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Hi,
I have read of reports that British scientist have linked weigh training to hair loss. Would you know if this is legitimate and if so would it effect individuals who are not genetically susceptible to hair loss. Here are some links: The Sun and UPI

Regards

Do most bodybuilders look bald to you? Do most men at gyms look more bald to you? You are asking me my opinion on an article from a gossip tabloid from the UK that features nude girls on page 3. Moreover, the articles reference that scientists have concluded this exercise/hair loss link, but do not quote a source. Both articles have the same single quote from a medical group with no published study or even a scientist’s name to attach the quote to.

The most common cause of balding in men is genetic. Personally, I’d rather be fit and in shape rather than flabby, fat, and bald… so both Dr. Pak and I work out to address the fat issue, and both of us take Propecia for tackling balding.

Should teenagers be proactive about their hair i.e. can they take propecia as a safeguard against losing their hair in the future especially if both parents have experienced hair thinning? At what age can young men take finasteride?

The best way to be proactive is to get serial mapping of the scalp for miniaturization. When early hair loss occurs, the use of finasteride may be a good idea. You will need to get medical attention for this process.

Propecia studies that lead to the FDA approval were conducted on men age 18 and up, but if a doctor should prescribe to a 16 year old, for example, that is up to him/her ultimately. I would never recommend just popping a Propecia pill each day or applying minoxidil if you have no hair loss.

Hi,

I’d like to hear your input on this new theory that the weight of the scalp might be the cause of hairloss. Mediafire.com (Don’t worry it’s just a .PDF file)

If the theory is indeed true, what new approach should we take toward MPB?

The article was published in a journal called Medical Hypotheses, which does publish fringe ideas and speculation. There’s a summary of the article here.

This theory is new to me, but really makes no sense whatsoever. We are always looking for something that is not there when we are confronted with something like hair loss that we can not understand.

Hi,

Have you heard any recent news on the robotic hair transplant procedure from Restoration Robotics? I had read a while ago they were conduction clinical trials at the end of this year, but haven’t heard anything since.

Do you know if they are accepting volunteers for the clinical trials? If so I’d be interested in participating.

Thanks

The last I heard was that they were moving forward with clinical trials on a limited basis, and a Google search reveals that they were hiring for a clinical trials manager just a few months ago (see job listing). There’s info about the trials in a posting at HairSite, although it is from about 6 months ago. Unfortunately, Restoration Robotics doesn’t have a website, so it’s difficult to find a central location for their current news.

I’m 22 years old with early frontal hair loss confirmed with a miniaturization test. Right now I’m a NW2 but going up if I don’t stop this. I’m 5 ½ months into treatment with Propecia and nothing got worse since being on it. For the past 2 months I see way less hairs in the shower and during styling. And now I noticed a little thickening in the left side of my mid anterior which is good. But at the same time I noticed very little loss in the right side of my mid anterior as well. What is going on? Is this normal or very bad? This got me totally freaked.

We do not bald evenly, and if you are experiencing regrowth from Propecia it wouldn’t surprise me to learn that it isn’t thickening the hair perfectly even, either. Don’t get freaked out, this is normal.

Story time! Although I can’t provide photos (by patient request), I’ll do my best to paint the picture…

A man in his early 20’s flew to Los Angeles from Alaska to see me last month. He already had two hair transplant procedures using the follicular unit extraction (FUE) technique — one surgery of 1,000 grafts, and another of 3,000 grafts — by two different doctors (that I won’t name) who each claim expertise in this process. The 1,000 FUE case by the patient’s estimate was about 50% successful, while the 3,000 FUE case had, according to the patient, no growth after a year. The donor area was heavily scarred from the FUE extractions and were easily seen by lifting up the hair. A strip procedure would have produced less scarring than this patient showed now. To compound the problem, those hairs that did grow from the first surgery were placed in a radial direction (like the spokes of a bicycle wheel) and the hair pointed to the sides, not the normal frontal position. So not only was he dealing with a huge failure of growth, but now he had to deal with poor placement for those grafts that did grow! Imagine a person with hair growing out of his head like the spokes of a bike?

This patient most certainly had a low donor density to start. I recommended a strip surgery to harvest the most grafts he can get and with the reduced donor density, I recommended about 1,300 grafts, which is possibly the most I can harvest. Fortunately, his hair loss was only in the first 1 1/2 inches of the hairline and by taking Propecia he might hold the rest of his hair in place, although there is miniaturization behind the frontal 2 inches, suggesting that he might bald further over time. He wanted to look normal, but I could only suggest that I would try to make him look better.

FUE is not a panacea for scars. As I have said here before, the follicular holocaust that is seen in FUE is substantial, even in the hands of those who claim success. This is a buyer beware market. You should always ask to see a number of patients who had the procedure and look carefully at the donor area. Another FUE procedure on this patient will be disastrous (even in my hands), as scarring is clearly a problem.

Hi Doctor,

I know you’ve touched on this about a year ago but it wasn’t really answered so I’ll ask again, plus I’m sick of reading and hearing from all these hypochondriacs who seem to clog all Hair Loss forums telling me how I’ve ruined my sex drive forever!

Im 23 and I’ve been on Propecia for 4 months. I’ve noticed I’ve gradually lost my libido so I cannot tell you exactly how long it has been a problem for - possibly a month or 2? If I skip a day’s dosage it returns almost back to normal. I do not want to stop taking it as it has stopped my hairloss and i think even thickened my hair - not to mention it’s positive physcological effects!

My questions are:
- Does my libido return to normal while still taking Propecia or is it a permanent side-effect? and,
- Are there any pills I can take (perhaps Horny Goat Weed) that will counteract this loss of libido until (if?) it returns to normal?

Thanks Doctor.

Merry Xmas and a Happy New Year!

Loss of libido with Propecia occurs in about 1% of the male population. Of those unfortunate men who experience it, many will see that is disappears in a few months. Taking half the dose still gives you the benefits at the 80% level of a full dose, so cutting a Propecia tablet in half may be a solution for those that see (or think they see) side effects. Check with your prescribing doctor.

I do not know much about Horny Goat Weed, but then again, I have not treated any horny goats lately. Har har. As for libido pills, well, I don’t have much to offer so I’ll open the floor to the readers. If anyone has any libido remedies that you’ve tried (including supplements, potions, etc), I encourage you to post about it in the comments below. I’m curious to see what people have tried. Keep the purely spam comments out though, please.

Hi

I’m thinking of having a hair transplant done but I have a question before I bother to consult with you.

I attend college and with college come wild parties. I spend most of my time studying but I do go to atleast one part per month. I usually like to do cocaine at the party. I do this recreationally and it’s only one time per month at most.

I don’t think I would be able to give up my one party per month for a hair transplant. Is it safe to get a hair transplant if you know you are going to be doing a gram of cocaine every month for the post operative period?

Oh boy. So as a physician, did you expect that I’d be fine with telling you its alright to use cocaine at any point, let alone during your post-op period after a hair transplant procedure?! Come on, now. The obvious answer is to stop using illicit drugs, even if it’s just once a month. Cocaine is not only illegal, but it can also kill you.

I’m not your doctor, but I expect any doctor you talk to will have the same reaction to your question. Now that I’ve given my mini-lecture, here’s a link to another site where another physician has his take.

I had my first transplant almost four years ago and my second one last October. I STILL have redness on my right side from the FIRST transplant. It is almost as if I got sunburned and that area stayed burned. It is not really bad, but it is bad enough that the transplant area still looks “outlined” making it look a little unnatural. The other aspects of the surgeries are spectacular, just have this one issue. Is there anything I can do about it? Thanks!

This is the type of question you should be asking your surgeon. Redness can be helped with the judicious use of topical steroid, but this is not a good idea without medical supervision as the body can absorb the steroids if you use too much of it. Also, the redness should not last that long — certainly not years, as you describe. Please discuss this with your surgeon.

Hi,
My Dr gave me a prescription for propecia for my hair loss. He was not willing to write for proscar for me to split. What options do I have? Can I send my script to be rewritten to someone out there who is willing to write for the proscar?

You can always seek another opinion from another doctor. There are those that focus on patient finances and those who do not and tend to be more rigid (a proper approach, of course). Proscar and Propecia are the same medication in different dosages, but it is up to the doctor to prescribe it to you.