Category: Drugs (Cause Hair Loss)

Dr. Rassman,

Thank you for maintaining this blog, its great to have a free trustworthy resource in a world full of scammers and misinformation.

I’m a 24 year old man and have been experiencing loss since age 18. I started on Propecia at 20 and was able to maintain my hair and score some regrowth. Unfortunately I stopped taking the drug for 10 months starting about two years ago. I started back on Propecia last May(2009).

My problem is that in the past 10 months, while back on Fin, I have experienced significant loss. My hair has gone from a solid norwood 2.5 with full density in the mid scalp and mild thinning in the crown to a norwood 3v with profound diffuse thinning all through the pattern. I have added Nizoral shampoo and some multivitamins to my regimen a few months ago. Still, my hair is getting progressively thinner. Do you think my situation is attributed to the catch-up loss phenomenon or could it be that my body has stopped responding to Propecia…or something else?

Thanks for your advice.

Thank you for following the site, but unfortunately, I really cannot give you a definitive answer.

You are likely losing hair due to genetics, but the degree of your balding is yet to be determined. Maybe you are destined to be a Norwood Class 3V and will stop there. Maybe it’ll get worse. I really couldn’t say. The key point I want you to understand is that there is nothing to stop your genetic fate at this point. Propecia will only slow things down, but I don’t believe your body stopped responding to it nor do I believe it necessarily stopped working. In fact, you may have experienced “catch-up” hair loss after stopping Propecia for 10 months. You could’ve experienced a shedding after restarting the medication or it could just be coincidental timing as the progression of your hair loss was in full swing.

In the end, I would suggest you follow up with your prescribing doctor and continue on with the treatment plan (Propecia).

Paid advertisements (not an endorsement):

Can Propecia cause shedding after 6 months? Or is it just a sign that it is not working as well as I once thought? My hair density seemed to get better but after the 6 month mark I have noticed a big step backwards. Thanks guys for the great info.

If shedding were to occur, it generally begins upon starting Propecia and ends within a few months. If you see accelerated loss 6 months after starting the treatment, that is uncommon and might not be shedding from the medication. As for what it is, I couldn’t say with any certainty — but that is why talking to the doctor that prescribed Propecia to you is important.

If there were miniaturization studies with mapping of the scalp done prior to starting the Propecia, then this question could be answered a little better, as a new mapping would show changes since the original mapping. Baseline studies will tell you if this is an acceleration of your balding process.

I’m 26 and have been thinning for the past year on top/crown and my hairline is receding a little. I have finally started rogaine and just found out about “shedding”. This makes me very nervous, and I have some questions:

1. What percentage of men who use rogaine experience shedding?
2. What are the side effects if I discontinue rogaine during the shedding phase?
3. How many men who report shedding also report not regrowing the hair that was shed?
4. Are there other drugs that can be used besides propecia that contain finasteride?
5. If rogaine only regrows hair and doesn’t prevent hair loss how is it helpful in maintaining a full head of hair?
6. How many of your patients who use rogaine see results?
7. Do you recommend Propecia and, if so, why?

Thank you very much

Calm your nerves!

1. Shedding from Rogaine (minoxidil) is really not that common, but I don’t have actual percentage statistics to back that up. I’m just going by my experiences with patients. It might seem like there are a lot of incidents as reported on the Internet, but remember that those with a complaint will often want to alert others, and those with no problems just go about their day.
2. If you have taken Rogaine for some time (more than 3 months) you can shed hair when stopping it, as there is a dependence on Rogaine in some people.
3. I can not answer this question. I’ve got no statistical info.
4. There are two pills available that contain finasteride. They are Propecia (1mg finasteride for hair loss) and Proscar (5mg finasteride for prostate). Plus, generics depending on your country. You do not want to take Proscar for hair loss treatment though.
5. Rogaine does not work all that well for most patients. Sure, there are some results, but I’ve never seen Rogaine give anyone a full head of hair. Hair growth is a side effect of the drug.
6. My candid view is that minoxidil generally does not yield much regrowth in most patients. Again, I don’t have actual stats to tell me how many patients that just use a single medication have had positive results. This is the kind of information that is gathered by doing a focused study, of which I have no interest in doing. Plus, many patients that use Rogaine will also take Propecia, making it difficult to say which medication is providing benefits.
7. I do recommend Propecia. For known genetic balding, finasteride is the drug of choice to stop, slow, or reverse hair loss.

My question is what to do about gynecomastia from Avodart, which stays in your system for months (maybe even a year) after discontinuation. Since the usual treatment for drug induced gynecomastia is to stop taking the drug, this is essentially not an option with Avodart.

My doctor feels otherwise, but wouldn’t you think a more aggressive treatment such as tamoxifen would be warranted? There is already a lump you can feel, and my understanding is that this will become permanent if it lasts more than six months.

Any advice what I should do?

You need a doctor to guide you in a direction here, and your prescribing doctor is the one to go to. I would probably suggest that you just discontinue the drug, maybe switch to finasteride in very low doses, but I am not your doctor.

I don’t have experience with using tamoxifen as a treatment, as described here. Hair loss is listed as a possible side effect from tamoxifen, by the way.

Paid advertisements (not an endorsement):