Future Issues for Young Woman Taking Finasteride?

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

Hello,

Thanks in advance for your time. I am a woman with PCOS who has experienced a great deal of hairloss in the past year and a half (my only symptom of PCOS is hairloss — I am on the pill to regulate my cycle). My doctor recently prescribed finasteride (5mg I believe?) but I am afraid to take it because of the harmful effects it is supposed to have on children. Could taking it now be harmful down the road? Is it a bad idea for a woman of my age to start on a drug she can never get off of, like this?

Desperate for answers.

Thank you.

If you are pregnant while you are on finasteride, the chances are high that your baby will develop a sexual differentiation problem. That includes accidental pregnancies, which is something that you must consider. That bit is strictly for women that take finasteride while pregnant — for men reading this, simply taking Propecia while trying to conceive a child should not be a concern. The word from Merck (pharmaceutical company) 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.”

Just a reminder, finasteride is not FDA approved for treating women, and your doctor prescribed it to you off-label. On its own, the drug is not harmful to women, that is, unless they harbor the breast or ovarian cancer genes. The good news is that once you are off of the drug, it is out of your blood stream in 1-2 days and out of your system in 1-2 weeks. Still, it is not recommended for use in women that could become pregnant. I assume you’ve asked these questions to your prescribing physician, as well?

This page has some good information on finasteride use in women — Finasteride for the treatment of female pattern hair loss.

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

The Drawn Hairline Is Different From What Was Transplanted a Week Ago!

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

Hello. I recently got a hair transplant in Canada. I am a resident of the United States. I didn’t have severe loss, but my hairline has always bothered me. It was very unsymmetrical and missing temple points on an otherwise full head of hair. I had a procedure last week and the swelling has just subsided the last couple of days. Well, what the doctor drew in for my hairline is very different than what is now on my head. My temple points are extremely unsymmetrical now, more than before. When looking at me directly, one temple point can be seen and looks great, but the other one is further back the side of my face and can’t be seen from front view. One is lower than the other… The way it is now, is not what was drawn on my head prior to the surgery. The doctor took a picture of me before the transplant, but did not take a picture of me after the hairline was drawn or after the procedure.

My question is, how do I approach this situation.. Is it the doctors responsibility to fix this for me or am I bound to this agreement even though it was not what was discussed and agreed on prior to surgery? I have seen tons of pics on forums of people who have had temple work done, even from this doctor, and none of them look as unsymmetrical as mine. Should I have this fixed asap or wait till my results grow in and go have it fixed then… I mean, it is ridiculous how much I have paid and it was a fairly easy procedure from what I understand.

The good news is that you had a photograph taken before the surgery, hopefully outlining the hairline that was proposed. If the transplant was done in the last 5 days, it would be unlikely that you could undo the problem work. The best thing is to communicate with the doctor and address your concerns.

You trusted the doctor to perform your surgery after all. It is all about communication and having a trusting relationship. My answer may sound generic, but it is really as simple as that. Your doctor should be very concerned if the work is unbalanced. You can always get a second opinion. Keep taking good photos of your hairline and growth.

Tags: hairline, hair transplant, hairtransplant, doctor, physician, hairloss, hair loss

Is Female Hair Loss Related to Female Facial Hair Growth and High Testosterone?

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

(female)
I am 61 years old and I am experiencing balding on the top of my head and thinning of hair on the rest of my head. I have developed a mustache and beard. I have found that my testosterone level in 486. Would this cause my hair loss?

Normal total testosterone levels are as follows:

  • Men — 500 to 1000 ng/dL (nanograms per deciliter)
  • Women — 50 to 100 ng/dL

I would look to your doctor to find out why your testosterone is so high. There are many potential medical reasons for this. High testosterone can cause hair loss in women and possibly even the appearance of a beard.

Tags: testosterone, hairloss, hair loss, women, woman, female

Does Normal Hairline Miniaturization Apply Only to the Center?

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

Hi you said that it is normal to have miniaturization where the hairline starts so my question is:does this only apply at the center of the hairline or it applies to all of the hairline including the temples?

Finer hairs in your hairline (front, corners, side, temples) are common, as it gives a fine, transitional appearance. This is not miniaturization… just fine hair. It is also mixed with fine vellus hairs.

Miniaturization should not extend far back (1 inch, for example), as that would indicate a receding or balding pattern, assuming that this 1 inch is not the movement towards a mature hairline.

Tags: hairloss, hair loss, vellus, fine hair, miniaturization

More Johnny Depp and Hair!

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

Sorry to bring this up yet again! I notice people ask you about Johnny Depp a lot. I’ve always really liked his hair and I too have noticed that he sometimes appears to be balding. I’ve seen a lot of photos in magazines, and now I see this online too: jezebel.com

Is it possible that he is balding and just uses some sort of cover-up sometimes? Thanks for the great blog, by the way.

Anything is possible, but I don’t think that this is balding. What you may be seeing is that when the hair is parted, the scalp is showing. We don’t know his density, but the black (or dark brown) hair and white skin accentuates the scalp. If he comes in for a miniaturization study, I will tell him if he has early miniaturization, but I wouldn’t publish that online for confidentiality reasons.

Tags: johnny depp, depp, actor, celebrity, hairloss, hair loss

Body Detox and Propecia

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

I was wondering if a body cleansing detox program would interfere with Propecia? If so, what kind of side-effects would occur?

I don’t think so, but I am not familiar with detox / body cleansing programs enough to tell you much about them. Are you talking about something like an enema on a regular basis? Or starvation? It sounds like you need to speak with your primary doctor and have a physical examination before starting such a program.

Tags: detox, toxins, propecia, finasteride, hair loss, hairloss, enema

Acid Reflux Drug Protonix and Hair Loss?

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

Does Protonix cause hair loss? I have been taking protonix (pantoprazole generic brand) for about two months and my hair is falling out by the hand full.

Many patients all over the world with acid reflux that take Protonix (pantoprazole) still have hair, but with that being said, hair loss is a known side effect of this drug. It is rare, however. See WebMD for a complete list of potential side effects.

Tags: protonix, heart burn, acid reflux, hairloss, hairloss, pantoprazole

My Doctor Says to Take One Proscar Every 5 Days for Treating Hair Loss

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

Hey Dr. Rassman I have some question

  1. My doctor says that to take one pill of 5mg finasteride (proscar) every 5 days amounts to take 1mg finasteride each days, i’m not sure he’s right, what do you think about it?
  2. I have less than 20% of miniaturized hair all over my scalp (about 6% all over), but miniaturized hairs have not an equal diameters. Do you considered this as a MPB?
  3. When consider you that the MPB is stabilized? No more miniaturization on the scalp?
  4. Is the finasteride bad for the body-building (whithout steroids or anything else of course)?

thanks!

  1. I hate overruling other physicians, but your doctor may be wrong. To treat hair loss, you need to take 1/4 pill of Proscar a day (ideally it would be 1/5 pill, but that is not practical to split into 5 equal pieces). If you take one full pill of Proscar (finasteride 5mg) once every 5 days, it would be be out of your system in 24 hours. There is some tissue (hair) fixation that may last 5 days, but that is not well documented and what it means is less documented.
  2. If you have less then 20% of miniaturization over your scalp then you should not be on finasteride (Propecia / Proscar), because you don’t have male pattern baldness (MPB).
  3. It is normal to have 10 to 20% miniaturization on your scalp as these may represent vellus hairs, not miniaturized hairs.
  4. Finasteride has nothing to do with body building or exercise.
Tags: finasteride, propecia, proscar, dosage, hairloss, hair loss

Eyebrow Baldness

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

Dear Doctor,
I’m a 41-year old female and in the last six months my eyebrows started falling out to the point of almost complete “eyebrow baldness” (I don’t wax or tweeze them, so that’s not it). The dermatologist I saw did a scalp test and that was all fine and bloodwork done revealed nothing abnormal. He has prescribed twice-a-day application of topical Clobex. Does that sound like it’s on the right track of proper treatment? What about those “eyebrow growth stimulator” lotions I’ve heard about. Are they worth trying?

Thanks for your time and have a great day. Kind regards

Clobex is a topical steroid, so I would ask your prescribing physician what the working diagnosis is. Biotin deficiency has been strongly linked to hair loss and, when severe, can even lead to loss of the eyebrows and lashes. Deficiency is rare, but can be caused by excessive consumption of raw eggs, which contain high levels of the protein avidin, which binds biotin strongly. Biotin can be taken orally.

Another diagnosis that needs to be ruled out is alopecia areata, and a biopsy may be indicated for this. The Internet is not a place for a comprehensive review of your problem, but your doctor should be able to go over this with you if he spends the right amount of time, as I do with every patient I see.

Tags: eyebrow, hairloss, hair loss, alopecia, biotin, clobex

What Doctor is Recommend for Chemical Burn?

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

Dr. Rassman:

Regarding a chemical burn from blonde highlighting: 20 YO female was under hair dryer c. 4-5 minutes when burning sensation was felt on the L upper scalp; a 30 volume developer was mixed w/ionic powder with foil wraps. A baseball sized area now (6 mos or so later)has damaged hair follicles requiring two surgeries (apparently infusion for hydration first and then some over-flapping of productive skin over damaged skin ?). To properly examine this area to determine what caused the burn, would you recommend examination by a dermatologist or some other medical specialist?

Thanks so much.

I would recommend an examination by a dermatologist for chemical burns to the scalp that caused hair loss. I’m not clear if you were just told two surgeries would be required, or if you actually had two surgeries to correct this. If you have had surgery, you might want to get a second opinion if you are not comfortable with the management or the outcome.

I think I have more questions for you than answers. I think an examination is critical for me to make any sense of your case.

Tags: chemical burn, burn, chemical, hairloss, hair loss, dermatologist

Does Miniaturization Always Mean MPB?

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

Hey doctor,
Thanks so much for your time. This would be very helpful for me if you could answer this question! My question is, does miniaturization for sure mean that one has male pattern baldness or can miniaturization be a result of other causes of hair loss (i.e. meds). I’ve been taking minocycline for 4 years because of acne prescribed by a doctor and I also have A LOT of miniaturization. Is this just coincidence or could there be other reasons for miniaturization/balding

Thanks for your time!

There could be other reasons besides genetic male pattern baldness. Get a good examination by a doctor who knows about this. Miniaturization could be drug induced along with a variety of other diseases.

Minocycline is not known to cause hair loss, but I suppose it could be a rare side effect (I’ve read conflicting reports online about it being a side effect at all). The official documentation does not mention it.

Tags: miniaturization, hairloss, hair loss, medication

Hair Loss Paranoia

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

Hey, thank you for keeping this blog – it’s a great help! I’m an 18 year old male with a little bit of paranoia (nobody else thinks I’m losing hair). I’ve been reading about miniaturization. I noticed that some of the hair that comes out when I’m washing my head is finer than other hair. I have no idea if this is normal or not – what do you think?

It is normal to lose around 100 hairs every day as new ones grow in. If you have product in your hair (hair spray, gel, wax, etc), it may keep some of those hairs trapped until you shower, and then appear to have a bunch of hairs coming out at once… when in reality, it was just your normal daily hair cycling.

Tags: hairloss, hair loss, gel, product

Clarify the Best Time to Take Propecia

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

I didn’t really understand your answer to the best time to take propecia. You said the best time is in the morning because you get the half life of the drug being 4 hours thus reducing
concentration. Wouldn’t you want full concentration for better effects?

Like I’ve said in past blog posts, the best time to take Propecia (finasteride 1mg) is in the morning when your testosterone levels are at the highest. In reality and practicality, the best time to take Propecia is anytime you can remember to take it on a consistent (daily) basis.

Tags: finasteride, propecia, hairloss, hair loss

Will Nioxin Regrow Hair Lost from Medication?

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

(female) When hair loss is caused by a medication, in my case Abilify – an antipsychotic I’m using for bipolar disorder – does medication such as nioxin work to prevent the loss or promote growth? I’ve started to notice large amounts of hair loss which began soon after starting Abilify. One of the rare side effects mentioned in Abilify literature is unusual hair thinning, apparently I’m experiencing this rare side effect.

I do not believe that Nioxin will help regrow your hair. Minoxidil might be worth a try, but be sure to read the warnings on the packaging. At this time, minoxidil is the only FDA approved medication for treating female hair loss.

Tags: nioxin, rogaine, minoxidil, women, woman, female, hairloss, hair loss

Could Propecia Prevent Me From Having a Class 7 Pattern Forever?

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

I’m currently taking propecia, and have been doing so for nine yeras with good effect. My question is, can I expect not to lose any more hair due to male pattern baldness as long as I’m taking propecia, or will the effect fade with time? That is, if I’m genetically destined to become a NW7, can I prevent this from happening by taking propecia for the rest of my life, or will I only delay the time to get there? Will my genetics eventually catch up with me, although I take propecia?

FortuneForever is a long time, and unfortunately I am not a fortune teller. As I’ve said time and time again, the drug works differently in each person that takes it, so without an examination (miniaturization mapping) and a follow-up or two, I can’t make that prediction for you. So while I do not have any other-worldly prediction talents, it seems that you are doing the right thing by staying consistent for 9 years on the medication.

In all seriousness though, my best guess is that Propecia will delay the inevitable Norwood Class 7 (if you are actually going to go that far), but I couldn’t say how long or how strong the delay will be. As anyone could tell you, forever is a long time. I do know that if you stop taking Propecia (particularly after 9 years), your genetics will catch up quite quickly.

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