I’m Sure My Propecia Side Effect Isn’t Psychological

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

Hello Dr. Rassman,
Firstly, thanks for this very informative blog. I’ve been following this blog for the past few months.

Reading your answers to various questions about Propecia 1 mg as a starting point, I considered taking Finasteride 1 mg to slow down my hair loss. I started using the pills keeping in mind that I also need to consult a doctor about it. I took it more or less for about 54 days, and eventually did talk to a doctor as well, who advised me to continue using it at least for 3 months overall to see how good it works.

And now I see there are some sexual side-effects (erectile dysfunction). I’ve often seen various write-ups on Finasteride (like the Wikipedia entry for it) and your own answers quote or paraphrase the results of the clinical studies that was originally done on the drug. Here’s what it says (taken from drugs.com):

“Resolution occurred in men who discontinued therapy with Propecia due to these side effects and in most of those who continued therapy.”

The second part of the sentence (“and in most of those who continued therapy”) makes me curious. In your experience, would you say this a common occurrence as well? Is it useful to continue using it and see if the side-effects go away? I’m planning to consult a urologist as well, but would be great to hear your thoughts on this.

[I’m positive that the side-effect I’ve got is genuine and not psychological because I was never particularly apprehensive about starting this drug. Which is why I also didn’t worry too much about starting on the drug before visiting a doctor. I did ensure that I eventually met one and I don’t see how it could have made a difference because the doctor also suggested I give it a try for a 2 to 3 months.]

It is possible for the side effects to subside, but I don’t have statistical information to give you any peace of mind. I often advise my patients that experience side effects to reduce their dose to 0.5mg and see if the sexual impact is still present. If this does not do it, I will often advise the patient to take 0.25mg, which is about half as effective as the full 1mg dose. If that fails, then discontinuing the drug is a decision that you will have to confront.

A good doctor at your side helps. And of course, discuss any changes to your medication with the prescribing physician.

Tags: propecia, finasteride, hairloss, hair loss

Can I Force My Hair To Grow Straight?

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

Is there anyway where I can get new straight hair? I can’t deal with them chemicals nor straighteners. I want natural straight hair…
is there a way for that?? Thanks

Sorry, but there is no way other than the use of a variety of hair products available today.

Tags: hair characteristic

Ichy, Red Scalp a Month After FUE Procedure

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

Hi dr,

1 month ago I had a fue hair transplantation, but almost all of the hair transplant are fallen out right now. they say this is normal but im concerned because some hairs fall flat like a triangle.

also i have many itches and redness on my head. maybe this is the healing process? I assume this is normal?

thanks

Wasn’t there a doctor who performed surgery on you? Did your doctor abandon you? You should be concerned and should be asking your doctor what is going on with your head. That doctor has more knowledge of you (by way of examination and access) than we do on the internet. What you’re describing a month after surgery is not normal. Not all FUE is performed the same way and not all hair transplants are the same.

The two people in this world that knows what is going on is you and your doctor. This is not a brush off — if there is redness and there is a concern over an operation you have had, the internet is not a place for reassurance.

You may have an active folliculitis that requires treatment, and if you do, the prolongation of the incubation period can only harm your grafts. This isn’t something I should be guessing about, though. Please speak to your doctor.

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

I Just Figured Out That My Blood Pressure Medication Made Me Lose Hair

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

This is my first time to your site but I wanted to share my hair thinning experience because it may help others. I am a 43 year old male who has a full head of thick hair but over the last 5 years I have noticed thinning at the crown of my head. I tried Rogain but never really got my hair back to the thickness that I expected. I couldn’t believe I kept a full head of hair up until my late 30’s and now I have to deal with balding.

Well it wasn’t until I did some research on the blood pressure medication Lisinopril that I had been taking for 5 years that I linked the two together. My blood pressure was around 140/80 and my doctor recommended getting on a low dose of blood pressure medication(2.5mg) to bring it down slightly. Within 2 months of taking it my hair started thinning but my doctor never told me this could be a side effect and I thought I was thinning because of my age.

I have been off the medication for almost 6 weeks and my hair started growing back and the bald spot has almost filled in completely!! I am not telling anyone to stop taking their medication but I can tell you I will look for other ways to lower my blood pressure before I give up my hair!

Thank you for sharing. I will take your word on your experience, but it is hard to believe you can see changes in hair growth in just 6 weeks after stopping a medication. For a normal person, hair grows about 1/2 inch in a month. So 6 weeks is really nothing in the world of hair. Nevertheless, please consult with your doctor before starting or stopping any medication.

With respect to hair loss in men, there is a reason we call it male pattern baldness (MPB), as in it occurs in a pattern (like the crown of your scalp). Hair loss from stress, illness, and medication would normally NOT occur in such a pattern.

Tags: hbp, blood pressure, medication, hair loss, hairloss

Short Comedic Film About Hair Loss (with Video)

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

Hey! I’m a balding film maker out in LA, and I recently shot a short comedic film about my hair loss – take a look…would love it if you posted…I think many people would relate. Bald is beautiful!!

Link to the entire 10 min film: Chris Weisberg is Growing Bald

Keep in mind there is some cursing in the video, so if you’re at work or somewhere that requires the F word not to be uttered, you should probably wait to watch the video. It’s very funny, though! Here’s the trailer:

Tags: hairloss, hair loss, balding, video, short film, comedy

Removing a Cowlick and Replacing it With Transplantation

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

Hi,

A friend of my fathers has recently had a hair transplant to cure his baldness and it got me thinking of a possible solution to a problem I have. I have a cowlick at the front of my hairline and I was wondering if it would be possible for me to have this removed by laser treatment and then replaced by hair transplant. Is this a viable option?

Yes, this is a viable option. Many people with these ‘licks’ complain about them to me. Of course, I only see those people who are not happy with them. I happen to like the look, as one of my sons has a cowlick and I think it makes him look handsome.

Tags: cowlick, hair removal

Permanent Finasteride Side Effects Article in Journal of Sexual Medicine

/by William Rassman, M.D./8 /

Dr. Rassman, et. al, the Journal of Sexual Medicine has recently published an article describing the permanent sexual side effects of using finasteride. I quit taking propecia approximately 2 weeks ago and am terrified that I have permanently damaged myself. What are your thoughts on the article?

Adverse Side Effects of 5?-Reductase Inhibitors Therapy

Many of my patients have been taking Propecia for over a decade without side effects. I have yet to meet a person in my practice who complains of permanent side effects associated with Propecia after they stopped the drug. The few that do have side effects at all elect to stop taking the medication and the side effects have subsided as their hair tumbles to the ground. But that is just my humble experience.

The article itself doesn’t provide anything new, just reviewing previously published reports from a subset of men that raises the possibility of a casual relationship. They did report a single case of a man with total sexual function loss, but that sounds peculiar and I’m not convinced. I would wait for confirmation by other investigators on claims of permanent damage from finasteride. The Journal article was digested by the Boston Globe here and even mentions what we’ve been saying for years about the percentage of those that saw side effects:

“In one trial, about 1.9 percent Propecia takers who took the drug for up to two years experienced a loss of libido compared to 1.3 percent of placebo takers; 1.4 percent of Propecia users had erectile dysfunction and 1 percent had an ejaculatory disorder compared to 0.9 and 0.4 percent of the placebo takers.”

For most of the frightened men, I wonder what they’re so terrified about. Did they actually have side effects? Are these men willing to risk balding over a 1-2% chance of side effects? As I’ve often said, the medication is completely elective. You don’t have to take it and I am not trying to convince anyone to do so. I am just presenting my opinion based on experience. The Mayans predicted the world will end in 2012, so I would be more terrified about what will happen in 11 months!

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

NASA Pioneered Chemotherapy Hair Loss Prevention Decades Ago?

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

Snippet from the opinion article:


I read with interest your article Chemotherapy Hair Loss Invention From Sweden Might Help Patients Keep Hair but it really is old news !

Around thirty years ago, Dr. Bill Williams, of NASA, conducted research on thermo control of body temperature (very important to astronauts in space suits). He patented his invention of the “Cool Head and Cool Neck Band”.

Read the rest at the Epoch Times — Chemotherapy Hair Loss Prevention Pioneered by NASA, Thirty Years Ago

The above is part of a letter by a retired NASA researcher, and it should be noted that it is in the opinion section.

It basically says that a NASA scientist helped develop a cooling system for helmets, and although the headline might lead you to believe there’s more info about hair loss and chemo, it only briefly mentions an “experiment to save the hair of chemotherapy patients“. But that’s it. Unfortunately, it doesn’t discuss the study or what that experiment was… and I’m coming up empty when trying to find if the study was ever published. Anyone?

Tags: nasa, chemotherapy, chemo, hairloss, hair loss

After I Cut My 5mg Finasteride Pill, The Pieces Are Basically Crumbs!

/by William Rassman, M.D./3 /

DR. Rassman,
I just started taking Finasteride 5mg. I cut it up into 4. My question is, since the size of the pills are very small are the less effective? I mean small! size of a large crumb.

No, the size of the pill wouldn’t have much to do with effectiveness. The 1mg Propecia pill isn’t 100% finasteride alone. There are fillers used to help make the pill a reasonable size, plus give the pill a distinctive shape. So if the 5mg finasteride pill is cut into four pieces, it won’t be the same size as 4 Propecia pills.

Check with your pharmacy about other makers of generic finasteride 5mg — different pharmaceutical companies may have different shapes that are easier to cut or a little bigger if that’s what you’re looking for.

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

Do Eyebrow Transplants Look Normal?

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

Hello Dr. Rassman,
I was considering eyebrow transplant surgery after many years of overplucking and abuse to my once bushy brows. I have read that as a side effect the hairs may be “raised” or grow in awkward directions. I was wondering in your experience how often does this occur? Say in 150-200 grafts how many may grow this way? And can they be “trained” over time to grow correctly? Thanks

EinsteinEyebrow transplantation is a delicate art and even for skilled medical groups it is never perfect. As you correctly state, the eyebrows can grow slightly raised and grow in slightly different directions, regardless of how precisely you pay attention to detail. And since the focus is right above your eye, the eyebrow transplant subtleties are not as forgiving as with hairs transplanted on the scalp.

I can’t give you a generalization of what to expect, as each and every person is different. It depends on hair texture, curl, shaft diameter, follicle length, orientation around its central axis, how it lays down, etc. I can say that male eyebrow transplants are more forgiving, as men have bushier eyebrows. My eyebrows seem to be admired by many men who request eyebrow transplants, as mine are the spitting image of Albert Einstein (see right).

I can also say that if you don’t like a certain eyebrow hair in the mix, just pluck it out! Often times patients usually have at least two eyebrow transplants to get it just right.

Tags: eyebrow transplant, hair transplant, eyebrows, overplucking

Are Side Effects a Sign That Finasteride is Working?

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

I have been taking a generic Finasteride called Finpecia for just under 3 months and I’m unsure whether it is doing anything for me or not. I am aware that buying generics is risky but I simply cannot afford Propecia, being a student.

I have read on forums that side effects are a sign that the drug is working. I experienced a couple of sides very early on (around a week after starting) which subsided soon after, I was wondering if this is a sign that the drug is legit? Or could this just be caused by some other ingredient found in the pills I am consuming?

Thanks

I do not believe that seeing a side effect is an indication of whether the drug you are taking is real/legit or even if it is working. A side effect is just that… a side effect. Placebos can even provide side effect-like instances. After only 3 months though, that’s not enough time to really notice benefits from finasteride.

It also sounds like you are self treating without a doctor’s supervision. There is a generic finasteride in the U.S. that doctors can prescribe available in 5mg strength (approximately $30 to $60 for one year supply) that patients cut into four pieces to make the dose semi-equivalent to Propecia (which is finasteride 1mg). If you’re not under the care of a physician and taking a prescription drug, you really should see a doctor.

Tags: finasteride, side effects, hairloss, hair loss

Hair Transplant for Woman with Central Centrifugal Cicatrical Alopecia?

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

I am a 24 year old African American female who was just diagnosed with CCCA on yesterday. I have no idea what it is that I can do other than take the steroids that were prescribed in order to slow down the progression of the condition. Would I not be a candidate for hair transplantation or a scalp reduction?

If you were just diagnosed with central centrifugal cicatrical alopecia (CCCA) and didn’t get your questions answered by your doctor, you can find a lot more information at the Ciicatricial Alopecia Research Foundation site.

It’s possible steroid treatment would help, because steroids can alleviate the inflammatory reaction associated with CCCA… but there’s no specific cure. Hair transplants are not recommended for patients with CCCA.

Tags: central centrifugal cicatrical alopecia, ccca, scarring alopecia, hairloss, hair loss

Propecia at 17 Years Old?

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

I’m turning 17 this summer, is it too early to start taking propecia? My doctor and I already know I’m going bald.. my hairs thinning and I have a receding hair line. Can I start a 17?

I would make a firm diagnosis with bulk measurements, miniaturization measurements, and great photographs of your hairline location. Then if you decide to take Propecia with your doctor’s assistance, you will know for sure what your diagnosis is and how the drug is working year after year.

I’d suspect that most doctors do not feel that 17 years old is too young for this drug, though I can’t speak for all physicians.

Tags: propecia, teenager, age, hairloss, hair loss

Proscar Half Life

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

I have heard you mentioned many times that Proscar has a longer half-life than Propecia. For people who are taking Proscar, will it be longer before they experience catch-up hair loss if they stopped taking the medication?

ProscarProscar is a brand name for the generic drug called finasteride in 5mg strength. Propecia is a brand name for the generic drug called finasteride in 1mg strength. Despite the difference in the strength dose, the half life is exactly the same… because they are the same drug.

Perhaps you are thinking of a drug called Avodart, which is the brand name for the generic drug called dutasteride. Dutasteride (Avodart) has a very long half life in the order of many weeks, whereas finasteride (Propecia or Proscar) has a short half life in the order of hours.

The half life of a drug refers to the time it takes for your body to rid itself of half of the drug in your system.

Tags: proscar, propecia, finasteride, halflife, half-life, avodart, dutasteride