I have been experiencing dyslexia side effects from Propecia. Have you ever heard about this?
There have been rare side effects reportedly associated with Propecia, but I have never heard of dyslexia as one of them.
Hi Doc. I just found it interesting that as we get past our 40s, Testosterone decreases gradually, yet people seem more prone to losing their hair by the age of 50 or so. Isn’t it true, testosterone levels and dht levels really have nothing to do with hairloss? It’s actually the scalp’s own sensitivity to dht?
For example, a man with high levels of both testosterone and dht can have a full head of hair, where as the man with low levels can be bald as a goose egg.
Response by Dr. Sharon Keene:
As chief medical officer for Dermagenoma, a company which manufactures and distributes a genetic test for androgen sensitivity, my esteemed colleague, Dr. Bill Rassman, asked if I would like to comment on the blog regarding the association between serum testosterone, DHT and hair loss especially as it applies to aging.
Dr. Rassman’s comments about the difference between genetics and the hormones of hair loss are right on target. First of all, the association between testosterone (T), dihydrotestosterone (DHT) and androgenetic alopecia (AGA) are indisputable…there are some people born without the enzyme to convert T into DHT, and these men have been observed to never develop male pattern baldness. The same observation has been made historically among twin brothers where one was castrated before puberty, and maintained a full head of hair in contrast to his brother who experienced male pattern baldness.
Since then there are many excellent studies which have documented the efficacy of the medications which are used today to treat AGA, such as finasteride, which blocks Type 1 5 alpha reductase and reduces the amount of DHT produced by the body. The fact that we notice different rates of hairloss in different families, and within families illustrates some of the genetic variability that exists among men who share this genetic trait.
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To what extent, if at all, would a topical such as minoxidil or Revivogen interfere with oral finasteride. I feel like trying to jam all of these things in you follicle together may cause them to interfere with one another. The last thing I want to do is reduce the effectiveness of the finasteride. But if they do not interfere with the finasteride, then adding one or both could be beneficial.
Thanks for the help. You have a great site.
I don’t think adding all the treatment options will diminish the effects of Propecia (finasteride 1mg), however, as enthusiastic and motivated as you are, you need to think in realistic terms.
Once you start three separate treatments how do you know which product is working and which is not? At what point are you going to say “Yes, this works” and continue the treatment, or “Nope, this one isn’t for me” so you can stop dumping money into it? Another way to put it — are you prepared to indefinitely invest in all three treatment plans? Remember, once you stop using a product that has shown to be effective, those benefits will disappear.
I am aware of the idea that creasing your forehead will show you exactly where your hairline was when you were younger, but I am sure this isn’t the case for me. I am 18 and have some recession which seems to be stable (maybe a mature hairline) and may have been there way before male pattern balding can even begin to manifest itself. When I crease my forehead, the highest crease falls two inches below my hairline, but looking pictures from my 11th birthday, my hairline, at least the centre, definitely was not noticeably lower than it is now. Is there any chance this theory is not entirely true for everybody?
The top most wrinkle crease we talk about is just a rule of thumb that generally holds true on most men. Without seeing your 11 year old hairline with a wrinkled brow, one can not be sure of anatomical points of reference. Of course, not everybody is the same. Some people naturally have a very high hairline or a very low hairline.
We are all special, each and every one of us!
Hello Dr. Rassman,
I know that statistically finasteride is more effective than minoxidil, but is it possible that some individuals may respond better to minoxdil than to finasteride? Have you seen any examples of patients who didn’t respond to finasteride but had good results from minoxidil?
I’ve seen great responders to minoxidil, but it had no association with them being non-responders to Propecia (finasteride). The medications work in different ways, so yeah, I suppose if you didn’t find finasteride to be effective minoxidil may still hold some promise.
I have a 17 year old son with Autism. The endocrinologist suspects he may have had precocious puberty. I am concerned because he has been losing his hair for about 3 years. My sons body hair is so thick we jokingly call him big foot. My father was bald, and I know there has been some research into baldness being hereditary on the mothers side.
However,currently my second son is 14 and shows no signs of thinning, although he also has excessive body hair, and there have been concerns he may also be going through precocious puberty due to his height. I am at a loss as to what I can do to help my 17 year old. My husband is bewildered because he is Native American and has an abundance of hair… He doesn’t quite know how to help either… Do you have any words of wisdom to offer?
Precocious puberty is when a young man goes through the puberty process much earlier than normal, somewhere around 9 years old. But boys usually go through puberty in their teenage years… and your son is 17 years old! By the age of 17, I would think that your son should have gone through puberty by now. For your other son that is 14 years old, X-rays can tell you if his bone growth centers have fused (a sign that puberty is behind him).
Unfortunately male pattern baldness (MPB) or androgenic alopecia (AGA) is a genetic trait that sometimes shows up early in boys going through puberty. I have seen men in their late teenage years who are very bald. Balding is not a disease, but a trait that can come from either side of the family tree. It seems to be passed on more from the mother’s side of the family, but this is not statistically valid. Body hair is just another familial trait (and unrelated to the scalp hair loss).
While there is no cure for genetic balding, there are medications to slow it down (Propecia or Rogaine). Talk with your son’s doctor get the correct diagnosis and discuss treatment options.
Hi
I am a 17 year old male and have just started to notice that my hairline has just started to recede (to about just before a norwood 2 I would say) and starting to thin a bit on top. I’m getting a bit worried as my dad is bald. I have been researching ways to stop my receding hairline going any further and came across this thing called scalp excercises. Apparently they allow more blood to flow to the scalp which stimulates the hair follicles and makes them stronger. Just wondering if u think that may work?And also I found a drug called procerin it is a natural drug that has had lots of good feedback and it says it works best for people aged between 18 and 35. I would just like your opinion on if u think this may work for me. This problem has been haunting me for a while so any information u have for me would be greatly appreciated thank you.
Procerin is a boutique version of the herbal saw palmetto. Some people swear by it, others say it doesn’t work. There have been two studies that I’m aware of to determine the effectiveness of saw palmetto as a hair loss treatment, and they were inconclusive. What I know works for early hair loss is Propecia (finasteride). It’s a prescription medication and FDA approved to treat hair loss. Talk to your doctor.
Scalp exercises won’t stop your hairline from receding. You have a family history of hair loss, so while trying out things you read about on the internet might seem like a good idea, the genetic expression of your hair loss won’t be stopped by rubbing your head.
Snippet from the article:
Gray hair is, along with premature balding, one of the greatest fears of image-conscious men and women everywhere, but it may soon be a thing of the past. Scientists at the Ito Lab at New York University’s Langone Medical Center have identified the proteins that cause gray hair, which could lead to an eventual cure.
Scientists have known for years that hair color is determined by the stem cells that guide the development of hair follicles working together with color-producing stem cells called melanocytes. Today, NYU researchers announced they had isolated the wnt protein, which serves to coordinate pigmentation between the two types of stem cells.
Read the rest — NYU Scientists Find Possible Cure for Gray Hair
Protein manipulations are getting closer and maybe what we learned from these rats will be available to humans in the future. Of course, we need assurances that it will be safe, so the breakthrough will have to grind through the FDA process… which might take years.
Hello Doctor,
I’m really interested in scalp micro-pigmentation, but browsing on the internet looking for before/after pictures I noticed something strange. The men with a brown skin color seem to have better (more natural) results than the caucasian men. Not only did the SMP ‘grafts’ look more the same as their own remaining hair, the transition between the pigmented area and the natural hair area looked more seamless.
Is this maybe because brown men tend to have coarser, thicker hair?
You may be correct, but shaved heads are more common in the African-American community so we are more accustomed to that look. Light skin and dark hair accentuate any balding pattern, but Scalp MicroPigmentation (SMP) does work well. The key is choosing the right shade of SMP, since every patient is different.
This was received in response to my post — The Economic Impact of Illicit Drug Use on American Society:
I am surprised to see your post on the issue of The War On Drugs. I believe there are a lot of opinions on this matter some in favor of yours (Ron Paul for example) and many who would disagree with you mainly people of a substance abuse history who are now recovering. You use the words lives lost and lives ruined. These words can fit perfectly with a opposing argument in which lives have been lost and families ruined from a love one overdosing or simply using certain drugs.
I for one do not believe legalizing and taxing and distributing meth or any other lethal drug would solve the ultimate problem at hand. And that is that our nation at its present state could possibly have the biggest drug abuse problem in the world, and this is not counting the millions on prescription medication. Its a shame that government has to step in and help us or hurt us, depending on how you look at it, but do you really think that having a legal distributor supplying an addict with a harmful substance and making money so we all can benefit from it is such a good idea? I was taught that the bad guy was the drug dealer and that drugs ruin lives.
There is no easy answer. Our prisons are filled with drug victims and I would not want to promote that we let them out of prison and then encourage them to overdose on legalized drugs. I know that we can not stop people from doing what they will do, one way or the other, legally or illegally. I just see what is not working… and what we are doing is not working.
I agree with you that our drug dependent society goes all the way into the doctor’s office. People demand the prescription medications that they see advertised on TV and some of the problems like “restless leg syndrome” were not even taught to me in my medical school curriculum, yet the industry that surrounds all of the restless legs out there is growing and growing and growing.
When I see patients in my hair transplant practice, I encourage the use of Tylenol, aspirin, and other non-narcotic medications to use after surgery and with the power of my suggestions, my patients seem to manage without heavy use of narcotics. Some of my patients call to ask for antibiotics when they sneeze, sniffle, or cough and I tell them that their body can handle the sneeze, sniffle, or cough without prescription antibiotics, as most of the sneezes, sniffles, or coughs are caused by allergies or viruses that will not respond to antibiotics. I try to be proactive.
Hi Dr. Rassman!
First of all I would just like to thank you for a really good blog, I am a frequent reader and very much appreciate the time you put into it. I have read several times that you say that testosterone does not cause hair loss. However in theory I believe this is wrong, but I would also like to hear what you have to say about it in practice:
As you most certainly do know, testosterone and DHT bind to the same receptor – generating the same type of response. Therefore they both have the potential to cause hair loss. However, as DHT is more biologically active and binds with more affinity to the receptor, it is seen as the main culprit in hair loss. And as long as a person has normal DHT levels, the testosterone probably does not play a big role in hair loss.
But in a person with aggressive hair loss who blocks most of the conversion from testosterone to DHT with finasteride or maybe even dutasteride. Wouldn’t it be fair to assume that the testosterone (which will also be somewhat elevated when on these meds) actually contributes to the continuous loss while on these medication?
And that this could, in fact, explain how a persons hair loss can actually progress even though they might be blocking 90-something % of their DHT with dutasteride? Any input on this will be highly appreciated.
It is a mixed bag, since testosterone is converted by the liver to dihydrotestosterone (DHT), which then gets to circulate in the blood stream. Increasing testosterone levels will increase DHT as well, so which is the cause of balding on those people with genetic balding?
We can not really separate what is happening neatly as you described, as the human body is a “bag” of chemicals mixed together. I realize how elegant that sounds, but that’s the most simple way to describe it. If testosterone levels rise, DHT levels also rise and in this bag of chemicals (the human body) any change in testosterone will absolutely impact DHT levels comparably.
My 5 year old has a bald spot right on his hair line, about a 1 1/2 by 2 in. area. It seemed to have occurred when his mother was cutting his hair short with scissors so i could buzz it short later for the summer time. She cut a little too short in that and some other areas (down to the scalp). The other areas all grew back normally except the one on the back of his head. Could the hair follicles have been damaged enough to where they wont grow back any more or is a waiting game? Its been almost a year now and nothing. Should we try some type of stimulation? Any help would be appreciated.
I find this story difficult to surround. Short haircuts do not cause bald spots. I mean, I’ve never seen balding created from a fully shaved scalp, so the idea that a haircut could cause loss just doesn’t make sense. There might’ve been a scar revealed from previous trauma, which you didn’t see until the hair was cut really short.
This is a situation that requires a one-on-one consultation and after doing that, digging into the history and examining the 5 year old, I might then be able to help.
Dr Rassman and company,
With all of the recent advances in hair cloning technology: Intercytex, Aderans, Histogen, Acell, WNT proteins, and etc., are you becoming more convinced that we’re getting closer to solving the donor supply problem and thus the hair loss problem?
I don’t have the answer to your question. Ten years ago, we were told that the answers would be seen in under 5 years… and now a decade later we hear the same thing. That says much about the real answer. It’s still a big question mark, though there’s some progress being made.
I am considering surgery – FUE. I have been on propecia for 3 years now and it’s difficult to tell the effect it’s had. I mean it could be working, I haven’t seen any more hair loss really. It may have stabilised the hair loss. Or has the hair loss could have simply gone into some kind of rest bite!? If I go for FUE, would you recommend I stay on propecia – I would rather be safe than sorry! Although it does cost a lot, I currently purchase my medication for £62 per month.
On another note, about a year ago I started minoxidil to improve the density of my hair. I think it’s had some kind of small positive effect, not much though. But here’s the issue I have. If I decide on a FUE, do I have to continue on minoxidil – because I cannot afford to both this and propecia.
You need to continue Propecia and minoxidil to see their benefits. As soon as you stop one or the other (or both), the benefits from that medication will be gone. In other words, you’ll see hair loss. The transplanted hair won’t be the issue, as it is permanent if taken from the donor area, but it is the remaining hair around the transplant area that will be unprotected. Propecia also helps protect from shock loss following transplant surgery.
Some patients choose to use generic finasteride in 5mg (prostate medication) and cut it to smaller pieces. Propecia is 1mg finasteride and not available (at least in the US) as a generic. The 5mg generic will be a lot cheaper than the 1mg name brand. You just need to find a doctor to prescribe this to you. Or if the 1mg generic is available in your country, that might be a way to save money. Also, your doctor should be able to show you some analysis from before you started Propecia and compare it to today to find out if there are real results. Hopefully your doctor has such information for you.
Snippet from the article:
A cream which slows the growth of hair by 70 per cent could result in men shaving just once every three weeks. It works on both men and women, meaning five o’clock shadows and girls spending hours in the bath shaving their legs could soon be a thing of the past.
Adonia hair serum uses organic plant oils to weaken hair formation and is being hailed as a healthy alternative to expensive hair removal treatments such as electrolysis.
More than 10,000 people have already put their names on a waiting list for the product. During trials in the U.S. the hair reducer showed an impressive 46 per cent reduction in hair growth after 21 days with a 70 per cent reduction after six weeks.
Read the full story — The gel that slows hair growth and lets men shave every THREE WEEKS
I can’t tell you how tired I am of shaving my facial hair, so if this is real, it would be very welcome. I can imagine women would love to give this a try, rather than shaving their legs.
The product, Adonia Hair Reducer, is for sale via a 3rd party seller on Amazon.com, but there are a few reviews that are highly suspect. Three of the four reviews were posted on the same day, and the reviewers have only written about products sold by that 3rd party seller. Glowing reviews, of course. I don’t know whether the cream actually does what it says, but the reviews I’ve found are more than likely phony, and I can’t find any other mentions of the product actually being used.