Category: Drugs

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I’m in My 60s and Losing Transplanted Hair – Would Avodart Stabilize That? – Hair Loss Information – Balding Blog

Hello Dr. Rassman,
In your opinion, would avodart as a substitute for propecia in my situation be ok to take & would the avodart dosage be more effective in stabilizing hair loss? I’m in my 60’s & the avodart sterility side effects don’t concern me. I have been taking propecia for approx. 8 years, & have been experiencing substantial hair loss in the last few years of even previously transplanted hairs from two HT’s as I was a Norwood 6-7, & had very thin, fine hair in my donor site, & quite bald on top.

I’m out of state now, but my surgeon is very well known & extremely skilled & I respect him & was enormously happy with my HT’s I had 7-8 years ago. I’m assuming my donor hair is one of the few cases where it wasn’t destined to last a lifetime. I still some have hairs on top, but quite thin & sparse.

I realize you won’t give specific suggestions concerning Avodart, but any direction would be appreciated. I don’ want to go back to wearing a hairpiece (over 30 years)! Thank you!

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Taking Avodart (dutasteride) for a man over 55 years old and not concerned about fathering more children is a reasonable approach. I have heard from the transplant physician community that when hair loss is not stopped with Propecia, the use of Avodart may help.

I am curious about the loss of your transplanted hair, however. This should not typically occur and should be discussed with your surgeon. Don’t just assume! Talk to your doctor!

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I’m in My 60s and Worried About Possible Shock Loss – Hair Loss Information – Balding Blog

I’m thinking about an HT, and after reading all your topics I see my biggest concern is shock loss. I’m a 61 year old male and have a high degree of miniaturization in the proposed recipient area. In one of your responses, I believe you recommended not having an HT for thinning hair?

You often recommend Propecia for younger men and say it might prevent shock loss for possibly 90+ cases? You also recommend taking Propecia 2 weeks to a month in advance of the HT(but even the day before the HT is better than not at all?). Would this advice apply to an older guy like me? Or if I’m correct that you would not advise cases of older age onset thinning to not seek HT?

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Propecia works at any age to prevent shock loss. It is best to use this medication in advance of the surgery (at least 2-4 weeks). Older men generally have less hair transplant shock loss than younger men. I would need to know more about your miniaturization and your last 1-2 year history of hair loss. At 61 years old, few men are actively losing hair.

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Age and Finasteride – Hair Loss Information – Balding Blog

Doc,

Do you find older men may need more that 1 mg of Propecia. I’m in my 50’s.

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Not usually. The dose is fairly standard and effective for treating hair loss at the 1mg level. More won’t hurt (possibly more side effects), but the impact just might be stronger in a slightly higher dose. Also remember that Proscar (finasteride 5mg) is commonly used for treating the prostate, something that older men should be concerned with.

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14 Weeks Into Finasteride Treatment, My Permanent Zone is Starting to Thin – Hair Loss Information – Balding Blog

Hey Doc,

I have been on proscar split into 5 for 19 weeks. At about week 14 I noticed a lot of hair loss at the back of my head in the permanent area. The hairs that fall out are full thickness/growth and have a ‘bulb’ of skin from where it was joined to my scalp. I now lose more hair from here than anywhere else on my head and running my fingers through my hair just above my neck results in 5-10 hairs to come out at once.

Would you think this is TE? And if so would you recommend me to let it run its course? It doesn’t worry me because it is the permanent area I am just curious.

Regards

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Norwood 7For those that aren’t familiar with the “permanent zone” of hair — it is the sides and back, as seen in the remaining hair of a Norwood Class 7 balding person (see image at right). We call it the permanent zone (or “donor area”) because the hair is not effected by male pattern baldness.

I cannot say if you have telogen effluvium (TE) just from your description. It is quite unusual for finasteride to cause thinning in the permanent area… and in fact, I’ve never heard of it happening. I would go back to the doctor you received the medication from and have him/her reassess your permanent area that you are concerned about. Your description of seeing 5 to 10 hairs fall out when you run your fingers through your hair is subjective not scientific… and it will not give you the answers you need.

You should have gotten a donor hair density measurement, which shows how many hairs you have in a given area. You also should have gotten a miniaturization study evaluation to see if there were hairs that were thinning. Of course, this may be an ideal case scenario for some, but that is the standard way I run my medical practice.

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My Results from Rogaine are Leveling Off After 3 Years – Hair Loss Information – Balding Blog

I’m 61 years old and have been using Rogaine for about 3 years. I have had positive results, but they recently have been leveling off as I still have some bare spots where my hair simply won’t grow. Could this be because the hair follicles have miniturized to the point where they have simply vanished?

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I would need to map out your scalp for miniaturization to determine an answer to your question, but it is not unusual for minoxidil to level off on its value over time.

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My New Dermatologist Prescribed Propecia for My Female Hair Loss – Hair Loss Information – Balding Blog

Hi. I just came home from seeing a new dermatologist. She said if I tested positive for AGA then she would prescribe Propecia as a hair loss treatment. Is this the right solution for a 33 year old female? I heard that it isn’t use in women. I thought the better course of action would be the combination of Yasmin and Spiro.

Also, I would like to know how safe is Rogaine for the long run (decades). I am very hesitant about taking anything orally that would play around with my hormones (Yasmine, Spiro., or Propecia). Thanks for your time. Much appreciated!

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There is no really great, proven treatment for a typical female hair loss. Rogaine (minoxidil) is FDA approved to treat hair loss in women, but it doesn’t get to the root of the problem (no pun intended). Even if your hair loss is found to be androgenic alopecia, there are no studies to validate that any treatment really works for women. In other words, there really isn’t a better course of action.

In theory Yasmin (drospirenone and ethinyl estradiol) and spironolactone should work for treating hair loss in women, but that is not always the case. Yasmin and spironolactone are not FDA approved treatments for androgenic alopecia, and I would be particularly cautious about starting Propecia (finasteride), as it is not FDA approved for women due to a risk of pregnancy complications (birth defects) and other unknown hormonal issues. While many doctors do use these medications for certain women with some benefit, they are not for everyone. The best advice is to be closely followed by a physician or get a second opinion (this does not count as a second opinion — I am not your doctor).

It is safe to use Rogaine for a long period of time, but follow the instructions. It is a topical medication and many patients have been using it for decades.

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Could My Diabetes Be Causing My Neck Hair to Thin? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,
I’m a 55 year old male in good health with the exception of being a type 1 diabetic. I have been using propecia and rogaine for 10 years with very good results and have maintained almost all of what I started with.

Here’s my question. My hair is thin at the nape of my neck. I can pull on it and 5 or 10 hairs will come out each time. I don’t think I have DUPA because I cannot see any change in my crown,vertex or hairline. I have read on your site that this type of loss is genetic. I know you prefer not to diagnose online but could the diabetes have anything to do with it? my A1c is 7.5 to 8.0 which I know is an the high side – Thanks

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I doubt that the diabetes is causing your neck hair loss. I have seen men over the years (in airports, on the streets, in shopping centers, etc) who have lost just their neck hair and not their scalp hair, so I believe that this is a genetic trait in these men. I suspect that the number of hair cycles your neck hair has is limited and those hairs develop apoptosis (meaning that they have reached the end of their lifetime); if this is the case, there’s not much you can do. Perhaps applying minoxidil to the area will cause new hair growth? Also, I agree with you — it doesn’t sound like it is DUPA if it is limited to the nape.

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Heavy Drinking Blocks Finasteride Effectiveness – Hair Loss Information – Balding Blog

New study showing heavy alcohol usage blocked effects of finasteride (half way down page): Prostate cancer and alcohol

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BeersThe link has quick paragraphs about a variety of topics, but here’s the relevant info from the page (the bold emphasis added was mine) —

    “This study analyzed data on 10,920 men. In a seven-year span, prostate cancer was detected in 2,129 of them, including 564 men with high-grade tumors, which grow and spread quickly. Those who consumed, on average, four or more drinks a day (totaling roughly two ounces or more of pure alcohol) five days a week in the year before diagnosis were more than twice as likely to have developed high-grade prostate cancer as were those who did not drink. No link was found between prostate cancer and more-moderate drinking. Also, among men who had been randomly assigned to take finasteride (Proscar, Propecia) as part of other research to test the drug’s ability to prevent prostate cancer, heavy drinking blocked the effectiveness of the drug.“

This is interesting, but it doesn’t necessarily prove that heavy drinking blocks finasteride effectiveness. Heavy drinking (4+ drinks a day) in itself can cause higher grade cancer. It should go without saying, but heavy drinking is not good in any case. If there is indeed an association with finasteride not working when you drink heavily, I would say it is a good idea to limit your alcohol intake!

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Testing Fertility While on Dutasteride? – Hair Loss Information – Balding Blog

Doctor,

I’m a 29 male in good health who has been taking avodart daily for ~5 years and took propecia for four years before that. I recently had a sperm analysis done along with my physical as I was concerned about potential risks associated with avodart. The results that came back were positive in the sense that my sperm count was in a normal range. My question is can you recommend any other tests that I could take to monitor my fertility while on avodart?

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SpermI do not specialize in male fertility, but if the sperm have a normal count and a normal motility, I would expect that there is no problem with it. I would pose this question to your primary doctor or better yet, a fertility specialist. This is beyond my scope of knowledge.

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My Rogaine Shedding Has Been Going on For Months! – Hair Loss Information – Balding Blog

Hi,

I understand that Rogaine may cause initial shedding, but I’m concerned that mine is going on longer than it should- 2.5 months. At first I had some minor thinning on the crown and minor receding at the temples (my friends think I’m crazy, but I saw a dermatologist who noticed thinning), but not really anywhere else. After following her advice to take Rogaine, my hairline (not just the temples) has receded some, and all of the hair on top of my head is thinner, to the point that I can see scalp, which I never could before. At this point, should I discontinue Rogaine, or try to stick it out for a few more months?

Thanks

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I can’t tell you what you should do with medication, but I can tell you that shedding from Rogaine (minoxidil) may last up to 3 months. You have a dermatologist and I would ask her that question, as she has the advantage of being able to examine you.