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Hello,

Thank you once again for your blog.

Now, to make a long story short: I’ve gone abroad for three weeks, and I forgot to bring enough Propecia with me.

I have only got three pills untill I return home in three weeks, and my question is this: How can I make the best out of the situation? Should I take one pill a week, or would it be better to cut each pill in four pieces and have a dose of 0.25 mm every day untill I ran out?

Best regards

Oops! 3 pill to last 3 weeks? Really, there’s no best way to go about this. If you can cut the pills into smaller 1/4 pieces, I’d guess you could take a piece each day.

The best solution I can think of is to perhaps visit a local doctor and try to get the generic 5mg finasteride (Proscar), telling him/her that you use it for your hair. Then break the pill into 4 pieces, taking one of those pieces per day. If you’re real lucky, the doctor might even have a sample pack of Propecia you can have for this unusual situation.

Dr. Rassman I recently switched to avodart after using propecia for 3 years now. I’m in my mid 20s and switched as I found propecia to have somehow loss its effect. I have noticed increased shedding which I did expect but some of it seems to be coming from the back and side of my head. It is mild but wanted to know if this could be caused by the use and switch to avodart? Many thanks

Shedding occurs when the hair cycle is impacted. In your case, Avodart (dutasteride) may have caused the shedding, but it should be very short term — less than 3 months or so is my guess.

Theres a new product around the stores named bioxsine and from what i learned on this blog, the ingredients doesn’t match any that make your hair grow or stop hair loss.

What do you think? Another misleading product?

That’s quite the fancy website they have. The clinic, as shown in the photos, look so futuristic! Like an 80s sci-fi movie showing what a doctor’s office would look like in 20 years.

I have no idea what’s in this Bioxsine serum or shampoo, besides what the maker calls Biocomplex B11… and that might as well be “Ingredient X” since “Biocomplex B11” is meaningless to me. Basically, they gave an herbal extract an important sounding name, but in reality its zinc, vitamins, and other ingredients that won’t regrow hair. As far as I know and with all my years of experience in the field, there is no cure for hair loss. So in the end it is still a buyer beware market. If you want to try it, good luck to you. Their FAQ says it’ll take 2 years for hair to grow, but I doubt people that use this will have the patience to stick with 2 years of expensive treatments in hopes that it pays off.

Hello, im hoping you could kindly help me please? Ive been suffering hair thinning and balding patches for the last two to three years, gradually becoming worse, i have naturally long dark curly hair. I have had been given all sorts of treatments to try and im under the care of a Trichologist and a Dermatologist, ive finished my Minoxodil 4% as the 2% wasnt strong enough, but unfortunately it has not worked, so i went back today to see the consultant dermatologist and he told me he would like to try the steroid injections into the scalp, but i would like to have hair transplant as it is affecting my confidence and feel ugly and constantly compare myself to other women.

Im 28 years old, female, and studying to become a doctor, so i just put the hairloss down to stress but its been over to years now and its worse, please help! Is my doctor correct in trying the injections? he said the transplant would not work. my hairloss and thinning is on my temple area and around the size of the bottom of a mug (cup) and hair thinning on my roots. Thank you for your help.

You need a real diagnosis, and I really can’t help you without that. There is no definitive medical solution for genetic hair loss in women in most instances. You are wasting money by seeing all these specialists and you may end up worse off after these invasive procedures that may not work. Steroids have never been proven to work for genetic female hair loss, but do work for particular diseases like alopecia areata. Plus, steroid injections to the scalp often cause hair loss.

As you say you are studying to be a physician, empower yourself by educating yourself on women’s hair loss issues and treatment. Hair loss in women can be from a variety of reasons, some of which are listed here. As for hair transplants, many women just are not candidates, but I couldn’t specifically say whether you are or not as I’ve never examined your loss.

Yes i have two daughters ages 2, and 3. when they were born they had hair. as my oldest got a few months old all her hair was gone. both of my daughters have very light almost white peach fuzz as i call it. it isnt even half an inch long. i have consulted thier doctors and they have never seen it. i dont know what to do. i just found out im pregnant again and i would like to find out what condition my daughters have so i can correct it. At least know what is causing it so i can become more educated in the matter. My oldest realizes there is something different about her and even asks mommy why dont i have hair like you, as a mother this is breaking my heart. Please help!

This sounds like a genetic disorder. I would want to know about your family and the father’s family history. Has this type of lack of hair been seen before in either side of the family? I really can’t help you much more through the internet without taking a careful history where, I suspect, you will find what is wrong.

A pediatric dermatologist would be the best place to visit first. There’s a group that focuses on pediatric dermatology, and they have a physician locator that might help point you in the right direction.

hello doctor,
my hair is thin and i dont know if all the hair that falls out is because of the telogen stage. my family has no balding but my hair getting thinner and always falling out. i keep on pulling it out all the time and i am always stressed about it so i am all day pulling and freaking out. i went to a doc but she recommend me propecia right away. i dont know if i wanna be on a medication. what should i do? thanks!

Did you tell your doctor about your hair pulling before the Propecia was recommended? Propecia might help if you are a man with genetic hair loss, but it won’t stop you from pulling the hair out.

It sounds like what you’ve got is an obsessive compulsive disorder called trichotillomania. I’m not an expert on OCD, but a good place to learn more and seek treatment help is at the Trichotillomania Learning Center.

Would scalp massage benefit sufferers of dermatitis? To avoid flare ups and prevention of mass dandruff scales, i try to minimize what i do with my scalp, i avoid brushing it, using any product in, shampoo 3 times a week with a shampoo that does not contain many chemicals and condition once every month. Sometimes i have the psychological desire to pick these flakes resting on my scalp with my fingernails which results in hair breakage.

Will this hair breakage repair if there are no bald spots, they are more of unnoticeable thin spots (only i would notice) naturally over time and would regular scalp massage which regulates blood flow have any positive or negative impact on this process?

A gentle scalp massage feels good and will not do damage (breaking hairs), but a vigorous massage might cause hair breakage, pulling out hairs as well. Massage will not cure the dermatitis or impact the dandruff.

if this is answered in your blogs forgive me and just send a link. i am clear i want a ht. i have done much research and am still meeting with docs. i can do in thailand, uk, usa. my one reservation has been the scarring and after effect, plus temporary nerve damage on the head. after realising FUE could be done in a megasession i feel this is it for me, (told i need 3-4000 hairs/grafts). as i research so many are careful, sceptical of it. i have come across you (dr. Rassman) and dr. cole. i understand a skilled physician is necessary. will FUE of 3-4000 grafts megasession handle it for me (norwood 3v to a 4)? do you recommend it more than strip or not? is it a very viable option? with dr. cole or you? thank you.

A skilled physician is necessary for any surgery you have, and one that specializes in the cosmetic surgery you’re looking into is absolutely something I’d recommend. If you’re asking me whether you should go to me for your hair transplant or go to another surgeon, well, I think the answer would be pretty obvious. However, I cannot recommend surgery options for you at this point, as I have not examined you or know of your medical history. Everyone is different and all surgery has its risks and benefits (FUE vs strip, etc).

What I can tell you is that I have never performed a 3000 to 4000 graft follicular unit extraction (FUE) procedure in one session. I think I can say this with some authority, as I was the one who introduced the FUE technique to the international community in 2002, but an FUE procedure of that size will likely lead to a higher transection rate due to physician fatigue.

I realize it has been 8 years since the technique was introduced and other physicians have performed and tried to perfect the technique, but there are factors that the general public do not know of in such surgery. To the general public, FUE sounds slick and the best of all worlds (you get hair with minimal scarring). But there are some thing you need to look out for. Please read about these in my post from a few years back — What Doctors Don’t Want You to Know About FUE.

Hi…I was wondering if this was possible. Say I wanted all my hairs on the back and side of my head to be transplanted to the top of my head. Not just the 9 thousand graphs or whatever donor supply most people have, but all your permanent hair on the back and sides, would you be willing to do this? Then the hairs on back and the side can be tattooed to look like a hair buzzed with a 0 clipper and the top can be clipped to a one or two.

What do you think of this?

I love the creativity of some of you that write in. You’re wanting to move every hair from the donor area (sides and back of the head) up to the top of your head and then tattoo hair all along the formerly-hairy donor area? That just isn’t possible. It sounds like you’re looking for one of those hairstyles that was popular in the late 80s or early 90s…

To move every single hair from your donor to the top of your head would create tremendous scarring. And if it was possible, I wouldn’t want to perform this procedure anyway, because even if you are enthusiastic about the results today, you will likely regret it tomorrow.

Hi Dr Rassman,

I had two transplant done. One in aug2008 and another one in January 2010. Total about 5000 grafts altogether. Sometimes after showering I see 2 to 3 hairs in the towel with a bulb. the hair that falls out is also thick. Do you think I am loosing a root? or its normal hair cycle. Please advice. I am not sure if the hair that is lost will grow back .

thanks

Everyone goes through normal hair cycling, meaning every hair will fall out and then after a few months in the telogen phase, it will regrow. I can not comment on any particular hair loss that you are reporting, because I don’t know exactly what you’re seeing. Both transplants would’ve taken hold by now, so those 2-3 hairs on the towel are likely nothing to worry about. You should go back to your surgeon for his/her confirmation of that. Hopefully, the transplanted area will hold its overall fullness and that will be the best indicator of the permanent nature of those hairs.