Could Propecia Be Used to Treat Cardiovascular Disease?

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

Doctor,

There is an established correlation between (early onset) androgenic alopecia and both cardiovascular disease and prostate cancer. Now interestingly, Propecia (more than likely) reduces the risk of prostate cancer. Since Propecia seems helpful against hair loss and against prostate cancer, could it also be helpful against the third correlate: cardiovascular disease?

At least some studies seem to consider DHT to be proatherogenic while others consider estradiol to be antiatherogenic (in men). Given the fact balding men carry an extra cardiovascular risk and prostate cancer risk, could finasteride not only reduce the risk of prostate cancer but work cardioprotective as well in this population? Unfortunately I did not find much empirical data (only one study – PMID: 12234510 – reporting a non-significant RR of 0.3). How plausible do you consider finasteride to be helpful in reducing the added CVD risk in balding (young) men?

HeartA valid and interesting point. I honestly don’t know how plausible it is, but it is certainly a refreshing perspective from a sea of anti-Propecia campaigns and the paranoia of its side effects that I’ve been receiving via email lately.

Medications are not magic bullets. They have limitations and might not always work the way we think they should work, but there may be benefits as well as detriments (for those anti-Propecia fans) still undiscovered. After all, Propecia was an accidental discovery, but there is clearly a need to study the connection between heart disease on those men taking Propecia. Considering that many men on Propecia are young, the number of people needed for a valid study may be very high.

Tags: finasteride, propecia, cardiovascular, prostate cancer, cancer, hairloss, hair loss, cardio

My DHT Levels are 5 Times Higher After Being on Propecia

/by William Rassman, M.D./3 /

Hi,

Before started propecia my dht levels were normal, now after 7 months i had great results but my dht levels are 5 times higher. have any of your patients reported this? or do you know anyone who happened this?

I think it could be a reaction of my body, everyone said to me to never take propecia again, but i’m really worried about my hair loss.

thanks!

It’s great to hear you had good clinical results from Propecia. This is just a blood test, but what I want to know is — what are your testosterone levels? Usually these go up initially and they drop down to normal levels within a few months.

Tags: testosterone, propecia, finasteride

Vitamin D Caused My Female Hair Loss to Stop!

/by William Rassman, M.D./6 /

(female)
Hi – two weeks ago my Md told me I was really deficient in vitamin d. I started taking 5000 units a day and to my astonishment – when I washed my hair- almost NONE came out… ( usually its handfuls) … also muscle spasms stopped and i feel great…

Vitamin D is a miracle… really!

Now that your vitamin D deficiency is cleared up, so is your hair loss. That’s great news! Congratulations!

I’m posting this to show that female hair loss has so many potential causes (a partial list can be found here), and some solutions are as simple as adding vitamins to your diet. Talk to your doctor!

Tags: vitamin, supplement, female hair loss, hairloss, hair loss

You Only Want to Sell Hair Transplants to the Fruits and Nuts in California!

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

Sir,

I am 58 and starting to lose my hair front and top.

I have never used any product other than Nioxin, (for 20 years) but not for hair loss, I simply like the products.

I am having a very hard time, not only believing in the infomercial hair loss products like Provillus but also your negativity towards all these products. I find your foot print, disclaiming most of the infomercial hair loss products and this includes Rogaine…

Should I believe that all these products are completely bogus OR are you degrading them because you charge an insane amount of money for your hair transplants, especially in Calif where the fruits, nuts and very vain people live! I seem to feel that you are bias towards these products because you need to buy another million dollar mansion some where in the fruit and nut state? Am I correct?

By the way, I have many friends that live in Calif and I consider them to be fruits and nuts also!

Sincerely,
– Name removed
New York

Transplanted fruitI’ll just assume you were making a very poor attempt at humor with all your “fruits and nuts” comments, so I won’t take offense. Considering our fees for hair transplants are lower than many physicians in your own state, you’re pretty narrow-sighted to think pricing is outrageous because we’re in California. But let’s get to the real meat of your oh-so-insightful email…

Most of the hair loss products you read about on the web are bogus and the makers prey on desperate people trying to retain their hair. The products that do work (and are proven to do so) are finasteride and minoxidil. And even then, I post plenty of reports from readers about side effects and concerns for those medications. I like to think I’m pretty balanced when it comes to this stuff. If you like a particular hair product then by all means continue using it. I never said these products were unhealthy or would hurt or kill you. A product like Provillus just contains minoxidil, so it works like minoxidil does. If you want to spend more on a boutique minoxidil with vitamins that I feel won’t aid in regrowth, that’s your call to make. If you want to buy a shampoo because you like the way it makes your hair feel, then please go for it.

It sounds like your biggest gripe is that I’m not writing positive things about unproven treatments. I’m asked about nearly every hair treatment product under the sun, and all I can do with most of these is review the ingredients listed and give my 2 cents. Recently I was asked about a product that lists rosemary as some kind of hair growth treatment. Simon and Garfunkel might’ve had a hit with Parsley, Sage, Rosemary and Thyme, but it doesn’t mean those same ingredients will work to grow hair (otherwise I’m sure Garfunkel wouldn’t have had his infamously bad hairline). My point is that there are hundreds of products around that claim to work — and they simply don’t. There’s no proof that they are effective… and it seems people don’t tend to care if there’s proof, as long as the website looks slick and they’re offered a “guarantee” that may or may not be worth anything.

You’re free to believe what you want to believe about me, but you couldn’t be more wrong. If I was going to try to persuade people into getting surgery, I wouldn’t bother recommending any medication (which I don’t make money on). If I was trying to buy a “million dollar mansion” (actually, it would be my first), I wouldn’t offer my services, time, and support for free through this website. Why would I bother educating people about how to be a better consumer if I was trying to take advantage of them? Give me a break. As for the so-called “fruits and nuts” in California, this state has some of the most normal, driven and brightest people in the world. If you want more information on what this state has to offer, you can visit the California Tourism site. I found that site by using Google… which incidentally was founded in *surprise, surprise* California.

Tags: hair transplant, hairloss, hair loss, rassman

Rogaine on Eyelashes?

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

(female) Can I use Rogaine on my eyelashes? I know it has not been tested on eyelashes, but do the ingredients seem harmful, or simply not yet approved for that purpose? Also, what about using Rogaine on my eyebrows?

EyelashesRogaine (minoxidil) is an irritant and if you use it around the eye and accidentally get it into the eye, you could be in for problems. I would think that the use of minoxidil in any form would not be a good thing to do for eyelashes. The new eyelash growth medication is Latisse (bimatoprost).

I know some patients have tried minoxidil on their eyebrows with mixed results. Just note that minoxidil isn’t recommended for anywhere other than the scalp, so be cautious if you do use it on the eyebrows.

Tags: rogaine, minoxidil, eyelashes, eyebrows, latisse, bimatoprost

My Dermatologist Said I Had Alopecia and Injected Steroids

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

My hair started frontal thinning 6 months ago and now i am almost completely bald up front. i have two questions.

1. does it make sense it fell out so fast?
2. i’ve been visiting a dermatologist and he said it was a form alopecia and he injected it with steroids. not to insult his credentials but it doesn’t look like any of the alopecia pictures i seen online and my hairline is starting to look like my dads could it be a misdiagnosis.

Really, you didn’t supply any information to work with here. If you are a male, injecting steroids in male pattern balding could be very damaging. If you are a female, it may not be as damaging as with a male, but I am not familiar with the benefits unless your doctor thinks that you have some autoimmune form of alopecia.

Alopecia is just another word for “hair loss” — so unless there is a defined form of alopecia (such as alopecia areata), I’m not sure what your doctor diagnosed you with. You should go back to that doctor and find out what your condition is and be sure to ask as many questions as you need to. Open communication between doctor and patient is a really beneficial thing to both parties.

Tags: dermatologist, steroid, alopecia, hairloss, hair loss

I’ve Got Scalp Burns from My Childhood, and Now I’m Starting to Thin

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

I have two problems with my hair that are now conflating to cause a major problem. First problem: when I was three years old I was burned with bacon grease and ended up with several bald spots on my head. Up to this point (I am now 40) my hair has been able to cover the bald spots. Second problem: now I am starting to experience some hair thinning and slight hair receding at the temples. So my hair is no longer able to cover up the bald spots. Can you help?

This is not a difficult problem, but without seeing you myself, I really couldn’t give you options on what to do. I’d have to see the size and location of the burn, along with the type of hair you have and the loss pattern you’re seeing. At the least, send me good digital pictures so I can see what the problem is. As you indicated that you live near my Los Angeles office, visit me for a private consultation and then you will get answers fairly fast.

Tags: burn, hairloss, hair loss, grease burn

In the News – Genetic On-Off Switch Found?

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

Snippet from the article:

Scientists have identified the gene that keeps females female. An international team found that the action of a single gene is all that stops females from developing male physical traits, including testes and facial hair.

When this gene was artificially “switched off” in adult female mice their ovaries began to turn into testes and they started to produce a level of testosterone found in healthy male mice.

Read the full article at TimesOnline UK

Maybe this type of finding will give us insights to those people who express the genes for hair loss in a somewhat random generation ‘skip’ pattern. Regardless, this is very interesting and exciting news!

Tags: genetic, gene, science

Hair Length Needed to Cover a Donor Scar?

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

Hello Dr

I was just wondering about donor scars. How high up is the donor area on the back of the scalp? Also in your opinion how long does the remaining hair usually need to grow to get a good cover-up over the scar? I prefer to wear my hair short but i was just curious to know what the norm is for most patients that go through the HT surgery.
Thanks

Norwood 7The donor area starts at the base of the skull (feel the prominent bone on the bottom of the skull) and go up a distance of 2.5-3 inches high. That is the donor area (see Norwood 7 art at right).

Scars from strip surgery vary in width. On average about 95% of patients will have a less than a 3mm high scar after one procedure and less than a 6mm high scar after the second procedure. Scarring varies and I see many patients who keep a very small scar (under 3 mm) for as many as 3 procedures. Likewise, some patients will stretch their scars more than others, and the scar could be 1cm high in the rare case. The wider the scar, the longer the hair has to be to cover it. Generally, the width of the scar (height) will require almost twice the hair length to cover it well, but that depends upon the hair thickness and the color / contrast between hair and skin color. On occasion, there is no significant visible scar in strip surgery and this is even more common when a trichophytic closure is used to close the donor area. In these patients, the scalp hair length can be 2-3mm long without showing anything. Having the FUE technique used will change the visible scar risk radically.

Tags: scarring, hair transplant, donor area, donor scar, hair loss, hairloss

My Hair Loss Is Fairly Stable but I Don’t Like My Hairline

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

Hi Doctor,
I have written to you before about my hairline; I was about to make my TV debut a year ago and was a little freaked out about my hair. My hairline started maturing when I was about 15 and at age 17 all recession stopped. I had some hairs along the edge and corners of the hairline that I suspected I would lose one day. About 2yrs ago I noticed some slight changes as those hairs did miniturize. I am now 38yrs old and I decided to see Dr. Bernstein in New York a couple of weeks ago. Most people laugh when I tell them I am worried about my hair. It is full and thick, and I wear it longer as I always did. Dr. Bernstein said I was on my way to a norwood 3, but I still had a great hairline. He put me on finasteride, and rogaine. He did not map my scalp for miniturization, and said he would not suggest surgery at this time. So I guess I am a norwood 2/3. My hairline looks very much like Johnny Depp’s or Robert De Niro’s. The thing is; I don’t like the way my hairline looks. My hair is almost black, and my skin is very fare which accentuates the hairline. If I decided to get a TP, I wouldn’t need alot of grafts, but it would give me more confidence. Any suggestions?

At 38 years old with a stable hairline and no significant miniaturization, a cosmetic lowering of the hairline starts a process that could impact you as you get older and possibly lose hair. If you want a hair transplant to lower a non-balding look, then that decision will be in the hands of you and an honorable surgeon who will not do harm to you if he transplants you. I have seen some doctors go overboard in people like you, put in 3000-4000 grafts, make a lot of money off of you and do you no good in the long run.

I know Dr. Bernstein and if he believes that you are not balding, you can always go back and ask him to consider this as a cosmetic approach to a hairline you don’t like and see what he says.

Tags: hairline, hairloss, hair loss, cosmetic, hairline lowering

Can I Take Medication After a Hair Transplant?

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

Dr first this site is AWESOME and I really wish I would have read all this before I underwent my transplant 2 weeks ago…

My question is and I know you had questions simular but I’d like to add a question to it. Transplant was 2 weeks ago, and now I’m taken Terbinafine 250 MG AKA Limisil for small amount of fungus on my toes, IF, I were to see myself losing hair will taken Propecia cancel out the hair loss and bring it back to it’s normal state? Do you think it’s too soon to take Lamisal just having the surgery just 2 weeks ago? I am really trying to undertsand how Lamisil in the 1st place could cause hair loss in some!?

I am just so paranoid cause I just spent all this money on a hair transplant and dont want to LOSE any of it, and it also a catch 22 cause I don’t want yellow nails either. Thanks in Advance

Side effects from medications (except steroids) that produce hair loss are generally rare. Those people who take anti-fungal medications do not have a problem with hair loss as a rule, but you need to discuss this with your prescribing doctor who probably has more experience with these medications than I do. I tell my patients that they can take all of their medications after a hair transplant and will frequently let them take their medications before and after the surgery.

Tags: hair transplant, medication, hairloss, hair loss

I Just Turned 40 and Have Some Hair Loss

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

Hi,
I have been on minox for the last 10 years when I noticed my hair started to thin and have managed to keep it fairly well. About 1-2 years ago I started on Dutasteride (I know you don’t recommend this) as I felt I saw an increase in thinning of my hear, especially in the crown region).

I have seen a few times that you have indicated that hairloss may be less aggressive after you are 40+.

As I’ve just turned 40 and have some hairloss, I’m of course curious if I maybe statistically have an increased chance to keep the remainder of my hair?

Kind regards

It is true that in general men’s hair loss tend to slow down as they age (after 40 years old, etc), but the cause of hair loss in the great majority of men is due to genetics. So while you might be an exception to the statistical rule, you could find that these statistics don’t apply to you.

Tags: hairloss, hair loss, statistics

In the News – Cracking Cancer’s Genetic Code

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

Snippet from the article:

Scientists have unlocked the entire genetic code of two of the most common cancers – skin and lung – a move they say could revolutionise cancer care. Not only will the cancer maps pave the way for blood tests to spot tumours far earlier, they will also yield new drug targets, says the Wellcome Trust team.

Scientists around the globe are now working to catalogue all the genes that go wrong in many types of human cancer. The UK is looking at breast cancer, Japan at liver and India at mouth. China is studying stomach cancer, and the US is looking at cancers of the brain, ovary and pancreas.

Read the full article at the BBC

This is a huge breakthrough in understanding cancer and how to treat it! While this article is not about hair loss, the importance of their research deserves a highlight here as it is far greater than anything we could ever do with saving someone’s hair.

Tags: cancer, genetic, health, science

Instant Growth of Hair Transplant? (with Photos)

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

Here’s a patient that reported continued growth of his hair transplants without going through the dreaded dormant phase that usually occurs for some time following the procedure. Now to be honest, the After photos were taken just under 2 years after the surgery so I can’t say I saw this instant (or continued) growth with my own eyes… but the patient is a doctor and is convinced that the reason he didn’t experience any fall-out was due to taking vitamin B2 and fish oils. I’ll leave it up to you if you want to try that approach in hopes of continued hair growth following a transplant, but I wanted to share the results here nonetheless. Click the photos to enlarge.

After one procedure of 2031 grafts

 

Before

 

Tags: hair loss, hairloss, hair transplant, surgery, hairline, hair restoration

Will a Hair Transplant Increase Propecia Efficacy?

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

Dear Dr Rassman,
You’ve said before that Propecia and Rogaine work best where there is still some hair left, not in completely bald areas of the scalp. If that’s the case, can having a hair transplant to a previously bald area actually increase the efficiency of the medicines in that area too ?

Norwood 7I think you’re confused. It is true that Propecia and Rogaine do not work in completely bald areas, but drug impact and surgical results are independent of each other. In a person with a slick bald area, the difference will come from the hair transplant and not the medication. If the hair grafts were transplanted successfully and from the donor area, those grafts will not require medication to grow. Remember, the donor area is the back horseshoe-shaped area as seen in the diagram at right. This area is permanent in most men (unless disease is present) and that is why it is used in transplantation.

Propecia and/or Rogaine can compliment the transplant for those that still have thinning areas. Sometimes, the goal of Propecia or Rogaine is to slow down further balding in the areas that you still have some hair. So to answer your question — no.

Tags: propecia, finasteride, minoxidil, rogaine, hair transplant