Author: Dr. William Rassman

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Article examining the genetic connections from finasteride symptoms

Has there been any definitive studies done on which genes have an effect on post-finasteride syndrome (side effects that persist after discontinuation of Fin)? ARTICLE: https://www.smoa.jsexmed.org/article/S2050-1161(16)30075-7/abstract

Very interesting. I just read the full article and I will quote the last of the result analysis and the conclusion of the article. My interpretation suggests that the ability to detect men who might get PFS is not understood by any of the genetic findings of this report; however, there are some influences of symptoms reported by men who take finasteride as summarized below:

” A general limitation of this study work is that some symptoms reported by patients with PFS could not be objectively determined. Furthermore, the retrospective design of our study did not allow a clinical assessment of these men before finasteride use. Future studies are necessary to assess the AR genetic profile and testosterone levels in subjects who developed PFS compared with subjects who did not develop adverse symptoms after using finasteride against AGA. CONCLUSION Causes and predisposing factors responsible for the development of long-term adverse side effects in young men who used low-dose finasteride against AGA remain an enigma. Several symptoms were in common in more than 70% of patients with PFS, but a plethora of other disturbances was reported by a minority of patients, with some clearly related and some not to androgenicity. Our study showed that the length of two trinucleotide repeats in the AR gene contribute to the frequency of some specific symptoms reported by patients with PFS. The (CAG)n and (GGN)n polymorphisms were involved in two specific symptoms (ie, scrotal discomfort and increased skin dryness); for other symptoms, only one of the two polymorphisms was involved, which is likely a reflection of the complex modulation of AR activity.16,40 Our investigation using a precision medicine approach suggested genetic implications in symptoms of patients with PFS. Much more genetic and non-genetic research is necessary to elucidate the pathophysiologic pathways leading to the onset and persistence of adverse effects in former finasteride users.”


2019-09-30 11:35:46Article examining the genetic connections from finasteride symptoms

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Artichokes and Hair Loss?

My Grandmother told me that in Sicily where she grew up it’s widely held that artichokes cause hair loss. I’m not sure what to make of this. Any thoughts?

There is no connection between artichokes and hair loss that I know of. Sometimes I laugh at myself as I put in some quick research to be sure that there are no connections between hair loss and the variables presented to me on this blog time after time. Every once in a while, I am surprised that I actually find an informative connection that makes me wiser and more humble.


2006-10-25 08:47:39Artichokes and Hair Loss?

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Article showing finasteride in scalp

This is an interesting article showing the effects of varying doses on DHT when finasteride is taken at varying doses.

https://pubmed.ncbi.nlm.nih.gov/10495374/


2020-04-25 13:36:28Article showing finasteride in scalp

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Article on scalp blood flow has it wrong

The authors show that the blood flow in the scalp with less hair is less than with more hair. This is because the hair requires a great deal of blood because it has a high metabolic rate. The body pumps blood to the scalp to meet the need to support the high metabolic hair organ system. The reduced blood flow, long held as the cause of hair loss, has never been proven. This is an issue of cause and effect, less hair produces less blood supply not the other way around.

Subcutaneous blood flow in early male pattern baldness

Under an Elsevier user license
open archive

Abstract

The subcutaneous blood flow (SBF) was measured by the 133Xe washout method in the scalp of 14 patients with early male pattern baldness. Control experiments were performed in 14 normal haired men matched for age.

The SBF in the scalp of the normal individuals was about 10 times higher than previously reported SBF values in other anatomical regions. In patients with early male pattern baldness, SBF was 2.6 times lower than the values found in the normal individuals (13.7 ±9.6 vs 35.7 ±10.5 ml/100 g/min?1). This difference was statistically significant (p ? 0.001). A reduced nutritive blood flow to the hair follicles might be a significant event in the pathogenesis of early male pattern baldness.


2020-04-19 09:35:58Article on scalp blood flow has it wrong

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Are you a big fan of microneedling?

Yes, ever since I have been seeing the wonderful results of microneedling on Reddit, I have become a fan of it, especially for the men under 24 years old when hair loss is more easily reversible.


2021-03-03 06:41:08Are you a big fan of microneedling?

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Article: Two articles on microneedling

This article requires a lot of patient feedback which can be quite subjective; nevertheless, the focus of the article is interesting and I suspect would be as good with finasteride as with dutasteride.

  • Medicine

Topical dutasteride with microneedling in treatment of male androgenetic alopecia

Introduction Male androgenetic alopecia (AGA) is the most common type of hair loss in men. It accounts for more than 90% of all cases of alopecia in men . It occurs when genetically predisposed men are exposed to androgens. AGA may negatively affect patient’s quality of life and can lead to social and job-related problems . AGA can also cause indirect physical harm, such as sunburn as a result of hair loss and exposure to ultraviolet light . AGA may also be associated with increased incidence of hypertension, hypercholesterolemia, and myocardial infarction . The only FDA approved therapies for treatment are limited to topical minoxidil and oral FIN with limited efficacy (40-60%) . As multiple factors are implicated in the pathogenesis of AGA and the existing conventional therapies (i.e. FIN and minoxidil) fail to target all of them; the demand for new treatment techniques for AGA is growing . Dutasteride (DST) is a dual 5?reductase inhibitor, with some reports about the use of oral DST in the treatment of AGA in men . Hesitancy about the widespread use of oral DST in the treatment of male AGA results from its potential side effects on erectile, ejaculatory functions and fertility . Mesotherapy using DST has been used in patients with AGA with promising results (8, . It is believed that systemic absorption after mesotherapy is equal to after oral DST because the scalp is highly vascular. So the possibility of using DST topically with scalp MN would have some advantages . Microneedling (MN) is a relatively new minimally invasive procedure involving superficial and controlled puncturing of the skin by rolling with miniature fine needles . The use of MN in combination with minoxidil showed promising results in treatment of AGA . Furthermore; the addition of MN to minoxidil and oral FIN improved AGA in patients who were resistant to minoxidil and oral FIN . To the best of our knowledge; the use of MN in combination with DST hasn`t been previously reported. This study was designed to evaluate the efficacy and safety of topical DST with MN in treatment of male AGA. Patients and methods This prospective, randomized, clinical study was approved by Ethical and Research committees at Faculty of Medicine, Sohag University. An informed written consent was obtained from all participants. The study included 30 male patients complaining of progressive hair loss diagnosed as AGA attending at Dermatology outpatient clinics at Sohag University Hospitals, Faculty of Medicine, Sohag University. Exclusion criteria ? Patients with other forms of alopecia including telogen effluvium, alopecia areata. ? Patients with dermatological or systemic illness known to cause diffuse hair loss (as thyroid disorders or anemia).
Another article shows results from adding microneedling to treatment routine: https://www.semanticscholar.org/paper/Response-to-Microneedling-Treatment-in-Men-with-Who-Dhurat-Mathapati/90b0a2dfd226763e0a4c82267d393e638d01923c


2020-02-11 10:56:26Article: Two articles on microneedling

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Aspirin reduces the effectiveness of minoxidil

https://pubmed.ncbi.nlm.nih.gov/30226287/

Low-dose daily aspirin reduces topical minoxidil efficacy in androgenetic alopecia patients

A Goren 1, A Sharma 2, R Dhurat 2, J Shapiro 3, R Sinclair 4, M Situm 5, M Kovacevic 5, V Lukinovic Skudar 6, M Goldust 7, T Lotti 8, J McCoy 1
Affiliations

Abstract

Topical minoxidil is the only US FDA approved OTC drug for the treatment of androgenetic alopecia (AGA). Minoxidil is a pro-drug converted into its active form, minoxidil sulfate, by the sulfotransferase enzymes in the outer root sheath of hair follicles. Previously, we demonstrated that sulfotransferase activity in hair follicles predicts response to topical minoxidil in the treatment of AGA. In the human liver, sulfotransferase activity is significantly inhibited by salicylic acid. Low-dose OTC aspirin (75-81 mg), a derivative of salicylic acid, is used by millions of people daily for the prevention of coronary heart disease and cancer. It is not known whether oral aspirin inhibits sulfotransferase activity in hair follicles, potentially affecting minoxidil response in AGA patients. In the present study, we determined the follicular sulfotransferase enzymatic activity following 14 days of oral aspirin administration. In our cohort of 24 subjects, 50% were initially predicted to be responders to minoxidil. However, following 14 days of aspirin administration, only 27% of the subjects were predicted to respond to topical minoxidil. To the best of our knowledge, this is the first study to report the effect of low-dose daily aspirin use on the efficacy of topical minoxidil.

Keywords: alopecia; aspirin; minoxidil.


2020-11-13 06:21:36Aspirin reduces the effectiveness of minoxidil