Drugs – Page 136 – Balding Blog

September 15, 2009

Minoxidil and Kidney Disease? – Balding Blog

I am recently diagnosed with ckd (kidney disease) stage 2 (mild one). i was on topical minoxidil for almost 4 years but i stopped after my knowing about my ckd. is it possible that minoxidil cause ckd within this 4 years? And can i use minoxidil 5% again or it is dangerous for progression of my kidney problem ?? does minoxidil worsen kidney problems?? I also take propecia for almost 2 years.

A precaution in the literature for minoxidil states, “Tell your doctor your medical history, especially of: heart problems, kidney problems, liver problems, other scalp conditions, allergies (especially drug allergies).” This is a question you need to discuss with the doctor treating your kidney disease.

Minoxidil is an antihypertensive medication, which means it can reduce your blood pressure when given orally or when absorbed through your skin in substantial doses. Generally, lowering high blood pressure helps to prevent kidney problems, but that connection between blood pressure and kidney function is what you need to discuss with your doctor.

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September 14, 2009

Could Cutting the 5mg Finasteride Pill Result in Poor Absorption? – Hair Loss Information by Dr. William Rassman

Hello Doctor Rassman!

Huge Balding Blog fan here! Have you considered selling official ‘Balding Blog’ T-shirts? Regardless, my wife thinks it’s nuts I have this site bookmarked, but it’s an invaluable resource!

My question is this:

I’ve switched from Merck Propecia (1mg) to generic Teva Finasteride (5mg). When I cut the pill into 1/4 (1.25mg), I get a fair amount of powder that comes out of the pill. Undoubtedly, when I put the pill into my mouth, my saliva would break down some finasteride. I guess my worry is that by splitting the pill, exposing the white powder, and swallowing is resulting in poor absorption.

A picture of the pill is here: photo

What are your thoughts?

Thanks!

Thank you for following the site. We played with the idea of selling BaldingBlog shirts, but the idea never took off simply because we really didn’t think anyone would buy them.

Splitting the 5mg finasteride pill in quarters should not have any clinical significance on absorption or effectiveness. My Propecia drug representative from Merck has raised this question before, but there are conflict of interests there as you may guess.

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September 11, 2009

Fluocinonide Stopped My Female Hair Loss for a Couple Months – Hair Loss Information by Dr. William Rassman

Hi. I am a 32 year old female who has been experiencing hair loss every six months for the last two years. Every time my dermatologist or GP would prescribe Fluocinonide Topical Solution (.05%). The shedding would stop about 2 months later. However, 5 months later the shedding would start up again. I had some blood work done, but they came back normal. Can you tell me what is going on?

Also, can you recommend a hair loss expert/dermatologist in Orange County? I would like some answers.

Thank you so much for taking the time out of your busy day to answer my questions.

This may be a jaded perspective and opinion, so be forewarned…

Hair loss for women can be a very frustrating condition to treat and diagnose for physicians. Miniaturization studies will show the status of the hair, thinning possibly in some areas. The doctors are under pressure to be proactive and to provide some form of treatment to the distraught patient even if they are not losing hair. If a doctor prescribes a harmless treatment that does not really have any clinical basis or proven results, is the doctor being honest? Treating hair loss with a corticosteroid (anti-inflammatory drug) such as fluocinonide would mean that there may be some inflammatory process going on behind the hair loss, but even without the use of such drug it is more likely the shedding would have stopped in a few months time. Hair loss can be cyclical in women. Oh… and don’t discount the power of the placebo effect.

I would think that if you have some sort of an inflammatory cause of hair loss (that is responding to fluocinonide) you would need a scalp biopsy to make the diagnosis. Any GP or dermatologist would be able to do that. Be forewarned that a biopsy would leave you with a small bald spot.

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September 10, 2009

Tongkat Ali and Finasteride – Hair Loss Information – Balding Blog

Hi Doc,
Thank you for this site, it is a source of valuable info for a lot of people including me. Keep up the good work.

My question is, can tongkat ali affect the effectiveness of finasteride (Proscar) in stopping hair loss? I read that tongkat ali is a natural testosterone enhancer and can benefit the person using it with stronger libido, sexual performance enhancer, and can promote good physical well being. Will it make the finasteride less effective? According to some research it has not found any baldness side effect for people using tongkat ali. Thank you and more power to your work.

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I’ve got no experience with this herbal, also known as eurycoma longifolia, so I turned to the internet for some info. According to this page, tongkat ali requires DHT to boost the libido, and finasteride blocks DHT. Therefore, you should not take both at the same time if you want the tongkat ali to work and if what I read on that site is actually true.

I don’t know if it’ll make finasteride less effective, but it seems that the finasteride would make the tongkat ali ineffective.

September 10, 2009

My Hair Thinning a Few Years Ago but Stopped — Should I Take Propecia Now? – Hair Loss Information by Dr. William Rassman

Hello. I noticed that I started thinning at the top of my head when I was about 23-24 years old. I lost quite a bit of hair but still had a reasonably decent amount of hair left. I am now almost 28 and have not really lost any more hair but haven’t really regrown it either. I have started Propecia to prevent any further loss but I was wondering if I have waited too long for any regrowth to happen. If my hair stays like this it’s ok but I do feel a little bitter at myself for not starting propecia earlier.

I would follow up with the doctor you are receiving Propecia from and get a good documentation of your current state of hair. This may be in the form of a photograph… or better yet, a miniaturization study to get an estimate of the percentage of miniaturization on certain areas of your scalp. Then you can judge if Propecia is worthwhile or at the least keep track of the hair loss progression. Lets try to take a scientific approach! Regrowth isn’t guaranteed for anyone taking the medication (some will just see the hair loss halt), so I wouldn’t beat yourself up about it.

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September 9, 2009

I’m Losing Hair at 21, But My Dad Lost His Hair at 36! – Hair Loss Information by Dr. William Rassman

Dear Doctor. Thank you for this blog. It has helped me so many times!

I was wondering…Im only 21 and I’m already beginning to loose my hair. Actually my hair loss already began in the age of 19. But I was looking at some old pictures of dad when he was about 33-35 years old, and his baldness first kicked in around the age of 36. I really dont understand why I’m already beginning to loose my hair? Is it just bad luck, because you can’t look at your dad and foreseen when your hair loss will start? I was just thinking that 15 years is a lot before my dad’s hair loss started! Can there be another reason to my hair loss besides genes? I’m in good shape and I’m eating healty. I can litterly “pull” oyt my hair when strokeing my fingers trough it. Or when I’m washing it my hands are full hair. Thank you for your time!

Best regards

The most common cause of hair loss in young men is genetic. There could be other causes, but it is much more likely that it is your genes. The fact that there is hair loss in the family tree helps, but you won’t necessarily follow the exact same timeline of loss as your father.

A direct examination of your scalp with mapping for miniaturization will tell you the diagnosis. Then if you are positive for genetic hair loss, Propecia is a great (prescription-only) drug taken daily to address the loss problem as it will slow down the loss, possibly stop it, and if you really lost hair it might even reverse it at your age. See a good doctor.

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September 8, 2009

Propecia Dosage, Genetics, and David Beckham – Hair Loss Information – Balding Blog

Hi Dr. Rassman, I just have a few questions. Basically, I’m 24 years old and I have had (from what I can tell) diffuse pattern thinning on the top of my head. This has progressed for the past 3-4 years now as the hairs are becoming gradually more and more miniaturized. However, it wasn’t particularly noticeable until about a year ago. At this point (as it began to bother me) I went to my doctor and upon his recommendation I obtained some Propecia.

Anyways, after the first week I had some side effects (erectile ones) and it was recommended to me that I should take a half dose. I did this for about 10 months, and from what I can tell, the half dose didn’t seem to have much effect on slowing down the miniaturization (although, who knows it may have). Finally, about a month a half ago I got up the nerve to try the full dose everyday. The great news is I am not having any side effects. However, a friend of mine told me about a study (which I also looked up online) in which it was shown that there really isn’t much of a different in potency between the 1mg and .5mg dose. This makes me apprehensive about whether the full dose will make a difference.

So my first question is, do you think I should take Propecia for another year on the full dose before I make conclusions?

As for my second question, does Propecia have a propensity to work less/more/the same on people with a patterned diffuse hair loss in your experience?

My third question is related to my family genetics. I have two uncles who are bald. Both of them thinned out around their mid-30s and had the typical norwood-scale baldness pattern with a bald spot in the back that gradually got bigger until they finally started fully balding on the front and crown around 40. I don’t have this. Does that mean anything of significance, other than the fact that I probably have this issue from their genetics?

My final question is, I met soccer star David Beckham at a dinner a little over a year ago and he had what appeared to be the same kind of diffuse hair loss I have now at the time. Since I watch a lot of soccer, I couldn’t help but notice recently that his hair is significantly better than it was when I met him. I took another look at some pictures on the internet and its almost like he completely grew his hair back. How is this possible? Have you heard anything about what he did? I know you have been asked this before, but I figured I would ask again since I know for a fact that he was thinning at the time.

Sorry for such a long email. Any comments you can make would be greatly appreciated! Cheers

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David Beckham

From what I recall, the difference is not that big between half dose (0.5mg finasteride) and full dose (1mg finasteride) of Propecia. I believe half dose is about 70 to 80% as effective as the full dose. In your particular case, I cannot really say if the problem is dose related, but as you do not have side effects from the drug now at full dose, I do not see any reason for you to cut back to half a dose. I’m not your prescribing physician, so discuss this with him/her. Remember, Propecia is not a cure for balding. Some patients will have some hair growth in the first year or two. Some patients will have no further hair loss. Some patients will continue to have hair loss. In the end, all of these patients taking the drug will continue to lose hair to some degree, albeit at a SLOWER rate than if you were not taking Propecia. You see it may not be a cure, but it slows the hair loss down.
Propecia works for angrogenic alopecia (genetic male pattern balding). You self-describe your hair loss as “diffuse”, but I have a hard time believing you actually have diffuse hair loss. Diffuse hair loss would mean the back of your head is thinning as well. If you actually have diffuse hair loss (even in the donor area), then Propecia would likely not work for you. I would see a doctor for a diagnosis and a miniaturization study to document what you are treating.
Male pattern hair loss is genetic, but if you have it, you have it. It doesn’t really matter if your uncle, cousin, grandfather, father, or brother is bald because it is very difficult to associate a predictive inheritance pattern.
I didn’t think David Beckman was thinning or balding from the many pictures I reviewed of him asked by various readers. It is possible that there is a difference in lighting or hair products or perhaps even medication. I really have no way to know. Your definition of diffuse hair loss is peculiar to me though, and perhaps we are not on the same page here. I would love to examine you if that is possible.

September 8, 2009

Any Guess As to Why DHT Blocking Drugs Don’t Help as Much in the Hairline? – Hair Loss Information by Dr. William Rassman

Hi Doctors,

Thanks for all the great insight and help. Recently, you’ve had a few posts about frontal hair loss. My question relates to medical (non-surgical) options for treatment and why drugs only seem to be effective for the back/crown of the head. I realize that today’s most effective medicines, Rogaine and Propecia, only are scientifically proven to work in the back/crown of the head. However here is where I get caught up:

If DHT is one of the primary causes of MBP and these drugs, specifically Propecia, block DHT, why then are benefits not typically seen in the front? Likewise, why is Rogaine only medically proven to be effective in the back?

I realize that science doesn’t yet have the exact answer, but given your vast experience and exposure, could you venture a guess as to why these drugs do not affect frontal hair loss the way they affect back/crown loss? In your experience, do users of these drugs see a benefit in frontal loss as well?

Many thanks!

The impact of Propecia on the frontal hairline has not been impressive, but it clearly slows down loss in the frontal area. This is the results of observation on thousands of people. The same applies to the crown where both Propecia and Rogaine seem to have value. But everyone is different and responds differently to medication.

I do not know why there is less hair regrowth on the front than the crown with Propecia and I do not want to make a fool of myself for guessing.

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September 4, 2009

I Heard Rogaine Causes Heart Attacks – Hair Loss Information by Dr. William Rassman

i was wondering is rogaine safe. i hear that rogaine causes heart attacks but you know how people are. i just had a hair transplant and wanted to see if it was safe. thank you doctor

High doses of Rogaine (minoxidil) can drop your blood pressure and may not be a good idea if you have existing heart disease. I can imagine some case where a person uses minoxidil and has one of a variety of existing heart conditions, and the medication causes a drop in blood pressure leading to a heart attack… but that is theoretical and I have not actually heard that such a case exists.

So to answer your question, Rogaine does not cause heart attacks.

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September 4, 2009

Propecia and Minoxidil Made My Hairline Look Eaten! – Hair Loss Information by Dr. William Rassman

ive been on propecia and minoxidil for four months and am going through a horrible shed, my whole temple point has thinned out, my hairline looks eaten and my hair feels horrible, from your experiece is this common?

thanks

I am not sure what “eaten” looks like other than some erosion that is asymmetrical. We are all different — and that includes hairlines. It could be accelerated shedding from either of the medications, but you need to see an expert in the field to give you and examination, or at the least send me a photo so I understand what is “eaten” about your hairline.

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