Clobex Spray and Spironolactone to Treat Female Hair Loss?

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

(female)
I recently saw a dermatologist for my thinning hair. I’m not familiar with the medical terms he used, but he has me on clobex spray twice daily and spironolactone twice daily. I so desperately want something to work! I use hairmax lazer comb and rogaine. I am seeing hair growth on the sides near the temples but not much on top.Please guide me in the right direction. Thank you

There is a difference in wanting something to desperately work and something actually working. Sometimes you have to face the fact there really is no treatments for some types of balding.

There is no right direction I can guide a desperate patient who will just about try anything. I realize this sounds very pessimistic but nothing (aside from Rogaine) you are trying has ever been proven to work. Clobex is a steroid with the problems associated with chronic steroid use; I’ve written about spironolactone here; and there’s also no evidence I’ve seen that the LaserComb regrows hair to any visible degree.

Tags: clobex, hairloss, hair loss, lasercomb, lllt, spironolactone, female hair loss

How Long Can Vellus Hairs Get?

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

Hey Doctor

My question is a brief one, in regards to Vellus hairs, how long can they grow?

Occasionally i will find that a hair has fallen out that is quite abit shorter than the rest on my hair, and alot thinner. For example my hair is 5 inches long, and the smaller thinner hair that falls out is 2 inches long. Is this a vellus hair?

Thanks

Vellus hairs are present in every follicular unit (one or two of them), and I believe they are defined as the peach-fuzz like hair usually 2mm or less in length. So if you’re seeing a 2″ long hair falling out, it’s not going to be a vellus hair.

Tags: vellus hair, hairloss, hair loss

Side Effects from Finasteride, But No Side Effects from Dutasteride?

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

Hi Doctor!

I am very happy that I found your great site! I am 24 year old male with about a Norwood 2. Here in Hungary I dont think we would have good doctors being expert in hair loss treatment. I visited one of them (advertised by the spectral dnc site), but she stood against taking pills for my hair loss at such a young age (and after reading some hair loss forums I think she seemed to be incompetent in the topic). However a lot of international sites contain posts by even younger men successfully applying medications. I insist on trying them because any more hair loss would destroy my self image.

My frontal hairline must have started receding about when I was 20. The previous and this summer I observed that my frontal hairline rapidly shedded about 2-3 millimeters and I have a bit high forehead already. All my existing hairs are thick and they suddenly switch to short light hairs so the thinning is not gradual. What I want is to keep my current hairline from getting worse, but I would like to aim regrowing some hair, and I would have a few questions regarding this. I may also have some thinning on the entire crown, but Iam not sure about that, maybe its only my hair dresser who lessens the density…

I already tried Spectral DNC for 6 months with no success. (Note that the source of the DNC was not trusted but I admit that it was truly minoxidil because it made the hair on my hands and face much stronger…) I want to attack the problem at its roots so I would like to take finasteride or dutasteride. Is it possible for some men to keep all their hair with finasteride? I have a lot of small light hairs along my original juvenlie hairline. Do I have a chance to regrow them, or is it going to remain just normal bald scalp for sure? What do you think about starting with dutasteride 0.5mg if I want better results (www.dutasteride.com)? I read about some men with side effects on finasteride, but great success without side effects on dutasteride, is this possible? Thanks for your answers!

Cheers

AvodartIf any medication made it so you kept all of your hair, that could be considered a cure. At the risk of sounding like a broken record, there is no cure for hair loss. Finasteride (and perhaps dutasteride) will slow the loss down, possibly regrow hair, and should hopefully maintain the existing hair for some time.

Dutasteride (also known as Avodart) has a longer half-life and is a stronger medication than finasteride. If you see side effects from finasteride, I would assume you’ll have those same effects from dutasteride… but they may be stronger and possibly last even longer. Dutasteride was studied as a prostate medication in men over 50 years old, and I don’t have all the info because as far as I’m aware, proper studies of younger men taking it to treat hair loss have yet to be released. It also isn’t approved by the United States FDA for treating hair loss and thus, I can’t recommend it at this time.

Regardless, both finasteride and dutasteride are prescription medications and you’ll need to talk to your doctor about taking either. If your doctor wishes to prescribe dutasteride to you, that’s not my call to make.

Tags: dutasteride, avodart, propecia, finasteride, hairloss, hair loss

What Could Cause Histogen to Fail?

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

Hi Doc,

i’m sure you heard and saw Histogen’s Pilot Study and the general comment i saw in all the forums were that is really promising. i hope you can answer my question..

what do you see that MAY be a downfall in Histogen HSC plan? and do you think its results are more promising than hair cloning? i know that we have been hearing the quote “3 to 5 years time” BUT i dont think science had ever had such results than now so things are moving i guess..

HistogenI suppose the downfall could be the same for any new company in this space — financial backing. If the trials don’t go as well as expected, it may be harder to secure additional funds to keep making progress. I’m just speaking in generalities though.

I do not follow Histogen’s business or science plans close enough to scrutinize its progress, so I do not really have an opinion on its technology. The last I read about the HSC pilot program, it looked promising but only had a couple dozen participants… and it wasn’t known if the results would last for any significant amount of time.

It may be the hope to most (if not all) readers out there for a cure to balding, and I could only share the same hopes as any other.

Tags: histogen, hairloss, hair loss

LaserComb Cooking DHT?

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

I came across an interesting blog post of a guy stating that by the prolonged use of laser comb (holding it in position for a long period) allows it to neutralize the effect of DHT by making the scalp to secrete it along with some sebum and that it gave him wonderous results in the long run

could you please share us our comments on this, do you think that his claim has any credibility?….

CookingLaserComb does not cook DHT, nor have I seen evidence that any of the hair lasers do anything to DHT. People can believe what they want to believe, but there has yet to be any scientific study that provides a connection. I suppose that maybe what the guy with a blog reported in reversing hair loss had value (possibly circumstantial), but I truly doubt the cooking hypothesis. I’ve yet to see lasers show regrowth benefits in my own patients.

Anyone can post or say anything on the Internet, but it does not mean you have to take it at face value. I suppose that goes for what you read on my blog as well, so see your doctor if you need a second opinion.

Tags: dht, hair loss, hairloss, lllt, laser comb, lasercomb, laser

Staph Infection on My Crown

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

i had a staph infection on the crown of my head. my question is that it has left bald patches in my scalp and in other areas around my head but mainly on the crown. I do not have male pattern balding but will Rogaine help regrow the hair?

Rogaine (minoxidil) may help regrow some hair, but it usually takes about one full year for you to notice some difference. I’d just be patient and wait out for the hair to regrow on its own if you’re certain you don’t have genetic male pattern hair loss.

Tags: staph infection, hairloss, hair loss, minoxidil, rogaine

Is the Hairline More Sensitive to Testosterone?

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

Doctor reading this really scared me. Its from hairlosshelp.com

This is what someone posted regarding propecia

“Yes. I barely had any recession, it honestly looked like maturing of the hairline, and me having my dads hairline, it looked like thats what was happenning. Eight months in 2/3 of the front of my head fall out, I end up shedding 100+ hairs a day for 5 months, where as before Fin I only shed 15 a day. I was in so much denial I kept using it. So yah I ruined my hairline. Thankfull it’s growing back, but I probably permanately turned on the balding genes in those hairs, because it raised my testosterone so much. My testosterone used to run around 650, it got all the way up to 900 on fin. And, by the way, fin DID DO what its suppose to – it lowered my DHT signifcantly, it’s the testosterone that killed my hairline. Hairlines are beleived to be more sensitive to all androgens.”

Is it true? The hairline is more sensitive to testosterone and fin make the testosterone go up?

I would really appreciate it if you can answer this question ASAP. Im sure alot of people would also want an answer to this question.

The hairline is less sensitive to DHT blocking, but I don’t know if it is more sensitive to testosterone. The probability is that frontal hair experiences apoptosis (cell death) at an earlier age than the hair in the crown in most people.

In regard to the story you read that was posted about Propecia, that is one person’s experience and the story hasn’t been validated. I won’t make light of what this person says, but it isn’t objective and I just don’t believe everything I read (particularly on message boards where anyone can sign up with fake information). You can find all kinds of claims on the Internet, but who will validate the story?

And even if it is true, what would you like me to add? Are you asking for reassurance that Propecia will not cause hair loss? You will lose your hair with or without Propecia if you have the gene for male pattern baldness. Hopefully you have a doctor to work with, so talk to your doctor. Get the facts straight. If you look hard enough the Internet, you will probably never leave your house due to the fear mongering that goes on.

Tags: propecia, finasteride, dht, testosterone, hairline, hairloss, hair loss

Did I Lose Part of My Hairline Because I Stopped Propecia for a Week?

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

hi doc,

A few months ago i was studying for exams, which was obviously stressful. Around that time i ran out of propecia for a week, suprise suprise, i then realised my left hairline had taken a beating which wasnt there before. my question is, is it possible that i lost hair by stopping propecia for a week? if i lost hair because of stress when can i expect to see it grow back?

thank you

PropeciaIt does not quite work that way. Just because you stopped Propecia for one week does not mean it caused the loss of your frontal hair. I wouldn’t expect you to notice much loss in benefits from a week off the medication. Moreover, Propecia isn’t really as effective for treating frontal hair loss and works best in treating crown/top hair loss.

Now there are rare occasions where medication does provide some regrowth at the hairline, but these are very rare and it most likely won’t regrow. There is no medication that can prevent or reverse this with any level of certainty.

As well, stress-induced hair loss in those men with genetic hair loss will likely not regrow. Perhaps your hairline is maturing?

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

I Was Told to Use Minoxidil After My Hair Transplant

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

Hi
I recently had a direct implantation and I was told to use minoxidil 5% which I am not sure if is something I would like to use because of its many, quite weird for me,side effects.

Is it essential after implantation? or is there something else I could use that could be safer? thanks

RogaineMinoxidil (Rogaine) isn’t essential after a surgery, but Propecia would be recommended to prevent shock loss (and taking it before surgery would be optimal). I hope your surgeon discussed the possibility that the transplant could cause additional loss around the recipient area, and taking Propecia before the surgery could help to prevent that.

What weird side effects from minoxidil are you talking about? It could cause skin irritation, which isn’t too “weird” to consider for a topical medication. That being said, side effects are rare in both minoxidil and Propecia, but you’re under the care of a doctor already so I’d expect you should discuss these with him/her.

Tags: minoxidil, rogaine, hair loss, hairloss, propecia, finasteride, hair transplant, shock loss

Can Food Cause Hair Loss?

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

I would just like to ask if a food can cause hair loss. Because I have a project for school and my topic is about hair loss vs. aging. For example if i eat a mango it will caused hair loss? is there something like that? THANKS~!

MangoMango does not cause hair loss. In fact, I do not know of any specific foods that would cause hair loss. Perhaps if you have a severe allergy to a certain food, that could cause hair loss… but in general, normal foods do not cause hair loss.

Good luck with your school topic. If you want more information about hair loss, you can read my book — Hair Loss and Replacement for Dummies.

Tags: food, hair loss, hairloss

Scalp Reductions Done Today?

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

Hi Doc! I’ve just about made it through all 800+ pages on the Balding Blog and have a couple of questions about scalp reductions. I know you and most hair restoration physicians discredit them, but are there ever cases where one could be performed? Assuming good scalp laxity, how much could be removed without causing the slot deformity in the back? Some physicians still list some form of scalp reduction on their site and I’m wondering what they do these days that won’t cause more problems later.

Scalp reductionScalp reductions are not the “gold standard” in treating male pattern hair loss, because the results are sub-optimal and you end up with a scar along the top of your scalp that will be visible with continued hair loss. Although I hate to use the term “never”, I will say that I can not imagine using scalp reductions on any patient today.

Now with that said, a few of the old timers that have judgments and experience with follicular unit transplantation may find an indication for performing a scalp reduction and it might be reasonable in their hands to do a few. If the scalp reduction is limited to no more than 1-2 surgeries, then the probability of a slot deformity would be minimal and the thinning of the scalp will also be minimized. Reductions also tend to lose their value over time (a term called stretch-back) and the patient would need to understand that risk.

I had 3 scalp reductions in 1992-1993 and my scalp became very thin and easily damaged by sun. I also had a full stretch-back, resulting in a return to the original balding pattern from before the first surgery. The medical-legal risk of scalp reductions to the doctor is not insignificant in today’s litigious society, so few doctors will face the legal risk with complications that were so frequent in the early days. In the 1980s, doctors would do these frequently because the money was good ($2,000-2,500 per procedure) and the skilled doctor would be able to do it in 15-20 minutes. So the attraction to do something so profitable was irresistible for many doctors, bringing out the larcenous side of those who had that tendency. Add to that the need for 3-6 surgeries in most people and that made the money look better and better for the doctor, so much so that they lost their sense of compassion for the patients who had the many, many complications of this procedure.

For more information, including the history of scalp reductions and photos, see here.

Tags: scalp reduction, hair transplant, surgery, hairloss, hair loss

A Limited Physician Survey About Finasteride

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

SurveyI belong to an email group of hair transplant physicians who communicate regularly to share information. Most recently, the group was polled to determine the side effects that these doctors see with finasteride.

Most doctors reported sexual side effects (range from 2-5%), breast enlargement (very rarely, seems like substantially less than 1%), reduction in ejaculate volume (substantially less than the 20% I have seen when I ask about it), bouts of testicular pain (rare), and mood swings (rare). All side effects have been reversed by stopping the medication in 100% of the experience of these doctors.

This was an informal survey, but the general numbers seem to be similar to the instance of side effects reported by Merck. If someone in our group hopefully formalizes this possibly in a publication, I will post the results.

Many of our questions posted on BaldingBlog relate to Propecia/finasteride issues, which we point out may reflect the panic of some posters on the internet. Those in panic mode or those who are very fearful do not reflect the majority of men taking this drug.

Tags: finasteride, propecia, proscar, side effects, hairloss, hair loss

In the News – Getting the Word Out About Trichotillomania

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

Snippet from the article:

Laura Forbes has a ten-a-day habit that she is desperate to break. She tries to keep her hands and her mind occupied, but when she does succumb to temptation she feels guilty and frustrated to have derailed another attempt to give it up for good.

Laura is not addicted to cigarettes or to any other well-known vice. She is a trichotillomaniac – one of more than a million women in Britain who are tormented by the constant urge to tear out their own hair.

That Laura is plucking only ten hairs from her head a day is a great triumph of willpower for a girl whose obsession, at its peak, left her bald from the crown to the front of her head.

Trich
Photo source

Read the full story at DailyMail UK — The secret compulsion that’s as disturbing as any eating disorder

Trichotillomania is an obsessive compulsive disorder, and the article delves into looks at what triggers the desire to pull out your hair and how to possibly treat it. There’s no single solution that has worked across the board for everyone, but research has pointed towards new treatment paths.

Just a little over a year ago, we wrote about an over-the-counter pill that might help control the compulsion, but I haven’t found any newer info about it. If I find out more, I’ll post it on this site.

Tags: trichotillomania, trich, ttm, hairloss, hair loss, female hair loss, hair pulling, ocd

Preventive Propecia?

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

I have read many articles and questions on Propecia, but one think I never see is if propecia can be used as preventitive measure. For example Im 22 years old and still have a pretty thick heas of hair with a small receiding hairline, but my father is bald and so was my mother’s father so it is more then likely I will also go bald, so I was mainly wondering, is it ever to early with the hair loss stage to start using propecia even if I’m not sure if I will actually go bald.

You should not use Propecia (finasteride 1mg) for preventive measures. It’s a prescription medication, and you’d use it after you are examined by a doctor who can diagnose you with androgenic alopecia, prescribe it to you, and discuss all its risks and benefits. You have to know what you are treating first.

Tags: propecia, finasteride, hairloss, hair loss, preventive, preventative

I Can’t Take Medication During Military Basic Training, But I’m on Finasteride!

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

Quick Question:

I am joining the military, slighted to leave for boot camp in a few months. I JUST started taking finasteride about a week ago (experiencing lots of shedding, which I am fine with), but I am not allowed to ingest any medication for the duration of basic training, which lasts a minimum of 11 weeks.

Should I continue the treatment, knowing I have to stop? Will the shedding I have encountered even grow back without treatment? Will stopping, then starting again, effect future treatment (the drug’s potency)? Thank you in advance!

Army trainingI do not believe 11 weeks in and of itself should have a detrimental effect on your hair loss issue.

I have had patients in the military that didn’t have issues with taking Propecia during training, particularly since it is a medication prescribed by a doctor. Even in boot camp I believe it would be against the law for the government to flat-out keep you from taking a physician-prescribed medication. Now if you are taking Propecia obtained from the Internet without a valid doctor’s prescription that would be another issue entirely.

About.com has more on taking prescription medication in basic training — “Over-the-counter medication is not allowed in basic training. If you bring any with you, it will be taken away. All prescription medication will be re-evaluated by a military doctor upon arrival. If the doctor determines that the prescription is necessary, the civilian medication will be taken away, and the recruit will be re-issued the medication by the military pharmacy.”

So I guess it depends on what the military doctor believes is a necessary prescription. Since it is a cosmetic issue, there might be some resistance… but perhaps you should talk to your recruiter about meeting with a military doctor ahead of time to find out for sure.

Tags: medication, military, army, hairloss, hair loss, boot camp, finasteride, propecia