I’ve Been Losing Hair Since I Was 15, But I Wonder if Working Out Is Accelerating It

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

Hello Mr Rassman,

I have been balding since I was 15 and now I am 21. I am currently using rogaine foam and propecia.Despite of I am on these two medications my hairline keeps receding. I am working out in gym 6 days in week and I am taking whey protein supplement. There is no steroid in it but on the product it says that there are testosterone supporting elements and it helps support normal serum testosterone levels. From this information,I concluded that this whey protein can support hair loss. All of my family members are bald so I tend to lose hair. My questions are do whey protein increase my hair loss? also I wonder working out in gym can contribute to hair loss?

Thank you for your help

You have a family history of hair loss and you started balding as a teenager, but you’re worried that whey protein or exercising is causing an increase to your hair loss? I’d say your genetics are most likely the reason for your hair falling out at the pace it is. There is no direct connection between hair loss and whey. Also, working out at the gym isn’t causing your hair loss.

Rogaine and Propecia work best at the crown / top of the head. These medications rarely work at the hairline, so it isn’t surprising that your hairline is continuing to recede. Some men do see regrowth at the hairline or slowing of loss at the hairline, but everyone is different. I don’t know how long you’ve been using these medications, but you may wish to follow-up with your prescribing doctor.

Tags: hairloss, hair loss, gym, whey

David Beckham’s Hairline Corners?

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

I saw a picture of David Beckham, and it brought up some confusion I have about temples. A few people, including Beckham, have this huge bald area the temples, despite showing no other signs of baldness. Others have a very full look in the temple region, despite reaching a Norwood 3 balding pattern. Do this mean that temple hair loss occurs independently of male patterned baldness, or are we seeing evidence of surgery, during which the temples were left out?

Here’s the picture of Becks

Just so we’re on the same page, what you’re referring to as the “temples” is the hairline corners. The temples would be the triangular peaks below the hairline, and those look strong. With that out of the way…

In my opinion, David Beckham has a normal hairline. We’ve written about his possible hair loss in the past, but I would consider his hairline to be maybe a Norwood class 2. I would not call the hairline corners “bald” areas, as this is a normal male hairline. Even the young boy in the photo has a similar hairline. His temple triangle peaks may look a bit pushed back and make the forehead look wider, but this is not balding.

Tags: david beckham, soccer, athlete, temples, hairloss, hair loss, hairline

Testosterone and Intelligence?

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

Hello, I have a question regarding finasteride. I have heard that there are correlations between intelligence (IQ) and testosterone. Now if I take finasteride, it will lower my dht, but apparently it will also increase the testosterone slightly. Now, which form of testosterone is related to intelligence and what would an increase/decrease do to the intelligence.

thank you in advance for any anwser.

This is a new one for me. I haven’t read anything about testosterone and intelligence being related, and I don’t know where you picked that up from. If you believe everything you read on the Internet, Elvis will be your neighbor and the world will come to an end shortly.

Sorry, but I wouldn’t be concerned about your testosterone affecting your intelligence.

Tags: hairloss, hiar loss, testosterone, intelligence

My Hairdresser Told Me Paraffin Regrew Hair

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

My hairdresser told me her father used liquid parafin on small balding patch on his head and it grew back. Is there any truth in this?

Paraffin is a substance made from hydrocarbons with many uses (treating hair loss not being one of them). I don’t know what your hairdresser is talking about.

Tags: paraffin, wax, hairloss, hair loss

Is It Common for People to Run Out of Donor Hair?

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

How often do people run out of donor hair? I have low density, straight Asian hair. I am already thinning, and my dad has a diffuse NW6 pattern. I am afraid that if I go for a hair transplant I will not have enough donor hair to cover my entire head. Is this a common thing?

This is a very significant question. An Asian has an average of 80,000 hairs on their head. A Caucasian has an average of 100,000 hairs on their head. The donor area can be exploited so much that you can see through it. That is a particular problem for Norwood class 5, 6, or 7 Asian patients who will not have enough hair to cover the entire balding pattern (on average), so I would expect that many of these patients with the higher degree of balding need to have a Master Plan created by the doctor to account for this problem. If I met with a typical Asian with a class 6 pattern, I would tell him (up front) that he will not have enough hair to cover his entire head. This is particularly important in Asians who have finer hair, as they will run out of donor hair earlier in the process. There are some solutions to this problem, but every Asian patient who has these advanced patterns of balding must be aware of the finite amount of donor hair that they have.

I see some Asians and many Caucasians who have run out of donor hair and are perplexed that their doctors never told them this truth. In many of these patients, the donor area is see-through and has become more of a problem then the balding area. Scars in the donor area compound this problem significantly.

I can write a book on this particular subject, so I hope that readers realize that I am just answering the fundamental question posed in this post.

Tags: hairloss, hair loss, donor hair, hair transplant

If My Hair Loss Was From a Vitamin Deficiency, Would It Look Different from MPB?

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

Hi, I’m 18 with diffuse thinning on my crown and the top of my head (hairline is fine). Since the thinning is quite aggressive, I was wondering – would it be advisable for me to take a blood test?

My dad also started balding at the age of 18, and I read some statistic that 95% (or something) of hair loss is genetic. Am I also right in thinking that if the hair loss is because of a vitamin/iron/etc deficiency, I would be losing it in the sides and back as well, not just the MPB areas?

The reason I ask is because I’m in university, and it’s difficult for me to find time to schedule a blood test. Thanks!

Male pattern baldness implies that there is a pattern to the balding process. Vitamin deficiency does not have a specific pattern. In any case, if you are concerned about your hair loss you should find a good doctor who can examine you and give you a diagnosis.

Considering your family history and your age, genetics (rather than a deficiency) would be the most probable reason for your loss.

Tags: hairloss, hair loss, pattern, vitamin

In the News – High Dose Finasteride for Treating Female Hair Loss?

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

Snippet from the article:


Off-label use of oral finasteride at 5 mg/day proved safe and effective for the treatment of female pattern hair loss in 43 premenopausal women in an 18-month study.

Treatment effectiveness was assessed in two ways: patient satisfaction scores and two blinded investigators’ evaluation of photographs. As a precondition for study participation, patients needed to have normal serum androgen levels, no clinical signs of hyperandrogenism, and no wish to become pregnant ever again. They also had to go on drospirenone/ethinyl estradiol for oral contraception.

At the 6-month mark, 25 patients (58%) characterized their improvement as “huge” and 14 (33%) as moderate; 4 reported no improvement. These results were stable across time, with the women reporting the same results at 12 and 18 months of follow-up.

Read the rest — High-Dose Finasteride Halts Hair Loss in Women

The study appears to be unpublished and includes only a few dozen patients, but I found it of interest to our readers and worth posting. As the article points out, “an 18-month study is not sufficient to draw solid conclusions about the possible long-term risks of extended therapy“.

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

In the News – The Hair Loss Cures Are Coming

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

Snippet from the article:

The good news is that new research in Japan, France and the US has moved closer to the goal of “curing” male baldness.

Dr George Cotsarelis, head of dermatology at the University of Pennsylvania, recently announced he was in talks with pharmaceutical companies about making a drug to block an enzyme he believes causes baldness. The enzyme, prostaglandin D2, was identified in a research paper in February as instructing follicles to stop the production of hair. But his laboratory is not the only one racing for a cure.

In June, Dr Bruno Bernard of L’Oréal said he and his team had discovered that thinning hair is often due to follicles being in a “dormant” phase. It is all to do with the level of oxygen around stem cells called CD34+ cells. He thinks that by targeting these cells he can awaken them.

Meanwhile in Japan, a hairless mouse was given a stem-cell treatment to transplant hair follicles on its head from a hairy mouse. This breakthrough could mean that follicles might be grown in a lab and then transplanted on to the head.

Read the rest — A cure for baldness? It’s just a hair’s breadth away

There was a great focus on the work by Dr Cotsarelis and prostaglandin D2 at the recent 2012 ISHRS meeting. I’ll keep my fingers crossed that any of these new treatments (or “cures”) become a reality.

Tags: cotsarelis, hairloss, hair loss, hair loss cures

I’m Taking Finasteride — What Medical Check-ups Should I Have Done Regularly?

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

I have two questions if I may:

I take Proscar and split it in to 5 pieces for my intake of finasteride to combat hair loss. When I do take it is only 1 piece per day which equates to 1mg I believe is what propecia pills are made to. However, I sometimes take a piece every 2 days or every 3 days – so it is quite a big gap between than what most people are told to take daily. I have been doing this for 5 years now and have a very good coverage.

Prior to taking proscar I was extremely paranoid as I had very noticeable thinning on my scalp, and would obsess about it every day to the point where it got me very depressed. Out of my family on both sides, only my dad and his brother were the very first to experience balding in the family chain, so I was convinced I would continue this after seeing my thinning. I saw are Tricologist and was recommended finasteride. After taking the drug and seeing great improvements after a month I no longer worried about it and my hair started to grow back. My hair on the scalp does feel thinner than the front but is no way noticeable to anyone else but me.

Do you think my stress levels were the cause of my original hair loss? I’m too worried to stop though in case it resumes.

My second question is what medical checks should one have and at what regularity for taking this drug? I’ve read that using proscar may increase the risk in developing prostate cancer?

Thank you for your informative website

If you saw significant improvement from taking finasteride, then I would assume that you had/have genetic hair loss and the drug was appropriately prescribed. At 1 month, the only benefit a person would see would be a reduction on hair shedding. In a person without genetic hair loss taking this drug, nothing will be seen and the normal hair cycling (100 hairs lost per day) should not change. Stress can accelerate the balding/thinning process, but I don’t know if your loss was purely stress related, or a combination of genetics and stress. That is something your doctor should’ve considered before prescribing the medication.

With regard to your prostate, if you are under the age of 40, you should not have prostate problems such as trouble urinating. A good doctor can provide a rectal exam, where the doctor can feel your prostate (not necessary without symptoms) or colon/rectal cancer (very rare in men under 30). There’s no specific evidence that I’ve seen which shows taking the low dose finasteride for treating hair loss poses a prostate cancer risk. I’ve written more about that here.

Tags: hairloss, hair loss, prostate

Does Zinc-PCA Block Minoxidil Penetration?

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

Is it true that is not recommended to use topical products that contain minoxidil and Zinc PCA at the same time? Right now, I’m using finasteride and minoxidil but I want to add Alpecin ASL (that contains caffeine and Zinc PCA) because that lotion had a great effect on my hair growth after 7 months of use when I use it few years ago.The problem is that I read somewhere online that Zinc PCA blocks the penetration of minoxidil. Is it true or false?

The use of zinc shampoos (topical) was studied in conjunction with minoxidil, but it wasn’t shown to offer more than minoxidil itself (see here).

I haven’t read anything that says zinc PCA (pyrrolidone carboxylic acid) would block minoxidil penetration, though. You can contact the maker of the Alpecin lotion to find out what their thoughts are, but that’s a new one to me.

Tags: alpeci, zinc pca, minoxidil, rogaine, hairloss, hair loss

In the News – Actress Anna Kendrick Reveals that Stress Has Caused Her Hair Loss

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

Snippet from the article:

Anna Kendrick‘Twilight’ actress Anna Kendrick is used to spending a lot of time in the public eye alongside her co-stars Robert Pattinson and Kristen Stewart, but nothing could prepare her for the stress that she felt when she was nomination for an Oscar and a Golden Globe for her part in ‘Up In The Air’.

The actress was talking on The Late Show With David Letterman when she revealed that the stress built so much that she started to lose her hair.

Read the rest — ‘Twilight’ Star Reveals Hair Loss Over Awards Stress

Stress can cause hair loss, and even celebrities aren’t immune.

Tags: stress, hair loss, hairloss, celebrity, hollywood

Should I Not Take Finasteride If I Have a Long Family History of Cancer?

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

Dear Dr. Rassman,

My doctor has recommended Finasteride for my hair loss (28, Male, NW 2-3-ish, rapidly receding hairline and rampant loss). However, I recently learnt that finasteride causes breast cancer and very aggressive forms of prostate cancer which are typically beyond treatment, and various other forms of cancer.

Moreover, this is my central cause of worry: Many members of my family have expired due to cancer. My maternal grandmother, my mother’s twin sister, and my father (hodgkin’s disease). In my case, does Finasteride increase the likelihood of me developing some form of cancer? Or am I no different from regular candidates whose family history isn’t markedly carcinogenic like mine?

I understand that you are in no position to provide any subjective information pertaining to my particular case, without having see or diagnosed me, so please treat this as a general question.

In your experience, do you feel Finasteride would be extremely dangerous and significantly increase the likelihood for developing cancer in balding-folks whose family history is carcinogenic?

Thanks

Step back and think about what you just asked me. Why would a doctor prescribe a “dangerous” or “cancer causing” medication to you? Finasteride does not cause cancer and is not a “dangerous” medication. There are studies that suggest that Propecia (finasteride) decreases prostate cancer. There are also confounding studies that suggest for those men who end up with prostate cancer, the cancer may be more aggressive. This does not mean it causes cancer. I’ve written about this many times before, including here, here, and here.

I do not know of any study that suggests finasteride causes breast cancer. Breast cancer in men is rare and it has been reported in men who take finasteride, but the causality is not clear.

In the end, I strongly urge you to speak to your doctor about these issues and your medical and family history.

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

New Study – Finasteride vs Dutasteride Safety and Efficacy in Patients with BPH

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

Snippet from the study abstract published in the International Journal of Clinical Practice:

Objective: We evaluated 5-year safety, efficacy and prostate volume data from BPH patients treated with finasteride or dutasteride. Methods: A retrospective analysis of 378 consecutive men treated with 5α-reductase inhibitor monotherapy between January 2004 and September 2009 (197 on finasteride and 211 on dutasteride) in a single clinic was performed.

Conclusions: In this retrospective analysis of data from consecutive patients treated at a single clinic, both finasteride and dutasteride were effective therapies for the management of lower urinary tract symptoms. However, dutasteride resulted in significantly more sexual side effects and breast complications than finasteride.

Read the full abstract — A 5-year retrospective analysis of 5α-reductase inhibitors in men with benign prostatic hyperplasia: finasteride has comparable urinary symptom efficacy and prostate volume reduction, but less sexual side effects and breast complications than dutasteride.

This study contained 378 men with the mean age of 58.7 years old, and the conclusion of the study (see above) is one of the reasons why we do not prescribe dutasteride off-label. Yes, this is a study of men with prostate issues and the dose is most likely different for treating hair loss… but the side effect risks and dosage for using dutasteride as a hair loss treatment are still unclear.

Tags: dutasteride, avodart, finasteride, proscar, safety

I’m 19 and Have Been on Propecia for a Year — Should I Be Worried About Sterility?

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

I am a 19 yr old male taking Propecia for about a year with great results. I have had minimal, if any side effects, though I have read some aritcles about people complaining that the drug can cause sterility. I am hoping to have a family someday and was wondering if you believe any of these claims about the drug. Thanks

I do not believe Propecia causes sterility. If you are having side effects (whatever it may be), please tell your doctor. If you are concerned, you can ask your doctor for a test to measure your sperm count to set your mind at ease — or at least have a baseline measurement.

Tags: propecia, finasteride, sterile, sterility

Female Hair Loss Specialist in France or Switzerland?

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

Thank you for your website, which is the best source of information I have seen. My twenty-four year old daughter has been losing her hair severely for six years and has been seeing doctors and trying various ways to stop hair loss, without success. Can you please refer her to a doctor either in France or Switzerland?

I don’t have any personal doctor recommendations in France or Switzerland, but you can find doctors in your area by using the physician search at ISHRS.org.

Be sure to research any doctor you’re interested in, but you should also know that treating female hair loss can be quite difficult. I wish your daughter the best.

Tags: female hair loss, france, switzerland