Drugs – Page 118 – Balding Blog

February 12, 2010

I Want a Hair Transplant, But Don’t Want Propecia Anymore – Hair Loss Information by Dr. William Rassman

I stopped taking propecia 6 months ago, after having taken it for 18 months. I believe the drug did stop my hairloss and I may have even gained some growth. I stopped taking the drug however, as I became very uneasy with it and the side effects. I am now using regain extra strength. My hairloss has returned and continued as expected. I am now seriously considering a transplant, but do not wish to go back on propecia. As my hairloss is very slow (over the passed 17 years), is it okay to undergo a transplant, but not use propecia?

Propecia is a great medication, but to a minority of patients the unwanted side effects may be an issues (as it is in your case).

You do not have to be on Propecia for a hair transplant surgery, but if you are under 30 years old and started to lose hair in the past 5-8 years, you run a risk of developing hair transplant shock with loss of hair from the transplant. I don’t know your age, but you mentioned losing hair for 17 years, so I’d assume you’re over 30. You still run the risk of shock loss, but it is less. Plus, without the medication the progressive nature of hair loss will cause your native hairs to continue falling out. As long as you know these facts, it is a decision you and your doctor need to make together.

Paid advertisements (not an endorsement):

February 11, 2010

Gynecomastia and Avodart – Hair Loss Information by Dr. William Rassman

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):

February 11, 2010

Increased Tear Production from Propecia? – Hair Loss Information by Dr. William Rassman

After a year on Propecia, my hair loss has slowed to the point that its virtually noticeable. My hope is that my hair loss will incur very slowly over time, thus losing my hair on a more age appropriate time-line. Losing my hair now, at such a young age, will probably bother me more than losing hair 10 years from now.

The only side effect I experience is increased tear production. When I am having an emotional dialog, my tear ducts are more active. This has been a very strange experience! Even so, my Doctor is unsure whether or not Propecia is the cause. The problem is not nearly severe enough for me to consider stopping the medication. Overall, Propecia has been working great!

I would challenge your first paragraph, as men of all ages are impacted by hair loss… and no one likes to look older because of balding.

I am not familiar with tearing problems from Propecia. I don’t recall ever reading any report of this or having any patient mention it. I’d check with an eye doctor.

Paid advertisements (not an endorsement):

February 11, 2010

Mild Depression from Finasteride? – Hair Loss Information by Dr. William Rassman

Doctor,

Love the site, check it out routinely.

I noticed someone previously had written you having had bad side effects from Propecia. You said for him to send you what the effects were to see if he was doing enough to counteract them.

Well, I tried three go-rounds with finasteride. Twice via Propecia (for about 1 year each), and once via Xandrox 15% w/Finasteride as a topical solution. All three times I experienced noticeable mood changes; I would describe it as almost a mild-depression as well as loss of libido. What do you prescribe for patients like myself with these problems to counteract these side effects?

Thanks

Coincidentally, I was going to post something today about a recently published article in Prague Medical Report discussing the relationship between finasteride and depression in some people. From time to time I’ve gotten comments about changes in mood, possibly resulting from finasteride use. Although these are reported in the Merck studies, there is not much information on the mechanism of such side effect possibly because they are very rare. I found this quote from an abstract in a medical journal, which might shed some light on the mechanisms of finasteride action…

“In the course of finasteride treatment the decrease of the concentration of circulating steroids with known inhibitory activity on GABA-ergic excitation in the brain is very probably an important factors contributing to the development of the symptoms of depression seen in some isolated cases of finasteride administration.”

Read the full abstract here — Finasteride treatment and neuroactive steroid formation.

Paid advertisements (not an endorsement):

February 11, 2010

Severe Rash from Provillus – Hair Loss Information by Dr. William Rassman

I’m a 61 year old male and began using Provillus treatment about two years ago. The results were encouraging and after about four months, I felt lots of new hair growth all over my scalp, about 3/4″ long. Some if this fell out but enough continued to grow to make a real difference and I was happy with the result.

I continued using the product for about a year with no problems. Then I re-ordered the product gave me severe rash all over my scalp and hair in some of the really aggravated areas fell out or at least has stopped to grow. I queried the supplier about the product because of the rash and also because the viscosity of latest shipment was decidedly higher than the original. The advice was there was an improvement to the product which brought about the change in fluidity. Obviously this was the end for me using a scalp treatment (I experienced the same effect later with Rogaine)

Not wanting to take defeat just yet, I’m thinking about trying a laser comb. Do you have any advice for me? Thank you

It sounds like you have developed a skin allergy to the product. This can happen. Perhaps you’re allergic to an ingredient in the Provillus, particularly if you say they changed the product before you ordered another shipment. I really don’t have any way of knowing. You can try using regular minoxidil, which is the active ingredient in Provillus. Then again, minoxidil itself is known to cause skin irritation in some people (see side effects). It’s worth a shot, I suppose.

With respect to the LaserComb, it is our feeling that it does not work. We’ve written extensively on this subject. See those posts here.

Paid advertisements (not an endorsement):

February 10, 2010

I Got Rid of Many Stresses in My Life, So Can I Stop Rogaine Now? – Hair Loss Information by Dr. William Rassman

Hi I’m a female of 25. I have used Rogaine for men for about three or four years now, and my hair is relatively thick. When my hair loss began I was under a serious amount of stress, Had just come off of the depo shot (which I’ve heard can cause some hair loss), later developed a pretty serious eating distorter (I know also causes hair loss), and was a drug addict and alcoholic. Quite the laundry list I know.

Recently in the past year and a half I have recovered from the eating distorter, drugs and alcohol, and have a stable stress free life. My question is this, since there were so many factors contributing to my hair loss, and there is no way of knowing if it was onset adult hair loss, If i were to start weening my self off of rogaine would the hair loss start again. Is it possible for me to discontinue the use if it wasn’t female pattern balding, or does your hair develop a dependency to minoxidil. Further more is it possible to drop the dosages to the 2% in the woman’s without losing my hair as well. I appreciate any help you may be able to provide.

thank you

I honestly don’t know, but I can provide a mostly theoretical idea for a best case scenario: If there were hairs gained from Rogaine use, then those hairs will likely fall out when you stop using Rogaine. But if the hairs grew back on their own (without the help of Rogaine), then those hairs would stay.

Paid advertisements (not an endorsement):

February 10, 2010

Shedding More After Starting Minoxidil – Balding Blog

Dear Rassman,

First of all, let me thank you for the kind of attention you give to the balding community.

I have been told that I am suffering from MPB. As far as I can remember I first noticed it 6 years ago. I have used Fin and Minoxidil on and off but never more than 5-6 months and when I did, I never really paid much attention to the decline or progress due to the treatment. For the past year it has become rapid.

Since 4th Dec 2009 I have started a regular regime but I notice hair shedding from all over the head, obviously excluding the side and back of the head. I have a strong feeling it’s due to Minoxidil. I’m using the generic called Hair4u, indian make. Let me also tell u that earlier it was just the crown area(have miniaturised hair there but not very dense so my scalp shows distinctly)and had started in the temples as well. Now, its going from all over!!! It’s been almost 2 months but there’s only shedding no regrowth that I can notice. Please advise what to do.

It seems you are doing everything you can and if you stay on the minoxidil and finasteride on a regular basis for at least a year, you may see value for it. But genetic hair loss is what it is. As you said, you are shedding everywhere, excluding the sides and back of your scalp. This is classic genetic hair loss. Drugs such a finasteride and topical minoxidil will not stop the balding process completely. It may greatly postpone the balding process for some men, but it seems you are not in that category.

I have heard reports that minoxidil does cause some shedding initially (1-3 months). You may consider seeing a good doctor to get a full examination of your condition and do this properly with good baselines and a mapping of your scalp for miniaturization.

February 9, 2010

Japanese Nizoral Study – Hair Loss Information – Balding Blog

Have you seen this study? Japanese Nizoral study

Very small sample, but very interesting. Any comments?

Block Quote

Nizoral Studies are great, but often difficult to dissect from a scientific perspective. Reading about the final results is one thing, but one must always have critical thinking. What I mean by this is that you must think of the motivation behind a study, and if the researchers will benefit from it (for example, by selling more product). Also, the methods used and the sample size are very important. The list goes on and on. Because of this, most studies are fairly weak.

The study in question about Nizoral is almost worthless with only 6 people enrolled. It reads more like someone’s homework assignment. One can not draw statistical significance to the data shown and without it, there is nothing worth believing.

February 9, 2010

Hair Loss InformationCan Propecia Be Replaced in the Future with Another Drug? – Hair Loss Information – Balding Blog

I take propecia, which has halted my hair loss and re-grew some hair at the crown and top. If a better drug or a cell-based/cloning procedure comes along, would that mean I could get off propecia to start the new therapy, or will I always have to take it to keep what I got back?

Thank you

Block Quote

If another DHT blocker comes along with less side effects, you will be able to switch as long as it does block DHT. Dutasteride will retain benefits seen from finasteride (Propecia), but safety is still a concern of mine with dutasteride. Propecia is non-surgical (daily pill), and when hair cloning comes to be practical sometime in the future, it will almost be a surgical process of some sort. They’re entirely different processes, and if you stop the blocking of DHT from the drug, you’ll lose those benefits you saw.

February 9, 2010

27 Year Old Just Started Propecia (with Photo) – Balding Blog

Hi Dr Rassman,

Your blog is a gift so thank you for your efforts. After reading your blog and doing a bit of research I have decided to get some guts and visit my local doctor to start Propecia. I have been on it for two weeks so far with no major side effects – so any one reading scared off by all the internet hype out there – you will just have to suck it up and give it a go.

When reading your blog and looking at the Norword scale I am a little confused by my pattern, I am a 27 year old male and have progressed to the attached photo, its taken in high lighting conditions with a flash, in normal light it doesn’t look too bad and I can style it so its not very noticeable.

In January 2007 I had a full head of thick hair. I currently have many 1cm long thin miniaturised hair still left on the top of my head. I guess I was in denial for the last 2 years as I had a very difficult time plagued with family illnesses and stress. So my question is what balding do I have? Is it diffuse pattern which will end up as a Norwood 6 or 7? Or is it something else? I have a history of MPB in my family.

After much depression and why me’s!!! I have accepted the fact that I am going to be bald eventually.. On my course of Propecia what should I expect? Regards

[you have my permission to publish the photo]

I appreciate you allowing me to publish the photo (click to enlarge). Your hair is thinning in a Norwood Class 6 pattern, which means that you may lose all of the hair in the thinning area. So as a 27 year old man with what appears as miniaturization in the Class 6 pattern (this needs to be confirmed by microscopic assessment), you have a good chance at arresting the process or reversing it since it’s only been going on for 2 years. If you were over 35 years old, I would not be as optimistic. Diffuse unpatterned alopecia (DUPA) would have similar loss in the donor area, so a good mapping of your entire scalp would be warranted. Wait out the first full year on Propecia and then make a reassessment.

Get your scalp mapped out so that you can objectively put a number to the miniaturization and then compare those numbers after a year. What you see with your naked eye may be easily quantified with a good mapping of your scalp.

Paid advertisements (not an endorsement):