Testicle Ache After Restarting Propecia

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

I took Proscar for 6 months with no problems whatsoever and great results. For whatever reason I decided to cut my dose of finasteride in half and see if I could get the same results. In short, that didn’t happen. So after 5 weeks I jumped back on 1 mg and am back to where I was before I decided to lower my dose.

Here’s the problem: I have had constant testicle aches since then. I don’t know why this is happening since I never experienced this on 1 mg. This could be my imagination, but I find lifting weights helps reduce the ache.

What do you think?

I assume you mean that you took Propecia, not Proscar, since you say it was 1mg finasteride. Here are some past posts we’ve made about this issue. It’s worth pointing out that testicle pain may not be associated with the medication and could be a serious medical issue.

Regardless, I would take this seriously and follow up with the doctor who prescribes you the medication. If that is not possible, follow up with your general physician.

Tags: finasteride, propecia, hairloss, hair loss, testicle, pain, ache

What Age Will I Know If I’m Balding?

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

Hi doctor, i will like to know how long will it take to know if you are balding or just have a mature hair line. is like if my hairline have stay the same for 2 years does that mean that im not balding now? or i have to wait more time like 4 – 5 years

There’s no way to tell when you’ll go bald just based on an email. You need to be examined for miniaturization and then re-examined again in 6-12 months to compare the results. Then an educated guess can be made as to what type of loss you’re going to be seeing down the line. It’s not as simple as just applying a deadline to your hair loss based on an age range.

Balding (in men) can start in the late teens or in the 60s, but usually most people who bald will have signs of it in their 20s. The most sensitive test for balding is when the hair bulk is measured on the front, top, and crown and compared to the fringe area on the sides and back of the head.

Tags: hairloss, hair loss, age

Hair Transplant at Temples Resulted in Hairline Thinning?

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

Is it common to experience hair thinning as a result of shock loss? I ask because I recieved a transplant at my temples a few months ago and suddenly now my hair in the front is thinning as well as my hair at the crown.

Temple vs CornerIn general, thinning hair in the front and crown sounds like male pattern baldness. I am confused by your description of the temples and wonder if the area you’re referencing is actually the corners of the frontal hairline, which is commonly confused terminology. See the photo at right for clarification.

Regardless, shock loss would be mostly limited to the near the recipient area, which in your case may include the hairline… but I wouldn’t expect the crown to be associated with shock loss if your surgery was just in the frontal area (corners or temples). In other words, it sounds like a coincidence to the surgery and is more likely just the progression of your hair loss.

Not all hair transplants are the same. I don’t know anything about your hair loss history, age, or any knowledge of the surgery you have had done. Please follow up with your doctor to address these concerns.

Tags: hair transplants, shock loss, hair loss, hairloss, temples

In the News – Low Iron Doesn’t Cause Female Hair Loss?

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

Snippet from the article:

Although past research has suggested a correlation between iron deficiency (ID) and female pattern hair loss (FPHL) or chronic telogen effluvium (CTE), a recent population-based study published in the December issue of the Journal of the American Academy of Dermatology finds no such association.

Elise A. Olsen, M.D., of the Duke University Medical Center in Durham, N.C., and colleagues assessed 381 women with FPHL or CTE and 76 controls to see what, if any, role ID plays in the two conditions.

Read the rest of the story — Iron Deficiency Not Likely Culprit in Female Hair Loss.

The study shows that while iron deficiency is commonly found in women, it doesn’t appear to be increased in those women with hair loss or telogen effluvium. This goes against what we previously believed to be one of the many possible causes of female hair loss.

I’m sure there will be more research to come, and I’ll post more about this as I find it. Read the abstract in the Journal of the American Academy of Dermatology.

Tags: ferritin, iron deficiency, hairloss, hair loss, female hair loss

Can I Inherit MPB from the Female Side of My Family?

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

For several years I have had thinning whilst stressed; but it has always grown in. However, this year my hair thinned out due to stress, unlike times before I also had spot areas of hair loss. That has grown in however my hairline has started fall out in a ” V” shaped peak. It’s not dramatic or noticable; with this said I have no male blood relatives suffering hair loss; only female. Is it possible to inherit hair loss through females if you are male.

A common myth is that male pattern baldness comes from the mother’s side of the family, but in reality, the genetics can be passed to you from either side of the family (paternal or maternal). It can skip generations, too.

Without seeing the loss you’re referring to, I’m having a difficult time figuring out how pronounced the “V” shaped hairline you’re seeing actually is. It could be that you’re just experiencing a maturing hairline, or it could be that you’re seeing genetic hair loss that is starting at the hairline. I don’t know enough about you (age or history) to make any kind of real guess online.

Tags: hairline, hairloss, hair loss

Experiencing Hair Loss After Back Surgery

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

(female)
I recently (5 weeks ago) had back surgery. Now I find that I am losing hair. How long does this last?

It could be a few weeks, perhaps even a few months. It may have nothing to do with the surgery, or it could be related to the stress your body experienced from the procedure. Have you talked with your physician about the hair loss?

It generally takes one year to see if you regain some hair.

Tags: back surgery, surgical procedure, hairloss, hair loss, female hair loss

Can I Remove Scalp Scars I Got From a Car Accident?

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

(female) I have a couple scars on my head from a car accident when I was around 4 years old, and I am now 21 and was wondering if there are any ways to get rid of these scars? One is about three inches in length and the other is about one inch. The hair has never grown back, and I would love to wear my hair down but cannot because the scars are then very visible.

About how much would a procedure cost to fix this problem? Thank you so much for your help, you have no idea how much I appreciate it!

Langer's linesHair transplantation works well for scars. I would imagine that a transplant would be in the $3000 range. We would, of course, need to evaluate you first and then a quote can be offered.

Removing the scar may not work well if the scar falls outside of the directions seen in Langer’s lines, which are lines that “correspond to the natural orientation of collagen fibers in the dermis and epidermis” (source).

See if your scalp scars are in line with Langer’s lines. If so, this would imply that they might be removable. The image at right is a quick view, and you can see the larger version here.

Tags: scalp scar, car accident, hairloss, hair loss, hair transplant, scarring

Letting Propecia Dissolve Under the Tongue

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

Can I take finasteride sublingualy? because i heard that by taking it sublingually can bypass first pass effect and it can goes directly to your bloodstream.

SublingualYou are supposed to take Propecia by swallowing the pill. Taking it sublingually (administered under the tongue) does not mean you will see better results. Similarly, taking double the dose (or even 10x the dose) does not mean you will have better results.

What I’m getting at is: Please take the medication as directed. Plus, I’m sure it would taste really bad.

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

My Husband Stopped Propecia So We Can Get Pregnant

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

My husband has been using propecia with good effect for 10 years. We are now trying to get pregnant and he stopped taking propecia. My question is, 1) how long can he be off the pills before the hair starts to fall out? and 2)does the hair grow back if he starts the pills again?

Thank you for your answer.

Men who stop taking Propecia while they are trying to conceive with their partner usually stop for two to four weeks. This should not have an impact on hair, but if in the worst case scenario there is a negative effect on the hair, the hairs lost will most likely not grow back (even if you start back on Propecia). This phenomenon is often referred to as “catch-up” hair loss. Your husband should discuss this further with his prescribing physician.

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

In the News – Scientists Reverse Aging in Mice

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

Snippet from the article:

Toss the Rogaine and Viagra? Not just yet.

But Harvard scientists have found that some effects of aging, such as hair loss, infertility and decreased brain function, can be stopped. And not just stopped: the scientists’ research, published today in the journal Nature, showed that it’s possible even to reverse the signs of aging.

“Basically, what this study teaches us is that there’s a point of return in aging,” senior author Dr. Ronald A. DePinho, professor of medicine at Harvard Medical School, told CBS News.

Mighty MouseRead the full story at CBS News — Aging Reversed in Mice: Have Scientists Found Key to Immortality?

Not all research on mice can be applied to humans, but regardless of that, the published research sounds quite intriguing.

Hmm… mice living forever? Probably good for the pest control industry, but that would be a whole lot of rodents in this world. What’s next — flying, muscular mice?

Tags: mouse, mice, aging, news

Female Hair Transplant Shock Loss?

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

I am a female who had a hair transplant last week with the FUE method. I have FPB and a very thin donor area. I was told that on the day of operation and too far into the procedure i dont have thick donor hair so the coverage wont be very good. I am concerned now as i wonder will i get shock loss too as i have weak hair then and will i be balder then before.

  • When will the hair fall out now it is placed and how can i look after what i have to look like a normal lady?
  • Can i use Regaine as that did work when i used it last time but it irritated my scalp?
  • Should i take extra vitamins?
  • Shall i just say a wig and be done with it?
  • Does FUE not work for FPB then?

Hair loss in womenFirst off, if you are female with a poor donor area, why would you even consider follicular unit extraction (FUE)? That surgical technique is mainly for people who want to cut their hair very short (like a crew cut) and not see any scar or just might want to shave their head, not likely for a female. If you are a woman, a scar (large or small) on the back of your head should be inconsequential and will never be noticeable with long hair covering it. I generally try to convince my females patients against FUE.

I am outraged and you should be furious. How can one have surgery and not understand what to expect?! It seems that you got conned into doing a surgery by an unethical doctor. The doctor should have told you about this before you underwent the surgery. Now the problem you face is waiting for complications of the transplant such as shock loss, accelerated cyclical loss, failure to grow, and on and on. If you were told that the surgery you are having won’t give you good coverage while the surgery was being done, then you might have a malpractice claim against that doctor if you are worse for doing it!

Vitamins will not help with your surgery. The wig is up to you, but it could ultimately make your loss worse from any traction alopecia that could develop. I would not use Rogaine (minoxidil) if it irritates your scalp. Let us hope you have no or minimal shock loss from the surgery itself and you can at least achieve some coverage. Only time will tell.

For the rest of the readers out there — beware of unethical doctors and do your research. Use this guide to help select your hair transplant doctor. We generally believe that 80% of female patients do not make good hair transplant candidates, especially if their donor hair shows diffuse thinning.

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

In the News – FDA Rejects Proscar and Avodart for Prevention of Prostate Cancer

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

Snippet from the article:

An FDA advisory committee has voted against approval of two drugs for the prevention of prostate cancer because of a link to increased risk of high-grade, aggressive forms of the disease.

GlaxoSmithKline’s Avodart and Merck’s Proscar are approved to treat benign prostatic hyperplasia (BPH), or enlarged prostate, which is common among men over the age of 50. In studies, both drugs showed a nearly 25% reduction in the risk of developing low-grade forms of prostate cancer compared to participants taking a placebo.

FDA medical officer Yang-Min Ning, MD, PhD, says such forms of cancer “propose very little threat to men during their lifetime.”

Read the full text at WebMD — FDA Panel Rejects Drugs to Prevent Prostate Cancer

FDAThere is a great deal of politics going on that I really do not understand, but even with this panel rejection, I would not advise my own son to stop taking 1mg finasteride to treat his hair loss.

It is clear that finasteride at the 5mg dose seems to prevent prostate cancer to some degree, but it wasn’t enough for the FDA to label it as a preventive medication for prostate cancer. People will ultimately need to make their own decisions in regards to this medication, but keep in mind that at the 1mg finasteride dose that is prescribed to treat hair loss, there is really no evidence one way or the other that it could be a problem or even if it will prevent prostate cancer. More will be written by other societies and I will fill in the readers of this site once we know where it all “falls out”.

Tags: proscar, avodart, dutasteride, finasteride, prostate cancer, cancer, fda

ACell and DUPA?

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

Hi doctor,
Great site. My question is about ACell and all the other in development treatments like it. Will this in theory work for those who have dupa or fpb? I mean I understand the are years away and a big ? If they will even work. But if they do will the help those individuals as well. Eventhough there us miniaturization in the donor, or is there no hope for us?

Please answer… Thanks again.

Clearly, ACell will not impact DUPA (diffuse unpatterned alopecia) or female pattern hair loss unless it was used in conjunction with an auto-cloning procedure. We need to take one step at a time. We still need to see how well ACell works when used in an auto-cloning fashion. We do not know if you pluck a hair from the permanent zone that is not miniaturized in a person with DUPA or female balding, if that hair will grow at all. How it would be compared with a plucked hair in a non-DUPA patient is yet unknown.

Tags: dupa, hairloss, hair loss, acell

Headband / Bandana and Hair Loss?

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

BandanaWould wearing a ‘head buff’, like they do on Survivor cause more hairloss?

as in suffocating the scalp etc. my whole head would not be covered I would wear it like a thickish headband. I am thinning all over/crown, and desperately need to cover up. They are microfibre with no seams. They are very light fabric, I would just wear it as a wide headband sort of thing.

regards

I do not believe wearing a “head buff” or any form of head gear, bandana, helmet, or hat would cause hair loss. You cannot suffocate your scalp. If you want to go to the extreme and wear a very tight head gear everyday for hours at a time, you would (over the course of several weeks or months) cause traction hair loss.

Tags: bandana, head buff, hairloss, hair loss

Proscar Packaging Says I Need to Use a Condom Now?

/by William Rassman, M.D./10 /


Hi Dr. Rassman,

I’ve been taking finasteride (1 mg tabs of propecia) for 3 years with great success. Recently however I switched to Procar with a pill cutter and am horrified to read from the proscar finasteride package information for users leaflet:

“If you partner is pregnant or planning to become pregnant you should use a condom or other barrier method of contraception when taking proscar. This is because your semen could contain a tiny amount of the drug and may affect the normal development of the baby’s sex organs.”

This is news to me after 3 years of using fin. I know of the dangers of women handling tabs but have never read anything about this. Is it only relavent to the 5mg doses of proscar? Your professional opinion is highly respected. Please advise.

Kind regards

CondomThis is news to me, too.

We have known about problems arising from a fetus exposed to finasteride — the US leaflet for Propecia states, “If a woman who is pregnant with a male baby absorbs the active ingredient in Propecia, either by swallowing or through the skin, it may cause abnormalities of a male baby’s sex organs.” — but this is a warning for women that want to take finasteride or handle crushed pills.

As I’ve understood it, finasteride does not have any significant concentration in a man’s ejaculate. In my searching, it appears that this line about a condom is only in the UK Proscar leaflet. This wording is not seen in the US or UK Propecia leaflet, and I’ve not seen this in any of the literature before. Although it is the same drug (finasteride), Proscar is 5 times the dosage of Propecia. Merck’s official word is that Propecia poses no risk to unborn children.

I will have to ponder this one for a while, as it is against what has been revealed to me in the past.

Tags: finasteride, proscar, propecia, condom, ejaculate, semen, sperm, hairloss, hair loss