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Snippet from the article:

Australian cricket great Shane Warne has found himself at the middle of a storm of controversy surrounding his latest campaign for a hair replacement company.

Advertisements featuring Warne and former England captain Graham Gooch have been banned by an advertising watchdog over their misleading content, reports Eurosport.

Advanced Hair Studio’s advertisements have for years been centred on Warne and Gooch’s strand-by-strand replacement success, but the new ad implied that laser hair treatments produced the same results.

Read the rest of this article at Yahoo Sports — and more info at Guardian UK

I don’t follow Australian sports so I’m unfamiliar with the spokesmen mentioned, but this seems like another case of a company getting caught attempting to mislead the public about hair loss treatments and the results they can offer. The problem was in the wording of the advertisement, and although these ads were limited to Australia, it shines a small light on false marketing in this industry.

Dear Doctor. Thank you for this blog. It has come in handy several times!

I have two questions.

1. I’ve been on propecia for about 4 months now. My dad started growing gray hair in the beginning of his twinties, and now I also see some gray hair. I’m 21. But I’ve seen a decrease in gray hair since starting on propecia. Do propecia has an effect on gray hair?

2. My doc. also gave me nizoral shampoo and some nizoral creme for my chest. But I was wondering…At some website they wrote that nizoral has a small effect on DHT. Not much, but some. Does it make any sense to apply Nizoral creme on your scalp?

Best regards

I’m glad you find the site useful!

1. Propecia (finasteride) does not usually cause gray hair to revert to its original color, so this is an unusual finding.
2. Nizoral (ketoconazole) has no proven impact on DHT that I’m aware of, but I’ve read of people putting the cream on their scalps to treat hair loss. I have no clue of their results, though.

I have been taking propecia for a year now, I am currently twenty. Propecia has worked wonders to regrow hair all over my head, including the temples. My question is, and I know results vary, but on average do young patients that use propecia long term continue to retain the majority of their hair over the long term, ten-plus years. I know that at some level it will continue to work, but what has been your experience? Do young people retain a significant amount of their hair over the long term?

It all depends upon what your rate of genetic hair loss will be and the degree of balding you may undergo. At 20 years old, it is almost impossible to determine this.

Now with that said, I just saw a 20 year old male with a full Norwood Class 5 pattern hair loss. He has miniaturization through the remaining hair and although he was not treated with finasteride prior to seeing me today, I discouraged surgery on him at this time until he had a year’s course of finasteride. His hair density was lower than average, which tells me that his long term supply of hair will be limited and when he gets the surgery, he will probably be limited to a frontal restoration only (based upon his low density). I am hoping that Propecia will help him, but I strongly recommended that he take the decision process slowly and have his parents come in with him when I see him again in a year or so.

Hi Dr.Rass. This is my fifth question in this blog. This blog has been doing a phenominal job. Now going thru this has become one of my daily habits. Its a great job that you are doing.
Congrats Please keep it up. Now my Questions.

1. While answering my previous question regarding my itching problem with minoxidil(even with 2%) You have advised me to stop it. But I cant be bald and I want some solution for this problem . Shall I take finastride(Propecia) alone without topical minoxidil.Will I be getting any benefits out of it.Because only those two are FDA approved drugs.
2. You have written several times in this blog that topical solutions never grow new hair.(Foltene, segals solutions , procerin e.tc) Then how topical minoxidil works?
3. Please go through this web site. This has been growing popularity in India. They are saying that there is something called “aromatherapy” which contains aroma oils, a massage for 4 months grows hair back(together with saw palmetto 350 mg supplement and lase comb treatment).They are also saying shampoos should not all be used especially the one with “sulphates” but unfortunately no shampoos without sulphate is available? Can you suggest any one shampoo without sulphate (sodium lauryl or loreth)?
4. Currently my dermatologist has recommended me a tablet which contains the following “Biotin 40 mg. L-Methonine - 60 mg ans L-Cystine 100 mg” one tablet per day.Whether these vitamins and amino acids help to grow hair.She has advised me to continue for 60 days. And I also came to know that Biotin defficiency is very rare in human beings and our body recycles biotin. Is it possible for me to do any tests like blood sample to test the level of biotin in my body?

Sorry for such a big question

1. I don’t know what to tell you. If you’re itching with minoxidil, stop using it, but you run the risk of losing the benefits the medication gave you. Propecia won’t keep hair grown by minoxidil, and vice versa. Propecia works to prevent or slow down the balding in the man who has started to lose his hair.
2. I say that those topicals won’t work because they contain nothing proven to regrow hair. Minoxidil is proven to regrow hair. If those other products contain minoxidil, they’ll probably work.
3. Aromatherapy might make your bathroom smell nice, but it won’t regrow hair. Sorry, but I don’t have a clue about shampoos without sulfate. I’m not an expert on which shampoos have which ingredients.
4. A biotin deficiency would be rare, but shouldn’t you be asking your doctor about blood tests? Since you’re under the care of a doctor, I’d continue with the plan she has for you… unless you seek out a second opinion from another physician.

How do you keep the hair that you have without any side effect medications?

Most men have no side effects from Propecia, as the sexual side effects only occur in 1% of patients. Members of my own family take it and have no side effects, nor have they ever had them. Minoxidil has side effects of its own, including changes in blood pressure and skin irritation, but these are also not the norm.

Every medication has some potential for side effects, including extremely common drugs like Tylenol. Each person will react differently.

What happens if the hair doesnt grow after a transplant? Do doctors offer a guarantee of some sort? I know each doctor or clinic would have their own policy, but I wasn’t sure if there was some sort of standard thing most doctors offer.

Guarantees in medicine are illegal in most of the 50 states. Imagine guaranteeing that your cancer will be cured by one particular doctor as a marketing gimmick, then you die. What is the recourse?

There are practical guarantees of replacing that did not grow at no cost to you and this is common in the industry without violating any laws.

Dr Rassman if someone rub a little vigorously your head at the 9th day post operation the grafts are damaged or they are secure?

Thanks

If there were no scabs (eschars) present, then there should be no problem. See our published article on graft anchoring here (PDF file).

Hello Mr.Rassman. I know your main profession is regarding the hair and scalp, but I have a question regarding finasteride and acne. you seem to be an expert on finasteride. Studies say dht also causes acne. Finasteride inhibits dht, so can someone with acne benefit by taking finasteride. I found a website that states that in europe, the dermatologists prescribe finasteride for acne.

Here is the link. read under 5-alpha reductase inhibitors:
“A recent development in anti-androgen acne treatment is the inhibition of androgen-metabolizing enzymes in the skin or in the sebaceous glands themselves. One such androgen-metabolizing enzyme is the 5-alpha reductase inhibitor finasteride, which metabolizes testosterone into 5-alpha-testosterone in androgen-regulated target tissues. This enzyme exists in its two isoforms. The Type I isoform mainly occurs in the skin, located in the sebocytes, epidermal and follicular keratinocytes. Antagonists that bind selectively to this Type I isoform includes finasteride and dutasteride, and are believed to be capable of treating acne. European dermatologists have been using finasteride (used in combination with oral contraceptives for female patients) to treat acne, and have received effective results. Such an approach is yet to be approved for use in North America.”

since this method is not approved yet here in North america, what is your opinion on this?

Acne is a problem in the production of sebum and infections that get established in the glands of the hair follicle. If I am not mistaken, there is a bit of error in your quote: Finasteride (which is a 5-alpha reductase inhibitor) inhibits mostly the Type II isoform of DHT. I’m not an expert on acne, but I believe it is the Type I isoform of DHT that is partially responsible for acne. That said, I’ve read that DHT inhibitors can in theory treat acne, though theory does not always work out in real life.

I am not aware of a particular dermatologist in the U.S. that prescribes finasteride as an acne treatment, but I have read of such practice. As you know, finasteride is not approved by the FDA for the treatment of acne… but I don’t think it’ll be approved for that purpose, as the costs for the studies likely aren’t worth it to Merck. Honestly though, I get disproportionate emails from people on the Internet who are scared of using finasteride for male pattern hair loss despite its efficacy and safety profile. It takes real work for me to actually educate each and every patient on the real side effect and dispel Internet myths. If indeed finasteride can help with acne, good luck with the other swarm of myths to follow.

Dear Dr Rassman, I would really appreciate your response to this question. I cannot find the answer anywhere. You say that “if you are concerned about finasteride and its impact on your unborn child, you can stop using finasteride for about 1 week prior to conceiving a child as the medication should be cleared from your body.”

I was told by my Dr. that the semen which you ejaculate was produced 60 - 90 days ago in the body. Assuming you took finasteride in the 60-90 days prior to stopping for one week, surely the sperm you produce will still contain / be affected by finasteride because it was made well before you stopped taking it?

You make a good point. The drug company Merck has not reported any deformities (sexual identification of the fetus) with the use of finasteride and many of the men that take it are in their 20s and 30s. The real answer is there is safety in numbers and the lack of medical or fetal complications with finasteride (Propecia) indicates that this is not a problem.

Of course, you will have to be the final judge on whether you feel it is safe for the unborn child. The FDA would have made it known if this was a problem and they would have forced publication of such complications if they occurred.

What kind of shampoo would you recommend and product to use. I use gillette and softee indian hemp hair & scalp treatment. But it doesn’t seem it’s helping at all. I looked on the internet found that Nisim can help keep your hair natural. What do you think?

It does not make a real difference. In my book, Hair Loss and Replacement for Dummies, I discuss the ingredients of various shampoos in detail. There are many good shampoos, but none of them will prevent hair loss. If a company makes that claim, they will be violating the FDA guidelines which define what can and can not be said. If they make false statements that can not be proven with appropriate FDA scientific studies, then their business will be shut down. But just because there are rules, it does not mean that companies will not misrepresent themselves.