Hi,

I’ve been using Rogaine consistently for over a year now. I haven’t had any obvious side effects or reactions from it and am completely healthy. However, I’ve noticed that over time, my cheeks don’t seem to match the rest of my body. In other words, I have a very low body fat content (I’m lean and in shape) but have big “chipmunk cheeks.” I’ve looked around and found people reporting similar experiences while on Rogaine. Could this be a side effect of the Rogaine? Have you heard anything about this before? If so, would there be a way of counteracting it? The ideas I’ve read thus far have suggested that it might cause water retention in the face or redistribution of fat. I’d appreciate any insights! Thanks!

Facial swelling is a known rare side effect possibly due to an allergic reaction of Rogaine (minoxidil), and we’ve reported on this before. Changing the dose or the formulation (like the use of foam rather than the liquid) may be helpful.

Dear Dr.,

Thanks always for devoting your time to the public with this forum. I notice you’ve been getting swamped with questions about a cloning cure (i.e. a class 7 bald person having a teen-age head of hair again), and people don’t seem to want to accept such a thing is so many years away. I was wondering if it’s more realistic to speculate: for those of us in our early 30’s who’ve preserved most of our hair and reversed some thinning with Propecia, is it reasonable to think a better pharmaceutical for holding on to what we’ve got will come out at some point this decade?

Thank you

There are drugs in the pipeline for hair loss, but the real question is which, if any, will make it through the investigative and FDA process. It must be proven to be safe and effective at doing what the manufacturer will claim. So I suppose it is reasonable to assume (or at least hope) something will come out eventually, but I couldn’t begin to guess at how much better it will be than what is available now. Keep your fingers crossed.

Dr R

Do you have any opinion on Azelaic acid as a dht inhibitor when used topically by itself or in minoxidil tandem?

Thanks

I do not think there is real evidence that azelaic acid inhibits DHT or works for genetic balding. I am aware that there was a study which was published in 1988 (22 years ago) titled, “Inhibition of 5α-reductase activity in human skin by zinc and azelaic acid“. The testing was not carried out in humans, but in a test tube, and the information is floating around on the Internet (our everyday source of good solid medical information *note sarcasm*).

Aside from this study, I do not know of any other information with regards to azelaic acid and its “theoretical” treatment for balding, yet the legend of one decades-old study will propagate down the immortal path of the internet. For further reading and other physician opinions on this, take a look at this post from a few years back.

Dear Dr Rassman,
In your last post you wrote the following in regards propecia.. “It does not work for frontal hair loss in most instances other than possibly slowing the process down, but is it the only real medication to address what you are going through”. However in December 2005 you wrote that “Propecia slows or stops hair loss throughout the head”.

I was just wondering if in the intervening years you have become more pessimistic about the effectiveness of Propecia on frontal hair loss?

Regards

I’ve not become pessimistic about Propecia. I have seen a few cases where the drug has reversed frontal hair loss to some degree (regrew hair), but it is not common. What is common is that this drug can slow or stop frontal hair loss, and stabilization of hair loss is a real benefit for those who are actively losing hair.

Hello Doctor,

I want to thank you for a great blog that I visit nearly daily. I visited your offices around 5 months ago and had a consultation with Dr. Pak, who was very informative and understanding. Since then, I’ve been on a daily regimen of Finasteride 1.25 mg/day but am going to wait until the follow up appointment before I make any judgments (superstition does that to you).

I have two questions. I already know that Finasteride does not completely stop hair loss. It just provides its patients an outlet for growing old gracefully (under my impression). Have you seen or heard of any patients who took Finasteride while also including Minoxidil in their regimen to maintain for longer than 10 years with good results?

My second question is how big a part does diet factor into the MPB process? I’m already exercising 6 days out of the week even before MPB hit me but diet (what kind of foods to eat) has always escaped me. I would like to know if there is any information a professional such as yourself can provide pertaining to what kind of diets would promote hair growth and what kind of diets work best in conjunction with Finasteride and Minoxidil to maintain hair.

I apologize for the long message and sincerely appreciate all the help you have given.

Best regards!

I believe that for some people, the use of both Propecia and minoxidil has value when used in combination, but that may depend upon a variety of factors including age, appropriate use of the medication, where the minoxidil is applied, and where on the head the balding is that you are treating. The crown generally does better with combined treatment compared to the frontal hairline. I have seen patients using both medications with good results after a decade of use.

I do not believe that any particular diet works better than another, provided that the diet is well balanced.