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Dr. Rassman, I am a patient of yours from years past and remember you were involved in many things over and above your hair transplant practice. Can you tell me what you are doing now and how you keep everything in balance. There are only so many hours in every day, so how do you cope?

I am very well organized, depend heavily on computers and software to keep my non-surgical work efficient, and I have a wonderful supportive staff that keeps me prepared. My thirst for information is helped by reading journals and magazines which cover the entire field of science and scientific discovery (such as Scientific American and The New Scientist), and each day I get an email from LBN E-Lert to keep me informed of the latest worldwide news. I must constantly stay in contact with the world around me.

Along with writing for the blog almost every day, I’m a surgeon, business owner, and inventor. I need diversity in my life, so I have invested time and money into a biotech company with their focus on rapid disease diagnosis and screening — Maven Biotechnologies. The best way to explain the vision of Maven is to imagine a disposable bio-chip (like a microchip on a small piece of glass or plastic) that can precisely test a drop of your blood for hundreds of diseases, along with your reaction to available drugs for the treatment of these diseases in just minutes! Now imagine visiting your doctor, who inserts the chip into a small desktop device for processing, then presents the results to you in the very same visit. This animation will give you an idea on how Maven’s unique technology will eventually facilitate the development of personalized medicine, a rapidly evolving change in the future of clinical medicine.

One recent invention of mine that I’ve worked on with one of my patients, is the newly patented Ski Brake, which will make it much easier for adults to learn how to ski. One prototype has been developed and you can view a simple animation of how it works.

I live and feel every minute I am alive and am fortunate to have the health and the associates to make these dreams turn into a reality. This is no different than what Dr. Bob Bernstein and I did in the 1990s to change the way hair transplantation is done.

New study showing heavy alcohol usage blocked effects of finasteride (half way down page): Prostate cancer and alcohol

The link has quick paragraphs about a variety of topics, but here’s the relevant info from the page (the bold emphasis added was mine) –

“This study analyzed data on 10,920 men. In a seven-year span, prostate cancer was detected in 2,129 of them, including 564 men with high-grade tumors, which grow and spread quickly. Those who consumed, on average, four or more drinks a day (totaling roughly two ounces or more of pure alcohol) five days a week in the year before diagnosis were more than twice as likely to have developed high-grade prostate cancer as were those who did not drink. No link was found between prostate cancer and more-moderate drinking. Also, among men who had been randomly assigned to take finasteride (Proscar, Propecia) as part of other research to test the drug’s ability to prevent prostate cancer, heavy drinking blocked the effectiveness of the drug.“

This is interesting, but it doesn’t necessarily prove that heavy drinking blocks finasteride effectiveness. Heavy drinking (4+ drinks a day) in itself can cause higher grade cancer. It should go without saying, but heavy drinking is not good in any case. If there is indeed an association with finasteride not working when you drink heavily, I would say it is a good idea to limit your alcohol intake!

Hi Doc, I have a buring question, I am a 29 year old Asian made with very thick black and have very good hair coverage, my question is when i comb my hair I see thick black hair that come out approx 10-15 not what you would describe as minutrized hair. Must hairs be minutrized when they fall out as mine seem very strange becase they appear to be very health ‘normal’ hair?

Thanks doc

I do not believe that hair must be miniaturized to be lost hairs in the balding patterns. Miniaturization does point to a problem, though, for as the DHT attacks the hair, the impact suppresses the hair growth to normal circumference (hence “miniaturized”). As the balding process probably reflects the number of cycles of a hair in any given location, a hair will only live out the number of cycles it is destined to live (for example, hair in the front might have 10 cycles in your lifetime of 3 years each). The hairs around the head usually will outlive you, while the hairs in the front for a Norwood Class 4A (see image at right) balder may last only 7-12 cycles, on average.

Hi,
Can someone have shedding after increasing the dose of propecia? I’m 22 years old started losing hair 2.5 years ago, a year ago I started taking proscar pills cut in quarters, hair loss continued but it may have slowed down a little bit, about 3 months ago I started taking proscar pills cut in half, and since then my hair loss increased a lot and I lost hair much faster than before, so could it be shedding from increasing propecia dose?

thank you

When finasteride is taken and is effective, it can accelerate the hair cycle and can give you temporary hair loss. We have seen this rarely in people who start the drug and it often disappears in 2-3 months. I would guess (although I have not seen it) that the same phenomenon can be observed if the increased dose was working on you. It should abate in 2-3 months.

Doctor,

I’m a 29 male in good health who has been taking avodart daily for ~5 years and took propecia for four years before that. I recently had a sperm analysis done along with my physical as I was concerned about potential risks associated with avodart. The results that came back were positive in the sense that my sperm count was in a normal range. My question is can you recommend any other tests that I could take to monitor my fertility while on avodart?

I do not specialize in male fertility, but if the sperm have a normal count and a normal motility, I would expect that there is no problem with it. I would pose this question to your primary doctor or better yet, a fertility specialist. This is beyond my scope of knowledge.

I was stupid and took steroids for a little while to improve the results in the gym. I realised I was being very stupid and doing harm to my body and have stopped. I have been taking Proscar (finasteride) before, during and after taking steroids to try and slow down going bald but with just ok results. While I was taking the steroids I was getting spots on my head. Since I stopped these spots did not go away and I went to my doctor and got Tetralysa l (Lymecycline) to take to help with the spots. This has helped somewhat but I am losing more hair now than I have done in a long time. Do you think the Tetralysal is affecting the Proscar or is it possible that I have some infection in my scalp that may be affecting the Proscar from working?

I would really appreciate any help you can give me. Thanking You

You said you’re already taking Proscar, but is it the full 5mg pill or did you cut the pill to take a smaller dosage? 1mg is recommended for treating genetic hair loss, but I have no idea how much you’re taking or how long you’ve been on it. Keep in mind genetic balding is lifelong and it will progress to a certain pattern. Finasteride is not necessarily a cure, though it does slow down the loss dramatically in many men. I doubt lymecycline has anything to do with finasteride.

Lymecycline is an antibiotic used to treat infections and sometimes acne. I am not sure why lymecycline was prescribed for you. You need to ask your doctor what your diagnosis is and what you are being treated for. Until then, you are approaching your problem backwards! Find out what you have first! Perhaps you’re seeing a temporary stress loss unrelated to any medication you took. Perhaps you do have an infection and that is why you were prescribed lymecycline. Perhaps, perhaps, perhaps. There’s much I do now know about your situation that would make it impossible for me to provide much more help without typing up a page of random guesses.

Dear Dr. Rassman,

Thank you for your excellent, informative site. I’m 32 and still have my juvenile hairline, but like most men, I’m concerned about the prospect of balding in the future, and have considered starting Propecia just in case.

I’m writing because something occurred to me while watching the coverage of the passing of Ted Kennedy: he’s an excellent person for you to hold up as an example of a maturing hairline. Footage and photos of his first election in 1960, at age 30, show a pretty severely receded hairline at the temples, probably more severe than the average mature hairline. Anyone looking at him at the time probably thought he was destined to be bald. But, when he died nearly 50 years later, he had basically the same hairline — just replaced, of course, with white hair.

Thanks again.

I have assembled some photos of Ted Kennedy throughout his political career to reflect your insights…

In all three of these photos above, you can see that the shape of the hairline is convex (mature male hairline) rather than concave (which would be a more juvenile or female type). What is notable is that the forelock is lower than usual and this is often a hereditary issue. At times, a lower forelock (like with talk show host David Letterman) runs independent of the hair around it and becomes isolated. Ted Kennedy’s hairline is the shape that I like to obtain in my patients, but I often go slightly higher.

Sir, my problem is that my moustache started disappearing on left side gradually. I have a habit of shaving daily so it was not noticed by me earlier. But now it has reached to about half. How to stop this and what to do so that hair is again grown in the bare part? Please cure my problem!

That is rather strange. Perhaps you can send me a picture? I can’t simply cure your problem for a couple of reasons, the first one being that I’m not a magician and the second one being that there is no cure for hair loss. I have no clue what could be causing it and you really should see a dermatologist in your area to get to the bottom of your disappearing mustache.

I’ve answered a similar question before here and was just as baffled then.

hair loss has seemed to progress. after 13 months on finasteride, i started taking hgh injections however have stopped since. reading the blogs on hgh and hair loss, however never getting a straight answer. why does hgh cause hair loss? and what can i do to stop mine. im using rogaine, spectal dnc-l and on 2.5mg of finasteride daily…and wash with revita shampoo. is there anything else i can do?

Human growth hormone (HGH) has anabolic properties that include increased androgen production. Increased androgens contribute to the androgenic alopecia (as the term implies). The impact of hair loss from HGH or androgens like testosterone is generally not reversible. It seems you are doing everything you can, but still losing the battle.

Hi,

I understand that Rogaine may cause initial shedding, but I’m concerned that mine is going on longer than it should– 2.5 months. At first I had some minor thinning on the crown and minor receding at the temples (my friends think I’m crazy, but I saw a dermatologist who noticed thinning), but not really anywhere else. After following her advice to take Rogaine, my hairline (not just the temples) has receded some, and all of the hair on top of my head is thinner, to the point that I can see scalp, which I never could before. At this point, should I discontinue Rogaine, or try to stick it out for a few more months?

Thanks

I can’t tell you what you should do with medication, but I can tell you that shedding from Rogaine (minoxidil) may last up to 3 months. You have a dermatologist and I would ask her that question, as she has the advantage of being able to examine you.