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I had a question regarding a moustache transplant. I have a sparse moustache and thin hair on my head. I’m concerned that my head hair would not be thick enough for facial hair. I was wondering if it is possible to transplant my much thicker coarser beard hair on my neck to thicken my moustache without too much scarring. My beard goes all the way down to my chest and I hate shaving it anyways. Thanks

Hair from anywhere on the body can be transplanted to another location. Follicular unit extraction (FUE) is a good way to do a limited number of hair transplants into a mustache. This is something that you and your doctor should discuss.

Remember, however, that hair from different areas on the body have different hair cycles, which means that if the telogen (resting) cycle is long and the anagen (growing) cycle is short, then less of the hairs will be working for you at any one time. You can learn more about hair growth cycles here.

Hello,
Can there be a “normal” amount of minaturized hairs throughout your head without a balding problem present?

I’m wondering because just from observing women’s hair, woman of all ages, I’ve noticed a lot of woman with some wispy hairs sticking out on different areas of their head, but these woman are without signs of hair loss. Do people have a normal about of miniturized hair through out their head? Or perhaps are these wispy hairs caused by blow drying,coloring,etc.

Thank you and hope you can answer my question.

A “follicular unit” has full terminal mature hairs and some vellus (shorter and thinner) hairs. If you take a small area of your scalp (like the size of a pea) and cut down the hair, the thinner hairs produced by the miniaturization process in genetic balding may not be distinguished from vellus hairs (both hairs have smaller diameters). When I look at the scalp under intense magnification, I will often see some hairs that have thinner hair shafts. I generalize that a normal non-balding person will have less than 20% of the hairs that I see with finer hair shafts. They may be miniaturized hairs of the balding process if they impact the entire follicular unit to some degree OR they may really be vellus hairs in their numbers are less than 20% of the follicular unit hair count.

Hi:
I was on Propecia for roughly six years between 2000 through 2006. I had decent results, kept the hair on the top of the head, however the temples were receeding a bit. The hairline in the front was thin as well. In 2007 I was diagnosed with stage 1 testicular cancer. It was localized to my left testicle and I was lucky to catch it early as it did not spread anywhere else. I had surgery to remove the affected testicle and undergo preventive tests on a quarterly basis.

My questions are: Could the cancer be caused by the Propecia? I would like to start taking the Propecia again to re-gain what I lost as I am starting to get the dredded “hair ring” around the head. I am 38 and was wondering about fertility since I only have one “factory” left?

Thanks!!

I would ask this question to your oncologist. I highly doubt testicular cancer is caused by Propecia. There are many men who get testicular cancer who are not on Propecia. Most of the time you cannot establish a causal relationship.

With respect to your fertility, I am not the doctor to ask this question to (as I am not a fertility doctor).

I have taken propecia for almost a year with good results and now I would like to consider switching to Proscar. Is the use of Proscar commonly understood by dermatologists to be effective for treating MPB, or should I assume that my doctor is unaware about this use of Proscar?

thanks.

Simply looking at the generic name (finasteride) will tell them that the drug is the same, but in different dosages. If you’re worried that he/she doesn’t know the differing marketing names of Proscar and Propecia, you can bring it up when you have your next appointment. I would expect it is commonly known though, as the medication has been on the market for years.

Hey doc, This site is great. Anyway, been on propecia about 8 months. Hair isnt really any better def a little worse. So what do you think a person like myself, chances are of seeing any improvement in the next 4 or so months?

Did you see a doctor before you started Propecia? Did you get a miniaturization study to see how much of your hair was thinning (miniaturized)? Did you document the process by taking pictures before you started the medication? These are some of the basic things I would look for if a patient of mine states they are continuing to lose hair while on Propecia.

Propecia is not a magic pill and it does not cure or stop hair loss completely. It just may be that your natural (genetic) hair loss is rapidly progressing and Propecia cannot stop it completely. Perhaps without Propecia you may be bald by now. But all of this, I am merely guessing.

I would follow up with your doctor to see what your progress has been. I really cannot predict your future, but if all baseline tests are done, you can have an objective idea of where you are going. At the least start the baseline measurements now (better late than never) and then see what happens in 6-12 months if you stay on the medication.

Hello Doctor Rassman,
I have come to you as you are the first and final ray of hope for me to save my hair. I’m 17.5, male, and I play guitar, longing to become a rockstar some day. I started to lose hair one year ago, yet back then it was too subtle and I was able to successfully hide it…But now it’s different. My hair loss is becoming as visible as daylight and is becoming harder to hide as we speak.

As you can probably tell, I live in a place -heck, a country- where, for my seriously bad luck, no Proscar is available. I have explored various online pharmacy sites that supposedly sell genuine Proscar without prescriptions, yet I preferred not to risk such a thing. It is because of this that I come to you and ask of a genuine Proscar prescription that can permit me to purchase Proscar from a trusted online pharmacy.

I heard that taking Proscar at this age may disrupt the growth phase and turn me more “feminine”. Is this the case in every seventeen/eighteen-year old who decides to take Proscar? Plus, do the feminine side-effects instantly wear off as soon as I stop?

I’m really confused as to whether I should take Proscar or not.. I want to grow normally, lead a normal male life, but I’ll definitely be bald by a year from now. It’s a dilemma I really need your help and advice in to solve. Please, I swear to everything holy that you are the only person who can help me in overcoming this disaster.

You’ve referred to Proscar over and over, but I have to assume you mean Propecia since you’re talking about treating hair loss. Just to clarify, Proscar is 5mg finasteride and Propecia is 1mg of the same medication. The lesser dose is for treating hair loss, the higher dose is for treating prostate problems. If you get Proscar (or generic 5mg finasteride), it should be cut into smaller pieces if you’re treating hair loss. Now that that is out of the way…

I do not prescribe drugs without seeing a patient, as it is against California law. The risks for a 17 year old are minimal (it was studied in men as young as 18, however). I have prescribed the drug for men at your age, but you need to have a doctor involved and the dose should be 1mg of finasteride if it is indicated for you. I can’t tell you if finasteride is even right for you, as I’ve not seen you and I don’t know enough about your medical history, family history, etc. Please, please see a doctor. You’re 17 and likely in the early stages of losing your hair, which is when Propecia works best. I’m not sure which country you’re in, but I’d assume if you’re having a difficult time finding Propecia or Proscar name brand, you can find the generic name, finasteride.

First of all, I’d like to say this is the best hair loss website. Thank you for all the insights.

My question is this. I’ve switched from 1mg propecia to the generic 5mg finasteride.I am a patient of Dr.Pak. The staff member at your office recommend I go to Cotsco to buy the generic finasteride to save money. I did. However, I’m concerned. My concern is that the blue 5mg pill is EXACTLY the same size as the 1mg propecia. It is difficult to cut, but ive managed. Is this the right product? Surely it says 5mg finasteride, a blue pill, but how can a 5mg pill be the same size as the 1mg pill? And even if it is, when you evenly cut it into 4 pieces (1.25mg a piece), how do you know which side has more mg while the other has less? Your honest answer would be appreciated. Thanks.

The 1mg Propecia pill contains more fillers so that the pill can be at a size that is easy to swallow, but not so easy to have it disappear if you accidentally drop it. The medication is evenly distributed in the pills, so that when you cut the 5mg pill you should have the same amount of finasteride in each piece.

It sounds like you got the right product, so long as it is actually 5mg finasteride. Some pills might be bigger with score marks (intended to be cut), but each generic manufacturer is different.

I meant to post this a little while ago, but it slipped through the digital cracks…

ABC News posted a list of drugs that have dual uses (some being for off-label use). While not all of the mentions are hair loss related, among those medications that are relevant to this site are:

1. Dutasteride — used for hair loss (off-label) and prostate
2. Finasteride — used for hair loss and prostate

Regular readers of this site will note that both medications are approved by the FDA to treat prostate issues, and finasteride is also approved in a smaller dosage for treating hair loss (Propecia). Dutasteride (Avodart) is still not FDA approved as a hair loss treatment, but some doctors in the article believe it was stalled because of side effect concerns.

The Wall Street Journal looks at various toupees/wigs/hair systems/rugs. Here’s a snippet from the article:

Business was booming for sellers of men’s wigs back in the day—but that day ended in the 18th century. For a 21st-century man looking to conceal hair loss or to make a fashion (yes, fashion) statement, the choices are limited. That’s because about 75% of all wigs sold in the U.S. today are for women, according to hair-industry experts.

The men’s ready-to-wear wig industry is under assault from two angles. The growth of hair-replacement systems, where a product is custom made and fitted to a client’s scalp, continues to take market share. And many men no longer care that their hair is falling out because the shaved-head look is increasingly popular. Instead of concealing bald spots, men are eliminating hair spots by shaving it all off.

Read the full article at Wall Street Journal

If you’re going to wear a wig for whatever reason, this article serves as a splendid little review of some of the top wig sites. At the very least, it is interesting to read about the pricing and policies of these sites.

I read that some doctors have suggested that Botox can help in the reduction of scar widening following a hair transplant. If this is true, why don’t doctors use this routinely?

Botox (Botulinum Toxin Type A) works by paralyzing muscles. If the widened scar was the result of muscle pull, then the idea would make sense. Let’s take a look at the anatomy:

In the area below where the donor area is taken out lies a muscle that is called the occipitalis muscle. It has the unique character of not attaching to any tendons or bones, and is a vestigial muscle that has no real function in humans. It does not connect to the scar, so paralyzing this muscle will have no benefit. The only other muscle in the vicinity of the donor area is the occipital head of the trapezius muscle, which inserts on the occipital bone on the skull and its purpose is to allow you to lift your head and hold it upright. Paralyzing this muscle might just give you a head drop, which would not be a good idea. I am not sure what else might be paralyzed to help heal the donor wounds.

In conclusion, it does not makes sense to use Botox for scar stretching prevention.