I am being prescribed finasteride 2.5/ day for BPH. would this also promote hair growth, or does it have to be 1mg/day to be affective for MPB?
Any dose of at least 1mg each day may help treat hair loss. A friend of mine who is 76 years old took Proscar for his prostate and grew a great deal of hair on the top and back of his scalp as an added bonus.
I fell and have a tiny sliver 1/4 inch scar, but a i lost a chunk of hair and thin layer of skin about the size of a quarter. Will hair regrow when the skin does? how long?
If you lost hair bearing skin, then hair will not grow back. If the skin is sutured skin edge to skin edge (hair-to-hair edge), it will grow back.
Hello Dr. Rassman,
I understand that your overall opinion on askdocweb isn’t too good.. however, I read something on their website that I thought I should consult you about.The “doctor” mentioned that it is possible for users to develop a tolerance towards minoxidil and propecia. Is it true? Also, this “doctor” mentioned that the FDA reports stated that hair regrown by minoxidil does not last more than 48 weeks. Is that true as well? Here’s the link: AskDocWeb
Thank you, Doctor! Best Regards
Minoxidil, originally and still used for the treatment of hypertension, was incidentally found to increase hair growth and is now used in products such as Rogaine. When used as an antihypertensive, it has been shown in one study published in the Journal of Cardiovascular Pharmacology (J Cardiovasc Pharmacol. 1980;2 Suppl 2:S93-106), that there was no development of tolerance if it was administered long term. I would suspected that the same may be the case for topical minoxidil, but have not seen any evidence to support this.
The same can be the case for Propecia. Propecia (finasteride) has been used by urologists for the treatment of benign prostatic hyperplasia (BPH), and is currently the only FDA approved medication to treat hair loss by decreasing the levels of DHT, one of the key cause of male pattern baldness. In a recent study published in the Journal of Urology in July of this year, the authors noted that “long-term (more than 4 years) treatment with finasteride … led to a consistent, clinically significant reduction in total prostate volume compared to placebo in patients“. Again, extrapolating this information to the hair transplant/treatment arena, we can suspect that the same may be true for hair regrowth.
As for whether minoxidil hairs don’t last more than 48 weeks — read this study from Journal of the American Academy of Dermatology. The trial was 48 weeks long, and I’m guessing this other site you referenced either got confused or they’re making stuff up.
Hello Dr. Rassman
I think you blog is a very wonderful thing, and most of all its like a release for anyone who is having difficulty with their hair-loss as it shows that they are not alone. I have been studying doctors, new so-called cures and intercytex therapy for about two years now. I understand why we become so aggravated with Hair-loss and I believe its our society that has put us in this small ugly box if we become bald. I have come to the conclusion that your the most qualified doctor among your piers, however due to pricing needs I have chosen Dr. Ron Shapiro, although he himself has said that your highly regarded as the best. Can you recommend Shapiro as a more then a suitable doctor?
Why is a receding hairline so immune to any forms of medicine?
It is rare that I’ll give any kind of recommendation, but yes, Dr Ron Shapiro in the Minneapolis area is a very good hair transplant surgeon. He was one of the first doctors I trained.
With regard to your question on the frontal hairline, it is important to note that most men do not know that they are balding until the frontal recession or thinning is detected. By the time it is recognized, the hair loss is too far gone to be brought back by drugs. The first stage for most men is denial and that may take years so treatment is often delayed during this period. When treatment for balding is finally started, the frontal loss is well along the balding path, possibly too late to reverse. Medication does work in the hairline, but I believe the hair loss has to be treated earlier.
Hello, I have a couple of questions:
- Is hair supposed to be the same thickness all over the head or are there zones in which thinner/thicker?
- How important is shredding to the process of balding? I’ve heard from balding friends that they see a ton of hair in the pillow and specially in the shower or while they comb their hair. Does a substantial increase in shredding from your usual mean that you’re going bald?
- I used an acne cream on my face when I was younger, I used it on my forehead and I noticed that my hair turned blond. Two years later I read the package and it said to avoid the hair. Do you think I could have lost the hair that turned blond or did it grow back eventually?
Thank you.
Hi doc, it seems that you often state for men it is no doubt DHT that is causing hairloss or MPB. is it possible for a man to have hormone imbalance (e.g low testoterone or high estrogen) that could be causing the problem?
looking forward to your reply and thanks alot for your time for all of us here!
Genetic hair loss in men is always precipitated by DHT, which comes from testosterone catabolism. High estrogen may actually protect the hair and we see this in women. When women go through menopause, they lose estrogen support for their hair and resulting hair loss is not uncommon in these women. 50% of post menopausal women experience hair loss.
I understand your view on styling wax clogging the hair follicles not to be a cause of hair loss. However, I have been using the Nizoral 2% shampoo and wonder if my heavily waxed hair style (which doesn’t entirely wash out) could potentially block the shampoo from penetrating effectively into the scalp? Could this also be a concern for those of us on minoxidil?
What is on your hair does not impact the hair that is being manufactured below the skin, but with using wax, the barrier to the skin will prevent the minoxidil from working (and I suppose the Nizoral, as well). Minoxidil works below the skin, but it must have access to the skin to get through it. I tell people that they are best washing their hair before the application of the minoxidil.
Once miniturization of the hair begins, how long does it take until a person notices his hair is even slightly thinner ?I go back a year ago and it was still good and today less dense. A year seems pretty fast, but doesn’t it take longer?
The hair loss process varies with the individual and his/her genetics. There are no rules here. Some people take a long time to lose the hair while others can lose it in a year or two.
Hey doc,
I want to know if there is any problem if I switch brands. Lets say i’m using brand A of generic minoxidil and switch to brand B of the same type (i.e: 5%), would there be any problems?
Thanks
As long at the minoxidil concentration is the same, there should be no difference. The FDA has rules that control the quality of the drugs and the claims in ingredients.
I saw you (Dr. Rassman) on Extreme Makeover last night. There was a man who had a receding hairline and you did a transplant on him. The procedure involved plucking the hairs from the back of the head instead of cutting a strip. What is the name of this procedure and what are the pros and cons in comparison to other procedures?
This is called follicular unit extraction / FUE (also known as the FOX Procedure) and is a technique I invented and published back in 2002 (see article). More information on FUE can be found here:
Pros are the quick healing time and no linear scar in the back of the scalp (giving you the ability to have a very closely cropped haircut without any noticeable scarring). The cons at the time of writing this would be pricing (it is much more labor intensive, and the fees reflect this) and not everyone is a candidate (depends on a number of issues).
Also, here’s all of my Extreme Makeover cases (these were filmed and originally aired a few years ago) — NHI: Extreme Makeover. I’m glad to hear that they’re still being aired.
I am a 23 year old male who has been using propecia for one year. I wanted some clarification on whether or not propecia can have an effect on brain function. I have read various sites that claim it does. Some users post confusing scientific data related to rats and state that it proves their allegations. They claim that propecia has caused, “brain fog, memory problems, aniexty, and depression” to name a few side effects.
In your expert opinion, can daily 1mg doses of finasteride change brain function? Specifically, change GABA function. Am I at risk if I continue to take the medication? If not, why do so many users claim to be negatively effected by this drug?
Please note that the use of the Internet for researching such reports may be biased towards sensationalism or focusing on the unusual. The reports of mood changes with Propecia (finasteride) seem credible, after all, since it does cause hormone changes in the body. For example, we have seen major mood alterations in women with mild hormone fluctuations. Propecia will alter hormone balances and this could be claimed to impact brain function, because I would think that mood alterations are connected with brain function. With regard to “brain fog” (confusion, forgetfulness) though, well, I really don’t know what it is that you are addressing and there is no way to really know what it does to the brain in any meaningful study that is currently available in the medical literature.
Snippet from the article:
Just seven months after its $5.5 million Series A financing round, the Boston-based startup today announced it has raised an additional $11 million to bolster its efforts to develop new methods of treating male- and female-pattern baldness and other hair-follicle disorders such as excessive hair growth and acne.
Read the full story — New Fundraising for Hair-Raising: Follica Takes in $11 Million for Baldness-Treatment Approach
What does this all mean for the future of hair cloning / multiplication? Well, that remains to be seen. This is exciting stuff and I hope the additional funds will bring this technology to the next level. As for when/if it’ll make it to market — well, I couldn’t say. Follica just came on the scene in late 2006 and I’d expect many years to come before anything of substance came out, if at all. Not to be a pessimist, but we’ve seen a number of failed attempts at these types of methods over the years. Lots of questions remain, and this is still the very, very early stages.
Dear Doctor,
after 6 years of Propecia, I have started to take also 1mg of Dutasteride daily. Would the daily combination of finastride and dutasteride run the risk of making both drugs ineffective?
I would not suggest that you take both medications at the same time — as both are prescription medications, you should be discussing that with your doctor. That being said… no, they won’t cancel each other out. These medications work roughly the same way on the mechanism for hair loss. There is a suggestion that dutasteride is a bit more powerful than finasteride, but there are more side effects and the dose in dutasteride to get a better DHT block is high (2.5 mg/day). There are reports that these higher doses may cause infertility in some men and we do not know if this is reversible. At this time, dutasteride is not FDA approved for the treatment of hair loss. For more on dutasteride, see past posts here.
My scalp seems to absorb the shampoo and the conditioner that I use while washing my hair. The day after I wash my hair I can scrape off what appears to be concentrated, semi-paste, shampoo and/or conditioner of my scalp if I run my fingernail through it. This makes my hair look bad and it makes my scalp feel weird and itchy. Is there anything I can do to relieve the suffering?
This doesn’t sound like your scalp is absorbing the shampoo. It could be caused by inadequate washing. Wash your hair thoroughly and the shampoo and conditioner should come off. If you’re taking cold showers, use a little warm water to try to break up this semi-paste you’re describing (doesn’t need to be burning hot, obviously).
I recently took a 4 week cycle of steroids and now my hair is falling out and thinning really bad and I’m scared I will go bald. I purchased some DHT blocker from a local drug store along with some hair regrowth vitamins in hope that it doesn’t cause permanent damage. My question is just that. Will the hair loss and thinning be permanent and how long does it usually take to stop the cycle of hair loss once started? Please any suggestions would help. Oh and don’t worry I’ve learned my lesson not to mess with steroids! Thanks.
You went from one bad thing to another. Buying an over-the-counter DHT blocker is like buying a sugar pill. Your worst scenario comes from you wasting time with this stuff when you could be doing the right thing. See a professional (a doctor) to make the diagnosis and treat it correctly.