March 2009 – Page 6 – WRassman,M.D. BaldingBlog

Erections Aren’t Intense After Taking 0.25mg Finasteride for Just 2 Months

Mar 13, 2009/by William Rassman, M.D./0 /Drugs

Hi Doc,
I’ve been taking about 0.25mg of Finasteride for 2 months. Due to paranoia, I was on the look out for sides. I noticed my erections, despite being just as hard, could not be ‘tensed’ quite as well. And didn’t feel as intense as a year or so ago (But I’m not sure if it was like that before I started the treatment). I’ve come off Propecia for 2 weeks with no change. Is it safe to say Finasteride was not the cause of this minor change, and it could simply be related to aging/diet? (I’m 22). It doesn’t cause me any problems as my erections are still easily hard enough for intercourse, it’s just I’d rather be at ‘100%’ if possible.

Thank you.

It sounds like you have an erectile problem which should be addressed by your doctor. It is generally safe to assume that once you are off finasteride for 2 weeks, it is essentially out of your system (if there is some tissue fixation) and should not be contributing to your problem. Plus, you’ve been taking only a fraction of the recommended dosage and say that you’re paranoid and looking for side effects (which could lead to a psychosomatic illness).

Tags: erection, hairloss, hair loss, finasteride, propecia, psychosomatic

Sun Exposure After a Hair Transplant

Mar 13, 2009/by William Rassman, M.D./0 /Hair Transplantation, Post-Operative

What is your opinion on Sun exposure for a new Hair transplant patient? Is there a danger to getting any direct sun on the scalp at all? If so, what is the proper waiting time after the surgery? Is it only sunburn I need to worry about? If I use sunscreen on my head, what is the correct SPF I should use. I was told direct sun might slow or prohibit any new growth. Thank you for taking time to respond.

UV light is not good for fresh wound healing and is known to slow it down. This would be most sensitive in the first few months, which is when I would suggest using a good sunscreen with an SPF factor of 45 or more. Generally, it is easier to wear a baseball cap.

Tags: uv light, sunscreen, sun, hairloss, hair loss, hair transplant

Does Depeche Mode Singer Dave Gahan Have a Mature Hairline?

Mar 13, 2009/by William Rassman, M.D./1 /Hairlines

One of my favorite singers in music is dave gahan. From these pictures, would you say he has a mature hairline? My hairline seems like it will be going down this road.

Photo 1 and Photo 2

He’s got a good, strong hairline, but with the way the corners are creeping up a little bit, I’d say this is about where the mature hairline exists. I would want to see him wrinkle his brow to be sure.

Tags: depeche mode, dave gahan, hairline, hairloss, hair loss

Hair Restoration for Black Men?

Mar 12, 2009/by William Rassman, M.D./0 /African American, Hair Transplantation, Videos

What are the hair restoration options for a black male with a receding hairline, and preferred style of a brushcut?

With respect to hair transplant surgery, there is no difference in black men or white men or Asian men or any other ethnicity or race. For very short haircuts, follicular unit extraction (FUE would likely be the way to go so that there isn’t any chance of a visible linear scar, but even the strip method doesn’t discount a short haircut in all men. Scarring is dependent on multiple factors that I’ve described before here.

Actually, I have seen great results for black men with hair transplants. I wish I had some very current results to show, but I can only use photos of those that allow me permission (privacy issues, of course), and with that being said, below is a patient that was featured in our NHI video from quite a few years back. His photos are also on our site here.

Tags: hair transplant, hair restoration, african american, african, black, hairloss, hair loss

Generic Propecia from India is FDA Approved?

Mar 12, 2009/by William Rassman, M.D./1 /Drugs

Dr. Rassman, generic finasteride is available in india manufactured by Cipla and other pharma companies. the name written in them are Finasteride tablets USP 1mg (eg: finpecia from cipla). A search in internet for USP returns “the United States Pharmacopeia (USP) is an official public standardsâ€“setting authority for all prescription and overâ€“theâ€“counter medicines and other health care products manufactured or sold in the United States.” Link: https://www.usp.org/aboutUSP/

so does that means these generics are approved by FDA or are they keeps the standards set by US law? thanks

There are some companies outside the US that make generic drugs that are marketed in the United States and they are legitimate. There is a difference between when the manufacturer meets FDA manufacturing guidelines and the company’s ability to sell the drug in the United States.

In the case of finasteride 1mg tablets, the restrictions are enforced through the laws that govern patent protection. If company ‘X’ decided that it wanted to sell a drug in the US that is covered by U.S. Patent, the patent owner can get a court to supply a cease and desist order to company ‘X’. The owner of the patent can also file for triple damages for lost revenues under existing patent laws.

Tags: patent, fda, generic, finasteride, propecia, proscar, india, hairloss, hair loss

HairDX Tests for Finasteride Response

Mar 12, 2009/by William Rassman, M.D./0 /Drugs, Hair Products

I don’t know if you have seen this new test by HairDX, but it caught my eye. It supposedly will predict your response to Finasteride.

HairDX

I also found this interesting news release at Marketwatch.com that discusses the HairDX (RxR) Genetic Test for Finasteride a bit more.

I am trying to understand how I would use the information that this new test would supply. I suppose if the test shows someone is not going to be very responsive to Propecia, then it could open up the possibility for the patient to have a hair transplant earlier, rather than waiting to see results from Propecia that may never occur. It’s not uncommon for me to turn potential surgical patients away if there’s a possibility that a single daily pill could solve their problem (I’d much rather recommend a pill over surgery if it’ll help). I think that I will offer the test to my patients and let them decide how to use it.

Tags: finasteride, propecia, hairdx, hairloss, hair loss, genetic, rxr

Oily Skin After Taking Propecia?

Mar 12, 2009/by William Rassman, M.D./0 /Drugs

Dr. Rassman,
Thanks for your fine blog and the wonderful service it provides. In your experience, how common is oily skin as a side effect of propecia, when does it present, and does it resolve itself over time under continued treatment. I took my first dose of Propecia this morning and even now (12 hours later) my skin seems much more oily than normal.

30 years old. Thinning in front and just starting to thin in the back.

Thanks

I am unaware of Propecia (finasteride 1mg) producing oily skin, but there is some logic that it could make the skin less oily. Propecia blocks dihydrotestosterone (DHT); oily skin is caused by DHT. Here’s a page that has more info about oily skin — Dermadoctor.com

Tags: propecia, finasteride, oily skin, dermatology, dht, hairloss, hair loss

Non-Hair Allergy Question

Mar 12, 2009/by William Rassman, M.D./0 /Other

This may be more of a non-direct hair question and thought you could answer this from your medical background. I’ve been consuming a bit of soy for hair protective measures and a friend of mine said that her roommate developed an allergy to soy because she got sick all the time. I always thought an allergy was manifested by itching, hives, etc. and not being sick. Does this make sense?

Bad reactions to natural substances do happen and it is not necessary to have itching, hives, etc. For example, some people get sick from dairy products and they do not develop itching, hives, etc but will develop ‘stomach’ problems like cramps or diarrhea.

Tags: allergy, soy, dairy

Fish Oil and Hair Loss in Asian Populations?

Mar 11, 2009/by William Rassman, M.D./3 /Hair Loss Causes

Great site. I have always thought that large amounts of fish oil can cause diffuse hair loss. The reason I think this is because of observing Asian woman and men. I have notice a LARGE amount of this population have diffuse hair loss, on the sides and back. I’m actually surprised of how many. I live in a major city and live in the ChinaTown section. I understand they have different hair characteristics ect…like skin color and dark hair but am convinced that this group of the population suffer from more diffuse than any other. I am convinced large amounts of Omega 3 can cause diffuse hair loss. It is interesting that GSK’s new prescription fish oil also list hair loss(Alopecia) as a possible side effect.

Lovaza Product Info PDF

Just thought I would get your view.

I do not think large amounts of fish oil cause diffuse hair loss. Are you implying Asians consume large amount of fish oil because they eat more fish and fish products than non-Asians? If we were to entertain your argument, I would think the Eskimos have a very high Omega 3 fish oil diet. I do know that they have less balding than the general population of Caucasians and American Indians. I can not address any suggestions by some manufacturers of fish oil supplements that hair loss is a known side effect, because I have no personal or professional experience one way or the other. The information PDF you sent (linked above) doesn’t have an actual percentage of those that experienced it. It could’ve been 2 people out of hundreds, but I have no way to know.

Asians (non-balding) generally have less hair than their Caucasian counterpart and also have less balding than their Caucasian counterparts according to studies I have researched in the past. Asians also have straight black hair which contrasts with their light colored skin and may look thinner. These factors can sometimes make non-balding Asians look as if they have thinning hair.

Tags: asia, asian, china, fish oil, omega 3, hairloss, hair loss, lovaza

I Want to Rock and Roll All Night (And Keep My Hair)

Mar 11, 2009/by William Rassman, M.D./0 /Age, Drugs, Hair Pieces / Systems

Doctor Rassman
I’m 20 years old and afraid I’m losing my hair, probably a mature hairline but I still fear the worst. I’m in a successful rock band and was wondering what my option are if i start to bald because i can’t just shave my head. I know i can use propecia but that would only last for so long right? Would a wig or weave stay on with all the constant head movement associated with playing rock concerts?

Rock! Genetic hair loss is due to genetics (as the name implies)… meaning, if you are going to lose hair you will lose hair and there is nothing you can do to stop it 100%. Drugs such as Propecia or Rogaine can slow it down or sometimes reverse some hair loss, but over the course of your life you will continue to lose hair (if you have the genes for genetic hair loss). Propecia is the best solution for a young man like yourself, if there is early hair loss going on. I would start by seeing a good physician who can diagnose you with genetic hair loss (also know as androgenic alopecia / male pattern baldness). There is no need to start any medication if you are not balding.

Wigs and weaves can stay on if fitted and attached properly, which many performers wear without it falling off while they “rock and roll” all night.

Tags: musician, hairloss, hair loss, weave, wig

In the News – New Hair Institute in the Los Angeles Times

Mar 11, 2009/by William Rassman, M.D./0 /Other

LA Times There’s a nice article in today’s Los Angeles Times business section (sprinkled with Dr. Rassman quotes and a plug for the Hair Loss and Replacement for Dummies book) written by a reporter that attended our free Open House event last weekend in our LA office!

Snippet from the article:

The recession has caused patient volume at cosmetic-surgery facilities to fall by a third, according to the American Academy of Cosmetic Surgery. With money so tight, it’s hard for many people to contemplate spending thousands of dollars on face-lifts or boob jobs.

But when I attended an open house at the New Hair Institute in Century City last weekend, I found a waiting room full of guys who were willing to spend as much as $20,000 apiece to restore what nature was taking away.

In many cases, the motivation is vanity or self-esteem. But increasingly these days, another incentive for men to undergo hair-transplant surgery is a desire to be more competitive in a challenging job market.

The full article can be found at the LA Times website — In a hairy job market, can transplants aid the balding?

Tags: los angeles times, la times, latimes, hairloss, hair loss, rassman, balding, hair transplant, job, employment

Cutting Proscar

Mar 11, 2009/by William Rassman, M.D./1 /Drugs

Dear doctor,
I have few questions about Proscar.

Do you think it is safe to cut proscar to 4-5 pieces?

Do you think that it is safer than buying generic finasteride?

Do you think that small differences in cutted pieces could have some negative effect?

thanks

Pill cutter And here’s a few answers to your questions about Proscar:

Yes, it is safe to cut Proscar into 4-5 pieces. Just cut one pill at a time.
I don’t think it is safer or less safe. The generic should be the same, just cheaper.
I don’t think the effect would be much, if any. This is why if you’re going to cut a 5mg pill, you should try to cut it into 4 equal pieces — much easier than cutting it into 5.

Tags: proscar, finasteride, hairloss, hair loss

Xolair (Asthma Medication) and Hair Loss?

Mar 11, 2009/by William Rassman, M.D./0 /Drugs (Cause Hair Loss)

Hi Doc.

Can the usage of Xolair an expensive asthma injectible cause hair loss. I have read warnings that this is possible. I may be taking this medicine in the near future and wondered if you have any thoughts on this issue with this medicine. It appears that most people take this med for multi years.

Thanks

Xolair Yes, Xolair (omalizumab) has been reported to produce hair loss in some patients. I don’t have anything else to add, as I don’t use nor do I prescribe this medication (I do not treat patients for asthma ailments). Sorry.