Body Hair, Semen, and Hair Loss Drugs

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

Dear Dr. Rassman,

I am a 22 year old male, and I have been on Propecia and Rogaine for about 2.5 months now. I was developing slight hair loss at the crown, and a receding hairline. It seems as though hair loss in all these places is being reversed as a result of the medication. I can still see room for improvement, but I am pleased with the results thus far.

I have two questions: can either of these medications cause hair to grow on other parts of the body? I’ve always had a lot of body hair, but it seems as though some parts of me have gotten hairier.

The other question is on sexual health. I’ve noticed that my semen has become much less viscous than before; the color remains cloudy white, but it is not as sticky and thick as before — almost like a fairly runny liquid — and orgasms seem less potent. Could this be because of the medications? Can I expect the problem to reverse itself over time? And, a matter of great importance to me: could that be a sign of compromised fertility?

My libido remains as high as always.

Propecia (finasteride) can give you less viscous semen and a smaller volume of semen. These are well known side effects. This drug does not compromise fertility.

Rogaine (minoxidil), if you apply it on other parts of your body, can give you more hair. I recall a patient that worked outdoors, and sweating in the hot sun caused the Rogaine he applied to his scalp to run down his neck. As a result he grew more neck/back hair than he was used to. I do not know if Propecia is making you have more hair on your body, but it has been reported.

Tags: rogaine, minoxidil, finasteride, propecia, hairloss, hair loss, body hair, side effects

Hair Loss from Hormone Replacement Therapy?

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

Hello, I have been on male HRT now for about 4 months and have noticed my hair thinning almost from the beginning. I have had great with the therapy and would like to continue. I have had a full head of thick hair all of my life and have no MPB on either side of my family.

If I quit the therapy altogether or have my Dr prescribe me a medication ( Proscar )to block the DHT will my hair grow back to its original form.

Thank You

Everybody is different and will react to the medications differently. I’m obviously not familiar with your medical history, so I can’t comment on whether medication will help. I don’t know anything about your case. I do not even know why you would want to start finasteride in the first place if you do not even know if you have MPB.

I would think the first thing you should do is discuss your hair loss issues with your doctor who is managing you with the HRT.

Tags: hairloss, hair loss, hormone replacement, hrt, finasteride, andropause

I Thought DUPA Was Diffuse All Over the Scalp?

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

In response to My Hair on Top is Thick, But My Sides Are Thinning Quickly!

You said, “If you are thinning only on the sides, something that I have rarely seen, it’s often associated with diffuse unpatterned alopecia (DUPA).”

Doctor….How the heck can he have DUPA if only his sides are thinning and not the top? Makes no sense.

You’re right. In the above referenced post, I was a little quick in my reply. Perhaps what I should’ve said in addition to the above quote is, “There may be additional miniaturization in the front, top, and crown that you’re not noticing, but if the hair is longer it could be more difficult to detect.”

Generally if the sides of the head have significant miniaturization, the rest of the hair on the scalp will also show the same. The degree of miniaturization may not be the same in different parts of the scalp, though. As I can’t see the hair loss through text sent in an email, I have to make guesses (educated or otherwise) when trying to answer a question like this. The individual needs to be seen by a doctor to examine their scalp, since who knows what is actually happening with their hair loss.

So just to clarify once more… in the case of someone losing hair on the sides of their head, chances are good that there will be hair loss elsewhere on the scalp. I apologize I wasn’t more clear about that in my earlier reply.

Tags: dupa, diffuse unpatterned alopecia, hairloss, hair loss

Give Me Hope for My Propecia Weakened Erection

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

I am 27 years old and I write regarding a side effect of propecia which is making me extremely nervous — to the point that I haven’t been able to sleep for many nights, and have been surfing the internet in search for answers and hope leading me to your site).

I took propecia for about four weeks, and at the fourth week mark, I noticed that my erection was significantly weaker. Because I am only 27, this was very odd — it had never happened before. I apologize for being graphic, but by weaker, I mean that the erection was only “half way” and “half full” and it was noticeably smaller, even though I was still able to ejaculate. The experience was not that pleasurable. Moreover, even when I am walking around on a daily basis, my penis “feels” smaller. One month later, the problem is just as bad.

I read online that a small percentage of men can suffer permanent, irreversible ED from propecia. I have already set up an appointment with a urologist, but suppose the worst happens and I am in that 1% group. Then, what could the urologist even do? And, what could I even do? Will I need to take Viagra the rest of my life?

This wouldn’t be as big of a deal if I were 50, but because I am only 27, I’m so, so worried that the rest of my life will be worse. I am being serious here: How can I ever be happy if I cannot perform sexually anymore? How can I even have a girlfriend or get married to someone or have a fulfilling life? Of course, if I had to take Viagra the rest of my life, I guess that wouldn’t be as bad as never again experiencing a full erection — but will Viagra even work for me?

Again, I know that you will advise me to see a doctor, and I will. Until my next appointment, though, I just need some hope. Besides, through your site, you probably have more knowledge and information about this problem than the urologist I will see.

Please, please help. I feel like my happiness in life is on the line.

You need to make an appointment with the doctor who prescribed you Propecia and discuss these issues with him/her. I suppose the appointment you made with the urologist may help too. I may be a doctor, but I am not your doctor and can’t give specific medical advice. I simply don’t know any of your medical history. There’s absolutely know way for me to know if you need to take Viagra for the rest of your life or if it would work for you.

In general, patients who have erectile dysfunction (ED) issues with Propecia can stop the medication and have the side effects go away within a week. That is the norm. I am not sure of reports that reflect permanent ED in men from Propecia, so there is hope in that regard. According to data in the medical literature, sexual side effects are not permanent in the less than 2% of men that experience them.

Tags: propecia, finasteride, erectile dysfunction, ed, hairloss, hair loss

Some of My Transplanted Hairs Never Fell Out After the Surgery

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

Hi –

Is it normal for some, but not all of the transplanted hair to remain in the transplanted area? I thought that it was an either/or kind of thing — either you were apart of the minority of s that would retain all of the transplanted hair or all of the transplanted follicles would eventually shed. I am going on 5.5 weeks now, and probably 85% of the transplanted hairs have shed, but there remains some hairs here and there that have “taken root” so to speak and begun growing. Should I expect these to fall out eventually? I have never heard of doctors talk about some but not all the transplanted hairs falling out.

Thanks!

For those that aren’t familiar, after a hair transplant surgery it’s common for the grafts to take root and the hairs to then fall out, with growth taking a few months to occur. A minority of patients (less than 5% is my unscientific guess) continue to grow the transplanted hair immediately after surgery.

I really have no way to know if you’re one of the rare patients that doesn’t go through the dormant phase following a hair transplant (it doesn’t have to be all-or-nothing in regards to immediate growth), and only time will tell if your hair will hold. In any case, keep your fingers crossed that the 15% of remaining transplanted hair continues to grow.

Tags: hair transplant, hairloss, hair loss

Could I Have Lost Hair During My 3 Week Propecia Hiatus?

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

I had been taking Finasteride for around four months until I stopped due to side effects. I was off the drug for around three weeks but then began to think that the side effects were psychosomatic so I decided to start taking it again. I was wondering if I could have suffered some hair loss during my brief break?

There’s really no way for me to know if you lost hair after your brief finasteride vacation (I don’t have access to any before/after miniaturization mappings), but I’d suspect that it’s possible to lose hair in as early as 3 weeks time.

Side effects are entirely possible (thought the percentage is small), and there are plenty of times that these side effects are psychosomatic. I mean, some men even documented hair growth when they were taking a placebo. The mind is a powerful thing.

Tags: propecia, finasteride, hairloss, hair loss

Novophane Capsules

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

Dear Doctor,

I am a great fan of you.. I am suffering from Androgenic Alopacia. I am developing baldness,front area some hairs are there.. in between i am having less hairs, back side i m having more hairs.. my scalp is very oily and i am having lots of sebum balls in my scalp.. Coming to my health, if I couldn’t have my lunch at proper time I will get severe headache and some times I might do the vomiting. The same thing applies to when I smell some fragrances and have some sweet food items. I sleep very late in night like 1 am or 2 am. I heard that taking novophane capsule will help at some extent. Please suggest and help me..Thanks in advance!!

NovophaneI’m not sure that your headaches or sensitivity to smells have anything to do with your hair loss. If you’re losing hair due to genetic causes, you should talk to your doctor about finasteride (Propecia) which is a prescription medication, or you can get minoxidil without a prescription. Those are proven hair loss treatments. You’re free to try any other capsules or lotions you want, but I sincerely doubt they will help if you’re experiencing genetic hair loss.

I wasn’t familiar with Novophane, but what little I was able to find about it online is as follows — “Novophane capsules is a complete formula which provides a set of nutrients that favour the production keratin in the nails and hair. For this it contains sulphur amino acids (cistina and metionina), vitamins and trace minerals.”

That sounds like meaningless marketing jargon. It contains vitamins and minerals. Great. The Novophane caps don’t contain anything proven to treat MPB. If your loss is due to vitamin deficiency or something else entirely, that’s a different story.

Tags: novophane, capsule, hairloss, hair loss

Propecia Before a Hair Transplant… and Does Stress Speed Up MPB?

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

Dear Dr,

Your Q and A’s are absolutely priceless in an industry where most people would not know where to start looking to gather info, so thank you for that. I have a couple of questions. I’ve read quite alot of your site now and have grasped most of what I need to know but would like to ask you about my specific case now if I may.

I am 27 and have been a Norwood 2 for 3-5 years and thought it was my mature hairline. But within the last year I had drastic life changing circumstances and alot of stress. That lasted to 4-6 months and I noticed I started losing hair around the temples(windows peak area) quite rapidly but in an even MPB fashion. I thought at the beginning it was stress induced but as it was happening evenly around both temples I thought after reading alot of your site that its just MPB getting stronger or whatever. Thus here are my questions!! :)

  1. Started Propecia and it is working amazing, from the first few days hair stopped falling out and every week it gets better. 1-2 hairs from a 4-5 day bedding wash cycle is all I get on the pillow now. I have been on it for 4 months now and obviously will continue for good, who knows what else will happen. But my Q is this, I want to get a hair transplant soon and fill up what I lost so I have all my hair back and keep the hairline I had which is windows peaks, which im fine with, suits my face and age etc.. But I was wondering. Do you think I should wait for 8 more months to see what Propecia can do before getting one or will it continue to improve wherever anyway in conjunction with the transplant?
  2. And secondly do you think in general stress really can speed up MPB evenly falling out like mine was? And if hair does fall out from stress does it ever grow back like it was before the event? Or is stress and MPB just to hard to diagnose other than on a case to case basis. Thank you so much for your time!

I’m glad you enjoy the site and find it useful. Thanks for visiting and writing.

I usually recommend to young men like yourself with male pattern baldness (MPB) that are interested in hair transplantation to get on Propecia for at least a few weeks before going for a surgery as you want the drug to bind to the hair follicle tissue to get a protective effect. In some people, waiting even longer than a few weeks may have value in seeing the benefit of the drug over time when the hair loss is still early.

Stress can certainly cause hair loss, and in men that are genetically programmed to lose hair, stress can speed up that timeframe. For those without MPB, stress-induced loss might regrow… but for those with MPB, stress-induced acceleration of hair loss is unlikely to see any regrowth even upon getting the stress under control.

Tags: propecia, finasteride, mpb, hairloss, hair loss, stress

Restoration Robotics Still Looking for Participants?

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

I just found this ad online. They are still looking for participants for Restoration Robotics’ automated transplants.

See ad

RobotYep, the ad is requesting participants for a paid research study in Colorado.

I have just had a personal viewing of the Restoration Robotics technology in my office last week and it is quite impressive. The robot only cores the grafts, then the doctor pulls them out by hand. They have not solved the placing problem for the inexperienced doctor that still plagues the industry.

Please note that the image at the right is not of the Restoration Robotics hair transplantation technology, but just imagine if it were…

Tags: robotics, restoration robotics, hair transplant, fue, hair loss, hairloss

Finasteride Decreased My Ejaculate; Is There Anything to Increase Volume?

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

I have been taking 5mg of Finesteride daily for a year now and noticed early on a sharp decrease in ejaculate volume. I have since found out that this sympton does occur so any concerns have been laid to rest.

My question though: Is there a medication that can be safely used along with Finesteride that will increase the force and volume of my ejaculation? – Thank you

VolumeThis is a known side effect of finasteride, particularly with the higher 5mg dose (used to treat the prostate). There’s no medication that I know of, but I’d recommend drinking plenty of water and eating a balanced diet to see if that helps.

There are natural supplements some people swear by to increase ejaculate volume, and while I can’t vouch for any of these, I suppose if you want to try them it couldn’t hurt. See the list here.

Tags: ejaculation, ejaculate, semen, finasteride, propecia, hairloss, hair loss

In the News – Laser Hair Center Accused of Swindling From Clients

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

Snippet from the article:

They say he assured them, his clients, that he could re-grow their hair. Out of desperation they say they paid him thousands upon thousands of dollars in the hope his promise was true.

FOX Chicago News has been investigating an accused con artist to find out how he’s managed to stay in business in Chicago for at least five years, despite repeated lawsuits claiming he’s a bald-faced liar.

His name is Steve Bennis.

Bennis advertises his hair clinic in several promotional videos on his web sites. In one, he talks about the lasers he uses for treatment. “It’s the best laser machine in the market,” Bennis said.

Scam AlertRead the full story at FOX Chicago — Hair Regrowth Center Accused of Swindling Clients out of Thousands

This is a follow-up to a post from late last year about a laser hair clinic in Chicago being sued for fraud… and as it turns out, the story is much more complex.

Desperate men were handing over tens of thousands of dollars after hearing promises of hair regrowth that are just not possible with any hair laser. When complaints were filed, he simply changed the company name. The investigation showed, “Bennis’ business has changed from Natural Hair Growth Institute to Omega Hair Group to Quantum Hair Sciences to Chicago Hair Growth Centers to American Hair Growth Centers“.

Much has been written about Steve Bennis online, and you can find a good starting point at Women’s Hair Loss Project.

Tags: laser, hair laser, fraud, chicago, hairloss, hair loss

Why Might My Transplanted Hair Appear Damaged After it Grew Out?

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

Hi. I received 1500 grafts 16 months ago. The transplanted hair has grown in very well but still remains damaged. It’s very dry and frayed, is this normal for it to still be damaged? By the way my hair is slightly over two inches in length.

I do not know what to make of your description. Sometimes the transplanted hairs may look a bit different in texture, but they usually return to their natural state over time. So in other words, no… it is not normal for transplanted hair to appear or feel any different from the rest of your hair, but on rare occasions (or more often in the hands of a less experienced transplant team) the hair can be damaged during the time it is moved.

Not all hair transplants are the same, and I don’t know the exact transplant technique and methods used by your doctor. Possible damage (if that is why your transplanted hair feels different) can be caused by trauma from handling or being left open to the air for more than a few seconds when it is transplanted to the recipient site.

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

Actor Mark-Paul Gosselaar’s Mature Hairline

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

Hey doc,
I was trying to find a good example of a hairline going from juvenile to mature and I found actor Mark-Paul Gosselaar, better known as Zack Morris from Saved by the Bell (kid/teen show in the 90s) and later he was a cop on the show NYPD Blue.

For someone like me in my 20s I think it serves as a good example of what a mature hairline is. Would you agree?

I know you’re all shocked to learn that I didn’t pay too much attention to teen sitcoms in the 1990s and thus am not familiar with Mark-Paul Gosselaar… but I absolutely agree that this is a great example of a young man’s hairline maturing.

Mark-Paul Gosselaar

 

Note in his teenage photo on the left that his hairline is squared in a typical juvenile hairline. In the photo on the right (I assume taken 15 or so years later) the hairline is a classic example of a mature hairline. Just based on photos I’ve seen, this man appears to have a great head of hair.

Tags: saved by the bell, nypd blue, actor, celebrity, mark-paul gosselaar, hairline

Juvenile Hairline and the Highest Wrinkle

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

Thanks for the great site Dr. Rassman.

My questions is merely to clarify one of your points. Does the juvenile hairline touch the TOP of the frontalis muscle or the bottom (i.e. the highest wrinkle)?

Thanks in advance

A juvenile hairline usually starts at the top of the frontalis muscle, which is usually seen with the top end of the forehead wrinkle.

Tags: juvenile hairline, frontalis, hairline, mature hairline

Nizoral and Dutasteride Together?

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

Hi Dr. Rassman,

Just wanted to say a very big thanks on how informative and up to date this website is.

My question is in relation to using both Nizoral and Dutasteride together. I have read in a few places the active ingredient in Nizoral has some sort of interaction with Dutasteride which reduces the effectiveness of Dutasteride in the body. Is this true and if so, is the effectiveness of Dutasteride reduced dramatically.

Thanks in advance.

NizoralI do not know of any interaction between Nizoral (ketoconazole) and Avodart (dutasteride), and while I attempted to research it, I came up empty. Where did you read that there was an effectiveness reduction? Perhaps I’m the wrong person to ask, as I don’t usually recommend either treatments (Nizoral never, Avodart rarely). If you’re taking dutasteride, you should discuss drug interactions with your prescribing doctor.

Nizoral is an antifungal shampoo, and although some people insist it helps to treat hair loss, this has yet to be proven. I honestly don’t think it works much better than any other shampoo.

There is some suggestion that dutasteride is more effective at treating hair loss than Propecia (finasteride), but this hasn’t been proven yet. Dutasteride has some history of sterility problems that concerns me (which is why I’m reluctant to prescribe it), whereas Propecia has no significant sterility problem history. Plus, Propecia is FDA approved to treat hair loss and dutasteride isn’t.

Tags: nizoral, ketoconazole, avodart, dutasteride, propecia, finasteride, hairloss, hair loss, shampoo