Author: Dr. William Rassman

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Avodart and Mixing Shampoos

Hello Dr. Rassman.
Thank you for taking the time to respond. I also wanted to ask you about going on Avodart (Dutasteride) or it’s Generic Dutagen. I have been on Propecia since 1999, and I think it is no longer working. I read Merck’s official report on Propecia’s 5 year efficacy, and it looks like after 5 years Propecia stops growing any hair at all, and it’s ability to keep hair is weakened. Dutasteride appears to block 93% of DHT production, where Propecia can only block 38-45% DHT. Can I get a prescription form you or Dr. McClellan? I am noticing that my “own” non-transplanted hair is thinning, and hopefully the Dutasteride or it’s generic version can stop any more loss.

Also, I am using Nizoral shampoo (Ketoconazole) 2 times a week, and Head and Shoulders shampoo (Pyrithione Zinc) on the other days. Is it safe to mix the Ketoconazole and P. Zinc? A friend told me that the P. Zinc can cause miniaturization of the hair follicle, and mixing the 2 shampoos can have disastrous results. Then on the the other hand, many people on online hair loss forums are saying it is fine to mix the two shampoos. Only using Nizoral 2x a week does not stop my newly acquired incessant itching. It would be great if I knew it was safe to use Ketoconazole and P.Zinc.

Thank you so much for you time, I’m sure you hear all these worries all of the time. Now that I see my new hair sprouting, I want to keep it growing, and keep or grow more of my own.

Here is a link to some of my other posts with my comments on Avodart. I will make a decision with regards to prescribing Avodart in early September, after I return from the International Society of Hair Restoration Surgery meetings in Sydney, Australia.

With regard to the various questions you had concerning the shampoos you mentioned, I really do not know the answer, as many people respond differently to each. Experiment with each and when you find something working, then stick to it. Mixing shampoos should not be a problem.

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I Had a Bad Hairline Lowering Hair Transplant

My forehead came down about 1cm with 1500 grafts. I am unhappy with the unnatural look, and my skin is elevated and white. I would like to reduce my forehead surgically and reverse the transplant.

This is not an easy assessment without seeing, at the least, a photo. You said the hairline was only lowered about 1cm, so I need to know what it looks like. Also, your comments about the elevated grafts after growth and the white color of the skin is concerning. If the entire area in front of your normal hairline is no more than 2.5 cm, then a hairline lowering procedure may be able to remove the entire transplanted area. You should see a surgeon that offers hairline advancement surgery, and this could be a good solution for you.


2018-06-21 09:30:51I Had a Bad Hairline Lowering Hair Transplant

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Azor, Toprol-XL, and Hair Loss

Hi,

I am currently taking Azore for high blood pressure and occassionally toprol xl for heart palpatations. Can these medicines cause hair loss of a significant nature?

Azor (amlodipine and olmesartan) does list hair loss as a possible side effect. Taking Toprol-XL (metoprolol succinate) can also lead to hair loss in rare cases, as we’ve mentioned before. With the combination of these two drugs, you do have a higher likelihood of seeing thinning hair.

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Avodart Info

A BaldingBlog reader named Greg originally posted this as a comment to a blog entry, but I’ve formatted it to make it easier to read and have reposted it here.

The FDA has found Avodart to be safe (for BHP). The side effects were very simliar if not a tad less then Proscar 5mg, which also was cleared by the FDA many years ago. I think Avodart should be indicated as a off label prescription in some instances.

  1. non-responders to Propecia
  2. When the loss of efficacy of Propecia becomes bothersome to a indivdual

One other interesting point is that the age group the FDA studied on Propecia (18-42) was quite younger than what Proscar/Avodart (50+ median age 66 approx) so the chances of sexual side effects will inherently be larger in this age demographic as opposed to Propecia… meaning the side effects are probably even closer then one thinks/ Propecia versus Avodart. The one draw back with Avodart is that there is no “human model” with type 1 suppression so there is a question on “long term” safety as with many drugs. As long as you dont have any side effects with Avodart, the long half life can only be beneficial with Androgentic Alopecia and the phase 2 studies show this. People held onto the hair they gained (even grew more) 12 weeks “after” the the medication was discontinued (0.5 mg/ 2.5 mg only). Proscar users saw a sharp decline in this time frame. I hope these facts are helpful in some way.

Thank you for your insight. I believe that what you said makes good sense. I would hope that I could adopt a similar view in an ethical/legal framework.

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Aveda Invati Shampoo

I was wondering if you have any thoughts on the new Invati Treatment for Thinning Hair (shampoo, conditioner, and scalp revitalizer) from Aveda. Supposedly it won’t regrow hair, but it will stop hair loss (at least that’s what they said in the store.) Sounds too good to be true. It also seems to be mainly targeted towards women, though they claimed it would work just as well for men.

Thanks!

I found the product’s page and have seen the commercials on TV. The site says it stops hair loss from breakage, meaning it does nothing for actual genetic hair loss, but rather, it may strengthen hair. I think you answered your own question about it sounding too good to be true. Having said that, if you want to try it, it is your prerogative.

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Avodart Gave Me Severe Abdominal Cramps

Dear Sir .. I am suffering from severe hair loss since last one year.

Recently my doctor prescribe me the Dutasteride (Avodart) Medication for hair loss prevention. I continued the medication for 10 days and then I started to get severe Abdominal Muscle Cramps. After I stopped taking this medication the pain subsided slowly. I have recently read the article about Prostaglandin D2 protein and baldness on some website. Wanted to know that the Dutasteride is the cure for Prostaglandin D2.

Now I am confused that should I continue the Avodart medication or should I discontinue it permanently. I want my hair so I wanted to have your help, If you can prescribe me a good medication for hair loss prevention and regrowth .. So that I can discuss your prescription with my doctor.

Will be thankful for your reply and suggestions.

Regards

First things first — Avodart (dutasteride) is not approved for treating androgenic alopecia, and I don’t know what dose you’re even taking. I’ve read internet reports of abdominal cramping for some users upon starting Avodart, but I don’t really have much info beyond that. With respect to taking a prescription medication, you need to discuss these issues with the doctor that prescribed you the medication, especially if you feel you are having side effects!

As far as I am aware, dutasteride has no correlation with prostaglandin D2.


2012-04-03 10:27:46Avodart Gave Me Severe Abdominal Cramps

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Avodart’s FDA Status?

You have mentioned that Avodart is not yet approved by FDA. Do you know what the status is on them approving it? Is it in its beginning trial stages or are the trials mostly complete and the FDA is just evaluating all of the research before making a decision. Or have they rejected it all together?

Avodart was approved by the FDA for treatment of benign prostatic hyperplasia (BPH), in 2001. While I do not know which stage the trials are currently in, I am sure that the manufacturer of Avodart is doing all they can to speed up the FDA approval process for use in hair loss, if it is even at trials to begin with.

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I Have Let My Hair Grow Out 3 Months and the Back of My Head Looks like It Is Balding

You have significant donor site depletion. This problem is caused by over-harvesting the grafts from your FUE three months earlier. The only thing you can do is to get Scalp MicroPigmentation, which will hide the balding spots, but it will not add hair.

See here: https://scalpmicropigmentation.com/scar-covering/


2018-06-21 08:57:49I Have Let My Hair Grow Out 3 Months and the Back of My Head Looks like It Is Balding

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Avodart (Dutasteride) vs Propecia

Hi.DR.RASSMAN, I would like to know if type 1 DHT causes hairloss?? or is it just type 2..?? Please let me know when you get a chance… and do you think they will becoming out with anything better then propecia in the near future???

Propecia is a type 2 competitive inhibitor of DHT and Avodart is a competitive inhibitor of both Type 1 and Type 2 receptors. I think that is what you are asking. There is no clear evidence that blocking both Type 1 and type 2 receptors is better. What we do know is the Avodart does drop the DHT level in the blood stream more effectively than Finasteride (90% vs 75%). What this means is suggestive that it might work better in some people. But I must state clearly that safety and effectiveness is the mainstay of the FDA and until we have a handle on these two issues, I believe it is better to stick to Finasteride.