Rogaine Foam on the Temples Has Caused Shedding All Over My Scalp

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

I am a 21 year old male who has recently (6 weeks ago) started using Rogaine foam. I had noticed the hair at my temples thinning but the hair elsewhere on my head I was happy with- it has been the same thickness (I THINK) since I was 16.

I have a couple quick questions which I would be extremely grateful that you answered to put my mind at ease!

Firstly, will 5% minoxidil foam help this type of balding? I have only been applying the foam to my temple area. Secondly, since starting the treatment, my hair has been shedding more ALL OVER. This has lasted the whole 6 weeks (getting slightly better now). I have noticed this is said to be a good sign but should the shedding last this long and is it normal for the minoxidil to affect the hair I haven’t applied it too? Finally, the texture of my hair has changed all over since beginning treatment, feeling more dry and lifeless. Is this normal or should I be worried?

Thank You!

Rogaine FoamRogaine Foam is meant for use on the top, crown, or vertex area of the scalp. It is not likely to work on the front temples. I realize many people apply the foam to the front areas, but it will have minimal effect (if any).

Rogaine should not cause hair loss or shedding of hair all over the scalp, though it may cause some initial shedding in the first month, as I have heard some people mention this phenomenon. With continued use it should grow back.

I am not aware of changes in texture of hair being a common side effect, though I suppose the alcohol in the treatment could be the culprit.

Tags: rogaine foam, minoxidil, hairloss, hair loss

It Seems Everyone Blames Every Bad Thing on Propecia

/by William Rassman, M.D./13 /

Doc, I can fly. Is that a side effect of Propecia? Reading your blog makes me laugh, because it seems like everyone blames every single bad thing in their life on Propecia. Propecia has allowed me to keep a full head of hair and I have had zero side effects from it.

Thanks for sharing your experience. I think you’re right — I have definitely noticed a lot of blame pointed toward this medication. Not many men will write about the positive benefits of Propecia, as they use the medication without any problems and go on with their lives. It’s those that feel they’ve been wronged that become the most vocal.

The side effect risk from Propecia is in the range of 1 to 2% of the men who take it. Those 1 to 2% are the most vocal, along with possibly another 10% of men just need a cause to rally behind, like the building bandwagon against Propecia.

Tags: propecia, finasteride, hairloss, hair loss

Should a Norwood Class 3 Person Consider Himself Lucky?

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

You may have touched upon this question before but I was looking for clarification. In an early post (I’m talking a few months ago) you mentioned how a norwood class 3 would rarely, if ever, progress to a norwood 6/7. By this, can a norwood 3 consider himself quite lucky in the sense that he’s probably not going to experience crown loss? What exactly did you mean by this?

Norwood 3Everybody is different. If you have stabilized your hair loss pattern at a Norwood class 3, then you will probably not progress to further balding.

You are born with certain traits ranging from eye color, skin color, dimples, to hair loss patterns. I would not say having one trait is better or luckier than the other. I believe about 8% of men are born with a Norwood 6/7 trait. Does that mean those men are unlucky? For example, Michael Jordan is likely a Norwood 6. Would you consider him unlucky?

Tags: hairloss, hair loss, luck

I Want to Transplant a Slight Widow’s Peak to Frame My Face

/by William Rassman, M.D./2 /

I am 29 with a stable NW 2 after taking Propecia for a year now. I’ve always had a high forehead and have always wondered if it is possible to have a small hair transplant to create a slight V in the middle of my hairline like Keanu Reeves, Leonardo Dicaprio or Johnny Depp. I feel like if you took that part of their hairline away, their hair wouldn’t frame their face right and I feel like if I had that bit of hair there, it would frame my face better.

The slight V you’re talking about is a widow’s peak.

Beauty is in the eye of the beholder, as the expression goes. If someone wants a different hairline, that is what we do. This is cosmetic surgery, after all. Meet with a hair transplant surgeon to go over your options.

Tags: widows peak, hairline

What is Activance with Rhodanide?

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

Dr Rassman,

What are your thoughts on the following hair loss treatment? Is it another scam?

Activance

ActivanceI don’t know if it’s a scam, but I guess it depends on what you’re using it for. This Activance product claims to treat hair health, but I don’t see anything here that would make it treat hair loss. Strengthening and thickening hair isn’t anything extraordinary, as many hair treatments can do this.

I didn’t know what rhodanide was, so I had to do a little Googling. Rhodanide is also known as thiocyanate, which isn’t a common hair loss treatment outside of guinea pigs. The US distributor of rhodanide says that there is some study (which one?) from 1997 that showed this ingredient regrew hair in 80% of participants in a trial. No real information is given other than that.

I’ll let you draw your own conclusions, but if you want to try the product and report back, please feel free.

Tags: activance, hairloss, hair loss

Months After Extreme Illness, I’m Still Losing Hair

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

Hi,
I’am 19 years old and suffering from a great amount of hair loss. I got extremely ill about 4-5 months ago and almost lost my life. After the hospital i lost a lot of hair but eventually went to normal a month or two after. A couple of months after, i started losing even more hair. When i wash my hair, lumps of it fall out. I have seen many doctors but they all say nothing can be done. I have been taking Nutricap for a little over a month now and I see no difference. Any suggestions? I feel like i’m going to be bald by 20!

Hair loss after a major illness can be normal. I can’t explain why your loss stopped and restarted. It may all grow back in about one year time frame. If you were going to eventually bald due to genetics, the illness may have kickstarted your genetic process early… but if the hair grows back, then you don’t have to worry about that being the case. You’ll just have to be patient, though.

Look on the bright side — you didn’t lose your life!

Tags: hairloss, hair loss, illness, sick

What Do the New RepliCel Results Mean in Layman’s Terms?

/by William Rassman, M.D./7 /

Dear Dr. Rassman,

Replicel results are in! But I couldn’t understand, given the presented statistical data, if there are any reasons to be excited. Not that I’m mathematically crippled or anything, but because I’m not sure what a 12.3% change in vellus hair density would mean to a consumer like me, who is concerned more with adjectives like “bleh, ok, good and awesome”.

Care to share your thoughts for us laymen? Link is:

RepliCel Releases Positive Results from the Interim Analysis of Data from its First-in-man TS001-2009 Clinical Trial

Thanks

In layman’s terms, I do not know exactly what 12.3% change in vellus hair really means either, but I think that it is safe to say that this is not an awesome result. I would like to know if there were noticeable cosmetic differences in appearance and knowing that the vellus hairs do not contribute much to the fullness of your hair, I would think that any impact would be best described as “ehhh”.

Tags: replicel, vellus hair, hairloss, hair loss

Lysine and Finasteride

/by William Rassman, M.D./2 /,

I started taking lysine with finasteride in the mornings and now my hair has been getting much thinner. Is there an interaction between fin and lysine. I’ve read that Lysine is supposed to be beneficial for hair growth?

I have no experience with lysine and finasteride together, but it you are getting a negative impact from the combination, it seems obvious to me that you should stop using it. What does your prescribing doctor say?

Tags: finasteride, lysine, hairloss, hair loss

Small Hairs at the Maturing Hairline

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

Dear Dr Rassman,
I’m confused! In this previous post (Receding Hairline Corners — Is It Just a Mature Hairline? ) you say that the person in the images now has a ‘mature’ hair line. But when he is holding his hair back I can clearly see a lot of smaller (miniaturised) looking hairs hanging down.

How can this be maturing? I thought you said in another post that generally you don’t see smaller hairs like this at the leading edge of the hair line unless it is maturing?

In the transition from a juvenile hairline to a mature hairline (like mine), the leading edge often has small vellus hairs in greater quantities than further back.

In a transplanted hairline, the leading edge has very few vellus hairs that makes for a hairline with few softer hairs. In men with coarse hair, I place more single hairs in the frontal edge to try to make up for the missing vellus hairs as this could become detectable on close examination in men who have coarse hair. When I do a hair transplant on a coarse haired man, to adjust for this, I place more one-hair grafts in the frontal transition zone and break it up more that I would normally for a man that has medium or finer hair.

Tags: vellus hair, hairloss, hair loss, hair transplant, hairline

I Have Severe Dandruff, Diffuse Hair Loss, and Questions

/by William Rassman, M.D./2 /

Hi Dr. Rassman,

I have been diagnosed with some pretty serious seborrheic dermatitis (scalp). I have chronic severe dandruff (easily noticeable from a distance), major flaking and yellowish scales. Also, there is intense itching and patchy inflammation.

For sometime now, I have also been losing hair. It has been what is known as diffuse hair loss, but the saving grace is there is no visible miniaturization (after diagnosis), and there is absolutely no emerging pattern (I have always been a NW2 from my early 20s and remain perfectly so).

But the diffuse hair loss is worrying me, since my hair is starting to appear a lot thinner.

My questions are:

  1. Will controlling dandruff and reducing inflammation help stop the diffuse hair loss?
  2. How does dandruff cause hair loss? (More specifically, how does it affect the follicle?)
  3. I’ve heard about cortisones being used for seborrheic dermatitis. Are they effective and safe?
  4. I have been put on a 2% ketoconazole shampoo to be used thrice a week. Is this safe to use for seborrheic dermatitis?

Thanks

1. Dandruff doesn’t cause permanent hair loss. It is a skin issue.

2. See above answer. If you’re constantly scratching your scalp or brushing out the dandruff, it’s possible you could be causing hair loss.

3. Efficacy or safety of topical cortisone is something that is a doctor/patient issue. Sometimes the use of steroids can induce hair loss. That is why you always should follow your doctor’s advice.

4. Ketoconazole shampoo 3 times a week is a seborrheic dermatitis treatment that many doctors recommend. See here for other treatments.

Tags: dandruff, seborrheic dermatitis, hair loss, hairloss

Could SMP Fill In My Donor Scarring?

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

I have had some extensive hair surgery done, and it looks quite good. Still I have some scars from the 90’s transplant days and thinning in the crown. Could some SMP be done to fill in just the scars and in-between the grafts for illusion purposes? I’m afraid if I shaved it completely, there is just too much extensive donar scarring from before. I’m afraid I might be stuck at the mercy of Topik or Couvre, but the mess really is a hassle. Thanks!

If you look at our SMP site, you will see examples of what you are asking about. Micropigmentation is not as good as Toppik for thickening up areas in the crown the way you described your present problem, but if I examined you, I might be able to tell you what benefit you could get. Without examining you, I can’t guess what will happen with the pigment in the crown area where you presently have hair.

Tags: scalp micropigment, hairloss, hair loss, pigments

In the News – Man Sues Hairpiece Company and Wins

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

Snippet from the article:

A judge has awarded damages to a man suffering hair loss who had gone to a clinic in Dublin to undergo a hair restoration procedure.

Judge Raymond Groarke held it would have been ridiculous for garage worker Jeremy Keogh to have believed that having a wig or membrane glued to his head would cause his hair to regrow.

He said Mr Keogh (29), St Killian’s Crescent, Staplestown Road, Co Carlow, had succeeded however in convincing the court he had not been provided with what he thought he had purchased at Advanced Hair Studios, Dublin, in March 2009.

Read the rest — Man wins court case over anti-balding treatment

Tags: wig, hairpiece

A Specialist Recommended Scalp Reduction Surgery For My Small Bald Spot

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

Hello,

After having a bald spot on the left side of my head for 28 years, I’d like to do something about it. The bald spot is circular in shape and 2cm in diameter, about 7cm directly above my left ear. The hair fell out when I was 2 and the bald spot has remained the same size for as long as I can remember. I am able to cover it with hair surrounding it, but it does take an emotional toll on me as I see it every day and I have to be very careful every month when having my haircut. I saw a dermatologist about a year ago who told me it’s triangular alopecia. He was not able to locate any hair follicles under the skin, and told me the chance of regrowth is slim to none, especially as there has been no hair there for 28 years. He suggested we first try cortisone injections which did not work, and then referred me to a specialist. I went to see a specialist and he recommended scalp reduction surgery given the small area and lack of hair follicles.

I’ve done some reading on scalp reduction surgery, on your blog and others. The risks seem to be significant (stretchback, slot scaring, hair angled incorrectly, etc.) and it’s clear you’re not a proponent. I’ve also been unable to find any success stories/testimonials online. I’m going to ask the specialist to share more information (# of surgeries he’s done, before/after photos, # of surgeries I’ll need, risks, type of incision, etc.), but before doing so I’m hoping to get your advice.

Given the small area (2cm in diameter) and being able to cover with existing hair, do you think this is a case for a successful scalp reduction surgery? If not, are there any alternatives you’d suggest (e.g., Rogaine, hair transplant)? Both my dad and grandpa have full heads of hair, so I’m not really worry about the hair on the left side of my head receding back to the site of the bald spot.

Thanks for your help!

You are correct in that I am not a proponent of scalp reduction surgery. This is because over the years I have never seen it work well. I’ve written about this type of procedure before here.

A scalp reduction could be very tempting to the surgeon and the patient, because it makes logical sense — just take out the bald spot — but the best you would get is maybe 50% improvement. Or you might get considerable scarring from this, depending on the location.

There are other options, such as a hair transplant using the follicular unit extraction (FUE) technique into the small area you described. This is a more predictable result, particularly for the small area.

Tags: scalp reduction, hairloss, hair loss, hair transplant

Everything Looked Fine A Year After Stopping Propecia — A Year After That, It Was Bad

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

Hi,

2 questions – first, when I previously used Propecia, 12 months after I quit, my hairline and frontal region, my areas of concern, didn’t look or feel different. 24 months after quitting, it looks much worse…I thought all hair is lost 12 months post quitting, does this mean that my recent loss is unrelated to quitting the medication?

Second, I am thinking of getting back on Propecia for the hairline, I am a NW 3, just looking to get back some of the loss in the last 12 months, is this doable?

Thanks!

It’s interesting that the Propecia held for a year… or at least, the hair stayed for a year after discontinuing the medication. That is unusual. I suspect that hair loss was really a start-up of a new hair loss process, but I really do not know or have any way to know for sure.

You can restart the Propecia and see what happens. Usually there will be some benefits, but the full benefit you originally got will probably not occur the second time around. Talk to your prescribing doctor.

Tags: propecia, finasteride, hairloss, hair loss

Press Release – RepliCel Reveals Updated Early Trial Results

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

Snippet from the press release:

RepliCel Life Sciences Inc. is pleased to report that further analysis of results from its successful first-in-man clinical trial revealed substantial hair growth including seven participants with growth in excess of 10%, including 17.2%, 19.2% and 19.6%. Furthermore, there were no negative health effects.

“The RepliCel TS001-2009 trial was a first-in-man trial with a primary endpoint of safety and this was confirmed emphatically,” stated Dr. Rolf Hoffmann, Chief Medical Officer at RepliCel. “Even though the size of the trial was only powered for safety measures, secondary endpoints were included in interim analysis to give us an early look at efficacy to allow us to better drive the design of the next steps of the clinical development of the RepliCel(TM) procedure,” Dr. Hoffmann concluded.

Read the rest — Further Analysis Reveals Double Digit Hair Growth in RepliCel’s First-in-man Clinical Trial

These are updated results that were announced, but the release goes on to say that the trials will be continuing into August 2013, with results to be announced by the end that year.

Tags: hairloss, hair loss, replicel, trials