Dr Rassman ,does side effect of weight gain always occur in all male patients who uses 5% topical minoxidil? After how many days/months of discontinuation of topical minoxidil 5%, will the patient reach to his original /actual weight?
As far as I know, weight gain is not a side effect of Rogain.
The main source of hair loss in men is genetics.
The main source of weight gain is generally over eating.
An article in Indian J Dermatol. 2014 Mar-Apr; 59(2): 163–165 States: “Finasteride is more effective for treating AGA patients who are pileous in other areas of the body.” This means that if Gorilla’s should bald, or apes should bald (which some Chimps are known to do), they may respond to finasteride better than their human cousins. OF course, not such study on balding Chimps, I believe, has been done.
What do you think is the best program for an 18 yr old who is experiencing MPB.
It all depends on your goals and expectations. You can read about the Master Plan I advocate and consider seeing a doctor. Don’t jump to do any surgery what-so-ever. At 18, you never know where your balding is going and that is why we talk about developing a Master Plan with a good doctor. Close to 100% of men your age, will go on the drug finasteride (Propecia) to slow, stop or reverse the hair loss. At the time of your visit, we will perform a bulk assessment of your hair and that will give us close to 99% certainty just how far the hair loss has gone, if at all.
Happy 2015! David (Van Halen) Lee Roth performed this past Saturday with the Foo Fighters in LA.
I was watching the clip online and when he took off his cap, he had a shaved head. What I noticed was what looked like a strip scar on the back of his head. Does this appear to be a scar from a HT? Would it be less obvious if he had SMP to help conceal it?
Just curious. I enjoy your site and have been pleased that you have answered my questions over the years.
Many celebrities have had hair transplant strip surgeries hidden under their long hair and from the photos I’ve seen circulating around the Internet it does seem like a hair transplant scar.
I wonder if he knows it can be camouflaged with SMP? If not, someone should show him this post.
NHI_SMP_to scar
Sir does alpecin caffeine liquid helps in halting hairloss and stimulating regrowth in male pattern baldness patients? And can it be used with minoxidil 5%?
The only medication or treatment I know that helps (not stop) hair loss in male pattern balding is Rogain (topical minoxidile 5%) and Propecia (finateride 1mg). You will find hundreds if not thousands of Internet websites and advertisements that claim a cure, but my point has always been “buyer beware”. Caffeine or special shampoos with exotic ingredients do not stop hair loss.
Hey there, so I have a serious question. It is probably on that you have seen frequently. Well, last year in October/ early November I began 1.25 mg finasteride due to slight temple recession ( I have a V hairline and it started to round a tad on the right side). All was going fine. No side effects from the drug, no initial shed in which I’ve read about happening, nothing at all. During all of this I switched to liquid minoxidil after being on foam.
Fast forward a while to November of 2014 (1 year later). I randomly got a weird burning sensation on and above the left side of my hairline. It lasted for about 2 seconds and then it was gone. The next day, same thing. Lasted two seconds but I started to get really itchy. Two days later, I woke up and went to style my hair for school and noticed I could see my scalp on that side. Well I started getting a little upset. I thought of everything that it could be and can’t find an answer.
It has now been about 2.5 months and in those months I was shedding a boat load of telogen hairs. However, during this time the left side of my hair line has been stinging.. I thought maybe I had a reaction to the propylene glycol that is in minoxidil because I got a rash under my armpit from my deodorant, a sty in my eye, and a rash on my neck from Cologne.. All of which was on my left side..
I stopped using liquid minoxidil and switched to foam for the past 2 months but haven’t used it on my left side. Only the right hairline. What do you think this could be? Is finasteride not working after the first year? Did minoxidil cause this? Maybe folliculitis?
Ps. I saw a dermatologist and she said my scalp looked fine and clear. She said that what I described sounded like sebborheic dermatitis and gave me a topical steroid to use, but I have not seen any decrease in the stinging pain on the left side.
Also, I would like to note that in the summer I started a workout routine called p90x for two months (stopped late July due to injury) and I also changed my diet, limiting what I ate and how much I ate. I did notice that I lost about10-12 pounds and I was not fat at all. I’m 5″11 and was 158-160. Now I am 148-150. I was thinking maybe it could have been a bout of TE? I had blood work done for thyroid, anemia,etc.. And all wer normal.
Anyway, sorry for the long message. You know how this effects people.[/bq]
Not sure how I can help or where to begin. Maybe some readers here have a comment.
Burning sensations lasting 2 seconds, P90X workouts, proplylene glycol, stye in the eye, cologne, left side all seem random and unrelated issues that you are trying to tie together into what you describe to be genetic male pattern balding.
I would defer it to your doctor. I will add that genetic male pattern balding does not cause sharp or burning pain. If you believe you are balding, see a doctor who will do a bulk analysis of your hair and give you with almost 100% certainty if you are losing any hair. A good diagnosis is the key.
At less than 48 hours after my hair transplant. To return home I took high speed train, unluckily this train had very high frequency vibration, actually makes the trip of 3 hours rather uncomfortable. I wonder if this continuous movement during three hours could have dislodged any of my transplanted grafts. The head movements where continuous and impossible to stop. I am between second and third day and it seems that everything is going wrong…
Wow, it must have been one hell of a train ride. I’m not sure what you mean by “everything going wrong”, but I would follow up with your doctor and avoid the train wreck.
There are a few articles on how train vibrations affect human physiology but I am not sure how it impacts hair transplant surgery.
This is an email I received from a doctor in Brazil: “Today I had a consultation. The patient told me he was buying tickets for Phantom of Opera in New York (around 1996). Someone behind him realized he had had an alopecia reduction and a bad hair transplant (that someone was you). You talked to him and suggested to go to your office in L.A. to have a better result. Two years later he was in your clinic and had the surgery done by you. You fixed it for him.
Other coincidence: newhair.com was opened in my computer when he came to my consultation room and so was the e-mail you sent me. I showed him all the coincidences!!! I took a Picture by his side and am including it for your pleasure. It is a honour to have you as a mentor, colleague and friend.”
I am very concerned because my two nights just after hair transplant were in a hotel room without heating. Temperatures outside during night were below 0C, there was hot air conditioning machine but I switched it off during night due to noise. When I woke up I had sore throat due to low temperature in bedroom, I slept well covered under blankets but my head with my just transplanted new grafts were obviously out. I wonder the effect of low scalp temperature during 8 hours night at scalp blood flow, as this seems to be one of the most important factors during first three days after hair surgery. Would these two nights have a similar vasoconstriction effect like smoking or drinking, or would it be even worse?. Is it possible to know if this could impaired my hair transplant outcome?. Many thanks for help in advance, I am really stressed specially because this is my third procedure, my last remaining donor to get a normal look…
Seem like you caught a viral infection or at the least developed flu type symptoms after a cold night. I don’t think it should matter much in terms of your surgery unless your body is so stressed that it cannot cope with the surgery. Please follow up with your doctor and express your concerns with your doctor.
Before and after three sessions totaling 5,966 follicular unit grafts
Patient AQQ is in his early 50’s with medium weight, wiry, light brown hair with advanced Norwood Class 6 hair loss. Results shown are after 3 sessions of Follicular Unit Transplantation.
Hello Doctor, I have a question. I take propecia eveyr morning, and then 15 mins later have breakfast. usually oatmeal, with kiwi and bananna. thats a prerry heavy fibre diet. I just want to know can the fibre have an ill affect on the finasteride? meaning it gets excreted to fast and less gets absorbed?
I’m not sure about the reasoning behind your question, but I don’t think a high fiber diet will affect your hair or how your medication gets absorbed.
I want my eyebrows transplanted. A new plastic surgeon just came to town and is offering eyebrow transplant. Should I trust him?
Eyebrow hair transplants are very difficult to perform. The hair grafts for the eyebrow must to placed flat against the upper bone of the eye socket. Unfortunately getting this done correctly, is not easily accomplished and should not be attempted except for the most experienced surgeons who have created many of these reconstructions with good results. I have seen the eyebrow hairs stick out forward as they were not placed flat or in the correct direction. Plucking them out work, but why should you have to pluck after having it done? Good question!
Restoring eyebrow hair is a rewarding endeavor, as this structure is so important to a person’s appearance, perhaps even more so than scalp hair. The secret to eyebrow transplantation (as in other types of hair restoration) is to closely observe nature. Unlike scalp hair, the eyebrows consist of only one-hair follicular units, so that if the source of hair is the larger follicular units obtained from the permanent zone in the back of the scalp, these units (of 2, 3, and 4-hairs) must be carefully split up into individual follicles under the microscope.
Replicating the unique directional changes of eyebrow hair is also critical to a successful restoration. The hair points upward in its medial aspect (near the nose) and then fans outwards as one moves towards the temples. However, the angles are not quite so simple. As one moves laterally (towards the temples), the hair in the upper half of the brow points to the side and down and the hair in the lower half points to the side and up. The upper and lower hairs interdigitate causing the central part of the eyebrow to slightly rise and form a gentle ridge which gives the eyebrow its unique shape. This interlocking also keeps the eyebrow hair orderly and “neat” in appearance. All of the eyebrow hair emerges from the skin at a very acute angle (almost flat), so the recipient sites must be made with the needle actually lying on the skin surface.
Just as the outer edge of the female hairline is often comprised of finer hair, so are the outer boarders of the eyebrows. In a sense, each eyebrow can be viewed as a cosmetic unit, just as the scalp, with transition zones of fine hair around much of the perimeter. As with the frontal hairline and temples, this fine hair may be replicated by removing or producing controlled, intentional damage to the bulb (cutting off part or all of the bottom) of a normal terminal follicle. The practice of using all fine hair for the eyebrows is incorrect since the eyebrows, like the scalp, require a central area of greater density, and bulk, and this is best accomplished with intact (but in this case individual) hair follicles. In all cases, multiple sessions are needed for a complete eyebrow restoration.
The other day, I overheard a group of my friends speak (behind my back) that they trought that I had cancer because my hair was very thin. They said I looked sickly and it hit me like a truck. I have seem many doctors about my thinning hair in the past, but most told me that there was nothing to do about it. The other night I saw an infomercial on TV which showed the value of hair transplants for people with thinning hair. Is this the right next step for me?
The treatment of women’s hair loss must be approached differently than hair loss in men, as most women rarely lose all of the hair in a pattern as men do. In fact, much of the hair remains, but the thickness of the hair shaft becomes smaller than normal hair and the density of each follicular unit reduces from the normal of 2 hairs per follicular unit to between 1 – 1.6 hairs per follicular unit. When this is combined with the finer hair, then the bulk of hair in each follicular unit is significantly reduced. This reduction of hair bulk from miniaturization and loss of individual hair follicles causes the hair to appear thinner, at times making the patient look sickly. Because a relatively large area can be subject to this thinning, it is important that hair is transplanted in areas where it is cosmetically most significant or where it can enhance a specific styling plan to increase the appearance of fullness. Unfortunately, the process discussed above occurs, at time, even in the area we call the donor area, which in 99% of men, is perfectly normal regardless of the degree of balding present. In women with this donor area looking like the rest of the hair, this makes them significantly different from men whose donor area has normal hair, normal hair bulk and no significant miniaturization. If women have such hair in what we call the donor area, they are not candidates for hair transplantation under any circumstances. Too many doctors transplant such women just for the surgical fees, and these women are never made better, and at time even made worse.
When the hair in this ‘donor area’ is reasonably unaffected by the disease process discussed above, then they might become candidates for hair transplantation. We generally confine the transplant process to a localized part of the scalp where balding is worst (such as behind the “frontal hairline” or “along the part”). When women have a dense, stable permanent zone and a loose scalp, it is possible to provide more coverage over the top of the scalp but far few women are able to get a significant benefit from a limited hair transplant.
Since hair transplantation in women generally involves placing hair into a part the scalp that is thin, but not completely bald, there is a risk that original hair in this area may be lost. This process is called “telogen effluvium” and is usually (but not always) reversible. In addition, if the donor area continues to thin, then the transplanted hair will also thin over time, since it came from the same area. For these reasons deciding when it is appropriate to perform transplantation for women can be difficult and requires the careful judgment of a very experienced and ethical physician.
Congratulations on ten years, and an excellent blog. So, I have a delicate problem. Around 10 months ago, I unfortunately ‘broke’ my penis during rigerous sex (imagine a monty python movie mashed with quinten tarentino). It healed, but with a scar and subsequent slight curve upwards. The latter only progressed after around 6 months. I visited my urologist, and he suggested I might consider penis traction, as a means for straightening my penis and to preclude future curvature. Now, I also take 0.25 mg of finasteride EOD (and have done for 14 years). My question is, do you think the suppression of DHT will affect my efforts to straighten my penis. In other words, does an adult male need DHT to repair an injured penis. Thanks and all the best for the next ten years.
Deformed penises are not uncommon. They could be a symptom of Peyronies disease (https://www.mypeyronies.com/symptoms-of-peyronies.html). I think your question is best fit for your urologist who should be well versed in finasteride. I personally do not think finasteride will impact the straightening of the penis.
This is probably a dumb question to ask but I don’t understand balding. I have thinning hair and possibly new regrowth on my temples. I’ve read that your hair thins out slowly until that area stops producing hair.
So my question is should I be expecting finasteride, and minoxidil to help keep those thin hairs and possibly thicken them or should I be expecting that area to be bald shortly. There’s so much conflicting information when it comes to thinning hair that I’ve read online and I’d really just like to know if I’m going to keep those hairs or lose them so I can stop stressing over it.
I’m a 22 year old male if it makes any difference.
Hair loss or balding in men is mainly due to genetic predisposition/ inheritance. It may not follow an exact father to son path but it is nevertheless a genetic trait. There are medications such as Propecia or Rogain to address the genetic male pattern balding and it works better in some men. However it does not stop or reverse the balding completely. Eventually your genetic balding pattern will take shape. Many men take these medication to slow the process down and some have great results. The bad news is that the medications do not work for the front hair line or front corner / temple hair loss in (what I would guess to be) roughly 95% of men. They also do not work in the temple peaks. Only a hair transplant offers this solution.