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Dear Dr. Rassman,

I understand that hair cannot be donated from another person, yet why is it possible that organs can be?

I was reading an article today, Doctors Report Transplant Breakthrough, that mentions the possibility that organ recipients could one day not have to take anti-rejection drugs the rest of their life. If this prove to be true, can hair transplants from other people be a reality?

Unless the genetics are a perfect match, any organ that is transplanted (including hair, which is an organ) has until now forced the patient to take drugs to knock down the rejection process. The reason that a hair transplant works is that each person is his own donor and therefore has perfectly matched genetics. The drugs that you take for controlling organ rejection from a heart or kidney can kill you, but not having a heart or a kidney will kill you anyway. Rejecting hair from another person won’t kill you… just leave you bald and it it 100% certain that the hair from another person will reject.

The five patients in this article all had kidney transplants and were on anti-rejection medication for a period of time and have received marrow from the donor. I would not want to be the first volunteer for such procedures, and the relationship between these patients and a potential to harvest hair from others are decades away.

my son has alopecia. i was woundering if that has a risk on life and is it dangerous. he is barely 9 years old and has extreme bald spots and lots of hair loss. i want to know if its like cancer and what the difference

Without seeing photos of your son or knowing anything about his medical history, it is difficult to tell, but from the brief description you gave, it does sound like he has alopecia areata. This is a condition that affects about 1-2% of the population with initial presentation in the teenage years. It is not contagious and is thought to be an autoimmune disorder, and not cancer. It is an inherited process. Since the exact mechanism of hair loss is not known completely known, there is no known cure to date, but in the hands of some specialists who focus on this disease, there are some effective treatments. In 90% of cases the hair will ultimately regrow. It would be wise to have your son seen by his primary care doctor to determine if there are any potential underlying causes of his hair loss and a dermatologist for possible biopsy.

Since taking propecia for three months then switching over to avodart for a further six months, i seemed to be very agrivated all the time and angry to the point were i was arguing and getting into fights. Is there any connection with this and taking avodart.

Why the switch to Avodart (dutasteride) from Propecia (finasteride)? Propecia is the only FDA approved oral medication for the treatment of hair loss. Avodart is not. If the Propecia was working well for you and had an acceptable side effect profile for you, you should go back to using it. Avodart has not been shown to help with male pattern baldness better than Propecia unless the dose is three to four times higher than recommended dosages and even this information is suspect. Since it may be causing you severe emotional issues, you should strongly consider stopping this medication. We do on rare occasions see personality changes with these drugs. You may also consider talking to your doctor or therapist about your anger issues if in switching, your anger has not subsided.

I am 52 years old (male) and have pretty good hair and after taking Prilosec for 2 months and then changed to Nexium for another 3 months, my hair has become quite thin. I have three questions.

1. if I stop the Nexium, will my hair recover back to what it was?
2. what alternatives are there to Nexium or Prilosec?
3. are H2 blockers better to your hair that the PPIs?

1. Your hair will probably not come back, but please know that your hair loss may not even be associated with these medications.
2. Sorry, you’ll need to ask your doctor about any alternative drugs. I am not your doctor and do not know your medical history.
3. Again, you’ll need to pose these questions to your doctor. I am not a GI doctor or an internist.

If these medications are the cause of your hair loss, stopping them may help to stop further loss, but these are rare side effects. Please do not discontinue or change your medication without consulting your prescribing physician.

I had a Hair trasplant procedure 5 months ago and i recieved a email from the clinic which read;

By now you should be starting to see some of the results from your procedure with us. Please forward pictures for your file, and any questions you might have. What type of hair products are you currently using? Don’t forget our referral program, we will pay you £500 for every patient you refer that has a procedure with us.

My question is, is it normal for a clinic to pay a client money if they refer a patient to there clinic for a procdure.

This may be different depending upon the country, but to my knowledge it is illegal in all of the United States. Despite this, the practice is unfortunately common not only for patient referrals, but for hair dresser and other stylist referrals, though if a doctor is caught, he/she could lose their license to practice medicine.

Hi Doc,

I am 27 year old male. I had some degree of success with rogaine foam. But I stopped using it about four months ago as I was experiencing increased eyebrow hair growth. I made sure foam would not drip or reach eyebrow hair and despite this, I still continued to see more eyebrow hair. I am thinking to start the foam again. Do you think rogaine foam grow eyebrow hair? Or Am I seeing increased growth because of genetics?

Thank you

Since it seems you have been careful not to let the Rogaine (minoxidil) reach the eyebrows, it is likely that you are absorbing the medication into your body. Rogaine works by getting into your scalp and hair follicles to stimulate hair regrowth, but from a historical viewpoint, we know that it grows hair when it was used to treat high blood pressure some years ago.

can propecia cause constipation? thanks

This side effect is not published anywhere, so I would doubt a connection. You should look to other causes.

Just wondering if you could speak about the HairDX test and whether it is useful to use for men who want to know how severe their future hairloss will be.

My knowledge of HairDX is limited to what I can find on the Internet (not much outside of their official website and official press releases). Assuming HairDX works and does give you an accurate genetic testing profile, why would you want to spend $149 when you can get a free consultation with a doctor? I guess some people just don’t want to meet with a doctor at any cost. Furthermore, I personally base my medical and surgical recommendations on a physical examination, history, and a miniaturization study. I would have a hard time recommending surgery or medication (Propecia) for men who show no signs of balding, but do have a positive genetic test.

It is nevertheless an interesting test from a marketing and consumer perspective and as more genes are identified that contribute to the hair loss process (MPB), then this approach may help us find better treatments and possible cures for genetic hair loss.

You’ve mentioned in the past that alcohol and finasteride is safe.

But…is it as effective? I know some other drugs are less effective if you have alcohol in your system…something to do with the liver or kidneys working overtime to filter out the alcohol, and being unable to really focus on absorbing all the finasteride.

Any reason to be concerned?

It really depends how much alcohol you drink. If you drink to a point of a drunken stupor every day or have cirrhosis of your liver from all the drinking, or have dietary deficiencies associated with your drinking, I would think many things are not safe.

From a biochemical point of view, both alcohol and Propecia (finasteride) are metabolized in the liver by an enzyme called cytochrome P450 (Cyt-P450), so there is definitely an interaction (as with many other drugs). If you have one or two glasses of wine with dinner, I doubt it would be a problem.

Dear Dr. Rassman,

I think it is great that you have this blog. I am sure I should come in to see you for a consultation, but first I’d like to see if you can shed any light on my particular circumstance. I am extremely healthy, eat mostly fresh fruits, salads and soy protein powders, but also eat meat, whole grains et cetera. I have worked-out for 25 years and handle stress better than anyone I know (all my friends and family say that too). At the end of June, 2006, I returned from vacation and my THICK, beautiful hair started falling out FAST. In one month I had lost so much it looked like I was going bald and one could easily see my scalp, which was an impossibility before that. The only 3 things I could think of as a cause for the rapid fallout were the following: 1. a very STIFF, THICK, HARD hair product which I had begun using 2 months prior. 2. I had begun taking 12,000 mg’s of fish oil daily upon returning from vacation. 3. A stressful life incident, but I have had so many of those, it doesn’t seem likely that another would affect me. Anyway, I stopped the product, stopped the fish oil, and my stress has increased if anything. By about 6 months out, my hair started to return, but no where near what it had been. People who look at me think I have a good head of hair, but I know it is not what it was. I want it back. Super thick like before. In what I wrote to you, can you identify anything that may have caused this rapid fallout? Or do you think it is best I just come in so you can see my scalp?

Thank you for your time, and have a great day.

I really do not have a good answer for you. Your hair loss could be due to many factors and sometimes a stressful event (emotional, physical, chemical, etc) can trigger a hair loss process. Nobody really understands why, but it is thought that a genetic ’switch’ is turned on and once it is turned on it is difficult to go back to your original state. If your hair loss is due to genetic causes, there are medications such a Propecia (for men only) than can slow the process or even partially reverse the process in the best case (though it will rarely bring your hair back completely).