I Want to Stop Propecia After My Hair Transplant

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

Hi,

I’m due to get a transplant in a couple of months and have been on Propecia for around 2 years (I’m 26 years old). For the last 6 months or so I’ve noticed side effects that are getting worse, even after cutting the dosage down. I plan to stop taking finestaride after surgery, but will keep on it for now to help prevent shock loss. How long after the surgery do you need to take finestaride for to help prevent possible shock loss?

Thanks for your help

You should take the drug for a full 6 months (minimum) after a hair transplant and then after stopping it, watch as the hair gain (or retention) you saw from Propecia will be lost over a few months.

Tags: propecia, finasteride, hair loss, hairloss, shock loss, hair transplant, hair restoration

Is Merck’s 2007 Patent Filing for Topical Finasteride Just to Squeeze Out Other Companies?

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

I heard Merck applied for a patent for a topical finasteride product in 2007. Any recent news on this? And, do you know if this would be effective, or if it might be a move to enhance profits by weeding out companies selling topical finasteride?

MerckI know very little about Merck’s patent for topical finasteride, although they did file 2 patents (one in 1993 and the other in 1995) in the general area of finasteride use on skin. Johnson and Johnson holds at least two patents for topical finasteride, so it does appear that this is a hot field and what differentiates one process from the other is something that I do not have the time to review. Does anyone with a bunch of time and interest care to go through these and create an itemized list?

Certainly both J&J and Merck are giants in the drug field, so if you wish to read these patents check them out in the Google Patent Search and have a blast reading the intricate legal jargon. Good luck!

Tags: merck, topical, finasteride, patent, hairloss, hair loss, johnson and johnson

Rogaine for Women vs Provillus for Women

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

Hi. I would like to know whether Rogaine or Provillus is better for women. Which one has better results at growing back hair and stop hair loss? Also, less likely to have the side effect of unwanted facial hair. Thanks!

They both are just 2% minoxidil… different names and labels. The Provillus might also have some supplement vitamin pills (with biotin and B6) to take. Ingredients are listed here for Provillus, if you’d like to check them out.

Also, Provillus costs more than twice the price of Rogaine. How much is that packaging worth?

Tags: provillus, rogaine, minoxidil, female hair loss, hairloss, hair loss

Is 5% Minoxidil Safe for Women?

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

Is it safe for women to use 5% minoxidil? My dermatologist recommended it but, in speaking with the people at Rogaine, they acted quite alarmed by the idea.

I recommend it for women as a routine. There’s a higher risk of facial hair growth with the 5%, which is what most (if not all) women wish to avoid… but that risk is still minimal. Officially, it was tested on men so that is the drug company’s line. You can see more about this here.

Tags: minoxidil, rogaine, women, female hair loss, hair loss, hairloss

I Don’t Think I’m Responding to Finpecia

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

Hello Doctor,
I need your advice. I am 24 years old Indian losing hair for last 4 years. Last year doctor prescibed me finpecia (1 mg). I am taking it since then but I am still losing hair. I feel that it is not working. I came to NYC this jan for higher studies and I have brought finpecia with me. Do you think whether I am not responding to medicine or there is some issue with finpecia itself?

Since I am a student I cant afford Propecia. Do you think ,I should give Proscar a try and do I need medical presicption for getting proscar? I want to meet you, but I cant come california for next one year (due to studies) and moreover I will not be able to afford your fees before that. So suggest me what to do ? I will be very thankful to you.

FinpeciaProscar is the same drug as Propecia, just in higher dosage (Proscar is 5mg finasteride, Propecia is 1mg). If you cut the medication, it is the same. You do need a different prescription for that, and some doctors may have a problem giving you a prostate medication prescription at 24 years old. Explain to them that you know to cut the medication into 4 pieces. If one doctor won’t give you a prescription, you can try another one.

With all that being said, if you’re still losing hair on Finpecia (generic 1mg finasteride from India), I’m not sure Proscar will help. Are you taking it daily? You’ve been taking it for less than a year, so I’d stick with it until the 1 or 2 year mark to see how you’re responding by then. At 24 years old, you may have some strong genes for balding dominating your system and working against the finasteride. Look at the HairDX finasteride response test and see if this applies to you. It might tell you why the drug has not worked well for you.

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

Rogaine on the Hairline — Worth a Shot?

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

Dr. Rassman:

I recently met with a new dermatologist after I noticed significant and abrupt patterns of shedding. I am 30 years old, and I’ve been on Propecia for 10 years and was thrilled with it up until about a year ago. It was then that I noticed a ton of sheddin in the shower, pillow, etc, etc.

I asked my doctor about Rogaine, and told him I had been using on the crown of my head for about 8 months, as a preacautionay measure, in case Propecia stopped being effective for me. He said to use it on my hairline as well. He said that although Rogain is not FDA approved to be effective on the hairline, that doens’ mean that it isn’t. He said “its worth a shot”. What are your thoughts on this?

Thanks

There have been reports of minoxidil being effective on the frontal hairline, but they are few such observations with significant hair growth. I suppose it is worth a shot.

Tags: rogaine, minoxidil, hairline, hair loss, hairloss

RevitaLash as Hair Loss Treatment?

/by William Rassman, M.D./3 /,

What is you opinion on the product Hair by Revitalash? Do you think it has potential as a hair loss treatment? I know you would have to be careful not to get it in your eyes.

RevitaLashThis post gets two responses…

Response from Dr. William Rassman:

There is no proof that this product will work on scalp hair, although there are some doctors trying it with their own form of human experimentation. I will certainly let you know when there is a credible scientific study released. I spoke to a representative of the manufacturer and they are interested in learning if it has an effect on scalp hair loss but they have not begun testing it.

Response from Dr. Bessam Farjo:

Actually at the ISHRS annual meeting in Amsterdam 2 weeks ago, I (Dr. Bessam Farjo) presented some initial data from a study my centre is working on in collaboration with University of Bradford in the UK. Our work so far is on human hair in the laboratory, but there were encouraging results showing that Bimatoprost (the active ingredient in Latisse eyelash treatment) can make the hairs grow longer and faster and prolong the anagen (growing) phase. We also identified that there is a receptor for this compound in the hair follicles explaining its mechanism of action. Further work is ongoing and may in the near future result in a clinical trial that would show what value if any these medications have for scalp hair.

Tags: revitalash, bimatoprost, latisse, hairloss, hair loss, hair growth, ishrs, eye, farjo

The Doctor at the Aderans Interview Said Cloning Would Be Available in 5 Years

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

Dear Dr. Rassman,

I am a 29 year old male. I became aware of thinning in my crown area in April of ’09, and got on Propecia at the beginning of May. I volunteered for the Aderan’s phase II hair/cell replication study, but was told I had too much hair to be a subject. The Dr. at the clinic where I was interviewed said the cloning procedure would be available in about 5 years.You state that you see the cloning procedure as a decade off, so from the information you’ve gotten at this recent convention, is it reasonable to imagine that in my late thirties, around 2019 or so, that I can get hair restoration through a cloning procedure? And in the next few years, do you see a better drug, like an FDA approved version of Dutasteride coming to market?

Thank you for you time

The folks at Aderans predicted the cloning solution would be available in 5 years… and that was 5 years ago. So by that timeline, it should be here now… yet here we are, wondering where it is. I probed that question to those who are knowledgeable and found that no one really expects a cloning solution in 5 years. Perhaps ten years… and maybe more.

Dutasteride is already FDA approved to treat the prostate, but I’d like to think it’ll be available for treating hair loss at some point down the line, once any other studies are concluded and safety can be assured. It’s not up to me, and I’ve got my reservations about the medication already. There are no other new hair loss drugs like dutasteride that I know of coming in the next 5 year horizon. It takes years to clear it through the FDA so we will have plenty of notice when the process starts for a new medication.

Tags: aderans, cloning, hair cloning, hairloss, hair loss, dutasteride, avodart, medication, drug

One Side of My Hairline Getting Worse After 5 Years on Propecia

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

Hi Dr., great site!

I’ve been in Propecia for nearly 5 years and I think I’ve maintained for the most part. In the last 8 months or so, I’ve noticed the left part of hairline getting worse. What can I do? i was thinking of adding Tricomin. Possibly Rogaine Foam, but I didn’t want to get started on a major product just yet.

Thanks for any help.

Asymmetrical hair loss is not uncommon. You can add Rogaine Foam (minoxidil) to your routine, but stay on it for at least a year, possibly your lifetime. Chances aren’t fantastic that it’ll help with the hairline, but it couldn’t hurt. Hair transplants to the frontal area work really well, but for you, it may be too radical a move based upon your statement that minoxidil is a major product shift.

Tags: propecia, finasteride, rogiane, minoxidil, hairloss, hair loss

My Doctor Told Me Finasteride Caused Telogen Effluvium

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

I recently saw a doctor about my problem of excessive shedding several months after finasteride therapy has started. He told me that around the 11th to 16th week, there can be sudden shedding, sometimes on a massive scale. The entire phenomenon fits the description of a telogen effluvium. In the case of finasteride use, the telogen effluvium appears to be a reaction to the sudden change in the systemic levels of the sex hormone, DHT.

First, I would want to examine you, do a hair pull test and map out your hair for miniaturization, as I typically do. I am not doubting that this could be a case of telogen effluvium (TE), but over the internet, the diagnosis by me can not be made. If you are impacted by finasteride, stopping it is an option.

The loss of hair on an acute basis may be a TE and that would explain a large amount of hair loss between the 11th and 16th week, but the cause of TE is often mysterious.

Tags: finasteride, telogen effluvium, propecia, hairloss, hair loss

I Abused Steroids and Lost Hair

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

hello, i used steroids for bodybuilding for about 3 years i basically abused them. my question is i noticed hair loss torwards the end so i came off immideatly, i never touched steroids or any drugs since. My hair began to grow back nice and healthy within 2 months or so after i discontinued, then all of a sudden one day about 6 months later it began to thin again, why would this be?? No one in my family mum or dads side has genetic hair loss. Please Help me figure this stressful problem out.

Thank you

The steroids may have triggered genetic hair loss and you are now following through with your genetic pattern. Even though you don’t see hair loss in your immediate family, the expression of the gene can skip generations. Finasteride might be good at blocking this effect, but you should get a doctor of your own to give you a diagnosis and then treatment recommendations. This isn’t something I can do online.

Tags: steroids, steroid, hairloss, hair loss

I Buy My Finasteride at Walgreens, But it Comes from Israel

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

Hey Dr. Rassman,

I currently cut a generic version of Finasteride 5 MG, which I purchase directly at my local Walgreens. I keep reading on your site that you should make sure that you are getting what you pay for and should question the validity of across sea’s medication.

I did some research and I found out that Walgreens get’s their generic Finasteride 5mg version from a company called: Teva Pharmaceuticals US. Walgreens.com

I then googled that company and their generic Finasteride together and I found out the following: Teva finasteride

At the bottom I can identify that they are talking about my pill by it’s identification of being blue and having “93” on one side and “7355” on the other. But what I noticed was that the medicine is manufactured in Jerusalem, Isreal (By Teva IND) and then they send it to their Pennsylvania location to Teva US.

I called 3 different Walgreens and asked them about this drug and they assured me that it is FDA regulated and that I am getting what it says I am. I don’t think a company like Walgreens would allow bad medication to be sent in….but my question to you is if you would trust the validity of this drug because it’s being manufactured in Isreal?

Thank you for your time

TevaMany drugs are manufactured overseas by good companies which subscribe to FDA quality manufacturing rules. Teva Pharmaceuticals is one of those companies. They’re one of the largest makers of generic medications in the world.

Tags: teva, israel, walgreens, hairloss, hair loss, finasteride, propecia, proscar, fda

Where’s the Saw Palmetto Study? There’s Money to be Made!

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

Since there’s obviously a ton of money in hair loss products, why hasn’t anyone done a conclusive study on the effects of saw palmetto on hair loss? It seems like if it’s believed to help, a conclusive study would (if it’s found to slow loss) help products containing saw palmetto off the shelves

I agree that a better controlled study would help us understand the impact of saw palmetto on hair loss, provided it was dose response oriented. The reason that this is probably not being done is that there is no patent coverage available for this drug, so when a study comes out, anyone can profit from the sale of the drug (in this case it is an herbal remedy not a drug). So there’s money to be made if it shows the herb is effective… but one company financing the study will potentially open the floodgates for other companies to profit. This does not make for a good business proposition if you were paying for the study. In other words, studies are not cheap and who is going to finance it if the money can’t be made back?

There have been limited studies on this very subject in the past. One such study from 2002 contained only 19 men. Of those men, 60% showed “improvement”, but I don’t know if that means their hair looked thicker, darker, or there was actually more hair. Plus, it was just a pilot study and too small to be worthwhile in proving effectiveness.

Tags: saw palmetto, herbal, herb, hairloss, hair loss, study

Notes from the ISHRS 2009 Conference, Part 1

/by William Rassman, M.D./6 /,

ISHRS 2009I just got back from the 17th annual scientific ISHRS meeting (basically a hair transplant doctor’s convention), which went on from July 22-26. Lots of information was presented… lots of lectures, presentations, and discussions. This year’s meeting was in Amsterdam, so I had quite a long flight back to California when it was all over and I was able to do a write up on the plane of what I learned. I thought I’d share…

 

Treatments

 

Dutasteride:
Review of the Korean study for this drug indicates that it is safe and effective drug with side effects consistent but slightly higher than those in the finasteride study. The tests, however, did not study the impact of this drug on sperm count. One doctor present at the meeting reported two patients who had become sterile while on the drug (one being his son). Both men, upon stopping the drug, found their sperm count returned to normal. The failure to study sperm count is, in my opinion, a major oversight in the Korean study from a safety point of view. Based upon this private report, I will not prescribe dutasteride without at least 2 years of treatment on finasteride or a frank failure of the finasteride. I will require that anyone getting a prescription from me (each case would be individualized) would have to sign a legal document that states they recognize that sterility is a possible side effect and risk of the drug.

Finasteride:
Finasteride limits Type 2 receptors for 5 alpha reductase, which reduces the incidence of cancer of the prostate… not the risk of developing prostate cancer. The information available only covers a 7 year period and longer term studies are not available. It is unknown if this drug will reduce the risk of prostate cancer.

PRP:
The use of platelet rich plasma (PRP) was a theme for many scientific papers. We have known that for topical use on skin wounds, this PRP has shown value in accelerating healing when applied. Studies for its application for alopecia areata was suggested by one doctor and a few doctors have started to soak the grafts in the plasma of patients to see if the grafts grew sooner, looked more robust and had a high “take” rate. I would not trust the conclusions of these doctors without a good scientific study to back up their observations. For the moment, I would call this “human experimentation”.

Prostaglandin:
Dr. Bessam Farjo presented a paper on prostaglandin receptors in the stimulus of hair growth. The drug latanoprost has been successfully used to grow eyelashes and is now FDA approved for this (in the form of bimatoprost), but the actual mechanism for what has been observed is unknown. It clearly increases the hair length, rate of hair growth and pigment in the treated lash, and there is a suggestion that there may be applications of this drug in the treatment of hair loss with a bit more research. Some early research by Dr. Farjo suggests that this may very well work as a stimulant for hair growth and in future treatments for hair loss.

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