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I’m in my mid-20s and began taking Propecia about 6 months ago. I was quite scared of the possible sexual side effects before I started the medication, and after 2 weeks on it, I think I experienced the erection troubles. A couple weeks later, the side effect went away. I went for a few months with no sign of symptoms, no problems with maintaining the erection… until I started seeing a new girl. We fooled around a few times and I didn’t have any troubles whatsoever. Then one night she got a little liquored up and we started to mess around. I was rock hard, but after several distractions I went to half mast. Since she’d been drinking, I think she just figured my problems in the bedroom were due to that. Like maybe I didn’t find her attractive when she was drunk or something.

The next day I got some Viagra from a friend so I wouldn’t have to worry about my performance and ever since then I’ve been using it whenever I thought I’d need it. But if I don’t take that blue pill yet and we start to get frisky, I start to wonder if I’d be able to keep it up. So is this just a case of me worrying about things too much, or could this be from the Propecia? I don’t want to have to constantly worry about taking a pill before I get physical with a girl.

It sounds like you could be willing yourself into having problems like this. I mean, it sounds like you got so worked up about the possibility of side effects that you had a nocebo response. It could be from the Propecia, but erectile issues occur in less than 2% of men and the vast majority of claims made on the internet are unsubstantiated, so that percentage can seem greater than it is if you rely solely on fear-mongering web forum posters. The 2% number comes from actual medical studies. The erectile dysfunction symptoms can occur in adult men of any age without a medicinal cause, particularly in cases where you have a new sexual partner (or maybe even alcohol in excess). It’s not uncommon, but it’s just not something younger men… or men of any age… will openly share with their friends.

Talk to your physician about your own prescription for Viagra or a similar drug if you’re really concerned, and you should let him know that you’re taking Propecia (or go to the same doctor that prescribed that to you). You may want to experiment with Viagra when and if you get a steady girlfriend so you can sort through the psychological effects and the physiological effects. When men take Viagra and build psychological dependencies, that tends to take the fear factor out of sex.

hello doc, I have to questions

i recently had a HT via FUE on thursday, today is tuesday so it has been 5 days so far. I have been wearing a hat and realized that it was breaking off a few transplanted grafts. When I look closely the stub of transplanted hair is still in my scalp but the rest of it has broken off. Do you think I killed my grafts this way?

Another Question. I washed my hair on friday night (next day after ht procedure) but then i read some where that I wasn’t suppose to wash it for 3 days. Could washing my grafts with a sponge and water next day after HT damage the grafts completely?

Thank you for your time

I suppose if you see stubs of hair follicles out of your body with bulbs on them, it could reflect grafts and if that’s the case, what you lost will never grow. I’m really not sure what you’re seeing. A tight hat can pull out grafts, though the grafts should’ve been secured by the 5 day mark. I don’t know enough about your surgery — like where you had your hair transplant or what was really done.

You can wash your hair 12 hours after the surgery. As always, I am happy to answer all questions, but sometimes questions like these bother me. Why are you not asking this to your doctor? Why haven’t you got instruction on how to wash your hair after a hair transplant? Special instructions should’ve been supplied to you for the washing technique.

Hello Dr Rassman, I was wondering how you can tell if new hair is growing. I had Telogen Effluvium starting in october or so and it has stopped and i can only see new growth right at my frontal hair line. I am also using retin A and it gets applied around there so im not sure if it is the retin a regrowing the hair or my hair is growing everywhere. IN SHORT: Is it possible to see new hair growth mid scalp amongst long hair.

Also, Im unclear about when people say hair may not regrow from TE. Is this only if the people were going to bald within the next few years, in other words will hair always grow back from TE so long as you have no predisposition to genetic balding .

With telogen effluvium (TE) you will likely regrow the hair, but in some people it may not always grow back to the full thickness you once had. In your case though, you stated that you are seeing new hair growth. So there you go! If you want to see it under a video microscope, these new hairs show up well. Logically if you are seeing short hair growing amongst long hair that would be new hair growing, right? There is no big secret to seeing hairs grow.

With respect to Retin A, I doubt that is causing the hair growth, as it is an irritant.

Snippet from the article:

A man who tore the wig off a telegenic Taiwan legislator last year was sentenced to five months in jail for depriving the MP of his freedom to look good, a court spokesman said Tuesday.

The Taipei District Court sentenced Huang Yung-tien, 50, to jail for snatching the toupee off the head of ruling Nationalist Party lawmaker Chiu Yi. Chiu has become a household name for his media-friendly offensives against the political opposition.

Read the rest — Man toupee for revealing bald truth

The freedom to look good! I love that. I guess this actually happened in December of last year, but the article is about the man’s jail sentence. Seems a little harsh, but I’m no judge in Taiwan. The photo I included above is of the wigged man in question.

I am a woman who was taking avodart for hair loss. I took this for approximately 1 year, with no visible results. I stopped taking avodart in January this year.

I am thinking of becoming pregnant. How long to I have to wait before avodart is completely out of my system? I understand this drug has a long half-life.

Check with your doctor. The half life of this drug is about 3-4 months, which means it may hang around for a couple of years at some level in your blood stream. Dutasteride (Avodart) is known to produce sexual development problems in the first trimester of pregnancy when taken by women.

My hair has been pulled out in a fight 12 weeks ago & is showing no signs of growing back. Please can you advise

I would expect that the hair should regrow within 4-8 months of the incident. Be patient and wait it out.

I am male and in my late 20’s and starting to see that my hair is thinning. I was on propecia for a very short time and had to stop do to side effects(breast pain and ed). I tried cutting down the dose (without stopping) but the side affects continued. I’ve read on a few sites including wikipedia that Sweden claims finasteride has permanent sexual side effects. Has anyone found something to take with propecia to eliminate or block side effects? If you think I should give it another chance how would you suggest I go about it? I don’t want to take minoxidil because how it works is fairly unknown. If topical Spironolactone works for acnea doesn’t that mean it does absorb into the skin enough to compete with dht receptors? Topical spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands: an autoradiographic study in subjects with acne vulgaris.

If I decide to try topical spiro, is it something my gp can prescribe? if not could you varify if the much talked about Dr. Richard Lee is credible (or atleast not another scam). I’m not opposed to a hair procedure but because I’m just starting to thin I’m not sure how and how often it would be done and the cost. I know this was lengthy but it’s much appreciated

I do not know of anything that will block the possible breast and erectile side effects of finasteride that a tiny percentage of men will see. If you experience erection issues, Viagra or Cialis will likely solve that. For my patients that might see a side effect (real or otherwise), cutting the dosage is better than stopping it completely. In other words, some finasteride is better than no finasteride if you want to treat your hair loss. Most men will choose the hair transplant approach if the side effects are a problem, but the risk of shock loss in young men with transplants is the other side of that coin.

Spironolactone is a prescription medication, so while your doctor could prescribe it to you, he/she might not be willing to do so. That article you referenced is over 20 years old, and spironolactone is still not a popular hair loss treatment for men… so that should tell you something about it’s effectiveness. And as for Dr. Richard Lee, he has a number of customized minoxidil and finasteride treatments for sale via his website, one of which I have written about before.

Dear Dr Rassman,
I recently had about 420 grafts put into a scar that was about 10mm wide and 100mmlong. Some of the hairs that were implanted in there (this is from about 4 months ago) are still in there. They haven’t grown, and are just sitting there..they are bent as well, where the growth has stopped. What does this mean?

Also, I keep getting scabs in the scar tissue where the hair was implanted. Would this be because my body is trying to remove those hairs that have not shed(but not growing), and does hair that grows in scar tissue cause the scar to scab, when breaking through the scar? Also, I was told i’d have to wait 18-24 months before most of the growth. Do you agree with this?

thank you

First and foremost, I would go back to the doctor who performed your surgery for a recheck. He/she should be able to answer your questions more specifically as it relates to a procedure they were a part of and know more about your overall health.

On average, it takes 6 to 12 months for hair to grow. Hair growth in scar tissue tends to be slightly slower than in non-scarred tissue, and in general, it is thought that hairs transplanted into scars do not grow as well as hair transplanted to normal scalp/skin. There is no study to prove one way or the other if that is true, though. In a few cases where I transplanted a small number of grafts into a scar and counted them at full growth, 100% of what I put in grew.

Do you think that Dolph Lundgren has had a hair transplant? Does he have a norwood 2 hairline?

Thank you Dr!

I would guess that the answer is no on the hair transplant and yes on the Norwood Class 2. For starters, anyone in Hollywood with a transplant scar at the back of his head would likely never cut his hair that short (note the photo below on the left from late 2006). Even an FUE procedure would produce a small set of punctate scars. In addition, the density I can see appears normal, indicating that it is not a hair transplant… but pictures could be misleading.

Photo sources: Dolph at Rocky Balboa premiere (2006), Dolph (unknown year), Dolph in Rocky IV (1985)

Hey Dr. Rassman,

First off thanks for the great information and honest answers.

Are you following the process of Dr. Hitzig’s Acell experiment? He claims to have regrown hair in the donor area and multiplied hairs in recipient sites. The pictures he has provided to the public are not of great quality, but I figured you might be able to shed better light on his progress/procedure. Is there any way for you to contact him doctor to doctor and get specifics so we know if the results are legitimate?

I would always be skeptical when a doctor tries to prove a point with poor quality photographs. This is the digital age and good photography is common place even for a 3rd grader. Now I’m not going to say much more about the doctor, but I will point you to a thread on the Regrowth.com forum that might shed more light.