I’m Treating HBP and High Cholestoral, But Now I See Female Hair Loss!

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

I am a 56 years young woman with beautiful silver hair. I began taking Lisinopril 40MG for HBP & Pravastatin 20MG for cholesterol 1 1/2 years ago. Shortly thereafter, I noticed that I’m losing my hair at an alarming rate. I am afraid to comb my hair as I would lose hundreds of strand at each session. I am very concerned that if this continues, I will have lost all my hair within the next two years.

PillsWhile the timing of your hair loss beginning may sync up with the start of your medications, I really cannot say for sure if the two are related. It’s possible that it was coincidental timing, and that there is another underlying issue. A partial list of causes for hair loss in women can be found here.

Pravastatin and lisinopril both list hair loss as a rare side effect, but the most common causes of hair loss in women is genetics or an underlying medical problem (not medication). Please see your doctor for your hair loss if it bothers you.

With respect to losing all of your hair within the next two years, that would be quite uncommon… especially if the loss was from medication.

Tags: hairloss, hair loss, female hair loss, lisinopril, pravastatin

Are My Nose Bleeds and Watering Eyes Due to Toppik?

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

Hello doctor. I’m upset because i’m wondering if there are side effects in using toppik (me for five years). Sometimes i have my nose bleeding and sometimes my eyes are weeping. i suspect the ammonium chloride including in the product. For the past 2 years i’ve used a mask to put it on.

Also when i get up in he morning my mouth is very dry. My doctor also discovered a nodule recently in the thyroids gland. do you think all these
events are related with toppik? Perhaps nanogen is less harmful.

i thank you for your response

ToppikI would see a doctor about the nose bleeds and eye irritation. Certain substances can cause irritation to your eyes, but I cannot say if Toppik is the cause. If you’re getting Toppik in your eyes, perhaps another camouflage might do better for you, such as DermMatch.

I’m not sure why you would immediately point to Toppik as the source of dry mouth, nose bleeds, a thyroid nodule, and eye irritation. I’m not saying Toppik is not the cause. Perhaps it is, but there must be hundreds of other potential causes higher on the list than Toppik.

Tags: toppik, hairloss, hair loss

In the News – Man Has 6 Botched Hair Transplant Procedures

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

Snippet from the article:

From Wayne Rooney to James Nesbitt, the list of celebrity men who have resorted to hair transplants to revitalise their balding manes is a long one. As a result, inquiries about the treatment have shot up by 260 per cent over the last 12 months while 59 per cent of men say they would consider the treatment if they started losing their hair.

But as Michael Avola, 49, an unemployed former martial arts champion from Northampton knows only too well, the fiddly surgery doesn’t always go to plan. After he began losing his hair – and his confidence – at the age of 23, he turned to surgery in a bid to fix the problem.

‘They promised me there would be a really good result,’ he reveals. ‘They said the scarring would be invisible and that there would be full coverage at the front.’

Instead, after a bungling surgeon botched the operation, Mr Avola was left with a small amount of wiry regrowth and a front section without any hair on it at all. But six operations and £7,000 later, Mr Avola was left badly scarred and still bald.

Read the rest — Bungling surgeon leaves man scarred and hairless after botching operation SIX times

The article mentions that Dr. Bessam Farjo did a 7th surgery on this man, though it doesn’t say who did the first six botched procedures.

Tags: hair transplant, failures, hairloss, hair loss

What is Scarring Alopecia?

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

Are scarring alopecias the only forms of alopecia that result in permanent damage to the hair follicle? if so is Androgenetic Alopecia scarring or non-scarring? Also, is hair loss due to vitamin/iron deficiencies and/or hypothyroidism a scarring or non-scarring form of alopecia? If so then is it theoretically possible to regrow hair years after losing them to these conditions even if it is not yet known how to do so?

Scarring alopecia (otherwise known as cicatricial alopecia) is a hair loss condition caused by an underlying medical issue that causes “scarring” of the hair follicles and the skin around it, as the name implies. It is is generally not treatable with a hair transplant procedure.

According to WebMD, some examples include “dissecting cellulitis, eosinophilic pustular folliculitis, follicular degeneration syndrome (previously called ‘hot comb’ alopecia), folliculitis decalvans, lichen planopilaris, and pseudopelade of Brocq, to name a few. Scarring alopecia may also be part of a much larger condition such as chronic lupus erythematosus, where many organs of the body can be affected.”

Androgenic alopecia is NOT scarring alopecia. Androgenic alopecia is genetic, where the follicles are genetically programmed to “die” after a certain period of time (no scarring).

Vitamin/iron deficiency or hypothyroidism can cause hair loss as a side effect from the underlying medical issues, but there is no scarring involved. In general, scarring alopecia is permanent; however, for many patients we have found a good cosmetic solution with Scalp MicroPigmentation (SMP).

Tags: scarring alopecia, hairloss, hair loss

The Right Side of My Body Has More Hair Than the Left

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

Hi, im a 18 year old lad, and was just curious if there is any reason why my left leg is much less harrier than my right? i dont think i have lost any hair but its also the same with my facial hair. i have much more hairs on my right side of my face than my left.

any ideas? thanks

We are not completely symmetric. Some people have a longer arm, leg, or even a larger breast on one side. Hair is no exception. What you’re seeing is probably just your genetics.

It’s possible that your body hair will even out at some point if you’re still going through puberty at 18 years old.

Tags: body hair, hair growth

Press Release – RepliCel Receives Japanese Patent

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

Snippet from the press release:

RepliCel Life Sciences Inc. today announced that it has been granted a patent by Japan’s Ministry of International Trade and Industry for hair follicle mesenchymal stem cells and their use thereof. These cells are used in RepliCel’s RCH-01 treatment for androgenetic alopecia, also known as pattern hair loss. With the issuance of this patent, RepliCel now has patents issued in Japan, the United States, Australia and the European Union protecting its technology with other jurisdictions still pending.

This patent approval is an important milestone as RepliCel’s licensing partner, Shiseido Company, prepares to conduct human clinical trials using RCH-01. Shiseido has an exclusive license to use RCH-01 in Japan, China, South Korea, Taiwan and the ASEAN countries representing a population of approximately 2.1 billion people. According to the International Society of Hair Restoration (ISHR), the leading authority on hair loss treatment and restoration, almost one million patients sought treatment for hair loss in 2012. Of this number, 41% of the patients were from Asia, representing the largest single region, surpassing the United States by 15%.

Read the rest — RepliCel Receives Japanese Patent Covering its Hair Regeneration Technology

Tags: replicel, japan, patent, hairloss, hair loss, alopecia

Would My Body Adjust Quickly If I Increased My Finasteride Dosage?

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

If one were to up their daily dosage of proscar could side effects like loss of libido, morning erections, and loss of sex drive happen right away and then quickly go back to normal a few days later. In other words, can the body adjust to the increased dosage of the drug in a matter of days and all the things I mentioned above return to normal?

In general, higher doses of medication can cause an increase in side effects. I usually do not endorse higher than the recommended dose of finasteride for treating hair loss, which is 1mg a day. A higher dose does not equate to better results.

If you’re taking Proscar, that is already a 5mg tablet, so I am hoping you’re taking a split pill, otherwise you’re already getting way more medication daily than necessary. Propecia is 1mg finasteride (for hair loss), Proscar is 5mg finasteride (for prostate). In any case, talk to your prescribing doctor about any changes in dosing.

With respect to your body adjusting for changes in dosage, it is not so specific and everyone’s response is different. I have no way to know how your body will respond to a medication increase.

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

If Caffeine Raises Cortisol Levels (Which Produces Stress) Then Could Coffee Cause Hair Loss?

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

hello Doctor,

I have reviewed your position on caffeine not effecting hair loss. Now it you would be safe to say that everyone’s body would react differently to all sorts of different substances. Like a lactose intolerant person reacts to milk, like the reaction to a person consuming nuts who is allergic, or even as simple as someone whose stomach reacts harshly to certain foods. So when you say that you would be bald by now because you drink 5 cups a coffee a day, your personal reaction can not be regarded as good scientific data.

In my case, (which may be completely different then others) i have noticed this; After consuming my daily coffee pick me up, I feel motivated, determined and willpowered to carry on my day to the best of my ability. But in reality I have read that caffeine is actually creating higher cortisol levels in my body. And that is why I feel that way. Cortisol is what is in our bodies that creates stress. Don’t get me wrong, we need cortisol in certain area in our lives to protect us from being too careless. But wouldn’t the constant consumption of caffeine, which increases cortisol levels which produces stress, accelerate someone’s hair loss problem?

Also taking into consideration that many peoples bodies react differently to the substances we consume.

Thanks

I know people tend to want to find outside reasons for their hair loss rather than admitting that their genetics are the most likely culprit for their hairline betraying them…. but I will make this very short. Caffeine does not cause hair loss. I’ve written about this before here.

You can be as theoretical and debate this all you want, but in the end if you believe this to be true, the simple solution would be to stop drinking coffee and see if your hair regrows. My guess is that it won’t.

Tags: caffeine, coffee, hairloss, hair loss, cortisol

Does Propecia Have Any Heart Related Side Effects?

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

Hello,
are there any side effects on Propecia that affects the heart? I know that right now it’s not part of the official listing on Propecia’s side effects, but as an expert, I believe you hear a lot from people who’s taking it and might have any information regarding it.

I started taking propecia about 2-3 weeks ago. Since yesterday I started to feel a strong pump in my heart every now and then, specially at night, and it seems to intensify when I lay down. The strong pump is a bit odd, it feels like an uncomfortable tension in my chest, and it’s also slightly respiratory.

Ps: I’m 25 years old, weight 175 pounds. Don’t have any heart issues, and never felt this before. I also take another medicine, an anti-depressant: Zoloft.

Congratulations for the blog! Thank you.

I have not had any patients in the years I’ve been prescribing Propecia that developed heart related side effects. If you have heart related issues, you need to speak with your doctor ASAP. It probably is unrelated to Propecia and can be a very serious medical condition.

Tags: cardiac, heart, propecia, finasteride, hairloss, hair loss

I Had Almost Total Success with Rogaine Regrowing My Hairline After 4 Months!

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

Doctor:
Enjoy your site very much. I’ve used Rogaine 5% for four months. I’ve had almost total success in the hairline area (almost complete restoration). About 70% return in the crown area. (I’m 44 and was just beginning to thin).

Do follicles develop a tolerance over time? Should I stop for about two weeks every year or so? Will Rogaine work as long as it’s used?

Thanks

It’s rare to hear about a near-complete hairline restoration after just four months of using minoxidil, but hey… that’s great to hear about your results! Why don’t you send us your before and after photos? I’ll blur out your face if you’d allow us to publish the results.

As for stopping — why would you want to stop something that gave you great results? Why would you not use the product as it was intended? There’s no evidence that I’m aware of that shows a tolerance built up after using minoxidil (Rogaine) over time.

I will point out that since Rogaine isn’t actually blocking DHT, your hair loss may continue over time as it is a progressive process. That doesn’t mean the Rogaine stopped working, but just that your genetics are continuing to thin your hair.

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

Hair Loss and Scalp Blood Flow

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

I was talking to this guy from a natural hair loss website on the phone, and he seemed really knowledgeable about natural remedies. He told me that the idea that lack of blood flow to the scalp causing hair loss is a partial truth. You say that blood flow is not a problem because transplanted hairs there grow fine. His rebuttal to that is that transplanted hairs pierce through the fibrosis that develops on the scalp, and that fibrosis is what causes the constricting of the capillaries. Thoughts?

You can believe what you want and engage in all the mental gymnastics about blood flow, hair loss supplements, natural remedies, hair loss cures, etc, etc. If there is really a natural product that works for treating hair loss, we would have heard about it by now and there would be a lot less bald men. Unfortunately, most natural “remedies” for treating genetic hair loss are pretty worthless.

The hair loss doesn’t occur because of the decreased blood flow, the blood flow may decreases because of the hair loss (which is caused by genetics in most cases). Either way bald men bleed just as much as men with a full head of hair.

Tags: hairloss, hair loss, blood circulation, blood flow

Can One Side of My Hairline Remain Juvenile?

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

Dr. Rassman,

I’m 30 and I know a mature hairline ideally matures around 30 and hairlines can be asymmetrical. My question is can one side of your hairline (top corner not the temples) remain juvenile while the other side is a norwood 3. Have you seen or dealt with cases like this? One side of my hairline is still juvenile while the other has crept up to a norwood 3.

Thanks

If you know that hairlines can be asymmetrical, then I think you just answered your question. The issue is whether you’re happy with that hairline or not. If you’re not OK with it, you can have surgery to correct it. Otherwise, you can accept the asymmetrical hairline. Or the other side of your hairline may even itself out over time.

Tags: hairline, hairloss, hair loss

My Brother and I Both Took Propecia and We Both Had Testicular Cancer

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

Hi:
I was wondering about a few things, but first I was happy to see a site designated for those who have thinning hair and baldness… Good job!

First, I wanted to state I was diagnosed with a testicular tumor (cancer), had surgery and been cancer free for over a year and a half! I was lucky to catch it early. No need for follow up treatment except regular testing and exams. So far so good. With that said, I was on Propecia for roughly five years prior with decent results; i.e.: still thinning around the hair line slowly, but holding on to most of what was on the crown. I was off the product for roughly a year when I was first diagnosed. My brother used the product for about a year prior to being diagnosed with test. cancer as well four years ago. Could there be any link to my/our cancer? Or would it just be inherited? My dad, nor anyone else in the family has ever had testicular cancer so I was wondering.

Also, since I’ve been off the product the thinning seemed to be a slow process but it seems all of a sudden it has accelerated rapidly. Anything I can do to get some back? Meaning, I buzz-cut my hair anyway, but I hate the look of the “ring” around the temples through to the back with the shiny scalp showing through the thin hair on top…

Will Rogaine work to add some density? I’m not looking for a full head of rockstar hair here, just a little to blend in the top to the sides…

Any news on the old “baldness pill” we hear soo much about? I’m 38 and you never know if the Rolling Stones may need a new bass player! :D

Thanks!!

I’m glad to hear you’re cancer free now! I am not aware that there is a link between testicular cancer and Propecia. I also am not aware of brothers having the same testicular cancer, but there is literature on twins and testicular cancer in this meta-analysis (though unrelated to Propecia/finasteride use). I would expect in your cases that it was inherited, but I would certainly pose this question to your doctor, as I’m not a testicular cancer expert. Testicular cancer rates have doubled over the last 40 years, and researchers are still learning about the potential causes.

Rogaine (minoxidil) is another medication used for treating hair loss, but it usually works best in the crown. I don’t know that it’ll add too much density, but it might be worth a try. Keep in mind that even some rock stars have hair loss issues, and some even have had hair transplant surgery.

Finally, I’m not sure what baldness pill you’re referring to, but the only other pill I know of that is still being tested is dutasteride (Avodart). It is a stronger medication than Propecia, but it works in a similar way. I’ve written about that many times before (see here).

Tags: testicular cancer, hairloss, hair loss, cancer, propecia, finasteride

If I’m Losing Hair, Will My Newly Grown Hairs Come in Miniaturized?

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

Hi, I am a 20 years old male and recently I have notice my hair become finer and smoother all over my head even on the back and permanent area. Can miniaturization affect both existing hair and new grow hair in the same time?

Thank you very much.

Maybe, but if you are indeed thinning in the back (permanent) area, then you probably do not have genetic male pattern hair loss. Hair loss in the permanent zone is likely something else, so it sounds like you need a good examination and a diagnosis.

Tags: hairloss, hair loss, miniaturization

Class 2/3 Patient Just 5 Days After FUE Procedure (with Photos)

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

This patient is clearly not balding, or marginally so. He is in his mid 30’s and he did not like the corner ‘recession’. At worst, he may be a Norwood class 2 or 3. He just wanted a cosmetic improvement to lower his hairline the way it always was before it moved upward. His hair was medium coarse so only 800 grafts were needed and the probability will be that this one session might meet his orbjective because of the medium-coarse hair. The risk of shock loss was discussed and was considered minimum. He is not on Propecia (finasteride). He did not experience any shock loss anytime after the procedure.

The following results photos were taken only 5 days after follicular unit extraction (FUE) surgery of 800 grafts. What you see are small scabs with short hair stubble. These scabs and hairs will fall out within a week from the date of surgery and he will look like he never had surgery by that time. The transplanted hairs will start to grow in the coming months.

The reason I wanted to show these photos is to point out how easy it was for the patient and his recovery. You can barely notice anything in his donor or his recipient areas.

Click the photos to enlarge.

After (just 5 days post-surgery):

 

Before:

 

Tags: fue, hair transplant, results, hairloss, hair loss