Do I Need to Apply Minoxidil to Every Single Thinning Spot?

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

Hey doctor,

I have been using propecia and minoxidil for nearly 10 months now and seen almost excellent results on the hairline but not on the crown (I know it is supposed to be vice-versa). I have two questions for you:

1. Because my hair is somewhat long, I use a dropper to apply minoxidil. Do I need to apply minoxidil on every single thinning spot (massage my scalp to distribute the medicine) or does it get absorbed on a wider area? For example, if I miss the thinning spot by half an inch, will I still benefit from the drug?

2. I have used this treatment called the Nanogen Serum VEGF. However after around 9-10 months of using it I thought it didn’t have any effect at all and quit. I have seen light shedding after quitting the medicine but so far it is acceptable. My question is, they published some sort of trial results regarding their product. I couldn’t make a lot of sense and therefore wanted to ask you before being skeptical about it. Here is the link to the study.

Thanks in advance!

1. First and foremost, you should read any instructions that came with the product. Many minoxidil packages come with some “how to” info. What you usually would do is apply topical minoxidil (Rogaine) to the areas you want to grow hair. If you put it on point A, you probably will not see growth on point B.

2. As with all products that claim to grow hair, my mantra has always been “Buyer Beware!” If you tried a product and it didn’t work, what makes you think a fancy study or a website will make a difference? It just means they used the money that they’ve made for better a marketing presentation.

As for that Nanogen study you linked to, it’s not published in a peer-reviewed medical journal and looks to be just a small test of hairs in petri dishes that sat in different solutions. There’s nothing in the study that shows the product is safe or effective.

Tags: hairloss, hair loss, minoxidil, nanogen, serum

Thymosin Beta-4

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

Is there any truth that a peptide called TB-500 also know as Thymosin beta4 help with thinning hair?

Not that I’m aware of. There was a mouse and rat study published years ago that got companies excited to start marketing Thymosin beta-4 as the next great “cure”, but such studies are a long way away from human proof.

I haven’t seen anything about it in recent years, which leads me to believe it went nowhere. If anyone has more current info, please feel free to send it in!

Tags: thymosin, tb-500, hairloss, hair loss

In the News – Suave Hair Loss Lawsuit Reaches Settlement

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

Snippet from the article:

Hair loss from Suave product causes Unilever to settle for 10.2 million dollar lawsuit. Women reported having their hair become discolored, breaking off, falling out in clumps and suffering scalp burns after using Suave Keratin Infusion treatments.

According to a report by Law 360 which was published on Feb. 10, in United States District Court in Illinois late last week, Unilever settled a class action lawsuit filed by consumers concerning their hair care product, Suave Keratin Infusion treatments.

The company reportedly agreed to pay $10.2 million. The settlement will be split into two separate settlement funds, a $250,000 reimbursement fund and a $10 million injury fund. Plaintiffs who simply purchased the kits and did not use them will receive a $10 refund from the reimbursement fund.

Read the rest — Unilever settles $10.2 million class action lawsuit

Tags: unilever, suave, hairloss, hair loss, shampoo

I’ve Used Provillus and Emu Oil for Months with No Success

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

I’m 17, 18 in 2 months, and I am a norwood class 3. My hairline is receded and the rest of my hair is extremely thin on the frontal, temples, mid-scalp and vertex. I’ve been taking Provillus for 3 months now with no success and emu oil for about 2 months with no success. I’m so depressed and i have to wear a beanie 24/7 now. All i want is to have my hair back, is there anything i can do?

You should really see a good doctor to get a treatment plan in order. At your age, finasteride works very well at reversing the hair loss. Nothing is guaranteed and I can’t say for sure what kind of results you’ll see. That said, I’m not surprised that Provillus or emu oil did nothing for you, even though it was only a few months of use.

The more time you waste with unproven products, the more hair you’re likely to lose.

Tags: provillus, emu oil, hairloss, hair loss

ZX42

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

There is a man by the name of Alan Tomlinson (at least I think that’s his name) and he created a product called ZX42. There are videos on youtube as well as websites that sell his product along with before and after pictures that can be found on said websites as well as on Google images, of course.

The marketing used to promote this product is pretty lame, but some of the results I have seen the customers have with it (not to mention the product creator’s own progress with regrowing his front hairline back) makes me unsure as to feel about this product.

Have you heard of this product or not, Doctors? Also, if ZX42 were shipped to you, could you analyze the product and see what, if any, efficacy it has in aiding and abetting in the regrowing of hair and such?

Thank you.

ZX42I personally hadn’t heard of it before, but the marketing for it does look pretty poor. One claim the product makes is “get all of your hair back in a year.” That’s a very bold claim and ultimately I’m going to assume it is complete BS. There is nothing that will bring back all of your hair, and if this stuff had an validity it would be the talk of the internet and medical literature. When I Google it, all I see are people calling it a “fraud” and “scam”.

We do not test products. We basically subscribe to the saying: “If it sounds too good to be true, it probably is“.

Tags: zx42, hairloss, hair loss

Are My Nose Bleeds and Watering Eyes Due to Toppik?

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

Hello doctor. I’m upset because i’m wondering if there are side effects in using toppik (me for five years). Sometimes i have my nose bleeding and sometimes my eyes are weeping. i suspect the ammonium chloride including in the product. For the past 2 years i’ve used a mask to put it on.

Also when i get up in he morning my mouth is very dry. My doctor also discovered a nodule recently in the thyroids gland. do you think all these
events are related with toppik? Perhaps nanogen is less harmful.

i thank you for your response

ToppikI would see a doctor about the nose bleeds and eye irritation. Certain substances can cause irritation to your eyes, but I cannot say if Toppik is the cause. If you’re getting Toppik in your eyes, perhaps another camouflage might do better for you, such as DermMatch.

I’m not sure why you would immediately point to Toppik as the source of dry mouth, nose bleeds, a thyroid nodule, and eye irritation. I’m not saying Toppik is not the cause. Perhaps it is, but there must be hundreds of other potential causes higher on the list than Toppik.

Tags: toppik, hairloss, hair loss

Measuring Density with HairCheck

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

Dr. Rassman

Thanks for all the information on your blog. Im 29 years old male with thick head of hair but was wondering about the Haircheck device. My dermatologist that I see every year looks and examines my hair and says its good with no signs of male pattern baldness or thinning. He told me that everyone has different hair patterns. Sometimes your hair transition from the front different which I have a frontal hair whorl which makes my hair go different directions.

You are always talking about the Haircheck device to get your bulk test done. I was wondering what is considered normal hair density for your hair not to be considered hair loss or thinning (male pattern baldness)? Is it 5% or 8% or below that? I now that you have to measure the back donor hair to get a good reading for the rest of the hair. Every video I’ve also seen of the Haircheck device they tell you to measure in the middle of the hair and the video shows it too. If you measure it from the hairline would your hair density be a little different than back even without male pattern baldness? If you do have 10% percent difference in the front or hairline than the donor hair in the back does that mean you’ll definitely be bald there or thin out there or could it stay like that the rest of your life possibly?

Thanks for your time and hope to hear back from you soon! Sorry if too long! Have a good Holiday!

Hair loss can be a very subjective thing. Measuring how much you are losing or gaining over a period time can be an issue if you do not have an objective metric. Using pictures with constant lighting may be good, but even with the same haircut and same hair style, subtle changes in angle and light can make your hair look better or worse. Thus using photos are a very subjective assessment.

We try our best to be objective by putting a value / number to things we can measure. We use miniaturization studies to give a general understanding of what is going on visually at the microscopic level, as the more miniaturized hairs you have, the more active your balding process is. Perhaps one day there will be a machine to count every single hair on your scalp with an analysis of the miniaturized hairs to good, healthy hairs

We also use the bulk measurement studies to estimate the bulk of hair at different parts of the head in a given fixed area. But all these tests have their issues and limitations. Bulk measurements can be inaccurate if you have gel or other products in your hair, giving a false high value. They also cannot be done if your hair is too short, as we can’t “grab” a portion of your hairs to fit in the caliper.

We do not measure the hairline necessarily, because we use microscopic assessment in the leading edge of a hairline. The HairCheck instrument usually measures an area behind the hairline. If you really want to measure the receding hairline, just get a tape measure and mark out the relative distance from a fixed point (such as your eyebrow or tip of your nose). Bulk tests are mainly used to compare the donor (back) hair against areas on the top and front of your scalp.
Read more

Proteins, Vitamins, and Minerals That May Help to Prevent Hair Loss?

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

Dear Dr Rassman,

I just finished reading the “Hair Loss & Replacement for Dummies” which was very informative and interesting reading. In chapter 9, there are references to suggested intakes of daily proteins, vitamins and minerals that may aid in hair loss prevention. Can you recommend some over the counter supplements that would contain the daily recommended dosages without having to use several brands at the same time?

Secondly, if there is no one type brand that supplies all the recommended proteins, vitamins and minerals, which ones and what dosages would you recommend to take on a daily basis?

Thank you in advance

Vitamins and minerals may be good for the hair, but it will not reverse or regrow hair for those with genetic balding. I do not have a specific brand of supplements I recommend; however, I found that many patients seem to take prenatal vitamins since they’re a good source of vitamins and minerals and a low cost alternative than the branded “hair vitamins” (and they are OK for men).

Despite what is advertised, there is no specific vitamin or mineral that is targeted for hair.

Tags: vitamins, minerals, supplements, hair

I Bleached My Hair at 15 Years Old and It’s Been Falling Out Since

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

(male)
I’m 17 and I’ve noticed that the hair on the top of my head has been thinning and falling out alot in the past two years. I strongly think that the problem was caused when I bleached my hair unprofessionally two years ago. After I bleached it and washed it off, I felt irritation and burning sensations on the scalp for about half an hour to an hour or so. What has happened to me and what can I do to prevent my hair loss? Also what products can I use to help?

Maybe the bleaching was coincidental to the natural genetic male pattern balding. Do you have a pattern to the thinning? In general, bleaching your hair doesn’t cause hair loss. If it did cause your hair loss, I wouldn’t expect it to reverse now that it has been 2 years since the insult happened. I don’t know of any products that will regrow hair that fell out from chemical damage.

I also can’t advise you without seeing you, or at least a set of good pictures.

Tags: bleach, chemical burn, chemical damage, hairloss, hair loss

Will Using Chemical Relaxers Always Result in Causing Damage Over Time?

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

(female)

Hi, I have been relaxing my hair for 10 years, I am currently experiencing hair loss (due to ringworm!) which has lead me into taking better care of my hair.

My question is: Is it possible to relax your hair for, say 50 years, without damaging your scalp, if you avoid burns? Or is it inevitable that you will experience some form of hair loss/acute damage? Most people I know of have some problem or other due to relaxers.

Thanks for any help you can give.

I don’t personally know too many people who relax their hair, so I am not the best person to give you a professional opinion about this. Most of my patients are men and they usually do not relax their hair.

Tags: chemical damage, relaxers, hairloss, hair loss

My Hair Continues to Thin, So Should I Try Microneedling?

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

Hello Doctor
Thank You for your time and effort spent on Balding Blog, it is very informative, I check it daily. I am a 51 yr old male that has had several transplants over the years. I currently use Finasteride and Rogaine daily. I have continued to thin in spite of making every effort, which is extremely stressful. I was interested in Microneedling. Is this something that one may do at home or does this require a visit to the doctors office. I live on the east coast just out side of Boson Ma. I would like to learn more about the treatment.

Thanks very much!

No doubt that my posting about the small microneedling trial piqued your interest. Unfortunately, I have little experience with the technique you asked about.

You can contact doctors in the Boston area and see if someone has experience with it. To find a doctor in your area, check out the physician search at ISHRS.org.

Tags: microneedling, minoxidil, rogaine, hairloss, hair loss

What Else Should I Be Doing to Treat My Early Hair Loss?

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

Hey Doc,

I started suffering from hairloss round the age of 21, I noticed some thinning and loss in the right side of my temple (strangely enough not the left). Anyways, I decided to act. I am now 24 and still have that hair loss on that side of the temple and also moderate thinning in my crown. So I went on a strict rampage of everything. I got Revita & Nirozal Shampoo, a 3 month supply of Rogaine, MSM and Biotion tablets. Is there anything else I should be doing?

You should have seen a doctor, gotten a diagnosis, and then probably started on finasteride (Propecia). A doctor’s prescription is required, but it would have probably stopped or at least slowed down the hair loss. Young men with early hair loss often have the best results from Propecia.

The rest of what you used and did was a waste of money and time, possibly aside from the Rogaine on your crown. Shampoos and supplements aren’t going to regrow your hair if you have genetic hair loss.

Tags: finasteride, propecia, nizoral, rogaine, biotin, hairloss, hair loss

Study – Microneedling with Minoxidil for Treatment of Genetic Balding

/by William Rassman, M.D./6 /,

Snippet from the study:

Hundred cases of mild to moderate (III vertex or IV) androgenetic alopecia (AGA) were recruited into 2 groups. After randomization one group was offered weekly microneedling treatment with twice daily 5% minoxidil lotion (Microneedling group); other group was given only 5% minoxidil lotion. After baseline global photographs, the scalp were shaved off to ensure equal length of hair shaft in all. Hair count was done in 1 cm 2 targeted fixed area (marked with tattoo) at baseline and at end of therapy (week 12). The 3 primary efficacy parameters assessed were: Change from baseline hair count at 12 weeks, patient assessment of hair growth at 12 weeks, and investigator assessment of hair growth at 12 weeks. A blinded investigators evaluated global photographic response. The response was assessed by 7- point scale.

Read the rest — A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia

DermarollerThere is an interesting pilot study that looked at the use of minoxidil and wounding in 100 balding men. Using a microneedling instrument (a dermal roller) and 5% minoxidil the following results were reported:

“In the Microneedling group, 41 (82%) patients reported more than 50% improvement versus only 2 (4.5%) patients in the Minoxidil group. Unsatisfied patients to conventional therapy for AGA got good response with Microneedling treatment.”

I was not surprised that some value for this combined treatment showed some effectiveness. I personally wonder if this is the type of service I should offer. I would appreciate your feedback.

Tags: dermaroller, microneedling, minoxidil, rogaine, hairloss, hair loss

Could I Be Allergic to my Chemical Hair Relaxer?

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

Hello,
I am experiencing hair loss in the crown of my head the size of a quarter. I am an african american woman. When I keep my hair braided with no chemicals, the hair grows back, so I know that it has the ability to grow. When I put a relaxer on my hair, I experience itching from within in only one area, then a month or so later the hair will fall out, but it only comes out in the same area. Could I be just allergic and sensitive in only one section of my hair. What do you recommend?

Yes, an allergy would be highly probable. It might also be a chemical burn. I have no suggestions other than speak with your stylist or your dermatologist.

Tags: allergy, chemical burn, hairloss, hair loss, relaxer