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    Does Rogaine Cause Hair Loss in Normal Hairs After I Stop Using It?

    Sep 9, 2013/by William Rassman, M.D./0 /Drugs

    I understand that I have to use Rogaine throughout my life if I want to retain my hairs but my only concern with it is its impact on other natural hairs (not affected by DHT yet). I have read somewhere that when you stop applying rogaine, not only the hairs which were grown by it would be gone but along with, your natural hairs will also be affected due to the way it works. Is it true doctor?? As you can see in the picture, my hairs are quite thick except the crown area so if I have to use rogaine, I will only use it on crown area, which means if I stop using it in future for some reasons, I will only loose regrown hairs (on crown area) and not anywhere else. But if that publication is true about the impact of rogaine on other hairs as well then don’t u think it is risky to use it as I may end losing more hairs if I have to stop it??

    So to sum up, my question is that once the rogaine treatment is stopped, does other hairs (not effected by DHT) will also be lost along with rogaine dependent hairs?? Secondly, I also read that with years of using rogaine, your body becomes immune to it thus negating its positive effect. Is it true?? For how many years, it can be used before it stop working on your body.

    In the end, I would like to thank you again for taking the time out to reply to me….It really means a lot to me to get an answer back from the world most renowned doctor. Thank you so much.

    If you stop Rogaine, the only hairs that may be lost are those that grew as a result of this drug. What you’re asking me is something people refer to as minoxidil dependence, but that only applies to the hairs that minoxidil grew. You can learn more about that here.

    Rogaine (minoxidil) should not impact normal hair in any way, nor does it impact DHT in any way. The impact of Rogaine is strictly a side effect of this drug, and DHT will still cause hair loss on genetically impacted hair. Finasteride (Propecia) is a DHT inhibitor, but Rogaine is not.

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

    I Emailed Other Doctors And They Said Stress Doesn’t Make Genetic Hair Loss Worse

    Sep 9, 2013/by William Rassman, M.D./1 /Drugs, Hair Loss Causes

    Doctor, you keep mentioning that stress impacts Genetic hairloss, and im sure it might in a way, but I emailed a lot of hair transplant Doctors, and even dermatologist and they said stress doesn’t make genetic hair loss worse in men.

    They say stress usually causes hairloss in women rather than men and its very rare for stress to impact the speed of genetic hairloss in men. A few Doctors said it might cause telegen effluvium but it will grow back. An these are all prominent Doctors I emailed from the ISHRS website. Especially if a guy is on propecia stress can do nothing. But overall its better to be stress free as it can help with the overall body and not damage other organs.

    Opinions differ, but I am certain that stress can impact genetic hair loss, as I have made this correlation for years. It is possible that the loss is temporary, but that is not always the case in my experience. Also, Propecia is no guarantee to cure stress related hair loss or stress-related acceleration of your genetic loss.

    Take a look as some of our previous posts on this subject here.

    Tags: stress, hairloss, hair loss

    Not Hair Loss News – Cancer Vaccines and Patent Law

    Sep 9, 2013/by William Rassman, M.D./0 /Other

    Snippet from the article:

    Six years from now, when my daughter turns 11, she will get a three-part human papillomavirus vaccine that will reduce her chances of getting cervical cancer by around 70 percent. Currently a little over half of American girls get the HPV vaccine, a public health intervention that will prevent tens of thousands of cancers. It’s one of modern medicine’s few success stories in finding a means of preventing cancer.

    Maybe the reason we have so few cancer vaccines is that they’re harder to develop than treatments for patients who already have cancer, which are more common. But in an as yet unpublished study, economists Eric Budish and Heidi Williams teamed up with patent lawyer Ben Roin to argue that the scarcity of preventive measures and relative abundance of late stage cancer treatments can also be blamed on the distorting effects that the U.S. patent system has on medical research.

    Read the rest — Why Aren’t There More Cancer Vaccines?

    Tags: cancer, vaccine, patents

    What Can Someone with MPB Do If Doctors Won’t Prescribe Finasteride?

    Sep 6, 2013/by William Rassman, M.D./0 /Drugs

    hi doc
    i have serious miniaturisation but the doctors i met didn’t even look at my hair closely and gave me some vitamin pills. what can mpb sufferers do if the doctors wont prescribe drugs like proscar? i seriously doubt those docs have heard about fin

    The answer seems pretty obvious to me, but if the doctor you went to won’t prescribe you finasteride to treat your MPB, seek out another doctor. It might be possible that you don’t have genetic hair loss, in which case, finasteride wouldn’t be necessary.

    Finasteride has been available for over a decade, so I don’t know how your doctor might’ve not heard of it. It sounds like your doctor didn’t understand hair loss if he didn’t even examine your scalp.

    I should also point out that if you were looking specifically for a Proscar prescription to treat your hair loss, your doctor should prescribe it with the direction to cut the pill into 4 pieces. Propecia is for treating hair loss, Proscar is a higher dose for treating the prostate.

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

    Persistent Scalp Pain 5 Years Following a Hair Transplant

    Sep 6, 2013/by William Rassman, M.D./0 /Post-Operative, Scarring

    Hi,

    I had a hair transplant 5 years ago. Some months after the procedure, I noticed some persistent pain and sensibility in my scalp, mainly in the scar and areas near it (example: where the eyeglasses touch my head). But it did not heal. The areas near the scar are extremely sensitive. I need eyeglasses to work but its impossible to use them (my astigmatism is incompatible with contact lenses), so my situation is very hard.

    Some surgeons said that its necessary to remove the scar, because I could have some neuromas. The scar is very homogeneous, it is not wide, and the HT was made by a very experienced surgeon. He said that this never happened to his patients and has no idea of what happened with me.

    I went to some pain specialists (psychiatrists) that told me to take amitriptilin (50mg/day) and pregabalin (Lyrica, 225mg/day). None of them had any effect. Other things I already tried are: laser therapies, topical capsaicin and local injections of corticoids. No results.

    Now, the surgeons think that the only thing to do is to a surgery to completely remove the scar, like a new strip (very very thin) for hair transplant, without transplanting follicles. Do you think it is a good idea or the situation can become even worse?

    I already did lots of search and some web sites and surgeons comment that it is possible (very rare) to have persistent pain after years of HT, but I never found suggestions of how to treat it.

    Thank you.

    You have risk no matter what you decide. Have you had injections of steroids into the painful part of the scar? I would need to evaluate you before giving you a recommendation. I’ve written before about nerve damage from a hair transplant in some past posts that might have some value to you:

    • Did My Surgeon Possibly Damage a Nerve During My Transplant?
    • Trapped Nerve After a Hair Transplant?
    • Throbbing Pain Weeks After Hair Transplant!
    Tags: hair transplant, pain, nerve, surgery

    Masturbating After a Hair Transplant

    Sep 6, 2013/by William Rassman, M.D./1 /Post-Operative

    Can grafts be displaced or dislodged, although they look normal and well stuck in the scalp? I had hair transplant with a combination of HUT and HUE techniques 3 days back. I had a tight dressing on my head after surgery, which was removed 24 hours after surgery. Everything was normal except that I had banged my head sitting in car a few times while going home and jerked off after 6 hours of surgery unaware of the consequences.

    The hairs look well stuck in the scalp but is it possible that they may be misplaced from their original position and are lying at the skin border and may fall off. I have seen a few grafts dislodged while cleaning my head, but that no. could hardly cross 5.

    I doubt that masturbating after a hair transplant would be a problem. I guess it depends on how vigorous you are with yourself. If you are concerned that some grafts were dislodged, I’d talk to your surgeon about that.

    Tags: hair transplant

    Study – Microneedling with Minoxidil for Treatment of Genetic Balding

    Sep 5, 2013/by William Rassman, M.D./6 /Drugs, Hair Products

    Snippet from the study:

    Hundred cases of mild to moderate (III vertex or IV) androgenetic alopecia (AGA) were recruited into 2 groups. After randomization one group was offered weekly microneedling treatment with twice daily 5% minoxidil lotion (Microneedling group); other group was given only 5% minoxidil lotion. After baseline global photographs, the scalp were shaved off to ensure equal length of hair shaft in all. Hair count was done in 1 cm 2 targeted fixed area (marked with tattoo) at baseline and at end of therapy (week 12). The 3 primary efficacy parameters assessed were: Change from baseline hair count at 12 weeks, patient assessment of hair growth at 12 weeks, and investigator assessment of hair growth at 12 weeks. A blinded investigators evaluated global photographic response. The response was assessed by 7- point scale.

    Read the rest — A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia

    DermarollerThere is an interesting pilot study that looked at the use of minoxidil and wounding in 100 balding men. Using a microneedling instrument (a dermal roller) and 5% minoxidil the following results were reported:

    “In the Microneedling group, 41 (82%) patients reported more than 50% improvement versus only 2 (4.5%) patients in the Minoxidil group. Unsatisfied patients to conventional therapy for AGA got good response with Microneedling treatment.”

    I was not surprised that some value for this combined treatment showed some effectiveness. I personally wonder if this is the type of service I should offer. I would appreciate your feedback.

    Tags: dermaroller, microneedling, minoxidil, rogaine, hairloss, hair loss

    My Identical Twin Brother’s Hair Has Thinned Less Than Mine, But I Have More Stress

    Sep 5, 2013/by William Rassman, M.D./3 /Drugs

    Hello Doctor,

    I’m a 25 year old male- who has an identical twin brother. We’ve both had shoulder length hair for about 10 years.

    In the past year I’ve noticed my hair around my temples and sides thinning out a lot, and noticing my scalp more after a shower. The hair on my crown has also thinned out a bit but not as bad, and the hair on the top feels much less dense and thick than the hair at my sides and back of my head, even though I have fine hair. My brother’s hair has thinned out less, but I do stress more than he does.

    I finally plucked up the courage to see my doctor who gave me topical rogaine 5% and proscar 5mg to be divided into 4 (rather than propecia due to cost).
    Is it safe to take the two together? And is it ok to take proscar instead of propecia?

    I’d very much appreciate your advice as I’m a bit embarrassed to ask my doctor this.

    We have known for years that stress accelerates the impact on balding for genetic hair loss. Your brother may eventually catch up with you, as you both age further.

    It is perfectly safe to use Rogaine and finasteride at the same time, and splitting a Proscar pill into 4 pieces is equivalent to taking Propecia.

    Tags: rogaine, propecia, finasteride, twin, identical twins

    Did Generic Propecia Go Up in Price?

    Sep 5, 2013/by William Rassman, M.D./1 /Drugs

    1 mg generic Finasteride (Dr. Reddy’s) has gone up in price significantly. Walmart now charges 62 dollars compared to back in April 2013 went it was 44 dollars for a 30 month supply. Walmart pharmacy claims that the distributor of Dr. Reddy has increased the price. I called around and prices at CVS and Walgreens have also increased. I am hoping that more generics will enter the market place driving the cost down, permanently.

    I had a member of my staff call around a couple months ago for pricing, but I wasn’t aware of any increase lately. Give it some time and I am sure we will see the price come down early next year once there are more pharmaceutical companies making it.

    Tags: generic propecia, finasteride, hairloss, hair loss, dr reddys

    I Have a Juvenile Center Hairline and Mature Corners

    Sep 4, 2013/by William Rassman, M.D./0 /Hairlines

    Dear Dr Rassman,

    Probably like most males in their 20s, I’m concerned about my hairline recession. As you say, it seems as though most men will experience some form of recession in these years whether it be balding or not.

    At the moment I think it is maturing only, but very unevenly. Now, I have read posts on your blog saying that one corner moving up quicker than the other is common. Well, that is indeed happening, but the middle doesn’t seem to be moving much at all.

    I first noticed some recession when I was about 19/20. Up until that point, and for a fair while longer afterwards, my hairline was extremely low and straight and so fortunately caused me no concern at all. When I first observed some change at that age, it wasn’t so much recession as that the corners were a little less dense. The left side was also less dense than the right.

    I remember at that time I had experienced some diffuse shedding (telogen effluvium) and was worried I was balding. I consulted a hair specialist who didn’t seem to be aware of the ‘mature hairline’ concept and said that any recession is balding, but said I didn’t appear to be balding.

    Since then I’ve been keeping a close eye on my hairline. I’d say only in the past 6 months (and I’m 23 now) has there been more marked change. The left side seems to be thinning out more completely to establish what I think (or hope) is its NW2 mature shape. I’d say the recession will be about 1.3inch from the corners. However, the middle part is still basically juvenile. The right is perhaps a NW1.5 and still more dense than the left. Is this normal?

    The problem is, the angle created by a ‘juvenile’ center and a mature corner makes it look weird, more like balding, even though I think the corners are still within mature parameters. Can I reasonably expect the middle to move up by a couple of centimeters to form a less sharp, more straight and rounded angle? The problem is, it seems as though a lot of men bald by receding up through the corners, while maintaining the middle. It’s possible this may be caused by styling, i.e. the left is maturing more rapidly as I tend to comb/style from that side (using products/dryers) so perhaps the miniaturizing hairs are falling out quicker.

    There is balding in my family, as both my older brothers started balding early (but at different rates), and my father also started balding in his late 30s/early 40s. However I seem to have escaped the late teens balding pattern (which struck my brothers, and they never had a really strong teenage hairline like me), and my father actually seemed to maintain a juvenile/NW1.5 hairline and his balding pattern came mainly at the crown, not the corners. My progression thus far does not seem to fit any of these patterns.

    Is this encouraging? Or is it simply a matter of not being able to tell if you’re balding until you actually ARE? My grandfather on my father’s side never lost his hair and had a full head of hair when he passed away in his 80s, and my uncle on that side also never experienced MPB (though appears to possibly be experiencing some thinning at 60, but at that age I’d say he doesn’t have standard MPB).

    I think my father on my mother’s side experienced balding in the 40s, but I don’t know much about my family on that side.

    To summarize, it’d be a lot easier if hairlines stayed put! For sure, a solid juvenile hairline can look odd on a grown man, but NW1.5 seems the perfect compromise. Any comments on this would be greatly appreciated !

    Thank you

    The central part of the hairline has a different genetic code in many people. When it is small, I call it a persistent forelock, but when it is large, it takes on a different appearance, though it still has the genetic code of a persistent forelock. What you are describing is such a phenomenon. The corners mature, while the central portion of the hairline remains at the juvenile level. I just wrote an article on this topic for publication in the Journal of Facial Plastic Surgery, which is due out sometime this month.

    What I think you should do is determine if you have balding on the top and/or crown of your head by getting a hair bulk analysis with the HairCheck instrument I have discussed previously on this site (see here). I suspect that your corners will continue to rise, at least, until the mature hairline areas are reached — assuming you do not have genetic balding.

    Tags: hairloss, hair loss, hairline, mature hairline

    Should I Take Finasteride Early in the Morning When Testosterone Is Highest?

    Sep 4, 2013/by William Rassman, M.D./2 /Drugs

    Hi Doctor Rassman,

    Thanks for all your great work you do answering people on here. Just wondering about what time I should take finasteride, and if my current regime could make it less effective? I have been taking finasteride for about a month and a half, so it’s obviously too early to tell if it’s working, but I have had no discernable side effects. I work evenings, so because of my routine I wake up around midday, and take the quartered 5mg then. I have heard that it’s best to take it very early in the am. Is testosterone highest in men generally in the early morning, or is that just because it’s when the average man wakes up? Should I wake up at 7 to take the pill then go back asleep?

    Hope to hear your answer,

    Thanks again

    There’s no need to wake up early just to take finasteride.

    I used to tell patients to take it when they woke up, but that was really just because it would help them to remember to take it as part of their morning routine. Really though, there is no evidence that finasteride in the morning or the evening is better one way or the other, as long as you remember to take it regularly each day.

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

    I Saw Immediate Rash and Shedding After Starting Rogaine

    Sep 4, 2013/by William Rassman, M.D./0 /Drugs, Drugs (Cause Hair Loss), Female Hair Loss

    Hi,
    I am a 45 yr old female and have been diagnosed with hereditary loss. I started rogaine 5% about 10 days ago, I immediately developed a rash and started to shed more than 200 hairs a day and worse when I washed it? My hair was already diffused on top and now it is ten times worse.

    I want to stop use because i cannot afford to continue to shed like this. Will the hair I lost grow back without use of rogaine, or is it gone forever?

    There is no way to predict if the hair will grow back, but I suspect it will once the allergic reaction passes. It will take months to see the positive impact on regrowth.

    Tags: rogaine, minoxidil, female hair loss, hairloss, rash

    I Currently Have No Signs of Hair Loss, But Will I Go Bald at Some Point?

    Sep 3, 2013/by William Rassman, M.D./0 /Age

    Hi,

    I am a man in my mid 30s and currently have no signs of hair loss. Recently however, I have developed a fear of going bald. My Dad has a full head of hair at 60 and his Dad had a full head of hair til his death at 61. However, my Mother’s Dad went bald from his early 40s and my Dad’s brother started going bald in his early 30s. I need to know – will I go bald?

    Look for any advice you can give. Thank you!

    I have no way to know if you will go bald. I also have no way to know if you will develop heart disease, or if you will get audited by the IRS. Determining who will go bald is not as simple as just looking at the age of when your father, grandfather, or uncle went bald. Hair loss can skip generations.

    You can find out if you have any signs of balding by having your hair bulk analyzed. Since you’re in your mid-30s, if the test does not show balding, then you are probably in the ~90% probability of not developing balding. For most men that have genetic hair loss, the balding process starts in their 20s.

    At this point though, there is really no way for me to tell you for sure if you will go bald, if you will start thinning, or if you will have no loss at all.

    Tags: hairloss, hair loss, age, balding

    After I Read About Propecia Side Effects, I Had Them the Next Day!

    Sep 3, 2013/by William Rassman, M.D./1 /Drugs

    I am a 26 year old man with male pattern baldness. I have had had three 1 mg doses of Propecia over three days – normal course. After the second day, I was able to get a normal erection pretty easily. On the third day, I came home terrified I wouldn’t have an erection, as I had been reading so much about potential side effects, and on the fourth day I seem unable to get one.

    I have never had this kind of issue before. It might be psychosomatic or real. Should I see it through for a few more weeks or days, cut dosage, stop, etc.?

    Some men are highly suggestible, so I would not be surprised if you talked yourself into the problem. The power of suggestion is a very real thing. Reading and worrying about the side effects could’ve given you anxiety, which in turn could cause the same problem you’re describing.

    I am not your doctor, but you should make it a point get his/her advice. Propecia is a prescription medication, so before you cut the dosage or stop the medication, talk to the person that prescribed it to you.

    Tags: propecia, finasteride, hairloss, hair loss, power of suggestion

    In the News – Confusing Pharmaceutical Brand Names

    Sep 3, 2013/by William Rassman, M.D./0 /Drugs

    Snippet from the article:

    What would Don Draper make of Xalkori? Pfizer’s lung cancer drug, released in 2011, has a name that would make an old-school ad wizard scratch his Brylcreemed head.

    It begins with one of the least commonly used letters of the alphabet. It’s impossible, at first glance, to know how to pronounce it correctly. It looks like it could be the name of one of the creatures from the Star Wars cantina.

    In any other industry, calling your product Xalkori would be the business blunder of the century. But this isn’t any other industry; this is pharma.

    “Xalkori is not just a crazy name,” says R. John Fidelino, who, as director of creative at the firm InterbrandHealth, helped bring the word into existence.

    Read the rest — New drug names aren’t just bizarre—they’re dangerous.

    Tags: branding, pharmaceutical, medication
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