I Ordered Generic Propecia Online and Received Proscalpin

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

I ordered generic propecia online and got a product called proscalpin… ever hear of it or know if people have achieved good results?

I’ve never heard of Proscalpin, but there are a variety of names the generic 1mg finasteride is sold under, mostly by pharmaceutical companies based out of India. I’m not familiar with all of the brand names, but I’ve heard of or have been asked about many (Appecia, Finpecia, Finax, Finara). The drug patent hasn’t expired yet and these generic 1mg pills aren’t legally available for sale in the US.

Based on what I found online, Proscalpin is made by an Indian company called Dadha Pharma that sells generic medications primarily for the online market. There doesn’t appear to be too much info on Dadha available online that I can find, and I’m at a loss to even find a website for the company.

So long story short, I’ve never heard of this particular brand and I have no way to know if what you’re getting is really 1mg finasteride. I don’t recommend buying prescription drugs from online pharmacies that aren’t legally allowed to sell them in the US.

Tags: proscalpin, propecia, hairloss, hair loss, finasteride, dadha

Should Non-Responders to Propecia Just Stop Taking It?

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

Is it best for nonresponders to simply quit taking fin/propecia to have thicker hair? I’ve been taking it for about two years and continued to loose ground, but only severe thinning at the temples.

Since it is known that fin/propecia hurts the hairline, would it at least shed less after quitting the drug?

It is known that Propecia hurts the hairline? Some people have asked (through this blog) about shedding upon starting the drug, but this isn’t a typical occurrence and doesn’t seem to be limited to just the hairline.

You are asking me to give you advice on whether or not to take a prescription drug — something that I do not do. There may be answers to your situation (such as taking dutasteride), but I would insist on a bulk metric measurement before you were put on other medications to get some objectivity in analyzing the results. You might also consider having a HairDX Genetic Test for Finasteride Response done. Talk to your prescribing doctor.

Tags: propecia, finasteride, hairloss, hair loss

Could FUE Move Hair and Skin to Eliminate Scarring?

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

Dear Dr Rassman, please excuse my question if it is stupid. I’m not medically trained!

What is normally discussed is the movement of hair follicles *from* the donor site *to* the recipient site. And this inevitably leaves some form of scarring in the donor area. But is it technically possible (in FUE) to also implant skin *from* the recipient area *to* the donor area, in such a manner to “eliminate” scarring? i.e. for every follicle the surgeon would swap tissues A and B, where A would be the tissue originally at the recipient site, and B the tissue originally at the donor site.

I’m sure this would be more costly for the patient, buy I’m wondering: has this ever been tested? And would it eliminate scarring?

A number of years ago, a well-known doctor preached that small punch extractions of scars would produce “mini-scalp reductions”. It never worked. This sounds like what you are asking about, and if one removes scar from a scarred area, you just get scar to replace it. Not such a good idea.

By the way, there are no stupid questions. Your question reflects an inquiring mind.

Tags: fue, scarring, surgery, hair transplant

My Surgeon Said I’ve Exhausted My Donor Area After Multiple Hair Transplants

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


I am a 60 yo male. I’ve had multiple transplants via the strip method, most recently 2years ago. I’m pretty pleased with the results, but there is an area on the top toward the front where my hair is thinner than surrounding areas. It does not involve the hairline.

My surgeon told me I had exhausted the donor site after the last surgery. My ballpark guess is that 100-200 grafts would make a big difference.

1. Am I a candidate for FUE given my history?
2. If so, are 100-200 grafts a realistic expectation?
3. Do patients on Coumadin have to stop it prior to FUE surgery?

Thank you

You might be a candidate for 200 graft FUE style, but we would have to evaluate you first. Each case is unique.

If you are on Coumadin (warfarin), I would consider still doing a limited FUE procedure, but you will almost certainly have some more bleeding than normal. This has to be discussed one-on-one with either Dr. Pak or myself.

Tags: fue, coumadin, hair transplant, donor area

Does Miniaturization Mapping Determine Your Future Hair Loss Pattern?

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

Hi Dr,

I recnetly went to visit a hair transplant surgeon and asked him to assess my hair and in particular to do a miniaturisation study. I told him about your blog and said that I had learnt from your site and wanted to get an analysis of where my final balding pattern would be.

He said that I clearly have some frontal recession at the corners (not a mature hairline because there was miniaturisation apparently) but overall a good hair of ableit fine hair. I am in my late 20’s.

My reason for this appointment was because my father is a NW6-7 and his hair loss turned aggressive at age 30 and my maternal grandfather is probably about a NW3-4 with vertex thinning.

I was hoping that the surgeon could give me an accurate idea of where my final hair loss pattern would be from the miniaturisation study that I insisted on (taking microscopic photos to count hair thickness and density at various points of my head), but he did say that using these methods it was just not possible to really know what my final pattern might be because in his words “Just because you are receding a bit now, and don’t have any apparent thinning elsewhere – doesn’t mean you won’t start going bald in those areas later as you’re still quite young -family history is the best guess”. So I suppose you could say that he was disagreeing with some of your ideas?

Anyway, having had this study done, I am still no wiser as to what my final hair loss pattern will be. I don’t want to take propecia and minoxidil didn’t work for me but I wish I could have a better idea of things so I could consider maybe a transplant to the front in future if no other areas are to go bald. I suppose that if my final hair pattern is similar to my grandfathers then I could have a transplant but this would be much more risky if i take after my father.

Interested in your comments…

There are no absolute ways to determine what your final balding pattern will be with 100% accuracy; however, good measurements are the basis of good science. Miniaturization mapping and bulk measurements of the hair where balding is not appearing to the naked eye will absolutely show signs of reduced bulk if your pattern is moving in the direction of your parents or grandparents.

I do not believe that preventive hair transplantation has a role, but knowing where you are going with all of the evidence you can muster will give you an idea what is going to happen to you and what may not happen to you.

So your doctor is correct in that just because you have thinning, it does not mean that you are going to go completely bald in that area… but his assessment is limited to what the eye can see, while what I am discussing puts good clinical science behind where you may be going with your hair loss. I would want to know.

Tags: hairloss, hair loss, miniaturization mapping, science

My Doctor Said I Need Laser Treatments After My FUE Procedure

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

I am a 30 year old female and I had FUE last December, 600 grafts. Almost 7 months later, it seems like the grafts are not falling off. A couple of months ago, I got an infection due to one of the grafts not falling off and new hair already growing in the same place. My doctor had to use a needle and pull out the graft and i ended up with a bald patch. I have another bump on my scalp now due to the graft not falling off but it is not infected yet. My doctor is pushing me go for her laser treatment saying all my problems will clear up if I do.

Is it necessary to go for treatments like laser after an FUE?

Most people will see the newly transplanted hair fall out and go through a dormant phase before regrowing months later, but some will see those grafts just start growing without going dormant. I am confused by what you’re describing about pulling grafts out months after surgery. After 7 months you should see some hair growth from the grafts you had transplanted. Lasers are not necessary to get the hair to grow.

Lasers treatments do not work for hair growth, for FUE scars, or ingrown hairs. As for bumps following a hair transplant, I’ve discussed that here.

Tags: hair loss, hair transplant, laser

I Have Excellent Results from Propecia, But I Have Lumps on My Chest

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

I have been taking propecia for roughly 10 years. Excellent results, stopped hair loss with slight regrowth. no sexual side effects, if anything my libido was increased. when I started taking propecia I had multiple lipomas on my body. about 5 years ago I went back to my prescribing physician regarding lumps i noticed in my left breast. I had mammography completed but nothing showed up. but the lumps are palpable. regardless the dr concluded they were benign. no significant changes since.

should I be concerned given the new warnings about propecias side effects?

If you had multiple lipomas (benign tumor) on your body before the medication, it’s quite possible that the Propecia is unrelated to more lipomas in your chest. It sounds like your doctor did the right assessment. Keep to his advice.

I’m not sure what new warnings you’re referring to, but I wouldn’t be concerned. Always talk to your doctor if you notice any changes in these lumps.

Tags: chest, breast, hairloss, hair loss, propecia, finasteride, lipomas, tumor

My Soon-to-be-Pregnant Wife Stored Ibuprofen and Finasteride Together

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

While on vacation my wife handled ibuprofin tablets that I stored in the same bottle as my daily 1mg dose of finasteride via a broken tablet. She is not pregnant but we will be trying in a few months. Is there any danger to her or to the development of a male fetus? Thank you.

I doubt that it will cause any danger if she’s not pregnant, but she should not use the ibuprofen that was stored with the finasteride tablets. Open a new bottle.

Tags: ibuprofen, advil, finasteride, hairloss, hair loss, pregnancy, pregnant

Guest Post – Analyzing the Recent Finasteride / Persistent Side Effect Study

/by William Rassman, M.D./9 /

Note: This post comes from one of our favorite readers (he has requested to remain anonymous), who has contributed posts in the past about FDA and clinical trial issues. Some of his previous contributions are here, here, here, and here.

He has broken down the latest finasteride side effect study for our readers and explains why interpreting the data is problematic:

—

Post by Guest Writer

    This month an article appeared in a medical journal (Irwig MS. Journal of Sexual Medicine, 2012 Epub ahead of print) that relates to persistent sexual side effects of finasteride and has generated discussion in your blog from both posters and commenters. An abstract of the paper can be found at: Persistent Sexual Side Effects of Finasteride: Could They Be Permanent?

    I am a physician scientist (MD-PhD) who spent over 20 years conducting clinical trials and interpreting clinical data. Because I believe this is an important issue, I wish to summarize this study (and discuss its strengths and limitations) for your readers. Two biases that I am disclosing: (1) I believe that persistent sexual side effects of finasteride exist, and (2) I also believe that well-done published scientific investigations on this phenomenon are lacking and readers (most who are unfamiliar with scientific investigations) historically come to form impressions from magazine and newspaper articles, lawyer-run web sites, and blogs… none of which are ideal to better define and understand this phenomenon.

    Method:
    Fifty-four men were recruited. Most men (undefined number) were recruited from an internet site that focuses on sexual side effects from Propecia. Other men (number undefined) were recruited from the author’s clinical practice. To participate in the study, all men were required to have had their finasteride use before age 40 and (by their self-report) and have no history of sexual dysfunction, medication use (other than antibiotics), or significant medical or psychiatric conditions at the time that they began taking finasteride. Initial information for the study was collected by telephone or Skype. Info on sexual dysfunction, medication use, significant medical or psychiatric conditions, etc before and after finasteride use was collected. Follow-up emails were sent to the participants 9-16 months after initial interview (average 14 months). Multiple valid questionnaire scales of sexual dysfunction were used.
    Read more

Rogaine Made My Hairline Much Thinner Within Weeks

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

Doctor,

Mid 40’s diffuse thinning. Not bad. Gave Rogaine a try and within weeks was much thinner. It says doesn’t work at the hairline, but the hairline went from fairly full to very thin. If it doesn’t work at the hairline why would it shed hairs there? If it shed hairs at the hairline does that mean it will grow them back? Otherwise why continue to use it?

Thanks

Your experience is unusual. Shedding reports with Rogaine do not explain your findings. I don’t have all the answers, and this is certainly such a case. There is a suggestion that for some users, Rogaine accelerates the anagen stage in the hair loss cycle, which means that it first has to go through telogen (hair loss phase). I would think it would regrow there, but I can’t confirm with any sort of guarantee.

Remember, hair grows at a rate of 1/2 inch per month, so in a month all the benefit you can get will impact only the lowest 1/2 inch of hair. This usually gets better in a couple of months, so do not get discouraged. Speak with your doctor and ask him/her to measure your hair bulk to get a baseline measurement to compare to after 3 months.

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

Side Effects from Finasteride in Just 4 Days and the Media Has Me Worried

/by William Rassman, M.D./4 /

I started taking 1.25 mg of proscar everyday for hair loss and noticed side effects. I took the medicine for four days and experienced nipple sensitivity, erectile dysfunction, and a cold tingling sensation in my penis. I’ve stopped taking the drug and am very concerned because of recent news reports of permanent side effects. Could taking such a small amount really cause permanent problems? Or am I too paranoid and do you think the side effects will resolve in the next couple weeks. It’s been 4 days since I quit proscar.

I think you’re probably being paranoid, but talk to your prescribing doctor about changing the dosage or stopping the medication completely.

In your case, I would worry about the power of suggestion being responsible for these side effects more so than the medication, but if you are concerned you can make the decision not to take it.

Tags: proscar, propecia, finasteride, side effects

When Can I Stop Sleeping On My Stomach After Having FUE Into My Strip Scar?

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

I had fue into strip scar, 300 grafts were implanted to the scar. I slept 17 nights on my stomach post-op. I’m aware of the graft anchoring study from 06, but it was on a virgin scalp. My question is that was that 17 nights post-op enough for the grafts to secure in the scar? My doc said one week is enough and then I can start to sleep normally. The grafts were all singles and doubles. I’m white male, 26yrs.

I agree with your doctor. A week should’ve been fine. Once the eschars are gone, the grafts are stable.

Tags: hair transplant, fue, scarring, sleep

Bioscal

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

Hello Dr Rassman,

I read hair loss blogs and research products on a fairly regular basis. Today I stumbled across a product called Bioscal. Taking a look on the website it seems to have been through numerous clinical trails and the results they claim looked somewhat promising. Here is the link to the website where I have read the information – Bioscal.com.

My question is have you ever heard of this product and what would your comments be over the clinical trail results summarized.

Thanks

This is another product line that I have no experience with, but am skeptical nevertheless. It appears to be just a set of shampoos and conditioners, but if you think it might be helpful, give it a shot. I doubt you’ll see much benefit as far as hair growth, though.

Their site says it is the “most effective and best documented topical hair loss treatment worldwide” — but I’d expect if this was really the case, it would be more well known and talked about within the industry. It isn’t.

Also, I don’t see where any of their clinical trials were published in peer-reviewed journals… so I don’t know what their trials actually contained. It sounds impressive to say “most effective” and mention studies that were done, but without proof, they’re just claims made on the internet.

Tags: bioscal, hairloss, hair loss

My Female HairDX Test Showed Sensitivity to Testosterone

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

Hair Dx test (female)..

I have a 2 part question.

1. What does it mean if the results indicate that a person has the gene that shows sensitivity to testosterone but not the gene for Androgen Alopecia?

2. Does finastride cause initial shedding? If so, what % of people usually get it.

Thank you

I’m guessing you’re talking about the Genetic Test for Female Androgen Sensitivity, but what does sensitivity to testosterone really mean? It does not mean you are necessarily a candidate for finasteride. Remember that finasteride is NOT approved for women, so I would talk to the doctor that conducted the HairDX test and discuss these results and treatment plans.

There’s generally no shedding phase from finasteride, but some have reported it through this site. It’s not common and I don’t have percentages available.

Tags: finateride, propecia, hairloss, hair loss, female hair loss

Increased Sex Drive with Qigong (with Video)

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

I saw the video from the other day about the guy that drank his wife’s breast milk and said it cured his ED. That reminded me of something I saw equally as funny that you might like to see

YouTube – Chinese traditional qi gong treatment for prostate problems

From the description of the video — “Qigong (Chi Gong) healing techniques is said to shrink enlarged prostates and result in healing and improved sexual functions.”

Is seeing believing? It’s not hair loss related, but the first few seconds were enough to make me want to post this. Ouch!

Tags: prostate, qigong, video, sex drive