Hi Dr. Rassman I appreciate your website and blog very much I visit here everyday. I have been considering propecia for a month now. After searching the internet of course I have been scared like everyone of side effects of ed,low libidio,and I know your answer to this. Now I recently have been seeing everywhere on the internet about propecia affecting fertility! I mean I wanna have kids and start a family one day which out weighs having hair.

I am a 27 year old male and have some thinning and receding up top. So my question is if I take propecia is there any chance of it affecting my ability to have children in the future? Can you please set me at ease I realize you have answered this before

The information available shows that there is little risk to fertility from Propecia. If there is an incidence of drug induced infertility, it is very, very rare. What has been reported seems to reverse on drug withdrawal. Permanent infertility to finasteride does not appear to be a problem. If you are still concerned after reading this, when you take the drug for your hair loss, consider taking a sperm count somewhere after 3 months while you are on the drug.

I’m wondering if there’s a way to lower my eyebrows. My face structure makes my eyebrows look like they’re too high on my head and I hate the space between my eyes and brows. What kind of procedure could be done to lower the eyebrows?

There are cosmetic surgeons who may do this, but I am not one of them. See a good plastic surgeon and ask that question to him/her.

Hello dr.Rassman

Is this true? TwinsHairLoss.com

Can dutasteride be so effective on maintaining hair? Or is it photoshop?

I hadn’t seen this site before. After reviewing the photos, my first thought was that they were fraternal (not identical) twins, but they claim they are identical twins and post pictures of their childhood years. I have no way to 100% verify that the photos were not doctored, but you can use your best judgment there.

Taking everything at face value, the difference in hair growth/loss seems remarkable between the twins and shows that dutasteride works for androgenic alopecia (male pattern baldness). But the misleading point (which I do not think was intentional) is that the casual readers may infer that dutasteride is “THE” drug to take. Propecia (finasteride) works in the similar manner as dutasteride in targeting DHT.

At this time, only Propecia is approved by the FDA for treating androgenic alopecia. Dutasteride is a drug prescribed for men with certain prostate issues and the long term side effects on young men are not clearly established. Proper dosage of dutateride for treating hair loss is also not clear. For those interested in taking dutasteride, you’ll need to find a doctor willing to prescribe it to you for off-label use. It should be noted that Propecia has its own fiercely debated side effect discussion on this site and the Internet, and dutasteride side effects are likely to occur in those that experience side effects from Propecia.

Doctor..

Thanks for keeping an archive.. It’s a treasure chest of info.

I had a couple of months were I was taking care of a sick family member and missed a minox application usually at night.. so I was down most days to just one application.. maybe 6 weeks. Had a lot of loss the last 5 or 6 weeks. I’m guessing since minoxidil is dose dependent there’s going to be loss from twice to once a day application. Also I switched to an online source that supposedly took over for Dr. Lee’s products. Which like Dr. Lee, is now out of business also. So It could have been a possible scam with phoney products. I needed a non PG formula.. though even the Rogaine foam is a problem..

I’m wondering if the loss is due to twice to once a day application for some weeks. The stress and lack or sleep in being a caretaker.. or could it be Minoxidil Solutions LLC was just a scam. In which case maybe some of your readers may have had the same result and offer a comment.

Thanks for being a “reliable” place to turn for the hair loss community.

You have suggested the many reasons why you experienced the hair loss. I can not tell you which is more possible than the other.

It could be from changing the dosing, or it could be from bad medication (I don’t know if it was indeed a scam), or it could be from stress… or it could be a combination of it all.

Since birth, I’ve had a large bone/lump where my head meets the neck. I think its called the occipital bone? I was wondering if I could still have a FUT surgery? My concern was basically would the area be more difficult to close after the strip was removed?

No problem at all! We see larger occipital bones in many patients who have had FUT (strip surger). We just saw a patient in the office with this same question and there is no issue.

My question is in regards to the SMP (scalp micropigmentation) procedure. I’ve been taking propecia about four years now–started when I was 18. My hair has halted the balding process, but I cant tell it’s slowly creeping back up, which is what I expected anyways. I’m very interested in the SMP procedure, since scarring (even minimal) and a life-time commitment to propecia just isn’t for me. My questions are:

1) As opposed to hair transplant, how old does one have to be to become a good candidate for SMP?
2) If the procedure was done, would constantly shaving the head destroy the tattooed “hair”?
3) If after SMP, one would to stop propecia and lose their hair that was retained from the drug, would the loss of natural hair be noticeable even with SMP?
4) Lastly, are there any more recent photos you could share with us other than the ones already listed?

Thanks

Any age above 18 years old will work for me if the patient understands the positive and negatives associated with the process. There’s a list of frequently asked questions at the SMP site.

Many people will shave the head every day or every other day. This is a personal preference. Shaving your head shouldn’t destroy the SMP.

If you stopped the Propecia, you would lose all benefits of the drug and the hair loss will play ‘catch up’ to what it would have been.

We only post the photos of patients that grant us permission, but we keep updating the SMP site with new photos all the time. Keep watch on it.

Hello. I had busted my head from a starbucks cappuccino bottle(Please don’t ask how It’s a personal issue..) And I was bleeding harshly from my head so my parents wrapped my head with some bandage really tight and put some healing glue over the scar. In like a week in a half it healed and the glue came off like a scab and I was left with a very smooth scar on the back of my head near the root of my head about the size of a quarter, the top part of your pointer finger(the first line part and up cant explain it good). I know hair isn’t growing back because its been three years.

I want to have the scar removed from my head, the surgery is they cut it out then sew your scalp back together and your left with a lined scar that is barely visible when hair is grown a little. I do NOT want hair transplant please don’t give me information about it. Please explain as much as you can about the “scar removal” surgery I have in mind and also a cost for this.

What I would like to have is have a surgeon cut out the scar since its a little smaller than a quarter and stitch the scalp back together leaving me with just a tiny thin line scar that would be. No wider that the original sizer of the sizer or length. Also since I am african american, I want to cut my hair down low to about a 2 but I can’t cause of this baldspot, my dad is willing to try surgery but not until its reasonable. Remember it is about the size of a quarter which is very small compared to others.

Thank you please help me with my problem. Also the color of the scar is about my skin color maybe even a bit darker, I have black indian hair so a big brown baldspot sticks out. Please fill me in with everything you possibly can.

Scar removal from the scalp sometimes works well… and sometime doesn’t work well. That depends upon:

1. Your healing abilities
2. The location of the scar
3. The direction of the excision scar
4. The surgical technique used

I would have to see your scars to determine what I would do. From what you described here, I am at a loss. You need to see a cosmetic surgeon with experience in scar revision.

Dear Balding Blog,
With so much conflicting evidence, how many times do you recommend washing your hair per week for optimum hair regrowth/restoration? The reason I ask is because I ride a motorcycle and my scalp gets quite oily, particularly during summer.

Thank you.

If your hair gets oily, then wash as often as you like to keep it feeling good and clean. Once or twice a day (when you ride your motorcycle) should meet your needs. It will not cause hair loss, nor will shampooing your hair cause it to regrow.

Hello doctor,

I want to start by commenting on this awesome blog to educate people on hair loss topics.

I’m 23 and I have had (noticeable) hair loss for about one year now. I saw a doctor that prescribed me 1mg of Propecia and I’ve taken it everyday since. In my family, my father and my uncle (mom’s side) both experience hair loss. But on both sides of my family, my grandparents have/had full heads of hair.

It’s been about one year since I started taking Propecia and I’m still thinning and losing hair. What are my options from here?

I look forward to your response. Thank you

See a doctor who will measure your hair bulk and map this out on your scalp. This will give you a metric on hair loss and if you compare this measurement over time, you will know if you are losing the battle or not.

If you are indeed losing hair continuously (and at the same pace), it’s possible Propecia isn’t working for you… and in that case, your options are even more limited. Minoxidil might be worth a try. Have you taken the HairDX Test for Finasteride Response?

Hi,

Me and my girlfriend are trying to have a baby. This morning, my girlfriend maybe touched, maybe not, some dust of finasteride… I am not really sure that I’ve well cleaned after cutting the pill. If she’s pregnant, it should be for 4 or 5 days because she stopped contraceptives two or three weeks ago.
Is there a risk for the foetus (if there’s a foetus… some cells actually - which is not proven at all…) ?

Thank you in advance for your reply. Best Regards.

I would not worry about this. To get the fetus to be impacted by finasteride, there has to be absorption of the drug into her body and the fetus must be in the process of forming sexual organs. At 4-5 days, this does not happen and the ‘dust’ you are reporting is doubtful to be putting her at risk. Enjoy the pregnancy without worrying.