When Propecia Starts Working, Is It Sudden or Gradual?

I am a 21 year old who has begun taking generic propecia for about a month now. However, I have yet to see any progress so far. I am shedding hair at the same rate as before, and the frontal hair line recedes at a very rapid pace that I can notice the difference daily. I understand from reading some of the answers on this blog that the effects of propecia become apparent after about four months of usage on the average. Does that mean the hair loss will suddenly come to a stop (assuming propecia works for me) after a few months of taking the drug? or Would my hair show a series of gradual signs such as thickening of hair and losing less and less hair that will eventually lead to a stop in hair loss? Thank you very much.

Block Quote

I generally tell patients it takes 6 to 12 months to see the effects of Propecia. You will definitely not see any effects in one month other than (in some people) the cessation of rapid hair loss, if they happen to have it. These things take time and it does not magically happen overnight, as the hair grows out 1/2 inch a month if it is healthy. Remember that seeing less hair falling out may be a positive sign. People do NOT always get more hair growth.

Tags: propecia, finasteride, hairloss, hair loss

A Year After My Transplant, It Looks Like Most Are Just Single Hairs

Hello Dr. Rassman,

I’m 29 years old and had a transplant exactly one year ago in Thailand. I had roughly 1000 grafts transplanted to my hairline and temples using the FUE method. After waiting the full year, I’ve got to say I’m somewhat disappointed in the results.

I purchased a digital microscope after reading many of your blogs. I’ve taken a good look at the recipient area and it appears that 90% of my grafts are just single hairs, as if the follicular units were transected during the operation. I’ve also noticed many colorless, short, thin hairs in that area. Are these the remnants of my native hairs that have miniturized? Would you say I can expect any more development in the transplant? Or is 12 months pretty much it? If I was a norwood 2 at 27, how far would you guess my balding will progress? My crown looks thin to the naked eye, but I believe it’s because of the cowlick and that I’m a blonde and the light penetrates through. With the microscope, I see no miniturized hairs in the crown. Thank you for your time

Block Quote

If you have 2-hair grafts placed and only a single hair grew from each, that could mean one of three things:

  1. Close to half of what grew in each follicular unit died from the process you had done. Or…
  2. You are Asian and have typical Asian hair densities, which means that there are equal one and two-hair follicular units growing in your native hair. Or…
  3. The doctors just divided the 2-hair grafts to make singles to increase the graft count.

Even if you are Asian, you should have 50% one-hair grafts and 50% two-hair grafts (on average). Strict quality control is critical for all of the hairs in the follicular units to grow and if you had all two hair grafts (typical of Caucasians) the growth of only one-hair grafts reflect some damage. You should also count the grafts, as well as the hairs. Was it a bargain deal? Take a look at our recent post about cheap hair transplants.

The doctor could have separated all the grafts into single hair grafts (if the doctor was not honest and tried to push up the graft count if he charges by the graft). In any event, 1000 two-hair grafts should have yielded 2000 hairs (in a Caucasian) and 1500 hairs (50% each of one and two hairs in each graft). That is the bottom line. I always measure the density of the patients prior to surgery so I know what I expect to achieve in the harvested grafts as well as how many hairs are transplanted, the count of each graft with regard to the number of hairs they contain. Some clinics charge per HAIR and not per graft, so look at how the billing was made. Maybe you were charged for 1000 hairs and not 1000 grafts (not uncommon to find).

Tags: hair transplant, grafts, hair growth

Proving or Disproving MPB?

I stubbled across this website and have one question. Does NHI provide a service that proves or disproves mpb for men? Reason I ask is because I have noticed hair loss or thinning for about a year and a half now and there are really only two areas that I notice a problem. Around my cowlick back left around the crown and front left which is noticeably thinner than the right. Wondering what can be done as I am already using finasteride, minoxidil, hair club EXT treatment and laser comb. Thanks

Block Quote

We are not in the business of proving or disproving MPB. We are physicians who examine, diagnose, and treat patients. We developed a concept of establishing a Master Plan for every patient who visits us. It sounds like you have tried everything (and the kitchen sink) and have not established a baseline to determine where you started and where you are going.

Tags: hairloss, hair loss

When I Stopped Smoking and Was in the Sun, My Hair Regrew

can you figure out how hair that i had lost and hadnt grown back in years, all of a sudden came back over 2-3 months of giving up smoking and jogging everyday in the scorching sun ?.

I ask as the moment i got it back i stupidly started smoking and stopped excercising and it all diffusely thinned again.

Im guessing my hairloss wasnt male patterned and whatever type it was reacted to the constant sunlight ?


Block Quote

I don’t know how these things are related to your hair regrowing, but thanks for sharing your story with us. Sunlight doesn’t make hair regrow, for those curious. If your hair is falling out and regrowing on its own, there’s probably something other than MPB going on.

Tags: hairloss, hair loss, sunlight, smoking

Has Merck Accepted That Propecia Has Prolonged Side Effects?

Dr. Rassman,

Thank you for your dedication to this blog site, it has been a source of great comfort on an issue that is often brushed under the table. Please respond at the very least by private message because I would really like to have a better understanding of what is happening.

Now that merck admits to prolonged site effects, do you at all feel betrayed? as looking back at most of the content on this website, you are rather adamant that any side effects will go away when propecia is discontinued…

as a propecia user myself, the idea of myself, or another young male in their 20’s losing normal bodily function permanently seems devastating to say the very least! even if the drug works well on 99%, and one out of 100 take it have a permanent reaction, then is that even really worth it? lives being ruined?

What is your whole hearted suggestion in light of recent developments, ie. class action suit, website removal etc. for someone like me. Do we stop taking the medicine? common sense says it takes a hell of a lot for a pharma giant like merck to take down their website. and it takes a hell of a lot of evidence to form a class action suit.

and at this point mercks acceptance of prolonged side effects almost negates the original clinical studies all together…no?

Block Quote

No. Every drug has its risks. I don’t believe that Merck knowingly withheld information from the public. The FDA and the drug companies work together to control safety and effectiveness, but they are never 100% certain that everything is covered.

One of my three sons is still on Propecia and I endorse his decision. He looked at his mother’s side of the family and saw Norwood class 6 balding patterns. Now he has all of his hair. I don’t know what his pattern would have been like had he not taken the drug when he was 29 and an early class 3 pattern, certainly not his mother’s family line. My son has had no side effects (same as most of my patients).

I always tell my patients of the risks, and they then make their own decisions as consenting, educated, knowledgeable adults. Pulling down a website and seeing advertisements for law firms trying to collect enough people to sue them isn’t enough for me to believe Merck is admitting guilt.

Tags: propecia, finateride, merck, hairloss, hair loss

Rosacea and Hair Loss?

Hello, doctors.
Can rosacea on scalp cause hair loss or hair thinning? or do rosacea sufferers have thinner hair?

Block Quote

The diagnosis of rosacea has many forms of severity and symptoms (see here), but it is generally limited to the face, not scalp. Hair loss isn’t a usual side effect of rosacea as far as I’m aware.

I found a post on the National Rosacea Society forum that discusses having scalp inflammation in addition to the facial rosacea, which might be of some help. You should talk to your dermatologist to determine the cause of your hair loss.

Tags: rosacea, redness, hairloss, hair loss

Prince Harry Has a Thinning Crown?

Dr. Rassman

I know you’ve commented before on Prince Harry, but I noticed some better pictures found here, including close up from above: link

Do you think this is balding and if so, what norwood would he be at and possibly progress to?


Block Quote

That is one great collection of royalty. He clearly has vertex balding, but his frontal hairline can not be seen clearly, so I can not guess what his final pattern is. I also do not know if he is using any medication, which makes sense to arrest the hair loss, thereby modifying his final pattern.

Tags: prince harry, royalty, british royalty, hairloss, hair loss

Why Is a Cure for Hair Loss Taking Forever?!?!

Flat out doc….
when is there going to be a cure for hair loss? I mean come on, our scientist have done some seemingly impossible things, yet we can’t figure out hair loss? I don’t believe it. There has to be a way. They seemed to have been able to reverse it in mice at a %100 effectiveness rate what about humans??? Our bodies can do amazing things there is no way you can tell me it can’t regrow hair. I believe it’s possible…….

Block Quote

The fountain of youth has also failed to materialize. I would like to think that one day there will be a true hair loss cure, but I have no way to know if or when it will happen.

Tags: hairloss, hair loss, cure

Recoverup Stem Cell Treatment?

Hi doctors,
I saw this video of a stem cell treatment that says you have “noticeable” results in a couple weeks. What do you think about this?

Here’s the link on Youtube.

Block Quote

When any stem cell treatment is advertised and promoted as producing hair within 2 weeks, I’d think that this is another stem cell fraud, just as the TV program 60 Minutes recently covered. It’s interesting that this video just shows computer animations and not photo results, but regardless, to my knowledge there is no proven effective stem cell treatment for hair loss on the market today… particularly one that grows hair in a couple of weeks.

I’ve embedded their video here, but I don’t believe their claims for a second:

Tags: recoverup, recover up, stem cell, hair loss, hairloss