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    When do you know if minoxidil is working?

    Mar 6, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    If patients are not seeing results with topical >6 months into treatment, do you think a switch is advisable then?

    If you are taking the oral, then you should see some benefit in 6-12 months or less. That may not be true for the topical because better than half of the men using topical get no response at all.  This is because for minoxidil to work, it needs a special enzyme , see here: https://baldingblog.com/sulfotransferases-and-minoxidil/

    Palpitations on minoxidil, what should I do?

    Mar 6, 2023/by William Rassman, M.D./0 /Hair Loss Causes
    I am 23 years old. I was told to start topical Minoxidil (rogaine) a few months ago by a specialist in my city as a preventative measure for hair loss.  However, I started having heart palpitations and chest pain while using the medication. It’s a bit difficult to reach the specialist on short notice, so I thought I would reach out to you.  Do you suggest that I stop using Minoxidil while I wait for an appointment? I’ve been using it for three to four months now so I imagine I’ll begin shedding heavily after stopping it. 
    Maybe you should take a look at the dose of the minoxidil.  If it is the 5% solution, switch it to the 2% solution.  Call you doctor for, at the minimum, a phone call. 

    This is a list of drug that commonly cause hair loss

    Mar 3, 2023/by William Rassman, M.D./0 /Hair Loss Causes
    • Accutane (isotretinoin)
    • Apixaban (Eliquis)
    • Heparin injections
    • Rivaroxaban (Xarelto)
    • warfarin sodium (Coumadin, Panwarfin, Sofarin)
    • Clofibrate (Atromid-S)
    • Gemfibrozil (Lopid)
    • Levetiracetam (Keppra)
    • Pregabalin (Lyrica)
    • Valproic acid (Depakote) 
    • Most common antidepressant drugs
    • Diet and weight loss drug like amphetamines’
    • Timoptic Eye Drops (timolol)
    • Timoptic Ocudose (timolol)
    • Timoptic XE (timolol)
    • Tenormin (atenolol)
    • Lopressor (metoprolol)
    • Corgard (nadolol)
    • Inderal and Inderal LA (propanolol)
    • Blocadren (timolol)
    • Birth control pills
    • Hormone-replacement therapy (HRT) for women (estrogen or progesterone)
    • Male androgenic hormones and all forms of testosterone
    • Anabolic steroids
    • Prednisone and other steroids
    • antarthritic drugs
    • Naprosyn (naproxen)
    • Anaprox (naproxen)
    • Anaprox DS (naproxen)
    • Indocin (indomethacin)
    • Indocin SR (indomethacin)
    • Clinoril (sulindac)
    • Methotrexate (MTX)
    • Rheumatrex (methotrexate)
    • Levadopa/L-dopa (Dopar, Laradopa)
    • Thyroid drugs
    • cimetidine (Tagamet)
    • famotidine (Pepcid, Zantac 360)
    • ranitidine

     

     

    Topical minoxidil and finasteride plus microneedling for 3 months

    Mar 3, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    This is amazingly fast response for these three modalities in just 3 months

    Finasteride made my hair worse

    Mar 2, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    I’m 8 months in and my hair is significantly worse from when I started. My hairline was not to my liking before finasteride but it has significantly gotten worse and it’s pretty discouraging.

    I suspect it wasn’t the finasteride that made your hair worse. It may be your genetic balding in an accelerated phase. See a good hair doctor

    FUE without taking finasteride

    Mar 2, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    I did research and saw it’s important to take fin for a year prior to FUE, but did my research a little too late, and discovered this sub after I had my FUE a week ago….  It’s too late to turn back time, and I started taking fin now post-op, but I have anxiety that my FUE will be a waste and unsuccessful. Will my transplanted hairs survive if I never took any fin/min prior to FUE, but will continue to do treatment after my FUE?

    FUE harvests the hair from the back and sides of the head which are never DHT sensitive, so finasteride has no impact on these hairs. If the FUE was done by a good surgeon with a good team, they will grow and last your lifetime; however, your native hair around the hair transplant may still be impacted by your balding process made worse by the FUE surgery. This is particularly relevant if you are in your early 20s, so I don’t do surgery on men under 26. The older you get, the more secure your native hair will be.  Finasteride started prior to your FUE will protect the native hair in most men.

    1 yr finasteride 2 month oral minoxidil

    Mar 1, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    The message is simple.  Some men, with appropriate medications and dedication, can get their hair back,  These are, however, lifetime commitments.  

    Oral minoxidil and finasteride 3 months (photo)

    Mar 1, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    It does look fuller after 3 months on these two drugs

    Trump uses hair clips, why?

    Feb 28, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    These clips are likely used to fix a hair system to the side hair that is the permanent hair that never is lost on every man who has genetic balding.  I believe that he uses a very expensive lace hair system which is glued in the front and attached with clips on the side and back.  That would mean that there are three clips used for side and back security. This photo shows the existence of one of those clips.  The fine frontal hair it attached to silk lace which is then glued on a shaved or bald frontal scalp.

    Topical minoxidil isn’t working. Why is that?

    Feb 28, 2023/by William Rassman, M.D./0 /Hair Loss Causes
    Many non-responders to topical minoxidil will respond to oral minoxidil, see why here: https://baldingblog.com/wp-admin/post.php?post=49218&action=edit  So oral minoxidil may be worth a try

    Finasteride, minoxidil twice daily, and microneedling plus many other things (photo)

    Feb 27, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    One of my nephews given finasteride by me developed a raging libido like you did from finasteride.  I have seen this not infrequently. I believe you tossed in everything but the kitchen sink at your hair and it worked.  This man used minoxidil and finasteride for one year and microneedling for 6 months and other modalities including nutraceuticals, pumpkin seed oil, etc

    Isolated forelock with “corner recession”

    Feb 27, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    This young man at 27 years old has a strong forelock and a thinning corner that appears to be miniaturizing away.  The genetics on #1 is classic for a maturing hairline and the genetic on #2 is different than the rest of the hair on his head.  Men with strong forelocks, even when they are bald, may retain the forelock if it continues to be present by the age of 35.  I have seen Norwood lass 6 and 7 patients who retain their forelock despite the extensive balding present.  In evaluating a man with a forelock, one has to look at his overall balding pattern, omitting his forelock in classifying him on the Norwood scale. In this man’s unique presentation, he is not really balding anywhere else on his head, so what we are observing  on the corner hairline may be a normal maturing process.  Over the next few years, we will know for sure. I wouldn’t treat the changes in the corner miniaturization as it may not respond to DHT blockers. 

    10 weeks oral minoxidil plus microneeding

    Feb 24, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    This is a terrific way to treat this type of early hair loss.  Nice early results

    Diffuse thinning (photo)

    Feb 24, 2023/by William Rassman, M.D./0 /Hair Loss Causes

    I treated this with minoxidil which I rubbed into my scalp once a day and microneeding once a week.

    5 months on finasteride (photo)

    Feb 24, 2023/by William Rassman, M.D./0 /Hair Loss Causes

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    Over 21 million women and 35 million men in America suffer from hair loss. For many of these people, the psychological impact on their life is debilitating.

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    This site exists to educate about hair loss and hair restoration.

    William R. Rassman, M.D.

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    This site is intended to educate the public on hair loss topics based on personal experience and opinions from Dr. William Rassman and contributing physician editors. Information provided on BaldingBlog.com should not be used for the purpose of medical diagnosis or treatment.

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