Gluten and Baldness?

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

Hello Doctor Rassman,

Love your blog. My question is, is there a link between consuming gluten and premature baldness? I’ve read quite a few articles about it, and part of me believes it’s just crazy talk, but I’m wondering. Obviously, there are plenty of people who eat gluten and never bald, but if it’s a person’s destiny to be bald and they consume a lot of gluten at a young age, can that cause the onset?

Thanks for your time!

I think gluten free diets have gained popularity and boasts many health benefits. With respect to hair loss and its link to gluten, I remain fixed on my stance. Male pattern hair loss is a genetic issue (not a diet issue). Perhaps certain diets may accelerate or trigger the balding process, but these things are all speculative.

Tags: gluten, hairloss, hair loss

SMP Result (with Photos)

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

This patient did not like his hairline and keeping his hair very, very short was a reasonable option for him. He achieved these results with Scalp Micropigmentation (SMP) when he walked out of the office the same day he came in. Many patients play with their hair length until they find the right length for their new look, and once he clips his hair a little shorter the effect will be more complete.

The photos below show the story. The following results are with only ONE (1) SMP session – For better even coverage he will follow up for the second or third sessions. Click to enlarge.

 

Here’s a close-up shot of the SMP:

 

Tags: scalp micropigmentation, pigment, hairloss, hair loss, photos

I Keep Losing Arm and Chest Hair When I Take Propecia

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

I am 43 years old and I have taken propecia for years with none of the scary sexual side effects but I have lost body hair on my arms and chest. In fact, I have gone off of propecia on a number of occasions (when my wife and I decided to start a family I thought it better to be off for a few months before we conceived). My body hair would reappear after a few weeks of being off propecia, and would then fall out again once I resumed propecia. Nobody can tell me loss of body hair is not connected to propecia. It doesn’t bother me seeing as I don’t have the other side effects.

A loss of body hair may be connected to Propecia (finasteride), but it is a rare side effect that I have seen only a handful of times. DHT (which Propecia targets at decreasing) is a cause of male pattern hair loss, but DHT is also responsible for secondary male characteristics such as arm, chest, back, pubic, nose, and ear hair GROWTH. I’ve also been asked about an increase in body hair after taking Propecia.

The majority of patients who take Propecia will not notice any change in their body hair. I’ve written about this before here, here, and here.

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

My Doctor Wants Me to Stop Minoxidil While Recovering From Surgery

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


Doctor,

My doctor wants me off minoxidil while recovering from a surgery. Wants me off all nonessential drugs.. It could be up to a month.. How long off before it triggers catchup loss..

Wonder if I start it again in say 3 weeks if I can minimize any problems.

Thanks

I generally tell patients that use minoxidil to continue doing so as normal up to the date of surgery, and then discontinue it for 2 weeks following the surgery. I do not believe that this approach will trigger withdrawal hair loss.

Of course, I don’t know what kind of surgical procedure you’re having and you should talk to your doctor about your concern. Ultimately, it would be best to follow your doctor’s post-surgical instructions.

Tags: minoxidil, rogaine, surgery, hairloss, hair loss

After Shaving My Mustache, One Corner Won’t Grow Back!

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

I have always had patches of hair missing from my beard but last year I grew out my mustache for a month during November. After shaving it off the left corner will not grow back. It is now uneven and I’m not sure way, it has always been full. Is there any reason for this hair loss?

You should be looked at by a dermatologist. Patches of hair loss may reflect an autoimmune process such as alopecia areata, or it could be something as simple as being related to stress. You need a diagnosis by an expert at the minimum.

Tags: hairloss, hair loss, facial hair, mustache, moustache

I Had 4 Different Surgeons Give Me 4 Wildly Different Assessments of My Donor Area

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

Hello Doctor
I am having consultations with well respected surgeons in Europe. I’ve had two strip HTs in the past and i’m looking into another one. What astounds me is the very diverse opinions i’m getting regarding my donor area supply for another strip. One surgeon tells me it is depleted, another tells me it can yield no more than 1000 grafts, another one tells me i could have as much as 1300, the other one claims he can safely extract at least 2000 – 2200 grafts, and the last one claims i could have 800 grafts but it comes with risk.

I understand that the donor assessment is quite simple elasticity + density + strip size. Shouldn’t there be more or less unanimity on how much grafts can be extracted? How come i get such diverse opinions?

The answer is simple — there is no formal training that hair transplant doctors go through, so their experience and assessment can be highly variable (as well as their credentials).

Another possibility for the large graft range difference could be that some doctors are not equipped to do a 2200 graft case, and may only be able to do a 800 graft case (having less experienced staff or skills).

Out of curiosity, if you previously had two hair transplant surgeries and the results were satisfactory, why did you consult with four different doctors for your next procedure? My point being, if you were perfectly happy with the first surgeon and you trust him/her, wouldn’t you go back to the same surgeon?

Tags: hairloss, hair loss, hair transplant

Prostaglandin D2 and Hair Loss

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

Dr,

Do you have any theories or ideas as to how prostogladin d2 (studies recently show bald men to have higher levels in the scalp) fits in with the factors which we know contribute to hair loss like genetics and DHT?

Is this something you discuss with your fellow professionals and do you think that this discovery of PGD2 will lead to less invasive ways to slow or stop hair loss any time soon?

I’m asking as somebody who can’t take propecia due to side effects who wishes there was another way!

Researchers have found that Prostaglandin D2 is present in bald scalp and not in a hairy scalp. The suggestion is that PGD2 is an inhibitor of hair growth in AGA and some researchers believe that the PGD2-GPR44 pathway is a potential target for treatment.

This is still in the research area and there is no drug that I am aware of that will be available clinically at this time. I’m always hopeful for new proven treatments, but whether this is one of them remains to be seen.

Tags: prostaglandin, pgd2, hairloss, hair loss

Propecia and Clenbuterol

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

I’m about to start taking Propecia, but I’m currently taking fat burners called Clenbuterol

Will it be ok to take both at the same time?

Many thanks

I have not found anything that suggests a problem mixing these two drugs, but I know very little about clenbuterol other than its use in breathing disorders (chronic asthma) and as an enhancement drug for athletic competitors. You need to do your research and possibly speak with the doctor who is prescribing your Propecia.

Tags: clenbuterol, propecia, finasteride, hairloss, hair loss, fat burner

Can Norwood Class 3 Only Have Deep Corner Recession?

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

Dr. Rassmann:

Your site is an excellent resource. Thanks a bunch.

Is it possible to have a norwood three pattern with no frontal recession? In other words, can deep corner recession alone constitute a Norwood three?

Yes, deep recession in the corners with a normal central or low central hairline can co-exist when the forelock is persistent. This is actually quite common. The forelock is genetically coded differently than the frontal area in some families.

Tags: hairloss, hair loss, norwood class

I Take a Cut Proscar Tablet 6 Times a Week

/by William Rassman, M.D./5 /

Hi i’ve currently been taking Proscar 5mg tablets cut into quarters I take it 6 times a week and have a 1 day break (so im intaking 7.5mg per week) I’ve been on the drug for close to 4 months. firstly is this acceptable or should I be looking to take it every single day?

Also my main question, I have alot of vellus like hairs some grow to a centimetre or so some are eternally lingering around 1mm, small and blonde my plan with finasteride is to revert these hairs back to the terminal stage, I’ve noticed my remaining terminal hairs look stronger right now but im wondering the rough timescale of when I should see my vellus hairs growing in stronger, I know everybody responds differently but if you could ball park the average for me and maybe explain what I should see process wise (does anything change to let me know etc) if the medication is working for me. Many thanks!

This should be discussed with the doctor that prescribed you the medication. In general, the recommended treatment for male pattern baldness is 1mg finasteride per day. Many patients break up the 5mg finasteride pill into four pieces and take 1.25 mg per day with no issues. The half life of finasteride (Propecia) is about 4 hours, so after 24 hours almost all of the medication is out of your blood stream (even if you took a 5mg dose or 1mg dose or 1.25mg dose). Thus, the medication is meant to be taken daily (without skipping) so that you maintain a consistent level in your blood stream. It is not a cumulative dose over a week. You cannot take a 7mg pill once every seven days and expect it to work the same as taking 1mg daily for 7 days.

Finally, without an examination I really do not have any way to know if the medication is working for you. Ideally, one would have a measurement done before you started the medication (such as a photograph, miniaturization study, or bulk measurements) and compare this with a follow-up measurement. Otherwise it is just a subjective guess.

The Propecia timeline for results can be found here.

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

My Plugs from the 1980s Look Ugly and I Don’t Want to Wear a Hairpiece Anymore to Hide Them

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

Iam 64 yrs old. I had transplants done in the early 80’s. Donor hairs from the back of my head to the front. In time the rest of my hair from the top fell out. The transplanted plugs looked ugly and I resorted to wearing a hair piece. I recently started to shave my head and I like it except for the scarring on the back of my head and the in front of my head where the plugs were inserted and hair grows. What can be done? The shaved look is really in style and I don’t want to go back to using a hair piece.

Your options are very limited, unfortunately. The plugs can possibly be removed, but you’ll still be left with scarring in that area and in the donor area at the back of your head.

Scalp Micropigmentation could be an option for covering the scars from old plugs. Many men with bad plugs and bad hair transplants have opted to shave their head and cover the scar with SMP, giving them the appearance of a closely cropped hairstyle. Each case is unique, but I doubt you’d be able to completely remove scalp scarring.

Tags: smp, pigment, hair plugs, repair

In the News – Hair Loss Myths (Slideshow)

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

Hey doctors,

I found this slideshow of popular hair loss myths that Dr. Bernstein wrote that I thought you’d like.

Link: CBS News – Hey, Baldy: 10 Things You Need to Know about Hair Loss

We’ve covered practically every hair loss myth I can think of (most of which I’ve never heard before I started this site), but the slideshow mentions a few of my favorites — Genes for hair loss come from mom, hats make you go bald, and clogged pores cause hair loss.

There’s not much substance beyond 1 liners and stock photos, but CBS has the myths on their site at the link above.

Tags: hair loss, hairloss, myths, genetics

Could 20 Laser Treatments Cause Complete Regrowth?

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

What’s your take on this woman that had 1 laser treatment each week for 5 months and got all of her hair back? It’s very remarkable!!

Link: Health Watch: Hair Growing Treatments

I don’t believe it for a moment. I suspect that this lady had chemotherapy and lost her hair, then after a time, it grew back. I also suspect that doctor (?) or clinic involved in the process took the credit for what would have happened anyway.

Tags: hairloss, hair loss, laser