I Started 3 Hair Loss Treatments At the Same Time

Dear Dr Rassman,

I have been reading your posts for sometime. Thank you for your informative answers to many questions that I myself have had in the past but have never asked.

I am a 38 year old male who noticed diffuse thinning approximately 2 years ago. This was accompanied by a greasy scalp and some itching as well, particularly in the evening when the greasiness was at it’s worse. I had NEVER had a greasy scalp prior to this. My wife cuts my hair so she noticed my hair was definitely thinning for the past 2 years. I started propecia 8 months ago, nizoral 1% daily as well as polysorbate 80+tsal(3% salicylic acid shampoo) daily. I started to notice results after approximately 4 or 5 months. My wife has noticed that my hair has definitely thickened up and is no longer showing the “see through” that it used to in the past. She estimates that my hair has improved by 50% in terms of thickness and texture.

My question is…is it only the propecia which is causing this stabilization/regrowth or is the nizoral+polysorbate having some effect. I have DEFINITELY noticed that after approximately a month of using the 2 shampoos, my hair was no longer greasy as it used to be. I have read articles on the internet on polysorbate 80 and was wondering what the general consensus is on the material. Thanks!

I am not a fortune teller. You started 3 separate hair treatments and now you are stuck not knowing if one, two, or even all three were the reason you saw improvement. Still another possibility is that none of the treatments worked and it was just a matter of being patient while the hair regrew, because maybe you didn’t have genetic male pattern baldness to begin with. Maybe you had telogen effluvium and it was self-limiting and the hairs grew back on their own (as it typically takes 6 to 12 months).

In other words, I really do not know… and this is why I generally recommend only using one treatment at a time, or you’ll end up “addicted” to all of them, too worried that if you stop one you’ll lose the benefits. This is also the reason why I tell readers to start with a good diagnosis. See a doctor before starting medications. Scientifically document before and after with a miniaturization study. I suppose if you are brave, stop one of the three and see what happens.

As for polysorbate 80, I’ve commented on that before here.