Are Drug Companies Making a Better Finasteride?

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

Hey Dr Rassman
First of all I would just like to recognize all the the individuals who help make this site what it is. Its great. I love it! To be honest it distracts me at school a lot. I keep saying to myself, okay read one more post and thats it! But now for the serious part. I’m just wondering about the progress which is being made in the development of new drugs for male pattern baldness. I know you are probably getting sick of these questions, but are companies researching the working mechanisms of the approved drugs minoxidil and finasteride and building off what they already know?

Also, who is the youngest person that you have performed surgery on, not including young children with burns, but with male pattern balding and if so what do these results look like? I am also pleased to say that I will be scheduling a visit with you in May to meet with you….. I’m very excited as I am from Canada and have never been to LA before. I hope it lives up to the hype!

I don’t know much about new drugs in the drug pipeline of the pharmaceutical companies, but as I do find out anything I try to post it on this site quickly. Sometimes I get emails from people alerting me to medications in the pipeline that I hadn’t heard of before. Contrary to popular belief, I’m not a drug insider that knows timelines on when medications are coming to market. Treating hair loss is a billion dollar business, so while I don’t know this to be 100% the case, it would make sense that some drug companies are working on the next possible medication to regrow hair.

In the treatment of male pattern baldness, I made a mistake once by taking on a 17 year old patient with strictly frontal balding. He had a very fast moving hair loss progression and eventually went on to a Norwood class 7 pattern. This was around 1993, years before Propecia was on the market and it was early in my hair career. Today, I generally wait for:

  1. Advanced pattern progression that does not respond to Propecia
  2. Ages of 22 or higher
  3. Adequate or high densities of the donor hair
  4. Maturity… and many other characteristics tied to hair and skin color, hair density, coarseness of the hair, character of the hair, and family history

I look forward to meeting with you. Los Angeles is a great city and I am sure you will enjoy it if you gave yourself enough time for touring.

Tags: finasteride, propecia, hairloss, hair loss

In the News – Avodart and Heart Failure Risks

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

A recent publication in the New England Journal of Medicine shows that Avodart (dutasteride) reduces the risk of prostate cancer along the same lines as finasteride did in earlier studies. The study also shows that in those men on Avodart, there was an increased incidence of heart failure.

Here’s a snippet from the Associated Press article:

Full results of a big study testing a drug for preventing prostate cancer show a higher risk of heart failure, a surprise finding that could dampen enthusiasm for expanding its use.

On Monday, GlaxoSmithKline PLC asked the federal Food and Drug Administration to approve its drug Avodart as a cancer preventive for men at higher-than-normal risk of the disease. The drug is already sold for urinary problems, and no heart failure risks have been seen with that use, doctors say.

Results of a study testing it as a cancer preventive were given at a medical conference last year, but the heart risk information had not been analyzed at that time so only the main results of the study were presented, a Glaxo spokeswoman said. Full results are being published in Thursday’s New England Journal of Medicine.

The study involved 6,700 men with high scores from PSA blood tests but no sign of cancer on biopsy. They were given Avodart or dummy pills and new biopsies four years later. Prostate cancer was found in 25 percent of those on dummy pills and 20 percent of those on Avodart.

Read the full article — Study finds possible heart risk with prostate drug

As the article does mention, the heart risk could be a fluke, but it is important to study this further. Just another reason why I can’t endorse dutasteride for users that wish to take it for treating hair loss.

Tags: avodart, dutasteride, prostate, hair loss, hairloss, finasteride, heart failure, heart

Is My Tight-Fitting Beanie Causing My Hair Loss?

/by William Rassman, M.D./4 /

BeanieI’ve been wearing a tight fitting beanie or toque as we call them here in Canada fairly regularly for about four months now. Often it will be all day, morning till night (so approx 12-14hrs). Quite frankly I just forget its on my head. I’d always had a full head of hair but have noticed some minor thinning at the hairline which I swear was not there some months ago before I started this beanie trend. I know you’ve spoken against hat or headgear wearing as a contributor to hair loss however some still suggest there may be a small correlation between the two.

I don’t believe excess dirt or sebum would contribute to hair loss but what about the notion of your hair/scalp needing oxygen? or vitamin D as produced by exposure to the sun? In regards to tight headgear, what about the idea of a decrease in circulation? Or a form of traction alopecia as the hair gets pushed or pulled in different directions for prolonged periods of time? Your insight would be appreciated.

Traction alopecia is certainly a possibility from wearing a beanie or anything tight on your scalp for extended periods of time. Problems with blood supply and oxygen levels aren’t going to cause hair loss, though they were once thought to be causes many years ago.

Hopefully, any vitamin D you’re not getting from sunlight is covered by your diet. It is my opinion that the hair does not have to get washed and sebum build-up will not impact hair growth, however, not washing your hair could cause your head to eventually stink.

Tags: beanie, hairloss, hair loss, traction alopecia

Edible Hair Treatments? — Coconut Oil, Eggs, and More

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

Hi Dr.Rassman,

I understand that there are products in the market that can slow down the hair loss. What do you think about coconut oil, and also I have seen people using hair mask with Egg and yogurt and lemon?

Are these good for for scalp treatment and conditioning? thanks

EggsThose all sound delicious, but they won’t slow down your hair loss.

Coconut oil is used as a hair conditioner (apparently this is common in India), and I read that the yogurt/egg combo is also used as a conditioner by some. I can’t vouch for how well they work as hair conditioners, as I just use a bottled brand.

Tags: coconut oil, egg, yogurt, lemon, hairloss, hair loss

I Had a Transplant and Take Propecia — Is It Too Late for Miniaturization Mapping?

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

Hi Dr. Rassman. You’ve written that after miniaturization mapping you can do a good job predicting what balding pattern a person will likely develop. If I’ve already had a hair transplant a few years ago and have been on Propecia, and mapping wasn’t done beforehand, is there no way for me to predict where I’m headed? Thanks.

I believe a miniaturization study is a good measurement of your hair status at one given point in time. It’s like taking your blood pressure or pulse when you go see your doctor. Even if you had a hair transplant, this should not matter. So to answer your question — no, it’s not too late.

Tags: hair transplant, propecia, finasteride, hairloss, hair loss, miniaturization