Transplant Specialist for African Hair Type?

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

Hi, where in the world would you recommend getting a transplant for an Afro-Carribean? Australia? USA or here in New Zealand ? I am happy to travel to any country..Thanks

This would be a biased answer since we at NHI routinely perform hair transplants, including curly hairs (African men, etc). I would like to think we are the best in the world, but I generally leave that up to our patients to be the judge.

We also can do follicular unit extraction (FUE) on this hair type, something that few doctors can offer. I realize choosing a doctor or a medical group may be difficult but if you do the research, you will get a good idea. You can also refer to our guide, Selecting a Hair Transplant Doctor.

Tags: afro, african, hair transplant, hairloss, hair loss

Could My Hair Loss Be From Having Diabetic Ketoacidosis?

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

(female)
I have lost about 70% of my hair since January and am unsure if it was due to having diabetic ketoacidosis. I do have some regrowth but my hair is very thin, especially around my forehead hairline. Is this from the dka and will it grow back or should I see a dr.? I asked my endocrinologist but they said there could be a lot of reasons. I’m really concerned and don’t know if I should wait it out or seek further medical advice.

Diabetic ketoacidosis is a potentially life threatening condition. It is a major stress to your body, which could be one of the many possible reasons you are experiencing hair loss (much like what your doctor already told you). The most important point is to get your health back in shape and control the diabetes. If the hair loss is from stress, it should recover within a year.

Tags: diabetic, diabetes, hairloss, hair loss, female hair loss

After Stopping Propecia, My Libido and Erections Came Back — But I’m Losing Hair!

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

I had been on Propecia for years but unfortunately suffered with notable side effects, particularly sexually. I had little libido, suffered with incomplete erections, testicular pain, and limited ejaculate volume. I realized that it was negatively impacted relationships with women since I had little interest in them sexually.

I decided in January to come off Propecia as a trial. I noticed a bump in libido after a few weeks off and improved mood and motivation. My erections did not return however until about four months off Propecia, firm by five months. I am now in a dilemma because the hair loss has been terrific. I went from excellent hair to thinning lifeless hair (made worse by using Rogaine) and noticeable loss of temporal region hairline. My appearance has definitely suffered and I am not in a relationship.

I am contemplating going back on Propecia and wanted to know if you would recommend 0.25 mg starting dose or 0.5 mg? Can I expect some regrowth on top at these doses? What is your experience with these lower doses. Some have recommended 1 mg every two to three days due to the long action of the medication (in an attempt to limit side effects). Any assistance would be greatly appreciated!

My assistance and recommendation for you is to discuss your issues with your doctor who prescribes you the medication. This is a general source of information. I do not and cannot advise you on personal medical issues.

If you have side effects from medications then it is something you inform your doctor. Some patients continue to take the medications after the risks and benefits have been considered. Some patients take a lower dose in hopes that the side effect would be less and the benefits would continue.

There are reports that at even half the dose (0.5mg finasteride daily) can be about 70 to 80 percent effective on the treatment of androgenic alopecia. I’ve prescribed a lower dose to some patients and they’ve had continued benefits from the medication, but that is something you’ll need to discuss with your prescribing doctor.

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

My Senile Alopecia Has Continued Despite Taking Finasteride for 2 Years

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

My diffuse unpatterned hair loss (or senile alopecia, I’m 59) has continued to get worse despite 2 years straight of finasteride. In your experience, have you seen a reason for people to continue finasteride after 2 years, if their hair loss simply continues to progress?

Finasteride 1mg (Propecia) is for the treatment of androgenic alopecia, not senile alopecia or diffuse unpatterned alopecia. I realize they may co-exist, and some doctors and patients may make the decision the try taking the medication to see if it would help. If you are not seeing any results, speak with your doctor and decide on the course of action.

In my experience, I do not prescribe finasteride for treating diffuse unpatterned hair loss or senile alopecia.

Tags: finasteride, propecia, senile alopecia, hairloss, hair loss, dupa

Taking Propecia for 2 Days Made My Semen Watery!

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

Hey Doc, I just wanted to share my opinion on Propecia. I was noticing some recession of my hairline & got it checked by mt Derm. He told me it’s just my maturing/adult hairline forming. But I panicked & asked for a 1 month Propecia Prescription. I’ve taken it for only 2 days & have noticed a low volume in sperm when I masturbate; almost liquid/watery. Much less thickness then before. What I’m going to do is get my Hormone Levels check in a week since that might be enough for Propecia to exit my body. Could it be that I might not need Propecia if my DHT levels come back normal. And the low volume could have been a sign saying there’s no need to decrease your DHT levels since you have normal DHT levels. Again I’ll wait and see what happens.

The last thing I would like to state is that I think at least a good 70-80% might notice low volume when it comes to the sperm. Now this could just be a common side effect of your body getting used to Propecia, and will return to normal within a few weeks- hence the only 2% notice sexual side effects of a period of years when it comes to the trials. So basically I think the low volume when it comes to the Semen could be just like Shedding or mild headache from something like Rogaine which a lot of people experience while using Rogaine & then it goes away. So maybe the Low volume in Semen could be the same- first few weeks it could be low & then return to normal after the body gets used to it.

The thing is if this is true and Merk knows it, then they should state it clearly: That most men taking Propecia will notice a low count in the volume of semen in the first few weeks but then it will subside and return to normal. I think this very much is true, but Merk might be scared to state this clearly as it will scare of customers from hearing about low volume in semen in the first few weeks. Again I would love your insight on this, as I believe it is true. I’m not saying Propecia has a long time effect on Semen Volume, but it could have a short time? maybe a few weeks as the body is getting adjusted to the levels. Again Merk should state this as it could also put rest to all the stories of side effects ruining peoples life.

Thank You & I hope you take your time reading this

One of the side effects of Propecia involves the volume and/or viscosity of the semen, but I would be surprised if it would occur in just 2 days. This has nothing to do with the sperm count per unit volume of semen or one’s erection or libido.

The mature hairline evolution may not be impacted by finasteride, but I really am not sure on this statement.

Tags: sperm, semen, propecia, finasteride

Can Whey Supplements Accelerate MPB?

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

do supplements such as whey protein powders or glutamine affect or accelerate MPB? i have read protein powders raises testosterone which raises DHT, and glutamine raises GH which raises testosterone and again DHT.

thank you!

There is no direct evidence of a connection, however, it is possible that it might cause hormone changes. We’ve addressed this before in a guest post by Dr. Richard Shiell.

Tags: whey, supplement, testosterone, hairloss, hair loss

I’m a Breastfeeding Mom And My Dermatologist Told Me to Just Deal with My Hair Loss

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

I went to see a dermatologist in Raleigh NC. After he learned that my hair loss started 15 years ago, then got excessive in the last 3 months since I am a breast feeding mom, he came to the conclusion that I have the genetic type of hair loss and I have 2 choices if I am not going to have more kids – propecia or rogaine.

I mentioned that my scalp is irritated and I have a lot of pain. His response was that this may not be related to hair loss. Bottom line he said that he wished that he was a hero and could fix my hair but he is not and he asked me to look at his bald hair. He basically said there is no cure yet and just deal with it. This experience was so hard because I had hope that I will get some kind of help, instead I had to hear just deal with it and use rogaine.

it has been 2 days since then and still asking myself if I went to see a very honest dermatologist that happened to be a rude doctor or if there was some test and other practices that he should’ve proceeded with but would not or could not do.

I wish I was a hero too, but I am merely a doctor who has to inform you that there is no medical cure for hair loss in either men or women. Maybe your doctor was too blunt or was not sensitive to such a delicate issue, but I think your doctor was being honest.

In general, the only hope for women that want to treat hair loss (after excluding any medical reasons for the loss) is topical minoxidil, also sold as Rogaine. Propecia (finasteride) does not really work for women unless there is a clear diagnosis of androgenic alopecia and it should never be prescribed to any woman who might get pregnant. And since you’re a breastfeeding mother, it should be pointed out that it is unknown if the medication can be passed through breast milk. Besides that, even if you have androgenic alopecia, Propecia is generally not recommended for women since we do not know the potential side effects (including cancer). The cancer part may be very rare, but since there have been no large scale studies it might just be a worst case scenario that has been theorized.

The final option may be hair transplant surgery, but this is also a limited solution for women who generally have diffuse thinning. And since you were curious about tests for possible causes of female hair loss, they are listed here.

Tags: female hair loss, hair loss in women, hairloss, hair loss

My Hair Loss Started When I Began Using New Shampoo

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

hi doctor,
I am a serious victim of hair loss and I am really worried. I am only the age of 19. My hair started to fall since the time I started using the head and shoulder shampoo about a month ago. After I realise that my hair fall was because of the shampoo so I stopped using it 15 days ago. In this 15 days my hairs have fallen like a waterfall from my head. In my family only my grandfather is bald. Before using the shampoo my hair was quite thick. After avoiding using the shampoo my hair still falls. When the water is poured in my head I could really see my hairlines. I am really worried. Please help me. Will my hair grow once again?

A few things that stand out to me:

  • You’re at the age where it wouldn’t be unusual to see the genetic hair loss process start
  • You have a family history of hair loss
  • You’ve diagnosed your problem as being caused by shampoo

Shampoo isn’t going to cause hair loss unless perhaps you have an allergy to an ingredient. There’s a thread on this site about Head and Shoulders shampoo with hundreds of comments from people, but I really wouldn’t expect this commonly used shampoo to cause the hair loss you’re seeing. See a dermatologist for an examination.

Tags: hairloss, hair loss, shampoo, head and shoulders

Could Obesity Cause Female Hair Loss?

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

Hello Dr.

I am a 21yr old female. I am 5’5″ and 85kgs overweight girl. My TSH level is 7.49mg/dl. So I have hypothyroidism. I had started hair loss since the age of 12yrs. But I didn’t really notice it then. The hair loss then worsened gradually until at the age of 16yrs I developed a bald patch on the left lateral aspect of my scalp which slowly spread to my right lateral aspect also. This had affected my psychologically and socially. I am a MBBS student.

I had read that if there is excess Oestrogen levels then it gets converted into testosterone which causes hirudism and baldness. My question is this: does obesity cause baldness in any way? I am taking treatment for hypothyroidism and also am taking multi vitamin supplements. Still there is no improvement. In fact… My baldness is increasing. Kindly help me out please. Thank you

While obesity itself doesn’t cause female hair loss, stress and poor diet can certainly contribute. I’ve written the same thing before here.

Hypothyroid, polycystic ovary syndrome (PCOS), and many other medical issues can potentially cause hair loss. The goal is to treat the medical issues and the hair loss should slow down. You need to be followed by your physician. That is the best help I can offer.

Tags: obesity, hairloss, hair loss

Could the Topical Steroids Prescribed for My Foot Fungus Impact My Scalp Hair?

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

I have a small fungus on my foot. Mr dr. gave me clotrimazole/ bethameth. could it impact mpb?

I do not think a medication for your foot or a fungus can impact the hair on your scalp. Topical steroid on your foot should not affect male pattern hair loss. If there is long term / high dose skin applications with significant steroid absorption into your body, there might be a connection. Be sure to ask your doctor this question.

Tags: topical steroid, fungus, hairloss, hair loss

My Dermatologist Prescribed 2.5mg Finasteride Daily and Said She’d See Me in a Year

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

Hi There Doctor!

Im a 22 year old guy with a pretty good head of thick hair currently. No one currently would ever know I am thinning. Recently I went to get my haircut and my stylist told me i may have some “thinning issues” as she noticed short hairs near the front of my hairline. Crown is very thick at the moment.

I made an appointment with a dermatologist and she said that right now is a great time to catch it and potentially preserve everything I have and started me on Finasteride 5mg cut in half once per day. (2.5mg daily) and she said “see ya in a year!” I have been on it for two and a half weeks with no side effects yet.

My question is if it takes a year for Finasteride to show any results, isnt a year a VERY LONG time to lose hair? Couldn’t I lose A LOT of Hair in that period of time? I hate this feeling that I’m on the best medication for hair loss, but at the same time I’m gonna be losing hair at the same rate for a year before it even starts working?! Am I understanding how Finasteride works correctly Or does it immediately start to “help” but will just take a year to see any major preservation or potential regrowth?

Thanks!

It may take up to a year before you notice the effects of finasteride on treating androgenic alopecia. Maybe some will see signs in 6 months, but I generally inform my patients that they should be prepared for a 6 to 12 month time span before they can see results. That being said, Propecia (finasteride 1mg) is for the treatment of androgenic alopecia on the crown and top of your scalp. Some patients and doctors use it for frontal hairline thinning, but it is generally not effective.

As for the dosage you were given, the recommended dose is 1mg taken daily. Many patients and doctors, in the interest of cost saving, choose the generic 5mg which they break into quarters (1/4) to make 1.25mg of finasteride. There is no generic finasteride in 1mg dose legally available in the US yet due to patent laws. While breaking up a small 5mg tablet in to four small semi-equal pieces may be annoying, it saves hundreds of dollars a year. For example, a one year supply of finasteride 5mg taken 1/4 pill a day will cost you under $30 per YEAR. The brand name will cost you close to $800 a year depending on where you buy it. There is no difference in efficacy in taking the generic drug. Taking 1.25mg a day as opposed to 1mg should not have any significant difference. Ideally you should be cutting the pill in to five equal pieces, but this is not practical.

Taking 2.5 mg daily is more than doubling the dose and it would not have any beneficial impact in treating your hair loss. Taking more does not mean it will work better. Rather, it will give you more side effects. But some doctors have their own opinions and they’re in their right to practice medicine and prescribe medications as they see fit. If you do not agree with your doctor and have concerns, you should seek a second opinion. After all it is called a “practice” of medicine. Just to be clear, I am not your doctor and this is not a second opinion.

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What Dictates How Body Hair Grows?

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

Hello, ive been searching around for an answer or explanation about body hair and what drives it to grow with no luck, i stumbled upon this site and thought it would be good to ask.

Im a male currently 21, and ive noticed a gradual increase in body hair, the growth is dark, coarse, and fairly thick. i’ve talked to my local doctor about this and done some tests still waiting for results, but he assured me this is “normal” however i beg to differ, the hair is really an annoyance and making social interactions abit awkward.

so my question is, how does body hair grow? and what hormones dictate the length and type (vellus / terminal) of hair? ive read that DHT might have a contribution but im not entirely sure. i do know however that my Test levels are on the lower side of the scale, which makes me think that my body is converting too much to DHT.

kind regards.

In general, DHT is responsible for some of the secondary male characteristics, such as body hair. DHT plus your genetic predisposition may cause changes in your body hair. Likewise, DHT plus your genetic predisposition can also affect male pattern hair loss. The key is genetics.

As men mature from their puberty years into their early twenties, many changes in their bodies occur. In men who are in their 60’s and older, they also develop ear hair and nose hair and some of them can lose body hair in their senior years.

Tags: body hair, hair growth, dht

In the News – Infected Tattoo Ink Caused Rash

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

Snippet from the study abstract:

Between October and December 2011, a persistent, raised, erythematous rash in the tattoo area developed in 19 persons (13 men and 6 women) within 3 weeks after they received a tattoo from a single artist who used premixed gray ink; the highest occurrence of tattooing and rash onset was in November (accounting for 15 and 12 patients, respectively). The average age of the patients was 35 years (range, 18 to 48). Skin-biopsy specimens, obtained from 17 patients, showed abnormalities in all 17, with M. chelonae isolated from 14 and confirmed by means of DNA sequencing. PFGE analysis showed indistinguishable patterns in 11 clinical isolates and one of three unopened bottles of premixed ink. Eighteen of the 19 patients were treated with appropriate antibiotics, and their condition improved.

Read the full abstract — Outbreak of Mycobacterium chelonae infection associated with tattoo ink

This topic interested us because of Scalp Micropigmentation (SMP) and the use of pigments in our practice. What can you learn from this? A medical facility is critical for sterility and cleanliness, and the tattoo ink must be medical grade. We periodically culture our inks as a precaution for this problem.

Tags: tattoo, ink, sterile

If I Can’t Grow Facial Hair, Does That Mean I Won’t Have MPB?

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

I have heard that hair loss is caused by excessive DHT. I have also heard that it is DHT that produces facial and body hair particularly in men. If I don’t grow facial hair (past stubble) does that mean I have less of a chance of exhibiting traits of early male pattern baldness?

I am 19 and my dad is the only person on either side of my family (maternal and paternal) who exhibited some form of baldness, but said that he showed signs at my age (I am not). Do I have good or poor chances of keeping my hair?

I think we answered this question many times in the past in different variations.

Facial hair is not related to scalp hair or male pattern balding. You can have no facial hair or too much facial hair without it being related to the hair on your scalp.

Tags: hairloss, hair loss, facial hair

I Don’t Want to Spend My 20s Bald

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

First off, I am a 20 year old male who has been concerned with balding since I was a kid. My dad is almost completely bald but the men on my mothers side all have full heads of hair. When I was about 16 I notice the corners of my hairline are higher then the rest of my hairline. I’ve worn my hair long since I was a kid so I can’t tell if this is my natural hair line or if it is in fact receding. I compulsively check my hair and haven’t noticed any recession since I began checking 4 years ago.

What I am desperately wondering is whether or not a hair transplant can restore a mans hair completely? I know that doctors recommend waiting until MPB has stabilized but my concern is (1) I don’t want to spend my 20’s bald, waiting for mpb to stabilize and (2) if i end up nearly completely bald there won’t be enough donor hair to help me achieve the results I want. I’ve always maintained good hair care and styled my hair so the idea of losing my hair is devastating.

On a side note, I’ve read a bit about stem cells possibly leading to a better solution to MPB. Is there any truth or likelihood to this ever becoming a reality?

In the pages of this blog, there are many examples of men being proactive about their hair loss. You need to get a Master Plan developed with a good, honest doctor who can help you through these traumatic years. Each case should be unique, so you and your doctor need to form a plan.

You might be a candidate for surgery or for medication. You might not even be going bald, but it’s just that your hairline is maturing. You might have nothing to worry about (as you said, your hairline hasn’t changed in years). Without an examination, I’m not sure what more I could say.

Stem cell research is ongoing, most recently mentioned here and here. I hope at some point new treatments become reality, but I’ve got no timeline for availability, nor can I promise that they will.

Tags: stem cells, hairloss, hair loss