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Hi doctor i have been using the propecia for the last 5 months and my hair got thinner and softer . I started to use the prpecia 1 year ago for two weeks and i had the same symptoms i quite using it and my hair got back to normal. This is really disturbing me that i have overall thinning which i was never worried about beacuse i was only try to keep the corner of my frontal hairline.I have type early 3. in my family there is not anyone that has ever loose hair on top of their head.They all have thick hair.

They all have 3A .Now i have been worrying about thinning hair which was never the case. Is there any way propecia might have a reverse reaction on some patience, beacuse the body might see the dht blocker as a virus and fight back to the madicine by producing more DHT. Is it possible that this could happen in some .Thanks doctor for your time.

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To my knowledge, this is not a known side effect of Propecia. If you are a Class 3A and that is your family pattern and you think that (a) this is going to be your final pattern, (b) you can live with it, (c) you believe that it is a side effect of the drug, then stop the Propecia. Whatever the benefits that are claimed by the drug company, the decision to take this drug is yours and only yours. I have met some men who for their own reasons, abandoned their recommended Propecia treatment. This becomes a personal choice and like everything in life, we make choices and deal with the consequences of those choices. Propecia is not for everyone.


Dr. Rassman,
Recently I noticed that my hair has a slimy feel to it when it gets wet, and then it will dry as if it has gel in it, very hard. I have always lost hair in the shower, but it seems that this is increasing with the slimy hair problem. Another symptom that I’ve had is extreme scalp itch, but no more than normal dandruff visible to be the cause of it. This summer I spent a great deal of time in the swimming pool, but no one I’ve been with is experiencing similiar problems. Also, I’m taking Adapex for weight loss and wonder if this might have some correlation with my symptoms. I’ve tried researching my slimy hair and came up with a process used on wigs called decutilization, where layers of the hairs cuticle is removed for some reason. However, I can’t find anything to do with my own hair having this problem or how to fix it. A friend suggested that my hair had lost it’s acidity, but home remedies and ion hair strippers have not helped. Please help me figure this out. I want to solve the problem so my normally soft healthy hair will return. Thanks so much.

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Swimming daily will reduce the wax (sebum) what protects the hair from drying and becoming brittle. Maybe that summer is now over, the problem will go away. You might think about whatever you are using as hair products as a possible cause of your problem, so stopping or changing the entire regimen of products may be helpful, particularly if you change only one at a time.


Is it normal to drop between 30-50 strands of hair when washing if you have female AGA and using 5% minoxidil for 3 months already?

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The average person will lose about 100-150 hairs per day and replace that same number with new hair growth. I believe the proper question is: After 3 months of Minoxidil 5%, should I see results? The answer to this question is that if Minoxidil was to work on your hair loss problem, you should see a positive effect in this 3 month time-frame. Three months is the minimal time needed to get an effect of Minoxidil for losing hair but the impact on the visible effects may not be seen for up to a year or more.


There is an alternative therapy to propecia. Try this: Strong Green Tea Extract, Soy Isoflavones, and Evening Primrose oil. I also, would like to challenge any doctor that believe that is quackery. This combination will work much better than Propecia and there are no sexual side effects. Don’t believe me try it and you will begin to feel your hair stems getting stronger and you will slowly start re-growing hair.

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There are many herbal suggestions for alternative treatment for male pattern genetic balding. I have no experience with this, but clearly you have. I have stayed with traditional, known treatments for hair loss like Propecia and Minoxidil as they have predictive results that are scientifically well documented. I stay away from experimenting on my patients with unproven herbs or poorly defined drugs with benefits. I am also not aggressive when it comes to the unapproved FDA drugs for hair loss like Avodart. If the herbal approach works for you, then that it good for you. If it does not work, a person experimenting with these herbs run the risk of losing hair that may never come back. As hair loss is a progressive process, the pattern for hair loss in each man with the genetic predisposition for it, they may lose valuable time and valuable hair moving them further down the balding pattern scale.


I am a black woman age 27. Seven years ago I had thick black hair. I used chemical products on my hair and got my hair styled by various hair dressers. Fine bumps developed in the back of my head, I attended a doctor and I was told that there were keloids. About a year after I conceive and gave birth to my only daughter that was in 1999. I relaxed my hair again and this time I am not sure if it is as a result of the keloid but my hair started thinning at the front and it is getting worse. I try to keep my hair up to hide the bald spots and this has affected my self esteem some what. Can this problem be rectified. Can my hair grow back or can I have hair transplant to make it look normal again?

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This is a very complex problem that would require an examination of your scalp. Without seeing you, I would be loathe to suggest what to do. See a good dermatologist first, then see if he/she recommends another expert. Bald areas in the scalp are easily treated provided that there are no disease contra-indications for transplantation. Keloids and a variety of diseases that cause Alopecia need to be evaluated.


Can you please tell me what the latest information is on Propecia beyond the 5 year mark ? There was a hypothesis that a plateau might be reached at the 5-6 year mark as hairs entered a new growth phase and the hair counts might improve. Is this the case?
Thank you

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The formal Propecia study only goes out 5 years, and I can’t seem to find any official published data beyond that (even from Merck, the manufacturer). The suggestion from what I have seen in the 5 year study is that the number of hairs will probably drop off slowly, possibly more slowly than it would without the medication. It is also the experience of many that this is not just a ‘number of hairs’ game, but it is also one which reflects hair quality. The thickness of the hair shaft in those treated with Propecia gets better and will probably stay better while the drug is maintained. But your question is asking for the difference beyond 5 years, and I am afraid that a solid answer would only be speculation on my part.


i’ve been using propecia for about 3 yrs now & minoxodil. for the first 2 yrs my hair stopped thinning & stabilized, but just this yr & more specifically the last 4-6 months. but heres the thing, im thinning on the sides & back corners where your usually not supposed to go bald or lose hair. this started right around the time i started using minoxodil & something from hair club for men on the sides cause before that i wasnt, so i stopped doing that, do you have any suggestions, thx for your time

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You need to be evaluated by a good doctor that specializes in hair loss. Loss of hair from the sides and back is unusual in men and common in women. There are too many possibilities here to discuss and there is no substitute for a good doctor to evaluate you. You can contact a dermatologist that specializes in hair loss, or has an interest in this field. If I were to guess on your problem, I would have to make a list of possibilities and that may do more to confuse you than to help you.


can you correct a hairline transplant already done? I have had a hair transplant done and had the hairline move down and now i don’t really like it and it does not cover the area i want it most. Can you help me?

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Frontal hairlines that were transplanted in a manner that you do not like, usually can be fixed. I personally have many patients who have had old type of plugs, where I have repaired the hairline and now enjoy an undetectable, normal hairline. I have also moved hairlines up or down. We have published many articles in this area. Please see the following links for more info:


Could you send me a generic plan…I have been using propecia for two yrs.. might try avodart down the road but not until I hit the 5 yr mark. I would like to know what else I can do maximize .. keeping my hair… THANKS

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If you’ve followed the many questions and answers on this blog, you will see that there really is no ‘generic master’ plan. The doctor must create a full map of your scalp loss status, the degree of miniaturization of the hair at each point on your scalp showing the balding and thinning area so that the progression will be clearly defined. As you move from class of hair loss to another, you need to have a good doctor who UNDERSTANDS exactly where you are and where you are going. Then and only then, can you have a plan customized for you and modified as you get older and progress with the hair loss that is a certainty in the years to come.


What is the % of white men that eventually go completely bald, and partly the worry about the male baldness is my son’s best friend is almost completely bald with very thin follicles on top at age 27, how young does one start to experience MPB to have this stage of loss by age 27, he’s literally NW 6 1/2 if that’s on the Norwood scale

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The statistics are that about 45% of men will have some clinical balding by the time they are 45. I have seen the process start at 16 years old and some reports have placed it as early as 12 years old. Most of the really bald men see some sign of balding by the time they are 21 (clearly evident on high magnification views with miniaturized hairs with thin shafts). The real question still unanswered is can this all be stopped when the advanced balding young men start Propecia early enough. At the age of 27, the pattern in the man you are talking about will probably be a Norwood Class 7 balding pattern. Class 7 on the Norwood scale.


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