Increased Finasteride from 1mg to 1.25mg — Now I See Shedding

/by William Rassman, M.D./0 /

Dr Rassman,

I have recently transitioned from Propecia to the generic brand of finaseride. Within 2 months I began to ‘shed’ pretty significantly. This shedding has continued for several months. Right or wrong, through my experience I am more than a bit sceptical about the generic version of this drug.

I have read that increasing finaseride dosage(which was true in my case, 1/4 tablet of generic) can result in temporary ‘shedding’. I am hopeful that is my situation. Do you know if this effect was true for patients using Propecia, who after time increased their doses of Propecia ?

Thanks

There is no evidence that more than 1mg of finasteride is better than 1mg. As the dose goes up, the side effects (or potential for them) rise slightly. Maybe you are in an accelerated stage of balding, which is as you know, progressive over time. I can not comment on the value of cutting a pill over taking the 1mg Propecia offered by the drug company. A dose of 1.25mg should not be perceptible.

Tags: finasteride, propecia, proscar, hairloss, hair loss

I Think My Stepson Has Ringworm, But He Won’t Seek Medical Treatment

/by William Rassman, M.D./0 /

I reside with my stepson, he’s a 27 year old black male. when he first arrived he had what looked like a ring worm on the back of his head behind his ear. It’s been months now and the spot has taken over the entire side of his head. While I stay clear of his hair loss (i don’t want that) I’m really worried… He could be really sick and won’t seek any medical treatment. It started like a quarter with a dime patch of hair in the middle now it’s a melon and getting worst. What is it ? If it was a ring worm wouldn’t the entire family have it by now?

I’m sure you knew when you asked the question what my answer would be — HE NEEDS TO SEE A DOCTOR! Sounds like this will only get worse without good medical attention. Ringworm is a fungal disease and can be spread from person to person. I can’t say for sure what he has since I haven’t seen him or photos, but you can learn more about ringworm at MedicineNet.

Tags: tinea, ringworm, infection, hairloss, hair loss

Scalp Hurts When It Gets Greasy

/by William Rassman, M.D./0 /

hi doctor

i have recently been thinning out badly on top. i have very minimal recession of the hairline and i have a normal crown area. my thinning is through the centre of the scalp almost like female pattern baldness. it really bad at the front area. i have really greasy scalp conditions, and my scalp starts to hurt where the hair meets the scalp when it gets greasy.

what would you suggest for me to do next? thanks

Unfortunately, I can not tell much from what you are describing. You should be examined by a good doctor. I wish I could offer more help.

Tags: greasy, scalp, pain, hairloss, hair loss

Why Would You Be Concerned About Transplanting a 22 Year Old Patient?

/by William Rassman, M.D./1 /,

Dr Rassman,

I was reading some of the past blogs and came across an entry in which you mentioned you were disturbed by the patient having a procedure at age 22. What concerned you about having a procedure at this age? I’ve also had a procedure at age 22 and was happy with it however, my hairline has continued to recede over the past few years and I’ve contemplated a 2nd procedure. Would you recommend this?

I generally do not recommend hair transplant surgery on men in their early twenties, because of the following reasons:

  1. They risk accelerating their hair loss due to shock loss.
  2. One does not know how much balding they have in front of them.
  3. The patterns of hair loss may be difficult to identify, which makes building a Master Plan (for long term planning) difficult or impossible.

Of course, if you are already bald (a well defined Norwood Class 3 pattern, for example) this would not be much of a concern. So it is not an absolute rule and every man should be evaluated based upon their maturity, their realistic expectations, and their balding pattern. Your very question supplies part of the answer, as you have had surgery and now notice that you are thinning or receding. Get a good doctor to build that Master Plan I mentioned above, so the best and worst cases of what might happen to you will be clearly defined for your benefit.

Tags: age, hairtransplant, hair transplant, hairloss, hair loss, shock loss

Vegetarians, Nutritional Deficiency, and Hair Loss

/by William Rassman, M.D./0 /,

I am 17, male, and have been loosing the hair in the front of my head for about a year and a half now. I do believe during that time I had used a hair product I was allergic to, as I had a sore scalp in some ares. But I have discontinued it’s use, and was wondering:

  1. how normal (or not normal) it is to begin having a receding hair line at 16 years of age?
  2. being a vegetarian, could it be a nutritional deficiency?
  3. in other answers, I have seen you mention “normal ‘maturing’ hairline development”, or something of the sort. What IS a ‘maturing’ hair growth pattern?
  4. could masturbating or not exercising affect that, and if so, in what way?

  1. Yes, a receding hairline can start at 16 years old. Normal? That depends on the person’s genes.
  2. If you do not have a balanced diet and have a nutritional deficiency, you can thin or lose your hair — this has nothing to do with meat-eaters or vegetarians.
  3. You should get your scalp mapped out for miniaturization to determine when it is a receding hairline vs genetic hair loss. See Maturation of a Hairline — Moving From Juvenile to Mature for more on the maturing hairline.
  4. Neither masturbating nor exercise will cause you to lose your hair.

My best advice for you at this point is to see a doctor who can develop a Master Plan for your balding problem and work with him/her, as hair loss is a serious business.

Tags: hairloss, hair loss, vegetarian, carnivore, diet, maturing, hairline, masturbation, masturbating, exercise, teen

St John’s Wort and Propecia

/by William Rassman, M.D./0 /,

I see in a previous post that you believe that St. John’s Wort will not directly contribute to hair loss. My question is, will St. John’s Wort inhibit or decrease the effectiveness of Propecia? Since Propecia is absorbed in the liver, and St. John’s Wort has been shown to decrease absorbtion of certain drugs, could it also be affecting the level of DHT bockers in the blood stream, thereby reducing propecia’s potency? I currently only take 2 300 mg tablets of St. John’s Wort at bedtime (I take my Propecia at bed time as well). Thanks in advance for your reply.

St. John’s wort is an herbal product used for its flavor or potential therapeutic in treating mild to moderate depression. In my opinion, a healthy liver should not have a problem with both St. John’s wort and Propecia. Discuss this with your prescribing physician. Like many other herbal products, there is not enough research on long term treatment, safety, and effectiveness of this product.

Tags: hypericum, finasteride, propecia, st johns wort, herb, herbal, hairloss, hair loss

Losing Hair At Nape of Neck

/by William Rassman, M.D./0 /,

I have had hair loss in the nape area of my head for the last 3 or 4 years, my hair falls out completely down to the scalp it seems to happen around the same time each year but the symptoms are itching, burning and tingling. the hair grows back but falls out all over again. is this a sign of beginning Alopecia? Im 27 years old

I have seen people lose neck hair, but I have never heard of it cycling every year. I am sorry, but there’s really not much I can offer you, particularly without examining your scalp and seeing what you’re seeing. The word “alopecia” means “hair loss” so the question is not not precise for a cause of the hair loss. Various adjectives are used, such as traction alopecia (caused by pulling on the hair) or androgenic alopecia (caused by genes).

Tags: neck, nape, hairloss, hair loss, alopecia

Weight Gain from Rogaine

/by William Rassman, M.D./0 /

Can you using Rogaine cause weight gain? I have been working out frequently and eating better but since my start on Rogaine a few months ago, I’ve noticed an increase in my weight. Can you help me?

Rogaine (minoxidil) was originally used for the treatment of high blood pressure. If you are using and absorbing it, you may be retaining fluid due to cardiac/vascular side effects. I would suggest that you stop it and see your doctor to find out if you have heart disease or high blood pressure.

Tags: rogaine, minoxidil, weight, gain, hairloss, hair loss, cardiac, heart

Finasteride Has Increased My Sex Drive After 2 Months

/by William Rassman, M.D./1 /

I have been on 1/5 proscar for 2 months now and it has actually caused a massive increase in my sex drive. Is this because of the medication!? I have only read about it causing a decrease in libido. However it is a side affect I think I can live with :)

Finasteride will often increase the testosterone levels and I have heard reports of an increased sex drive. Few men have complained about it, but when it happens to an older married man, it is oftentimes the wife that will do the complaining.

Tags: finasteride, propecia, proscar, sex, libido

Can I Damage the Follicles If I Cut Myself Shaving?

/by William Rassman, M.D./0 /

first of all i want to thank the doctor for a such great site, and also taking the time to answer some questions.My first question how is easy can a hair follicle be damaged, for example I cut my self shaving my head does that mean that the follicle is damaged? second question is that if you get slapped in the head is that gone make hair to fall out?

Unless it is very deep, cutting your skin while shaving will not cause hair damage. And no, slapping your head will not cause hair loss.

Tags: hairloss, hair loss, shaving, cut, injury, wound, damage

Show Me Evidence that Masturbation and Hair Loss Aren’t Linked!

/by William Rassman, M.D./8 /

You seem pretty sure that no amount of ejaculation can contribute to hair loss. Where is your evidence?

I’m merely saying this because I know for a fact that my bald spot is a direct result of my excessive masturbation. Seeing that I’m only 19 and that the hair loss completely stopped after I stopped masturbating I’d say I have plenty of evidence at least for myself.

Testosterone is converted to DHT through frequent ejaculations…therefore masturbation does in fact contribute to baldness. I’m only 19 and after two years of masturbating 5-7 times a day I already have a huge bald spot on my head so don’t give me any bulls..t and don’t contribute to the suffering of others just because you don’t want your precious masturbation to be seen for what it really is -A dangerous addiction.

In addition masturbating does not relieve sexual urges, it merely feeds them. I haven’t masturbated or had sex for 5 months now and I don’t miss it.

You are a pitiful human being and I hope that one day you realize how big of a mistake you are making right now. You are being extremely selfish and you will have to answer for your actions just like the rest of us.

What can I say? Sexual addictions are addictions. I can not prove a connection between masturbation and hair loss… I just know it in my gut. There is no doubt that people who take high doses of testosterone can become overly sexually obsessed. That is how our biology works. You are correct, testosterone does cause hair loss largely when it is converted to DHT. I would have to do a study isolating hundreds of men who have the balding gene, then get accurate information about the frequency of their masturbation and separate the groups so that the balding would be considered. Then it would have to be statistically significant according to a statistician. I don’t know of anyone willing or driven to do this study scientifically. As this is your focused question, why not resolve the issue with your own study and report it back to me? I will post it if it is a serious study.

I gather from your email that you are also angry and have focused that anger on me. Excess testosterone has been known to cause aggressive behavior in some men. You may have a hormonal problem or an addictive one. In any event, your anger is misplaced. I do wish you well.

Tags: hormone, hairloss, hair loss, masturbation, masturbating, dht, ejaculation

What Hair Loss Treatment Is Recommended for a 60 Year Old Male?

/by William Rassman, M.D./2 /,

I’m a 60 year old male and my hairline is receding a little at the front but I’ve got a bald spot on top about the size of half a saucer. What products would you recommend I use to slow down what appears to be a natural thing?

At your age, the hair loss is in its slow progression phase. Hair loss significantly slows down in many people after their 40s. A miniaturization study can determine whether or not you are still actively losing hair with some degree of certainty from genetic male patterned hair loss. Of course, there is no substitute for a doctor’s examination to see what is actually going on. At that examination, if it is shown that you are having significant miniaturization at or around your balding area, you may be a candidate for finasteride. This medication can halt hair loss in the crown area and can even reverse the balding process to some degrees in people who have significant miniaturization. The restoration of hair in the balding area usually is not completed only by using medications and many people require a hair transplant as the ultimate method for restoring their hair.

For more on hair loss medications, please see Any Precautions for Those 60+ Year Olds Starting Propecia or Rogaine?

Tags: propecia, finasteride, hairloss, hair loss, treatment, age

Are Steroid Shots in the Scalp to Treat Occipital Neuralgia Causing Hair Loss?

/by William Rassman, M.D./0 /,

I am a physician assistant and my 66 y/o mother called me yesterday about hair loss. My mom was diagnosed with occipital neuralgia and has given multiple steroid injections under the scalp into the muscles and nerve sheaths. About 2 months ago her hair started to thin. Now it is falling out with just movement. She does not have a predisposition to balding. Both her parents passed away with full heads of hair. I have told her to stop doing the shots, but I wanted to see if this is possible a cause to her hair loss and if so is it permanent. Thank you for your help.

Steroids injections into the scalp can cause hair loss in the vicinity of the shots. Focal balding is common. As far as generalized hair loss, yes, steroids can cause that as well (assuming the systemic levels of drugs are achieved). Never assume a simple cause as she may have another cause of hair loss (much of it is discussed in various postings on this site). She should be checked out medically, so be sure that there is no underlying medical condition present.

Tags: steroid, injection, shot, hairloss, hair loss, occipital neuralgia

Woman Prescribed 5mg Finasteride for Hair Loss

/by William Rassman, M.D./0 /,

I am a woman and have been prescribed a dose of 5mg of finasteride daily for hair loss. It is working, but I am concerned about the high dosage. Since I am not of childbearing age, do I need to be concern about it?how long do I use it?

Women who have a high androgen level and genetic balding may be helped by finasteride. I do not know the proper dosage, but the 1mg dose should work. The experience with women shows that those who do not have a virulizing problem with higher than normal androgens, should not see any benefit from finasteride. You can read Treatments Available for Female Hair Loss for more information.

Taking Propecia Before Completing Puberty

/by William Rassman, M.D./4 /

can mpb or aga occur during puberty, opposed to after its completion? if so, should one think twice about taking propecia if they are not sure they have fully completed puberty?

Male pattern baldness (MPB) or androgenic alopecia (AGA) can start as early as puberty, when your hormones are at a flux. I would generally recommend Propecia (finasteride 1mg) for men who have completed puberty in their late teens. I am not aware of any studies on Propecia with respect to its effects on men still undergoing puberty, but I would suspect it might slow down or even block the appearance of puberty.

Tags: finasteride, propecia, hairloss, hair loss, puberty