Your hair loss questions, answered daily.

 

All Hair Loss Causes related posts

 

Many homeless men seem to have long hair and rarely shampoo, but we do accumulate dirt and air pollutants on our hair from living in the city. Shampooing daily or every other day keeps the hair clean. For me, I like a clean hair and scalp and would personally feel bad if I started to develop an odor in my hair, which is common in people who do not wash it.

 

The key to drying hair after a hair wash is to be gentle. Never rub it hard against the scalp because if there are miniaturized hairs, these will be easily pulled out. The use of a hair drier with long hair works if (1) you use a good conditioner to make the hair glide through brushes and comb and (2) use a low heat with the hair drier. Never pull on your hair when you have hair loss, even with a brush.

 

Finasteride attacks the cause of the hair loss by blocking the enzyme 5AR at the hair follicle level. Minoxidil produces hair in anyone who applies it topically, some time just fuzz, sometime some hair. The drug finasteride is a better and a more assured way to slow down or stop the hair loss.

 

This is an interesting question. I have had the opportunity to try to count all of the grafts that I put in. Even with good photography, it is difficult. I had a patient a while ago who paid me to count the 6100 grafts that he had done. I took 3 hours, with grids drawn on his head. I counted only 1900 grafts, nothing close to the 6100 grafts he claimed he got. If I was off on my counting, I don’t believe for a minute that I would have been off by ~4000 grafts in my count. This patient came back 8 months later and I counted the grafts that grew. Mu original estimate was close to what grew.

 

The internet has spread a great deal of information and misinformation about Propecia (finasteride) which is much over-blown. You need to put the decision in perspective. The risk of these sexual side effects are between 2-4% depending upon the sources you read. My son has been on this drug for 15 year and found an increased sexual drive, not a decreased sexual drive which his girlfriend appreciated very much. How often do you hear about an increased sexual drive? Answer: very, very rarely.

If you were one of the unlucky men to get the sexual side effect, 99+ % of these men find that the side effects go away within 2 weeks upon stopping the drug. Some very small percentage report long term sexual side effects; however these risks are very, very infrequent (less than 1% of the 2-4% people who get negative side effects that persists). Many of the people who reported these sexual side effects may have had sexual dysfunction (normally present in 30% of men 40, 40% of men 40, 50%+ in men over 50) so it is easy to blame this drug for sexual side effects when reduced sexual drive is unfortunately, a sign of aging in many men. Rarely do we see this in 19 year old men, however, you can have a placebo effect if you believe you will be one of them.

The real decision before you, of course, is the problem of progressive balding which this drug is very effective in treating in men of your age. It even reverses the hair loss in many men under 20. You are clearly in the drivers seat, so be careful about what you read and put everything you research into a proper perspective.

 

We are clearly more informed today that previous generations have been so today’s young people think that balding should not happen today when in our father’s time, it was just an accepted fact. In reality, Dr. Otar Norwood published his balding patterns in in early 1980s. What he said is that men bald in patterns and these patterns of genetic patterns that we inherit. The few balding men who have very advanced balding patterns (Class 7 patterns), usually, but not always, have them by the time they are 26 years old. Many of the less advanced patterns take years to occur. The reality is that each hair follicle has a ingrained number of hair cycles in its life time. If you have a 3 year hair scalp cycle for example, and you have an advanced Class 7 pattern of balding, the number of hair cycles that are ingrained in the hair follicles are about 7-8 cycles, at which time the hair follicles die out (called medically Apoptosis). Drugs like finasteride (Propecia), alter the length of these hair cycles and that is why they have become very popular.

Stress does add to the causative factors for hair loss. We see this in stressed college students and/or people who have romantic relationships that fall apart so managing stress is important to hold on to your hair. I do not believe that today, we see more balding than 30 or 100 years ago. Balding is genetic.

 

Dutasteride has been shown to be about 85% effective in blocking the enzyme 5-alpha reductase which is the active enzyme where DHT causes hair loss. Finasteride (Propecia) is about 70% effective. If you decide to take Dutasteride instead of Finasteride, don’t take the two together, no need. There are more side effects from Dutasteride than Finasteride. Initial shedding has been reported with both drugs but the shedding rarely lasts more than a few months and reverses the hair loss when it occurs. As hair takes time to grow out (1/2 inch per month), you don’t see the regrowth very quickly.

 

I have published a post on baldingblog in the past which shows that Saw Palmetto has poor responses for people with BPH (Prostate problems) here: https://baldingblog.com/2012/01/26/2006-study-says-saw-palmetto-does not improve-bph-symptoms/

 

Body builders are at the same risk for sexual side effects as the general population from the drug finasteride (Propecia) which is between 2-3%. They are at more risk for hair loss if they take anabolic steroids regardless of the use of Propecia (Finasteride)

 

It is a known fact that hair has cycles between telogen (rest) and anagen (growth). The growth cycle of scalp hair is different than body hair. Scalp hair grows for between 2-4 years on average and rests about 6 months on average. Body hair grows 6 months on average and rests 6 months on average. Younger people have longer scalp growth cycles than older people so they can grow their hair very long. When Propecia works at its best (completely arresting the hair loss from genetic hair loss, not common but more common in young people), their hair loss from telogen returns to its normal cycle. Calculate that the average Caucasian has 100,000 hairs on their head (Asians 80,000 hairs). If they have a 3 year growth cycle, then they will cycle about 100 hairs per day which will fall out (most never seen as they come out through the day in the wind or in a shower, etc..) and they will regrow through out the day at a rate of about 100 hairs per day. These new hairs get buried in the forest of hair on your head so you never see them.

 

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