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    Questions about finasteride

    Apr 29, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    I’ve had seborrheic dermatitis and a lot of hair shedding for several months, almost a year now, and my hair line has gone from NW2 at 16 to NW3.5 now at 18. I started min on my temples about a month ago to slow down the recession, but I’m scared my hair is gonna keep thinning and receding until theres nothing left

    I start college in a few weeks and I’ve been seriously considering starting fin, and I have a couple questions.

    1. How long will fin take to start working? will I even get my hairline back?

    2. How do I find out if I get sides? How soon after beginning do the sides show up?

    3. I’ve been pretty much the same height since 14 but if I do still have some growing left, does fin affect or stunt height growth in any way?

    1- It starts working within a couple of weeks, but you may not see benefit for months

    2- You will know if you have side effects. Most men don’t know that they are taking the medications

    3- Finasteride is reported not to impact growth

    Skin penetration of topical finasteride

    Apr 29, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    If I’m reading this correctly, the penetration to the skin layer is around 5 times more effective. What about further than that into the bloodstream, where we don’t really want it?

    There is minimal leakage into the blood stream from liposomal topical finasteride. Some estimates, from what I have read, run as high as 18% of the total dose. A few of my patients have had DHT blood tests before and after the topical liposomal finasteride with no change reported in their serum DHT levles

    Limit to FUE?

    Apr 28, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    If one decided to only do FUE transplants, are you greatly reducing your potential lifetime donor area capabilities?

    There is a safe limit with FUE that depends upon your donor density and your hair mass index. That is what a good examination will tell you

    Why is blonde hair better when thinning?

    Apr 28, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Is this because the colour is closer to the pigment of the scalp if you are of a lighter persuasion? Or what is the reason behind this?

    Many reasons: Closer match to lighter skin so less color/contrast, blonde hair reflects light as does white hair.  Of interest, 50% of women past menopause who have hair loss and become blondes to deal with the thinning to take advantage of the low color contrast between blonde hair and a blonde/light tan skin color.

    How long do you have to take hair loss medications

    Apr 27, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    I’m considering going on minox after jumping from Norwood 1 to 2.5 in a year at age 30, but I’m intimated by the commitment of having to keep successfully buying it, reacting well to it and consistently using it. How long you could try it out for without developing a dependency and triggering worse loss upon stopping? Is there any way to taper off it slowly in order to minimize shed if you had to stop? I have a mast cell disorder which results in unpredictable allergic symptoms and I never know when I will lose tolerance to a substance. Thanks

    All of the medications for hair loss are required to keep taking, essentially for the rest of your life. When you stop them, the hair loss returns because the hair loss support from the medications like finasteride or minoxidil cease.

    Gynecomastia and finasteride

    Apr 27, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    I developed gynecomastia during puberty and had it surgically removed at 20. I’m now starting finasteride and I wanted to ask if any of you know the chance of recurrence with finasteride

    Men with gynecomastia during puberty have the same risk as men who didn’t when it comes to taking finasteride and getting breast development in the form of gynecomastia as an adult.

    Blood work for finasteride

    Apr 26, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Do you still not recommend that men considering start finasteride not get pre-fin bloodwork?

    I never recommend blood work when I prescribe finasteride as I wouldn’t know what difference it makes

    Dutasteride in addition to finasteride

    Apr 26, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    I currently do 1mg fin a day, so 7mg a week. I’ve been thinking of starting 0.5mg dut once a week, so a step up on your scale I guess. My main question is this; I’m 23 amd started a year ago and have had fair results. Should I wait until I start losing ground again before adding dut so as to not get used to it earlier, or is earlier better?

    There is no need for finasteride if you are going to use dutasteride. You just increase the risks of side effects by doubling down.

    Can oral minoxidil make hair grow to the eyes?

    Apr 25, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    I’ve heard of Male patients growing dark hair all the way up to under their eyeballs. I wouldn’t want beard stubble growing that far up my face. Have you ever seen that with your patients? and is it common? I’m a 39 male with thinning on my crown and mid scalp and I’m about to start taking 1.25mg/day, I’ve been on fin for 2 years, but I’m losing ground.

    Oral minoxidil can increase facial and body hair. I have never seen the eyebrows grow up to the eyes

    No sides= finasteride not working (Not true)

    Apr 22, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    So I’ve been on fin 1mg MWF for about 4 months now. I’ve had zero side effects whatsoever, which I was not expecting. And I haven’t seen any improvements in my hair so far. In fact, it has possibly gotten worse. Do no sides mean the drug isn’t working?

    Finasteride almost always works to slow, stop or reverse hair loss.  Slowing it is hard to see if you are undergoing rapid hair loss.  If you stop the drug, which I am not recommending, you might see the value of it be accelerating your air loss

    Microneedling every 6 weeks plus finasteride and minoxidil

    Apr 22, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    6 months microneedling weekly, half dose of finasteride plus minoxidil

     

     

    I would rather give up my sex life than go bald

    Apr 21, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Hair transplants are always a good option so that you don’t have to give up your sex life.

    Sex drive sky high on finasteride

    Apr 21, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    I’ve been on fin for 17 days and i have the complete opposite effects my libido is sky high and my erections are making my balls hurt what am I supposed to do?

    This is a known side effect. One of my sons went on finasteride and got the same reaction.  His solution was an active sex partner with his girlfriend who he made very happy

    Finasteride and acne

    Apr 20, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Is it best to take 1 mg 3x a week as I’m so worried my acne will come back if I go on finasteride ?

    You can try 3 times a week but if it is not effective, start increasing it by one pill more each week until you hit the recommended dose of 1 mg/day. You can do this over months if you prefer.  I don’t think that acne will appear, but keep a careful watch.

    Cutis Vertices Gyrata (photo)

    Apr 20, 2022/by William Rassman, M.D./0 /Hair Loss Causes

    Imagine this man has inherited Male Pattern balding.  It happens. A challenge for hair transplant surgeons.

    Read more about this condition here: https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/cutis-verticis-gyrata/

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