Monthly Archive for May 2010
May 17 2010, 8:40 am PT | Posted in: Hairlines
What kind of hairline does John Mayer have. He’s 33, but I seem to have almost the same hairline as him and I’m 21.
Based on the photo you linked to and other photos I’ve seen of singer John Mayer, I’d have to say that this is a normal, non-balding male hairline that he likely had when he was 12 years old. Appears to be a great head of hair!
May 14 2010, 3:05 pm PT | Posted in: Personal Stories
A couple months ago I was invited to speak before the Anderson School of Business at UCLA about entrepreneurship, and I was able to talk about the diversity experienced in the multiple careers I’ve held since receiving my Doctor of Medicine degree from the Medical College of Virginia. So from time to time I’ll share some of these personal tidbits that I spoke to the Anderson School about so you can learn more about me.
I was encouraged by the feedback I received after posting about my short-lived farming career, so I’ll continue to post these as long as there’s an interest. For those of you who do not know much about my background or Dr. Pak’s background in various fields, you can find those here. So without further ado…
The Intra-Aortic Balloon Pump:
In medical school, I was fortunate to find a number of faculty who stimulated the inquisitive mind. I developed an interest while I took a job on the inhalation therapy team and the university hospital. I worked nights and was usually the first person to be called when a patient went into extremis or had a cardiac arrest. I quickly became an expert on cardiac resuscitation. I wondered why some of the patients survived and some did not, so I set up experiments, first in the VA hospital (under Dr. Yale Zimberg) where I started to develop cardiac pumps and then eventually in the research lab of the cardiac surgeon, Dr. Richard Lower. The dean of the school of medicine eventually funded my projects. That got me to eventually work at the University of Minnesota under the famous surgeon Dr. C.W. Lillehei, the father of open-heart surgery. Funds for my ideas eventually came from an endowment fund under Dr. Lillehei’s trust and when I moved from Minnesota to Cornell Medical Center, I eventually came up with the first commercial bedside assist pump, the Intra-Aortic Balloon Pump (see: demo video). The medical cardiology community initially opposed the application of the technology, so the only patients I had a chance to work on were those patients who would not come off of the heart lung machine after cardiac surgery. Dr. Lillehei was clearly my sponsor and not only paid for this work, but encouraged me in developing further improvements. I believe that cardiologists were intimidated by the technology, particularly because some minor surgery was required in the leg to insert the balloon, something that in those days cardiologists were averse to.
May 14 2010, 12:50 pm PT | Posted in: Diseases + Drugs
How is life treating you today?
I have a question but first I have to thank you for providing this excellent resource free of charge. The blog has been an invaluable tool in my continuing effort to learn more about hair loss and unicorns.
My question is this, is there a difference between the effectiveness of Proscar and Propecia? I recently switched to Proscar (I was prescribed it during my consult at NHI). I am a little nervous though because the blue Proscar pill looks to be the same size as the brownish Propecia pill, yet I am cutting Proscar into fourths. I thought a 5mg pill would be larger than a 1 mg pill. Am I missing something or is Proscar simply more potent?
Also, I have Hepatitis C. Prior to starting the medication, I found nothing to indicate that taking Propecia would be a problem for someone with my condition. Does this hold true for Proscar as well? I found nothing in Merck’s online product information to prove otherwise but the internet is so full of misinformation that I honestly don’t know what is what.
If you don’t feel comfortable answering the second question with certainty, do you know of any good Gastroenterologist’s in the LA/Orange County area?
I am sorry, that was 3 questions.
Thank you very much for your time and patience
Life is going well, thank you. I hope you’re doing fine and I’m glad you enjoy the site, but if you got your medication prescribed from us (NHI), you should call our office to discuss any issues/concerns at 310-553-9113. You’re our patient and we are here for you!
In general, I think some drug companies make it hard for patients to divide up and cut pills sometimes because it’s all about economics and making a buck. The reason the 1mg and 5mg pills might be the same size has more to do with the inactive fillers, which you can learn more about here.
With respect to Hepatitis C, as long as your liver enzymes are normal and your primary care doctor (or gastroenterologist) is aware that you’re taking the Propecia, I am fine with it. As for gastroenterologists in the Los Angeles area, you can try Dr. Norman Panitch.
May 14 2010, 10:39 am PT | Posted in: Hair Loss Causes
Experiencing severe hair loss. Over the last year I have had drastic hair loss. I also have thin layers of skin it seems, that is almost over my entire scalp. And these are not small flakes, these are like when you sun burn and peel, they aren’t flat either, when you peel them off they are quite long and almost like small white bumps on them. Anyways I don’t know if that’s related to my hair lose, though it has to be, because I don’t see how hair can grow thru all of that. But my family, parents, grandparents, still have there hair. And it’s not like I’m using receding, I’m going completely bald all over the top of my head. I’m wondering if you could tell me what it might possiblly be.
I really cannot give you a diagnosis. But personally, if I have white bumps and raised skin flakes that peel off on my scalp with drastic hair loss that is causing me to go completely bald, I would go see a doctor as fast as I could. Maybe you have seborrheic dermatitis, psoriasis, a fungal infection, or possibly even skin cancer. My point is I am guessing in the dark… so you really should go see a doctor for an examination.
May 14 2010, 8:39 am PT | Posted in: Female Hair Loss + Hair Loss Causes
My daughter use a mousse hair product that she used for several years and had an allergic reaction. Her forehead, neck, scalp and eyelids peeled. A few weeks later she notices her hair falling out. She went to the derm and he prescribed topical treatments. They said it would take a few weeks to see results and less hair falling out because of the severe seborrea? Anything you tell her from your experience.
It’s possible to have an allergic reaction to hair products, but she used that particular product for years and then suddenly developed a severe allergy? If your daughter is under the care of a dermatologist already, he/she will have more experience with allergic reactions than I would. Besides, I don’t know what topical treatment/dosage was prescribed, nor do I even know what the allergy was.
May 13 2010, 3:01 pm PT | Posted in: Hair Loss Causes
Dr.Rassman, you’ve written much about dermatitis and hair loss. It seems that in your opinion even the worst case of sebhorrheic dermatitis (excessive plaque, high levels of sebum, chronic flaking, bleeding etc.) doesn’t contribute directly to hair loss - especially of the patterned kind. However many people out there believe the two to be linked, including many physicians. I just came across an article from a non-profit organization called the American Hair Loss Association detailing various hair fungi and scalp conditions.
In their discussion of dermatitis they claim that, and I quote, “Although all this inflammation is not specifically directed at the hair follicle, if hair follicles are in the vicinity of the inflammatory cells then they can still be adversely affected. Hair follicles find inflamed skin an unhealthy environment in which to grow. Thus seborrheic dermatitis may non-specifically cause diffuse hair loss.” Is this a reputable source and how would you respond to this claim?
*The full article can be found here: AHLA - Infectious Agents
Flaking of the skin from seborrheic dermatitis itself does not cause hair loss, but if the scalp is picked and the flakes are pulled off, then hair loss can be a result of that process (meaning the hair will come off with the plaque). If a person picks on it regularly, that person can develop traction alopecia or even a condition called dermatillomania, a form of OCD.
I usually point out to our readers that the most common cause of hair loss (in men) is related to genetics. The differentiating factor for male pattern (genetic) hair loss from other types of hair loss is the “pattern” of the loss… but there are other causes of hair loss aside from genetics. Hair loss can be from fungus, psoriasis, anemia, immunologic, infections, stress, etc and many of these conditions may appear like a form of dermatitis. These types of hair loss can be diffuse or patchy, but there is not necessarily a cause and effect between the skin condition and the hair loss.
The American Hair Loss Association is a good, well meaning organization. I just do not agree with the opinion that they expressed connecting seborrhea to hair loss directly. I’m not sure where they got their information about that.
May 13 2010, 12:56 pm PT | Posted in: Hair Products
I have recently come across with this product: Go Away Gray
Your remarks will be appreciated.
I have no experience with Go Away Gray (and this is the first I’ve read of it), but I invite my readers to comment if they do have experience with this pill that promises to make gray hair disappear. What I could find on it (aside from a ton of sites trying to sell it) was that the pill contains catalase, and a study from last year did find that gray hair was caused by the body’s lack of catalase production as we age. That isn’t enough to convince me just yet, but I am open to learning more about this and reading some actual reviews. You can read more about last year’s gray/catalase stories here and here.
CBS stations around the US picked up the story and ran it in their local markets, causing at least one TV critic to dig a little deeper into why the product is getting all this publicity (see here).
May 13 2010, 10:45 am PT | Posted in: Drugs
I just switched from Propecia to generic Proscar (cut into fourths). The pills I am cutting are extremely small, and thus difficult to cut! Always be sure consult your pharmacist about the size of generic Proscar before filling your script!
Consulting your pharmacist about the size of the pill is great advice. Let the pharmacist know that you’re going to be cutting the pill. Different generic drug makers could have different pill sizes for the 5mg finasteride. Fillers are often used to make the medication easier for the patient to handle or to make production easier.
Do you know the maker of the generic you got? There’s a partial list of generic finasteride names available here.
May 13 2010, 8:35 am PT | Posted in: Drugs + Female Hair Loss
I’m a 21 year old girl and 3 years ago my hair started to get a lot thinner. i was under a lot of stress and my dermatologist told me this was the cause. He advised me to try rogain.
I have been using it for 3 years now and I have a lot of new hairs. it doesnt seem like its thinning anymore… although its still nowhere near its past thickness. Im curious as to when I can stop using rogain? Do i have to continue using it forever now that i have started it?
I would consult with your doctor first… but if the hair grew directly from Rogaine, those hairs could fall out after stopping the medication. You’re really taking a gamble that the Rogaine wasn’t beneficial and the loss was purely stress induced. I really do not know of your personal situation so I can just give you generalizations.
May 12 2010, 3:00 pm PT | Posted in: Hair Transplantation
I just saw a man that had two hair transplant procedures done a decade ago and then a third procedure done at a clinic just south of Los Angeles, which caused major surgical complications like gangrene of the scalp. This was probably from the use of lasers during the surgery to make the holes, which produced burns all over his head. The patient now has a deformity in the frontal area of his scalp which is incredibly difficult to cover with styling alone. His options to hide this include using Toppik and/or DermMatch, but he doesn’t like using these camouflaging agents. There may be some value with using FUE into the immediate areas, but then he would have to use use beard and body hair to get the value to this patient as his donor supply is markedly depleted. This is one of those rare cases where using body hair transplantation is acceptable.
This is a prime example of a patient who tried to save a few dollars on a hair transplant, but it ended up costing him more in the end. He told me that he even knew that someone died at that clinic, but their low pricing was enough to get him to go anyway! I can’t stress this enough — researching both the doctor and the clinic is critical. If he’d met with patients from that clinic and saw the type of results they had, he might’ve stopped right there. The Medical Board of California has allowed that place to continue to operate even though it is owned by a non-physician (which is against the law). So if the authorities can not really protect you from these criminals, you must protect yourself by doing the right type of research to avoid this type of problem. This applies to all types of doctors, not just hair transplant docs… but all types of surgeons and really, doctors of all specialists.