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Level 2 / 45a Bay Street 2028 Double Bay, NSW
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Hair Transplant Blog - The Knudsen Clinic

Finasteride and Prostate Cancer

Posted on 09 Sep, 2013

A long-running study of men in the USA with enlarged non-cancerous prostates (benign prostatic hyperplasia – BPH) using finasteride previously reported a 25% reduction in overall numbers of patients developing prostate cancer. However, there was some debate about whether the prostate cancers detected in users of finasteride were of the more aggressive variety. A recent analysis of this study showed that finasteride users had lower levels of the prostate cancer screening test PSA (prostate specific antigen) which led to more accurate diagnosis of those patients actually suffering cancer rather than just an enlarged prostate. In addition, the smaller prostates made tumour detection easier by biopsy.

 

Overall, men taking finasteride were 30% less likely to be diagnosed with prostate cancer and 43% less likely to get a diagnosis of low-grade cancer (slow growing). In addition, survival rates were not changed in patients taking finasteride compared to those not on finasteride.This is very reassuring news to patients taking finasteride for hair loss as these prostate effects are beneficial rather than harmful and will likely result in less unnecessary surgical treatment of prostate enlargement in future. We can reassure patients talking finasteride that there are no harmful long-term effects on the prostate from treating their hair loss.

Natural Ingredients for Hair Loss

Posted on 21 Jul, 2013

I frequently get asked the question: Are there any “natural” products I can use for my hair loss? The answer is – it depends upon the cause of the hair loss.

 

For example, if the hair loss is related to iron deficiency anaemia, then foods with high iron content or iron tablets could help. Biotin (Vitamin H) deficiency has been correlated with hair loss but it is a very unusual cause in the general population. Vitamin H, Vitamin B6 and zinc are all essential nutrients for healthy hair but are not necessarily involved in a particular persons hair loss, so supplementing them may not be effective.

 

That said, products like Provillus that contain them, and saw palmetto, are not going to harm anyone suffering from hair loss. The unfortunate assumption is that these “natural” remedies, essential for healthy hair, are helpful in the commonest forms of hair loss in men and women: male pattern baldness and female pattern hair loss. There is NO evidence that these nutrients are involved in these conditions and therefore NO evidence they assist in balding or female pattern thinning.

Hair Loss myths

Posted on 05 Jul, 2013

Tight hats make your hair fall out.

 

Not true. Tight hats might restrict blood supply to the scalp but only by a minimal amount. Whatever the cause of hair loss, hats have no effect on the condition.

 

Too strong a shampoo causes hair loss.

 

Not true. Shampoo is merely a soap for cleaning the hair shaft and has no effect upon hair growth. The hair growth cells are 3-4 mm under the skin and cannot be affected by ordinary shampoos or conditioners.

Shaving your hair makes it grow back stronger.

Posted on 24 Jun, 2013

Not true. As your hair grows it becomes subject to environmental damage (wind, sunlight, washing and combing or scratching). The result of this is that the tips of the hairs become tapered over time. If the tip of the hair frays you get a “split end”.

When you shave hairs and feel the stubble coming back, these hairs have not suffered environmental damage and feel quite “thick”.

They are just normal hairs without damage.

Most common Hair loss consultation questions

Posted on 07 Jun, 2013

The six most common asked questions in a hair loss consultation

1. Do hair transplants work?
YES, YOU CANNOT REJECT YOUR OWN HAIR. THEY GROW NORMALLY AND REMAIN HEALTHY IF PROPERLY SELECTED.

2. What supplements do I need to take to stop my hair falling?
NONE. NONE ARE PROVEN TO WORK.

3. Are there any side-effects with the medication?
SIDE EFFFECTS ARE DOSE DEPENDENT SO, USUALLY, THERE ARE NOT ANY.

4. Will my hair completely regrow back from medication alone?
USUALLY NO BUT IT MAY IMPROVE.

5. How long do I have to take the medication for?
AS LONG AS YOU WANT TO KEEP YOUR HAIR.

6. Have you had anything done yourself?
NO BUT I DO NOT SUFFER FROM HAIR LOSS BUT I AM TRYING LOW POWER LASER THERAPY TO IMPROVE DENSITY

If you have more questions you would like answered about hair loss and how we could help with a solution to your hair loss, please book a hair loss consultation.

FUE does it change donor planning?

Posted on 23 Jan, 2013

Strip harvesting’s rationale is to harvest all the donor hair is the area selected.  If we choose hairs from the safest donor area, then we can be more confident that the hair transplant surgery results will last. This makes it a proficient harvest of the safest area.

 

Now consider FUE’s (follicular unit extraction) harvesting rationale, where the technique only uses partial removal of hair from the donor area.   Only 25-35% of the available hairs are harvested, as over-harvesting leads to a variation in the density of the donor area compared to the rest of the hair. In extensively balding areas this becomes a concern but is unlikely to be a problem in small cases.

 

How do we deal with this potential issue? In my opinion, considerably bald, young patients should be urged to sustain long-term medication to limit future possible hair loss.

 

I do not believe that choice of strip harvesting or FUE changes any contra-indications to transplantation, but it may impact relative contra-indications to surgery. Consider a young man, developing extensive balding, who also has thinning from the nape of the neck. The restriction of existing donor area will reduce the number of ‘safe’ donor grafts that could be extracted by FUE whereas; a greater number of grafts could be taken from the safe donor area by strip harvesting (FUT). In this instance, more grafts could be achieved by strip harvesting than FUE.

The ongoing Finasteride debate

Posted on 03 Dec, 2012

Recently an international conference heard an in-depth panel discussion about Finasteride and sexual side-effects. It was again emphasized that Finasteride is a safe medication, side-effects were largely dose-related and disappeared upon stopping the medication. It was felt that recently media reports about the incidence and severity of side-effects was significantly overstated and that it remained the medication of choice for treating male pattern hair loss. In my hands, side effects are quite uncommon and only a small intermittent dose of Finasteride is required to achieve long-term stability of the hair loss in most balding men.

New Medication to treat pattern hair loss

Posted on 26 Nov, 2012

The recent Annual meeting of the International Society of Hair restoration Surgery saw discussion of upcoming medications to treat male pattern hair loss. In particular we were intrigued to understand that different versions of prostaglandins (chemicals involved in inflammation) have opposite effects on hair growth! Some prostaglandins have recently been shown to inhibit hair growth, whereas others are well known to stimulate hair growth. Perhaps the most exciting part of the research is that some medications currently being developed to treat asthma via inhibiting specific prostaglandins could have an unexpected benefit in stimulating hair regrowth in balding males. These new compounds are still a couple of years away but may turn out to be the next generation of medicines that positively affect balding.

Latest hair loss information

Posted on 18 May, 2012

I just recently came back from the Asian Association of Hair Restoration Surgery Annual Meeting in Seoul – Korea. The meeting was well attended with 250 surgeons there to find out the most up to date information concerning hair loss treatments.

 

Of particular interest to me were the talks referencing the influence of the recipient site on the growth rate of the transplanted hair. Original research was performed in Korea more than 10 years ago and showed the surprising result that, contrary to our initial belief, the body site where the transplanted hair is placed influences and changes the future growth rate of the hair.

 

The relevance of this result is that hairs in different areas of the body grow at different rates. When using scalp hair to reconstruct eyebrows the transplanted hairs initially grow at the scalp hair rate (three times faster than the eyebrow rate of growth). This means that the new transplanted eyebrow hairs need to be trimmed regularly because they grow much longer and quicker.

 

Over time the surrounding eyebrow skin influences the transplanted hairs and they slow down a lot to more match the growth of normal eyebrow hairs. More interestingly, if the transplanted hairs are removed from the eyebrow and then re-transplanted in to the scalp again, they begin to speed up their growth rate again! Simply amazing!

 

Another benefit from this research is that it proves that certain body hair can successfully be used to replace lost hair in the scalp and over time these body hairs will resemble natural scalp hairs in their appearance and the hair regrowth rate. Despite these compelling results, body hairs should only be considered as a last resort when there aren’t any more usable scalp hairs available to use as donor hairs.

Hairloss Treatment Medication

Posted on 16 Mar, 2012

A large amount of internet and media interest has recently focused on claims of persistent sexual side-effects long after discontinuing the use of Propecia (finasteride) hairloss medication. A study published by Irwig in 2011 suggested the occurrence a high incidence of long-term sexual side effects in some Propecia users. It should however be noted that this study was not a study of Propecia users in the general population, but a sample of men already claiming to have long-term side effects.

While not wishing to cast doubt on these patient claims, I do find them somewhat surprising. In over 14 years of prescribing Propecia/Proscar, to well over 4000 of my patients, I have no reported case of permanent sexual side-effects. Those few patients who reported these side-effects recovered fully after stopping taking the medication. In most cases recovery occurred within 4 weeks, in a couple of cases it was about 2-3 months until full recovery. A couple of recently published medical studies from Japan and Italy support the previously published lower incidence of side-effects and the long term effectiveness of Propecia. The Japanese study by Sato followed 3177 men for 3 years and the Italian study by Rossi followed 113 men for 10 years. In both studies, over 80% of patients show long-term growth and stability on the medication without any significant side-effects.

Another factor,  largely unknown, is that the frequency of sexual side-effects depends upon the dose used. In my hands, I have consistently recommended a dosing of a 1 mg tablet three times a week for the last fourteen years. This is because Propecia lasts much longer than 1 day in your system. In fact, the enzyme is blocked for up to 1 month! This means that you can maintain the effectiveness of Propecia without having to use it every day. The other great benefit is that, the frequency of sexual, or other, side effects drops dramatically if you only take the tablet every 2-3 days.

I believe that my frequency of patient sexual side effects is approximately 1 per 200 patients on 3 tablets per week and even less frequent on 2 tablets per week. All my patients have fully recovered after stopping therapy. Some who could not tolerate 3 tablets per week were able to be re-introduced to 2 tablets per week without any side effects.

With regards to altered mood (depression) whilst on Propecia, I have seen this in a handful of patients. It occurred quickly after starting the medication and resolved quickly on stopping the Propecia tablets. In summary, Propecia remains a very effective and also very safe treatment for male pattern hairloss. It has demonstrated clear superiority compared to other treatments for hairloss and side effects can be significantly reduced with adjusted or lower doses.

Finasteride Side Effects

Posted on 19 Jan, 2012

Recently an international conference heard an in-depth panel discussion about Finasteride and sexual side-effects. It was again emphasized that Finasteride is a safe medication, side-effects were largely dose-related and disappeared upon stopping the medication. It was felt that recently media reports about the incidence and severity of side-effects was significantly overstated and that it remained the medication of choice for treating male pattern hair loss. In my hands, side effects are quite uncommon and only a small intermittent dose of Finasteride is required to achieve long-term stability of the hair loss in most balding men.