Finasteride Has Thickened The Top of My Head But Not the Crown

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

Hey dr, let me start by saying that this site has given me a lot of information about hairloss. I give it an A+.

My question is – I have been on finasteride for about 5 months and a half and I am thickening on the very top of my head, even slightly at the hairline. I have been checking the crown, but it seems to be taking longer to show results. Is this normal? Will my crown fill in eventually as treatment goes on?

A+Thank you for the favorable grade!

Everyone responds differently to drug treatments. Finasteride (Propecia) works best for the top/crown area, so if you’re seeing good results elsewhere I’d hope you’d eventually see positive results in the crown. I would give it 6 to 12 months before you assess its efficacy. It takes up to one full year before you can judge what it is or is not doing.

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

My Hairline Looks Like a Reverse Widow’s Peak

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

I was born with an irregular hairline. Toward the center, it takes a sharp upward turn, almost like a large, reversed widows peak. I think it is due to a large bump on the back of my head from a cesarean birth. My hair is healthy, but it looks funny unless it is long enough to cover the spot. Is there a way to correct this?

Without examining you, I really can’t tell. We have corrected many hairlines and transplanted into scars. If you are in the area, you can always schedule a consultation. Our main office is located in Los Angeles.

A hair transplant may be an option, but you won’t really know what can be done until you are examined and seen by a doctor. Otherwise, it’s anybody’s guess.

Tags: hairline, hair loss, hairloss, widows peak

Doctor Prescribed Topical Propecia for My Female Hair Loss

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

Hi,

My doctor prescribed the use of topical propecia once a day, and 5% minoxidil that has retin-A in it (to be used twice a week). I’ve been on this treatment for about 3.5 weeks. In the last week my hair has been falling out in droves…pretty freaky. Anyways, is this normal or should I stop this regiment? I’ve also been directed to take Omega-3, biotin, follic acid, and iron. Anyways, I’ve read that minoxidil and increase hair shedding, but at the same time, being that I’m only directed to use it twice a week, should I be experiencing this much increased hair loss?

By the way, I’m a 26 year old Latina female, if that’s of any help.

Thanks

If there’s a topical finasteride (Propecia), I’d assume it was the doctor’s own formulation. Propecia is an oral pill made by Merck, and they don’t make a topical. Plus, there’s little evidence that topical finasteride works for treating hair loss in men, let alone women. Male hair loss is different from female hair loss (see here).

Finasteride is not recommended or FDA approved to treat hair loss in women, and it can cause serious health risks for those that are pregnant or can become pregnant.

Any hair loss you’re seeing could be from temporary shedding from the minoxidil, but I have no way to know for sure. I’d follow up with your doctor (call him/her to ask about this if you can’t make an appointment).

Tags: finasteride, topical, propecia, hairloss, hair loss, female hair loss

ACell on Non-Transplant Head Scars?

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

I have a non-hair transplant head scars and I was wondering if Acell would help this.

I realize the excitement level is pretty high for ACell right now, but it is not an answer to everything. It generated lots of interest and we are starting our clinical trials, but we aren’t looking at it for use in scar reduction at this time.

In your particular case, I do not even know where there scar is, how deep, wide, or even the shape. It may be that just a scar reduction surgery or a hair transplant may help. I do not know. Remember folks, at this stage ACell is being used for a study and there is no guarantee for success.

Tags: acell, scars, injury, wound

Increased Heart Rate from Minoxidil?

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

Hi Dr,

I took minoxidil topical and that too I have used it for 2 days. One sudden day I had pain in the heart and my heart beats 116 bpm when I checked.

I am wondering how long will it take the body to completely wash off all the topical that it absorbed?

Please go see your physician! Irregular or increased heart rate can be life threatening and although it is a known side effect of minoxidil, it might not be related (I don’t know your medical history). If you washed the medication off then you should be fine after one day.

I must repeat though… your heart issues may be unrelated to the medication and you should be evaluated by a physician.

Tags: minoxidil, rogaine, heart rate

Hair Transplant Into a Thinning Area?

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

Hello doctor. I wanted to know if you have to lose all your hair first in a certain area before u can get a transplant or can you transplant hairs in an area that has vellus or thin hairs still there, but wouldn’t there be shock loss?

Take care

There could be shock loss if you’re not taking finasteride first, but that is the risk one takes when having a hair transplant in a thinning area. Transplanting in a completely bald area obviously won’t have the same risk factors, because there’s no existing hair to succumb to shock loss.

Tags: hair transplant, shock loss, hairloss, hair loss

My Doctor Didn’t Oversee My Hair Transplant Surgery

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

i had a hair transplant done just a short while ago. I traveled a long way to have this doctor do it due to his high reputation as one of the best. My initial consultation with him was not even 3 minutes & he did no use any device that shows hair density. i had already been committed due to his requirement of a non refundable deposit in advance.

On the day of surgery he spent not even 15 minutes to do incision of 2400 FU Grafts. The only other time he came back was late in the afternoon to give me another 400 FU grafts incision. what really concerns me is that how he could not even once come back to check what is being done or how things are going the entire day. In the initial consultation he also told that i have extremely thin hair but i ended up getting more than 2800 FU Grafts, a lot more than what i was supposed to get. Is there anything to be concerned about here other than obviously so little caring or is this typical for any doctor to only do incisions & let his assistants do all the rest w/o any checking at all?

i wish i would have known about you before choosing this doctor & all i would have traveled would have been less than a very short distance. i was also told that i can do another 2000 grafts next year but i doubt if i will go back to someone who ended up spending not even a total of 25 minutes altogether for everything from consultation & doing a total of 2800 grafts.

Another concern even though i want to believe that i really got the number of grafts that i was told, but is there any way to determine or guess by an expert like you having trained eyes that i really got the number of FU or anything close to that? It will be just for my own curiosity & not anything else.

Thanks in advance for your reply.

SurgeonI feel bad for your experience. I try to advocate for the readers and patients, but ultimately the burden is upon you to choose the doctor you feel comfortable with. It might be a little late, but read this post on Selecting a Hair Transplant Doctor.

During the procedure technicians place the grafts, but the doctor should have been in the operating room to make the recipient sites and remove the strip from the donor area (if that is the technique used). If he did not do this, then he broke the law. There are some doctors who routinely break the law with regard to allowing a non-physician to create recipient sites, but it sounds like he was at least there for creating the sites.

At this point, all you can hope for is good results. It is very unfortunate that you don’t trust your doctor enough to believe you got the number of grafts you paid for, but we have offered and performed many second opinions for patients that need counts done. What I mean is, I have consulted with patients such as yourself and attempted to count every single graft placed, but that would likely be too drastic at this point.

At the least, you can start out by asking the clinic for your complete operation sheet, which should have all the hair and graft counts written down. Be aware that not all doctors or medical groups may have this or provide it for you, but also know it is also your right to obtain your medical records (by law). Good luck.

Tags: hair transplant, physician, surgeon, hairloss, hair loss, trust

Xanax and Female Hair Loss?

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

I have been taking one mg. of Xanax with my first dose of Xyrem, to put me to sleep since May or June of 2009. I have fibromyalgia due to severe insomnia, and need these drugs to sleep. I have been experiencing hair loss since June of 2009. I started on Xyrem in March or April of 2009. My doctor is now in the process of weaning me off Xyrem, which he routinely does with his patients once they have been on it for a period of time. The hair loss continues unabated, so Xyrem is not the culprit. Could Xanax be?

XanaxProbably not. While many drugs do have hair loss as associated side effects, Xanax (alprazolam) isn’t one of them. It’s possible in rare cases, I suppose, but generally speaking, medications are usually one of the last things to consider as a cause for your hair loss.

As I mentioned before in an earlier blog post, “We hear from our patients who just got started on Xanax that they lose hair, but it is hard to prove that their hair loss is really associated with Xanax or if it has to do with anxiety itself.”

Tags: xanax, alprazolam, anxiety, stress, hair loss, hairloss

How Long Can Propecia Realistically Maintain My Hair?

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

Dear Dr Rassman

It is clear from many of your posts that you believe that although Propecia slows down hair loss in most men with male pattern baldness, it does not stop it and the balding will continue, albeit at a slower rate. I understand that no published data is available which would elucidate this matter and confirm that this is indeed the case. As you will appreciate, many young men with male pattern baldness (in their early twenties, say) would obviously like to know how long they can expect to retain/regrow hair in practice.

Since Propecia hasn’t been available for long enough it seems clear that this question cannot be answered conclusively (the same is, of course, true of any long-term side effects that may be associated with Propecia), but I was wondering if you had access to any figures or data of your own which would support the idea that Propecia only slows down the hair loss rather than stops it for as long as the drug is taken.

Yours sincerely

Your question is like asking how long you will live. Everyone is different. Some die young, some die old. So does hair.

I am a physician, not a fortune teller. Male pattern hair loss is a genetic issue and there is only so much medications can do for each and every individual. I don’t have actual statistical numbers of my own patients, but I have seen some patients hold on to their hair since the drug was introduced over a dozen years ago.

Tags: propecia, finasteride, hairloss, hair loss

In the News – FDA Investigating Formaldehyde in Popular Hair Straightener

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

Snippet from the article:

In the multi-billion dollar hair care industry, “Brazilian Blowout” was a rising star. The product was touted for its ability to deliver frizz-free, straight hair and get customers out of the salon in 90 minutes. More traditional treatments can take in excess of three hours.

…

What was in it, according to a study by the Oregon Occupational Health and Safety Division, was significant levels of formaldehyde in more than half the samples tested. Trace levels were found in the air sampled from five salons.

The company behind “Brazilian Blowout” fought back, accusing Oregon of using “flawed” testing methods. It said it is pursuing legal action to get the state to correct the record on the product.

While that battle brewed, complaints were coming in across the country and around the world.

Brazilian BlowoutRead the full story — Hair Loss, Irritation Blamed on Popular Hair Product

I get emails all the time from women that experienced hair loss after applying chemical straighteners, and typically I assumed it was related to chemical burn or allergy. If these findings turn out to be true and Brazilian Blowout contains significant levels of a probably carcinogen like formaldehyde, it is quite alarming.

Tags: brazilian blowout, cancer, formaldehyde, hairloss, hair loss, chemical burn, straightener

Asking the Readers — Body Hair Loss and Propecia

/by William Rassman, M.D./7 /,

Body hairAs I’ve mentioned before, I’m part of an email group of hair doctors where we share patient experiences, share medical knowledge, and discuss various advances in hair loss treatments. Recently a doctor in the email group reported that one of his patients lost all of his body hair on Propecia.

For whatever reason, I’ve received a few emails via BaldingBlog lately about body hair growth or body hair loss where the writer assumes it is related to Propecia, so I was particularly interested in what other physicians in the email group had to say.

Medical literature and even Merck (the maker of Propecia) did not validate that body hair loss is a known side effect, and many doctors responded to the email with the opinion that this finding seemed isolated with the one patient who reported it. I have seen this side effect once in my own practice, so as unusual as it seems, I am posting this here to ask the readers out there if they’ve experienced body hair loss with Propecia or finasteride. If you have had this experience, please send me a note privately or leave a public comment.

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

Hair Multiplication and Regenerating Limbs (Video)

/by William Rassman, M.D./17 /, ,

Nearly 3 years ago we posted about limb regeneration, and at the time I stated, “I read this material with great anticipation that someday we will see such breakthroughs available to us all, but I couldn’t say when that might happen.” While I was initially skeptical that this would be made available for hair loss patients so soon, Dr. Cooley’s presentation at the recent ISHRS meeting shows that it can be effective for hair.

Someone recently pointed out a video from CBS News about extracellular matrix that aired in early 2008 that I don’t recall seeing, so I wanted to bring it to light here:

Tags: hair multiplication, limb regeneration, regenerative medicine, cbs, video

High White Blood Cell Count is Causing My Female Hair Loss?

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

Hello, I am a 54 year old woman and I am loosing my hair, this has been ongoing for years I have had many blood tests and I have been to see a dermatologist, tricologist ect. The only relevant result I have had is that I have a very high white blood cell count which can be killing my hair.

I don’t feel ill and the doctors are unsure why I have such a high white cell count. Do you have any suggestions on how I can lower my white blood count? I also use minoxodil and the lazer comb, I have recently started taking a DHT blocker too. Any information would be appreciated.

I really do not know what you would consider a high white blood cell count, but you also need to understand a high white blood cell count really should have nothing to do with hair (the exception is in cases of alopecia areata). Generally, a high white blood cell count can mean anything from an infection to cancer (leukemia), but please don’t jump to conclusions thinking you have cancer.

It seems like there’s a lack of proper communication, because if your doctor left you with thinking your white blood cell count is causing your hair loss, you need to setup an appointment with him/her so you can discuss this further.

Tags: white blood cells, hairloss, hair loss

Is MPB Just Genes or Are There Environmental Factors?

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

Hello Doctors,

When it comes to hair loss genetics is usually the main culprit. There has been a lot of discussion of what can “cause” hair loss which I think people mistake with the acceleration of a destined hair loss pattern. Stress can be one factor which can accelerate hair loss. Is male pattern baldness purely a result of genes or is there also an influence of environmental factors which determine if a person will have hair loss?

Also, I know weight lifting does not “cause” hair loss, but can it accelerate the rate of hair loss much like stress does? There a body builders without hair loss, and even some may have high levels of stress, so it may be a matter of just genetics.

Genetics, lifestyle, hormones, and stress all play a role in hair loss. For example, if you lead a stressful life and have the genetics for losing your hair, the stress could cause the genes to express earlier than they otherwise would. This is not a simple issue!

Tags: genetic, hairloss, hair loss, environment

How Fast is Shock Loss… and Could Hair Spray Cause Hair Loss?

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

Hello Dr.Rassman,

I really enjoy coming to this site and I really appreciate you trying to help us baldies out there.

What i want to know is, If you use hairspray on hair that has a lot of sebum buildup and dandruff in the hair and around the hair follicle can you experience more hair loss and death to hair follices?

My other question is regarding shock loss. How fast do the hairs fall out due to shock loss, is it right away as the surgery is occurring or couple months after?

I know u have mentioned before that you need to be completely bald in a certain area to receive a transplant otherwise there will be shock loss to the existing hairs even if you are taking finasteride. So does that mean when u first get a hair transplant to the balding area where finasteride didn’t save the hair, would u have to come back for a 2nd procedure because the area of the head where finasteride did save the hair would die eventually because of shock loss after the surgery?

I hope you can get a chance to answer these few questions. Thank you for a wonderful site.

Spray canHair spray, dandruff, or sebum do not cause hair loss. Genetic inheritance causes hair loss in men for the majority of cases.

Shock loss happens from the “shock” of the hair transplant surgery on the nearby hairs that are just barely holding on (those are programmed to eventually fall out anyway). It happens within weeks after surgery.

I do not believe I have ever said you need to be “completely” bald to receive surgery. The key point is that there are risks and benefits of surgery that need to be evaluated for each individual. This is where a Master Plan comes into play, as each and every patient is different. Patients should not be having 2nd surgeries just because they had shock loss from a prior hair transplant surgery. It wouldn’t make sense to have a surgery just so the groundwork is laid for follow-up surgeries.

Tags: hairloss, hair loss, shock loss, hair spray