Dr,

I am hearing lot of ads about ‘Segals Solutions’ in India nowadays and heard that this product is from Canada and claims to be working well for a long. Does this really help in growing new hair or reducing hair loss? Appreciate if you could pick up my question and give your valuable review/response,

Thanks in adv

SegalsThe Segals Solutions website says the product is “100% effective” and then just below it is says an independent study shows “67% noticed a reduction in hair loss”. So it works 67% of the time, every time? Uh huh. It then goes on to say that it is very convenient to use, in that you only need to rub their lotion on your scalp and leave it there for a minimum of 6-8 hours, then shampoo your hair with their product, and then take their pill in the morning. Where is the convenience?

I haven’t heard of this hair loss “treatment” before, even though they say it’s been made for 30 years. You’d think that with 30 years of success, there would be more than 2 before/after photos available on their site (and even those are smaller than my thumb, making it hard to see what’s going on). The lotion you leave on your scalp for 8 hours contains biotin, saw palmetto, B vitamins, and some other stuff, but the shampoo is just listed as containing “herbs”, and I have no idea what is in the pill. They say the entire treatment contains African “herbal technology” including rooibos, which is a tea common in South Africa. It goes on to discuss a French lab study showing hair benefits, but no further details are given, I can’t find the study, and I doubt it’s been peer reviewed.

I’ve gone over this before — there are two proven treatments that are FDA approved safe and effective, minoxidil (Rogaine) and finasteride (Propecia). If anyone wants to give Segals Solutions a try, by all means don’t let me stop you. Just keep in mind you’re probably wasting your time and money, as even their own marketing information sounds confused about what results you are “guaranteed” to see.

Tags: saw palmetto, india, segals solution, hair loss, hairloss, biotin, shampoo

Dear Doctor,

You routinely advise people to stay clear of Scalp Med, Follicare, Spectral DNC and other similar products. Your reason is that all of the aforementioned products contain minoxidil and if they work, at all, it is simply due to the minoxidil contained in them. Your conclusion: Just buy plain minoxidil!

Well, I would agree that many products have probably a zero chance of working. Fabao, for example, contains nothing more that Chinese herbs and is formulated based on folklore and an ancient meta-physical concept of disease. I seriously doubt it does anything. On the other hand, products like Follicare and Spectral DNC take a known active ingredient (minoxidil) and try to improve on it. These products take many promising ingredients that have been shown to grown hair, to some degree, in certain studies, like Adenosine, Amenexil, free-form fatty acids, caffeine, etc. They also add other things like either DMSO (in Follicare) or nanosomes (in Spectral DNC) to increase absorption. Clearly, the makers are going all out to “turbo charge” ordinary minoxidil.

Although none of these ingredients are effective enough to be used as a stand-alone treatment, nor are any of them proven, they all, at some point, showed some degree of promise or effect. Dr. Peter Proctor, in a Q & A session on one of the forums, said that “any ingredient that has ever been claimed to grow hair, probably does to some degree — in some people.” With logic like that, these companies take the “best of the best” of the unprovens and add them to a proven ingredient (minoxidil.) With few exceptions, I think most of these companies have good intentions to make the most effective product they can with what is currently available to them. I think very few are outright, deliberate scams.

It seems clear and logical to me that when these extra ingredients are added to a proven minoxidil base, there is bound to be some beneficial, synergistic effect.

The Million Dollar Question: Putting aside cost and value, which I don’t think should be a factor in choosing treatment, do you really believe that one of these products is not likely to be more effective than plain minoxidil?

Could the opposite be true — manipulating the basic minoxidil may make it less effective? Where is the science here? I don’t believe everything I read and when someone or some company is self-promoting the product or process and then makes claims of benefits, what proof is there really? I need to see actual proof before I can even remotely consider giving something a thumbs up. And as you suggested, most of these products seem like they’re just combinations of every herbal that is rumored to have hair benefits, along with a proven treatment like minoxidil. So then when the minoxidil ultimately helps, they can say “See, our product works!” — but in reality, it’s just a more expensive version of generic minoxidil with added vitamins that may or may not be of any use to the hair growth process.

Good intentions or not, it is a buyer beware process and these companies are ultimately just out for your money (makes sense being a business). Cost might not be a factor for you, but I don’t think many people would agree with that notion, especially in this poor economy.

Tags: minoxidil, hairloss, hair loss, herbs

Two questions. I was at CVS and looking at the back of an olive oil hair conditioner product. It said that product, unlike petroleum jelly, does not clog hair follicles. So does petroleum jelly actually clog hair follicles and would this cause hair loss?

Also, this is not a new occurrence, but I often feel little bumps on my head that seem to be caused by dry scalp, but these feel like tiny pimples that cannot be popped. Does this have anything to do with MPB? Perhaps they’re inflamed hair follicles?

Vaseline petroleum jellyAlthough the popular theory seems to be that clogged follicles have their growth inhibited (hair being unable to grow because it is blocked), it is blatantly untrue. I do not believe petroleum jelly causes hair loss. The product you saw probably just had clever marketing and semantics so consumers will buy one hair conditioner product over another.

With respect to the bumps on your scalp, maybe it is pimples, and maybe you should have it checked out by your primary care doctor or dermatologist. I doubt it has much to do with balding, but I can’t tell something like that without an exam.

Tags: petroleum jelly, vaseline, clogged, hairloss, hair loss

I was wondering if you could expand on your entry “Could Transplanted Hair Fall Out Months After a Successful Procedure?

Does all of the transplanted hair fall out or just some of it? How long after the HT have you seen this occur? From what you’ve seen does it happen in younger or older patients? Most importantly can you re-transplant new grafts into the area? Would the same thing happen again or could there have been a mistake made during procedure?

I am not sure about your question. The newly transplanted hair usually falls out in a month or so after the surgery and it comes back 2-5 months after in waves of hair growth. Once you’re past the 7th month, everything should be stable and your transplanted hair should be there for the rest of your life. If transplanted hair falls out, it may reflect hair that was not taken from the permanent zone and in that case it may reflect an error from the surgeon.

Tags: hair transplant, hairloss, hair loss

I’m looking for an explanation on why all of a sudden I have a bold spot in the right side of my mustache. I read about other persons having the same problem in your site and asking the same questions, but at that time, no specific answer was provided besides going to an specialist and sending you a photo. Any changes lately?

Just because I am a doctor, it does not mean I have all the answers. The sudden appearance of a bald spot could reflect a series of medical conditions such as ringworm, alopecia areata, and/or other autoimmune diseases. You need to see a good dermatologist if you want to know more.

Tags: mustache, moustache, hairloss, hair loss, bald spot

I got my hair transplant done in Dec of 2008. During the consultation the Doctor showed me the area that he was going to cut. After the hair transplant was done I found out that he has cut the wrong place , he has cut right under my crown area. He has cut the wrong spot and I have gone to 4 different Doctors and all of them have told me that the cut is to high and the doctor that has done the transplant didnot know what he was doing. He has taken hair from part of my head that he has told me that I will be going bald and placed it in the front. So What can I do about this. Can anyone help me with this . Oh. by the way I paid for 2500 Grafts and he told me he only did 2100. I do not think he is telling the truth about the 2100 also. Everyone of the doctors that I have seen after the Hair transplant have told me that my hair transplant is not 2100 . They all said it looks like may be from 800 to 1000 grafs. Please if anyone knows what should I do please help me out. Thank you.

LegalAs you indicated you are in the area, a visit to my Los Angeles office will allow me to really understand the damage you have. The hair that was transplanted is not permanent hair if it was taken from too high on the back of the scalp. I would want to examine that area today and measure the degree of miniaturization, which will tell me how long that hair may last. Donor strips taken from the crown tend to scar badly — is that the case with you also? If it is, it will need to be transplanted as well. You have legal recourse against the doctor for not only the costs of the surgery, but the damage that he did which may have a long term consequence to you. These options also should be explored. I look forward to meeting with you.

Doctor selection is doing your research, knowing the experience of the doctor, his patient results, his skill and artistry, and his overall integrity. Hair transplantation is a lifetime process and often can not be reversed.

Tags: hair transplant, hairloss, hair loss

Dear Dr Rassman,
According a study done on behalf of Merck, patients treated with 0.2 mg finasteride showed approximately an increase of 61 hairs versus an increase of 77 hairs in 1 inch square treated with 1 mg of finasteride over the 6 month period. So can we say that taking 0.5 mg of finasteride may yield nearly the same results with 1 mg treatment

Split PropeciaYou are correct. We have known about this for many years (and have reported it here), though the standard dose is 1mg. For those who have unwanted side effects, taking 1/2 of the standard dose of Propecia should be considered, which we have been advising for many years.* Some of the original studies suggest that 1/2 the dose can be 80% as effective as the full dose and 1/4 of the dose could be half as effective as the full dose.

The original Merck study wanted to know the best and most effective dose, and the statistical data suggested 1mg. This was across a large population and if you assume that there is a bell curve, there is a wide range of responses. That also may mean that as many people as impacted by 1/2 the dose with 80% effectiveness, one might see that a sizable proportion of the population may require a higher dose than 1mg. When we see the response fall off, or a poor response, we are now recommending doubling the dose provided that the side effects do not appear.

*As always, discuss any changes to your prescription medication dosing with your prescribing doctor.

Tags: merck, finasteride, propecia, proscar, hairloss, hair loss, dosing

Hi Dr Rassman – In my late teens I had a bald patch appear in the back of my head that was diagnosed as alopecia areata, but it all subsequently grew back within a few months and has been normal since then. I’m now 30 and I’m thinking about a transplant to my hairline, I’m wondering if the previous alopecia areata puts me at additional risk for shock loss or any other complications (I’m already on Propecia). Thanks in advance.

Alopecia areata will often disappear months after it first appears. There is always a risk of it reappearing at any time, but considering how many years it is since its last appearance, it seems unlikely.

Alopecia areata (AA) is often regional so if you are genetically balding (more patterned loss) and the diseased area is outside the area of your need, it can be transplanted knowing that there is a remote risk of AA appearing in the recipient area. If the desire is to transplant a bald spot created by AA, then there are two conditions that I feel must be met:

  1. The AA has not been active for at least 3 years
  2. A biopsy should be performed to rule out it being active at this time
Tags: alopecia areata, hair transplant, hairloss, hair loss

I started thinning in one temple at 18 and was prescribed rogaine and biotin supplements. At 20 the entire top started thinning (especially in the frontal hairline area) and I am now nearing 21 and considering propecia, however, I am hesitant to start at such a young age for a couple reasons. I am a late bloomer with no facial hair and am constantly told that I look much younger than I am. I have two questions: 1) Will propecia effect my body’s development including facial hair? and 2) Is it more likely that something other than MPB could be affecting my hair because my body is so early in its development? I enjoy your blog and would appreciate any help you can give me. Thank you

It is possible (but not probable) that Propecia will slow down body hair growth. That has not been my experience. I really don’t know the answer to your perceptions of being a “late bloomer”. Some men don’t grow facial hair well at all, but at 20 years old your body is not early in development. I can’t say for sure what you’re experiencing without an exam, but from your brief one-line description, it sounds like MPB (frontal hair loss, top thinning). Propecia is a prescription drug, so discuss your concerns with your doctor.

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

Dr. Rassman,

Good info is provided in this blog, I want to ask you a question regarding a previous posters comment on Generic Finasteride. Your response to the blogger was to purchase Generic Finasteride at Cosco or Wallgreens instead of ordering generic Finasteride online. How is this possible when Merck was granted an extended patent until 2013 (See Wikipedia on Finasteride)?

Also do you think its safe cutting the 5mg into 4ths which will be 1.25mg approx? Thanks!

Generic Propecia (1mg finasteride) isn’t legally available in the US due to the U.S. and International patents held by Merck, but generic Proscar (5mg finasteride) is available in the US and that’s what I was referring to. When cutting the 5mg pill, you’ll likely have some crumbs, so it might be a little less than 1.25mg. Regardless, I don’t think it’ll be a problem. If you can cut it into 5 equal pieces, that would be ideal… but not practical and the dose clearly does not have to be exact (as discussed elsewhere on today’s posts).

Tags: pill splitting, generic, finasteride, propecia, proscar, hairloss, hair loss

At least 5-10 years ago I had multiple sessions of hair transplants. All these years later, I am still getting scabby type growths at up to dozens of the implant recipient sites.They dont hurt ,but they feel annoying-as they feel like small crusty raised bumps that I have to kind of pick and tease off since hair is growing up threw the center of them.I am fair skinned Irish so I am very careful not to get a sunburn on my scalp or it makes this problem MUCH worse .Any advice/product or Rx recommended?? Thank You

I would have to see you and look at your skin to understand the problem. Flaky skin (dandruff) can be something brought on by a scalp surgery. Zinc and tar based shampoos will work to control this. You can buy this in any neighborhood drugstore.

Tags: dandruff, hair transplant, scabs, hairloss, hair loss

hello doctor,

My question is ive been doing both rogaine and propecia for almost ten years. All of a sudden a couple months ago i started to get some dandruff (mild case). i am now using dhs zinc shampoo. the dandruff is still there but im controlling it and its not too bad. should i stop using the rogaine as it may be causing the dandruff? and if i use rogaine having some dandruff will that cause hair loss? (i did see my dermatologist and he didnt seem to concerned about me having the dandruff plus using the rogaine)

Thank you for your time

Rogaine (minoxidil) can cause scalp irritation and give you flaking. The use of zinc shampoos like Head and Shoulders works to control dandruff, so you’re on the right path. You will not develop hair loss from the dandruff.

Tags: rogaine, minoxidil, dandruff, hairloss, hair loss, irritation

Dr. Rassman. I have noticed that you have a fair amount of threads about bad transplant surgeons such as this one here, but you never say the doctor’s name. What is the point in posting this unless you mention the Doctor’s name so patients in the future will stay clear of this doctor and others? Without mentioning the doctor’s name, other patients will be subject to his horrible results.

CrookI would love to mention the doctors’ names, but that would almost certainly bring me into court, something that I do not wish to spend my life doing (it might bring me to the brink of financial ruin with large lawyer fees just to prove what I said). I get angry when I see the mess created by many of these doctors, but alas, you must use the information in ways to become a knowledgeable buyer, so I use this blog to call people’s attention to what they need to look for when engaging a doctor’s service for a hair transplant.

In 1994, at a medical meeting that easily had 400 physician in the audience, I rose to the microphone and openly referred to the sleaze in this business, with doctors low balling patients and deforming them without telling them the risks to hair transplantation (giving them proper informed consent). The surgical results before 1994 were often deforming and pluggy. These, in hindsight, were very substandard when compared to today’s artfully performed hair transplants. Many doctors would not enter the business to perform hair transplants because of the deforming nature of the surgery at that time. One doctor, in particular, was my target and when I exemplified this sleazy, dishonest doctor without mentioning his name (I called him a “crook” in the true sense of the word), the audience responded with a standing ovation for my being so outspoken, echoing my message. At the end of the session, I was surrounded by many doctors congratulating me on my outspoken comment. One doctor (the one whose name was never mentioned) waited for the crowd to clear and approached me with great anger, saying that he did not appreciate my calling him a crook. As I never mentioned his name, I said “If the shoe fits, wear it” and walked away.

Tags: doctor, physician, negative, hairloss, hair loss, hair transplant

Dear Dr. Rassman,

If you watch the attached videos of Eric Lindros (former professional hockey player), would you assume that he has had a hair transplant or is that a hair piece? I would estimate that the videos are 5-8 years apart. If it is a transplant, the results are exceptional. In the first video, he clearly has signs of a receeding/thinning hairline. Conversely, in the second video (interview after his retirement) he has a full head of hair. What are your thoughts?

Youtube – Eric Lindros in 1997
Youtube – Eric Lindros in 2007

Thank you in advance for your time. Best Regards.

Here are side by side still shots from the videos you linked to:

Eric Lindros

The comparison with the 1997 pictures show Eric Lindros is a Class 3 Vertex balding pattern (front and crown). From the pictures, I can not tell if it is a hair piece or a hair transplant, but he is doing something to give himself hair. When the hair is combed forward, a lot can be hidden. Perhaps he started on medication like Propecia or Rogaine. Propecia was FDA approved in late 1997, so he could’ve started it soon after. I really am just speculating, of course. For all I know, it could’ve been witchcraft (though I’m 99% convinced it wasn’t).

Tags: hockey, eric lindros, lindros, hair loss, hairloss, speculation, hair, nhl

Have you ever seen anybody end up going completely bald while on Propecia?

Interesting question. Some men start Propecia when they have advanced balding patterns and few start when they have a full head of hair with early miniaturization. Those that started Propecia with a full head of hair (with some miniaturization) are slowing losing hair to some degree, but I do not recall anyone that became completely bald. I suspect that there are patients who will develop a Norwood Class 7 pattern of balding even on the drug, but these are few and far between. This does not mean you are guaranteed to not go bald on Propecia. I suspect I have not followed someone long enough in the last 10+ years to have seen it (or if they became bald, they never followed up with me).

Tags: propecia, finasteride, balding, bald, hairloss, hair loss