. The point of the surgery is to have your own natural hair. Treat it as such.

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


Recently at age 31 I have been diagnosed with female pattern baldness, although both of my parents have a lot of hair. I was told to wash my hair every 3 days because i lose a lot in the shower and then brushing it. My scalps starts to get really itchy after 2 days and then i shed a lot of hair, why is that so? I do not have psorasis and scalp seems to be in good condition. Is it cause I have too much dht? Also have you heard of any good results with laser hair treatments?

I have not heard of or seen any good results with laser hair treatments. In my opinion laser hair treatments do not work.

Washing your hair less will not cause you to lose less hair unless you are rough in the wash. There is no relationship between washing hair and hair loss. You can wash your hair as you like. Your itchy scalp might be looked at by a local dermatologist.

Tags: laser, hairloss, hair loss, shampoo, female, women, woman

In earlier posts you mention that half of men with DUPA receive benefits from propecia, but in more recent posts you seem less certain. In the past few years have you seen DUPA patients receive worse results with propecia, causing your optimism to diminish?

Also, you mention that propecia MAY have a better chance if the underlying cause of DUPA is genetic–what does this mean? In your experience, does the presentation of DUPA differ when “the underlying cause is genetic”?

(My brother, only two years older than me, is losing his hair in a traditional MPB fashion, while I am experiencing DUPA in a presentation similar to FPB). Any insight, at all, would be helpful. Thank you.

With more and more exposure to diffuse unpatterned alopecia (DUPA) patients, I am less convinced that Propecia works for them. If there are no side effects seen though, maybe there is value in taking it. Other industry experts tend to have adopted that view as well.

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

Hi. I have been using propecia for 8 or 9 years with great success but in the last few months I’ve really noticed loss. This happened a few years ago and the hair seemed to come back after a while . I have read a little on cyclical shedding while on propecia and rogaine. Do you think it happens? I have also been under a ton of stress too. I am considering trying avodart now after reading some people are having success with it after propecia. How does one go about switching meds? I’m worried if I stop propecia and start avodart I might shed more. Also I had no adverse side effects with propecia, am I at greater risk with avodart?


ps I love this site, it’s too funny… you have a great sense of humor.. well done

Robo-RassmanYou need to speak to your doctor before starting or stopping any medication. So first have this discussion with the doctor that has been prescribing you Propecia. I hate the idea that people are taking my words and using that as if is is a substitution for their physician, so please consider this a disclaimer (there’s one on every page anyway). That’s a general statement and not directed squarely at you. Remember — I’m not a substitute for your doctor, unless I am indeed your doctor, in which case cyber-Rassman is likely as good as in-person-Rassman.

Moving along — Avodart (dutasteride) is not yet FDA approved for treating hair loss, so doctors that prescribe it for that use are doing so off-label. We’re all waiting with baited breath for clinical trial results, but regardless of whether the benefits are better than those of Propecia (finasteride), I’m concerned over the safety of dutasteride since the serum half-life is measured in weeks, as opposed to hours with finasteride. In other words, dutasteride stays in your system for a long time. They are different drugs, of course, so if you had no side effects with Propecia it doesn’t automatically rule you out for side effects with Avodart. There is just no magic drug that will solve your problem. I suspect Propecia is still working for you and your doctor may increase the dosage of finasteride to handle the problem, as it may show more improvement. It is just that you can’t cheat nature and the gradual process of balding may not be stopped forever.

Tags: dutasteride, avodart, fda, hairloss, hair loss, propecia, finasteride