Revita Shampoo

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

Hello,

I am 25 years old and have a gradually receding hairline around the temples and thinning hair for about the past two years, but I’ve been wary of getting propecia because of the health risks, and I thought about Rogaine Foam, but I heard that it it smelled and led to shedding, among other things. Since I’m trying to hang on to everything I have left, I didn’t want to take the risk of incurring significant shedding with Rogaine, as well as no promise I’d grow any hair back around my temples or forehead, so I did nothing but occasionally browse message boards until I came across information on Revita. It seemed like just what I was looking for; a shampoo that would at least reduce hair loss/thining. Well, I started using Revita about 5 weeks ago, and the first time I used it, leaving it on my hair for 2.5 minutes, then approx. 4 minutes, and my hair seemed a little thinner, but shinier. The next day I got a haircut so my hair was a little shorter and I continued using Revita 5-6 days a week, for the prescribed times, and I’ve noticed I’ve shed a couple 1-4 hairs just about every time I use it. This has been exceedingly disturbing, but I’m not sure if it’s just something that has to happen before it starts working better . . . I don’t know.

My theory – the reason I’m still using it – is that the hairs that are shedding are the ones closet to my forehead and temples and these are the real light hairs that already seemed on the verge of falling off. So I’m thinking that maybe just keeping the shampoo in the hair for so long and then rinsing it out is causing the weaker hairs to come off b/c of the contact. I’m hoping it’s just the weak hairs that will shed and the healthier hairs will become even healthier. But so far, I’ve seen none of the benefits promised by the company.

Thank you very much

RevitaI need to make this very, very clear to everyone — there is no shampoo currently available on the market that can regrow your hair. None!

This Revita product contains ketoconazole, which is a volumizer and can increase the hair shaft diameter by about 7%. This increase in shaft diameter may look like you have more hair and in fact, considering that fullness is a result of numbers and thickness of hair, you will have more hair that produces more fullness. Any shampoo that uses ketoconazole will have the same effect. By keeping it on for a few minutes before washing it off, the ketoconazole probably does a better job with thickening the hair shaft.

For those keeping score, ketoconazole is the active ingredient in Nizoral, and is a commonly used antifungal medication and dandruff treatment.

Tags: ketoconazole, nizoral, revita, shampoo, hairloss, hair loss

After 10 Years on Propecia, I Finally Started Shedding

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

Dr, I have been taking Propecia for 10 years. If the drug would indeed stop working, what exactly would happen? Would I have some form of telogen shed? Or would the loss be gradual? The reason that I ask is because I am going through a severe shedding phase that began in September of 2008 and it continues until now. I have indeed ordered the “generic” drug from overseas the past couple of years. Could the overseas drugs be bogus and this is the reason I began shedding again?

There’s two possible problems — the generic you bought overseas could be fake, or your finasteride dosage could just be starting to finally lose the fight to your genes. I often talk about a tug of war of sorts, where Propecia works on one side of the rope and your genes work against it. The genetic side appears to be slowly winning. Talk to your doctor about increasing your dosage to 2mg daily and see if that helps.

Whatever you do, do not stop the drug! You’ve taken the medication successfully for 10 years now, and it hasn’t stopped working for you… but if it’s not due to fake overseas medication, then it’s not slowing the hair loss as well as it was before. Stopping it completely will likely result in a massive catch-up hair loss situation occurring.

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

Why Isn’t Minoxidil an Oral Medication?

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

Why isn’t minoxidil taken orally? I’ve always been under the impression that drugs taken orally (like Propecia) get to the root of the problem as opposed to ones topically. For instance, if caffeine theoretically helped hair loss, I would think consuming caffeine would work better than putting caffeine on one’s head.

Minoxidil was originally used as an oral anti-hypertensive medication for the treatment of high blood pressure. It was unpredictable in its use so it was abandoned, but people taking it (women) would notice face and body hair appearing from the oral pills. That is why it is not used orally today, as it has a tendency to drop blood pressure. That even occurs when you apply it topically, as some of the medication is absorbed into the body after a skin application.

Tags: minoxidil, rogaine, hairloss, hair loss, oral, tablet, pill, blood pressure

How Did People Come Up with the Idea that Saw Palmetto Reduced DHT?

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

Okay, let’s say theoretically that saw palmetto does in fact help to block DHT. My question is, how the hell did they figure out that saw palmetto berries reduce DHT and not other berries out there such as cranberries and/or bilberries?

Saw palmettoSaw palmetto has been around for hundreds of years and has been used successfully for treating prostate enlargement. Native Americans used saw palmetto to relieve urinary symptoms in older men who had difficulty in urinating. It has been shown to reduce prostate size and it is used quite frequently in Europe.

There are many potential side effects of saw palmetto, including abdominal pain, diarrhea, nausea and vomiting, erectile dysfunction, breast tenderness and loss of libido. That is the connection that made people think that there is a DHT blockade in process, as so much seems to parallel finasteride’s side effects. Some think that since finasteride works for the prostate and hair, then if saw palmetto works for prostate issues it must also work for treating hair loss. Unfortunately, saw palmetto has never been studied in any well planned clinical endeavor for treating hair loss.

Tags: saw palmetto, hairloss, hair loss, dht, berries, finasteride

Nanominox FMS

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

NanominoxDear Doctor ,

i am thinking of buying nanominox fms , a product which combines minoxidil sulfate , finasteride and Ketoconazole. Do you think it is safe to use this topical solution on a daily basis? I would appreciate, if you could help me on that issue.

I have no experience with the combination of medications in Nanominox FMS. I am skeptical with it, because finasteride has not been shown to work through the skin. I suspect the FDA would, have a problem with any claims of a hair loss treatment from the manufacturer in the use of finasteride as a topical. Minoxidil is well known as a FDA approved topical treatment, and ketoconazole is a good antifungal medication that seems to make hair appear thicker. More info at their site. With regard to safety, your guess is as good as mine.

Tags: nanominox, hairloss, hair loss, minoxidil, sulfate, finasteride

The 5mg Finasteride In Bangladesh is Too Small to Be Cut

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

Dr. i wanted your suggestion about taking finasteride 5mg. i wanted your advice for not having finasteride 1 mg in our country bangladesh. the available finasteride is 5mg named “Prosfin”. you have researched the producing company name is “BEXIMCO”. you have found that they are producing finasteride 1mg named “Recur”. but 1thing u don’t know that “Beximco” has recently stopped production of recur. the Prosfin can’t be cut into 4 pieces, and at present i am taking Prosfin (Finasteride 5mg), 1 tablet/3 days. Now the concern is that taking finasteride 5mg 1/3days,can it cause any potential affect if i want to take a child, or want to have sexual intercourse while she is pregnant? can it affect the child? all things i am talking about taking finasteride 5 mg 1 table/3 days. i would not ask you these things if i could get finasteride 1 mg, or could break the 5 mg tablet. your blog is very informative.

This is an interesting problem. I’ve written to the drug company to find out more about their 1mg finasteride possibly being discontinued. For now, I suppose you might consider grinding the pill into a powder and taking 1/5th of that per day, assuming that the pill is the 5mg finasteride tablet. Make sure you keep it dry or it will pick up moisture.

Remember, the pill is not meant to be cut and the drug companies have designed it that way — so it’s not going to be an easy task.

Tags: hairloss, hair loss, beximco, prosfin, recur, finasteride, pill, tablet

I’ve Been Off Rogaine for Weeks While My Shipment Arrives

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

hi, i ordered 1 can of mens rogaine foam about 2 weeks ago, and still haven’t recieved it. well i have been using rogaine for about 5 months with great results, but havent been able to take any for about 2 weeks, will this effect the process? thank you for your time and help

The longer you wait, the worse the withdrawal impact will be. You want to keep those great results you’ve seen, right? Buy some locally to bridge the time gap until your online order arrives. Even if it’s not the foam, just get some minoxidil from your local pharmacy. Then, I’d contact the place you ordered from and find out why it’s taking them weeks to send your order.

Tags: minoxidil, hairloss, hair loss, rogaine

In the News – LashFood, the Alternative to Latisse?

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

From the article:

The company’s product, called LashFood, looks like regular eyeliner, but it contains some ingredients that you might expect to find in a nutritional supplement, including the vitamin biotin, the amino acid arginine, extract of irises (the flowers, not the eye parts) and a blend of 15 herbs. Biotin and arginine are widely marketed as vital nutrients for hair growth.

LashFoodRead the full review at the Los Angeles Times.

Basically, what I get from the review is that this LashFood is marketed as the alternative to the newly FDA approved Latisse (bimatoprost)… but it’s just more quackery. It doesn’t contain the proven drug that works for the eyelash growth. Now I have no personal experience or any basis to determine the value of this product, so please read that full review and draw your own conclusions.

There will always be someone marketing a “natural alternative” to the latest FDA approved prescription drugs. Do they work as claimed? I guess folks will have to spend some money to find out for themselves, because no matter how many online reviews people read (from reliable sources, even), many will still have that “What if…” thought in the back of their heads.

Tags: lashfood, latisse, bimatoprost, hair growth, eyelash, eyelashes, fda, natural

Why Wouldn’t Finasteride Work as a Topical If Women Can’t Touch It?

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

Hi Doctor,

I was wondering why finasteride is considered to be ineffective when applied topically? There are many warnings advising that women who may be pregnant are not to come into contact with crushed or broken finasteride-containing medication. If the risk of absorption is that probably, then why has the topical approach been largely dismissed as being an effective delivery method?

Thanks

BobI personally doubt there are issues with Propecia if women simply touch it. It is not about the absorption issues, but rather it is medical-legal issues. As you can imagine in our litigious society the field day lawyers would have if a woman who touched Propecia claims her baby was affected.

Finasteride has not been proven to work topically. Just as Viagra has not been proven to work topically — that is, unless someone else is applying it for you!

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

Female Hair Loss from Birth Control — Should I Switch Pills?

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

I have been on birth control pills (Orthotricyclen Low, Loestrin FE, and now Yaz) since 2004. I’ve noticed what seems to be androgenetic alopecia on my scalp since about 2005. Since starting on Yaz a year ago, it has increased and become VERY noticable. Would it be safe to get off birth control pills altogher or would that make my thinning worse? Should I try a different pill? I started taking BC because I had severe menstrual cramps to the point of fainting and am very scared to discontinue the pill.

This is a medical issue which needs to be discussed with your doctor. I am not your doctor and can not make recommendations on medication options for you. You’ve got a prescribing physician — talk with him/her, please.

Tags: bcp, birth control, female hair loss, hairloss, hair loss

Stomach Pain and Bloating from Propecia, Follow-Up

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

Follow up to “Stomach Pain and Bloating from Propecia” —

Hello Dr. Rassman,

Thanks very much for posting my previous message “Stomach Pain and Bloating from Propecia”. As per your suggestion, I tried to take the half dose of Propecia everyday. This reduced the bloated feeling somewhat but after a few weeks I felt discomfort in the groin region. I had taken the full dose previously with no pain/ dysfunction but some noticeably watery ejaculation.

At this point, I think I am finished with Propecia. I am one of a few people who feels that they were better off not taking the drug in the first place. I lost a great deal of hair in the middle of my head and this area of the scalp is particularly visible (and never was before prior to starting the drug). Although my hair was thin and has been thin for several years, it has remained the same for about 7 years with little or no change in density. Propecia initially created some increase in thickness but the middle area of the scalp that was lost through shedding never returned.

Doctor, do you think that after ceasing the drug, the hair that I once had in the middle of my head (and didn’t appear to be going anywhere anytime soon) will return? Over the course of a year I used Propecia off and on for about 7-8 months.

I have booked an appointment to visit my dermatologist at the end of the month. This is a very frustrating result for a drug that is supposed to help grow hair (not shed it away). Thanks so much for your feedback. I do appreciate all your help and support.

It sounds like you medication schedule has been erratic. As such, I can not tell you what will happen with stopping the drug. I doubt that the hair you lost will return. Minoxidil might have value for you.

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

How Can I Detect Propecia Side Effects?

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

I’m going to start taking Propecia for hair loss. I’d like to be vigilant about identifying any side effects early on. It’s pretty easy to find a list of side effects, but I’m not sure how I’d go about detecting some of them.

Is there a comprehensive list of checks I can perform every week (or even every day) to make sure everything’s going ok? I suppose there’s a potential psychological effect of constantly
looking for side effects, but hopefully I can be objective about it.

The listing of rare, uncommon side effects of finasteride use is as follows:

  • Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue)
  • Breast enlargement, lumps, pain, or tenderness
  • Nipple discharge
  • Testicular pain

If you take the drug, the side effects will be evident within 2 weeks on average. Once you stop the medication, the side effects (except for breast issues) will be gone within that same 2 week period. I have seen the breast tenderness last a few months and often recommend that you see your doctor if it does not go away in a few weeks. You’ll be able to easily identify any of those side effects because they’ll be out of the norm. Most are uncommon though.

Tags: propecia, finasteride, side effects, hairloss, hair loss

Could Side Effects Show Up Over a Year After Starting Propecia?

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

I have been on Propecia for around 15 months will no problems and good results – however I am very concerned that I may be experiencing side effects (maintenance of erection) !!!

Are side effects likely after such a prolonged period of use with no notable problems??? Or are side effects likely to show themselves within the first few months of being on the medication???

Side effects from Propecia like erectile dysfunction (ED) can appear over time, particularly if you are over 40 years old when ED is more common. I also have been told that libido or ED problems do show up late and I can not tell for sure if there is a cause and effect from the drug. The use of drugs like Viagra can help most people with these side effects and allows them to keep their hair. Check with your doctor and see if there are other causes of ED in your situation, as this may be caused by something other than Propecia.

Tags: propecia, finasteride, ed, libido, hairloss, hair loss

Using Minoxidil After Hair Loss from Chemical Burn?

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

Hello Dr. Rassman,
about 3 weeks ago I had a procedure done called l’oreal x-tenso which is basically a hair relaxing (rebonding) treatment. The original goal was to grow my hair longer, which is normally not an easy thing given that my hair is normally very thick and wavy/curly. Anyway, a couple of weeks after the procedures I decided to get my hair cut and a couple of days after that my hair started to shed a lot and has continued to do so over the past week, although it seems that the shedding is somewhat decreaing over the last couple of days. I’ve seen 3 different trichologists here in London and they all seem to think that the chemical from the relaxer cause some bad breakage but that should reverse once new hair grows out. Instead they all seem to agree that I also exhibit signs of androgenetic alopecia. There is no history of hair loss on both side of my family, isn’t genetic baldness always hereditary? The trichologists that I have seen here in London are suggesting that I use different topical solutions, Minoxidil has also been suggested. If the hair loss is caused mainly by breakage and it is not a genetic condition, would it still be safe for me to use Minoxidil? Also, looking at my hair when it falls, some of it but not most of it, has the bulb attached. Is that a bad sign, i.e not simple breakage but damage to the follicle? I’m a 38 year old Italian male. Thanks in advance for your reply

Without seeing you there is little I can do or diagnose. Yes, genetic hair loss is hereditary. Minoxidil will grow hair even if you’re not losing it by genetic factors, but you shouldn’t use a medication that you don’t need, even if it is available over the counter. Stay with someone in your area that you trust. See a doctor and find out if what you’re seeing is genetics or a chemical problem.

Tags: hairloss, hair loss, chemical, burn, minoxidil

Taking Propecia for Over a Year — Should I Add Minoxidil?

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

I have a question about medication.

I am a 23 year old male who has been on Propecia for 1.5 years. I am in the very early stages of hair loss with just general thinning at the temples leading back. When I initially began the medication I felt a decreased sex-drive, so I decided to take 1mg every other day. Since then I have just had the same thinning with the miniaturized areas about the same or slightly thinner than two years ago. There was no reversal of miniaturized hairs.

I went to the doctor and he recommended I begin using Rogaine in addition. My question is: do you think changing the dose of Propecia might make a difference? When do you recommend using Minoxidil? Is there any reason not to use Minoxidil other than the fact that it is more difficult to use every day?

Thanks for your time.

The only time I’d say to not use minoxidil with Propecia would be when just starting treatment. If you use both at the start of your hair loss treatment, you won’t know which one is providing benefits and you’ll be stuck using both for life (unless you want to risk losing hair by stopping one). In your case, having taken Propecia for over a year, adding minoxidil shouldn’t be a problem. Some people do experience irritation from minoxidil, and I’ve heard from my patients that Rogaine Foam is easier to apply than the liquid.

Just because you didn’t see the miniaturization reverse with Propecia doesn’t mean it didn’t do anything for you — it could’ve very well just prevented further hair loss from occurring, stopping your loss where it was at. You could try taking just 0.5mg daily (instead of the recommended 1mg) if you experience a decreased sex drive, but check with your prescribing doctor before making any changes like that.

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