I Was Prescribed a Steroid for Facial Scaling and Redness, But Now I’m Losing My Eyebrows

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

(Female)
Hi,I was having some redness and scaling over my both eyebrows for about a week. It was very itchy and tingling. I also experienced eyebrow loss, about 1 to 2 each side everyday. I was prescribed with a combination steroid and dakarin cream. My condition improved after 2 days, less itchy but still finding my eyebrows dropping. May I know what should I do?

You should ask your doctor what condition he is treating. Was it for an allergy? A fungus? An infection? As I have not examined you, I can not give you an opinion on your problem.

Tags: facial swelling, redness

Another Young Man Who Had Almost 3000 Grafts Fail to Grow

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

I keep seeing more and more patients that come in to meet with me after the hair transplants they got elsewhere failed to grow. This seems to be the case in large session grafting, usually above 2000 grafts.

Last week I met with another young man who had 3000 grafts transplanted at a clinic with a doctor that I was not familiar with. Shockingly, he had a failure of graft growth to about 95% of what was put in. He is left with a scar behind his head and a significant depression from the failure. He refuses to remove his hat in public and he took much of the blame for the transplant failure. He told me that he thought he did his research, but it sounds like he was sold a bill of goods by the doctor about his reputation.

So many of these men blame themselves for the failure, not the doctor who deceived them. It was not a good meeting for me, and try as much as I could to deal with his depression with an optimistic view of his future, there was nothing I could say to lift his spirits. I am not sure why he came to me, as he did not want to do more transplants. I guess maybe he just wanted to get some sort of explanation of why his grafts didn’t grow.

Tags: hair transplant, failure

Arnold Schwarzenegger’s Hairline?

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

ArnoldHow did Arnold Schwarzenegger maintain his hair especially in his younger heavy steroid using days. It seems if DHT was the cause of hairloss he would have lost it all from all the testosterone they were using.

Over the years as Arnold aged his hairline did recede quite a bit but this was when he was much older and I believe he sorted it out with a hair transplant. Similarily Frank Zane in his younger days had a full set of hair presumably on a ton of juice – and he seemed to have lost it in his old age too.

Arnold probably does not have the genes for balding. It’s simple.

I don’t know that his hairline really moved all that far back. I’ve seen some photos from his younger bodybuilding days with a similar hairline to what he has now. His hairstyle back then seems to be hiding the corners, making it difficult to see. The straight across hairline from the Terminator movies was likely Hollywood movie magic to create the character’s look (why give a robot from the future a mature hairline?). Or maybe he had work done. I don’t know.

Tags: arnold schwarzenegger, hairline, hair loss, hairloss

Did Propecia Cause My Prostatitis?

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

Hello there, IM very glad I came across your website its very interesting reading peoples questions. My question is ive been taking propecia now for 4 years started at 21, for the last 6 months I have been experiencing a lot of prostate pains especially after sexual intercourse and sitting down for long periods.

My urologist says its prostitus and as this is not one of the side effects listed believes its not playing a role, have you had any case of this with your patients. Im thinking of taking a lower dosage 0.5 seeing if it helps or even coming off propecia and trying regain. My hairloss is a gradual progress. Im also concerned im only 24 and have been taking a drug for 4 years maybe its time to come off.

I’ve answered a similar question before here.

You should ask your doctor regarding your treatment plan for your hair loss. I do agree with your urologist that prostatitis and Propecia are not related. There are many causes of prostatitis.

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

In the News – Olympic Gold Medalist Joanna Rowsell’s Hair Loss

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

Snippet from the article:

Joanna RowsellAs she completed a lap of honour after winning Olympic gold, cyclist Joanna Rowsell pulled off her helmet to proudly reveal her bald head.

Having lived with the hair loss condition alopecia since childhood, the 23-year-old, from Cheam near Sutton, has not flinched from speaking about her condition.

Indeed she says her hair loss has helped drive her on to greatness.

And her win in the women’s cycling team pursuit at the velodrome on Saturday could not have come at a better time – it fell on International Alopecia Day which seeks to raise awareness of the condition.

Read the rest — Olympic cyclist Joanna Rowsell’s hair loss inspiration hope

Congratulations to Joanna Rowsell on her win and being an inspiration to people with this condition!

Tags: alopecia, olympics, olympic, joanna rowsell

Is This Cheap Hair Transplant Offer Too Good to Be True?

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

I’m thinking of getting a hair transplant,

I’ve found an Indian company that will do 2000 grafts at the forehead RS 80000 (£914). Is that too good to be true?

I’d like to do it.. But worried it might be a botched job.. Thanks for your help

I don’t know anything about that clinic in particular, but I’ve written plenty of times about bargain hair transplants that do more harm than good.

Remember, this is a cosmetic surgery… not a simple purchase like buying new shoes. The key to any cosmetic procedure is to do your research and remember that this is a surgery that will be with you for life. If something happens to your valuable donor hair (grafts don’t grow) or if the surgery looks bad (poor graft placement, ugly hairline, etc), in many cases these are things you will have to live with.

Also, why do you want grafts on your forehead? That seems a little low. Since you indicated you’re in the UK, I would suggest that you have a consult with Dr. Farjo in Manchester, so you’ll get a good opinion from an excellent doctor.

Tags: hair transplant, hairloss, hair loss, bargain, cheap

Why Isn’t There Time-Released Propecia?

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

Hi Dr.,
You often mention how the half-life of finasteride is not so long. Why can’t you make it longer so that the dose is distributed over a week, rather than a day, and you could just take one pill per week? Many drugs are “extended release,” no?

I think taking a pill once a day is not too difficult for most people, but I don’t know if they’ve attempted making an extended-release pill.

For those who may not know how half life works, if you take a drug at 8am and the half life is 4 hours, at 12pm you will have 50% of the drug left in your blood stream, at 4pm you will have 25% left, at 8pm you will have 12.5% left, at 12 am you will have 6.25% left, at 4am you will have 3.125% left, at 8am (NEXT DAY 24 hours later) you will have about 1.5% left. Time to take another pill!

Tags: propecia, finasteride, time release, extended release

I Have a Receded Hairline – Could It Be From Scratching Dandruff Years Ago?

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

Hi Dr,

Around four years ago (when i was 24) prior to every worrying about hair loss I hasd a bout of dandruff/itchy scalp.

This mainly affected my temple area. Naively, i remember sitting there at my desk scratching away at the area for a couple of weeks (before it cleared up) and seeing how much dandruff would fall as well as how much hair would fall (lots at the time of scratching it).

Not long after I saw pictures of my hair and became worried about going bald. In those four years, my hair hasn’t got a whole lot worse but I do have a receded hairline in those areas that I was scratching away at (and later using minoxidil on).

Could this have caused permanent hair loss in these areas? I do have a family history of baldness anyway.

A visit with a good doctor will probably tell you the answer after a thorough examination of your hair and scalp is done. It would be unusual for a 2 week bout of heavy scratching to produce permanent hair loss, but a doctor will tell you what he sees and make the diagnosis you need. Considering your family history and age, I’d expect genetics are at play… not scratching dandruff 4 years ago.

Tags: hairline, dandruff, hairloss, hair loss

Could Propecia Ruin My One Night Stands?

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

The dreaded ‘Whiskey Dick’ ruined what would have been a perfect one night stand last Saturday. Tell me, if I were to take propecia, could that make this problem even likelier? I’ve heard men can get ‘softer’ or ‘weaker’ erections as a result of using the product. Great blog by the way. Hope hair multiplication comes soon!

Sexual side effects from taking Propecia is still 1 to 2%. Sexual side effects from drinking too much whiskey is probably a lot higher.

Tags: propecia, finasteride, side effects

I’m an Actor and My Hairline Is Either Receding or Maturing

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

Fan from the UK here! Thanks so much for ‘baldingblog.com’, it’s a fantastic source that I use very regularly.

My question is this: If I were to start taking Propecia, and then cease usage after, say, 6 months, would my hair regress to how it would’ve been if I hadn’t ever taken the drug, or would it be worse?

I ask as I have noticed a change in my hairline. It’s either mature – or it’s receding. Nowhere in London seems to utilise your hair diagnosis techniques (miniturization study etc.) so I would like to come to you, but I am not visiting LA until January next year.

If I visited a doctor here, as a precautionary measure, and ended up getting on Propecia – only to be told by you 6 months later that it was just a mature hairline, would I have done myself any irreversible harm?

I am an actor so, unfortunately, a receding hairline would not only make me a little sad – but would also make getting parts a little more difficult, so I want to act (excuse the pun) sooner rather than later.

Thanks, and all the best.

You must understand some basic facts:

  1. Propecia does not work that well for regrowing a frontal hairline and I wouldn’t expect it to do much at all for a maturing hairline. It is mainly used for the top crown area.
  2. Propecia should not be taken for precautionary measures. You take Propecia because you have a diagnosis of androgenic alopecia and you want to treat it.

With these facts, you can make an educated decision. There is no simple answer and there is no simple cure for hair loss.

As an actor, you shouldn’t be too worried about the receding hairline. I am sure there are plenty of parts out there for you. Just look at Jason Statham. I don’t think he has any trouble with his career or even being a sex symbol. I guess it depends on what acting roles you’re up for.

With that said, a few now-famous actors (who will remain nameless) decided that they wanted their juvenile hairline back or wanted to stabilize the maturing hairline at a younger look, so they came to us for hair transplants. These men credit their career to me for the transplant. Having seen them on film, it was evident that they had great talent and the hair probably just gave them the confidence they needed to let their talent loose… and sadly to say for my ego, I had little to do with their success.

Tags: hair transplant, actor, hairloss, hair loss

Hair Transplant for Someone with Diffuse Thinning on Top?

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

Doctor,
I began to notice a bald spot on my upper left crown about 7 years ago (I am in my mid 30s) and have been on Propecia and Rogaine ever since. This regimen has given me good results. However, in the last few years, I have began to notice diffuse thinning on the top of my head (it is worst in summer). Currently, the bald spot is still on my upper left crown but the hair on my crown (and hairline) is thick.

My question is, when is someone with diffuse thinning a candidate for a hair restoration procedure? The diffuse thinning is getting to the point that it is noticeable even when I am not in bright lights. My potential donor hair is extremely thick.

Thank you

Believe it or not, the definition of “diffuse thinning” is highly variable for patients who are describing their hair status. So I would not know if you would be a candidate for a hair transplant surgery. You need a physical examination for that option.

In general, if you have thinning on the top or crown area, many patients who choose to have a hair transplant will get good results. For thinning in a young man, I generally recommend a trial of finasteride for 8-12 months prior to recommending surgery, as many young men will reverse enough of the thinning to avoid surgery.

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

I’ve Had Severe Hair Loss Ever Since I Had Typhoid Months Ago

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

Hi Doc,

I am 34 yrs old and I suffered from typhoid in the months of march-april 2012 and since mid May I am experiencing severe hair loss. I never had issues of Dandruff or any other scalp related diseases. What are the chances of hair regrowth and how long with the hair fall continue? I am currently taking Xtraglo tablet at night and an Iron tablet in the morning.

Hair loss can arise from extreme stress and medical illness. It generally reverses and hairs do grow back provided that the patient did not accelerate the male pattern balding that he may have had from his genetics. It does take up to a full year at the least for the hair to return.

Tags: typhoid, hairloss, hair loss

In the News – Bald is Tough

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

Snippet from the article:

Sometime in his late 30s, after his hair had been thinning for several years, Dr. Albert Mannes decided to shave what was left of his mane. He then noticed a curious thing: “Strangers were more standoffish, more deferential,” he recalls.

“I found that people treated me differently once I started shaving my head, which made me wonder whether my experience was unique,” says Mannes.

This led Mannes, a lecturer at the Wharton School, at the University of Pennsylvania, to design three experiments that tested other people’s perception of men with shaved heads. His findings appear in the journal Social Psychological and Personality Science.

All three studies found similar results: A man’s shorn scalp was linked with dominance. In other words, men with shaved heads were perceived as powerful by others.

Read the rest — Guys with shaved heads seem tougher, study says

These are interesting studies about how society sees completely bald men with shaved heads.

Tags: bald, shaved head, tough

In the News – Treating Diabetes With Surgery?

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

Snippet from the non-hair-loss article:

For some people with diabetes, surgery may be the best medicine.

Two studies have found that weight-loss operations worked much better than the standard therapies for Type 2 diabetes in obese and overweight people whose blood sugar was out of control. Those who had surgery, which stapled the stomach and rerouted the small intestine, were much more likely to have a complete remission of diabetes, or to need less medicine, than people who were given the typical regimen of drugs, diet and exercise.

The surgery also helped many to lower their blood pressure and cholesterol.

Read the rest — Surgery for Diabetes May Be Better Than Standard Treatment

(The story snippet above is from a few months ago, but I just read an opinion piece on Medscape.com that brought it to my attention. Since the Medscape article requires a login to read, I found the above NY Times link.)

In a recent article published in the New England Journal of Medicine, authors from two medical centers presented the results of obesity surgery in patients with type 2 diabetes. There was little doubt (from two small studies) that for reasons yet unclear, the diabetes was successfully reduced within 3 months even prior to reaching the goals for weight loss.

The patients in both studies were morbidly obese. The implications for surgical treatment of diabetes in patients who may not be morbidly obese is clearly there, but a greater understanding of the process needs to be in hand before this type of treatment can be offered.

Tags: diabetes, diabetic, health, surgery

I Apply 3 mL of Minoxidil Once a Day and Now I Have Blurred Vision

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

Dear Dr.,
For the past 4 weeks, I have been using topical 5% Minoxidil solution 3 ml once a day since I have long hair and a large area of thinning so the 1 ml is so unrealistic for my case and I am not willing to cut my hair. I am experience dizziness and blurred vision after using it for few hours but now I have puffy eyes and the puffiness is continuous. I also shed some hair specially from my hairline, these hairs I gained from using Finasteride.

Kindly, my 2 questions are:
1- If I stop applying Minoxidil after 1 month of using it, would I grow back the hairs I shed because of the initial use of it?
2- If I use only the 1-2ml recommended that will barely cover small area of scalp, then what about the other areas that are thinning? How can I apply 1-2 ml on a really large area with long hair?

Thanks an lot.

I think first and foremost, if you are using a medication and it is causing dizziness, blurred vision, and even puffy eyes, you should stop using the minoxidil and speak to your doctor. I am not your doctor and you should not be relying on the Internet to address a potentially serious medical problem. You may have an allergy to the medication and the more you use it, the worse it could get!

The questions you pose are irrelevant if you cannot use it. In general, topical 5% minoxidil is meant to be used on the scalp (not hair) twice a day. Each application should be 1 mL.

Tags: minoxidil, rogaine, side effects, vision, dizzy