After 3 Months of Propecia Use, I Can’t See My Scalp Under Harsh Lights Anymore!

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

Earlier this year I noticed my hair seemed thinner and a miniaturization exam revealed diffuse loss on the top of the scalp but not the sides or back. It was modest loss, only visible under harsh lights, but my hair definitely felt less dense.

Nearly three months later after consistent Propecia use, I could swear my hair feels thicker and I can’t see as much scalp in the mirror under harsh lights. Could this be a real effect or is it probably in my head? (No pun intended!)

This type of result seems like it might be too quick after just taking Propecia for 3 months, but I suppose it’s possible that you had a really great response, which we have seen in some men from time to time. It usually takes a few more months for most men to notice that much positive change, though. I’d keep taking the medication and keeping track of the gains.

Congratulations on the good fortune and better hair!

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

Not Hair Loss News – Married Men Go to the Doctor More Than Unmarried Men

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

Snippet from the article:

Guys, a loving spouse may save your life, U.S. health officials say. But living with a significant other doesn’t appear to confer the same health benefits as marriage.

Single and married men are more likely to see a doctor regularly than those living with a partner out of wedlock, according to a new U.S. National Center for Health Statistics (NCHS) study.

And compared to husbands or other single men, cohabiting men are also the least likely to report having undergone preventive screenings such as cholesterol and blood pressure tests in the previous year, the researchers said.

Read the rest — Marriage boosts men’s health. Living together? Not so much

The article goes on to say that, “about 71 percent said they’d been to the doctor at least once during the past year. For married men, the number was 76 percent, the study found. It fell to 65 percent for single men and 60 percent for men who lived with a partner.”

It doesn’t prove that married men are healthier, just that those surveyed spent more time in a doctor’s office than those men that just lived with their partner.

Tags: mens health, marriage

Could a Hair Transplant Today Cause Problems for Any Potential Cure or Cloning in the Future?

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

If hair cloning is a viable option in the future (perhaps in 15-20 years since I know the time line keeps moving every year) would you expect to see a large number of people elect to have a hair transplant for the sole reason of increasing overall hair density? If the amount of available donor hair was no obstacle, could someone thicken their existing hair?

Obviously, I would be satisfied just having decent hair coverage, and would elect to have a hair transplant in the future if I am a decent candidate, but I also don’t want previous hair loss remedies I’ve tried to affect any potential ‘cure’ in the future either.

I’ve always believed that hair transplant candidates should go ahead and get their hair now while they are young enough to enjoy it. To be bluntly honest, there’s no point in waiting until you are an old man for what may never come about (hair cloning).

Researchers are making great strides with hair cloning, but I have no idea how many years it’s going to be before anything reliably safe and effective is commercially available. If reliable hair cloning ever does come about to allow for unlimited donor hair, I could see possibly more people having their existing hair thickened.

I obviously can’t know what the future holds, but I don’t see how moving hair from the back of the head into the top/front of the head would prevent any possible future treatment.

Tags: hair cloning, hair transplant, hairloss, hair loss, hair loss treatment

Would Minoxidil Help Regrow My Crown if Finasteride Hasn’t Worked There That Well?

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

Dr. Rassman,

I appreciate your blog. I’m a 24-year-old male who started experiencing thinning and hair loss on my crown shortly before my 20th birthday. I started taking finasteride after my 22nd birthday and experienced fantastic results. However, I still have a somewhat large area on my crown that is much thinner than the surrounding areas.

I am considering using minoxidil on my crown, as minoxidil is supposed to be very effective in that area. I am wondering if, after being on finasteride for two years, there is any chance that minoxidil would be effective? I understand that the two drugs target different hairs (i.e. hair regrown using finasteride doesn’t preserve hair regrown using minoxidil, and vice-versa), but after four years of thinning, would minoxidil show any decent statistical chance of working for someone in my situation?

Finasteride plus minoxidil works better in the crown than finasteride alone in some people. My advice has always been to to start on the finasteride first (with a doctor’s prescription) and if after a reasonable time there is a poor response in the crown, then add minoxidil treatment to see if there’s an added boost to your hair growth plans.

For financial and time reasons, it makes sense to just start with one medication in case that accomplishes what you want it to, rather than committing to multiple lifetime medications from the start.

Tags: finasteride, minoxidil, propecia, rogaine, hairloss, hair loss

Is Facial Swelling a Common Occurence Following a Hair Transplant?

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

A close friend of mine had a hair transplant and I noted some serious swelling around the face immediately afterward. I did not expect a transplant to produce that degree of facial swelling. Is that normal or is this just a rare case? If it’s rare, why do you think this occurred? Was it the surgery or the medication he was on after? It doesn’t speak to any problem with the grafts, right?

I’m considering a hair transplant but I want to use styling to hide the transplants while they heal — I can’t hide a swollen face, though.

Facial swelling can occur after a hair transplant from either the surgical procedure or just from an anesthetic alone, and it could be quite obvious in some cases. It’s not terribly common to see a large amount of swelling, though I’m not sure to what degree you consider the swelling to be “serious”.

The swelling is more of an annoyance than anything, and it doesn’t signify a problem with the surgery, healing, or future graft growth.

To minimize this risk, I use a single large dose of steroids at the time of the surgery or scalp anesthetic, and it usually prevents its occurrence. We rarely see it, but it does occur from time to time. When it occurs, it usually lasts a couple of days.

Tags: hair transplant, swelling, surgery, surgical procedure, hairloss, hair loss

I Still See Holes in the Donor Area Over a Week After FUE!

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

Hello!

I had a hair transplant “FUE” 8 days ago. I can still see the holes in the donor area. Do you know how long is the average healing time for the scars? Should I worry? Also, do you know of any products that will help the skin recover?

Thanks a lot for your time!

The tiny holes in the back of the head that are created from a follicular unit extraction (FUE) procedure should disappear very shortly. What you may be seeing are scabs, not the holes, and this requires a vigorous shampooing technique to get rid of the scabbing.

Your surgeon should’ve provided you with aftercare instructions that explained how to wash your donor and recipient area.

Tags: fue, follicular unit extraction, hair transplant, hairloss, hair loss

Teenager’s Pubic Hair Growing in White

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

hi,
I am 14 yr old male with a patch of white pubic hair. The area with the white public hair is also a bit fair and different from other. I just wanted to know if this is normal or not. Is it a side effect of something or a disease? Will the hair become black or not?

I have shaved my pubic hair, but it itched very much. Even the new hair grew white. I am not close with my dad and I am not comfortable talking to my mom about this. Is there some treatment or medicine?

While 14 years old does sound pretty young, this can be an hereditary thing and there is really nothing that you can do. Shaving the area will usually result in it itching when it is regrowing, so that isn’t entirely surprising. I wouldn’t be concerned about the white color, and it doesn’t mean you have a disease or a side effect.

Tags: pubic hair, hair growth, hair color

Are Women with Bald Fathers More Accepting of Bald Mates?

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

I don’t buy into this false notion that women look at balding men and see their hair loss as a sign of virility. Do you believe that women who have bald fathers are more accepting of bald mates than women who have fathers with full head of hair?

StathamBald men aren’t more virile (we posted about it late last year), and actually, bald men can be just as virile and sexually appealing as hairy men.

I don’t think Jason Statham, Yul Brynner, Bruce Willis, Dwayne “The Rock” Johnson, LL Cool J, Patrick Stewart, Andre Agassi, Kelly Slater, Michael Jordan, Vin Diesel, Tyrese Gibson, etc have issues with virility or attracting a mate. Besides, I can think of plenty of hairy men who have negative sex appeal.

Women see deeper than men do when it comes to the outer shell of a person. They see the attributes of the personality and make the determination of attractiveness based upon far more factors than us men do. I don’t have actual scientific research on the topic, though I sense that women with bald fathers who have a good relationship with them, probably accept balding men better than women whose relationship with their father is not good.

Tags: virility, virile, hairloss, hair loss, balding

How Long Should it Take for My Sperm Count to Go Up After Stopping Propecia?

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

Dear Doctor Rassman,

Firstly I love your blog. I just read your article regarding the potential affect of Propecia on sperm counts. Myself and my wife are trying for a baby and I want to give myself the best chance possible of conceiving. How long after people who stopped using Propecia see there sperm counts raise, as I am considering stopping the drug during the crucial ovulation period

Thank

There was a study conducted at an infertility clinic (on men with severely low sperm counts to begin with) that I think you’re referencing — Study – Sperm Count and Finasteride.

As it seems that you’ve had a sperm count done, I would expect that an improvement in sperm count should occur within a month after stopping Propecia. I am curious as to how low your sperm count was or what your physician suggested. Most men on Propecia can conceive a baby, but some men have a reduction of total sperm volume even though the sperm count per unit volume remains normal.

Tags: propecia, finasteride, sperm count, conceiving

In the News – Cold Laser Therapy Helmet for Treating Hair Loss?

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

Snippet from the article:

Laser light therapy has been proven to improve hair health, but cold laser therapy has only been available at specialist clinics. Theradome lets people use this advanced technology at home, and contains high efficiency lasers that produce virtually no heat but allow the maximum amount of light to be delivered, the company claim. However, the technology comes at a price as the helmet costs $795 (£473 plus shipping).

The article continues…


Dr Bessam Farjo, Medical Director of the Institute of Trichologists, said: ‘I do believe that laser technology has validity, but I’m sceptical of the specific claims made by Theradome GB that this particular headgear has the ability to increase the hair shaft diameter by 200 per cent. I have not seen any scientific evidence to support this.

‘It’s great to see businesses putting resources to the development of this technology, but more scientific results are needed to back-up the huge claims that Theradome is making.’

Read the rest — The helmet that can cure BALDNESS (allegedly): $800 headgear uses lasers on the scalp to stimulate hair growth and thickness

I’m going to go with Dr. Farjo on this one — I’m skeptical until I see actual proof, as the claims that it can double the size of existing hairs are pretty wild.

Tags: theradome, lllt, laser therapy, hairloss, hair loss

I Was Responding to Finasteride, But I See More Loss Lately — Should I Switch to Dutasteride?

/by William Rassman, M.D./8 /

Dr. Rassman and co,

Thank you so much for this blog, it is a great source of information and truth.

My question to you: I am a very good responder to finasteride, have been on it since 2010. I have recently been losing more and more hair especially from my temples and hairline. Would you think or recommend that i switch to dutasteride?

Also i added Rogaine foam since 2012 and have noticed only slight results and maybe even some accelerated losses from the hairline and temples.

Thank you

The decision to switch to dutasteride is one that should be made between you and your prescribing doctor. I rarely prescribe dutasteride, however, when I do prescribe it, I usually require the patient to have had a course of finasteride first. I would allow a switch to dutasteride only on a case-by-case basis, so I can’t recommend it for you (especially because you’re not my patient and I don’t have your medical or hair loss history).

Tags: avodart, dutasteride, hairloss, hair loss, finasteride

Study – Low Laser Light Treatments Improve Hair Thickness

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

Conclusion from the study:


In four randomized, double-blind, sham-controlled trials of MPHL and FPHL, we detected a statistically significant increase in terminal hair density after 26 weeks of lasercomb treatment compared with sham treatment. Such improvement was independent of the sex and age of the subject, and independent of the laser comb model when similar laser dose rates were delivered. A higher percentage of lasercomb-treated subjects reported overall improvement of hair loss condition and thickness and fullness of hair in self-assessment, though the results did not always reach statistical significance. Increase in terminal hair count was comparable to the short-term trials of 5% Minoxidil Topical solution and 1 mg/day Finasteride, but less efficacious than longer term (≥1 year) trials. Further clinical trials are needed to define the optimal duration of treatment, the duration of response, and the use of the lasercomb in other alopecia conditions.

Read the rest — Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss

I have not been a fan of this modality, though I am now inclined to be more open minded in using this after reading the study published in the American Journal of Clinical Dermatology.

This study was still quite small (128 men and 141 women) and I can not tell which patients would be the ideal candidates for this treatment. I would suspect that it may have value for those who have advanced miniaturization in their hair, but not for those that are completely bald.

Tags: low laser light, lllt, hair loss, hair loss

Is There an Evolutionary Reason for Losing Hair at Certain Ages?

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

Hi Doc,

I have been wondering, what if any evolutionary reason was there for males going bald at as early as their 20’s and a lot more during their 30s and 40’s?

My speculation is that this trait becomes apparent well after puberty and sexual maturation, therefore it does not affect the passing of the genes. Do you have any thoughts on this?

I’m not sure of the evolutionary reason for going bald, but genetic balding can start at any age. The hair follicles have a programmed ‘death’ date and it is triggered by the hormone dihydrotestosterone (DHT) when the date comes to pass. Blocking the DHT with finasteride (Propecia) can delay the start date. Balding can come from either the mother or the father’s side, and very rarely does one see balding prior to sexual maturation, unless it is a variant of a genetic malformation.

There are case reports in family lines where complete hair loss starts at about 2-3 years of age. A family group has been studied in Pakistan where this genetic pattern is widespread in a particular town. The triggered age seems to be about 3 or 4 years old and unlike male pattern baldness, this is far more extensive balding, so it is clear that when there is a gene for some time or balding that is expressed, it is age triggered.

Tags: hairloss, hair loss, evolution, genetics

I Got Tinnitus After My ARTAS Hair Transplant

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

I had the the Artas® procedure performed on me, but unfortunately. I ended up with tinnitus (ringing in the ear) in my left ear. I would appreciate telling you the the potential hazards of the Artas® procedure to warn unsuspecting “hair transplant” people.

Yours is actually the second email I’ve received from someone asking about tinnitus following a procedure done with the ARTAS. I did probe another doctor who has the ARTAS, however, he did not report this side effect on his patients. I do not have this system in my office, so I don’t have personal patients I can reference.

For those of you who do not know what the ARTAS sytem is, it is a robotic hair transplant system used for extracting grafts. You can learn more about it here and here.

Tags: tinnitus, hair transplant, artas®, robot

In the News – Pumpkin Seed Oil as a Hair Loss Treatment?

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

Snippet from the article:

Researchers from the Republic of Korea’s Pusan National University have confirmed that pumpkin seed oil increases hair growth among balding men.

The medical researchers tested the pumpkin seed oil on 76 male patients with moderate androgenic alopecia – male pattern hair loss. None of the patients had tried any previous medication, supplement or topical therapy for at least three months prior to the beginning of the study. The researchers recruited 90 patients, but excluded those with high liver enzyme levels.

The patients were divided into two groups and half were given a placebo. The treatment consisted of giving the patients 400 milligrams of the pumpkin seed oil per day in capsules. They were given two capsules before breakfast and two capsules before dinner.

Read the rest — Pumpkin Seed Oil Found to Help Reverse Balding

Although this is a small study, the results are encouraging. The rule in research of this kind is to get another group to validate the results by repeating the study. I can not advise anyone to start immediately taking pumpkin seed oil pills, but this is clearly your call as it is not a prescription matter.

You can read the study abstract here.

Tags: pumpkin seed oil, hairloss, hair loss