Drugs – Page 149 – Balding Blog

June 17, 2009

Benicar and Minoxidil – Hair Loss Information by Dr. William Rassman

I am a 62 yr. old woman who has been using Minoxydil for about 15 years since I had always had very thin hair and its usage really helped prevent fallout and even made my hair a bit thicker.

About 3 months ago, my doctor prescribed a blood pressure medication (Benicar) and it appears to be causing terrible hair loss (even though I am still using the Minoxydil). I will speak to the dr. about the hair loss but is it harmful to continue using the Minoxydil if I am taking BP medications? I am hoping to find a medication that will not have this side effect. I look forward to your answer as this is very depressing and worrisome

Benicar Benicar causes hair loss in 1% of patients… so it is quite rare. Speak with your doctors and see if there is an alternative medication that he/she would consider. The blood pressure impact of topical minoxidil should not be enough to impact your blood pressure management, but again, discuss this with the physician that is already treating your blood pressure.

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June 16, 2009

I’m in My 20s — I Don’t Want to Take Viagra Because of Propecia! – Balding Blog

I’m in my mid-20s and began taking Propecia about 6 months ago. I was quite scared of the possible sexual side effects before I started the medication, and after 2 weeks on it, I think I experienced the erection troubles. A couple weeks later, the side effect went away. I went for a few months with no sign of symptoms, no problems with maintaining the erection… until I started seeing a new girl. We fooled around a few times and I didn’t have any troubles whatsoever. Then one night she got a little liquored up and we started to mess around. I was rock hard, but after several distractions I went to half mast. Since she’d been drinking, I think she just figured my problems in the bedroom were due to that. Like maybe I didn’t find her attractive when she was drunk or something.

The next day I got some Viagra from a friend so I wouldn’t have to worry about my performance and ever since then I’ve been using it whenever I thought I’d need it. But if I don’t take that blue pill yet and we start to get frisky, I start to wonder if I’d be able to keep it up. So is this just a case of me worrying about things too much, or could this be from the Propecia? I don’t want to have to constantly worry about taking a pill before I get physical with a girl.

Libido It sounds like you could be willing yourself into having problems like this. I mean, it sounds like you got so worked up about the possibility of side effects that you had a nocebo response. It could be from the Propecia, but erectile issues occur in less than 2% of men and the vast majority of claims made on the internet are unsubstantiated, so that percentage can seem greater than it is if you rely solely on fear-mongering web forum posters. The 2% number comes from actual medical studies. The erectile dysfunction symptoms can occur in adult men of any age without a medicinal cause, particularly in cases where you have a new sexual partner (or maybe even alcohol in excess). It’s not uncommon, but it’s just not something younger men… or men of any age… will openly share with their friends.

Talk to your physician about your own prescription for Viagra or a similar drug if you’re really concerned, and you should let him know that you’re taking Propecia (or go to the same doctor that prescribed that to you). You may want to experiment with Viagra when and if you get a steady girlfriend so you can sort through the psychological effects and the physiological effects. When men take Viagra and build psychological dependencies, that tends to take the fear factor out of sex.

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June 15, 2009

Hair Loss InformationIs There a Drug to Block Propecia Side Effects? – Hair Loss Information – Balding Blog

I am male and in my late 20’s and starting to see that my hair is thinning. I was on propecia for a very short time and had to stop do to side effects(breast pain and ed). I tried cutting down the dose (without stopping) but the side affects continued. I’ve read on a few sites including wikipedia that Sweden claims finasteride has permanent sexual side effects. Has anyone found something to take with propecia to eliminate or block side effects? If you think I should give it another chance how would you suggest I go about it? I don’t want to take minoxidil because how it works is fairly unknown. If topical Spironolactone works for acnea doesn’t that mean it does absorb into the skin enough to compete with dht receptors? Topical spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands: an autoradiographic study in subjects with acne vulgaris.

If I decide to try topical spiro, is it something my gp can prescribe? if not could you varify if the much talked about Dr. Richard Lee is credible (or atleast not another scam). I’m not opposed to a hair procedure but because I’m just starting to thin I’m not sure how and how often it would be done and the cost. I know this was lengthy but it’s much appreciated

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I do not know of anything that will block the possible breast and erectile side effects of finasteride that a tiny percentage of men will see. If you experience erection issues, Viagra or Cialis will likely solve that. For my patients that might see a side effect (real or otherwise), cutting the dosage is better than stopping it completely. In other words, some finasteride is better than no finasteride if you want to treat your hair loss. Most men will choose the hair transplant approach if the side effects are a problem, but the risk of shock loss in young men with transplants is the other side of that coin.

Spironolactone is a prescription medication, so while your doctor could prescribe it to you, he/she might not be willing to do so. That article you referenced is over 20 years old, and spironolactone is still not a popular hair loss treatment for men… so that should tell you something about it’s effectiveness. And as for Dr. Richard Lee, he has a number of customized minoxidil and finasteride treatments for sale via his website, one of which I have written about before.

June 12, 2009

Could This Be Shock Loss Behind My FUE in the Hairline? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

First I would like to take this opportunity to thank you for this great website.

I have two questions and i would be very greatful if you can answer them :

1. I had an FUE procedure done on the front area (frontal hair line)with approx. 1200 grafts before three months ago, the strange thing that i am experiancing is some hair loss in the area behind, which is in the mid-scalp area, is this shock loss? shedding period? or the normal genetic hair loss pattern? and how can i tell the difference between them?

2. If your answer to question no.1 is shock loss then can you tell me what is the solution for it? and is there any chance of hair regrowth for those that were lost? (By the way i have used propecia for 12 months before a few years ago but with no success and i experianced terrible testical pain)

Thank you and Best Regards.

If you were not on finasteride when you had your FUE procedure, it would almost be certain that you had shock loss. You should have worked this through with your doctor prior to having the surgery. I always assess the status of the hair behind the transplant recipient site and if it showed significant miniaturization, one could have predicted this outcome. I would need to see you and understand what the loss area shows now.

I would also have considered lower doses of finasteride, which may have allowed you to use the drug without the complication. One quarter of a pill finasteride (0.25mg) can be effective at minimizing hair loss from shock.

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June 11, 2009

If Propecia Takes Months to Start Working, Why Did My Loss Stop After Only a Month? – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

I’ve now been on Propecia for a little over a month and a half and it appears that I’ve noticed a slow down in shedding since before I started taking it. I know that on average we lose 50/150 hairs a day and I’m positive that I don’t notice all of the hairs that I lose over the course of the day (that would be impossible), but I am almost certain I’m not losing 100 a day, and it appears I’m shedding much less than before.

Is it pretty common for Propecia to start working noticeably a month and a half into treatment? I’ve read that it takes three months at least for it to start slowing down hair loss. I still have a pretty full head of hair (with some thinning at the crown and slight recession in the front. Not seeing as much hair shedding has me feeling really good that Propecia might work really well for me. Thank you, Dr!

Many people will report a reduction in shedding within the first month of taking the drug. I don’t know the hows or whys of it, but the medication doesn’t work exactly the same for everyone. In your case, it sounds like you’re seeing a positive result in a short amount of time. That’s good news!

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June 11, 2009

Where Is the Topical Finasteride? – Hair Loss Information by Dr. William Rassman

Hi
Great blog you have, really useful. I have a question about topical Finasteride. I take 1mg Finast and think it might be holding my hair loss + scientifically expect it probably should be, therefore very much don’t want to stop. However, I am convinced that I get sexual side effects whereby my penis is just not as full and pumped (flaccid and erect) when I take it. I’ve tried experiments of washing it out for 3 weeks and then going back on it and I’m pretty sure there is quite a marked difference.

This has left me in a dilema and I was very glad to see a recent Indian paper in which they’d compared topical Finasteride with oral for a few months and found that, though the effect took longer to come on, it seemed as strong after 6 months.

Do you know how far away we are from topical Finasteride being available? Whether there is any other data on efficacy? Whether there is any data on whether systemic absorption occurs? And whether one has to apply it for long periods which would make it problematic to use? Many thanks for any light you can shed!

I’m not sure which Indian paper you’re referring to, but to my knowledge topical finasteride doesn’t have proven value. It would require special formulations for topical use and some drug company would have to push it through the FDA before it was determined safe and effective. Some doctors sell it online and armchair chemists on hair loss forums have their own tips on how to make your own, but I’ve not read any formal studies that show topical finasteride works the same as the oral finasteride. I’ve written about this before.

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June 9, 2009

Finasteride Frontal Study – Balding Blog

Hello;

I read your blog from time to time and I remember you saying that propecia doesn’t really work in the frontal area. As someone who is hoping for regrowth in the front that’s a gloomy assessment. However there are a few studies that offer hope, here is one and if you google search “finasteride frontal study” you’ll find more.

Finasteride in the treatment of men with frontal male pattern hair loss — “RESULTS: There was a significant increase in hair count in the frontal scalp of finasteride-treated patients”

From what I am understanding, it doesn’t work in on the temples but it’s common to see results in the frontal area as well as the back. As someone who is on 1/4 Proscar every other day I can tell you I am seeing some regrowth nearing month 3 now and I am hopeful that by month 6 I will have achieved even more. Also, for what it’s worth…not a single side effect.

I know that finasteride does slow or stop frontal hair loss. With regard to regrowth, in many men who have visual frontal balding, the degree of growth in my experience has been less than enough to produce hair that can be combed. I have had hundreds of patients on finasteride, and although a very small subset of them have grown enough hair to see a difference in the hairline, most have not. The drug will work the same on any hair follicle that is undergoing genetic hair loss, but the frontal area is often ahead in its balding (more so than the crown), so maybe the failure to see substantial grown in the frontal area reflects where the balding is by region. All I can report is what I see in my patient population and although I have seen remarkable frontal hair growth in some, the percentage of patients who show it is very small.

June 9, 2009

My Dad, Grandfathers, and Brother All Have Their Hair — So Why Am I Balding? – Hair Loss Information by Dr. William Rassman

My dad has hair, both my grandpas have hair, and my brother who is four years older than me has hair. I don’t know if cousins matter, but I have four male ones that all have hair too. Its not just hair though, all these family members have full heads of hair, there is not one male in the my family who is balding, and yet im 18 and seem to be losing all my hair. Im trying to except it, but im curious if there is anything I can do?

The expression of the balding gene does skip generations, though I am not sure how many it could potentially skip. The more generations that are skipped, however, the less likely it will be. I’ve written about it before here.

As for what you can do — I’d see a doctor and ask about a prescription for Propecia. If you have early genetic hair loss, the drug should halt the progression for some time.

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June 9, 2009

Propecia Isn’t Stopping My Hairline from Going NW1 to NW2! – Hair Loss Information by Dr. William Rassman

Hi Doc,
I started propecia 5 months ago for a receding hairline. My hairline appears to still be a norwood 1, but it is closing in on the second one very quickly. I don’t think the propecia has helped at all. I don’t even think the recession is slowing down. Is there any way the propecia could help from here on in, even if it hasn’t even slowed down the hair loss in 5 months?

Propecia (finasteride) will not stop the appearance of a mature hairline, as that is what it sounds like you’re describing to me. You should send me photos and I will give you a more definitive answer. Mature hairlines are convex in shape, while juvenile hairlines are concave.

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June 8, 2009

Hair Loss InformationPropecia Shedding Indicates That It’s Working? – Hair Loss Information – Balding Blog

Hey Doc Thank you in advance for such an informative sight. I found this excerpt from a web page concerning shedding from propecia. I was wondering what was your take on it as I have experienced a considerbale shed within 4 weeks of starting propecia. The hairs come from not just the balding areas but from the back and sides as well. Just curious as to your assumptions.

Myth: Shedding is an indication that Propecia is working

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I have heard that in some patients, there is a period of increased shedding after starting Propecia, but this will stop within a few months in almost every one experiencing the problem. Some doctors believe that Propecia increases the cycling of hair, but I have no way to ascertain if this is the cause or not.