What Does DHT Do to Hairs?

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

How exactly does Propecia work? I have searched online for an answer but have only come across the phrase, “Propecia blocks DHT, which is a hormone… that leads to hairloss.” I was wondering if there is a more specific explanation to what happens.

Does DHT somehow tighten the skin around hair follicles, which would imply that Propecia relaxes the skin around hair follicles so as to relieve stress around the follicle? Or does DHT reduce the strength of the hair itself? Does it kill cells at the bottom of follicles, which would imply that Propecia prevents DHT from reaching these cells?

Genetic balding causes hair follicles to undergo a process called apoptosis (cell death). Hairs grow in cycles that last about 3 years for the average person. In the genetic balding process, somewhere between 7-10 hair cycles, hair death is triggered by the hormone DHT. When you take a DHT blocker (Propecia/finasteride), it prolongs the number and length of the hair cycles to allow it to keep growing.

See Why Does Propecia Eventually Lose the Battle to Genetics? for more info.

Tags: dht, dihydrotestosterone, hairloss, hair loss, finasteride, propecia

Scalp Flaking After Using Minoxidil

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

I have been using Minoxidil 5% for few months now, I noticed a lot of flakes on my scalp.The color of the scalp is whitish when compared to the rest of it. Also some time its very itchy. Please recommend me any medication or precaution or steps needed to avoid the flakes or remove them as it does get annoying. Thanks

I have seen this often as a side effect of minoxidil. Speak with your family doctor for treatment or a decision to possibly stop taking the medication.

Tags: minoxidil, rogaine, flaking

Study – Sperm Count and Finasteride

/by William Rassman, M.D./6 /

Snippet from the abstract:

OBJECTIVE: To determine the degree of improvement in semen parameters after finasteride discontinuation.

DESIGN: A prospective database of men presenting for a fertility evaluation was analyzed for semen and hormone parameters before and after discontinuation of finasteride.

SETTING: A male infertility specialty clinic.

PATIENT(S): Men presenting for fertility evaluation from 2008-2012 on finasteride.

Read the rest — Finasteride use in the male infertility population: effects on semen and hormone parameters.

In a study of 4400 men over a 57.4 month time span, sperm counts were performed after finasteride was discontinued. There was an 11.6-fold increase in sperm count on the discontinued use of finasteride (Propecia at the 1mg dose), suggesting that the drug brought down the sperm count in most men.

In men with severe oligospermia (low sperm count), the counts went up when the drug was stopped. No men had decreases in sperm count in the study. This suggests that individuals on finasteride who are interested in having children, should be aware that there is a risk of reduced sperm counts on the drug.

Tags: sperm count, fertility, infertility, finasteride, propecia

I’m Worrying About My Hair Loss And Now I See Hair On My Pillow

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

Over the last few months I have been worrying about whether I have hair loss. I am an 18 year old male. After stressing out over this, I feel like my hair is getting thinner, especially when I run my fingers through it. I have been noticing a bit more hair over the pillow and in the bathroom. But my parents have said that my hair looks fine. So can I have hair loss, or have started the process of hair loss? And what should I do to treat it?

You should see a doctor and get a proper diagnosis. At 18 years old, there is a possibility that you have genetic hair loss and if that is proven, then appropriate treatments can be taken.

Sometimes you can’t actually see the loss, but you’re still losing hair. A doctor can check your hair bulk to see if you’re thinning.

Tags: hairloss, hair loss

In the News – Singer Robbie Williams Had a Hair Transplant But Didn’t Need One?

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

Snippet from the article:

Singer Robbie Williams has revealed he had a hair transplant despite not needing one.

The 39-year-old made the admission while chatting about how living in Los Angeles had rubbed off on him during an interview on The Graham Norton Show, which airs on Friday evening.

He said: ‘I’ve lived in LA for a long time and they say, ‘If you sit in a barber’s shop for long enough you will get a hair cut.’ Well, if you live in Los Angeles for long enough you’re going to get some surgery.

Read the rest — Robbie Williams reveals he had a hair transplant despite not needing it after succumbing to LA lifestyle

Nobody really needs a hair transplant (it is an elective cosmetic procedure), but it looks like his hairline corners were going back a little before the surgery and are now filled in. Either way…

Tags: robbie williams, hair transplant, surgery, hairloss, hair loss

What Are Hair Transplant Options for Someone Like Steve Ballmer?

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

Steve BallmerHi doctor Rassman
If someone with the degree of loss of Steve Ballmer, Microsoft CEO, wants a hair transplant and has a very realistic expectations, what options will you give him?

While the options are more limited for those men with the most advanced balding patterns, I have surgically treated a number of patients with a Norwood class 7 pattern, as Steve Ballmer shows in the attached photo.

Hair transplantation can be done successfully if the patient’s donor supply is adequate, such as the case with Patient ZU. This patient had almost 10,000 grafts thanks to good quality, medium weight hair, and a significantly higher hair density than an average Caucasian. There are other class 7 patients you can view here.

Tags: hairloss, hair loss, ballmer, microsoft, hair transplant

Not Hair Loss News – Heart Disease and Erectile Dysfunction in Younger Men

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

Snippet from the interview:

“Erectile dysfunction is something that we haven’t talked about much in the cardiology office, but we are finding that it is a harbinger of coronary artery diseases. For instance, if you are a 70-year-old man with erectile dysfunction, your risk for coronary disease is increased one to 1.4 times, but if you are a 40-year-old man with erectile dysfunction your risk for coronary disease is 40 to 50 times higher.”

Read the rest — Erectile Dysfunction: Harbinger of Heart Disease?

The above quote comes from a Q&A with Dr Stephen Kopecky (professor of medicine and consultant in preventive cardiology at Mayo Clinic), so I wanted to highlight it here.

I am a strong believer that early identification of coronary artery disease can save your life, so if you are under 50 years old and have ED, then you should see a cardiologist.

Tags: cardiology, erectile dysfunction, heart disease

If Toppik Contains Silica, Could It Cause Asthma or Cancer?

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

I ordered some toppik. But something bothers me. It lists silica as an ingredient. As far as I know, silica is not the safest ingredient. It’s inhalation has been linked to asthma, silicosis and rarely cancer. Anything to add to this? I’d like to use the product further, but now I am worried about it. Thanks.

We wrote about this some years back, but essentially, unless you have an allergy to one of the ingredients in Toppik (or any of the topical concealers), you should not have anything to be concerned about.

Tags: toppik, silica, hairloss, hair loss