Low testosterone and overweight

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

I discovered a few months back that I have a testosterone deficiency which I have a feeling is caused by my lifestyle (very sedentary, was overweight/obese for many many years, no exercise at all for most my life, bad food decisions and my sleep often all over the place) I’m getting my life back on track now to hope improve my T levels, but my main question is.. does having low t with the combination of taking 1mg a day of fin for hair loss cause any potential problems? or since fin lowers dht and as a result makes your t levels rise slightly, would it generally be irrelevant either way? I’d love to hear your thoughts

It may be irrelevant. Be careful about rapid weight loss as it is a trigger for a balding event if you have the genetics for balding

Finasteride side effects

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

Ive been on oral fin for 11 month and I got severe sexual side effects.  Can I switch to the oral and avoid them?

The non-liposomal topical finasteride will go though the skin into your system. Don’t think that because it is topical, it stays there

Depleted Donor Area from Turkey Clinic

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

This man had a lot of hair removed from the back of his head and his neck that is not permanent hair. So much came out, he has little hair left in the back of his head and may of the transplanted hair will eventually fall out. He is also left with no reserves to cover future loss.  This was done by someone who didn’t understand how to properly calculate the limits of FUE.  The pictures speaks for itself

 

androgenetic alopecia, how it happens

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

I haven’t found answers to some questions which I would try to describe as clear as possible.  Androgenetic Alopecia causes miniaturization of hair follicle.  I’ve read that miniaturized hair follicle has shorter anagen phase and spends rest of the time in telogen phase.

androgenetic alopecia can cause miniaturization or hair loss without miniaturization. In the later for, it goes into telogen and never comes back

1.5 years after FUE

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

This man has the scars that are typical of Follicular Unit Excision (FUE).  I drew a line separating what is scalp hair and neck hair.  Neck hair is not permanent, so many of the grafts that were taken from the neck (below the line) may disappear in the years to come.

melatonin and hair loss

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

I’m taking oral melatonin everyday and experiencing hair thinning not sure if it’s because of the oral melatonin of everyday use, would you happen to know if this could be the reason behind it since it’s a hormone pill type of thing? 

There is no clear answer to the relationship between melatonin and hair loss or hair growth. I found references both ways. But you might try stopping it and see what happens.

afraid of taking minoxidil

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

Ive been using topical minoxidil for 3-4 months and theres no results . but ive noticed facial bloating , slight wrinkles on forehead, and bad eyebags. Considering im only 19 this is a big thing for me and im thinking of quitting minoxidil since my doctor just prescribed me Dutasteride and ive been on it for 6 days. she also offered oral minoxidil too. But i rejected the oral minoxidil because of the side effects . Do you guys think Dutasteride itself will be okay for a diffuse thinner like me? As ive made up my mind that i dont even want to risk the minoxidil side effects and even the hassle of applying it twice a day and making my hair look like complete poo poo. Let me know your advise or experiences from minoxidil!

life is full of choices and each choice has an up and down side. You have to navigate these variables and weight it against the value you get from one vs the other

Hair loss without miniaturization

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

I’ve never heard about AGA without miniaturization and with permanent telogen. How it’s even possible, what’s the underlying mechanism?

Some researchers believe that starting off the anagen cycle may be part of the AGA problem. Some men who go into telogen and catagen just don’t then pick up their anagen cycle. This will produce hair loss without miniaturization and we call this Apoptosis (death of the follicle). Maybe it is still alive in the stem cells that are sitting there, but if the hair doesn’t grow, how are we to know?