Author: Dr. William Rassman

Dear Doctor,
If you have miniaturization developed in the past 6 months at a rapid pace is it possible to fully reverse it or maybe most part of it ? I Got onto propecia last month once my derm confirmed I have MPB. I am thinking of adding Minoxidil too to the regimen the logic being since the miniaturization/ slight halr loss too has been in the past 6 months Minox might help steer those hair follicles slipping away into complete dormancy. Is my thinking right ? or will propecia and something like a 2% nizoral shampoo be enough to do the job/revive thoseminiaturized follicles ?. My miniaturization is mostly on the top and my hairline is intact. My hairloss history is about 7 months. I am late 20s. Also What is the ideal times a week you should wash hair for a male who has a desk job from 9-5 and works out 4 days a week. ?
I will appreciate your feedback.

In my opinion, I would hold off on the minoxidil and stick to the Propecia for the first 8 months. If the hair loss is as you have defined, then there is a high possibility that it will reverse because it seems to work best for short term genetic hair loss. If you take other drugs like minoxidil and make too many changes at once, then you will never know which one worked best and you’ll be ‘hooked’ on both of them for years. Play your bet out and try the 8 months of Propecia first.

As for washing your hair, I’ll just quote what I said in an earlier blog entry: “Frequent shampooing does not hurt, but aggressive massaging during shampooing and rough brushing will cause fragile hair to break easily.”

To conclude, yes miniaturization can be reversed. The more advanced the balding you have and the longer time you have had it, the less likely will be reversal of the balding process. But the resuls with Propecia (in particular) have at times been very powerful and I have seen a few men who I would have never guessed would reverse, reverse it nevertheless.

Is it possible for a general practitioner to prescribe finasteride 5mg if he knew what I was taking it for? The only dermatologist in town moved far away and will not refill my prescription unless I have yet another appointment. I have little time to visit a specialist outside my town.

Any physician can prescribe almost any medication… so the short answer is: Yes. Some doctors do not like to prescribe the 5mg finasteride pill under the assumption that you are going to split it into quarters. If your doctor won’t prescribe it at that dose (which is available in generic), try another doctor.

For those not familiar, 1mg finasteride is for treating hair loss and 5mg is for treating the prostate. The 5mg is available in a much cheaper generic form, the 1mg isn’t yet available in the US due to patent laws.