Foltene

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

In the local pharmacies in the UAE a hair-loss treatment product by the name of Foltene is readily available. What are your thoughts on it’s components and do they hold any merit on it’s effectiveness? foltene.eu

FolteneI haven’t heard of Foltene before, but I checked out the site. The ingredients are a bunch of vitamins and something they are calling “Tricosaccaride”, which according to information I can only find on their company site, is something that they discovered in the 60s. Common sense time — If this really worked as claimed, don’t you think in the past 40+ years it would’ve been a little more well known? The vitamins in the ingredients will nourish the hair, but I have no idea how they can assume that means it’ll regrow hair. Looking a little further into what Tricosaccaride is, it seems like it is an acid that helps with blood circulation to the scalp. The idea of poor circulation leading to hair loss is false. See here for more on that.

The product claims to change the number of hairs in the anagen (growth) and telogen (sleep) phases. In other words, it claims to be able to tweak the cycling of your hair growth. Hair cycle is something that is controlled below the skin (genetics) and not above the skin… so a topical treatment that can do as they claim just doesn’t make sense.

Tags: foltene, tricosaccaride, hairloss, hair loss, anagen, telogen

Having Troubles Applying Rogaine Foam

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

Thanks for all you great help and advice Dr. Rassman & Dr. Pak…Its obvious how much your site is appreciated by all the balding males and females…

Anyways, my question revolves around the application of rogaine to the scalp. I have a decent amount of hair on my head and find it hard to get rogaine directly to the scalp – especially the foam…..I part my hair but still find that it seems my scalp becomes more saturated with the medication rather then my scalp…Does rogaine get absorbed to the scalp systemic circulation and cause hair growth across the scalp or rather just in the area applied? Do you have any advice for the application of minoxidil or rogaine foam? I have read the information that comes with the actual foam but its not that informative…just tells you to part your hair and apply to the crown (from what I understand though is that Rogaine has shown growth all over the scalp except the temporal region). I apply to the frontal region and crown myself…

Any advice would be greatly appreciated.

Thanks again

I suppose having trouble applying Rogaine because you have too much hair is a good thing. You can try parting your hair and applying around the part. Or applying it when your hair is damp and shows more scalp area. I would apply the foam anywhere you want hair to grow. It may not work as well on the temporal or frontal region, but it does not hurt to try.

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

Gynecomastia from Minoxidil?

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

Dear Sir/Madam
I have been using minoxidil for more than year and i am happy with it, since the results are great so far!I have been pretty concerned lately though, given that i seem to be developing some kind of gynecomastia. Perhaps it is due to high levels of prolactine (just a guess)… Could minoxidil increase the level of prolactine and thus lead to gynecomastia?
Thanks a lot in advance

There are many possible causes of gynecomastia and you should certainly see a doctor to rule them out. I have answered the question of minoxidil and gynecomastia before, and there is no connection between the two that I’m aware of.

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

Can I Predict How Fast I’ll Lose Hair Even If I’m Already Taking Finasteride?

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

I am 25 (almost 26) and I am starting to notice some hair loss. I have been using generic finasteride…5 mg…and I cut it into 4 pieces to take once a day. I’ve been using it for a couple years now. I also use Rogaine (the foam), though sometimes I forget to put the rogaine on.

I have noticed on this board that you mention finasteride will “eventually stop working” and there is really nothing I can do about it. Is there any way to further slow the growth down? I was thinking of upping my dosage to 2-3 mg a day of finasteride. Will this work? Am I doing myself a disservice by using the generic brand instead of Proscar?

Also, is there any way to predict exactly how much hair I will lose, and how fast?

Thanks!

Finasteride does not stop working, but your hair loss can continue while you are taking it. Some people report a noticeable decline in the benefits they saw from Propecia after the 5 year mark or so, but that just means your body is winning the tug of war over genetic balding. If you stop the medication at that point, you will see even further, faster loss (which is what I refer to as “catch-up” hair loss). Finasteride slows hair loss in men, but does not necessarily stop it. I wouldn’t up the dosage without first consulting your prescribing physician. The higher the dose, the greater the side effect risk.

To my knowledge, there should be no difference between the generic finasteride 5mg pills cut into quarters from the 1mg Propecia pill. It’s the same drug, afterall… just different dosages.

There is no way to predict exactly what your hair loss pattern will be or when you’ll get to it. You can get a good idea by mapping your scalp for miniaturization, and then mapping it again in 6-12 months to see the progression (if any). An educated guess could give you some clues at that point, but it’s not an exact science.

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

Starting with 0.5mg of Finasteride, Then Increasing to 1mg in a Few Months

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

I just began taking 0.5mg Propecia this week. It was a decision of mine because I was a bit paranoid of the side effects and figured I would start halfway and at least save my hair. My plan is to increase to 1mg at 4-5 months. Is there any danger to this transition, like increased likeliness of a shed after going to 1 mg?

There is no problem with this approach, but I can not understand your doing it. I would understand if you got negative sexual side effects, which is 1 in a hundred chance. The full dose is the way to go for best results.

Tags: finasteride, propecia, hairloss, hair loss

What’s the Purpose of Taking Propecia If I Just Need Hairline Help?

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

I have a question regarding the entry “How Many Months Does it Usually Take for Regrowth from Propecia to Occur?”. You said it’s unlikely that people with a norwood 3 will be able to re-grow hair at the frontal hairline. In this case, is there a purpose in taking propecia? Would hair transplant be better in restoring the frontal hairline?

I am actually very worried about taking propecia because I am scared that I may have to stop taking it one day (due to the cost of the drug) or for other reasons that I can’t continue using it. And you mentioned that once someone stops taking the drug, hair will fall out rapidly. Even though 2 dermatologists told me that once I stopped using it, my hair will just go back to the state prior to taking the drug (so I am just buying time using propecia).

Can you also help me with finding a reputable doctor (or a hair transplant surgeon?) I can consult in Toronto, Ontario as I am not sure how to get in touch with one.

Thank you so much

Your question reflects your confusion of the facts as they exist. Propecia (finasteride) rarely regrows hair in the Norwood Class 3 balding pattern (frontal area). Transplants are the way to go if you qualify as a candidate (loose “rule” is if you’re over 24 years old… or if you are younger and have a good doctor that doesn’t just want to get your money). Hair loss is progressive in nature, and as I don’t have enough information about you, I couldn’t begin to guess as to whether your hair loss has stabilized or if you’re in for further loss. Your dermatologists told you correct info — if you stop Propecia, you may rapidly go back to where you would have been had you not taken it. There are generic forms of finasteride (in 5mg dosage that can be cut) which can be purchased at a fraction of the cost of Propecia, but you need a doctor’s prescription for it.

To find a doctor in your area, go to the ISHRS site and look up the doctors in Toronto using their physician search. Every city has some good doctors and some dishonest ones, so be sure to research your chosen physician on the web (and you can figure out the reputation of the doctors by looking on various industry bulletin boards, including Hair Transplant Network and Hair Loss Help).

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

Proscar and Insurance

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

I am aware that you are not in the business of insurance premiums, but I am curious to know if you have any insight regarding the possible negative affects (insurance related) of obtaining a Proscar prescription.

Specifically, have you ever heard of someone being negatively labeled by an insurance company after receiving a prescription for Proscar (in terms of increased premiums with current or future insurance providers)?

Thanks for your time.

For a young man, the answer is no. If you are over 50 years old, this medication is often associated with benign prostate hypertrophy (BPH), so maybe an insurance company can draw the wrong conclusions if your use is for hair only.

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

I’m 15 Years Old and Losing My Crown!

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

Hi, I’m 15 years old and for a long time now I have noticed a bald spot in my crown and from what people have told me it is getting worse. At the moment I have quite long hair but for some reason the crown is balding. This is making me very self conscious and I’m only 15! .. What should I do??

You should get help from a dermatologist in your area. I’m not sure what you’re seeing (is it actual hair loss or just the way your hair parts at the crown?), but a doctor should be able to tell you once and for all. Your options are limited at 15 years old, as you’re likely still growing. Minoxidil (Rogaine/Regaine) may work for you if you are losing hair, but most teens your age wouldn’t be too keen on applying medication twice daily to their scalp. Again, seek out a doctor for an in-person exam.

Tags: crown, hairloss, hair loss, teen, teenager

Effectiveness of Minoxidil Variations?

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

Doctor Rassman,

I am wondering just how effective a let’s say 15% minoxidil solution is, in comparison to a 5% solution? I believe that 5% minoxidil is 45% more effective than a 2% variant, but are there any scientific reports that can tell us how much more beneficial an increase is beyond that 5%?

I have not seen comparison statistics between the various strengths of minoxidil that show with certainty just how much better the drug is at the higher concentrations, but the benefits and effectiveness is clearly dose related. If someone has that information, please send it in!

Tags: minoxdil, rogaine, regaine, hairloss, hair loss, dosage

Prescription Rogaine for Women?

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

Is there a different prescription strength Rogaine for women? If so, is it by prescription only?

RogaineThe 2% and 5% Rogaine (minoxidil) solutions are available without a prescription, but some doctors might prescribe a 12 or 15% generic minoxidil that is formulated by pharmacists. Rogaine (name brand minoxidil) does not come in a prescription strength.

Since this drug is known to drop blood pressure in some people, high concentrations of it can cause fainting, chest pain and general weakness… and if you get these higher concentrations be careful to titrate your dose with any side effects as discussed above. Generally, the higher the concentration, the greater the impact on hair loss so some doctors recommend the high dosages to maximize benefits.

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

Why Doesn’t Minoxidil Require a Prescription?

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

If Minoxidil is a drug, why does it not need a prescription? Sure, things like toothpaste and acne medication also list “Drug Facts” but sodium fluoride and salycilic acid seem natural, whereas minoxidil doesn’t. I asked a similar question like this before but it wasn’t answered.

That is an FDA decision. It originally was a prescription item, but someone put in an application to the FDA to release it for general over the counter sales. The FDA must determine safety and effectiveness and I guess that they determined it safe enough.

Tags: fda, minoxidil, rogaine, regaine, hairloss, hair loss

Will Dutasteride Maintain the Finasteride Benefits?

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

I have switched from finasteride to dutasteride recently – my hair is definitely receding as i stopped taking anything for around 18 months. I started taking proscar again for a year before switching to avodart – will i lose all the hair that was kept or regrown by stopping finasteride and switching or will avodart just continue where proscar left off?

kind regards

If your transition from finasteride to dutasteride is transparent (stop finasteride one day and pick up dutasteride the next day), then there should be no impact on the switch as both drugs block DHT at the level of the hair. Keep in mind that appropriate dosage for dutasteride as a hair loss treatment has yet to be approved by the FDA.

Tags: avodart, dutasteride, propecia, finasteride, hair loss, hairloss

I Stopped Propecia After 10 Years

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

I was taking propecia for about 10 yrs. I’m a 47 yr. old male. I just recently stopped using it about 2mo. ago fearing that I’m doing harm to my body internally. I was always able to get an erection while using propecia, but it never seemed to be full. since I’ve stopped using the product I’ve noticed that I have a full erection and better feeling in that area, but the down effect is I think my hair is getting worse. I was still able to perform so I have a decision to make. Should I start using it again before I’m completely bald? and is it a good idea health wise?

Please give me some advise its a very depressing situation. Is there anything on the market that may be a better alternative? I’ve heard that laser comb works! In the mean time I’m going to start up today with propecia. Thank you very much and I’m looking forward to hearing from you.

I’ve written many times about the Laser Comb (and variations thereof), and I’m not impressed with the results. I do not think they work as claimed.

Since you took Propecia for 10 years and then stopped, seeing hair loss should be expected. Restarting the medication will hopefully halt your hair loss once again, but I can’t say that for sure. Cross your fingers and keep up the daily Propecia if you want a chance at maintaining your hair. If you’re having a sexual side effect from the drug and yet still want to keep your hair, talk to your doctor about Viagra or Cialis.

The only other FDA approved hair drug works a completely different way from Propecia, and that’s the commonly known minoxidil (marketed as Rogaine). If you stop the Propecia in favor of Rogaine though, the Rogaine won’t maintain what Propecia kept for you. So it’s not really an alternative, but it is something to look into if you’re running low on options.

Tags: propecia, finasteride, fda, rogaine, minoxidil, viagra, cialis

Stopped Propecia for 2 Months Then Restarted — Now I’m Losing Hair!

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

I took propecia pretty faithfully for all of 2008 and for some reason still unknown to me, stopped for the month of Dec and Jan. I started taking it again in Feb and then come March, I started shedding hair like crazy. When will the catch-up loss stop?? Its scaring me like crazy!

FootstepsIf you don’t know why you stopped taking Propecia, how are you sure you remember when you actually stopped taking it? I can’t give you an end date for the catch-up loss, as I wouldn’t know how to determine one. The hair loss may never catch up, even with just a 2 months hiatus. You need to hope and pray that it will reverse to where it was prior to your stopping the drug.

Readers, take note: If you’re serious about keeping your hair, do not follow in this man’s footsteps by forgetting to take the daily finasteride.

Tags: finasteride, propecia, hairloss, hair loss

Would Switching from Propecia to Cut Proscar Tablets Induce Hair Loss?

/by William Rassman, M.D./2 /

Could switching Finasteride products possibly be dangerous on my hair? I’m currently on 1mg Propecia, but when my prescription runs out I may to switch to 5mg Finasteride tablets and cut them into 1/4ths. I’ve read that switching medications like this, despite having the same ingredients, can bring on a sudden and serious shed. Is there any truth to that and should I perhaps get another renewed prescription for Propecia instead?

MerckNo, I don’t believe you’ll see a shed from switching. Most people who switch from Propecia to Proscar do it for economic reasons, as the 5mg pill is substantially less expensive (particularly the generic 5mg, since there is no generic 1mg legally available in the U.S.). I wish the drug company, Merck, would get that message… and maybe they will, as this blog is frequent reading by their sales force.

Propecia is a brand name for a drug called finasteride in 1mg strength and Proscar is the same drug in a 5mg strength. Splitting the pill into 4 or 5 pieces is a cost saver, but as long as you are taking 1mg finasteride daily it is the same thing for treating hair loss.

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