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    is it possible that finasteride will not metabolize?

    Apr 30, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I have been on it for a year and the situation has gotten worse, now NW3 diffuse forelock. I had a bunch of vellus hairs in the beginning of the year but they have all but disappeared and I just feel that finasteride isn’t being properly metabolised or something, since I never had any sides either.

    With a healthy liver, the drug WILL metabolize.

    If you’re balding, why not shave your hair off?

    Apr 30, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    Then why not shave it until you get the progress you are after with medication?  It’s not going to limit my progress and I will look way better in the mean time. My hair looks pretty bad right now…. its not attractive, That’s the truth. If you don’t care, then great….but if I didn’t care why would I be so invested in regrowing it.  Shaving it might take some of the fear away from being bald too.  Should I consider a hair transplant?  I’m 22 years old.

    Some men are satisfied with balding and shave their heads for a Bolder look. Today this is more than acceptable, it is common. Alternatively, you can get Scalp Micropigmentation instead of a hair transplant which gives them the look of a full shaved head of hair, but it is not hair, it just looks that way and the look is good and as you get older, you can then do a hair transplant if that is something you are thinking about (see my website main page: https://scalpmicropigmentation.com/.

    Does reducing Finasteride dose really reduce side effects?

    Apr 30, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    Yes! I have had patients with sexual side effects and then I reduced the dose to 1/2 or 1/4 the regular dose and the side effects went away

    Oral minoxidil’s maximum dose (From Reddit)

    Apr 30, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I saw 2 different cardiologists this week to ask them about taking low dose oral minoxidil. Kevin Mann scared the shit out of me with his videos on it. My dermatologist prescribed me 1.25mg per day.

    The 2 cardiologists that I saw:

    Dr. Vu Hoang, MD FACC

    Dr. Rohit Bhuriya, MD FACC

    I asked each doctor if I needed to worry about the following oral minoxidil side effects at low doses:

    1. Thrombocytopenia (reduction in platelet count)

    2. Leukocytopenia (low white blood cell count)

    3. EKG alterations in T wave

    4. Pericardial effusion (layer of water around the heart)

    5. Pericarditis

    6. LVH (Left Ventricular Hypertrophy)

    I went through the above 6 side effects with both docs and both said there is no need to worry about any of these sides at such a low dose. I then asked the doctors what they consider to be a high dose of oral minoxidil. They said high dose = 5mg twice a day. I asked if 5mg once a day was high, they said they would also consider it to be high. So stay with 2.5mg per day or 1.25mg per day.

    I hope this post will help people like me who were terrified of trying oral minoxidil. I already had several people on reddit telling me they were taking low doses with no issues but I really needed to hear it from a doctor to be sure.

    One of the above docs also suggested taking oral minoxidil before bed. This way in case your bp drops low and you experience light headedness or feeling of fainting, it won’t be an issue because you’ll already be lying down. It’s more problematic if you take it in the morning.

    I will be starting 1.25mg daily and will report back after a few months.

    Rice Bran Products in Hair Growth

    Apr 30, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    This is a fascinating read. It seems that Rice Bran Products applied cosmetically to the hair have many good benefits listed in the article here: Rice+Products+in+Hair+Growth

    More crazy stuff for hair growth

    Apr 30, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    https://www.hairlosslearningcenter.org/topic/does-the-grow-band-actually-stop-hair-loss/3318

    None of this makes any sense. I guess PT Barnum said it right: There is a sucker born every minute

    New Drug for alopecia areata hair loss

    Apr 30, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    https://www.biopharmadive.com/news/eli-lilly-baricitinib-alopecia-areata-results/598791/

    It treats hair loss as an inflammatory disease, which is the case for alopecia areata (an autoimmune disease of the skin that appears to be inherited).  Many doctors have believed for a long time that genetic hair loss also has inflammatory factors present as well.

    Predicting a Hair loss pattern in a 23 year old

    Apr 29, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I’m 23 with a Norwood 5 is it possible I never in my life reach Norwood 7? can I stop at a Norwood 5 or 6?

    I would have to examine your donor fringe area to see if there is miniaturization around the fringe indicating a Class 6 or 7 pattern. Also, at age 23, the pattern may not have declared itself. As you get older, you may find that pattern emerging, see here: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/.  Also the HAIRCHECK test is a valuable test to predict hair loss patterns before you can see them here: https://baldingblog.com/haircheck-test-how-it-is-done-video/. The advantage of this approach is that you buy time, time to see where your end balding pattern will develop, time to develop the money to do it right when you have a job that is secure, time to work through a Personalized Master Plan in tying to get your hair back while you wait with medications and possible microneedling.  Rushing only depletes your donor area way before you are ready.

    19 years old a devastated from hair loss (photo)

    Apr 29, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    Young men who end up with advanced balding patterns start off early and reach that advanced pattern by the time they are 25-26. This is certainly the case for this young man. One option often not discussed often is the use of Scalp Mmicropigmentation which can turn this young man into a stylish man with a full head of shaved hair, Although it is an illusion, it is a great illusion as shown in some of the photos here: https://scalpmicropigmentation.com/ Take a look at the man on the front page of our website and tell me you can tell he is balding?

    How to tell a Class 6 from a Class 7 pattern of balding

    Apr 29, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    I’m not sure what Norwood level my uncle is as I believe I take after him.  If I describe his hair loss stage hopefully you can help me determine if he is a Norwood 6 or 7 please. So my uncle has quite a large donor area on the back and on the side. On both sides of his head he has high parietal ridges but he is completely bald on top on his head I did see he has like 10 hairs still on top but they were spread out. His crown is bald. And looking at his head from above it is a horse shoe. If my description doesn’t help I don’t mind sending pictures.

    Here are three links with pictures of a Class 7 pattern of balding: https://baldingblog.com/class-6-7-pattern-balding-can-expect-hair-transplant-photo/ AND https://baldingblog.com/generation-gapphoto/ The back remaining hair sweeps low and the side fringe area is mostly absent. The picture on the right here: https://baldingblog.com/permanent-zone-hair-lasts-lifetime/ shows the classic way to determine the Class 7 pattern patient with arrows showing how I do it.

    Do person to person hair transplants work?

    Apr 28, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    Hello Doctor, what are your thoughts on person to person hair transplants?

    Person to person hair transplants only works with identical twins because with non-identical twins or other person to person hair transplants, each hair follicular unit (a complete organ system) rejects as would a kidney or a liver. I have done one set of identical twins back in the mid-1990s. It worked out fine. The reason that there was a difference in hair loss between the twins (which should not be the case) was that one twin wore a Hair System which was attached with tape and glues which pulled out the hair at the point of attachment. The donor’s identical twin didn’t use a hair system and although he had only a little bit of recession, he had not lost his hair as his twin brother did.

    My blood creatinine is above normal. Can it cause hair loss?

    Apr 28, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    Can high Creatinine levels cause hair thinning? I had a regular blood test done and results showed that my Creatinine was above normal. I also noticed that my hair looks thinner than normal. Could it be the reason?

    Creatinine is a byproduct of muscle breakdown and the more muscles you have, the more creatinine your body produces which must be cleared by your kidneys. The kidneys maintain the blood creatinine in a normal range but when it is elevated is often signifies impaired kidney function or kidney disease. Of course, any illness can contribute to hair loss. See a doctor

    Sprayed before going on Airplane

    Apr 28, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    1 day post op and I Had to take the plane to go back in my country,  problem is that before entering plane, I dad to enter a gate which sprayed some chlorine or hydroalcoholic anti covid solution on my head. Would that damage my hair transplant?

    Within one day after a hair transplant, your recipient grafts should be sealed in position so I would doubt that any damage would have happened

    18 month finasteride (photo)

    Apr 27, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    These are my pictures after 18 months on finasteride. About 5 months ago, I added microneedling as well which made a significant difference

    This is a wonderful example of how persistence and focus can get some men to impact their hair loss without a hair transplant.

    Family destroyed my self-esteem

    Apr 27, 2021/by William Rassman, M.D./0 /Hair Loss Causes

    We just had a video call with my uncle, my family is italian but we live in Mexico so we always make videocalls with my family, this was the first video call with my uncle in months and the first thing my mom says is look at his hair, he is also losing it, and they all laugh, my mom knows how losing my hair has affected me and still she seems to take it as a joke, my uncle just laughed and said is a family thing, i know it wasn’t with bad intention but still felt bad, people doesn’t seem to acknowledge how much the balding can affect own self-esteem.

    Today’s younger generation understand that balding is not an irreversible process. Unfortunately, the last generation needs to be educated not only on the advances in the treatment of balding, but that there is an emotional impact on many men going down the balding path.

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    Over 21 million women and 35 million men in America suffer from hair loss. For many of these people, the psychological impact on their life is debilitating.

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    This site exists to educate about hair loss and hair restoration.

    William R. Rassman, M.D.

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    This site is intended to educate the public on hair loss topics based on personal experience and opinions from Dr. William Rassman and contributing physician editors. Information provided on BaldingBlog.com should not be used for the purpose of medical diagnosis or treatment.

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