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    Micro needling redness

    Jul 28, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    when i microneedle i achieve redness all over the scalp, but within the hour the redness goes away and by the morning it’s completely gone and i feel no pain at all. am i doing it wrong? is there no inflammation?

    Some people have Histamine positive skin which turns red easily. If you scratch your forehead with your finger nail and it turns red in a few minutes, then you have Histamine positive skin. It just takes longer to lose the red color. Microneedling is becoming more and more popular to bring back the hair from the micro-wounds it creates. It does work on some people

    Finasteride and Alcohol

    Jul 28, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Has your relationship with alcohol changed since being on fin? Personally I used to drink a lot and now I kind of dislike drinking and only drink once in a while. Not sure if this is a rare reaction or even caused by fin.

    Drinking with finasteride is not a problem

    minoxidil after 8 months (photo)

    Jul 28, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    These photos show the results of minoxidil use alone over an 8 month period creating a normal maturing hairline from one that had slight recessions in it. The improvement is subtle.


    Do women ignore bald men?

    Jul 27, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Back when I had hair girls used to flirt with me and tell me how good looking I was. Now women see the bald head and don’t give me a second glance. It’s as if their minds are seeing my head and picturing their children with me coming out bald with a Norwood 6. Before I didn’t have to say more than 3 words to get a woman interested in me, but it takes so much effort now.

    Society has always discriminated against men with balding. It goes back over 2000 years when tuberculosis was running rampant producing balding men because they were sickly.  That set up a connection between balding on one side with a sickly man, and a healthy vibrant hairy man on the other side.  So the norm has been propelled for centuries and it is somehow ingrained in our culture.  Men wore wigs or hats to hide their balding so women wouldn’t be able to tell.  Met wore top hats in the late 1800 and early 1900s.  Today we wear baseball caps. We are still victims of this culturally, unfortunately.

    Hair Transplant 4 months ago and the redness remains (photo)

    Jul 27, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Be patient and everything will turn out ok.  Some people, a rare few, keep their redness for up to a year. It always happens in redheads, blondes, and fair haired people when it happens.  Sometimes the use of topical steroids can address the redness.  When all of the hair grows out, the redness will barely show,

    persistent redness 1

    Microneedling alone (photo)

    Jul 27, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Without the use of medications such as finasteride or minoxidil, this young men just performed microneedling over a 1 year period with great results



    What is the incidence of Post Finasteride Syndrome (PFS)?

    Jul 24, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    A reader on Reddit answered it this way. Not a bad attempt but I can’t endorse it all.  I see incidence reports that run from 1% to .1%.  Here is the reddit response

    0,02 % of people based on clinical studies made from pfs foundation….

    This is 1 of 5000 people in lifetime during using

    Of which medium time to get normal is 3 years…

    3 years without medication, like trt proviron ecc

    You literally have 50 more chances to die on a car accident

    You have 10 more chances to die walking by street

    And you have 2 times more chance to die choked on food…

    So in reality is pretty safe like a drug, and to be even safer just do a blood work controlling your hormone panel….

    Than after this every 6 months do hormone profile to check if everything is in range and you are good to go….

    The majority of pfs, comes from hormone that was bad at the start of medication and during the medication they hormones get messed up (which can be seen on blood work) and they continue because they didnt have sides and then when they stop they body overact and pfs comes….

    Other than that you can have once in a year a stop of one month, to wash the chemicals in your body, and restart again….

    With all this literally the chances to get something its almost 0.

    And in many reputablr clinical studies, after discontinuation of the drug, more people experienced persistence of sides on placebo grouo than the finesteride group….

    Which doesnt mean that pfs fin sides doesnt exist, but many people nocebo themselfs to think that they have something which they dont, and many people have some problems in they body outside the drug

    1 in 5000 is a real pfs, so if there is like 1milion consumers, we can expect that we have 200 pfs patients with it…

    This number is so low, that doctors cant know how to take out this people from that, and this is why having blood work pre fin and during fin so that an endrychonologist will know how to bring you back in normal state if they have something to work with….

    How good does SMP look? (photo)

    Jul 24, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    I had a How good does SMP look? Also see: https://scalpmicropigmentation.com/ You can judge for yourself. Every ‘hair’ on his head is actually a tattoo.

    I have Peyronie’s syndrome, can I take finasteride?

    Jul 24, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    I just got diagnosed with peyronie’s. I’m in very early stages but started finasteride 3 months ago. Can I continue using it?

    Peyronie’s syndrome reflect a deformity of the penis reflecting the development of fibrous scar tissue inside the penis that causes curved, painful erections. Penises vary in shape and size, and having a curved erection isn’t necessarily a cause for concern. Finasteride should have no impact on this sundrome

    Another failed FUE performed by a technician with photo

    Jul 24, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    The picture says it all. Yes, it was a bargain but at what cost?  This patient had over 3000 FUE grafts permanently removed from his donor area (possibly had only 6000-7000 total for all hair transplants in his lifetime), plus he is now scarred and he will have to go after another transplant just to look normal. When that is done, he will be depleted in his donor area and probably be bald there.  Switching balding from the top of the head to the back of the head is not bargain.

    6 months on finasteride (photo)

    Jul 24, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Some men are very responsive to finasteride, have recent hair loss and are young.  These combinations can produce such great results in just 6 months of finasteride use

    Erectile Dysfunction may be precursor of heart disease in young men

    Jul 23, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Erectile dysfunction might well be the “canary in a coal mine” of men’s health, indicating that men need to “metaphorically evacuate” before they develop life-threatening disorders, said Arie Parnham, MD, from the Christie NHS Foundation Trust in Manchester, United Kingdom.

    More than half of all men 40 to 70 years of age have experienced erectile dysfunction — defined in EAU guidelines as “an inability to attain or maintain an erection sufficient for sexual performance” — according to the Massachusetts Male Aging Study.

    Many of these men have multiple comorbidities, the most prevalent of which is coronary artery disease, Parnham explained during his presentation at the European Association of Urology 2020 Congress.

    The link between erectile dysfunction and coronary artery disease was first made by Italian researchers in a 2003 study of 300 men with acute chest pain and angiographically documented coronary artery disease. The prevalence of erectile dysfunction in the study cohort was 49%, and in 70% of those men, the onset occurred in the 40 months preceding their diagnosis of coronary artery disease.

    Then, a 44% increase in the risk for cardiovascular events, a 62% increase in the risk for myocardial infraction, and a 25% increase in the risk for all-cause mortality were seen in a 2013 systemic review of 14 studies — a pool of 92,757 men with erectile dysfunction — with a mean follow-up of 6.1 years.

    “Younger people were at higher risk” the systemic review showed, said Parnham, which “highlights the importance of screening in this group.”

    Source: Medscape, Erectile Dysfunctin: A Urologic  ‘Canary in a Coal Mine’ by Ingrid Hein,  July 21, 2020

    I have had Gynecomastia since I was 14

    Jul 23, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    Am I more likely to get a worsening of my problem if I go on finasteride?

    Men who have gynecomastia are not more likely to get breast enlargements or breast lumps than men who don’t have it when then go on Finasteride

    Can correcting a folic acid deficiency correct hair loss?

    Jul 23, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    For the few patients who have a Folate deficiency, taking Folic Acid may reverse hair loss caused by this problem.

    Scarring alopecia following a hair transplant

    Jul 22, 2020/by William Rassman, M.D./0 /Hair Loss Causes

    I was just told (from another doctor) that one of his patients who had two hair transplants surgeries totaling 5500 grafts, got a third hair transplant and then lost all of the previous hair transplants. The third hair transplant did not grow.  A biopsy was done and the diagnosis of Scarring Alopecia was made which clearly caused the loss of the hair.  This is an autoimmune process.  Of course, the patient was concerned that the scarring alopecia risk was risk he was told about and the patient was angry. This is the very first time I heard about the appearance of a Scarring Alopecia after a hair transplant. I am not certain that there is a one-to-one- correlation between the last hair transplant and the appearance of the scarring alopecia, although the incidence is highly suggestive of it.

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