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

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