Does Propecia Work in Cycles?

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

Is it possible for Propecia to work in cycles? It would be great to get an opinion on my experience:

Month 1-3: Hair felt and looked thicker, barely any falling out or shedding.
Month 4-6: Thinner hair and a lot of shedding. I thought it had stopped working. But then…
Months 7-10: Same feeling as months 1-3, thicker hair and i was excited that the drug was working again.
Now I am in Month 12 and my hairline has never been receded further and I have more scalp visible on the crown than ever.

Is it possible that these are natural hair growth and hair loss phases? I dont know if the drug has just stopped working or will start up again because nobody seems to experience this. Thanks for your help.

Propecia does not work in cycles, but your hair grows in cycles (with or without) the medication. Propecia does not just stop working. It is that everybody responds differently to medication.

Tags: propecia, finasteride, hair cycle

Guest Post — Popular Baldness Causes and the Lack of Evidence

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

This post comes from Dr. Richard Shiell:
–

    Dr Masumi Inaba, who wrote a book on Androgenetic Alopecia (Springer 1996), was firmly convinced that the increase in Western style animal fats was causing an increase in baldness in young Japanese males. I am not sure that his statistical method would stand rigid scrutiny however.

    The same lack of good statistics applies to all the popularly believed “causes” of baldness. Forty years ago when I was a young HT surgeon, the patients all blamed the wearing of hats in the Army or Police Force as the cause of their baldness, when I am sure that it was just that they entered these institutions at the precise age that severe AGA usually kicks in (19-21 years old).

    I certainly believed throughout my career that “gym-jocks” lost hair more quickly than their “lay-about” brothers and cousins. The problem is that many were taking steroids and other “dietary supplements” so it was a very confusing issue to ascertain causality.

    I had one of a pair of 25 year old “identical” twins who had lost significantly more hair than the other. When I spoke to the more hirsute twin about it he laughed and said it was because his brother was married with a child and mortgage, and had more stress. So there you have undeniable evidence from a large series of ONE case!!

    Hair loss is the results of many complex things. For example, dietary supplements like whey and a variety of branched amino acids including creatine, push up men’s testosterone levels (and their DHT levels), which in turn accelerate hair loss. We are what we eat, I just wish I understood all of the complexities of diet as it impacts the hair loss we see.

Tags: hairloss, hair loss, balding, testosterone, dht

If I’m Splitting the 5mg Finasteride Pills, Are the Side Effect Risks Greater?

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

I’m turning 26 years old soon and been on Propecia for 4 years now starting in mid July. For over 2 years I been cutting generic fin in 4 pieces and have saved tons of money. If you are cutting fin you are taking a slightly higher dose can it give you side effects? Because when cutting those pills the dose can be sometimes from like 1mg to maybe 1.5mg it’s hard to cut it accurately! And even if you do you be still taking 1.25mg!

Unless the pieces are perfectly symmetrical and you didn’t lose any crumbs in the cutting process, you probably aren’t getting a full 1.25mg finasteride dose — and like you said, splitting it accurately is difficult.

But let’s assume you’re getting an average of 1.25mg per day. I suppose taking that dose by cutting a 5mg tablet can theoretically give you a slightly higher risk of side effects than taking a premade 1mg finasteride pill (Propecia)… but in practice, we have not seen this.

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

My Child Says Haircuts Are Painful

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

my 6 yr old son cries excessively during a haircut and when i wash his hair. Being african american I also brush his hair while washing it to make sure it’s clean. It seems when he’s getting his haircut it’s not painful to me, but he says it hurts when he’s getting his haircut. Is there anything that can be done or should I be worried about anything inside his head or anything. Please help?

If you have curly, kinky hair and someone is brushing it out, I would think that would be painful. Perhaps this is what your son is experiencing. There may be rare scalp conditions that cause pain, but that would need an examination. You should follow up with your child’s pediatrician.

Tags: haircut, scalp pain, child, pediatrician

Could I Now Have an Allergic Reaction After 6 Years on Propecia?

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

I have been taking propecia for almost 6 years and its worked perfectly. However, recently, I started to have an itchy rash all over my chest. I wanted to know if you have seen this before and if I do have an allergic reaction to Propecia, what options are available to me as I really do rely on it. Thanks

I have never seen an allergic reaction to Propecia that caused a rash on the chest. I suppose anything is possible, but it does not seem probable based on your brief description alone. I would follow up with your doctor.

Tags: finasteride, propecia, rash, allergy

Propecia Doesn’t Get Rid of All DHT, So Why Take It?

/by William Rassman, M.D./18 /

There was doctor last night talking about hairloss on tv and about propecia. He siad that propecia only gets rid of 70% serum DHT and 38% scalp DHT. there is still 30% serum left and 62% scalp DHT left which is still alot of DHT. Then he said those remaining DHT can still do a number on hair follicles, and cause hairloss even by taking propecia. so he said taking finasteride is basically useless and that he would not prescribe it for that reason.

His words were, “why take this propecia drug, when it leaves behind a huge percentage of the DHT in the blood and scalp, that can still cause hairloss. He used a colonoscopy example. he said when people do a colonoscopy and a patient has lets say 5 polyps the doctor removes all 5 the polyps and doesn’t leave any behind. he said a drug like propecia removes one polyp and leaves 4 behind which can turn deadly. so why take propecia when its not that effective at removing the source hormone.

whats your opinion. I value your opinion more than the doctor speaking on tv. this threw me off lol. there is alot of dht left even with propecia. 62% scalp dht is alot.

I thought my opinion on Propecia was pretty much established here.

The reality is that Propecia works at preventing or stabilizing hair loss in most men. His numbers on DHT seem reasonable, but when you see the drug work to slow hair loss or even reverse the loss in young men, then the results speak for themselves. The visual results have been well documented. Add the fact that it has been proven safe for 98% of men without side effects, and that is what is important.

When all is said and done, it’s really not about the numbers, percentages, or colonoscopy analogies. Propecia does work, but your genetic predisposition in the long run will catch up to you. It buys you time, so to speak.

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

In the News – Mice, Yogurt, and Large Testicles

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

Snippet from the article:

Last sum­mer a team of researchers from the Massa­chusetts Institute of Technology set out to better understand the effects of yogurt on obesity. They were following up on the results of a long-term study from the Harvard School of Public Health that had suggested yogurt, more than any other food, helped to prevent age-related weight gain. The M.I.T. team, led by cancer biologist Susan Erdman and evolutionary geneticist Eric Alm, wanted to replicate the work in mice. The researchers took a group of 40 males and 40 females and either fed the animals a high-fat, low-fiber, low-nutrient diet meant to mimic junk food or fed them standard mouse meals. They then supple­mented half of each diet group with vanilla-flavored yogurt.

Read the rest at Scientific American — Mice That Eat Yogurt Have Larger Testicles

Mice that eat more yogurt have bigger testicles, are more fertile, produce more frequent pregnancies, and generally healthier offspring. Researchers also saw that these mice had “10 times the active follicle density of other mice“. In humans, I would suspect that the larger testicles could add to the DHT problem, creating more balding in men.

Tags: mice, yogurt, dht, testicles, fertility

Audio Update About Histogen HSC

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

listen to what the things going on in histogen: BaldTruthTalk.com

That is a lengthy audio interview (35 minutes) about the Histogen HSC. I do like what I am hearing… or rather, I want to believe what I am hearing, but the science needs to be presented. Without good science, we have no real understanding of what is happening.

Tags: histogen hsc, histogen, audio interview

68 Year Old Woman Lost Her Eyebrows — Is It Medication Related?

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

I have been taking Pradaxa for over a year-I also take metoporol & digoxin. I always had plenty of hair & my eyebrows were almost perfect naturally.about 6 months ago my eyebrows have disappeared almost completely & my hairline is receeding–could these meds be causing this??? Thank you! I am a 68 year old female & would like my eyebrows & hair!

metoprololWomen lose hair just like men, but in different patterns and stages. Women don’t go bald like men, but they thin out later in life. This can also be genetic as well. For women, there may be other medical issues such as thyroid conditions. There’s a list of possible causes here.

In general, medications can be the cause of hair loss. Pradaxa (dabigatran) and Lanoxin (digoxin) aren’t known to cause hair loss as far as I can find, but metoprolol (marketed as Toprol or Lopressor) does have hair loss listed as a rare side effect. More importantly, these medications are taken for serious health issues, so they should not be stopped or changed without a serious discussion with the doctor.

Many women lose their eyebrows and this can be genetic as well (as do men). A hair transplant procedure is a good option for those who want eyebrow restoration.

Tags: pradaxa, digoxin, metoprolol, hairloss, hair loss, female hair loss, eyebrows

In the News – Do Balding Men Have Sleeping Hair?

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

Snippet from the article:

It sounds more like an explanation that would be used by nursery children than respected scientists, but researchers have found that rather than losing their hair altogether, people who are going bald are suffering from “sleeping” hair follicles.

Trichologists have discovered that hair follicles on the scalp can become trapped in a resting state where they do not grow new hair, leading to thinning.

They now claim to have identified a way of waking the follicles up again to help restore a fuller head of hair to people who are going bald.

Read the rest — Balding men offered hope of waking their ‘sleeping’ hair

We have long believed that the stem cells that eventually grow into hair are probably still present in many people. Are they really dead in the balding man or can they be restarted by finding some defect in the pathway to the creation of an anagen hair? We really do not know this, so is it reasonable to call this sleeping hair?

L’Oreal in Paris carried out the research, and they’re reportedly working on a shampoo or cream to be a used as a new hair loss treatment. No time frame has been announced so far on this treatment, though.

Tags: loreal, shampoo, stem cells, hairloss, hair loss

Having Blood Work Done Before and During Propecia Use?

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

A comment received from the recent post about Propecia and free testosterone levels –

doctor…as an athlete, this is something about propecia which interests me greatly – but there just doesn’t seem to be enough information available about it.

Would there be anything to stop doctors like yourself taking bloodwork of patients before and during finasteride use so that you (as someone in a position who sees finasteride users daily) could report back to us – so we could make informed decisions taking into account not only our hair, but other matters also of interest to us like hormone levels?

Would really appreciate a response. Thanks.

This can be done, but insurance may not cover these tests. If someone wants to pay for the tests out of pocket, it would be in the hundreds or even thousands of dollars. And even if these tests were free, what would we do with the results? What significance or interpretations would come from the tests?

If you look in the literature, I am sure there have been similar studies done before Propecia or finasteride was approved by the FDA. You need to know what you’re looking for before searching for data points.

Tags: blood work, hairloss, hair loss, finasteride, propecia

I Want Propecia and The Earliest My Doctor Can See Me Is 45 Days From Now!

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

First off thank you very much for such an informative and helpful website.

I am 25 year old male who is concerned with my hairline. I have always had a high or mature hairline since my teens along with really thick hair, but I am worried about miniaturization starting and progressing in my temple and frontal areas. My family does have a history of mild to moderate hair loss. However nobody in my immediate family is completely bald including both grandfathers.

I am interested in taking propecia. I understand that at my age and my stage of hair loss, I am a good candidate for the drug. I live in Denver and have scheduled an appointment with Dr. James Harris who appears to be one of Colorado’s top Doctors in hair restoration. However, the earliest I can see him is in a month and a half. Would waiting this 45 or so day period be detrimental to the goal of maintaining my current hairline? How quickly can miniaturization advance?

I don’t want to miss out on my window of opportunity but at the same time I want to talk to an expert who can examine me to see if I even need the drug, and if I do, discuss the side effects of Propecia before recommending an appropriate course of action.

Thank you so much for your time and advice.

Best wishes

I do not think 45 days would be a cause for alarm. At least you are getting in to see a reputable doctor in Dr Harris and he can give you a good assessment and recommendations. You need a diagnosis, then a plan. You cannot go about it backwards and blindly go on a medication.

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

Other Uses for ACell in Hair Transplant Surgery?

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

There have obviously been lots of inquiries on the forum about ACell’s ability to multiply hair, but I’m curious about a different use. I had a consultation with a doctor that advocated using ACell in the donor region to aid wound healing (which you’ve discussed), but also injecting into the graft areas–not for hair multiplication, but to thicken miniaturizing hairs in the grafted areas and promote growth of the grafted follicles; sort of a nourishing property, if you will.

This is a completely different use from the “plucking” application yes? Any thoughts about this use?

ACell does not multiply hair. Some doctors, including myself, were involved in a year long study and the multiplication/plucking claims by the original doctors involved were false and unable to be replicated (see here and here). Otherwise, the entire hair transplant industry would have been changed by now (almost 2 years later).

Some doctors use ACell in the donor area to promote faster wound healing. It does not grow new hair there nor does it make the scar smaller. It just promotes healing faster. We have been using ACell at NHI for a couple years for this purpose and based upon our experience, I can say that there is no evidence presented anywhere that miniaturized hairs can be reversed with ACell.

Tags: acell, hairloss, hair loss, hair transplant, scarring

Men’s Health Magazine Warns About Propecia?

/by William Rassman, M.D./10 /

Okay, so let’s face it, hair loss sucks, hair loss does make a man less attractive by a noticiable amount. There’s no avoiding it. Propecia is an effective medication at stopping hair loss and regrowing hair. Is it really safe though? I have my doubts. One could say that anti propecia blogs are full of men who had problems in the first place and that most normal men wouldn’t be on these blogs in the first place. But the other day, I stumbled upon this article written by none other then Men’s Health magazine. Here is the link.

The full article is not available online but the first page does a good job of describing what the article will talk about. Now Men’s Health is no subtle underground publication it is read by millions of men. I’m no doctor but when you block DHT by using Finasteride which also happens to alter how your endocrine system functions, things probably won’t go well, hormones are emotional regulators and DHT is a powerful male androgen. Obviously hair loss is slighty devestating at worse and dissapointing at best but is it worth sucking out the life of an increasing number of men just for hair? Men want hair to appear as if they are full of life and virility so isn’t it ironic that propecia kills that motivation for many men?

The basis for the article in Men’s Health seems to be the tale of a guy with side effects from Propecia. Then it references a study that says sexual side effects occurred in men 45 to 78 years old when taking 5mg of finasteride (to treat their prostate problems). That is 5 times the dose for treating hair loss, and the prostate problems themselves can lead to libido issues without any medication involved. The article fails to mention that.

The rest of the article is a story about a man named “Charles K”. There isn’t much science here, but rather, a story about an unknown man.

Tags: propecia, finasteride, mens health