I have been experiencing dyslexia side effects from Propecia. Have you ever heard about this?
There have been rare side effects reportedly associated with Propecia, but I have never heard of dyslexia as one of them.
Hair Loss InformationDoes the Scalp Become More Sensitive to DHT as We Age? – Hair Loss Information – Balding Blog
Hi Doc. I just found it interesting that as we get past our 40s, Testosterone decreases gradually, yet people seem more prone to losing their hair by the age of 50 or so. Isn’t it true, testosterone levels and dht levels really have nothing to do with hairloss? It’s actually the scalp’s own sensitivity to dht?
For example, a man with high levels of both testosterone and dht can have a full head of hair, where as the man with low levels can be bald as a goose egg.
Response by Dr. Sharon Keene:
As chief medical officer for Dermagenoma, a company which manufactures and distributes a genetic test for androgen sensitivity, my esteemed colleague, Dr. Bill Rassman, asked if I would like to comment on the blog regarding the association between serum testosterone, DHT and hair loss especially as it applies to aging.
Dr. Rassman’s comments about the difference between genetics and the hormones of hair loss are right on target. First of all, the association between testosterone (T), dihydrotestosterone (DHT) and androgenetic alopecia (AGA) are indisputable…there are some people born without the enzyme to convert T into DHT, and these men have been observed to never develop male pattern baldness. The same observation has been made historically among twin brothers where one was castrated before puberty, and maintained a full head of hair in contrast to his brother who experienced male pattern baldness.
Since then there are many excellent studies which have documented the efficacy of the medications which are used today to treat AGA, such as finasteride, which blocks Type 1 5 alpha reductase and reduces the amount of DHT produced by the body. The fact that we notice different rates of hairloss in different families, and within families illustrates some of the genetic variability that exists among men who share this genetic trait.
Dr. Rassman mentioned androgen senstivity as being one of the many factors, and I agree, that is one of the genetic traits we have identified that seems to make a given person’s cells more responsive to their own hormones. This means that blood levels of a hormone can be the same between people, but response to the hormone can be very different, and even exaggerated in a person with greater sensitivity to their own DHT. At least 3 studies in men, and 2 in women have indicated response to anti androgen therapy, such as finasteride, as a treatment for hairloss is greater among patients who are more androgen sensitive. This is the premise behind the HairDx genetic test.
What I would add to this discussion is the fact that serum levels of hormones are no longer believed to necessarily reflect the activity level of T and DHT in androgen target cells. In the past decade, evidence has emerged that cells are able to create their own T and DHT from cholesterol, and metabolize it down to by products which are excreted, so that the T and DHT inside the cells are never seen in the blood stream.
Medications, such as finasteride, appear to be able to impact DHT at the cellular level to protect the hairs or reduce their response to their genetic predisposition to miniaturize and stop growing. The fact that men in their older years appear more likely to have hair loss may simply be the fact that it can take many years of gradual hair loss for the appearance of baldness or thinning to emerge, and is probably more a reflection of the fact that one must lose a great deal of hair before it is visible.
Nevertheless, there does not appear to be much protection against hair loss as men age and serum T levels fall, and this may be due to an as yet undetermined genetic time clock, but also because the androgen target cells are able to produce this hormone inside themselves in what is called an ‘intracrine’ fashion, even when the ‘endocrine’ hormones, those produced by the testes and adrenal gland, diminish. As long as the cell can produce DHT, and among those more sensitive to it and genetically predisposed, hair loss will likely progress in the absence of therapy.
Sharon Keene, M.D.
Chief Medical Officer Dermagenoma
Hair Loss InformationCould Topical Hair Treatments Interfere with Finasteride? – Hair Loss Information – Balding Blog
To what extent, if at all, would a topical such as minoxidil or Revivogen interfere with oral finasteride. I feel like trying to jam all of these things in you follicle together may cause them to interfere with one another. The last thing I want to do is reduce the effectiveness of the finasteride. But if they do not interfere with the finasteride, then adding one or both could be beneficial.
Thanks for the help. You have a great site.
I don’t think adding all the treatment options will diminish the effects of Propecia (finasteride 1mg), however, as enthusiastic and motivated as you are, you need to think in realistic terms.
Once you start three separate treatments how do you know which product is working and which is not? At what point are you going to say “Yes, this works” and continue the treatment, or “Nope, this one isn’t for me” so you can stop dumping money into it? Another way to put it — are you prepared to indefinitely invest in all three treatment plans? Remember, once you stop using a product that has shown to be effective, those benefits will disappear.
Hair Loss InformationJuvenile Hairline and the Wrinkled Brow – Hair Loss Information – Balding Blog
I am aware of the idea that creasing your forehead will show you exactly where your hairline was when you were younger, but I am sure this isn’t the case for me. I am 18 and have some recession which seems to be stable (maybe a mature hairline) and may have been there way before male pattern balding can even begin to manifest itself. When I crease my forehead, the highest crease falls two inches below my hairline, but looking pictures from my 11th birthday, my hairline, at least the centre, definitely was not noticeably lower than it is now. Is there any chance this theory is not entirely true for everybody?
The top most wrinkle crease we talk about is just a rule of thumb that generally holds true on most men. Without seeing your 11 year old hairline with a wrinkled brow, one can not be sure of anatomical points of reference. Of course, not everybody is the same. Some people naturally have a very high hairline or a very low hairline.
We are all special, each and every one of us!
Hair Loss InformationCan a Non-Responder to Propecia Still Benefit From Minoxidil? – Hair Loss Information – Balding Blog
Hello Dr. Rassman,
I know that statistically finasteride is more effective than minoxidil, but is it possible that some individuals may respond better to minoxdil than to finasteride? Have you seen any examples of patients who didn’t respond to finasteride but had good results from minoxidil?
I’ve seen great responders to minoxidil, but it had no association with them being non-responders to Propecia (finasteride). The medications work in different ways, so yeah, I suppose if you didn’t find finasteride to be effective minoxidil may still hold some promise.
My Teen Son Has Been Losing Hair for Years – Hair Loss Information – Balding Blog
I have a 17 year old son with Autism. The endocrinologist suspects he may have had precocious puberty. I am concerned because he has been losing his hair for about 3 years. My sons body hair is so thick we jokingly call him big foot. My father was bald, and I know there has been some research into baldness being hereditary on the mothers side.
However,currently my second son is 14 and shows no signs of thinning, although he also has excessive body hair, and there have been concerns he may also be going through precocious puberty due to his height. I am at a loss as to what I can do to help my 17 year old. My husband is bewildered because he is Native American and has an abundance of hair… He doesn’t quite know how to help either… Do you have any words of wisdom to offer?
Precocious puberty is when a young man goes through the puberty process much earlier than normal, somewhere around 9 years old. But boys usually go through puberty in their teenage years… and your son is 17 years old! By the age of 17, I would think that your son should have gone through puberty by now. For your other son that is 14 years old, X-rays can tell you if his bone growth centers have fused (a sign that puberty is behind him).
Unfortunately male pattern baldness (MPB) or androgenic alopecia (AGA) is a genetic trait that sometimes shows up early in boys going through puberty. I have seen men in their late teenage years who are very bald. Balding is not a disease, but a trait that can come from either side of the family tree. It seems to be passed on more from the mother’s side of the family, but this is not statistically valid. Body hair is just another familial trait (and unrelated to the scalp hair loss).
While there is no cure for genetic balding, there are medications to slow it down (Propecia or Rogaine). Talk with your son’s doctor get the correct diagnosis and discuss treatment options.
I Read That Scalp Exercises Will Stop My Receding Hairline – Hair Loss Information – Balding Blog
Hi
I am a 17 year old male and have just started to notice that my hairline has just started to recede (to about just before a norwood 2 I would say) and starting to thin a bit on top. I’m getting a bit worried as my dad is bald. I have been researching ways to stop my receding hairline going any further and came across this thing called scalp excercises. Apparently they allow more blood to flow to the scalp which stimulates the hair follicles and makes them stronger. Just wondering if u think that may work?And also I found a drug called procerin it is a natural drug that has had lots of good feedback and it says it works best for people aged between 18 and 35. I would just like your opinion on if u think this may work for me. This problem has been haunting me for a while so any information u have for me would be greatly appreciated thank you.
Procerin is a boutique version of the herbal saw palmetto. Some people swear by it, others say it doesn’t work. There have been two studies that I’m aware of to determine the effectiveness of saw palmetto as a hair loss treatment, and they were inconclusive. What I know works for early hair loss is Propecia (finasteride). It’s a prescription medication and FDA approved to treat hair loss. Talk to your doctor.
Scalp exercises won’t stop your hairline from receding. You have a family history of hair loss, so while trying out things you read about on the internet might seem like a good idea, the genetic expression of your hair loss won’t be stopped by rubbing your head.
Hair Loss InformationIn the News – The Gray Hair Switch Identified in Rats – Hair Loss Information – Balding Blog
Snippet from the article:
Gray hair is, along with premature balding, one of the greatest fears of image-conscious men and women everywhere, but it may soon be a thing of the past. Scientists at the Ito Lab at New York University’s Langone Medical Center have identified the proteins that cause gray hair, which could lead to an eventual cure.
Scientists have known for years that hair color is determined by the stem cells that guide the development of hair follicles working together with color-producing stem cells called melanocytes. Today, NYU researchers announced they had isolated the wnt protein, which serves to coordinate pigmentation between the two types of stem cells.
Read the rest — NYU Scientists Find Possible Cure for Gray Hair
Protein manipulations are getting closer and maybe what we learned from these rats will be available to humans in the future. Of course, we need assurances that it will be safe, so the breakthrough will have to grind through the FDA process… which might take years.
Does Darker Skin Have More Natural Looking Results from SMP? – Hair Loss Information – Balding Blog
Hello Doctor,
I’m really interested in scalp micro-pigmentation, but browsing on the internet looking for before/after pictures I noticed something strange. The men with a brown skin color seem to have better (more natural) results than the caucasian men. Not only did the SMP ‘grafts’ look more the same as their own remaining hair, the transition between the pigmented area and the natural hair area looked more seamless.
Is this maybe because brown men tend to have coarser, thicker hair?
You may be correct, but shaved heads are more common in the African-American community so we are more accustomed to that look. Light skin and dark hair accentuate any balding pattern, but Scalp MicroPigmentation (SMP) does work well. The key is choosing the right shade of SMP, since every patient is different.
Counterpoint to Dr Rassman’s War on Drugs Opinion – Hair Loss Information – Balding Blog
This was received in response to my post — The Economic Impact of Illicit Drug Use on American Society:
I am surprised to see your post on the issue of The War On Drugs. I believe there are a lot of opinions on this matter some in favor of yours (Ron Paul for example) and many who would disagree with you mainly people of a substance abuse history who are now recovering. You use the words lives lost and lives ruined. These words can fit perfectly with a opposing argument in which lives have been lost and families ruined from a love one overdosing or simply using certain drugs.
I for one do not believe legalizing and taxing and distributing meth or any other lethal drug would solve the ultimate problem at hand. And that is that our nation at its present state could possibly have the biggest drug abuse problem in the world, and this is not counting the millions on prescription medication. Its a shame that government has to step in and help us or hurt us, depending on how you look at it, but do you really think that having a legal distributor supplying an addict with a harmful substance and making money so we all can benefit from it is such a good idea? I was taught that the bad guy was the drug dealer and that drugs ruin lives.
There is no easy answer. Our prisons are filled with drug victims and I would not want to promote that we let them out of prison and then encourage them to overdose on legalized drugs. I know that we can not stop people from doing what they will do, one way or the other, legally or illegally. I just see what is not working… and what we are doing is not working.
I agree with you that our drug dependent society goes all the way into the doctor’s office. People demand the prescription medications that they see advertised on TV and some of the problems like “restless leg syndrome” were not even taught to me in my medical school curriculum, yet the industry that surrounds all of the restless legs out there is growing and growing and growing.
When I see patients in my hair transplant practice, I encourage the use of Tylenol, aspirin, and other non-narcotic medications to use after surgery and with the power of my suggestions, my patients seem to manage without heavy use of narcotics. Some of my patients call to ask for antibiotics when they sneeze, sniffle, or cough and I tell them that their body can handle the sneeze, sniffle, or cough without prescription antibiotics, as most of the sneezes, sniffles, or coughs are caused by allergies or viruses that will not respond to antibiotics. I try to be proactive.