Daily Hair Treatment Regimen

Dear Doctor,
Thank you for this excellent resourceful blog! My hair has been thinning excessively since past 6 months to the point that i can no longer apply gel since it shows my scalp. there has also been some hairloss. If I keep my hair dry my scalp hardly shows nevertheless hair is thinning. I recently got on propecia and some other natural treatments. Here is my daily regimen:

1. Propecia – early morning when I get up
2. Saw Palmetto – 12 hours after propecia 320 Mg (so that it starts working on the DHT since Propecia has a shorter half life and I doubt its effect will last 24 hours (does it ?)
3. Nizoral Shampoo twice a week
4. Biotin and B vitamin supplements
5. Zinc supplement
6. regular Multivitamin

I have some questions:

1. How effective would this regimen be and is there anything else I can add on to it ?
2. When can I expect to see the results ? (re- thickening of hair and reversal of some hairloss i have had. )

My hair loss seems more on the area right behind my frontal hairline. Vertex is fine.

Family history: Dad started losing his hair slowly at age 35. Grand father had hair till 60. Mom’s brother is 48 and has full head of hair. and his father had hair till 55. I am 27. Please advice. I am passing through a lot of emotions.

Your maximum response to Propecia will be up to two years, with fully 60% seen in the first 8 months or so. Be patient and wait it out for the full course. The approach you are using seems good. The Propecia does have a half life of 5 or so hours, but there is some discussion that Saw Palmetto may block the full benefit of the drug if it competes with the 5 alpha reductase inhibition. I can not certify this problem one way or the other.

I always recommend that the degree of miniaturization that you are having is documented by a good doctor. This will, at the least, tell you if the drugs are doing their job. Long term planning with a good Master Plan needs to take into account everything from your response to conservative treatment and the probable pattern of your hair loss. Minoxidil may be something worth trying if you do not get a good response from this regimen.