I have a small fungus on my foot. Mr dr. gave me clotrimazole/ bethameth. could it impact mpb?
I do not think a medication for your foot or a fungus can impact the hair on your scalp. Topical steroid on your foot should not affect male pattern hair loss. If there is long term / high dose skin applications with significant steroid absorption into your body, there might be a connection. Be sure to ask your doctor this question.
Hi There Doctor!
Im a 22 year old guy with a pretty good head of thick hair currently. No one currently would ever know I am thinning. Recently I went to get my haircut and my stylist told me i may have some “thinning issues” as she noticed short hairs near the front of my hairline. Crown is very thick at the moment.
I made an appointment with a dermatologist and she said that right now is a great time to catch it and potentially preserve everything I have and started me on Finasteride 5mg cut in half once per day. (2.5mg daily) and she said “see ya in a year!” I have been on it for two and a half weeks with no side effects yet.
My question is if it takes a year for Finasteride to show any results, isnt a year a VERY LONG time to lose hair? Couldn’t I lose A LOT of Hair in that period of time? I hate this feeling that I’m on the best medication for hair loss, but at the same time I’m gonna be losing hair at the same rate for a year before it even starts working?! Am I understanding how Finasteride works correctly Or does it immediately start to “help” but will just take a year to see any major preservation or potential regrowth?
Thanks!
It may take up to a year before you notice the effects of finasteride on treating androgenic alopecia. Maybe some will see signs in 6 months, but I generally inform my patients that they should be prepared for a 6 to 12 month time span before they can see results. That being said, Propecia (finasteride 1mg) is for the treatment of androgenic alopecia on the crown and top of your scalp. Some patients and doctors use it for frontal hairline thinning, but it is generally not effective.
As for the dosage you were given, the recommended dose is 1mg taken daily. Many patients and doctors, in the interest of cost saving, choose the generic 5mg which they break into quarters (1/4) to make 1.25mg of finasteride. There is no generic finasteride in 1mg dose legally available in the US yet due to patent laws. While breaking up a small 5mg tablet in to four small semi-equal pieces may be annoying, it saves hundreds of dollars a year. For example, a one year supply of finasteride 5mg taken 1/4 pill a day will cost you under $30 per YEAR. The brand name will cost you close to $800 a year depending on where you buy it. There is no difference in efficacy in taking the generic drug. Taking 1.25mg a day as opposed to 1mg should not have any significant difference. Ideally you should be cutting the pill in to five equal pieces, but this is not practical.
Taking 2.5 mg daily is more than doubling the dose and it would not have any beneficial impact in treating your hair loss. Taking more does not mean it will work better. Rather, it will give you more side effects. But some doctors have their own opinions and they’re in their right to practice medicine and prescribe medications as they see fit. If you do not agree with your doctor and have concerns, you should seek a second opinion. After all it is called a “practice” of medicine. Just to be clear, I am not your doctor and this is not a second opinion.
Hello, ive been searching around for an answer or explanation about body hair and what drives it to grow with no luck, i stumbled upon this site and thought it would be good to ask.
Im a male currently 21, and ive noticed a gradual increase in body hair, the growth is dark, coarse, and fairly thick. i’ve talked to my local doctor about this and done some tests still waiting for results, but he assured me this is “normal” however i beg to differ, the hair is really an annoyance and making social interactions abit awkward.
so my question is, how does body hair grow? and what hormones dictate the length and type (vellus / terminal) of hair? ive read that DHT might have a contribution but im not entirely sure. i do know however that my Test levels are on the lower side of the scale, which makes me think that my body is converting too much to DHT.
kind regards.
In general, DHT is responsible for some of the secondary male characteristics, such as body hair. DHT plus your genetic predisposition may cause changes in your body hair. Likewise, DHT plus your genetic predisposition can also affect male pattern hair loss. The key is genetics.
As men mature from their puberty years into their early twenties, many changes in their bodies occur. In men who are in their 60’s and older, they also develop ear hair and nose hair and some of them can lose body hair in their senior years.
Snippet from the study abstract:
Between October and December 2011, a persistent, raised, erythematous rash in the tattoo area developed in 19 persons (13 men and 6 women) within 3 weeks after they received a tattoo from a single artist who used premixed gray ink; the highest occurrence of tattooing and rash onset was in November (accounting for 15 and 12 patients, respectively). The average age of the patients was 35 years (range, 18 to 48). Skin-biopsy specimens, obtained from 17 patients, showed abnormalities in all 17, with M. chelonae isolated from 14 and confirmed by means of DNA sequencing. PFGE analysis showed indistinguishable patterns in 11 clinical isolates and one of three unopened bottles of premixed ink. Eighteen of the 19 patients were treated with appropriate antibiotics, and their condition improved.
Read the full abstract — Outbreak of Mycobacterium chelonae infection associated with tattoo ink
This topic interested us because of Scalp Micropigmentation (SMP) and the use of pigments in our practice. What can you learn from this? A medical facility is critical for sterility and cleanliness, and the tattoo ink must be medical grade. We periodically culture our inks as a precaution for this problem.
I have heard that hair loss is caused by excessive DHT. I have also heard that it is DHT that produces facial and body hair particularly in men. If I don’t grow facial hair (past stubble) does that mean I have less of a chance of exhibiting traits of early male pattern baldness?
I am 19 and my dad is the only person on either side of my family (maternal and paternal) who exhibited some form of baldness, but said that he showed signs at my age (I am not). Do I have good or poor chances of keeping my hair?
I think we answered this question many times in the past in different variations.
Facial hair is not related to scalp hair or male pattern balding. You can have no facial hair or too much facial hair without it being related to the hair on your scalp.
First off, I am a 20 year old male who has been concerned with balding since I was a kid. My dad is almost completely bald but the men on my mothers side all have full heads of hair. When I was about 16 I notice the corners of my hairline are higher then the rest of my hairline. I’ve worn my hair long since I was a kid so I can’t tell if this is my natural hair line or if it is in fact receding. I compulsively check my hair and haven’t noticed any recession since I began checking 4 years ago.
What I am desperately wondering is whether or not a hair transplant can restore a mans hair completely? I know that doctors recommend waiting until MPB has stabilized but my concern is (1) I don’t want to spend my 20’s bald, waiting for mpb to stabilize and (2) if i end up nearly completely bald there won’t be enough donor hair to help me achieve the results I want. I’ve always maintained good hair care and styled my hair so the idea of losing my hair is devastating.
On a side note, I’ve read a bit about stem cells possibly leading to a better solution to MPB. Is there any truth or likelihood to this ever becoming a reality?
In the pages of this blog, there are many examples of men being proactive about their hair loss. You need to get a Master Plan developed with a good, honest doctor who can help you through these traumatic years. Each case should be unique, so you and your doctor need to form a plan.
You might be a candidate for surgery or for medication. You might not even be going bald, but it’s just that your hairline is maturing. You might have nothing to worry about (as you said, your hairline hasn’t changed in years). Without an examination, I’m not sure what more I could say.
Stem cell research is ongoing, most recently mentioned here and here. I hope at some point new treatments become reality, but I’ve got no timeline for availability, nor can I promise that they will.
(female)
I would like to know if my hair loss sides front and back are a result of my doctor taking me off of thyroid medication. I was on 50mcgs and after he took me off of it i sustained an incredible amount of hair loss.
If your thyroid hormone levels are normal, I wouldn’t expect issues with hair loss. Usually people with high or low thyroid hormone levels experience thinning of their hair. Doctors generally monitor their patients thyroid levels and adjust the medication based on blood tests.
So stopping or starting thyroid medications is not the issue, but rather it is your own thyroid hormone levels that should be of importance.
I am late 20’s have begun to get thin in my front hairline and where my natural hair swirl is on my vertex and I’ve accepted that’s just within my family. But I am trying to keep track of how much is changing and I have noticed that ( I have dirty blonde hair) I am getting hairs turning almost black growing in random spots. Just single hairs and sometimes in groups of 3, one will be this black curly one. And those hairs have a seemingly denser feeling and posses a curl to them that does not compare to the rest of my natural hair texture. Any ideas what this is and what’s causing it?
If you have dirty blond hair, then dark colored hair is likely the norm. Some people just have random hairs that grow with different characteristics. It just may be the norm. Otherwise, I have seen some patients go through hair color change in their 20’s and 30’s as they go from lighter to darker or vice versa.
I do not think it has any relationship with respect to hair loss.
Snippet from the article:
Crucial to the hair-growth and balding process, scientists have found, are vitamin D and the microscopic receptors that bind to it in skin. These elements have become the focus for several research teams. (Supplements might offer health benefits for people lacking enough vitamin D, but they won’t bring back lost hair, researchers say.)
Some researchers, including those from the San Francisco Veterans Affairs Medical Center and Harvard Medical School, have identified molecules besides vitamin D that appear to activate the receptor and hold potential for future treatments. In July, Japanese researchers demonstrated in animals that adding vitamin D helped the process of using stem cells to generate new follicles.
Read the rest at the Wall Street Journal — The Search for a Baldness Cure
My friend Dr. Richard Shiell commented:
We are seeing Vit D deficiency in some Muslim women and children who cover-op and do not take advantage of our sunlight. I have not heard of any increase in hair loss. Kids at the beach these days are covered from head to knee as in the Victorian era so, if the author is correct, we should see more baldness in the future. I don’t believe it.
”It’s important to highlight the sentence from the article that states: “Supplements might offer health benefits for people lacking enough vitamin D, but they won’t bring back lost hair“.
In response to this news, some hair restoration doctors stated that they often recommend vitamin D as part of the treatment for women with balding or thinning hair. There does not seem to be a downside to this use, but I wouldn’t get too excited just yet about calling this a “cure”.
Dear doctor how are you doing. I love the website and you have helped me with a lot of my hair loss problems that my regular doctor hasn’t been able to answer. I am 30 yrs old and have been taking finasteride for a decade.
At first, when I started taking the drug, I was shedding a lot and almost thought I would go bald within a month. Thankfully I didn’t. However, now I am not shedding as much so does that mean the drug is losing its effectiveness?
2nd question is, I took 5 mg of proscar the other day just to try it out. If i take 5 mg which is meant for prostate, wouldn’t that make me want to go to the washroom more often? It didn’t, so does that mean the drug is losing its effectiveness.
Thank you very much.
So you just decided one day for the hell of it to take 5mg of finasteride instead of 1mg? I’m not sure I understand why you’d do that, but it won’t cause excess urination, nor would excess urination mean anything about finasteride’s effectiveness on hair loss. And if you’re not shedding while you’re on finasteride, it sounds like it’s being quite effective. Am I missing something here?
Talk to the doctor who prescribed the medication to you. It sounds like you need advice from someone who can examine you and form opinions on your hair situation, since you’re clearly concerned about effectiveness and willing to experiment on yourself.
I am very interested in the SMP procedure but am hesitant to do anything permanent without knowing if I will like the end result or not.
Is there a temporary procedure available (temporary tattoo, photographic manipulation) where a patient can see what they may look like with SMP, and if they like the result, go ahead with the permanent procedure?
Thank you
We have monthly Open House events at our office in Los Angeles where you can see first hand how Scalp Micropigmentation (SMP) is done and also meet with patients face-to-face that have had SMP.
It is considered permanent, but SMP can often – but not always – be reversed with laser treatments (pigment removal). But you’ll probably not want to have SMP done with the plan to go through the laser treatments right afterwards. If you want a temporary SMP look, you can try cosmetic camouflaging products like Dermmatch or Toppik.
I am 28 male with male pattern baldness which started at around 24 or so but last couple months has been thinning out very rapidly and I am not sure if this is normal. My front hairline on my left side is like a zig zag shape because the hairs are falling out and its uneven and doesn’t look natural.
Also, sometimes if I pull on those hairs some of the thick colored ones will slide out as if the follicle is dead and there is a black color where the root is. Why are these hairs coming out so easily with the black root and why is my hair loss/thinning all of a sudden happening rapidly? Thanks
It’s possible your hairline is maturing or you’re transitioning to a balding pattern that you’re genetically programmed to have. Perhaps it’s something else entirely. I really have no way to know just based on your email. But for your loss to start in the mid 20s, it does sound like it could be genetic male pattern hair loss. See a doctor if you’re concerned.
(female)
I am currently receiving chemotherapy for my synovial sarcoma. I have 2 more rounds of Ifosfamide to go (Cisplatin/Adriamycin in my previous rounds). I will have 6 total rounds of chemo. I’ve read everywhere that permanent hair loss can occur if there has been very high doses of chemo given. What counts as “high dosage?” Do you think 6 cycles of my chemo will cause permanent hair loss? I just want my hair back!! Thank you.
The reason for hair loss with chemotherapy is because these drugs kill cells that are fast growing, and hair cells fall into that category. We may not know immediately if the hair loss is permanent or temporary, because some of the women who have had such treatments may also have genetic hair loss that is triggered by the drugs. Only time will tell.
Within a year, there is enough time to survey the hair loss. Doing bulk measurements on the newly grown out hair and then repeating such measurements over time will tell much about how the hair may or may not be recovering.
I suggest that you finish your course of chemotherapy and after 6-12 months, you might consider being evaluated by someone like me if you are in the Los Angeles area. At one year out, call me and send me photos so we can start a dialogue.
Hi Doctor,
I’ve seen you comment on the topic of propecia-related gynecomastia before but, what I’m wondering is, how often you see it in your practice. Would you say it’s as common as the sexual side effects? Moreso? Less so?
I’m a bit worried at the fact that you say you now work with a doctor in your practice who treats this. I don’t supposed you’d have need for it if it weren’t pretty prevalent.
I’m starting to experience MPB. I am 26 and my father lost his hair at a very young age. Unfortunately, my visit to the dermatologist was not ideal. I was very nervous and she did nothing to calm me down. Honestly, she spoke to me as if my being there was a waste of her time. “You’re 26, it’s not unusual at this age.”
I understand that but a little understanding wouldn’t have hurt. She only suggested Rogaine for me. She mentioned Propecia but did not prescribe it for me due to being “disturbed by recent studies.” Being an FDA approved medication I really think it should be the patient’s decision as long as the risks are clearly explained. My general practitioner does not seem to want to prescribe it for me, either.
Any information you can provide on these topics is appreciated. I’d like to try the medication but, if I keep hair but grow breasts…I’m not sure what I’ve gained.
I think you read into things a little bit when I mentioned I now work with a doctor that surgically treats gynecomastia. I acquired a dermatology practice where one of the doctors has built up a massive experience treating this problem over the years. Most gynecomastia is not related to Propecia use, as this is very rare in my experience. Gynecomastia occurs in many men at many ages.
If you don’t like how your dermatologist treated you, you should find another doctor. I’ve written much about the “recent studies” which are actually just biased interviews with 50+ men.
Hi.
I cut the back of my head quite badly a few weeks back. I had stitches put in and now they have been removed. The cut is healing well but the problem is that there are 2 cuts with a gap in between. Currently I have a large-ish bald patch covering the whole area.
My questions are:
A) Will the area between the 2 scars ever grow back the hair
B) Is there anything I can do to encourage the hair to regrow.
Thanks.
Without seeing you, I can not tell you the answers to your question. The scalp frequently scars and the scar can widen. If that is the case, you may end up with a bald area where the scar forms.
Sometimes there is an area around the scar which has temporary hair loss. If that happens, it usually regrows in about 6 months. Best to see a doctor who knows about hair for an examination if you’re concerned.