Drug development with Amplifica

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

 I am wondering if there may be any photos released from the amplifica trials. I really am hoping this product is successful. I cannot tolerate 5ARI’s so any nuggets you can share about the research would be incredible.

Unfortunately, even if Amplifica had the answer to your problems, it would have to undergo more clinical trials and then turn the drug into a real product. This second phase is often done by pharmaceutical companies, who would get involved in that process. We are a long way to that point. In addition, Amplifica has other medications in the pipeline, and they will have to go through clinical trials, as well. All that takes a lot of money. Not easy to get from where we are to what you want.

Age Related Thinning and changes in the beard

/by William Rassman, M.D./0 /
Does our beard also decrease in its active follicle count in old age?  And if yes, is it to the same degree as the decrease in the hair at back and the sides of the head, or less?
I don’t know the answer to that question for sure. I developed Age Related Thinning on my scalp. I suspect that in some men, the beard may change with age as well but I have not seen that in my practice.  My hair changed 7 years ago but my beard did not.

Downs syndrome and hair loss

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

Hi, i was just wondering can men with Down Syndrome go on fin, min and niz? There is a huge percentage of young bald men with Down Syndrome not helped by the fact their predisposed to have a higher chance of balding than other men. In light of that, I would have expected there would have been a huge worldwide campaign to raise awareness about this to their parents and siblings getting them to care for their son and/or brother’s hair. Perhaps though they are not medically advised to take any of these hair loss combatants.

Downs syndrome men are no different than the rest of us when it comes to balding and treatment

Europe investigating hair loss drugs

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

https://www.ema.europa.eu/en/medicines/human/referrals/finasteride-dutasteride-containing-medicinal-products

Governments continuously investigate medications, especially medications like various hair loss drugs that are known to have significant health side effects.  The US FDA has done this as well for drugs like finasteride.  We must wait for their conclusions before drawing any of our own.

Female Hair loss After Cancer Chemotherapy

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

The loss of hair frequently follows chemotherapy.  This can often be protected using a “Cold Cap,” an iced hat that reduces blood flow to the scalp during chemotherapy.  I have had two members of my family treated this way with the Cold Cap, one following breast cancer and the second following lung cancer.  Both kept most of their hair during chemotherapy.  In this particular woman, she should wait a full year before considering a more aggressive treatment.  Drugs like Finasteride or Oral Minoxidil might reverse it.  Microneedling may add value as well.  Also, Scalp Micropigmentation works well for this type of hair thinning as a short-term solution that will give her instantaneous results.  

Wall Street Journal March 13

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

Hims and other telehealth firms make finasteride easy to get and don’t have to disclose side effects in ads

Mark Millich said he suffered serious side effects after taking finasteride pills from Hims.

Mark Millich said he suffered serious side effects after taking finasteride pills from Hims. Photo: Greg Kahn for WSJ

By Rolfe Winkler

March 13, 2025 5:30 am ET

  • Telehealth companies are aggressively marketing hair-loss medications to young men. Some of the patients said they had serious side effects and didn’t realize they were possible.

  • Finasteride, the generic name for Propecia, is widely prescribed but has been linked to serious side effects in some men, including persistent sexual problems and suicidal thoughts.

  • Telehealth companies say they disclose side effects and other risks on their websites. They say clinical studies show finasteride is effective and side effects are rare.

Mark Millich, 26 years old and insecure about his thinning hair, was curious about the ads he saw promising to reverse his hair loss. He completed a 14-question intake on Hims.com and received a bottle of finasteride pills days later. He never spoke to a doctor.  ……………………………….

As I discussed yesterday, my experience with finasteride is not the same as reported here; however, the report discussed telemedicine without doctors involved and the use of a product that contained finasteride and other medications.  I will not comment on the product as I have no first-hand knowledge of its use; however, I caution anyone who wants to treat their hair loss with medications to do it under the supervision of a good expert doctor in the hair field to avoid, prevent or manage complications.  Even drugs like topical Rogaine, at higher than recommended doses, can put someone into heart failure if used improperly,  higher dosage than recommended, or just as a consequence of taking it (rarely).  

Hair loss drugs can have bad side effects

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

Hair loss drug finasteride can cause debilitating side-effects, men say | CBC 

https://www.cbc.ca/news/health/hair-loss-drug-finasteride-side-effects-1.7483898

Comment:  Post finasteride syndrome, a condition that is associated with finasteride, seems to be much more rare than this article suggests.  I have always told my patients that if they get symptoms to always call me.  I usually discontinue the drug quickly. Dr. Bob Haber from Cleveland Ohio, studied this problem (see: https://baldingblog.com/comment-against-my-reporting-of-dr-habers-article-on-finasteride/). With feedback from over 50 doctors who have written prescriptions for well over a half million men, the conclusion was that they didn’t see post-finasteride syndrome if they stopped the drug relatively soon after starting it when these symptoms appeared.  The drug has helped many men with controlling hair loss in my hands, for decades. 

Folliculitis presenting before a surgery

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

This man has what appears to be a chronic folliculitis. A transplant should not be done on him.  He needs to be treated with appropriate antibiotics and should be clear of infection for at least 2 months before a hair transplant can be considered.  Folliculitis with a hair transplant can wipe out the grafts and cause a failure of the transplant, so proper treatment is critical.  I might even add a biopsy to confirm that there is no underlying disease in this man such as folliculitis decalvans, an autoimmune type of infection that is very difficult to control. I pointed to various clearly inflamed hair follicles in the photos with white arrows. Click on the photo to enlarge it. 

Depression on finasteride, what about heart effects on minoxidil?

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

I have started taking Fin 1mg for the past 20 days. I was suffering from mild depression, nothing serious, but the last few days, I have had more depressive thoughts. Does finasteride cause or increase depression?  If I switch to oral minoxidil, then the risk of heart problems frightens me.  How do I manage between these two drugs?

No drug is 100% safe.  Men who have depression might consider not taking finasteride and try oral minoxidil as an alternative drug, as finasteride can induce depression if you are prone to depression. If you take minoxidil, you should watch out for side effects such as shortness of breath, unusual fatigue, swelling of the feet, and bouts of rapid heart rate. Look up the side effects on Google.

 

“You have a bald spot”, I was told

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

I’m 38, topical fin/min/tretinoin user. Have seen some excellent recovery and regrowth which has given me so much confidence. I know this because I think less and less about my hair being thin. I have accepted there won’t be a full recovery and I’m at peace with it. Visited my brother and family at the weekend, I was sat with young niece on my shoulders and out of nowhere, she shouts out “you have a bald spot” whilst in the presence of friends and family. I was just like “cheers for that” and have thought it about for the past couple of days. I know it will pass, where I have this self-confidence issue but this isn’t the first time it’s happened – someone at work pointed it out as they walked behind me past my desk. “You’ve got a bald spot”. Thank you so much for that, I’m really glad you brought it to my attention, I will now think about this for the next few weeks.

My kids told me, when I was driving, that I had a bald spot and made fun of my Friar Tuck crown balding. I had it transplanted when I was in my 50s.

Feminizing to get hair back

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

2 months of difference with estradiol and spiro (4 months total w/ estradiol & spiro; 4 years of minoxidil and finasteride) (you should not take estradiol or spiro if you look manly and want to continue looking manly)

Adding medications that feminize your look, may bring back your hair (as seen here); however, this is an extreme way that should not be used for most men unless they are interested in feminizing their loss.  This patient returned to their juvenile hairline at the expense of possibly other changes, including the possibility of breast development of loss of male libido.