I just want to thank you for all the help you have given me in the emails/balding blog questions, regarding my hair loss and Propecia.

On June 1st 2012 was my full year on it. Almost for the entire year I was losing a lot of hair (as you know from my previous emails) and I wanted to give up on Propecia, but you kept telling me to be patient and that sometimes Propecia needs time to kick in.

During the last year on Propecia I basically counted every hair I lost, whether from showering, pillow, comb, etc. I was losing a lot, I mean a lot. it was very scary. I thought Propecia was useless. The weirdest thing happened. On May 25, 2012, for the first time I basically saw no more hair loss during that day. Today is June 5, and still no more hair loss. On my pillow there is no more than 2 or 3 as before there would be at least 20. when I brushed after showering there would be up to maybe 30-35 hairs on the comb, and now there is like 2-3 at least. As if a miracle happened. I brushed my hair today so many time, more than 50 times in 5 minutes and only 2 hairs came out, as before there would tons and tons and tons. I would easily lose up to 150-175 hairs during a day.

Basically on May 25 2012, it seems Propecia just kicked in. Do you think Propecia just magically worked all of a sudden? Was I a late responder? In your opinion do you think I might even see some regrowth on the 2nd year?

I’m so happy, I just wanted to tell you the good news. Its a big mystery how just on one day the hair loss stopped in its tracks.

Sometimes we note something that we had not noticed before. I suspect that the hair loss has been gradually slowing on the drug and culminating this month. Regardless, it’s good that you’re finally pleased with the medication. Let’s hope it stays that way.

What happens when a drug like finasteride loses its effect?

I read somewhere that when finasteride loses its effect, you will actually advance to the stage you would be at if the drug was never used in the first place. Does this apply only for the hair that was regrown, or for the hair that was maintained as well.. so that if you started using the drug at a nw2, you could rapidly become a nw4 when it loses effect?

I also read that the reason it loses effect is because the body starts producing more dht, if this theory and the above is true, wouldn’t you be even worse off than if you didn’t take anything at all, in other words completely bald before you should’ve been? I realize this might just be a crazy theory, but I would appreciate you giving a shot at it anyway.

I feel like I answer this type of question on a regular basis. The questions have little twists in them and are asked in different ways, but the answer remains the same. Male pattern baldness (MPB) or androgenic alopecia (AGA) is due to genetic causes. Men who are born with the gene will be susceptible to dihydrotestosterone (DHT). Controlling the DHT levels will not stop the balding forever, since genetics will have the final say.

In the grand scheme of things your genes win out over any drug; however, I have seen some men on finasteride for 13 years and have had complete reversal of the balding in the crown without any loss of effectiveness of the drug over this period of time. If you are going to lose your hair, it will happen. Drugs such as Propecia (finasteride 1mg) will prolong the inevitable, but as we don’t always know the timeline (as in the cases where a 13 year history is available), there’s no way we can really know how long you’ll see cessation of the hair loss. So it isn’t really about finasteride that stops working, but more about you aging and the gene(s) expressing its fate. Also note that everybody responds differently to drugs.

People also ask if the body produces more or less DHT to counteract the finasteride. In an article published in the Journal of the American Academy of Dermatology in 1999, they studied this very question and found that DHT levels went down under finasteride treatment at varying doses.

One of the interesting findings of this study is that the lower doses of finasteride (lower than the recommended hair loss treatment 1mg dose) shows significant reductions of DHT at the skin and blood level. This lends credence to our approach of reducing the dose (but continuing on the finasteride) when sexual or other side effects occur. The drug seems to continue to be effective at lower doses.

hello doctor rassman
there was a study done where finasteride upregulates adrogen receptors in the prostate. here is the link– PubMed

is it possible that a user who takes finasteride for hairloss can have an upregulation of androgen receptors at scalp level? therefore causing more hairloss while on propecia? or propecia not working at all?

I am not a biochemist to give you a clear answer on how this study relates to hair loss. Of note, this was a very limited study in 47 cases in a cell line study.

The big picture here is that people take Propecia for the treatment of hair loss, and the studies of this drug have shown effectiveness for this. The research does not show that it produces hair loss.

I’m a 44 year old male and have been using Rogaine foam for the past 3 months and at the begging of this month changed over to a Generic “Rite Aid” brand of the Foam Rogaine. After using it for a couple of weeks I noticed my finger tips started tingling and feeling numb. Maybe from working it into my head with my fingers? Has this ever happen to anyone and is this a possible side affect?

I don’t remember hearing this complaint before, but tingling hands are a rare known side effect of minoxidil. It could be a sign that too much medication is being absorbed in the body. Are you using the medication at the correct amount and only twice a day? The generic should be the same as the name brand (I wasn’t aware a generic foam was available yet).

Maybe you should also consider using disposable gloves to keep the Rogaine Foam (or generic) off of your fingers.

Snippet from the article:

Beware of fake versions of ADHD medication Adderall that are being sold on the Internet, the U.S. Food and Drug Administration has warned.

The agency issued the warning Tuesday after receiving complaints from the manufacturer Teva Pharmaceutical Industries that the 30 mg tablets, which do not even resemble the authentic version, was being sold online under the company name, FDA spokesperson Shelly Burgess told ABC News.

Adderall is approved by the FDA to treat attention deficit hyperactivity disorders (ADHD) and narcolepsy.

Read the rest — Fake Adderall Sold Online Gets FDA’s Attention

While not hair loss related, this is something to remember if you decide to purchase prescription drugs from online pharmacies that don’t require a prescription.