Could Side Effects Show Up Over a Year After Starting Propecia?

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

I have been on Propecia for around 15 months will no problems and good results – however I am very concerned that I may be experiencing side effects (maintenance of erection) !!!

Are side effects likely after such a prolonged period of use with no notable problems??? Or are side effects likely to show themselves within the first few months of being on the medication???

Side effects from Propecia like erectile dysfunction (ED) can appear over time, particularly if you are over 40 years old when ED is more common. I also have been told that libido or ED problems do show up late and I can not tell for sure if there is a cause and effect from the drug. The use of drugs like Viagra can help most people with these side effects and allows them to keep their hair. Check with your doctor and see if there are other causes of ED in your situation, as this may be caused by something other than Propecia.

Tags: propecia, finasteride, ed, libido, hairloss, hair loss

Using Minoxidil After Hair Loss from Chemical Burn?

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

Hello Dr. Rassman,
about 3 weeks ago I had a procedure done called l’oreal x-tenso which is basically a hair relaxing (rebonding) treatment. The original goal was to grow my hair longer, which is normally not an easy thing given that my hair is normally very thick and wavy/curly. Anyway, a couple of weeks after the procedures I decided to get my hair cut and a couple of days after that my hair started to shed a lot and has continued to do so over the past week, although it seems that the shedding is somewhat decreaing over the last couple of days. I’ve seen 3 different trichologists here in London and they all seem to think that the chemical from the relaxer cause some bad breakage but that should reverse once new hair grows out. Instead they all seem to agree that I also exhibit signs of androgenetic alopecia. There is no history of hair loss on both side of my family, isn’t genetic baldness always hereditary? The trichologists that I have seen here in London are suggesting that I use different topical solutions, Minoxidil has also been suggested. If the hair loss is caused mainly by breakage and it is not a genetic condition, would it still be safe for me to use Minoxidil? Also, looking at my hair when it falls, some of it but not most of it, has the bulb attached. Is that a bad sign, i.e not simple breakage but damage to the follicle? I’m a 38 year old Italian male. Thanks in advance for your reply

Without seeing you there is little I can do or diagnose. Yes, genetic hair loss is hereditary. Minoxidil will grow hair even if you’re not losing it by genetic factors, but you shouldn’t use a medication that you don’t need, even if it is available over the counter. Stay with someone in your area that you trust. See a doctor and find out if what you’re seeing is genetics or a chemical problem.

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

If I Have No Facial Hair, Will I Have Less Scalp Hair Loss?

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

I know that DHT causes both hair loss and facial hair growth. I’m 17 with no facial hair–does that possibly indicate that I will experience lesser hair loss?

Your lack of facial hair doesn’t have anything to do with future scalp hair loss. Your facial hair will probably just grow in later than your peers. Wait it out (up to 5 years or so). I would expect that you still might also grow chest hair. I wish I went back in time when I had no body or beard hair. Consider yourself lucky.

Tags: hairloss, hair loss, body hair, facial hair, mustache, moustache, beard

Hepatitis B and Hair Loss

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

Doc,
A while ago I asked if a Heb B jab could cause hairloss (here)

You replied that it could in rare circumstances. What I wanted to ask is what kind of hairloss are we talking about? Would all the hair fall out because of alopecia? Or is it possible that the jab could kickstart male pattern baldness speeding up my hairloss or is that just impossible from a jab? Thank you for a very informative blog!

Diseases of any significance can bring on hair loss. For men who have genetic hair loss, a disease and the associated stress can make it worse. In women, it is even more the case, as the connection of diseases and hair loss is more common.

Tags: hepatitis, hairloss, hair loss, stress

Transplanted Hair and Blood Supply

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

Hello there,

How long does it take for the blood supply to form (vascularization) to the hair follicles that are moved to the recipient area during a hair transsplant?

Thanks.

The blood supply increases as the hair volume increases. When all of the hair is growing from the transplant, the blood supply should be there. In some people it takes weeks, others months.

Tags: hair transplant, hairtransplant, blood supply, hairloss, hair loss, vascularization

What Percentage of a Chance Do You Give Laser Treatment of Working?

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

Hi Doc,

I am going to be starting the LUCE lds 100 laser treatment soon. Ive been losing hair for about a yr and half. I am currently 22. From your experience, what chances do you see of the treatment working on me? I’ve been on propecia for 5 months. Thinning on my crown is noticeable if pointed out. And the temples have receded slightly.

Thank you

LaserIn my personal opinion, lasers do not work to regrow hair. I base this on my experience with seeing many patients who have tried all sorts of lasers (from the big ones in clinics to the handheld models), and I have not seen it work. As I’ve mentioned before, I had a medical grade laser in my office for a year and offered free treatment, of which some patients chose to take advantage. None objectively grew any hair unless they used some medication like finasteride or minoxidil. I recall one patient who spent nearly $5000 on such laser treatments with another doctor for over a year, and as much as he wished and hoped that his money wasn’t wasted, the laser simply didn’t work for him.

If you are balding, there is no simple cure. You wanted a statistical assessment, so I’ll say that my best guess is a 0% chance of laser treatment working to regrow your hair. There are medications and/or surgery to address it, but there are always limitations.

Tags: laser, lasercomb, hairloss, hair loss, luce, lds, lllt

Taking Propecia for Over a Year — Should I Add Minoxidil?

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

I have a question about medication.

I am a 23 year old male who has been on Propecia for 1.5 years. I am in the very early stages of hair loss with just general thinning at the temples leading back. When I initially began the medication I felt a decreased sex-drive, so I decided to take 1mg every other day. Since then I have just had the same thinning with the miniaturized areas about the same or slightly thinner than two years ago. There was no reversal of miniaturized hairs.

I went to the doctor and he recommended I begin using Rogaine in addition. My question is: do you think changing the dose of Propecia might make a difference? When do you recommend using Minoxidil? Is there any reason not to use Minoxidil other than the fact that it is more difficult to use every day?

Thanks for your time.

The only time I’d say to not use minoxidil with Propecia would be when just starting treatment. If you use both at the start of your hair loss treatment, you won’t know which one is providing benefits and you’ll be stuck using both for life (unless you want to risk losing hair by stopping one). In your case, having taken Propecia for over a year, adding minoxidil shouldn’t be a problem. Some people do experience irritation from minoxidil, and I’ve heard from my patients that Rogaine Foam is easier to apply than the liquid.

Just because you didn’t see the miniaturization reverse with Propecia doesn’t mean it didn’t do anything for you — it could’ve very well just prevented further hair loss from occurring, stopping your loss where it was at. You could try taking just 0.5mg daily (instead of the recommended 1mg) if you experience a decreased sex drive, but check with your prescribing doctor before making any changes like that.

Tags: minoxidil, rogaine, propecia, finasteride, hairloss, hair loss, foam

19 Year Old Isn’t Sure if His Doctor Just Doesn’t Know About Maturing Hairlines

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

Dear Doc,
Hi, I’m a 19 year old male who just went in for miniaturization mapping. This is basically what I was told: there was no thinning on the crown and not much on the front, but there was thinning on the corners. Now already my corners have gone back quite a bit (about 1.5 inches, maybe a bit more, maybe a bit less). The front has gone back almost 0.5 inches.

When I left, the doctor recommended that I start propecia and start massaging my scalp with minoxidil once a day. Now I read what you had on “mature hairlines” and am wondering whether or not I have a mature hairline and if this treatment that the doctor recommended could cause more harm than help…

On the other hand I’m worried that maybe this is the beginning stages of balding. Should I go ahead with the treatment or is it likely that this is simply a mature hairline and that my recession won’t go much farther than it already is?

Thanks

As I have nothing to base an opinion on, I can not tell you what I think, but if you show me a photo of your frontal view from the eyebrows up and your brow lifted as high as you can get it so that the wrinkles in the forehead appear clearly, I will give you an opinion if this is a maturing hairline or early Norwood Class 3 balding.

Want to get the photo to me for review? Sign up at BaldingForum.com, upload your photo (or photos) there, then create a thread asking about your hairline in the Hair Loss Open Discussion category. It’s easier than it sounds, trust me.

Tags: mature hairline, hairloss, hair loss, hairline, norwood

Hair Loss Started When I Began Taking Ambien

/by William Rassman, M.D./60 /

I have been taking ambien for an extended period to aid in getting enough sleep. I go to sleep okay, but wake up after about two hours and cannot go back to sleep without the medication. I first took sonata and then ambien CR, but realized that, in my case, ambien worked just as well. However, I have noticed that my rate of hair loss has noticeably increased beyond the normal aging process. In looking back, the hair loss started soon after the time that I started taking the ambien. In addition, I have had itching scalp as well as one infected place on the crown of my head. I had never had these issues before. Could this result from the use of ambien products?

There seems to be many people who have personal experiences with Ambien (zolpidem) that suggest hair loss from it, although the literature does not state this relationship. You might probably reconsider taking the medication and see if stopping it stops the hair loss. As Ambien is a prescription drug, you should discuss the change with your prescribing doctor. I also couldn’t find anything in the literature relating scalp itch or skin irritation with this medication.

See our previous blog post about Ambien here.

Tags: ambien, zolpidem, hairloss, hair loss, sleep, insomnia, sedative

I Have Red Hair, but Some Fallen Hairs Are Nearly Black

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

Hi there lately ive been shedding alot of weird hairs there small and discolored. i have red hair and the hair strands are kinda thin but not really. they’re brown and they have white tips on them and ive had a few where at the bottom of the strand the bulb is completely white and towards the top of the strand its completely black almost. could this be some sort of deficiency? or maybe a auto immune problem?

Write back soon.

White bulbs are what we normally see with rotational shedding from hair cycling. There’s nothing unusual there. If you are female, you need to have a doctor’s examination and opinion, as there are too many possible reasons for hair loss in women. If you are male, then a miniaturization mapping is appropriate, as genetics is the most likely cause. I do not know what to make of the hairs that come out from a different color perspective.

Tags: miniaturization, hairloss, hair loss

Is Hair Normally Thinner Towards the Root?

/by William Rassman, M.D./5 /

Is it normal for a hair under an inch long to be noticably thinner towards the root? i see hairs that fall out that look kinda like an exclamation mark, thick at top and thin at the root. my hair is around 2cm long.

The exclamation point hair you’re describing usually points to a variety of conditions, such as allergic disorders, thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis (see Exclamation point hair). Normally hair is uniform in width.

Tags: exclamation point, hairloss, hair loss, alopecia areata, root

My 9 Year Old Daughter’s Hair Isn’t Growing and Falls Out!

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

My daughter is nine years old and is of the african american origin. Her hair is not growing and is falling out at the nap and temples. Yes I have gone to a doctor and still nothing works. I relax her hair about every six months with a PCJ just for me kids relaxer. Please help me I am at my wits end! What do I need to do to fix her problem?

It is highly probable that you are doing something (without realizing it) to cause hair loss, unless your daughter has some genetic disease. A good doctor should be able to tell with an examination. Make an appointment with a good dermatologist.

Tags: hairloss, hair loss, child

Why Might a Patient with 6000 Grafts Have a Thinner Appearance Than a Patient with 3000 Grafts?

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

Dear Dr.,
First of all thank you very much for the help you have given on this forum. I have had two HT operation 1000 FUE(1.5 years ago, worked very well) and 2000 FUT (3 months ago). My question is has to do with HT results and I would appreciate if you could answer;

  1. I saw pictures of more than 5K-6K grafts but has poor coverage/appearance compared to some 3K graft transplantation? Even, the pictures are from the same clinic. What are the reasons of this inconsistency?
  2. Most of the pictures show hairlines and first half of the top. How about the crown? Is it a common practice to leave crown bald? Is it because the budget or a bald person does not have enough donor for front and crown so has to select one?
  3. Does hair loss stop or decrease rate with the age? My lost started at age 26-27 with diffuse pattern now I am 31. A diffuse pattern goes till NW-7 or NW-6 or NW-6 with some diffuse hair still on top and crown?

Thank you very much.

Regards

Three months after a hair transplant should not produce enough hair to show any significant results. Wait a full 8 months to see the results of the second surgery.

  1. There could be a variety of reasons for that. Patient A and Patient B could have different hair color, skin color, hair characteristics, degree of balding, etc. Or it could be different techniques used (many clinics have damage problems with FUE grafts, for example). There’s just a lot of variables that could be the reason.
  2. The transplantation of hair in the crown does depend upon many factors, again including donor density, scalp laxity, thickness of the hair shafts, and the degree of balding. It may not be possible to transplant an entire head with a Norwood class 7 pattern of balding, but I have done it in patients with great hair qualities (see Patient ZU here, for example).
  3. Only about 7% of men go as far as a class 7 pattern, about 20% a class 6/7 pattern… and most of these men with the class 7 pattern have clear signs of it before the age of 30. You need to be evaluated by a doctor like myself or Dr. Pak that specializes in this field if your doctor does not answer this question for you.
Tags: hair transplant, hairtransplant, fue, hairloss, hair loss, crown

20 Year Old with High Metabolism — Could Propecia Work in Just a Week?!

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

Hello Dr. Rassman. I am a 20 year old male. I have been loosing my hair for about a year and a half and have thinned quite a bit all over the classic horse-shoe area. My questions are as follows: My hair has thinned, but not receded, my hairline is still intact, just diffuse. I’ve been on Propecia for about a week now,and I swear my hairloss has slowed. Is it possible that it could be working already? I have a VERY high metabolisim; could that be a factor? I’m crossing my fingers! Thanks….

I doubt Propecia would show any regrowth in only one week, but I suppose it is possible for slowing the hair loss. You should take a photo of your hair and keep it as a reference to see how it changes in the next year. That will tell you a great deal. Also, you can map out your scalp for miniaturization and follow the mapping results over time. Changes in miniaturization will show if the medications are working even if your metabolism is high.

20 year olds tend to do really, really well with finasteride (Propecia) and I have seen miracles with this medication on those in your age group. Good luck.

Tags: metabolism, propecia, finasteride, hairloss, hair loss, age

What Are the Odds a Teen Girl Will Bald?

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

Hi Doctor, I wrote to you and want to thank you for posting my question. I have taken my daughter to two different doctors and I received two different opinions. The first doctor said TE due to stress and the second said AGA due to family history. I did not think AGA could cause such loss on the corner forehead down to the temple. I wanted to know what the odds were that a 17 year old could have AGA. I know it can happen, but how unlucky would we have to be? Also, the area I’m talking about looks bald in photos. This has been going on since March with no regrowth.

One doctor says telogen effluvium (TE) and another says androgenic alopecia (AGA), but without an examination, I really couldn’t and shouldn’t try to help break the tie. So while I cannot comment on your daughter’s diagnosis, the general fact is AGA is more common in men. In fact, AGA (also known as male pattern baldness) is the most common cause of hair loss in men in post puberty years, including teens. I have seen rare instances where genetic hair loss can impact young women as well, but I don’t have actual statistics off hand for you. Luck doesn’t play a part, but based on my experience genetic hair loss in teen girls isn’t a common occurrence.

Tags: teen, hairloss, hair loss, balding, aga, mpb, teenager, puberty