Dear Doc,
I understand that once a person stops using Propecia he will lose hair that he normally would have lost if he wasn’t taking Propecia. My question is though, would discontinuing Propecia cause a person to lose hair that they normally would not have lost? Thanks.
Normal hair is ‘indifferent’ to Propecia, so stopping the drug will have no effect on hair that is not genetically impacted by male patterned balding.
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Dear Doctor;
My hair regrowth regimen consists of the following…1 .5mg Avodart soft gel every morning, then at night, 2% Ketoconazole Shampoo, under occlusion, for up to 1 hour. I do not use Rogaine Foam, or any other Minoxidil product. I have been doing this now for 5 weeks and see no real change in my crown/vertex thinning. Does this sound like a good regimen? Should I take the Avodart at night instead of the morning? How long would you suggest I give the regimen before I should at least start to see some regrowth? Thanks!
Hair regrowth from known medications can not be seen clearly for 8-12 months. That is because the hair cycle is about 4-6 months and then there is a period where the hair must grow out at 1/2 inch per month. I do not endorse the use of Avodart at this time for treating hair loss and have spoken many times about my preference with Propecia. As you may already know, Propecia (finasteride) is FDA approved for treating hair loss — Avodart (dutasteride) is not.
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gday doc,
great blog.
l’ve been on 1mg finasteride for about 9 mths and have recently noticed increased shedding (about 2-3 times more hair than usual).
lve read that finasteride causes synchronization of the hair cycle and as such this can occur and might be taken as a sign that the medication is effective.
Is this correct?
No one really knows for sure. I have heard reports from patients and readers such as yourself that starting finasteride may cause shedding. Aside from the anecdotal evidence, I have not heard or read about a scientific research on this phenomenon. I would hope that the shedding is the result of the drug and the hair going into another growth cycle rather than an acceleration of the hair loss that is due to your genetics. Time will tell the answer here as the shedding should stop and reverse by the 4th month if it is caused by a change in your hair cycle.
Nevertheless, the effectiveness of finasteride (Propecia) has been well studied and documented. Thus, it would not be a good idea to stop taking the medication if you are experiencing hair loss. The hair loss may be worse if you stop the medication as your body will play “catch up” and go back to the state as if you were never on the drug.
Here’s a story about a dermatologist who had a hair transplant when he was 25 years old, in 1975. Forgive the blurriness of the photo below.
What is particularly important about this first picture is the amount of hair that he actually had when the transplant process was started. He was clearly thinning his hair in the Norwood Class 6 balding pattern and if he were treated today, he would have been put on finasteride (Propecia) to halt the hair loss and hopefully lock in the Norwood Class 6 pattern. When he had the plugs put in, the hair was still there, although clearly heavily miniaturized. The photo above was taken in the first month after the surgery and the hideous looking islands reflected grafts that contained between 20-30 hairs and crusting after the surgery. The crusts which are shown here are only a few weeks old, but in those days, the patients were deformed for months after the surgery as the healing progressed very slowly. The only good news for this man was that many of the hairs failed to grow, reducing the pluggy appearance, simply because of the failure of hairs to grow. His first procedure put two lines of plugs in the frontal hairline, which were followed up with many more plugs at another surgical session.
He eventually lost all of his hair native in the Norwood Class 6 pattern. The grafts were taken out of his donor area with hollow drills measuring slightly under 1/4 inch which left him with white spots about 1/4 inch round that could easily be seen through the thinned out donor area. After he completed his surgery, he developed a comb-over to hide the plugs, but the hairline was still deforming and even with a comb-forward style, he could not hide the hideous grafts.
In 1988, he went to Denver and had a few hundred micrografts placed in front of the hairline by the inventor of the micrograft. The focus was to put camouflage in front of the plugs. This surgery did much to soften his look. Still, on meeting people in his dermatology practice, eyes focused on his hairline and the top of his head. That convinced him that he needed to find a better solution. Eventually, he had grafts removed, received dermabrasion to smooth out the bumps and cobblestoning, and had about 8 laser hair removal procedures to kill off the hair that he worked so hard to put there. To deal with the deformities created by the harvesting techniques, he had finely stippled tattoos created to look like hair and this hides most of the scars on the side and back of his head. His final look, one of a bald man, seems to work for him. His approach to his problem was creative and it showed me the value of the old saying: “Necessity is the mother of invention”. This doctor, armed with a unique set of skills (dermatologist) and facing his deformities every day in the mirror, applied his talents to solve his problem. He got there and now people who see him as a doctor, look straight into his eyes, not at his head. Congratulations!
Note: Most people see someone just like this man walking down the street, at a movie, in a restaurant, or at an airport. There is a perception that this pluggy look is the look of a hair transplant, but this type of procedure, if done today, would be clear malpractice and not acceptable in this litigious legal climate. Unfortunately, tens of thousands of men had this awful surgery done worldwide years ago. The victims were many — far too many. Personally, I can not imagine why a doctor would ever perform such a surgery. Fortunately, there are many ways to treat this problem and becoming bald is just one option (see Repair – Dean’s Story for an example of using hair transplantation to correct the old plugs).
For even more information on repair, please see:
Hi Doc!
Does male body hair, like chest hair and/or back hair, have anything in common with MPB? In other words, have you ever seen a bald/balding person without this kind of male body hair? (assuming he is not shaved)
I also wonder if a maturing hairline should be as thick as a juvenile hairline, or if it is common that it is a little bit thinner at the very front of the hairline.
I would really appreciate your expertise on these matters.
It seems at times that the bald men have bodies covered in hair, somewhat like a gorilla, but it is simply not the case. There is no connection between body hair and the loss of head hair, except to state that those with lots of body hair probably have good testosterone production.
The maturing hairline is as thick as the juvenile hairline, as long as there is no genetic hair loss in the actual hairline (no miniaturization). Sometimes, the mature hairline is thinner (at least it seems that way to me as I look at my mature hairline), but that is just a feeling. No facts on that subject to back up my ‘feelings’.
Can high estrogen levels in males contribute to hair loss (miniaturiztion/thinning)? I suffer from low libido, fatigue and a female hairloss pattern(dupa)… my estrogen/estradiol is at 45… my doc has put me arimidex…
Increased estrogen in men could be present in several conditions, including congenital adrenal hyperplasia, alcoholism, liver disease, and estrogen-producing tumors. Excess estrogen can cause sexual dysfunction, breast tenderness or enlargement, and increased body fat in a female pattern.
Hair loss is typically not one of the signs of excess estrogen and on the contrary could be seen in estrogen deficiency, like in telogen effluvium in women after pregnancy. As a matter of fact, estrogen is considered a protective factor for hair. Bear in mind that increased estrogen may affect other hormonal systems, and the imbalance of the hormonal system can cause hair loss. The cause of diffuse unpatterned alopecia (DUPA) in men is not clearly understood.
The hair on both sides of my head is quite a bit thinner than on the top. I’m 20 right now and I buzz my hair to a half inch every once in a while and just in the last year i started noticing really bare spots on both sides, but no problems on top… is this some weird sort of balding pattern or could it be caused by how much i wear hats? I am kind of stumped by it because i’ve never heard of the side balding before the top so any help would be appreciated.
Hats do not cause balding. You need to be evaluated. Get your hair mapped out for miniaturization to determine what is happening to you. You need to see a good doctor to do this properly. Get a diagnosis and stop guessing. You have too much to lose. Sorry I can’t provide more information, but without seeing the loss you’re talking about, there’s not much else I can do.
I am 30 years old,and have been dealing with thinning hair since I was 16, mostly in the front.
My question is, can certain vitamin/amino acid supplements increase rate of hair loss? I recently added Biotin, Fish Oil and Lysine to my normal supplements which include a multi-vitamin,C, folic acid and B-12 and it seems like my hair is falling out faster lately.
Also does dividing 5mg of Proscar into roughly 4 tablets work as well as Propecia since they are the same drug?
Thanks!
“Excessive intakes of nutritional supplements may actually cause hair loss and are not recommended in the absence of a proven deficiency”, as published in Clinical and Experimental Dermatology.
I might suggest that you stop taking these supplements. Dividing 5mg finasteride tablets into four 1.25 mg portions can be slightly difficult for some (it is even more difficult to cut it into five pieces), but should absolutely be as effective as the 1mg Propecia product.
TEENAGER Jack Taylor was left looking like an ‘elephant boy’ after trying to dye his hair black.
His head swelled up after he had a suspected allergic reaction to dye made by L’Oréal — whose slogan is “because you’re worth it”.
The 15-year-old still has a rash on his face and body TWO WEEKS later — and is being treated with steroids and antihistamine tablets.
Full article here — The Sun – Dye job just wasn’t worth it
I have a 13 year old african american daughter continually suffers from her hair shedding. She has alot of hair however, I cannot get it to grow consistently due to the amount of shedding she experiences. She has a relaxer done professionally and I keep her hair moisterized. She stresses over this and so do I. I do not know what to do at this point. Please help.
Many African Americans who use relaxers have hair pulling and hair loss. Look to what she is doing as the cause. Try to have her stop the use of relaxers and see if this does not stop the shedding.
