Been on Finasteride for Months, But Lost Hair After Starting Minoxidil

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

Dear Doctor,

Now i’m using Finasteride for 7 months and the results are good. Hair is regrowing and i’m losing less hair then before. (average 10 hairs a day). I’m a 20 year old caucasian male.

But now I started with Minoxidil (2%). I noticed that I’m losing more hairs than before (25-30)(Only when I comb my hair!!) I’ve been using Minoxidil for 2 weeks. But I don’t know if i have to continue this procedure, because it doesn’t guarantee any regrowth and now i’m losing more hair then before… I’ve read that you can lose more hair in the beginning with minoxidil, but now i’m losing 20-30 hairs more each day(!)then normal, how will the benefits compensate that on the long term?! Continue or not continue the procedure, that’s the question!

I hope you understand my question.

I do understand your question, but you need to understand that it’s normal to lose 100+ hairs a day. 20 to 30 hairs on your comb each day shouldn’t be a cause for concern. The hair loss from minoxidil is documented for the first two months when hair cycling is accelerated. There is good science to this effect. Likely what happens is there is a “resetting” of the hair cycle as the hairs fall out to get ready for new, stronger hair to grow.

Most patients tend to stop using minoxidil because they are worried that the hair loss will continue. Some patients do continue with the minoxidil and should see the loss stop after 2-3 months as the new hair cycle takes over. It takes patience of at least 6 to 12 months of using minoxidil for benefit and at least 1 year for maximum benefit. Ultimately the decision to use it is yours.

Tags: minoxidil, rogaine, propecia, finasteride, hairloss, hair loss, hair cycle, shedding

How Quickly Could Catch-Up Hair Loss Start If I Quit Finasteride?

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

What is the minimum amount of time someone can use finasteride and then stop and see “catch up loss”? I am 35 and have very minor hair loss and I am afraid if I start, and get sides, et, or am not comfortable with the pill, and can’t tough them out, that my hairloss will accelerate much faster than it was previously. What would you consider an appropriate amount of time to use the drug, quit, and get catch up loss?

Also, what do the shed hairs say about my MPB or loss? Is there a difference if I am shedding long/thick hairs vs wispy ones? In normal shedding and accelerated/catch up shedding, should a “bulb” be attached?

Thanks!

Catch up hair loss takes about 1 to 3 months after stopping Propecia. Hair loss will accelerate to “catch up” to the point where you would have been if you never had taken Propecia in the first place. You will NOT have more hair loss than if you’d never taken Propecia.

The bulb at the end can be normal and isn’t a concern. I’m not sure what you’re seeing as far as the long/thick hairs, but you might just be describing normal hair cycling.

Tags: hairloss, hair loss, propecia, finasteride, catch up hair loss

Applying the Rogaine Liquid is Difficult!

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

My boyfriend has just started using the generic Rogaine from Costco in liquid form, and I have been helping him since depositing a dropperfull of liquid on the bald spot is not an easy thing to do alone. I use the dropper to distribute the liquid around the spot, but no matter what we do it seems that much of it runs off down his neck or forehead. The rest sits in the few hairs he has left in little droplets.

My questions:
– are we doing this wrong somehow?
– should I be putting on a latex glove and trying to spread the solution around with my fingers?
– would the foam work better? He has the typical bald spot at the crown of the head, with just a few fine hairs and mostly just scalp. But I have found in my research that an awful lot of guys say the foam just melts from your body heat and runs off anyway…

Suggestions or pointers to articles would be much appreciated!

Your problems are well shared by many users of liquid minoxidil, thus Rogaine Foam was created so that the medication stays on the area you want to treat. It may “melt” and run off as you say, but it is better than the liquid in my opinion. If you still want to use the liquid (or your boyfriend does, more precisely), you can apply the liquid with a gloved hand. That might be best anyway, since you’re not using the medication.

Tags: minoxidil, rogaine, foam, liquid, hairloss, hair loss

I’m Just Taking Medication Until Cloning is Ready

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

I have been losing my hair since i was about 17 and a half and i have found it deeply depressing and i am sick of the smell of hairspray! I was just wanting some helpful advice …

I have been taking Propecia for about 4 months and i am yet to notice any results and i am beginning to consider but as i am only 18 i will probably be denied such treatment. I just want something to tide me over until hair cloning is made public. Do you have any idea when this may be?

Any Advice you have i would be very grateful to receive.

Yours sincerely

I just got back from the annual ISHRS hair doctor convention (this year was in Amersterdam), and that very same question about cloning was asked to the experts who where on a panel that I chaired. The answer is that there is no cloning in the near future. I’ll write more about the ISHRS meeting in a future post this week.

My honest opinion is that cloning is still a decade away from being available to the public. They’re making progress, but even the clinical trials seem not to be working as hoped. If you follow message boards, some believers will tell you to give it another year or two… but that’s a moving timeline. I’ve been reading it’ll be available in “5-10 years” for at least the past decade. If you believe that someone has the answer, please let me know as it might just be good marketing hype.

You won’t see results in just 4 months of Propecia use, but stick with it. The most common question I get from 18 year olds on Propecia is about hair loss in the hairline. I don’t know what your hair loss is like, but keep in mind that full regrowth isn’t a benefit of the medication that you should be expecting. Just stopping the hair loss where it’s at is benefit enough. The peak benefits of Propecia takes 2 years and the gain in the second year slowly appears.

Tags: propecia, finasteride, age, teen, cloning, hair cloning

Does Propecia Cause the Hairline to Recede Faster?

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

Hello Mr rassman

Why does almost everyone all over the internet claim propecia causes the hairline to recede and bald even faster? is this true. can it be because of the testosterone rise. because we all know testosterone does bind and hair thinning just like dht

Where are you getting your source of information? Hair loss from genetic male pattern baldness (MPB) cannot be stopped forever, but it is not accelerated by Propecia. In other words, you can be using Propecia, but still have receding hairline. Propecia does work mostly on the top/crown area and not so much on the hairline, so I suspect most people you are referring to are just noticing their recession and blaming it on Propecia.

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

Crackdown on Fake Propecia in UK (in 2007)

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

Note the importance of buying legit Propecia from a real pharmacy!!

Couple years old but a UK Press Release about fake Propecia rings true today.

Press release: Counterfeit medicines gang convicted

Thanks for sending this in. Yes, it is from late 2007, but it goes to show that counterfeit Propecia does exist and is a problem. One crackdown (no matter how large it was) in the UK doesn’t eliminate the problem altogether. Buyers need to use common sense when buying prescription drugs off the internet without a prescription.

Tags: propecia, finasteride, counterfeit, fake, crackdown, hairloss, hair loss, uk

Correlation Between Degree of Hair Loss, Time, and Propecia’s Effectiveness?

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

thanks so much for your work with this blog. i am 25, with what i would describe as a hairline that has receded about 1.25 inches at the corners and generally thinned in the front. i have been putting some thought into propecia’s timeframe lately, and would love to hear your thoughts on this.

merck of course has their (FDA approved!) literature, about what to expect after 3 months, 6 months, 9 months, etc…there are of course many variables that go into the whole equation, but what are your thoughts on the ratio of time an individual has taken propecia/total time the individual has experienced some degree of hairloss? i have been taking for just under 4 months now, and not really noticed anything. some people lose hair quickly, what has happened with mine has happened over 3+ years.

would you hypothesize there is a correlation between not only degree of hairloss and propecia’s effectiveness, but also between the amount of time that hairloss occured versus how long a person has been taking propecia? thanks!

There is a genetic test called HairDX Test for Finasteride Response that can check your overall sensitivity to DHT blockers like finasteride, as we are all different genetically. It scores a CAG repeat test, and when the patient scores low (less than 22, for example) they will have a better response from finasteride than when the score is high (above 22). In this way, it is possible to find out your overall sensitivity to these drugs (hence, effectiveness). Add this into the other variables you mentioned above, and you can get a more clear picture of what my happen to you over time, but the reality may not be as simple as just getting a genetic test.

The medical profession is at the doorstep of understanding genetic tests like this and fitting them into the course of patient’s balding patterns and the rate of the balding process. At 4 months, there is just not enough time to know how you will respond to the drug, but at a year or so out you may know more. Finasteride does not work as well in the frontal hair at reversing the process as it does in the crown. You can get yourself tested with this genetic test to anticipate your personal response to finasteride, but what you do with the information is not easy to ascertain. You will have to sit down with your doctor to explore the process further.

In all people, the effectiveness of Propecia over time will change because the balding process will change (it is progressive) and the degree of change varies with the individual. There are no rules other than what I discussed above, but I believe that as long as the balding person is taking Propecia, the drug is effective. To prove this, stop taking it and see that the hair loss just gets worse in a matter of months. Actually, I don’t advise you to try to prove it, because the cost in hair loss would be too great.

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

If a Natural Hair Loss Cure Existed, Would You Even Tell Us?

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

If you knew that natural cures to hairloss existed, you wouldn’t be holding back on us just to get a few more bucks, would you?

Also, it’s been one year exactly since I stopped my 58 days on Propecia, and I still have these mental side effects of stumbling over words/lack of fluidity when speaking/lack of wit and smoothness. The only other thing in the world this could be would be the high soy diet I put myself on for hairloss measures a few weeks after I started Propecia, and right before I felt my first side effects. I’ve seen a thyroid doctor (who said everything at Whole Foods was a fraud), a neurologist, and a psychiatrist (the latter just for kicks really), and apparently I’m the foremost expert in soy isoflavones and their effect on the thyroid. Just because someone has a medical degree doesn’t mean they’re knowledgeable in every arena. I still never had any sexual or physical side effects, and my wit is still present when I type or write, so something is only affecting my speech, which lends me to believe it really has to do with the physical properties of the thyroid and perhaps the larynx. Any thoughts?

Would I hold back the cure for balding if I had it? The answer to that is… absolutely NO. I obviously spend all of this time answering questions on this site just so I can squeeze money out of you, telling you there’s no cure when secretly I’ve been hiding it in my wall safe. Did you catch the sarcasm there? If you truly think a natural cure for hair loss is out there, by all means keep rubbing onions on your head and coffee in your eyes… or whatever the “cure of the day” might be.

I can not tie the speech/voice problems you have with the drug Propecia. What you said about soy is interesting and noted. There have been some patient reports that finasteride may have caused some impact on brain function but, I suspect, that would be extremely rare and not proven in the medical literature.

Tags: hairloss, hair loss, propecia, finasteride, soy, cure, natural

After Stopping Propecia Does Hair Loss Get More Severe?

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


Dear Dr. Rassman,

I have a question regarding Propecia side affects on the hair (!) if you stop taking it. If one stops using it after a long period (months or years), are there any chances the hair loss would increase? Meaning, if one took it for, lets say, one year and his body got used to the drug, can the hairloss get worst when he stops using it? I know of course that when one stops using propecia the shedding returns, but could it be more severe than if he had not taken the drug for the same period of time before he stopped?

Thank You

If you stop using Propecia, you may experience “catch up” hair loss. You will in effect lose all the hairs that grew from Propecia and lose all the hairs that would have been lost if you never took the medication in the first place. I have personally seen such cases and they can be pretty dramatic. The hairs that are lost will not likely come back if you re-start Propecia. I don’t know of any evidence showing that upon stopping Propecia, your hair loss even more severe than it would’ve been.

Tags: propecia, hairloss, hair loss, catch up hair loss

Why Not 0.75mg Finasteride?

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

In the past, you have reccomended .5mg of propecia for those experiencing side effects. Why not .75mg?

As long as you have a good way to split a 1mg oval/circular pill into the correct geometry to make it 0.75mg, I don’t see a problem. Then you can take the 0.75 and save the 0.25 remaining for the next three days when you can combine three 0.25 to take the 0.75 dose. Or I guess you can just throw away the 0.25. Get the point? It makes practical sense to split a 1mg pill in half to make 0.5mg.

Tags: propecia, finasteride, hairloss, hair loss, dosing, dosage

Reversal of Frontal Hair Loss from Propecia (with Photos)

/by William Rassman, M.D./5 /, ,

This is a patient who had reversal of frontal hair loss by just taking Propecia for 2 years. The miniaturization in the frontal area was 50% 2 years ago and now is 30%. This is rare to get such a good response to Propecia. The patient is 25 years old and I suggested that he wait 1-2 years to see what was going to happen on the drug. As it turns out, waiting and postponing surgery at 23 when I saw him initially was a good choice. No surgery is needed now.

Before on the left; After 2 years of Propecia (no surgery) on the right. Click to enlarge.

 

Tags: propecia, finasteride, hairline, hairloss, hair loss, photos

I’m Shedding Hairs Just From Sneezing!

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

Hi Dr. Rassman,
I had the pleasure to meet you at your open house and I think your great and honest. I have very very major concern right now. I want to have a HT and I think you said I am not ready, however I am going to be a NW 4A. I have been taking Rogaine foam for about 2 years now and for the last month I am shedding extremely bad and I mean bad. every morning about a hundred hairs on pillow. if I sneeze in sink I see 10 hairs in sink. the shower is clogging up the drain. If I run my hand thru hair over sink about 30-40 hairs fly out with each stroke.

DO I STOP THE ROGAINE FOAM? I still need A HT but don’t want to let this get completely out of control.

Thank You Very Much

TissueYou should be on finasteride. Didn’t I tell you that? If I met you and you’re a Norwood 4A, I surely would’ve suggested you get on Propecia.

Sneezing does not cause hair loss, and if you’re losing 30-40 hairs each time you run your fingers through your hair, your loss does sound pretty bad. If you stop the Rogaine Foam after 2 years, you’ll likely see more loss as the benefits from the foam will disappear. Come back and see me again.

Tags: finasteride, propecia, minoxidil, rogaine foam, rogaine, hairloss, hair loss, sneezing

The Corners of My Hairline Are About 2 Inches High

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

Good afternoon Doctor! I just want to thank you for this site.

Im an 18 year old boy, and since i was around 17 my hairline changed into what it now is today. However I’m not sure where to class ito n the norwood scale. The frontal hairline is, like you say in the normal place, exactly half an inch above the furrowed brow, however my concern is asscociated with the corners of the hairline. From the highest wrinkle, if i place a tape measure to the furthest point of the corner of the hairline it measures around 2 inches.

My question is with a corner reccession like this, could i still be placed in the Norwood 2 section? Because if you look at the stage 2 of the Norwood scale, the measurements found on this site for the mature hairline don’t appear to fit with it. The front of the hairline and the corners appear to have a far greater gap than the ‘norm’ of 1 – 1.5 inches…..

And just as a last question, if i start on Propecia at this age, is there a chance i could keep this hairline for the rest of my life? I hope i’ve been clear in what i’m saying. THanks alot and i look forward to your reply.

I’d stop trying to categorize yourself into a particular Norwood class. Perhaps you are a class 2 or class 3, but I really do not know (photos might help). Are you measuring at an angle? Assuming you’re seeing 2 inches when measuring perfectly vertical from the brow to the corner, it sounds like it’s past the Norwood class 2 level. But it seems more like things are changing and evolving as you are maturing. You’re 18 years old, and a maturing hairline is definitely not uncommon at that age. The real issue is finding out if you are actually balding or not.

Before thinking about Propecia or putting yourself into a category, go see a doctor and get your scalp mapped out for miniaturization. If you are indeed thinning, Propecia may be an option to halt further loss.

Tags: hairline, hair loss, hairloss, norwood, propecia

I Got My Propecia Prescription Filled at a Different Pharmacy and Now I See Results!

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

Hello Dr. Rassman-
I have been taking propecia for over 4 years. I am a transplant patient and have had success with that but wanted to keep the rest of my hair also. I was never really convinced of the quality of results from propecia which had been supplied by the transplant doctor only, but kept at it. Recently, I had to get a new prescription and decided to fill it locally at my local pharmacy. It has been almost two months, and I now seem to be getting the results I was expecting. Is it possible that previous filled prescriptions could have included inferior sources of propecia? I’ve not seen or heard of anyone else with a similar experience. Have you? Thank you for your time

I’ve not heard of a situation like this. I really don’t have any reason to believe the Propecia supplied by your doctor is any different than the Propecia from your local pharmacy. If you are concerned, I would get the two different samples and contact Merck with your concerns. They have anti-counterfeiting procedures in place, which you can find out more about here. Did your local pharmacy provide you with Propecia or generic finasteride, because perhaps the dosing is different?

Tags: propecia, finasteride, pharmacy, doctor, hair loss, hairloss

Adderall and Propecia

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

Hello Doctor,

I recently started taking 1mg of finasteride (approximately 3-4 months ago) and I’m seeing some noticeable hair growth.

A couple days ago I started taking some adderall and noticed that it was causing my hair to shed. Since the 1mg dosage is meant for men with normal testosterone and DHT levels (and considering the fact that adderall increases testosterone plasma levels, which translates into more DHT production), would an increased dosage of finasteride negate this increase in testosterone, and thus, DHT levels?

Also, when would be appropriate time to take the finasteride so that the drug’s effect will coincide to provide maximum efficacy against the increased DHT production from the adderall? How many hours/minutes before or after taking the adderall?

Thank you

AdderallI can understand your concerns, but you need to know the basics of hair loss. Chasing DHT levels is not the answer and this medication may have a direct impact on your hair, independent of any genetic contributions. If your hair loss is genetic (otherwise known as male pattern baldness or androgenic alopecia) there is no definite cure. Drugs such as minoxidil (Rogaine) or finasteride (Propecia) do work, but they do not STOP or CURE hair loss! Results vary among individuals. And even if you regrow hair, over the course of your lifetime you will still slowly lose hair. Taking these medications will help by minimizing the hair loss.

With respect to Adderall, it may have an effect on hair loss. Even if it did, taking more finasteride will likely not help. Studies have indicated that it does not make a huge difference between taking 1mg or 5mg of finasteride (aside from higher side effect risk). In some rare cases, I have recommended 2.5mg finasteride for patients, but I’ve yet to see any gain or slowing of hair loss as of yet (likely too soon to tell). I don’t mean to sound bleak, but DHT is not the only answer to hair loss. We have not discovered the complete mechanism for the way in which the genes work at the hair growth metabolic level… yet!

Tags: adderall, hairloss, hair loss, finasteride, propecia, dht, amphetamine, dextroamphetamine, adhd