Author: Dr. William Rassman

I have been on Propecia for 11 months now and on rogaine for about a 6 months. I have found that it is harder to style my hair after using the rogaine foam due to it making my hair stiff. Due to this, I started using the rogaine foam only at night. I have recently gone back to using the rogaine twice a day and just putting up with the difficult styling. The problem is that I have seen more and more hairs on my hands after applying the rogaine foam after a shower then before. Is this due to the change in using the foam once a day to twice a day? Also, do you have any recommendations for a doctor in Washington D.C./Northern Virginia area?

Thanks!

Some people report not liking the Rogaine Foam for the same reasons. Having never used it, I can not comment on your complaint. It should be the same when comparing liquid and the foam with regard to results. Twice a day use should be better than once a day use, but you may have accelerated the cycling, which in the long term should be fine for you.

I don’t have any specific recommendations in the DC area, but Dr. Robert Bernstein is in New York and does work that I have seen, approved, and I therefore can recommend him. It is worth the trip to NY. Or better yet, come visit me in Los Angeles and you can see Disneyland or Universal Studios as part of the trip.

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Dear Doctor,

I hope you are fine. I have a weird problem.

I am losing hair since last 4 years and I shave off my hair (completely bald) once in 4 months. Few years back, my dermatologist mentioned that I had Androgenetic Alopecia and I was thus placed on that medication for quite some time. After taking medication and doing relevant tests, it was found out that my DHT levels are low. But for some reason my hair still falls out!

Looking back at my history, my hair grows long for 3 months (and I dont lose much hair in these three months – 4-5 per day) and they start falling out rapidly in the fourth month (20-25 per day)! In the fourth month they become so weak that if one would gently smear on the head, my hair would come out on his hand!

My question is why does the hair keep falling out when it grows long, in spite of me being on the medication – dutasteride (0.5mg per day), rogaine foam (twice daily) and nizoral (thrice a week).

Doctor, my hair loss worries me quite a lot. In the last four years, you can actually notice that the density of hair on my head has reduced drastically!

I will be grateful for your advice and help.

Hair growth is unpredictable. Contrary to the cycle of hair loss and growth that you report, I am skeptical that you can see it in 4 month cycles. Measure it by mapping out your hair for miniaturization and then you can prove it either is happening or not.

Using all of the medications like a shotgun won’t get you more hair growth, and although not likely, it’s possible that your hair loss is from causes other than MPB and thus medication wouldn’t help anyway. Perhaps seeking out another dermatologist for a second opinion might be worthwhile. Also, it’s normal to lose around 100 hairs a day.

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Angiotensin II Receptor Blockers don’t seem to list hair loss as a side effect, even rare. At least these two don’t….These don’t have the combination of a HTC which can, Diuretic. Here are two:

1. Micardis and Hair Loss
2. Avapro and Hair Loss

I know anything is possible and you will say you can still lose hair on it. Heck you can probably say that about every substance on earth. It is reassuring that these two don’t have it listed and I think it would be helpful for your worried readers to look into which medications statistically have the lowest reports. Maybe that is something you can research.

Over 4000 people in the trials and no reports. The problem I find with post-marketing data is there are too many variables like other medications, consumer stress ect ect. Also since 40% of those people who need HPB medication also fall into the 40% of the population who lose hair. So what came first right?? Might be good for your worried readers to talk to their doctors about. I have read a few blogs that claim hair loss in one or two people but those people seemed to be on more than these two drugs and even had been on a beta-blocker recently which clearly states hair loss.

I though I would share my research with you. Also, don’t you think having HIGH BP for an extended period of time can cause diffuse hair loss over the entire head?(not to mention the other serious problems). I have often wondered if my untreated high BP could have caused my diffused thinning over my entire head w/out any real pattern of MPB. That is until now when I have gotten treatment. I guess I will find out if it thickens up. Thanks

The association of hair loss with any medication could be a cover-your-ass approach by various drug companies who find it easier to mention hair loss than ignore a possible association from a medical/legal point of view. As a hair transplant surgeon, I am not in a position to form an opinion of my own about this. You are correct that the incidence of high blood pressure is as high in the general population as balding, but these two observations are not necessarily connected. I am afraid that I can not shed more light on this.

You said much and I appreciate your research. I agree with what you said about worried readers talking to their doctors about these issues. The internet is a great, great tool, but even better is a one-on-one with the physician that is already treating you and has specialized knowledge based on your medical history.

Hello,
My question in in regards to potential long term side-effects of finasteride/propecia? I was perusing an article on the internet about the possibility of the long term side effect of it. Then a doctor commented in an article that he questioned the prolonged use of finasteride and said something to the effect of “remember phen, fen?” and we don’t know the potential long term side effects of finasteride yet.

So, did this doctor make a “blanket” statement or do we not yet know all we need to know about propecia?

I’m the kind of guy that doesn’t like to take medication unless there’s something “wrong with me”. So is this safe to start taking? I just didn’t like the reference made to phen fen. Thanks in advance.

Does anyone know everything about anything? The answer must be obvious, so even after 13 years on the market, there could still be surprises. They may not be all bad however, as there are always some good that comes out of such medications. In this case, we know that cancer of the prostate risks are reduced with steady use of the finasteride 5mg dose and many experts think that this will spill over with the 1mg dose. Cancer of the prostate and preventing hair loss (or slowing it) should be considered against the down side risks, of course.

We each need to make these judgments, but over and over again I hear men tell me that they WON’T take pills. Just the other day a 28 year old man demanded that I point him to an herbal for preventing hair loss with an emphasis on “certainty” motivating him. As he was demanding my herbal recommendations, I thought, “I am but a poor doctor giving advice, so please be reasonable with such questions.”

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