Did Surgeries from My Fibrous Dysplasia Cause Hair Loss?

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

Dear Dr Rassman:

I’m a 27 year old who has long suffered from Fibrous Dysplasia (I’m not sure if you are familiar with this disease). Due to my ailment, I have incurred over 30 medical surgeries over my lifetime. My hair was thick up untl high school, and then it really began to thin. The only ancestors of mine that have been bald were only two of my great-grandfathers. I was wondering if all of the major surgery I have had would have caused my hair loss. Also, I have been on propecia since November of last year and am having some back surgery next week. Would the shock of surgery or the medications used cause my hair loss to increase? Also, because I may be missing a couple of days of propecia doses would this affect the progress of the drug in combating my hair loss?

Fibrous dysplasiaI’m familiar with fibrous dysplasia (it is a very rare bone disease), but I do not know what surgery you have had or what medications you take. Your question is very general and it is not something I can give you an answer to in this format. You need to see a physician and have a complete history and examination.

In most cases, hair loss in men is caused by genetics. If you have an autoimmune disease like a form of a scarring alopecia, surgery done in these conditions can be dangerous and produce failures of the grafts and further scarring of the scalp. Any medical illness or surgery that is a stress to your body can cause hair loss (sometimes permanent). But to distinguish that from genetic causes is something that only a thorough examination with a physician can provide. You are looking for a cause and effect type of relationship and I really cannot help you with the limited information I have.

Tags: surgery, hair loss, hairloss, fibrous dysplasia, bone disease, tumors

What’s a Typical Result After a Year on Propecia?

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

Hey doc, just finsihing my 10th month on propecia, pretty sure hair isnt any better maybe alittle worse in front. However I think propecia is working to at least slow down my loss. So my question is, after 1 year of treatment what is the state of the typical propecia users hair. Also what is their own opinion of their hair, before you look at it, do they think that their hair is better, worse, or the same? Finally I have heard that best results (thickening of hair) do not happen until 24 months, how true is that for most of your patients? Thanks!

It takes about 2 years to maximize the benefits of Propecia (finasteride 1mg), but in one year you will kind-of know what you are going to get. Reversal of frontal hair loss is not common, but stopping or slowing the hair loss is common. Response to this drug is often age dependent with the younger men getting more benefits, provided that they are not heading to a Norwood Class 7 (extreme case) by the age of 23.

The hair that reverses in the crown is just like it was before it went away, but you really can not tell one hair from the other. The degree of miniaturization is a better indicator for benefits if you want a metric on this process.

Tags: propecia, finasteride, hairloss, hair loss

Anti-Itch Medication to Use with Minoxidil?

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

Hi doctor,
Twice you have answered my question. Thanks a lot for that.Now I would like to know Whether provillus is effective for thinning hair. The topical contains minoxidil 5% but the supplement contains 1500 mg of saw palmetto plus some vitamins and minerals. Since there is know proven results for saw palmetto’s efficiency on hair growth, Is it an effective way of combining it with minoxidil? as with provillus or what alternate supplement you suggest that can be taken with minoxidil which faster the hair regrowth process other than finasteride?

And I have tremendous amount of itching on my scalp if I apply minoxidil (even 2%) now what shall I do? Do I take some anti-allergic pills and continue application of minoxidil?

Kitchen sinkAllergy to minoxidil is a common side effect and other than stopping the medication completely, lowering the dosage is reasonable to try. I don’t think an over-the-counter anti-itch cream (with benzocaine or something similar) would be of much help. When you develop an allergy to minoxidil, topical steroids may be the only thing that will help, but it could do more harm than good and I don’t advise that.

Combining the saw palmetto with minoxidil in a topical medication as Provillus does suggests that the company is tossing everything but the kitchen sink into their product line. I’m not convinced of saw palmetto’s use as a hair loss treatment (especially as a topical), and the only suggestions I feel comfortable giving for hair growth are the FDA approved ones that are proven to actually do what they claim: minoxidil and finasteride.

Tags: provillus, minoxidil, finasteride, propecia, rogaine, saw palmetto, hair loss, hairloss

Can I Let My 15 Year Old Son Use Minoxidil Until He’s Old Enough for Propecia?

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

My question is for Dr Rassman: I have a 15 year old son who seems to be losing his hair (from the crown only – mpb in the family). I understand that Propecia is not suitable until he is 18. Is it worth using Rogaine until then and at what strength? Based on your experience how successful do you think it would be in retaining the hair he has until he is old enough to try the Propecia?

I know you have to deal with many questions but I would be so very grateful for your reply.

A worried mum.

I am reluctant to recommend Propecia (finasteride) for someone that young, but I and many other doctors have done this provided that your family doctor goes along with it. I have allowed my young patients to use Rogaine (minoxidil), starting off with 2% and moving up to 5% in the crown, if his family doctor does not want to use Propecia.

One thing to keep in mind — benefits from minoxidil are not kept by finasteride and vice versa. In other words, if he sees positive results from Rogaine and then decides years later that he wants to take just Propecia, it won’t maintain what Rogaine has kept.

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

MDF Advanced

/by William Rassman, M.D./2 /

Hi Doc

Any thoughts on MDF Advanced (site), seems like it’s a mega all in one treatment – but i thought duta wasn’t allowed to be used for hair loss?

keep up the good work

MDF AdvancedMDF Advanced contains a very high level of minoxidil (15%), dutasteride (a prescription medication), and flutamide (I’ve yet to see a study that proves it does anything to treat hair loss topically). I don’t see how this is safe or why a doctor would sign off on this. The way they sell the topical treatment is interesting — you order it and supply your doctor’s info, they fax something to your doctor asking for him/her to approve prescribing this medication, then they have their own pharmacy send you this formula containing a prescription medication. Is that even legal? It might be a gray area.

There’s a couple of red flags that I need to point out:

  1. Dutasteride is yet to be FDA approved as a hair loss treatment (it is a prostate medication), so the doctor would be signing off on something for off-label use. Doctors have to consider their liability when prescribing off-label medication. Also, the FDA controls all claims on lotions, potions, drugs, and any variation left open for misinterpretation can be actionable. Many doctors won’t do what this company wants them to do. I certainly would not!
  2. It contains dutasteride in a topical form (the limited studies I’ve seen have been for oral dutasteride). You’re risking a lot to use an expensive treatment that hasn’t been proven safe or effective.
Tags: mdf advanced, dutasteride, avodart, flutamide, minoxidil, hairloss, hair loss, samson

If My Libido is Higher on Propecia and Avodart, Does that Mean DHT is Increasing?

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

I started taking propecia when i began noticing my hairline receding and hair becoming thin in the crown. About 1 year later i decided to give dutasteride ago. Throughout both medications my testosterone increased quite alot, causing increased libido to such a degree that i was getting an erection almost 3 times a day compared to almost never (unless needed) when i wasnt on the medication. i have been taking these medications now for 3 years and my testosterone shows no sign of of decreasing back to normal.

My question is, if i am taking medications to reduce as much DHT as i can and my medications are actually increasing my testosterone which inturn is creating more DHT as its a by product isnt it a paradox and useless. I have however heard that this increased testosterone isnt almost a momentary thing that may last a while because my bodys thinking ‘we need to make more testosterone’ due to the decrease caused by the medication.

Thanks NHI Team

Few men will complain of an increased libido or an increase in the frequency of erections. As you noted that the increase in erection function has been now two years since you started it, I would imagine that it will continue. How do you know your testosterone levels increased? Did you have them measured before and after you are taking Propecia and/or dutasteride? These blood levels need to be compared to the normal values established by the lab testing you.

The connection with your sex drive and the DHT block from the drugs you are taking, and possible increased levels of testosterone are unclear. Without knowing testosterone levels before and after you started taking the DHT, I can not tell you much. I personally think that you are going overboard with analysis here, and should just enjoy the moments as long as everything is working well.

Tags: libido, dht, testosterone, hairloss, hair loss, dutasteride, finasteride, avodart, propecia

Any Minoxidil-Based Treatments That Just Require 1 Daily Application?

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

Dr. Rassman
I have started using scalpmed. It requires daily twice application. I cannot go to office with greasy head. I either have to take bath after applying or have another minoxidil based solution that needs daily once only application. So

  1. What should be the minimum time between application of minoxidil and shower?
  2. Is there any minoxidil based treatment that requires once nightly application?

The minoxidil will have been absorbed by the skin within an hour or so, so that should be the time in between applying and showering.

Using Rogaine Foam might solve the greasy head problem for you. Since both the foam and ScalpMed are minoxidil based, you wouldn’t lose benefits by switching between the two. Most minoxidil products recommend twice daily use, but some people do apply just once a day.

Tags: scalpmed, minoxidil, rogaine foam, hairloss, hair loss, shower

Will Finasteride Work for 30 or More Years?

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

Doc, I really appreciate this blog which I consider, by the way, the funniest blog on the Internet about hairloss. My question is about maintainance. You have written many times that baldness will catch up all of us sooner or later but, on the other hand, some people, mostly in their early twenties are still maintaining after ten years, their benefits of Finasteride. According to these: you think that those who are taking Finasteride will lose most of their retained hair, maybe at their late thirties or fourties? Or perhaps these people could get to keep their hair until they reach their fifties or sixties?

I know very well that you don’t like the guessing game but I am sure your professional experience gives you a better perspective about these topic.

You’re right in that I don’t like to guess, so I’m not going to do so here. The data is just not there. Finasteride hasn’t been around long enough to say whether it’ll maintain hair loss treatment benefits 30 or 40 years after you start taking it. What I do know is that it does still provide benefits after the 10 year mark for some men, because the medication has been available for about that long. Finasteride was around in a larger dosage (5mg) since 1992 to treat the prostate, but I don’t have data about hair loss treatment benefits in those that took the drug back then for prostate health.

The drug company Merck shows a slow loss of effectiveness over the first 5 years, but there is no published data beyond 5 years. I have had many patients starting this drug in their early to mid-twenties and over the 10 or so years the drug has been on the market, many of the men who reversed the balding in the crown have maintained all of the benefits. Unfortunately, I can not project this out for the length of time you are asking about.

Tags: finasteride, propecia, hairloss, hair loss

Any Hair Thickening Recommendation?

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

What product will you recommend for hair thickening and to stop hair-loss. When do you think Follica will be ready with the miracle drug?

For hair thickening, there are a variety of products like volumizing shampoos and protein fibers that you can apply to your hair. I don’t have any specific recommendation for these, as they’re over the counter and you can try them as you like. Some work better than others to give the illusion of thicker hair, but none of them will stop hair loss.

As for information on Follica, please contact the company (here is their Consumer Inquiries form). I have no insider information.

Tags: hair thickening, volumizing, hairloss, hair loss, follica

Spectral.DNC-L

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

Dr. Thank you for this informative site.D o you have any thoughts on using minoxidil other than Rogaine. DS Labs has there own formula DNC and a brand new formula DNC-L for advanced stages of balding. I don’t know if this company can be trusted due to it’s claims the their shampoo Revita will stop hair loss. It’s website is impressive and I do like the shampoo.

Spectral DNC-LIf you like the shampoo and it seems to be working for you, I’d keep using it. Claims on preventing hair loss may be in violation of permitted language from an FDA perspective if the formulation impacts the effectiveness of the minoxidil in their product. I believe if you want minoxidil, get it the generic way. If you want the minoxidil foam, you’ll have to get the name brand stuff. As for this lotion… well, it’s up to you. The combo products, without proper studies, just don’t do it for me. That kind of sums up my opinion.

I think it is easier to build a great website than it is to create a product that actually slows, stops, or reverses hair loss.

Tags: spectral dnc-l, spectral, dnc, ds labs, minoxidil, lotion, hiarloss, hair loss

Can Propecia Stop Any Medication-Induced Hair Loss?

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

I have been on propecia for about 6 months and it seems to have stopped my shedding. I read somewhere that Lexapro can cause hair loss. If i start taking Lexapro 10mg can it still cause hair loss even if i’m taking propecia?

The drugs that cause hair loss are not protected by taking Propecia. Keep in mind that Lexapro doesn’t cause hair loss for everyone taking it, but it is a possibility.

Tags: propecia, finasteride, hairloss, hair loss, lexapro, antidepressant

You Tell People What Products Won’t Work — So What Does?

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

I realize there are a lot of products claiming to “regrow” and “promote” hair growth. I also understand people that notice the loss and want to “nip” it in the but before it gets worse. You offer a lot of “No” that won’t work, “Buyer bewares”. People with hair loss, that don’t want to just accept it, need something that works. Even if it only helps some, it feels good to be trying and not giving up. I do not want to go bald. I have a feeling from watching my dad and brother go bald that it has something to do with skin build-up and regeneration blocking the follicles. Whether from hormones like DHT or Skin composition or both.

What do you think about Dr. Lewenberg’s formula? With both my dad and brother having the oiliest heads and dandruff on and off. How would the proven Minoxidil help if it can’t even get through the oil and build-up to improve the circulation?

There’s got to be something that helps, even if only a little. Like I said, some is better than none.

“Hope springs eternal,” says poet Alexander Pope. That is my view of the various hair loss remedies. There’s no cure for hair loss, and that’s what it sounds like you’re asking for. Medication isn’t guaranteed to work the same for everyone that takes it. As I’ve said over and over, the only medications I recommend are those that are FDA approved for treating hair loss — finasteride (Propecia) and minoxidil (Rogaine).

I’ve written about Dr. Lewenberg’s Formula before. Your focus on getting minoxidil through the scalp oil is not a problem if you wash your hair regularly. I don’t know where you got the idea that balding is caused by skin build-up, but that isn’t likely to be the case.

Tags: hairloss, hair loss, treatments, medication, drugs, propecia, finasteride, minoxidil, rogaine, lewenberg, fda

If I Were to Get Side Effects from Finasteride, When Might I See Them?

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

Hi doctor,
Am using finasteride (finpecia) for 7 months. So far i don’t have any side effect that usually tie with finasteride .So i want to know how long does it take to show side effect from finasteride normally.

I would expect that if you were to get side effects, you would have by now. Usually, the sexual side effects are noted within the first few weeks of use, but they only occur in 1-2% of people. For those curious, Finpecia is the name of the generic 1mg finasteride from India (it can’t be legally sold in the US due to patent laws).

Tags: finasteride, generic, finpecia, hairloss, hair loss, side effects

How Common is Hair Loss Following Gastric Bypass?

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

Hello Doctors,

I just read an article from a writer for the local paper about her 100 pound weight loss following gastric bypass, which is something I’ve considered doing for myself. One thing that stuck out to me was that she says, “One common post-surgery side effect is hair loss. And I have been losing my hair. I knew about this before surgery, so I am dealing with it. I don’t like it, but it will grow back, and I have also lost most of my eyebrows, but that too will grow back.” See article here.

So my question is, how common is this loss? Scalp hair loss is a problem in itself, but to lose my eyebrows too would be devastating. How long could something like this take to regrow (or will it not regrow)? My husband visits this site quite frequently and when I mentioned the story, he suggested I write to you. Thanks for your help.

A gastric bypass surgery causes weight loss and in many cases can produce signs of malnutrition. Weight loss is often associated with hair loss, particularly in men who have genetic hair loss. For women who do not have genetic hair loss, the hair loss may reverse as nutrition gets better and the weight stabilizes, but for men with genetic hair loss, it often accelerates the genetic process. For men in this situation, it’s best to take finasteride prior to having the gastric bypass, and maintaining this drug for life. Even with the DHT block offered by the drug finasteride, hair loss may still occur.

The good news is that hair transplantation can be used to replace the lost hair in the same way as in a person with hair loss that didn’t have the gastric bypass. As far as eyebrow loss, it would be unusual, but again, hair transplants into the eyebrow easily can solve that problem as well.

Tags: gastric bypass, malnutrition, hairloss, hair loss, eyebrow loss, weight loss

Is My Shedding From Propecia or Minoxidil?

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

About 3 weeks ago, I was prescribed generic finasteride by a physician (and told to use Rogaine, as well), but after I experienced some side effects he suggested that I stop the finasteride.

Since that time, I’ve continued using Rogaine and have experienced an increase in shedding which, while expected, is still pretty unnerving. I still have full coverage of my scalp for the most part, but my concern is that I’m shedding what appear to be strong, dark hairs rather than light, miniaturized hairs.

Should the quality of the hair I’m losing be a concern or is this type of shedding normal? Also, is it possible for the Propecia to still be inducing shedding even though I only took it for 9 days and stopped about 2 weeks ago?

If / when the shedding occurs with either medication (minoxidil or finasteride), it usually lasts no more than 3 months, often less. Be patient, wait it out, and stay the course. I couldn’t tell you which medication is causing it, though.

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