Author: Dr. William Rassman

Taken from Reddit.com. My comments: We reported this back in 2011 (https://baldingblog.com/does-botox-prevent-or-reverse-hair-loss/). I read through this article and the three references. Thanks for sending this interesting material to me. I do not understand the mechanism here nor do I feel that any good double blind study is available. There is not enough science to make this a dependable treatment but from the 4 publications, I would expect that more information will be available in the future. I wouldn’t want someone to take on Botox instead of a more traditional treatment and then lose their hair while trying this experimental approach as time is the enemy in genetic hair loss so the longer it goes on, the more is lost. I include as much information as possible for my readership to be able to see and understand that may be coming in the future, even if it is more hope than reality.

https://sci-hub.se/10.1016/j.jaad.2020.04.082

Dihydrotestosterone (DHT) induces transforming growth factor-?1 (TGF-?1) in dermal papilla cells (DPC) to suppress follicular epithelial cell growth. Thus, TGF-?1 is one of the key players in androgenetic alopecia (AGA) and its antagonist may prevent AGA Botulinum toxin type A (BTX) may inhibit TGF-?1 secretion from DPCs as it does with scar tissue fibroblasts, which shares the mesenchymal origin. Recently, BTX has been effective for the treatment of AGA.

Herein, we evaluated the efficacy and safety of intradermal injection of BTX (Nabota®, Daewoong Pharmaceutical, Seoul, Korea) in AGA and its relationship with TGF-?1.

AGA patients were enrolled according to the basic and specific classification. Patients undergoing treatment with finasteride, minoxidil or supplements that affect hair growth were excluded. This study was approved by the institutional review board. The participants received intradermal BTX injections every four weeks for 24 weeks. A total of 30 units of BTX were injected at 20 different sites on the balding scalp in each treatment session.

The expression of TGF-?1 from cultured DPCs under 100 nM DHT was evaluated by RT-PCR analysis. Suppression of DHT-induced TGF-?1 secretion from DPCs by BTX (2.5U/106 46 cell) was assessed by immunofluorescence staining. The doses of BTX in the in vitro study were selected on the basis of a previous report investigating the effect of BTX (2.5U/106 cells) on TGF-?1 secretion from the fibroblasts.

This study comprised 18 male patients with mean age 49.00 ± 6.50. In an unblinded phototrichogram image analysis (Lead M Corp, Seoul, Korea), the number of hairs per cm2 at weeks 0, 12, and 24 were 129.61 ± 28.05, 129.11 ± 28.80, and 136.22 ± 33.05, respectively. The number of hairs significantly increased at week 24 (P = 0.012) but not at week 12 (P = 0.803). Comparison of the pre- and posttreatment photographs showed significant improvement at week 24 (P = 0.031) (Fig. 1). DHT upregulated the TGF-?1 expression of DPCs in 96 hours, whereas BTX downregulated the TGF-?1 expression in 96 hours (Fig. 2). No serious adverse events or changes in laboratory parameters were reported.

DHT-induced synthesis of paracrine mediators (Dkk-1, IL-6, TGF-?1) in balding DPCs may play a role in AGA and represent alternative treatment targets. However, clinical studies targeting these paracrine mediators have not been reported. In our in vitro study, BTX successfully abrogated DHT-induced secretion of TGF-?1 from DPC.

Intradermal injection of BTX was effective against AGA by inhibiting TGF61 ?1 secretion in the hair bulb, which is thought to suppress follicular keratinocyte growth and changes in the hair cycle. Previous studies reported the use of intramuscular BTX injections to treat AGA without elucidating the exact underlying mechanism. Considering the diffusion of the injected liquid BTX and scalp anatomy, even the intramuscular injection may indirectly inhibit the secretion of TGF-?1 from DPCs in the hair bulb. Advanced AGA or elderly age may have adversely influenced our treatment outcome.

In conclusion, we suggest that intradermal injection of botulinum toxin could be a possible treatment option for AGA by inhibiting TGF-?1 secretion from the hair follicles. However, further research and long-term follow-up are required.

Some more botox related info

A Pilot Study to Evaluate Effectiveness of Botulinum Toxin in Treatment of Androgenetic Alopecia in Maleshttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5782443/

A small dose of botulinum toxin A is effective for treating androgenetic alopecia in Chinese patientshttps://sci-hub.se/10.1111/dth.12785

Treatment of Male Pattern Baldness with Botulinum Toxin: A Pilot Studyhttps://journals.lww.com/plasreconsurg/fulltext/2010/11000/Treatment_of_Male_Pattern_Baldness_with_Botulinum.79.aspx

I took finasteride for a year and developed gyno from it. When i noticed the lump in my left chest i stopped taking it. However, what happened was weird. After stopping finasteride for like more than a month, the hard lump in my left chest disappeared but at the same time a hard lump appeared in my right chest. My left nipple is still swollen and big though. But on pressing it i dont feel a lump.

I want to know whether this gyno will go back on its own or if surgery is must. I never had gyno before and i’m 100% sure its from finasteride.

If the lump remains, you should see a doctor. Breast cancer is very rare in men, but it does happen.

Is it true that fin really does alter people’s mental state (e.g depression) and altered their brain/cognitive functioning as well?

There does seem to be a small number of men who take finasteride and get depressed if they have a history of depression and there are reports of brain fog which has never been successfully explained. Brain fog or depression is a good reason not to be one finasteride.

Dr. Rassman PLEASE help, I was planning on sticking with fin but this morning after taking fin I had the worst brain fog and memory problems I’ve ever had. I’m working on becoming an MD so I have a lot to read and yet I couldn’t read, or focus on anything. I have an extremely careful diet and exercises regularly and this has never happened. I think I’m going to stop using fin but the brain fog won’t leave and it’s been over 15 hours. What do I do? Is there blood work that would help?

Stopping the finasteride is critical here. It may take a few weeks for the brain fog to go away. It stays in your body’s tissues for a few weeks, lessening each week until it is gone within about a month or less. You should have a doctor managing this problem for you. I can’t be that doctor over the internet.

As a physician with over 30 years in the drug development and regulatory industry, I think the doctors and patients advising you may not truly understand the drug development process (and most really don’t, unfortunately). The FDAs Office of Generic Drugs (OGD) within the Center for Drug Evaluation in Research requires generic drugs to go through the same rigorous manufacturing process as non-generic drugs (and sometimes only bioequivalence studies showing similiar pharmacokinetic effects are allowed). Unfortunately, they have no control over drugs purchased online from foreign countries or bought in foreign countries (under the regulatory authority of those regions) – and the language of your blog writer above makes me wonder if this is the case (“Japanese generic”). Of course, a foreign company can also seek regulatory approval in the US, but I suspect this is not the case here.

What this writer is saying is important. You must know the source of your drugs if you do not buy them from a known, approved pharmacy.

According to a Google look-up, Dr. Brotzu pioneered this lotion. It is reported to be an “Omega-6 fatty acid. It is supposed to be an anti-inflammatory lotion. It is being promoted in the product as a precursor to PGE1. Specifically, DGLA is converted to PGE1 via the cox-1 and cox-2 pathways.” There are no FDA claims that have been cleared by this. So much of what you read is hypothetical and possibly illegal in the US. I can’t say if it works or not, as I would have to read a clinical scientific paper on it first.

So I have been taking Finasteride 1mg daily and minoxidil 1ml twice a day for the past 2 months now. I thought I was experiencing brain fog as a side effect for awhile and denied it for a bit. I go to look up what brain fog is and it has more to do with confusion. What I’m experiencing feels more like an irl motion blur of sorts and as far as I know I’m experiencing no forms of confusion (or more than regular at least as I have adhd to begin with). Can this be classified as brain fog? Can this be caused by Finasteride or minoxidil? It seems to start every time I get to work and lasts for 3-5 hours and it’s really not that bad but its noticeable.