Month: January 2023

Dr Rassman, is it possible for a person who is very sensitive to products containing alcohol even have problems with the Rogaine Foam. I stopped the foam because it was drying out my hair alot and I noticed my hair thinning more and falling out more. Even if I go a few days without using it my hair looks better. I never had itching or redness from it but my hair texture changed to a more haylike feeling. I used good conditioners too but my hair still was still too dry and the hair diameter was thinner. I have my hair professionally colored and it even strips the color of my hair near the roots. So basically is it possible for someone to have a negative result due to even a small amount of alcohol in the product. I also notice my face retains more fluid and my skin gets more acne when I use the foam or any type of minoxidil. Would that also be considered a negative reaction to minoxidil?

Rogaine Foam has alcohol in it, so if you do have a sensitivity it could be an issue. While the 2% minoxidil is alcohol based, the 5% minoxidil liquid is propylene glycol based (though check the ingredients on the packaging since it may still have some alchohol). You may consider trying the 5% as an alternative to the Foam. Alcohol does dry the hair out. If you’re retaining fluid in your face, that is a known negative side effect. I’d meet with a dermatologist about the acne.

I have been using minoxidil and proscar as well as laser treatment for hair lose for the past 8 months and have had amazing results. I am 21 and don’t want to keep taking all these products for the rest of my life. Is it possible to slowly reduce the use of these products tell i no longer need them or at least be less dependent on them?

Of the three treatment options, you can stop using the laser treatment since it is very unlikely that it has contributed anything to your results. For finasteride, the 1mg dose has been judged scientifically as the ideal overall dose. There is no reason to change it. Since you have seen good results to date, stay on the minoxidil. Some people do develop minoxidil dependence, which means that when you wean off of it, the hair that were dependent on it may very well fall out. A very important take home message here is that once you are on the finasteride, then you are always going to be on it. If it is stopped, you will lose hair in the amount that you would have lost if you were never of the medication. You can’t lower the dosage until it isn’t needed — you will lose hair if you do this.

Hi, thanks for this service. While I am somewhat suspicious of your constant hawking of propecia to the exclusion of topical solutions (pun intended) such as minoxidil in your earlier entries, I would still love any insights you have on that topic. I am a 25 year old man. At age 18 or 19 my internist noted some frontal hair thinning/loss, evident to me retrospectively when I examined pictures (esp. if flash was used). I was immediately placed on minoxidil, which seems to have not only arrested the loss but perhaps, over the last 6 or 7 years, even allowed some regrowth toward the front. Finally, now, at age 25, I am noticing some thinning and folicle miniaturization in the center and back of my head for the first time, though I am still at the point that only other balding men notice—my female friends and loved ones think I’m neurotic and that even my minoxidil use is unnecessary. What I wonder is whether I should expect acceleration of the loss or merely loss at the same rate; if the loss rate itself is constant then I think I’ll try to hold on by using topical minoxidil.

Second, if I were to switch to a dht blocker, would you recommend avodart or propecia, and would you recommend cessation of minoxidil? I worry that after 6+ years my hair could do unpredictable things without the minoxidil. Lastly, I don’t think I yet qualify on any of those charts as balding, though I myself notice some thinning and, of course, many hairs in my hands when using hair products.
Thanks.

A DHT blocker impacts the cause of male patterned hair loss, so it is the best approach to use a drug that is known to be effective and safe. Avodart is not proven to be effective or safe (no scientific study for hair loss victims) for treating hair loss, but I believe that it is effective. Notice I did not say I believed it to be safe, because long term use of this drug has been on older men with prostate problems, not young men with hair loss problems. Is there a long term Vioxx type problem hiding in the closet? I don’t know, nor does anyone really know.

I tell everyone who is on minoxidil that when it is working to stay on the topical medication, for stopping it often causes ‘catch up hair loss’. Frontal hair loss and early crown hair loss indicate you may be a Norwood Class 3V pattern. You need to have your hair and scalp mapped out for miniaturization to make the diagnosis, otherwise you are flying blind.

I have no connection to Merck (producers of Propecia) and I am not ever paid by them for my opinions on this drug. I do not now, nor have I ever owned stock of this company (as I’ve stated before), so I am clean in expressing my opinions on this drug, because it has had wonderful results that I have seen in many of my patients.