Author: Dr. William Rassman

I have been using rogaine foam for one month now and my hair has fallen out and is thinner then before I started…this getting scary! I do not understand the concept behind the shedding.How long is it suppose to last and could some people be allergic to the product? And what about the high alcohol content is that bad for the scalp? Dr Rassman do you believe it is worth trying for a longer period of time ?

Some people are sensitive or allergic to the non-active ingredient in Rogaine. I do not believe that a small alcohol content is bad for the scalp, but it can cause drying in some people and the minoxidil itself could be an irritant in others (or you could be one of the “lucky” ones and experience drying and irritation).

The shedding of hair while starting minoxidil may be due to the fact that the hairs undergo a “reset” cycle, as old hairs fall out to start a new growth cycle. This has not been medically proven, but is a generalized concept to explain why some men experience shedding when they first start using the medication for the first couple of months.

Dear Sir,
This is with reference to comment titled “Periodic Shedding from Finasteride?” in which you had mentioned that Finateride do NOT help to control genetic hair loss. I was impression that Finasteride helps to control the genetic hair loss by handling the DHT accumulation. If Finasteride do not help to control the genetic fall off, what exactly this drug is intended for? Request your advise to understand this better.

This is part of what I said in that post that you’re referring to:

“It is important to realize the the genetic hair loss has its own course, independent of the effects of the drug. What you think is shedding from finasteride, is probably more genetic hair loss. Hair loss goes in waves and cycles of loss (shedding) most likely due to your genetics, not the finasteride. You should discuss this with your prescribing doctor.”

To clarify, finasteride is not a magic pill that stops genetic hair loss. It decreases DHT production at the hair level to combat the DHT that facilities genetic hair loss. As a result, most men on the drug will have some hair growth or slowing of the hair loss. The main point here is that the genetic predisposition will continue and finasteride will carry you only so far.

Hi Doc!

In several posts you state that breast enlargement (gynecomastia) caused by finasteride (propecia) is reversible after stopping this medication.

Well, I developed a slight breast enlargement (”puffy nipples”) after a year of taking propecia so I stopped immediately when noticing this condition. However, the puffy nipples are still present even though I have been off the propecia for about 7 months now (I have no other medical condition).

I have heard that the only way of getting rid of this “gynecomastia” condition is an operation, so how do you know that it should be reversible upon stopping propecia?

You need to speak with your prescribing doctor, as Propecia does cause gynecomastia in a very small proportion of men. This condition should reverse on its own when you stop taking Propecia and if it did not, then you need to see your doctor for other potential causes.

Something else to consider is that according to one study for those men (not taking Propecia) over the age of 44, the prevalence of gynecomastia was 57% (possibly the effect of being overweight in some men and this therefore may not be breast tissue, but fat buildup). This data indicate that palpable gynecomastia may be more common in normal adult men. See Journal of Clinical Endocrinology & Metabolism – Gynecomastia as a physical finding in normal men

You need a good medical evaluation by a doctor, in person. I wish I could offer more, but I’m limited by the Internet in that regard.

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