Drugs – Page 109 – Balding Blog

April 21, 2010

Using Rogaine After a Hair Transplant – Hair Loss Information – Balding Blog

I was using Rogaine with some moderate success. However, I have just had a hair transplant. If I start back using Rogaine, will it: harm the newly transplanted hair? stimulate the new hair’s growth? have no effect?

Thanks!

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If you saw benefits from Rogaine (minoxidil) prior to the hair transplant, you should get back on the drug since withdrawal may cause reversal of those benefits (meaning hair loss). The transplanted hair should not be impacted by minoxidil, but waiting until the scabs fall off is probably the best timing I might suggest. Or you may wish to talk to your transplant doctor about the best timeframe for restarting the medication.

April 20, 2010

Are There Downsides to Starting Propecia Early? – Hair Loss Information – Balding Blog

Here in England a nationwide pharmacy is running a “hair retention scheme” which basically seems to be a way to prescribe propecia. I went along for an appointment but was told that I was a Norwood II and I’d have to wait until I was a Norwood III before they would prescribe the drug.

Reading previous answers I assume this is because propecia does not seem to effectively regrow hair at the temples and because of issues around mature hairlines vs balding. I am a 20 year old male who has noticed a big change in my hairline over the last 18 months, including large amounts of hair shedding. Furthermore my father, who was very bald by 24 or 25, first noticed he was going bald when he was 20.

Would propecia be beneficial for a person in my situation? What are the potential downsides of starting it now? I have read a lot that as soon as you notice hair loss you should try and do something about it but my experience so far doesn’t seem to chime with that.

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Propecia I looked up the hair retention program you mentioned, and it sound like it is just Boots pharmacy’s way of marketing hair loss products.

Propecia is a medication that needs to be prescribed by a physician and it is for the treatment of male pattern hair loss. It works mostly on the crown area (rarely in the front corner areas for men with Norwood Class II or III) and it likely will not reverse the maturing hairline that we see in young men between 18-30 years old. That being said, many doctors prescribe it for this early frontal hair loss or maturing hairlines because they do not look for miniaturization, the cardinal sign of genetic hair loss and balding. Many men take it out of fear of losing their hair or on the recommendation of doctors who do not know much about the diagnosis of genetic balding. It does not work for frontal hair loss in most instances other than possibly slowing the process down, but is it the only real medication to address what you are going through.

There really is no downside to taking Propecia early on in the hair loss process, but if you are not balding why take a medication you don’t need? In the end, these choices are something you and your doctor need to discuss and come to an agreement. It sounds like there is some disagreement between you and your doctor.

April 20, 2010

Could Minoxidil and Finasteride Benefit the Same Follicles? – Hair Loss Information – Balding Blog

Dr Rassman,

My question is: does finasteride play any role in maintaining minoxidil dose-dependent hair?

I got started on 5% minoxidil topical in early Feb, 2009. My derm prescribed Finasteride oral 1mg/day too, but I did not pursue that medication due to the usual side-effects related concerns. There was an initial minox-induced shed: not a massive one, but scalp showed. Things started looking up 4 months later but then again in July/August a bout of minor shedding ensued. Survived that too. In November yet another shed started and this one was bad; short fine hairs all over the pillow in the morning. Scalp showed yet again, as bad as after the first shed in March. In December, I panicked, decided that Minox wasn’t working for me, and got started on Finstaride 1mg.

By mid-Feb this year, there was a sort of minor miracle on the top of my head. My hair is looking its best in maybe two years. I hope you agree with me that it’s unlikely that Finasteride started growing hair within 10 weeks of beginning its use. My (semi-literate) guess is that Minox first grew “peach fuzz”, which gave way to intermediate hair, which then was replaced by terminal hair. I suffered synchronized sheds, the last one being the shedding of intermediate hair. Maybe more sheddings are in store for me, maybe not.

To get to the point, I am so pleased with the result that I’ve gotten greedy: I want Finasteride growth too. No sexual side-effects so far. I’d like to press on with Fin, and reserve the option of discontinuing it in future if side-effects show up. I understand that that would result in catch-up loss, but then probably I’d be content with the hair that Minox grew for me.

Hence the question: do minox and Fin have a cumulative beneficial effect on the same hair follicle? Will minox-dependent hair too be lost in catch-up loss if Fin is stopped? If the answer is in the affirmative, I’d probably be better off stopping Fin right away, since I’ve been using it only for 3 months.

Thank you for a patient reading, and thank you for your time.

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You would have to poll each hair follicle and ask them what they liked better. If you can not communicate with them, then you are like me who frankly does not know the answer to your question. My best guess though (keep in mind I could be mistaken) is that because the medications work in different ways and finasteride will not keep hair grown from minoxidil and vice versa, that the benefits are independent of each other. Many men do use both medications concurrently, and as long as you can afford both (and maintain the regimen) I say go for it! It’s ok to be greedy and want your hair to look as great as possible. If the meds work well for you, that’s great news!

While it is unlikely that any major hair growth you’ve seen in just 10 weeks occurred from finasteride, you could’ve seen benefits from the medication that have helped your hair look better overall.

April 20, 2010

Can Propecia Keep Frontal Hair? – Hair Loss Information – Balding Blog

Hello Doctor.

I’m 18 and my hairline, while naturally high, has been receding, especially at the temples. It is thankfully not noticeable at the crown yet. I’m in my school show and am forced to have a combover which is slightly embarrassing because it clearly displays my receding temples (although they have always been high) plus my hair is wavy/curly, so that just makes it look worse. Fortunately i don’t normally do a combover and just have it all combed towards the front… but anyway, im seeing a dermatologist on Tuesday. I’ve read that if caught early enough MPB can be slowed or and even halted when DHT is blocked, and that Propecia can do this. I just had a question about it.

I know its not proven to regrow frontal hair, however can it help KEEP the hair that is still currently there? And perhaps thicken the amount still left so it looks healthier? Also, what should i be sure to discuss with the dermatologist on Tuesday? To make sure i receive the best benefit as possible (no surgery please!) Thank you for your time!

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Propecia does not usually regrow frontal hair, as you know. It may slow the recession a bit, but in general Propecia is not known to work well in the front (especially the corners). That being said, if you have genetic balding (your dermatologist can determine whether it’s MPB or a maturing hairline), I’d still get a prescription for Propecia since it may help slow your balding process down.

April 19, 2010

Does Propecia Work for the Vast Majority of Men Under 30? – Hair Loss Information – Balding Blog

Dr. Rassman,

Do you agree with the following statement: At least 50 percent of men in their 20’s today who have little or no hair on their head should not be bald.

Propecia doesn’t last forever, some can’t afford it, others will choose not to take it, and it won’t work effectively on some group of men. But for the vast majority of men, it works and it seems like most men under 30 who are visibly bald missed the chance to buy themselves a few important years by not taking Propecia.

Agreed?

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The statistics indicate that men over 50 years old have a frequency of some degree of balding in half of the Caucasian male population. That does not mean than the same statistic will be found in men under 30, as some men start balding in ages beyond 30. The full value of Propecia for those that see benefits changes over time (opinion backed up by the Merck study). The choices are always yours.

The other side of the coin is that Propecia works best when hair loss is earlier. If you start hair loss at 22 years old, then you are a better candidate for value (slowing, stopping, or reversing hair loss) than if you were 32 and had hair loss for the preceding 10 years. Also, if you start balding at 35 and start taking Propecia at 36, you will have a better value in its use than if you were balding since you were 22 (14 years of balding) in that same situation.

April 16, 2010

Eye Irritation from Rogaine for Women – Balding Blog

(female)
I tried using Rogaine a couple of years ago but stopped after 3 months because my eyes became very red and sore. I am considering starting to use the foam for men, 5%. Is there a known problem with the female version causing sore eyes?

Is it possiblle the foam will not have this effect – if it were indeed side effect of the Rogaine?

Rogaine Foam That could be an allergy to an added ingredient in the minoxidil liquid or it could even be the minoxidil itself. The liquid is known to cause eye irritation in the 5% solution. The female version that you used is likely the 2% formula… so if you had the problem with your eyes with 2%, I’d expect you would see it from the 5%.

That being said, it might be worth giving the Rogaine Foam a try since it is a different way to apply the medication.

April 15, 2010

Hair Loss After Radiation Treatment – Hair Loss Information – Balding Blog

I lost a lot of hair due to radiation treatment last June. I had a benign tumor removed and my doctors wanted to be sure they effectively treated me after surgery. They pretty much covered the top of my head with the treatments. It all fell out but only some of it grew back. And it’s obvious. I had a full, thick head of hair before this and now it looks like I have male-pattern baldness (and a large scar on top of my head from the surgery is visible). Would finasteride be at all helpful in this case? I can’t seem to find any information that speaks to this particular problem.

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Finasteride will not reverse hair loss caused by radiation, as it only works for men with genetic hair loss. The good news is that hair loss from radiation may grow back, though it can take up to one year.

April 15, 2010

I’ve Been Losing My Hair Since 14 Years Old! – Balding Blog

Dear Dr.Rassman,
I am so scared about my hairloss because it is so severe. I started to have a receding hairline around 14 in which I had a NW3 hairline. Now at 17 (almost 18) it’s safe to say may hairline is fortunately still an NW3 however i am starting to lose a little bit of hair in the front of my head and at the crown. I cannot stop thinking about it and I don’t want to be bald by the time I’m 20. Am I too young for a hair transplant? If so am I old enough to use propecia? If not is there anything I can do to stop or at least slow down my hair loss? Please help me out!

First and foremost, do not let fear interfere with your choices. Empower yourself with education to learn about hair loss. Unfortunately, 50% of men will have some type of hair loss in their lifetime. When it is genetic it usually starts above the age of 18, though there are cases that I’ve seen start around the same age you saw your loss start. I can empathize that you are frightened and afraid of going bald, but if that is in your genes, it is something you are going to have to accept. Fortunately, taking Propecia may solve the problem if you have the correct diagnosis. Get a doctor to map out your scalp for miniaturization and with that metric in hand, if you have miniaturization present, then the drug Propecia is the right way to go. Propecia was studied in men as young as 18, and as you’re nearing that age you should be fine.

Just know that you have choices and there are treatment options and plans, but you need to first start by seeing a physician that will address your concerns and come up with a life-long Master Plan. Propecia can certainly help if you have male pattern baldness, but you need a diagnosis first. Something else to note — Propecia has limitations and it will not completely stop or reverse hair loss. Hair transplantation may also be an option later on, but it is very important that your physician address that master plan to determine a worst case scenario of how bald you may be not just one year from now, but 30 years from now. Right now, you are too young for surgery.

April 15, 2010

I’ve Got More Questions Since My Consult at NHI! – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

I wanted to ask you a question about hairlines but first, I wanted to personally thank the staff at NHI, Dr. Pak and you for the wonderful visit I had at NHI this past Friday. This is a bit long winded but please bear with me.

I am a 25 year old caucasian male with light brown hair and am in good health. I started noticing a little thinning at my temples over the last year. To be honest, I was very nervous. I then went from nervous to hysterical. I could not stop thinking about it. Nothing can be more vicious than your own imagination and mine was painting all kinds of horrible scenarios.

In lieu of this, I made several appointments to see various hair transplant doctors here in Southern California. Of course, I never ACTUALLY meet with a doctor. Instead, I ended up talking to a consultant. To be perfectly honest, I did not gain a great deal of insight from these visits. I wanted something empirical to measure my hair loss, a metric I could use to stay informed and make an intelligent decision about my hair loss. None of these visit’s gave me that information.

The balding blog has been a part of my daily routine for a little while now and I decided to do what you suggest in so many of your posts and get my hair mapped for miniaturization and start my master plan. I was looking forward to my visit but also fearing it a little as well. So many things over the last few months have convinced me that I was going to bald to a Norwood class 4, 5 or 6. Pictures I had taken in the last few months, the look of my hair when it is wet or under bright lights. Except for my temples, I looked normal but I felt awful.

Then I came to NHI this Friday and that all changed in about 5 minutes.

I can’t tell you how much better I feel after visiting your office. I made an appointment to see Dr. Pak and he was very informative and understanding. He magnified my donor area for me to show me what non-miniaturized hairs look like. He then moved the scope to various parts of my head. This is the part where I held my breath. However, when he zoomed in on my crown, he saw no miniaturization. The same was true for my vertex and other parts of my head. In fact, the only area that showed any miniaturization was my temples, something my paranoid imagination would not let me believe.

Words can not describe how relieved I was. Dr. Pak was very helpful and he answered all of my questions. However, on my drive home I though of one more question I wished I had asked him and it is this: If none of my hairs, other than my temples, displayed miniaturization then where does my fight against balding go from here?

In your Hair Loss for Dummies Book (page 12) you say the following; “If you’ve inherited this pattern (Class 7), it is usually evident by the time you are 30“. In my examination, Dr. Pak said that my fears about progression to a class 7, 6 or 5 were unwarranted. In fact, he didn’t assign a class at all. He said my hair was healthy all over and my density (2.0) was normal (only miniaturization at the temples).

Am I simply developing a mature hairline? In this post from your blog you say that the mature hairline develops from ages 17-29. I guess what I am trying to understand is the correlation between someone’s age and their degree of miniaturization. At 25, is it too early or difficult to diagnose what class I may (if ever) progress to? Could a Norwood 7 be a lot easier to spot at my age that say, a norwood 3 or 4? I only ask because if I don’t progress any further in the next 5 to 10 years, would some moderate temple restoration be out of line with FUE?

I am 25, but I am not so naive as to think that the battle is over. I do not intend to let anyone else touch my hair except NHI now that I have visited your office. Dr. Pak put me on finasteride and I fully intend to visit your office on an annual basis to check on my hair. Like you say, tenacity and diligence.

Sorry again for the long winded question and many, many thanks to Dr. Pak and you for keeping me informed about my hair loss and educating me before I gave into my fears and did something drastic and foolish.

Sincerely and respectfully

If at any point in the future you want to address only the front corner areas, you can always do so with a small hair transplant procedure using FUE.

You may have a maturing hairline… perhaps in combination with slight recession in the corners. It remains to be seen as you age, but take comfort that Dr. Pak did not see miniaturization beyond the front corners. Stick with the medication and we’ll see you again for your follow-up appointment.

Finally, thank you for the kind email and allowing us to publish it.

Paid advertisements (not an endorsement):

April 14, 2010

Have You Seen a Case Where Propecia Makes Hair Loss Worse? – Balding Blog

Dear Dr –
I know there’s quite a lot of anecdotal, somewhat brutal indictment of finasteride on the web, some perhaps more grounded in reality than others. And of course, part of this revolves around frontal hair loss and so-called hyperandrogenicity, blah blah. You’ve given quite a lot of first-hand, practical and scientifically-based advice to folks who may be scared off by these reports.

My question for you is the following: Have you yourself witnessed in your thousands of patients any number of these patients taking finasteride see their hair loss situation get substantially WORSE (particularly in the frontal regions) given, say, a year of regular finasteride treatment? And, if so, is there any case in your patient-load where you might speculate that the finasteride treatment itself accelerated the situation?

I have seen hair loss progression even while a patient was on Propecia, but I do not believe that taking the medication caused the loss I saw or accelerated it. I can’t think of any case where I’ve speculated that the reason for the hair loss was the medication prescribed to treat it.