Soy and Eyebrow Hair Loss

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

Dear DR. Rassman

i started eating high amounts of soy per day (6 soy bars per day) for about 3 months ago. – i have been shedding my eyebrows for two months. they still look full. i just read this article about soy and the new research saying that soy is not as healthy as we all think. HealingCrow.com

Do you think that the side effects of Soy could lead to hair loss?

There is not enough data and clearly not a focused study to connect hair loss and soy intake. I suspect if you had an allergy to soy, hair loss wouldn’t be a total surprise. But for those without a soy allergy, I can’t make the leap to connect it to your thinning eyebrows.

Tags: soy, hair loss, hairloss

Blurred Vision from Minoxidil?

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


I have taken propecia and minoxidil for approximately 2 weeks (and have since stopped). I noticed blurred vision and believe it to be attributed to either the propecia or minoxidil, or both.

My questions is if my blurred vision is associated with either product. will the blurring go away now that I have stopped.

Please respond.

I haven’t read about it occurring with finasteride, but blurred vision is a side effect from minoxidil. You might want to see a doctor if it has not gone away for 2 weeks, as that would worry me.

Tags: blurred vision, minoxidil, rogaine, side effect

Transplanting Very Fine Hair

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

Dr. do you have pictures to show what a hair transplant may look like for someone who has very fine hair? I may need as many as 1000-1500 grafts at my age of 51. My concern is my hair thickness. I believe my donor hair density is ‘average’ but not thick in caliber. Thank you

Many men have very fine hair. Hair thickness will affect the degree of fullness that is obtained from a hair transplant. A very fine hair may have 1/4th of the volume of a coarse hair, so what a surgeon loses in volume must be made up to some degree in the numbers of transplanted hairs. In other words, men with fine hair need more hair transplanted compared to men with coarse hair. There are other factors, such as hair styling (wavy and long is better than short and straight) and hair color/skin color, that would also determine the appearance of fullness. For example, fine, black, curly hair on dark skin is better than thick, coarse, straight hair on pale skin.

You should discuss your expectations and results with your doctor. Here are some patients with fine or very fine hair — KP, HWA, KLA, UH, and HTA. If you want live examples, come to one of my monthly Open House events where many of my patients attend to show off their results, some of which have very fine hair. It has always been interesting for me to note that men with fine hair are easier to please than men with coarse hair. I think that they always had see-through hair and that is why they appreciate whatever they get from a hair transplant.

Tags: hair character, hairloss, hair loss, hair transplant, fine hair

Finasteride Induced Depression

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

Hey doc, I found this interesting study on the web: Finasteride induced depression: a prospective study

and I was wondering if you can comment on whether or not Finasteride can induce depression?

I have heard previous studies that show this risk and report depression in some patients taking finasteride, but no one really knows if it is a direct relationship. This is a difficult assessment, as some of our patients may be depressed at the time they start treating their balding so then it’s a chicken-or-egg scenario, where one is left wondering which came first. Those that are losing their hair might have feelings of depression because of it.The good news is that this problem is rare and this drug is totally elective. Not taking it will just mean risks of progressive balding will become more likely without the drug, but it isn’t a lifesaving medication.

I try to get to know our patients and by getting into their head, I may understand who they are more than many doctors who just write a prescription.

Tags: finasteride, propecia, proscar, depression, depressed, hairloss, hair loss

I’ve Seen a Dozen Doctors for My Female Hair Loss with No Diagnosis

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

I am a 31 year old female, experiencing hair loss for approximately four years. I have lost approximately 75% of my hair. The loss is diffuse throughout my scalp. My hair falls out everywhere even after I wash and brush it; sometimes as many as 500 strands in the shower. I’ve see at lease twelve doctors (generalist, internist, dermatologist, endocrinologist and nature pathetic) and I’ve never been give a diagnosis. Medications such as Spiornlcatone/Aldactone 200mg, Yasmin and Metformin (I have no glucose intolerance) have not worked. I’ve had every blood test performed and the only borderline low level (16 then, 56 now) was feritin. Testosterone was completely normal.

I’m completely depressed and feel so ugly. My hair is so thin I can no longer wear it down. I’m a hopeless case or is there something else I can do or a doctor that can help?. I’ll do anything…

I wouldn’t say you’re a hopeless case. Your problem is common (I have heard this from many women) and doctors often do not do justice for you by sitting you down to talk after all appropriate tests are in. With hair loss in women, the problem isn’t always so easy to spot and it certainly isn’t something I should attempt to do online.

Since you indicated you’re in the LA area, call my office at 800-NEW-HAIR (or 310-553-9113) to setup a free, private consultation with me in my Los Angeles office. I would be happy to see you. Or you can fill out your info here and someone on my staff will get back to you to schedule the appointment. You will get straight answers.

Tags: female hair loss, hairloss, hair loss, consultation, diagnosis

In the News – Busting Counterfeit Drug Rings in the UK

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

Snippet from the article:

In a sleepy suburban street, police and undercover agents prepare to raid the HQ of a lucrative drugs ring. But this is not a squalid bedsit or dingy warehouse. It is a detached bungalow on a leafy lane in an affluent area. The cops are not after crack or heroin. They are hunting substances that many believe to be potentially even more dangerous – fake prescription medication.

There is big money being made in counterfeit medicines, which are sold mainly on the internet. The market is believed to be worth around £45million a year.

Read the rest at The Sun.

Oh, and finasteride is listed as one of those drugs that they’re hunting. This is just one of the reasons I’ve never recommended ordering prescription medications via the web. I know some people disregard this type of information, so even if you’re adamant about ordering prescription meds online, at least use common sense and be careful.

Tags: counterfeit, medication, drugs, finasteride, viagra, prescription medication

In the News – Exploring the Link Between Hair Loss and High Blood Pressure

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

Snippet from the article:

Hypertension has been linked to heart disease, diabetes and early mortality. But hair loss?

Scientists are not exactly sure why, but a number of studies have suggested a relationship between blood pressure and men’s baldness, particularly the early-onset kind.

In a study published in 2007, for example, researchers looked at 250 men ages 35 to 65. After controlling for age, high cholesterol, smoking and other variables, they found that hypertension was “strongly associated” with male pattern baldness: those with a blood pressure reading above 120 over 80 had twice the risk of the others.

Read the rest at the New York Times — The Claim: High Blood Pressure Will Increase People’s Risk of Losing Their Hair

Hair loss might be an early indicator of disease risk in some people, but that’s a theory that requires further study.

Tags: hypertension, hbp, high blood pressure, hairloss, hair loss, baldness

Supplements and FDA

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

All the over the counter products (segals , foltene , viviscal , revivogen) keep on saying that FDA wont approve any vitamin and mineral supplements and thay also say they dont have enough money to do that is it true? Is getting FDA approval that much an expensive process.(One distributer of segals solutions told me that shortage of funds prevents them from proving the effectiveness of Saw Palmetto as DHT blocker)

FDAThat is not entirely true. There are of course costs involved, but most dietary supplements don’t require FDA approval before they come to market. The key issue is that there is no patent on saw palmetto, so these supplement companies don’t have an exclusive right to sell it. They’d just be spending money to try to prove a supplement worked as claimed, only to possibly allow any company to reap the benefits of their costs. Plus, if that money was spent and it turned out that saw palmetto didn’t work as they claimed, sales of the supplement as a hair loss treatment would plummet.

I’ve written about a lot of this before, but the FDA oversees claims by any company or person who sells nearly any type of health-related product. The key to the FDA is that the products comply with good manufacturing practices (a term of art as used here) and that any claims can be substantiated with good science. Effectiveness and safety must be proved by the supplier when making any claims about benefits.

Tags: fda, saw palmetto, supplement, hairloss, hair loss

Why Does this Transplanted Hairline Look Weird? (with Photo)

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

I need to get your opinion on a photo I found. I was researching something unrelated to hair and I found a single photo with no info provided. I have no idea anything about this particular surgery, including doctor and graft count. But the hairline struck me as really weird looking. Why might a doctor transplant this odd shape? Just poor skill or is there a valid reason? I’ve had a successful hair transplant a few years ago so I’m familiar with how a transplant should look right after surgery, and this looks gross.

Here is the photo:

 

You can click the photo to enlarge, but note that this is NOT how a hair transplant should look. I have many criticisms of this work. The frontal line has a series of peaks that will appear like a picket fence when and if the hair grows in. Behind the leading edge, the grafts were placed in rows and that will show in the final result. The grafts appear to be large and elevated, which means that there will probably be pimple-like elevations from which the hair grows.

I would be interested in seeing the final result, but based on this photo I’d expect it to look awful. I’d love to know who the doctor is that performed this atrocity, so if anyone has more info please let me know.

Tags: hair transplant, hairloss, hair loss, hairline

Actor Jon Cryer’s Hair Loss?

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

If you haven’t yet had a chance to watch it, the November 23rd episode of Chuck Lorre’s _Two and a Half Men_ has a scene with Alan spraying on a fictional “Captain Terry’s Spray on Hair”, taking some untested hair growth pill and going on J-Date. These are all things I have done in my life and I found it particularly amusing. It’s interesting that they wrote this in since Jon Cryer seems to use some kind of concealer in real life. His hair looks too thick on screen.

Of course, I suspect a lot of actors use concealers, even the ones who do not have balding.

Jon CryerYou’re not alone. Tabloid site TMZ did a quick double take on Jon Cryer’s hair situation about a year ago — see here. He could very well be using a product in his hair, or perhaps the producers of the show have him do it to maintain consistency or youthfulness in the character. There does appear to be something going on with his hair, but I really don’t know for sure.

And yes, I’d guess that your suspicion is correct about many actors using concealers. A youthful look is something many people strive for, and of course those celebs have many reasons to look their best.

Tags: jon cryer, actor, celebrity, two and a half men, hairloss, hair loss, concealer

Did Your Mature Hairline Example Get a Hair Transplant?

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

Hi Dr Rassman,

just wondering if the person in the mature hair line example ever got a hair transplant? And would you have pictures of it? Is he of asian decent? I have thinning hair similar to him. How do you determine if his hairline won’t recede further than the red line so future hair transplants wont be needed?

Maturation of a Hairline — Moving From Juvenile to Mature

Mature hairlineMature hairline

This was a consultation patient of Asian descent that allowed me to use his photos for the purpose of educating on the blog. He only came in once and never had a hair transplant (at least, not with us). Miniaturization mapping may help to determine a future loss pattern.

Tags: hairloss, hair loss, hairline, miniaturization, juvenile, mature

I’ve Got My Numbers and My Severe Female Hair Loss

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

I have blood dht levels of 4. My tsh is 2.71 I have been having severe hair loss for about a year. My hair which was once very thick is now thin and falling out. My testosterone is 33, estrogen 24 and progesterone is .5. Do any of these numbers tell you a possible reason for my hair loss? Does the dht level of 4 mean low levels of dht on the follicles also and if not, how can I test for dht on follicle? Please give me some insight and suggestions. I am a 53 yr old female.Thank you!

I would have to know the normal values for the lab you used. Female hair loss is a very difficult evaluation, and doing it without you in front of me will not be valuable. I do not read lab tests without the patient involved in the process.

Tags: female hair loss, hair loss, hairloss, blood tests

Propecia Expectations for Extreme Cases

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

A few days ago there was a post on your blog, the question was asking the effectiveness of finasteride in the time of a year, at the end of the first paragraph of your responce you talk about how effective it is in men at a young age unless they are headed for NW3 by age 23. Why is it different for men of that extreme case and what can they expect from taking finasteride? Is it pointless for them?

If there was confusion, allow me to clarify. Propecia should work better in men who are actively balding and have progressive miniaturization of their hair. The thicker the hair shafts are in the miniaturization process, the better the Propecia will work. People who have ‘twigs’ for hair (those at the end of the miniaturization process in the affected areas) or those who have completely lost their hair in the impacted pattern, are unlikely to get regrowth or thickening of the hair shafts, which is probably the way Propecia works anyway.

This drug may not work as well if you are heading to a Norwood Class 6 or 7 with existing balding areas, particularly if the miniaturization process is nearing the end of its process. For the very young man in his early 20s, advanced balding patterns are indications of an aggressive balding process and the drug may be less effective than those with mild (Class 3) balding patterns. If you lost all your hair in a Class 6 or 7 pattern or have been a Class 3 for years with little change, for example, Propecia probably will not be much benefit, because the hair is long since gone. Moreover, for reasons unknown, Propecia is reported to work best in the top/crown areas, not over the frontal areas.

Tags: propecia, finasteride, hairloss, hair loss

FUE and Scalp Laxity After 3 Strip Procedures

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

How many more grafts can you gain if you add FUE. Say i had three strips for 6000 grafts and i’m stripped out. how many on average more grafts can a person get with FUE? One doctor said between 1000 and 2000. Does this sound accurate? thank you

Your laxity might be good after three strip surgeries, but some patients might find the donor area to be tight. The higher the density at the time of the follicular unit extraction (FUE) harvest, the greater the yield will be. For an FUE, the remaining density will reflect your depletion of 6000 grafts from the original permanent zone. For those men with a high original density, there could be many more grafts available… and for those with an average or below average density, the different yield could be significant. If I examined you, I might be able to give you an educated guess, but there is no general answer to your question. A graft estimate of between 1000-2000 grafts is possible, but an examination is critical to the estimating process.

Tags: laxity, fue, hair loss, hairloss, hair transplant

Video: Why Hair Laser Can’t Work

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

Hey doc,
I know you’re not a fan of the various hair loss treatment lasers and I found this video that backs up your opinion. I thought you’d be interested in seeing it.

Thanks for sending this in. The video appears to have been produced by Feller Medical, and the basic argument it makes is that the laser doesn’t penetrate the skin, therefore it can’t possibly do what is claimed.

I’ve embedded the video here for all to see:

Tags: video, laser comb, hair laser, laser, hairloss, hair loss