Sinus Medication Entex PSE and Female Hair Loss?

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

(female)
I have been taking Guaifenesin and Pseudoephedrine (EntexPSE,Pseudovent400 etc.) daily for more than three years. I have noticed a drastic change in my hair’s texture and fullness. My hair has always been extremely thick and healthy. Recently, it has been thinning and now has the texture of brillo. I am definitely losing large amounts of hair, additionally, each hair seems thinner and more fragile and “wiry” but no bald spots. Could either of the components of my sinus medication be causing these disturbing symptoms?

I’ve read reports that guaifenesin can be associated with hair loss in some patients, though it is not listed in the official list of side effects. I am afraid I can not render you an opinion on your observations, but I suggest you see a dermatologist (or more importantly, your prescribing physician) for a proper evaluation.

Tags: guaifenesin, hair loss, hairloss, sinus, female hair loss, entex pse, pseudoephedrine

FUE2 for Body Hair?

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

Dr. Rassman,

You mentioned a couple of weeks ago that with Follicular Unit Extraction Enhanced (FUE2) that you should be able to successfully transplant body hair. When do you expect to experiment with this type of body hair procedure?

Thanks

When a patient comes in and requests it, I will test biopsy him with the FUE² first. No such patient has come forth yet.

Tags: fue, fue2, bht, hair transplant, hairloss, hair loss, body hair

Taking Avodart Daily to Treat Hair Loss?

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

My MD has me on Avodart 0.5 MG once daily for hair loss and I have been taking it for about 20 months now and it seems to work better than the Proscar that I was taking the five years before.I just had my second HTP a couple of months ago and the HT doctor said the Avodart that I’m taking stays in my system fot 5-7 days and that I should not need to take it daily to have the same results. Where do you stand on it?

AvodartAvodart (dutasteride) does stay in your system for several weeks (5 weeks are reported for half of the drug to disappear from your system). In other words, if you take Avodart today only, half of the drug will be in your body in 5 weeks. In fact, the drug will still be detectable in your body for up to 6-12 months.

I do not personally recommend Avodart to my patients, because it is not proven safe for treating hair loss in younger men (the drug is a prostate medication, so the FDA approvals were based on tests of those men in an older age group). There are reports of sterility with this drug on men. I do have a handful of patients that choose to take Avodart despite my concerns, but that is on an individual basis. Likewise, my feeling on it is that you need to address these concerns with your doctor and decide on the appropriate treatment plan after understanding all the risks and benefits associated with its use. That stands true for all other drugs and medical treatments.

In general (to confuse the situation even further), the 0.5mg dose of Avodart is not generally used for hair growth, as 2.5mg is shown to produce a better effect. However, the 2.5mg will increase the side effects and the risks associated with it as well. All that is just more to discuss with your doctor. Read this study published in the Journal of the American Academy of Dermatology for more info — Dutasteride vs. Finasteride.

Tags: avodart, dutasteride, finasteride, dosage, physician, hairloss, hair loss

Getting a Free Hair Transplant Like on TV?

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

Hello, Dr. Rassman, I am a 41 year old African-American female with extreme hair loss. My doctor said it was alopecia but I think it is male pattern baldness. All the hair on top of my head is completely gone. I started losing my hair in 1998 and now the hairs are completely gone. I do have hair on the sides and back of my head. It is very frustrating trying to hide this devasting secret. At times I am very depressed about my hair loss. I cannot go swimming, exercise in public and I have to wear wigs all the time. My question is with such extreme hair loss, is it possible that I could get my hair back. Is there any thing you could do to help me. I watched the episode of jon & kate + 8 and noticed his transplant was done free of charge. I am a full-time non-traditional student and at this point, I am not financially able to afford this procedure, however, I am willing to share my devastating story if you could help me. Thank you

TVI would have to examine you to understand what is happening. Genetic hair loss in women does take on a male pattern in about 15% of cases. If you have been using a wig, is it possible that the wig has caused more hair loss than you would have had if you never used it?

With regard to hair transplant work we do, we sometimes will do it for publicity (as in the case of the Jon & Kate Plus 8 show), or in special cases where children have lost their hair, or in people who have deformities with special needs and there is a financial problem for them. Each case is individually evaluated and although we do subsidize hair transplant work in some patients, it is more the exception than the rule.

Tags: hair transplant, hairtransplant, hairloss, hair loss, female hair loss

Andropause is Male Menopause?

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

From the article:

TIREDNESS, depression and lack of libido all seem inevitable parts of male ageing, but what if an age-related lack of testosterone is at the root of all these symptoms? Increasingly, doctors say such an “andropause” exists and that its effects may go beyond feeling a bit tired – obesity and diabetes also appear to be linked. The good news is that testosterone supplements might help treat the problem.

Read the full story at New Scientist — ‘Menopausal’ men could get sexual boost from HRT

This is obviously not hair loss stuff, but worth discussing. We see symptoms in men as they get older that include erectile dysfunction, loss of libido, loss of ‘zip’ and general fatigue and lethargy. The article discusses that some men have developed low testosterone levels which contribute to this set of symptoms and they may be helped with exogenous testosterone treatments by your local doctor. It is easy to get your testosterone levels checked to see if this applies to you (generally men over 50-65).

Tags: andropause, menopause, hairloss, hair loss, testosterone, newscientist, new scientist

Propecia at Less Than 1mg Dosing

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

Hello Doctor. I thought this might be interesting. it recommends that you cut propecia, not proscar, in 5ths because the effect of 1/5 mg of propecia has the same effect as 1 mg. Here is the link. It states: ” We advise you to stay away from Propecia. If you do decide to take it, you should know that the standard dose is one milligram, but studies show that one-fifth that amount works just as well. If you cut the pill into fifths or quarters, you can save a considerable amount of money. “(UC berkely)

What do you think????

I have reported on this blog that Propecia works at lower doses, but at varying degrees (see here, here, and here). If my memory serves me right, Propecia at 1/2 mg works about 80% as well as the full dose, and at 1/4 mg it works somewhere around 40-60% as well as 1mg. I would ask however, why reduce the dose if there are no side effects? The best dose is 1mg. I certainly don’t agree that 1/5th of 1mg will be as effective, as that site suggests. I think they are confused.

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

I’ve Been Losing Hair for 7 Months After My Hair Was Professionally Colored

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

Hi William,

It is good to see that your advices are helping millions of people, who are suffering from hair fall. I am a 28 year old male suffering from hair fall. I had bad hair color done,hair has become frizzy like dry grass. To give you brief history of my hair fall, 7 months ago I went to reputed hair saloon SPA, he applied a colour which was not a well known brand. immediately after applying, my scalp started itching, stinging and burning. it was severe and unbearable. From the 4th day of that incident my hair started falling and it is increasing every day, about 70 strands per day and hair has become frizzy like a dry grass. Before that there was not even a single hair fall.

Do you think my hair follicles have been damaged? How to restore the damaged follicles? I strongly believe so, because I am losing hair all over the scalp. the new hairs which growing are very thin, have pointed ends and are falling. I am losing thin and thick and all kind of hairs. Please give me best possible advice ASAP…I am very depressed…

Also, I have very oily scalp. I do wash every day with head & Shoulder oily scalp shampoo. If I do not wash a day, my scalp becomes very oily, and it will be itching and also boils will come up. I tried lots of things and no use. So please give me the best feasible solution ,by keeping my scalp condition

I really appreciate if you could help me. Thanks in advance.

The average person will lose 70-100 hairs per day so that alone may not be indicative of a problem, but if you believe that you now have a scalp and hair problems from the dyes used, you need to be seen by a good dermatologist who can examine your scalp skin and determine if you received a burn or had an allergic reaction to the dyes used. I can not tell you what to do without seeing you for myself.

Tags: hairloss, hair loss, color, hair color, dye

Massaging Minoxidil Into the Scalp

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

Anyway, I’ve read on many sites that minoxidil does not actually help regrow hair, except peach fuzz. Is that true? And is it better not to massage minoxidil onto the scalp, as it’ll get “lost” on your hair and fingers? Some people suggested just dropping it onto the scalp with the dropper, and leaving it be.

Thank you so much..

Using your hands can produce local absorption to the applying hand (see Should I Be Applying Rogaine with a Rubber Glove?). In some people it will only produce peach fuzz and on others it will produce actual hair. Using a dropper and spreading it locally around (probably good to use a rubber glove) will work.

Tags: minoxidil, rogaine, hair growth, absorption, hairloss, hair loss, peach fuzz

Do Vellus Hairs Follow the Same Cycles?

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

Hi Dr Rassman

As you have said before, it is perfectly normal to have some thinner hairs at the frontal hairline, temples, neck area. My question is, do these hairs follow the same cycles as the rest of the hair?
I.e, when I shower and notice that just a few (maybe 3, 4 or 5) of those that fall out are a bit thinner than the rest, could it be that they are those naturally thinner hairs from the temples etc??

Thanks!!

The vellus hairs may very well have a different cycle than the full terminal (normal thickness) hair. I don’t know that anyone knows for sure.

Tags: hairloss, hair loss, hair cycle, vellus

Slurred Speech and Lack of Wit with Propecia

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

I have a interesting situation ongoing. I took Propecia for 8 weeks total and stopped in late July, so I’ve been off of the drug for 13 weeks now. I experienced a major side effect my third week on it that has not subsided at all even to this day — slurred speech. When I speak to friends and/or coworkers, my sentences are not as eloquent and witty/dry humoresque as they used to be. In fact, they are not even half eloquent compared to BF (Before Finasteride) I am 100% sure my problems are from taking finasteride.

Interestingly, this is not a listed side effect on the literature and ergo was not told to me by my prescribing dermatologist. Even my parents and a psychiatrist, both who know nothing about the drug in my opinion, said it was just anxiety. However, I am not looknig for attention nor am I looking for money or anything. There’s no reason for me to bring any of this up if it wasn’t the reality.

Some might say my slurred speech could have been caused by a number of things, but those people are wrong. I took Propecia when I was in my early 20s. I have no health problems whatsoever and this was the first and only prescription pharmaceutical I ever took. My situation is analogous to a new house falling down during a big earthquake in San Francisco. Sure, the house could have fallen down independent of the earthquake, but it probably did not fall down on its own as it was new and had no other problems up until the point that it fell down, and the fact that a big earthquake hit at the same time it fell down is too great to be just a case of simple coincidence.

You’ve written to me about this a few times and I’ve tried to answer your questions before, apparently without much success. One that comes to mind is Is Propecia Making Me Lose My Quick Wit?… and I’m sure there’s others. You’re still the only person that has described this to me, and I think you’re looking to put the blame on Propecia when no blame is due.

As you state, it seems you are “100%” convinced that your problem is due to Propecia. I don’t think my reply would make any difference for you. I am all for free speech and expression, but slurred speech can be a sign of a brain process such as a stroke or evolving brain tumor. You need to see a physician (preferably a neurologist). Lack of “wit” or “dry humor” is a personality issue. You may need to see a physician if this is an issue, may be a psychiatrist. To be honest, your house/earthquake analogy wasn’t very good, but I do not know what else to say to you about this since you’ve made it quite clear that your mind is made up.

Tags: propecia, finasteride, personality, brain, hairloss, hair loss

Can I Shave My Head Bald After FUE?

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

Well I am black male and currently shave bald. I want to continue to shave bald. I am thinking of FUE to give me some hair in a thinning area. I have few questions: What does the donor area look like when you shave bald after FUE, does it show scarring? I mean razor bald like MJ. Is it worth doing?

I’m confused as to why you’d want a hair transplant only to shave your head bald. All wounds to the scalp will cause some scarring. With FUE, the scars are tiny dots, instead of a straight line scar like that of the strip transplant and they may have a white color to it that would show up after healing an FUE donor area. With dark skin, that might be a problem and one way to tell that is to have a test FUE session done of just 2-4 grafts and assess the healing at 3 months. These tiny scars allow you to keep your hair very short without noticeable scarring if the whitish scar does not appear, but that being said, completely shaving your head may make these scars visible. Again, a test is worth a try.

Tags: fue, scarring, scar, hair transplant, hairtransplant, hairloss, hair loss

Could Expired Shampoo Cause Hair Loss?

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

Dr Rassman help !

I just found out that for the past months i’ve been using a shampoo beyond its expiration date! The expiration date was on June 2008 and i was using it up until late October (2 – 3 times / week ). This is the shampoo: Bioderma Node DS

Would there be any permanent or temporary damage? I haven’t been experiencing any scalp problems ( apart from occasional mild itching and / or tightness ). I do have seen intense shedding in the past two months, which i though was seasonal shedding. I do have a couple of thousand plugs (last transplant was 6 1/2 months ago.)

I would really appreciate a reply. I’m really stressed about this one. Best Regards

Most labels for product expiration are usually not reflective of the actual life of the product (usually longer than stated). I don’t believe that you should have a problem with hair loss from using such an outdated shampoo. Look to other causes like genetic hair loss. You had a couple thousand grafts transplanted (I assume you mean grafts, even though you stated plugs, which often refers to the outdated hair transplant techniques of yesteryear), but I don’t know what degree of loss you had before that, whether you were on Propecia before your transplant, etc. You could be seeing shock loss from the hair transplant. Without seeing what you’re talking about and knowing more about your case, it would be difficult to guide you.

Tags: propecia, finasteride, shock loss, hair transplant, hairloss, hair loss, shampoo, expired, expiration

Can I Get Body Hair Transplants If I Want to Keep My Hair Short Forever?

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

Hi Dr.Rassman,
I see one of your recent post talks about transplanting leg hair to the chest. You mentioned also that you could transplant leghair to the scalp. Say you did a Fue2 procedure, coudln’t you reasonably get a LARGE amount of graphs using both legs if needed and the back of your head to fill in basically your entire head and then you could just have a shaved buzz cut for the rest of your life? I would not mind having to shave my head for the rest of my life for a fact as long as I know stubble would be up there!

I have discussed body hair transplants before (see posts about BHT). I would want to know why you felt that body hair was better than scalp hair. The growth success reflects the growth cycle and the sleep cycle of body and leg hairs such that far less than 90% growth occurs at any one time. Plus, the character of the two hairs (scalp and body) are quite different. And then, you’re saying you could make decisions about hair styling for the rest of your life. These are things you really need to consider.

Make an appointment with a competent and knowledgeable doctor if you are serious.

Tags: body hair, leg hair, hair transplant, hairtransplant, fue, bht, hairloss, hair loss

Hair Gel Caused Irritation Leading to Scabs That I Picked Off

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

Hello, I am in desperate need of advice about my hairline’s growth. From 7th to 9th grade I would wear hair gel. The chemicals in the gel had formed dandruff that irritated and dried my scalp. I would excessively scratch my head because of the itching. Especially around my hairline. Tiny scabs would form and I would pick them off with my nails because they would itch too. Hair stopped growing on those little areas of my hairline where the scabs were. Now it looks like I have a receding hairline. It has affected my confidence and left me full of regret. I think I permanently damaged the hair follicles on my hairline, because instead of thick hair tiny baby hairs grow out instead. These baby hairs seem like they do not grow. I am seventeen years old now, and I limit my use of gel to avoid itchy dandruff. It has been about a year and a half since I stopped scratching so compulsively. I hope you understand my perception of this depressing situation. Have I permanently damaged the hair follicles on my hairline? Will I ever have any growth, or is their something I can do about it? Please give me your insight and knowledge of what I can do.

You need to be evaluated by a good dermatologist. Sometimes gels can produce allergies, which may cause itching. Continuous scratching of the hair will produce traction alopecia and if you scratch it often in the same place, the hair loss can become permanent. I couldn’t tell you if you’ve developed permanent damage, though.

Tags: dermatology, allergy, scab, gel, chemical, hair product, hairloss, hair loss, traction alopecia

My Doctor Said Propecia Wouldn’t Cause Shedding

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

Hi I just got a propecia prescription but I wanted to ask you a question before I started to use it.

I’ve read on the internet that propecia may cause shedding but my doctor, when I asked him, said it wouldn’t. Can you possibly explain further (my doctor said that I was in the very early stages of loss). Hope to hear from you soon! Thank you.

Some people report shedding for a month or so when they start Propecia. We postulate that Propecia moves hair on an accelerated hair cycle and that the shedding that is reported is the result. I am not familiar with any permanence with whatever shedding that occurs (if, that is, it really occurs).

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