Month: January 2023

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Why Don’t Studies Discuss Type I or Type II DHT?

In all of the studies trying to determine whether natural supplements like saw palmetto or green tea block DHT, they never refer to Type I DHT or Type II DHT — just DHT. Why is this? Good question, huh?

Good question. Propecia (finasteride 1mg) blocks mainly DHT type II, and Avodart (dutasteride) blocks both DHT type I & II. You would think if you block ALL the DHT it would be better against androgenic alopecia. Dutasteride is three times more potent than finasteride inhibiting the type II enzyme and 100 times more potent than finasteride inhibiting the type I form of the DHT producing enzyme. There are clinical observations that suggest that dutasteride is better than finasteride, but it is not approved for hair loss by the FDA and the long term safety on human reproduction for dutasteride (reports of sterility is a complication) have been suggested in some rare patients. We have received many reports by varying doctors who switch people from finasteride to dutasteride and get a better response. The next logical question should be: If we increase the finasteride dose to 5 mg or so, will it be better to treat hair loss? I don’t know if anyone really knows that answer for sure. Some of the original studies on finasteride suggested that the 1mg dose is the most universal dose, but it may be that a high dose in those who are refractory to finasteride may help. Some doctors are using a higher dose of finasteride on long term users. It’s a prescription drug, so I’m not suggesting you should take a higher dosage. The problems for either finasteride and dutasteride is that side effects rise when increasing dosages.

To get back to your question though — it’s been proven that type II is linked to male pattern baldness, but type I hasn’t been linked yet (though it’s possibly just not been proven yet). I couldn’t tell you why the studies out there don’t provide a breakdown by type, but I have not found scientific evidence that saw palmetto or even green tea actually block DHT anyway. And even if it did block some DHT, there is nothing in the literature that shows saw palmetto or green tea being effective for treating androgenic alopecia. I don’t mean to be a pessimist, but even Propecia does not completely stop androgenic alopecia.

The real quest should be finding other (non- DHT related) mechanism for androgenic alopecia. DHT is not the only solution out there… we just haven’t discovered the other yet.

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Why Don’t Some Men Just Take Propecia At the First Sign of Hair Loss?

Doctor there was a topic about pro hockey player ryan getzlaf.

this is my question:

if ryan getzlaf had taken propecia at the first sign of hairloss, do you think he would still be to where he is today? or is there a good chance he could of of maintained what he had or freezed the hair loss clock by a decade or so?

my other question is: how come alot of people who show the first sign of hairloss dont go on propecia? I mean its proven to work, why not take it? how come they just let the thinning continue? I see alot of celebrities young males and pro athletes who are losing hair, and why not just take propecia? I mean they can afford it.

Propecia is an elective medication and it is only available after consultation with a physician after a good examination and understanding of its limitations, risks, and benefits. It may not always happen this way, but it should be. Propecia does not necessarily stop hair loss or reverse hair loss completely, but it does work to buy time for most. In the end, your genetic predisposition will eventually catch up and you may lose hair despite being on Propecia. This does not mean the medication is not worth taking or that the medication has stopped working.

Finally, it is not as simple as taking Propecia at the first sign of hair loss. You need to be followed by a doctor who can give you a Master Plan for the hair loss.

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Why don’t rich bald men get hair transplants?

So this thought popped in my head while a picture of Harvey Weinstein popped up on my news feed. The guy is rich as hell. Being in the entertainment industry he must have access to the finest cosmetic surgeons. Why the hell do people like this opt not to get a hair transplant? Same goes for other rich folk. Maybe they just dont need to since they are incredibly rich and it simply doesnt matter how they look. But seeing stuff like that makes me doubt that hair transplants are not quite as advanced as people claim them to be or the success rate isnt that high. I am probably over thinking it…could be a million reasons why. All I know is if I had the money I’d get the best damn hair transplant, lock myself in my big ass mansion until the scaring went away and I was presentable then just reappear to the public with a head full of locks.

There are many reasons for this, such as: (1) these people accept their hair loss and are not interested in doing anything about it, (2) They are afraid of facing their vanity, a hair transplant will make it evident if before pictures are public (a CEO of a billion $ company had a lazy marketing person take an old photo when he was bald and post it by mistake on the company’s newsletter then people came to him and asked him where the hair came from?), (3) some people don’t like the idea of a surgery, (4) the old stereotypes of plugs still prevail and some people think that a hair transplant sticks out like a sore thumb.


2021-01-04 14:45:20Why don’t rich bald men get hair transplants?

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Why don’t hair transplants fall out like the hair you lost?

If most hairless is due to increased testosterone output can someone explain how a hair transplant saves your hair? Wouldn’t you just lose it again due to hormonal issues?

Genetic balding never impacts the hair around the back and side of your head (donor hair) so a hair transplant moves this hair and put it where you lost it. The donor hair never react to DHT so it will grow in its new location for your lifetime.


2021-08-08 20:45:58Why don’t hair transplants fall out like the hair you lost?

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Why Doesn’t Finasteride Keep/Maintain Minoxidil Gains If You Switch?

I was reading about minoxidil and finasteride as I am wanting to start one or the other but am curious about something.

According to the wikipedia article for minoxidil, the reason minoxidil gains are lost when treatment is stopped is that DHT is then able to re-shrink the follicles unimpeded. But if finasteride inhibits or blocks DHT, shouldn’t one be able to keep minoxidil gains longer if they switch to finasteride with a, say, 6 month overlap of the two? Everything I’ve read indicates you lose everything from minoxidil if you ever stop it no matter what.

Despite how many seek information in the Internet, Wikipedia is not always a definitive or correct source of information.
Propecia (finasteride 1mg) and Rogain (topical minoxdil) does not have the same mechanism of action on hair growth. They work in different ways. Both medications will lose effectiveness once you stop using the medication. In other words, you will lose the hairs you gained when you stop the medication. Overlapping the medication or switching from one medication to another does not mean it will sustain the effects of the former medication.

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Why Does the Back and Sides of the Head Not Lose Hair?

[/bq] Most cells in our body have a ‘death’ time programmed into them. For reasons unknown, part of the hair on the scalp in about 45% of the male population may have programmed earlier death (the balding pattern seen in balding men). This patterned hair loss does not impact the hair around the sides and back of the head, the 3 inch wreath of hair we call permanent hair. Men generally do not lose hair on the sides and the back part of their scalp, because it is a genetically programmed trait not to lose the hair. This fact allows hair to be transplanted from the back and side of the head (permanent hair) to the balding areas. Furthermore, hairs on the side or the back of the female scalp are not generally considered permanent and when they have female genetic hair loss, it is usually a more diffuse type of hair loss impacting the hair all over the head. This is why most women are poor candidates for hair transplantation as they do not have this permanent wreath of hair around the sides and back of the head.

There has not been a good explanation that I’ve heard for this permanent rim. There was an interesting book I recall titled Sex, Time and Power: How Women’s Sexuality Shaped Human Evolution by Leonard Shlain, who had proposed a connection that might explain male patterned balding. He postulates that man’s history really goes back to tribal living when we had 150 people in a tribe (no large civilization existed at that time). He noted that 7% of men had extreme balding, and the same number of men were left-handed, color blind, and gay. He postulated that in the days when men hunted, there were left-handed spear tossers, men who could see through the camouflage of animals (color blind), men whose heads would go above the bush to spot game animals would not frighten the animals (animals knew to run from men and balding men did not look like men to these animals). The same number of men had to stay ‘back at the camp’ and protect the women (gay men). Not a bad guess, eh?

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WHY Does Shedding from Hair Loss Medications Occur?

Hey, Doc. I’ve been taking Avodart for the past 3 months and have been experiencing what can only be described as a “shed”. While I’ve seen other posts and answers here regarding shedding, I’ve never seen you delve into why it actually happens. Can you enlighten? Thanks.

I do not know why it happens. It seems to happen more through the reports on this blog site than I have seen in my own practice. As I do not have experience with Avodart (dutasteride), I can only assume that any ideas I might have will be a common thread to Propecia (finasteride). It has been suggested by some doctors that shedding can be explained, because acceleration of a hair cycle occurs. Hairs in the growth phase are pushed into a telogen phase (which means that it will have some shedding). The suggestion then is that the growth phase comes in stronger. This is the idea of others, so I am just passing what I hear, not what I know as fact.


2006-09-21 11:24:00WHY Does Shedding from Hair Loss Medications Occur?

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Why Does Rogaine for Women Contain Only 2% Minoxidil

I am a post-menopausal woman with female pattern hair loss. As you can imagine I am desperate to find a fix for this predicament. I’ve noticed that Rogaine for men has 5% minoxidil (sp?) while the women’s version has a maximum of 2%. The men’s version cautions that it is not to be used by women. Is that just because of possible child birth issues which would not be an issue for me?
Thank you.

Minoxidil will work better in women at a higher concentration. I can not tell you why some of the manufacturers recommend less than 5%, but I can tell you that the higher concentrations, although they may be more effective, do have more side effects. This drug is known to drop blood pressure and the more you use of it, the more the possibility of other side effects such as skin irritation.

With regard to use of minoxidil in pregnant women, this is a clear use that is contraindicated. Women must ‘know’ if they are pregnant and should be assured that they are not pregnant if they use this drug.


2006-04-17 14:46:46Why Does Rogaine for Women Contain Only 2% Minoxidil

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Why does my hair transplant of yesterday, look like this?

These are elevated grafts (photo on the left). The surgeon that put them in used a Choi or Lyon Implanter and left the upper part of the graft sticking out. This is not the way I do it for many reasons including:

1- You have to wear a hat for weeks after the surgery and can’t be normal

2- It may leave cobblestonning of the skin as the skin from the grafts lived and may remain elevated

3- It is not undetectable short or long term. Look at my patient to the right of your picture which is one day after the hair transplant. No cobbled grafts seen.


2019-04-15 10:07:55Why does my hair transplant of yesterday, look like this?