In the News – Korean Research Says Hair Loss Is Not Genetic for Half of Sufferers

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

Snippet from the article:

Heredity has been blamed as one of the main causes of hair loss but a recent study found that, for about half of those going bald, genes have nothing to do with it.

The Korean Hair Research Society traced the family records of 1,220 people suffering from hair loss and found that only 41.8 percent of their fathers had the same problem. About 47.1 percent seemed to have been affected by their father’s genes and about 10 percent are assumed to have been affected by both of their parents, but neither appeared relevant in 41.8 percent of cases. The team tracked the hair loss status of the subjects’ parents and grandparents.

DNARead the rest — Hair loss not as hereditary as believed

If the Korean Hair Research Society just looked at parents and grandparents, it might not tell the whole story since the genes for hair loss can skip generations. The article does go on to say that stress, extreme dieting, and some medications can cause hair loss… which I don’t think is a surprise to anyone that reads this site regularly.

Unfortunately, I don’t know that these percentages can be applied to a larger population, as I haven’t even seen the actual study. There’s no information on where or if this study was published, but even so, the numbers just don’t sound right to me. Though certainly there is a percentage of hair loss cases caused by factors other than genetics, I still believe the vast majority are cases originate from somewhere in the family tree.

Tags: hairloss, hair loss, study, korean, korea

What Happens if Finasteride Gets Too Hot?

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

What exactly is the risk to a finasteride tablet exposed to heat greater than 86F? Does the heat change the chemical composition of the drug? My room where I store my finasteride tablets has been very hot this summer. Accidently, I left my container where the sun shines through as well. Should I get my prescription replaced, or is this no big deal?

Ideally, finasteride should be stored between 59 and 86 degrees F (15 and 30 degrees C), but I do not know if just exposing it to temperatures above or below that would degrade its chemical composition immediately. While I doubt that it would be less effective, if you are worried you should replace it to be safe.

Tags: finasteride, hairloss, hair loss, temperature

How Do I Remove Scalp Scales?

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

If someone has sebhoraic dermititus or Psoriosis, and the creams or whatever treatment prescribed do not totally remove the unsightly dandruff/scalling what should some1 do? If you just leave the dandruff alone will it go away eventually on it’s own? or w/ repeated applications of treatment? Or should I keep washing it? or apply more treatment? I never know what 2 do exactly.

The treatment of seborrhea is best in the hands of skilled dermatologists that specialize in skin conditions such as what you’re describing. I am not the right doctor to ask about it, as I am not a dermatologist.

If you don’t have a dermatologist in your area that a friend or family member can recommend, I’d try the American Academy of Dermatology’s doctor locator.

Tags: dandruff, seborrhea, dermatology

Dr Farjo Warns About Media Inaccuracies

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

Snippet from the article:

One of the UK’s leading hair transplant surgeons – Dr Bessam Farjo – has conveyed his concerns surrounding the recent criticism of celebrity hair transplant surgery.

A number of tabloid publications have deemed Wayne’s surgery a ‘failure’ and pictures have been released showing the area where the surgery was performed.

Dr Farjo comments: “What the press are showing is images of the period of rest for the transplanted follicles, which may have broken off or fallen out. What’s important is that the roots stay inside the skin and will be working on brand new hairs that will start to sprout around four months after his surgery. A proper result can take as long as 10-14 months to fully mature.”

Read the rest — Leading hair transplant surgeon warns against media inaccuracies

Dr. Farjo is a contributor to BaldingBlog, but this article caught my attention because what he’s saying is absolutely true. As a population addicted to reality TV and dramas, we are becoming critical of things that we often do not understand. Media inaccuracies regarding hair loss or hair restoration are nothing new, but they’re making tabloid headlines in the UK lately since a number of celebrities have gone public with their surgeries (like this one).

As Dr. Farjo states, transplanted hair needs time to take to root and if you catch it in the various stages of growth, it may look incomplete as one area starts to grow before another. I always tell my patients that they must have patience and wait 6-7 months to see the hair go through its initial growth cycle. By 8 months, the average patient will have hair that is 1-2 inches in length.

Tags: farjo, rooney, footballer, hairloss, hair loss, hair transplant

Where is Nizoral Lately?

/by William Rassman, M.D./11 /

Hi Dr,

I’m a patient of Dr. Pak who came to the office in March. For the past year or so, I have been using a combo of OTC Nizoral and T-gel to combat an itchy scalp. I alternate between the two each day.

However, I can no longer find Nizoral anywhere — it’s gone from Amazon, drugstore.com and any physical pharmacy I’ve gone to. Any idea what happened? I can’t find any substantiated reason for the disappearance online. Also, in the absence of Nizoral, do you have a suggested replacement I could put in my routine?

Many thanks.

NizoralI haven’t followed the sales or availability of Nizoral (ketoconazole) shampoo. I’ve had a few readers ask about it, but I’ve not been able to find any news. I have no suggestion on a replacement shampoo. Have you contacted the manufacturer?

So I’ll open it up to the readers — have you read anything about why Nizoral has disappeared from shelves?

Tags: nizoral, hairloss, hair loss, shampoo

Shedding from Aminexil?

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

Hey Doctor.
I use Vichy Dercos Aminexil energy spray for like 2 month and im pretty sure I got some nice shedding from it. is it possible to have shedding from aminexil? Cause I saw that you wrote it acts in similar ways as minoxidil and this one has a known shedding effect. one more question is if there is any difference between the aminexil energy spray treatment and the aminexil sp94.
thank you.

I really do not know much about Aminexil, nor do I have any patients on it that I can recall. I do know some people use Aminexil topically to treat hair loss, but I do not know if it works or if it causes shedding.

In theory, if Aminexil is similar to minoxidil then it may cause the similar shedding you sometimes see with topical minoxidil use.

Tags: aminexil, minoxidil, hairloss, hair loss, shedding

If Propecia Doesn’t Work, Is the Hair Loss Unrelated to DHT?

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

Is it possible that if you are one of the people who didn’t respond to propecia that your hairloss is unrelated to DHT? I’ve read the Diffuse AA can look like diffuse patterned baldness and even chronic TE can end up looking like thinning on top. I’ve tried propecia for a long time now coming up on 16 months and my hair on top is gradually thinning.

a little background for you, I have lived with anxiety, stress and depression problems for a long time and think that having these problems chronically has lead to hair thinning. I only have slight recession in the temples but everything else is evenly thinning on top. In summary, for the 10 percent or so that Merck reported as not responding, could they have hairloss unrelated to DHT? Thanks.

As you suggested, there are many causes of hair loss that are not DHT related. I have no way to know the reasons for your hair loss, though. That being said, there are patients with genetic hair loss that just do not respond to Propecia and this can be tested for with the HairDX Finasteride Response test (written about before).

You need to get a proper diagnosis from a good, caring doctor. I can not help you without examining you, at which point I could map your scalp and conduct a hair bulk analysis in our office.

Tags: finasteride, propecia, hairloss, hair loss

MEP-90 Laser and FDA Clearance

/by William Rassman, M.D./11 /

I know you guys know about the MEP-90 laser and its manufacturer MidwestRF, I was looking around on the internet and I found something rather interesting.I found a page that goes somewhat in depth about the methodology as to how the MEP-90 received its clearance.

Apparently the MEP-90 study wasn’t double blinded and the the only explanation that the report gave was this: “However, a sham/placebo study is not applicable to the long term required treatment of female androgenic alopecia because too many variations exist that would make it unfeasible to run a large number of experiments and it would constitute unethical treatment of the subjects.”

Interesting considering that the Hairmax lasercomb recently recently received clearance for the treatment of androgenetic alopecia in females by use of a double blinded study. This report also stated that Midwest RF has been manufacturing hair lasers since 1999 but all records I could find indicate that the only thing they manufactured were MRI components. It’s also interesting to note that for some reason this company received stimulus funds why I have no idea. Here is a link to the report: here.

tell me what you or someone familiar with clinical trials thinks about it.

I generally do not trust clinical studies that are not double blinded, or have researchers with something to gain from the results. Most studies in the low level light area have failed to prove that there is a scientific result that is clearly positive.

I’m not a laser expert by any means, so I’ll defer to our readers that have more experience with this.

Tags: lllt, laser, hair laser

How Long Does it Take for Stress Related Hair Loss to Regrow?

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

Dear Dr.
I recently went through a stressful patch and now I’ve lost a quite disastrous amount of hair in a very short time frame. If this hair loss is related to stress how long will it take to recover after the stressful period is over?

Thanks!

Stress related hair loss may generally take up to one year to grow back for women, but for men it may reflect an acceleration of the genetic pattern that they are destined for.

Tags: stress, hair loss, hairloss, telogen effluvium

If ACell Can Regrow a Thumb, Why Can’t it Work for Hair?

/by William Rassman, M.D./9 /

Hello Dr. Rassman and Dr. Pak, Thank you for having this blog. I was wondering if Acell can grow (or re-grow) a new thumb, why can’t it grow (re-grow) a hair follicle? What if a 1mm punch was used to remove a section of the scalp and then the punched area was packed with Acell to see if a follicle will form?

I wish I had good news to report, but we know from our own studies using ACell powder and sheets in the wounds, that no significant amount of hair (less than 3%) was grown from the plucked hairs moved into the transplant area from the back of the head. I consider that this is not a supportable technique in our hands and I question the results of other doctors who report successful studies. This process is not rocket science that has technical barriers to entry that are for a doctor with my experience.

We were excited about the potential for ACell in hair transplantation following last year’s ISHRS meeting in Boston, but we haven’t been able to replicate anything close to the results from those original reports.

For those that want more information on ACell use in hair transplantation see these past posts:

Tags: acell, hair transplant, hairloss, hair loss, hair multiplication

Hair Extensions Pulled Out Some of My Own Hair

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

I recently had loc extensions placed into my hair because my hair is very fine and soft and refuses to lock on its own. In the process of it one of the locs on the back of my head was done to tight and eventually came out pulling my own hair with it there is some what of a bald spot there and the hair growing is very very very fine thin and small. I recently shaved my head to get everything on the same level while the rest of my hair is growing at a normal rate this patch is still very slow is this permanent or will it grow back if not is there anything i can do to help it

Hair extensions can produce traction alopecia, leading to permanent hair loss. Since you just shaved your head, I hope that means you’re going to discontinue using extensions. At this point, you’ll just have to see what happens over the next few months.

If there is permanent loss from the tight pulling, you’ll know within a year or so. Hopefully it isn’t the case, though.

Tags: hair extensions, traction alopecia, hairloss, hair loss

Having SMP and FUE Done on the Same Day?

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

Hi Dr. Rassman
I was just wondering you said that SMP and FUE would work well together! So my question is would you do both SMP and FUE procedures on the same day or one first and then the other on another day? Or would it just be better to go through FUE procedures until getting good coverage then going for SMP so it will look more dense?

Sorry for so many questions: cause my goal is to get at least 4,000 grafts with FUE (even if it means 2 or 3 more procedures) and then get SMP done on top of that to give the illusion of a dense hair? Or should I go through SMP first and then FUE? Once again sorry for so many questions.

And thanks for keeping us all well informed and keep up the great work!!!!!!!!

Follicular unit extraction (FUE) and Scalp MicroPigmentation (SMP) can work very well together, but you can’t have the two procedures done on the same day. I generally recommend having the SMP and FUE procedures done 6 months apart.

Tags: fue, smp, pigment, hairloss, hair loss, surgery

What Can I Do for Smelly, Oily Hair?

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

Hi Dr. Rassman,

I’m a 18 year old male and my hair is really oily and I mean REALLY OILY I take a shower every night but once I wake up in the morning its already really greasy and it smells, this started 4 years ago when I started High School I went to a regular doctor about 2 years ago so he could check out my scalp but he said it was fine. I have used Paul Mitchell Tea Tree Oil Shampoo, Head & Shoulders Hair Endurance for Men, Selsun Blue and Suave Clarifying Shampoo in the past couple of years and have have little to no success, so I was wondering if you can help me with my “smelly hair syndrome” as they call it I will really appreciate the help.

Thank You for your time

It’s possible there’s some shampoo out there that might help, but I couldn’t specify which one help for your particular case. A good dermatologist might be able to help you.

There is a pretty good article on this “Smelly Hair Syndrome” available here.

Tags: smelly hair, odor, oily hair

When Propecia Works in the Hairline, Are People Taking it Specifically for That Area?

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

Dr. Rassman, First of all, I really appreicate your great site. I learned a great deal from your answers. One of the most comforting answers was that some of your patients on propecia have retained their hair more than a decade. However, in other posts you mentioned that propecia does not work well in the front, especially for hairline. I am just curious that if patients seeing great result originally had loss limited to their crown or if Propecia actually maintained their front as well. If it has, did it completely prevent their hairline from receding also?

Another question is that do you see any particular trait in the ones with excellent result from propecia such as their lifestyle, diet or even their general personality(pessimistic, optismistic so on..)? Lastly, by rough estimate, talking about great result over a long-term, is it like only few of the total patients or is it actually some significant percent(like 30-50%)?

I apologize for these repetitive questions but just wanted to clear up if there’s any chance. Thank you very much in advance for your time and care for people from all over the world!

I don’t know that there have been specific studies, but (if I had to guess) less than 10% of patients who are on Propecia show benefit to their front hairline area, but even more rarely will they see regrowth there.

I’m not sure if I follow your question. If someone is just losing crown hair and takes Propecia, I wouldn’t consider the medication to necessarily be the cause of their hairline staying put. It could just be that their genetics limited their hair loss to the crown. There is no trait or lifestyle that predisposes someone for responding to the drug, though. It is just how their body reacts to it.

Propecia slows down the hair loss process and can reverse (in the first few years) hair loss in the crown, and it can also make enough of a significant visible difference by filling in behind the frontal hairline and in the top areas. But just keep in mind that Propecia does not COMPLETELY maintain or prevent hair loss. This is impossible.

Tags: finasteride, propecia, hair loss, hairloss