Seasonal Hair Loss?

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

AutumnHello Doctor

Any tips to fight seasonal ( autumn ) hair loss ? Might not be permanent but it sure is annoying !

Thanks in advance

There are seasonal changes in hair shedding that is mild for most people. We look at human hair loss as asynchronous, which means that it does not shed completely at one time of year. Some of the vestiges of molting may be left over from our embryonic pre-human existence… unless, that is, you don’t believe in evolution (in which case, I can do nothing but shake my head).

To answer your question though, there is nothing that I know of that will deal with any seasonal shedding.

Tags: hairloss, hair loss, seasonal, evolution

Child Hair Loss — It’s Not Fungus, So What Is It?

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

My daughter is 9 years old and I just found out she has several bald spot in the back of her head . We took her to the peditrician doctor, they scrape the bald spot to get it test. The lab just call me and they said that it wasn’t fungus nor ring worm. Can you please give me some information on what it could be? I’m very worry, please response back to me ASAP. Thank you.

I can only tell you what is not (fungus or ringworm). I cannot diagnose your daughter’s condition on the Internet without any examination. I would take her to see a dermatologist so that doctor can take the next step in the diagnosis. She may need a biopsy rather than skin scraping. There are many differential possibilities, such as alopecia areata, but that diagnosis has to be made by a physician who can examine your daughter in person.

Tags: child, hairloss, hair loss, fungus, ringworm

Hair Cloning and DUPA

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

Both you and Dr. Bernstein mention in various places that it will be ten years before hair cloning will be available as a successful treatment for hair loss. If and when this process becomes available to the public, would it be effective for DUPA patients as well? Or would the process still require a stable donor area?

I am a 19 year old male experiencing DUPA. Assuming propecia does not work, I think all of us with DUPA are wondering whether there is any effective solution we can look forward to, or if we should just shave our heads and get on with our lives.

My heart goes out to you. If the medications do not work, there is little to offer other than the use of concealers. Hair cloning can not be predicted for a time line. If/when cloning becomes a reality, these types of questions can probably be answered, but it is way too early to guess as to what future technologies could do.

Tags: hair cloning, cloning, dupa, hairloss, hair loss, propecia

Androscience

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

Dr Rassman,
What are your thoughts on Androscience’s approach to hairloss treatments ?

The Androscience website states the lead compound ASCJ-9 is being developed as a topical treatment for acne and male pattern baldness. And they will have completed a clinical trial for there acne cream soon. And they plan to start trials for MBP toward the end of 2008 (PDF).

Should the acne treatment make it to market would you end prescribing it off label for MBP until a foam arrived?

I only know what I read in the above references. Thanks for sending these, as it makes for interesting reading, but nothing practical that I can see at this time while we wait for the results of the clinical trials. It is far too early to speculate on what I would or wouldn’t prescribe. I’d need to read and learn a lot more about this.

Tags: androscience, hairloss, hair loss, acne

Saw Palmetto Was Junk — Is it Too Late to Try Propecia or Minoxidil?

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

I have been thinning pretty bad for a tad less than two years. I tried all those dht saw palmetto blockers which were junk. I have the horseshoe effect going but i have some miniature hairs on top that look like they are on their last limb. I was wondering if i start using propecia and rogaine asap if there is any hope since i still have visible hairs? Any advice would help. Thanks for your time.

There is always hope. While I doubt you will grow an abundant amount of hair, you can at least expect the hair loss to slow down. It’s not too late. See a doctor for the Propecia prescription.

Tags: finasteride, propecia, saw palmetto, hairloss, hair loss

Avodart (Dutasteride) Dosing

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

Dr. Rassman,

I just received a prescription for Avodart from a general practitioner. I have been on Propecia for 3 years; however, I think the drug is loosing its effectiveness. About 1 month ago I started taking 2 mg of Propecia daily. Then out of desperation, I consulted with a physician and received the prescription for Avodart.

The Avodart clinical studies on hair loss that I have read on-line involved doses higher than the standard .5mg which is recommended for men with enlarged prostates. I’m reluctant to take the drug every day. However, would you consider taking 2mg of Avodart 3x weekly and 1mg of Propecia on the other days an effective strategy to achieve maximum DHT reduction, stop further hair loss and/or grow back hair?

You are desperate and experimenting with your body. There are limitations of medical science and you need to accept you are losing hair. Taking a high dose of Propecia (finasteride) will not cause more hair growth. Taking a high dose of Avodart (dutasteride) may not cause more hair growth either. We just don’t know, and I certainly can’t give you recommendations on how much of a prescription medication you should take, even though you have a doctor that prescribed it to you for off-label use. The Internet is a wonderful source of information, but you need to understand that everything you read is not always 100% accurate.

I am purely guessing that your general practitioner agreed to prescribe you Avodart, as he saw how desperate you were and your need to be proactive with some sort of medical treatment. I am sure your general practitioner gave you information on Avodart and its possible long term side effects (risks of sterility is present) and how it is not at this time approved by the FDA for the treatment of hair loss. There are also no long term studies on young men taking Avodart. With these warnings I am sure you made an informed decision. Now you must accept some responsibility on limitations of drugs and your genetic predisposition for hair loss. I realize this sounds harsh, but it is an unfortunate fact of life. There are no easy answers or solutions.

Tags: avodart, dutasteride, finasteride, propecia, dosage, dosing, hairloss, hair loss

Norwood Class 2 and Had 3300 Grafts Transplanted to the Hairline!

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

I at 22 years old and had one hair transplant procedure with 3300 grafts in the first 2/3ds inch for my Class 2 balding pattern. Now my hairline is clearly not normal looking and runs like a straight line across my brow. What can I do to fix the problem.

Norwood 2A 22 year old with a Norwood Class 2 pattern (see image at right) should never have been transplanted. I am assuming that you understand that in many young men, the Class 2 pattern is a movement from a juvenile to a mature hairline. I am also assuming that the surgeon put your hairline against the upper crease in your furrowed brow and if I am right, you may have limited your options to fix it.

What you need is a thinner hairline, one that is irregular. I would want to know if you are balding behind the area that was transplanted and if so, what did the miniaturization study show (get one if you did not have one done). If you have had a successful transplant of that number of grafts in that narrow a space, you will appear more dense in the front if you are thinning behind it. You need to know all of the options and build a good Master Plan with a good doctor. Ask your doctor what he had on his mind when he built that hairline for you. More surgery may or may not be one of your choices.

Tags: norwood, hairloss, hair loss, hair transplant

Is Puberty Causing My Hair Loss at 16 Years Old?

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

Hi,
I am a 16 year old male, and i think i m losing my hair but i don’t know. Is it possible that this could be because of puberty perhaps, and to what extent is shedding hair normal?
Thanks

I am not sure how to comment without knowing more about you. Everybody loses 100 hairs per day… sometimes more, sometimes less. If you are paying more attention to your hair you may be noticing something that is normal, but you can definitely be noticing an increased hair loss rate. As you are a male and maturing, you may notice some stages of early genetic male pattern baldness (MPB). MPB starts as early as 16 years old in some men and it is related to the changes in your hormones combining with the balding genes. I am NOT suggesting you indeed have MPB, but I am just answering a generic question. To find out, go get your hair mapped out for miniaturization and if you are really in the evolving balding process this will make the diagnosis.

Tags: hairloss, hair loss, puberty, mpb, teen

CNN Contributor Roland Martin’s Hair

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

Roland Martin

Hi doctors,
I’ve been watching a lot of CNN lately and keep seeing this contributor named Roland Martin on there with a very unusual looking hairline. It looks like it’s caving in at the front. I’m just curious as to what class that might be considered or is that just a weird version of a mature hairline or something?

Here’s his photo from CNN.

I do not think this is an unusual hairline. Rather, it looks like he is showing early signs of balding, possibly a Norwood Class 3A. His balding is starting in the middle and on the sides, leaving two mounds of hair off center. In the years ahead, he will most likely lose all of the frontal hair, leaving only these mounds which will eventually go away in time. I see this fairly frequently. In other words, we don’t bald all at once. It is a slow and gradual process.

Photo source: RolandSMartin.com

Tags: roland martin, cnn, news, hairloss, hair loss, hairline, author, journalist

A Reader’s Story of Propecia and Weak Erections

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

Dear Sir.

I am writing to share my experience with propecia. I started taking the pill 13 month ago. I was very frustrated with my hair loss (but it is still in very early stage, NW1 i would say). Before I started propecia I did my reserch on the web. I heard about unwanted side effects, but I did not believe nothing, saying people are lying (propeciahelp.com). When I started the medication I’ve noticed little decrese in libido (nothing special). As a reader of your blog I knew this was normal in first week, so I did not panic and I was very excited to see the results results.

After 8-10 weeks my hairloss returned to normal (about 50% less hair falling out). I was very happy. After a few months I started to see my erections are geting very weak. I was under a big stress. I know the problems with erection are normal from time to time. But it never returned to normal. Well from time to time I’ve gotten good erection but it was not often and it didn’t last. At the time I didn’t have a girlfriend. But that changed in july 2008. We moved slowly. I’ve was scared because I knew I was not able to perform normal sexual intecourse. When the time came I just couldn’t get a normal erections (like the last 9,10 months or so). It was really embarrassing. Before this event I was not blaming this on propecia (because my problems started after 2 months (or so) on propecia). But then I’ve immediately stop with propecia. I was very very concerned at the time. I’ve read a couple of sites. And I’ve learned even if you stop taking propecia the side effects stay (in most cases).

When i was a week off I’ve started to knowing big differences in my erection. I was able to maintained a hard erection (i was not able to do that 10 months). And every day it got better. I’m 20 days of propecia and now I am capable to normally performed (in bed). But I still do not think my libido is back on 100%. Well I am very heapy now. I don’t care about hair loss that much. There are some thing just more important. And I can always buy a hair system :) they are much cheaper here then in the US. I’ve took the time just to inform all of you that the propecia side effects are VERY real. And I do NOT believe that they appear in just 1% of males. I’m in my 20s good health and everything and it strucked me. I’m not saying it will do this to everybody (but just more then 1%).

I wish you post this and give your opinion. Thank you. And have a nice day. :)

Thank you for sharing your experiences. It goes to show that sometimes there are more important things than hair.

The erection side effect of Propecia occurs in a very small number of individuals and those that do have problems may very well respond to Viagra, Levitra, or Cialis (medications for erectile dysfunction), and may be a better alternative to giving up the benefits of the stabilization of your hair loss. You may be that 1 to 2 percent that has the problem. The side effects do not stay in most people after discontinuing the medication, though.

Tags: viagra, cialis, levitra, propecia, finasteride, erection, hairloss, hair loss

Female Hair Loss — Is it Because of New Shampoo or Cancer or What?

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

Hi. I am a 36 yr old female. I have lost approx 60-70% of my hair in the past month. Scary. I had a kidney/liver and thryroid blood test done which came back normal. I am just so worried. Could this be a sign of cancer or something terrible. New hair is growing in a little, but I think I’ll have to shave my head. I understand the stress related hair fall and am not sure this could apply to me. Is it possible to have this reaction to a new shampoo? I have always used natural shampoos but have lately used a cheaper drugstore shampoo…any ideas?
Thank you in advance.

You need to see a dermatologist or hair doctor to make a diagnosis. Something is wrong and there is no substitute for a good doctor’s examination. Perhaps it is as simple as an allergy to an ingredient in the new shampoo? Perhaps it is something more. I couldn’t possibly determine that via the Internet.

You can learn more about possible causes of female hair loss here.

Tags: female hair loss, hairloss, hair loss, shampoo, cancer

Smoking Cigarettes Caused My Hand Hair to Die Off

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

Hey doc, well this isnt really a question, but a comment on an observation i made. I’ve read your posts on how smoking may cause hair loss,which kind of intrigued me a little. I recently started smoking again after 8 months of quitting, and the hair on my left hand got introduced to a lot of smoke about 5-6 times daily. Today,after a week of smoking, I’ve noticed that the hairs on my left hand fingers and back of my hand have either shortened, or have disappeared. What makes me believe that smoking has caused it, is that the hair on my right hand fingers are just as they used to be. It doesn’t seem to be a possibility that the cigarette smoke ‘burnt’ my hair off because if that was the case the the back of my hand wouldn’t have lost hair, and smoke from a cigarette isn’t hot enough to be able to do that anyways.

I know the mechanism behind your statement on smoking and hair loss is related to the blood flow, but there may be another way on how smoking damages hair. It’s a toxic emission and has caused the hair to die off. Something I would now try to keep my head hair away from, and it’s now made me think of qutting again! I know that body hair is different from head hair, but who knows, and I’m not willing to risk my already dying head hair!

I don’t have much to add to your comments, so I’ll just say that your statement alone expresses the unknowns and your observations stand on their own. Smoking is harmful in many ways.

Tags: smoking, cigarette, hairloss, hair loss

Using the FUE² Technique to Remove Only 3 and 4-Hair Grafts

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

I am a technology freak so I liked your FUE2 process. I already had a couple of hair transplants and the frontal area is still thin, needing more hair. I figured that you can use your new FUE procedure just to thicken up the front area with less grafts and more hair. If that is true, the price is a real bargain.

FUE2I think you’re essentially asking if the doctor can just transplant 3-hair and 4-hair grafts. You could arrange to have a limited FUE² procedure performed (without shaving your head) to add hair to the frontal area or crown very cost effectively. I would ask the surgeon to take out mostly 3-hair (or more) grafts and as long as they are placed at least 3/4 inch behind the hairline (or the crown), these grafts will be more effective for thickening up the recipient area. This approach makes sense, as many people who would like to get their hair to appear fuller could just come in for a limited FUE² procedure and have limited pain or detectability after the procedure. I say “limited pain” because although most won’t experience any significant pain, I’m not going to BS you and say it’s 100% painless — we have to give you a shot to numb the area, and some people might find that part painful. After the area is numbed though, you won’t feel a thing.

Anyway, with this approach to a more limited surgery, you can get hair without a substantial recovery process and at a lower cost on a per hair basis than when compared to a traditional strip surgery provided that you have naturally 3 and 4 hair follicular units. Some Asians, in particular, may only have one and two hair follicular units. Normally, a strip surgery in a person with a uniform hair density of 2.2 hairs mm square, will have about 15-20% single hairs and 70% two hair follicular units and the remaining 3 and 4 hair follicular units. On a hair for hair cost, removing only two, three, and four hair follicular units will create more value for the patient if he has them to remove. The only problem I see with approaching the FUE² this way is that the number of grafts you harvest is limited by the area that is shaved and the distribution of 3 and 4 haired grafts that you are born with may be so widely spread out that it would be impractical to remove exclusive 3 and 4 hair follicular units because the area of hair that has to be clipped may become visible.

Tags: fue, fue2, follicular unit extraction, hair transplant, hairloss, hair loss

What Role Does DHT Play Besides Hair Loss?

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

Hello Mr. Rassman,

I have two questions regarding hairloss. First one is, what is the role of the DHT in human body other than attacking hair follicles? I mean male human body (as far as I know women produce DHT too but very low, I am sorry If I am wrong) produces that so I assume it must have some beneficial effects too. Can you explain the other effects of DHT please?

My second question is regarding the type I and type II a.reductase enzyme. Based on what I did read finasteride inhibits type II, and dutasteride inhibits both type I and II. is it necessary to inhibit type I as well to prevent hairloss? Based on my knowledge it is unnecessary to inhibit type I, am I right with my opinion?

Thanks for your time, I appreciate that. Best Regards

Dihydrotestosterone (DHT) is produced by the body as testosterone is broken down in the normal course of your overall metabolism. As testosterone is also produced in women in smaller quantities, it will break down (be metabolized) just the same as in men. DHT for males is involved in the descent of the testes in fetuses, some of the maturing factors in adolescence like changes in voice, changes in hair character, underarm and pubic hair in both sexes, and the appearance of body hair as we get older (including the beard). For those men who are beyond 50 years old, it produces nose and ear hair as well… so there’s something to look forward to.

With regard to your second question, you are right. The role of type 1 5AR is poorly understood, but does not seem responsible for hair loss.

Tags: dht, hairloss, hair loss, finasteride, dutasteride, type 1, type 2

Capiplus

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

Dear Doctor,

I have used propecia for several years now with limited success – no hair gain, just prevented further hair loss. I have recently came upon capiplus, which is supposedly natural alternative to propecia. Although I would like to try something new I am afraid stopping using propecia might start hair loss again. Is it possible and does it make sense to combine propecia and capiplus?

Best regards

I do not know of any natural alternative to Propecia (finasteride) that works like the companies claim they do. These claims are unregulated by government authorities and as I have written many times, “It is a buyer beware market”. Capiplus is yet another saw palmetto concoction available on the market (the product also contains calcium and other vitamins that won’t stop your hair loss). See this post on saw palmetto.

You indicated Propecia has at least prevented further hair loss. That means it is working! Perhaps it isn’t working as much as you may like, but you have to understand the limitations of medication. Why do you need an alternative? You are already taking the real thing. You must also understand there is no absolute cure for hair loss and many men such as yourself will continue to buy into the promises of hair loss cure advertisements.

Tags: capiplus, saw palmetto, hairloss, hair loss, finasteride, propecia, natural