Drugs – Page 151 – Balding Blog

May 28, 2009

Hair Loss InformationTaking 2.5mg of Finasteride and Exercising – Hair Loss Information – Balding Blog

Hey Doc – I emailed you a while back and wanted to thank you for your response on the blog. I recently upped my dosage of finastride to 2.5 mg proscar after a 10 yrs of propecia (1mg), based on my HT surgeons advice. My hairloss had really progressed so this was a clear course of action. I intially had great results on proetica in my early 20s.

My first question was related to dosing – I lift weights/workout intensely 6 days per week (often twice per day) and wondered if it would behoove me to split this dosage – 1.25 prior to weight lifting in the early evenings and 1.25 first thing in the morning, as recommended in your book.

My second question was, does taking Finastride with a multivitamin, a vitamin C, a vitamin E, vitamin D, Potassium, Magnesium, and Calcium – all in seperate pills, and a protein shake (organic from non hormone cows) in the morning before I do some intense cardio (I eat no real food till I come back from the gym) have any impact on Finastride absorbtion/effectiveness?

I have read your book and realize it is ok to take Finastride with food but this may be a tad different.

Thanks in advance

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If you can keep up the regimen of taking a pill twice a day without forgetting, then go for it! Theoretically, it should give you a consistent level. Be sure to talk to your prescribing doctor to clarify this.
I do not believe taking finasteride with your supplements or food or exercise has any real impact on its absorption.

May 28, 2009

Can Propecia Be Transmitted to Women During Sex or Kissing? – Hair Loss Information by Dr. William Rassman

Some reports shown that propecia is not suitable for women as it may cause birth defects.Therefore, I want to know if a man is taking propecia continuosly, then will the contents of the propecia transmitted to women during having sex with his partner(which is transmitted via kissing or sperm) and indirectly will it affect women’s health?

thanks for your reply. I do appreciate it.

From a practical perspective Propecia is NOT carried via sperm/ejaculate, when kissing, or having intercourse or oral sex.

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May 28, 2009

My Doctor Prescribed Propecia for My Acne – Hair Loss Information by Dr. William Rassman

Hi Doctor. I recently went to my doctor regarding an acne problem I have had for years, and he prescribed me to take propecia for it. He said that acne is caused my the same hormone that causes hairloss. Something called DHT. And that the ingridient in propecia inhibts DHT and thus eliminating acne. What do you thik about this, it seems kind of wierd to me. Please inform me soon because you seem to be an expert on propecia. I wanted to ask him more questions, but he is one of those doctors thats always in a hurry.

He was pretty condfident that propecia treats acne really well

I haven’t heard of Propecia (finasteride) being prescribed for treating acne. Acne is generally caused by bacteria on your skin and certain hormones in conjunctions with a high sebum production. I recently wrote about acne and DHT here.

So while Propecia does inhibit some of these androgens (such as DHT), Propecia is not prescribed for acne as a treatment. I would consider seeking another physician for a second opinion (mine does not count as I am not your doctor) since you are clearly not comfortable with your treatment plan nor your doctor.

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May 27, 2009

I Think My Hair Loss Is Too Aggressive to Be MPB! – Hair Loss Information by Dr. William Rassman

I would like to get your opinion on why I am experiencing relatively sudden thinning. I am 19 years old. I can’t pinpoint the exact time that my hair started getting thinner, but I can say that my hair was completely full a little under a year ago, because of my driver’s license photo.

I have a feeling the hair loss is far too aggressive to be male pattern baldness, because I have had no signs up until recently. I don’t recall before a couple of months ago. In fact I have never seen hair fall out of my scalp or seen actual “hairloss” but i’m sure people rarely do.

I would like to know if you think this hair loss is temporary (based on the photographs) and if you think this is possibly permanent or even male pattern baldness. I have no history of the disease, my grandfathers on both sides died with a full head of hair. So did the grandmothers!

Male pattern baldness (MPB) does not always require a doctor to assess. Look at your hair loss pattern (use two mirrors). Is it thinning mostly at the top, but you still have good hair on the back and sides? If so, chances are you have MPB. We recommend a miniaturization mapping of your scalp hair and you can make the diagnosis that way. You can see how to do this yourself — here. By the way, MPB is not a “disease”. It is a genetic trait that you inherited from one of your parents. It may skip generations so you may not see it in your immediate family tree.

Finally, the aggressive nature as you describe does not surprise me, as men who lose considerable amounts of hair with an advanced balding pattern usually have a more rapid course of hair loss, often starting in their very early 20s. That may not be your case, but don’t fool around with it as there is a good medication (finasteride) to take if you are unfortunately balding. See your doctor and get a correct diagnosis and ask about options.

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May 27, 2009

I Trust My Transplant Doctor, But I Think I Had Shock Loss – Hair Loss Information by Dr. William Rassman

Firstly, I would like to thank you for your input on the website; I’m a daily reader. I have read your previous posts regarding preventative transplants. I am in my late 20’s and essentially had a first transplant done 1.5 years ago in what was pretty much a preventative measure. The transplant definitely had the impact of which you speak, namely causing native hairs to fall out, replacing miniaturized hairs with a lesser number of transplanted hairs. My transplant was only done in the front portion of the scalp, not touching the crown. I was not taking Propecia before the surgery, although there is doubt as to whether or not that would have prevented the shedding. Either way, I now am being told the following from my doctor, whom I trust and with whom I’ve developed a very good relationship:

The procedure was not wasteful as if we had waited 1-2 years, there would have been less hair to camouflage the procedure.

You did lose some pre-existing miniaturized hairs, but gained permanent, terminal hairs that give much more of a cosmetic fullness than miniaturized hairs.

It is disappointing that you did not get the full potential cosmetic fullness because of miniaturized hair loss so the relative change wasn’t as great as you had hoped. But if you had waited there would have been less hair to camouflage what we were doing, and you would have been perceived as having more hair loss going into the procedures.

For now you can go on Propecia for 6 months to help maintain hair and perhaps beef it up somewhat. Then you may have a 2nd and 3rd procedure at some point for the frontal half of the scalp to get the density you can get with transplants. You can also do a second procedure at any time, and I know you will feel that much better when that second session is in and growing.

My questions at this point are the following: Should I do another transplant now or should I wait longer? I’m told that 70% of the hair in that area now is transplanted hair and that I wouldn’t really get much if any shock loss from the next one as there are very few miniaturized hairs between the transplanted hair. Should I take Propecia before going to another transplant and if so for how long or does it not matter because there will not be anymore shock loss?

Thank you for your answer. I have had a great experience with my doctor so far and trust him to the fullest. I simply post as an educational measure for myself and for all other readers as I think this is a topic of great interest to younger men in the initial stages of hair loss.

I am a bit critical of your doctor for not using Propecia prior to your first surgery, as this probably would have prevented much of the hair loss you experienced. Propecia (finasteride) is very important in young men having transplants to protect against shock loss. Anytime after 8 months you can follow up with another procedure. Best this time to be on Propecia before hand.

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May 26, 2009

Online Doctor Consultation and Propecia Purchasing – Hair Loss Information – Balding Blog

Hello Dr,

I have been following your blog for a while now and am definite that I am beginning to suffer MPB.I am 20,and my dad and brothers were all 16/17 when they started balding. They have all followed a pattern of continued receding from the front hairline untill it reached all over. My temples and frontal hairline however resemble a normal mature hairline. It is the hairs on top and mainly in my crown which when they fall out are noticably and quite a bit thinner than the rest of my hair, which otherwise is probably thicker than average! The crown also looks and feels thinner. MPB has appeared in most men on both sides of the family (just one uncle has escaped it), my genetics are against me!

Although I want to get the situation controlled, I cannot bring myself to go to the doctor, the embarassment is too much. Especially here in the UK it seems trying to beat hairloss has a lot of stigma and embarassment attached to it. Even my parents think I am ridiculous thinking that I am thinning (they think I am ok seeing as i don’t have the same pattern as father and brothers)…obviously not having read what I have here about minaturization and not necessarily following an identical pattern.

I came across this website and wondered what you thought. It claims to give a consultation with an online doctor and then to allow you to purchase propecia online if they authorise it. I wondered if you think this all looks genuine, as I am considering doing it, It does seem so!

The beginnings of MPB is ruling my life but I can’t face the embarassment of a doctor considering friends and family think I am being stupid, also there doesnt seem to be much knowledge on the subject here or specialised doctors/clinics.

Thankyou.

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I do not generally condone strictly online consultations, but would not be against it if you can take Propecia to prevent the family hair loss problem following you into adulthood. Nothing compares to a one-on-one patient to doctor relationship. I don’t know if that site is genuine or if prescribing medication like that is legal in the UK. There is nothing wrong with being bald and there should be no embarrassment to request medications to stop the hair loss. I would do your research and find a doctor in your area and have a confidential consultation and examination.

May 26, 2009

I’ve Experienced Shedding After 4 Months on Propecia and Now I’m Freaking Out! – Balding Blog

Whats up Doc?
I am 25 and in the early stages of balding, almost 4 months on propecia (112 days to be exact) and the front of my hair line, not at the temples, but the the middle, is noticeably worse/thinner than it was when I started. Now here are my questions: Is it just that it hasnt started to work yet (I know its still early). Or am I experiencing a shed? Or at the worst case scenario is it making my hair worse! I dont really see any hairs on my pillow or shower drain or anything, but im def losing them. In all of your years of experience, is this normal at around the 4th month mark? I know I have to wait a year, to start seeing results but, the hair loss seems to be quickening! I go to a dermatologist who is convinced it will work for me, but at the same time doesn’t really seem to know what they are talking about when it comes to hair loss. I am aware that you can’t make a diagnosis over the internet but how about an educated guess? Ive read on some sites that this is normal and that new thick hairs will grow in, but im still starting to get a little freaked out here. THANKS!

It could just be a shed situation. Many men will lose hair after a hair cycle is complete (ending in catogen) and not restart another cycle right away due to the genetic situation. This could be what you’re experiencing. I wish that I could be of more help, but you will probably know for yourself in another 4-6 months.

For me, the measurements that I take when I start a patient on Propecia (miniaturization mapping) are good for comparison purposes down stream, when there is a change going on. Change tells a great deal with regard to miniaturization and I would hope that the miniaturization that you had present when you started the drug has reduced, rather than increased. I like all of the insights I can get to render a prediction as to where a patient’s hair loss pattern is going.

May 21, 2009

I Don’t Know if My Finpecia is Working – Hair Loss Information – Balding Blog

I am 24 year old Indian. I started losing my hair when I was 19. Ten months before I went to see dermatologist, and he prescribed me 1 mg generic Finpecia(cipla). I am taking since then, but I havent seen any difference. Moreover for past 2 months, I think my hair are falling at slightly more rate.

I have less density at crown area, my hairline is not so affected. Do you think finpecia is working or not? I know that you cant tell properly without examining me, but still I would like to know about your opinion. Moreover,I know finpecia is not FDA approved, but in India, we dont any any FDA approved finastride tablet. What are your opinion regarding Cipla’s finpecia?

Thanks & Regards

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Cipla I can’t tell if the Finpecia (generic Propecia from India) is working or not without an examination, but it sounds like you’re seeing most of the loss in the crown, which is where finasteride tends to work best. I would stay with the medication, but discuss this with your prescribing doctor to find out his thoughts.

Cipla is a very large drug company and I haven’t heard or read any complaints about their 1mg finasteride being anything less than the regular Propecia. It isn’t sold in the US due to patent laws, but I’m not sure how those laws would apply to the Indian market. I believe Indian law requires drug makers to provide compulsory licenses to other companies to allow generics to be made, regardless of patent. There seems to be a lot of sales over the internet from sources outside the United States, though I don’t have any recommendations (nor would I provide them for legal reasons).

May 21, 2009

Getting Concerned After No Results on Propecia for 7 Months – Hair Loss Information – Balding Blog

Hello Doctor
I am in my mid 7th month of using Propecia everyday (alone without anything else), and am starting to get concerned. As I understand it, you need to wait 9-12 months to see any effect from the treatment, and thats where I need clarification.

Would I notice worst symptoms (loss of hair bulk/mass) before it got better? My hair was diffuse beforehand but still covered my head. Now, the rear crown of my head is very close to being bald. (Please see images..I sent them to your email) Frontal has remained basically the same. I now keep my hair very short, so I dont know if there was shedding (and it just wasnt apparent for this reason.) But I havent noticed ANY hairs falling out….instead the hair just seems to be getting thinner and thinner.

At this point, I am trying to determine whether to use Rogaine on top of Propecia as a last ditch effort. I know that would make it hard to determine WHICH product is helping my hair (which is why I have been holding out on that), but my big concern is that if I let things continue to progress at this rate than I won’t have any hair in the crown for Rogaine to even “thicken”…What is your take on that.

The only reversal/progress I THINK I have found is a few disperse black hairs that have spouted up in areas that I believe were bald before (in my frontal region). This could very well be my imagination, but I am wondering if that is a sign that things are picking up..or if some people just gain a few of these random hairs and nothing else.

In considering that I started taking Propecia 7 months ago….does Propecia work to try and maintain THAT base level hair (with ups and downs in the process). Or does it work to maintain baselevel from the 6-12 month mark when you guys say it typically starts to take effect….I am very confused at the “typical” experience I should expect for the 1-12 month term of treatment (with Propecia)

I would be open to take that genetic test, but they dont list any NY doctors on the site…any suggestions for that?

Thanks for the help!

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Some report shedding, but it doesn’t seem extremely common. At 7 months, things shouldn’t necessarily be worse than before. The HairDX finasteride response test might be a good idea (see #5 below).
Many men use both medications. I see no problem with that as long as you don’t mind the financial aspect of sticking to two medications for life.
Not really sure what you mean. Random black hairs?
Aside from regrowth, the goal of taking Propecia is to maintain your hair at the point of when you started taking it. Obviously, each person is different.
The HairDX site has a list of clinics that offer their genetic tests, but if there’s no listings for New York, you should contact them to find out about local options. I’m sure they’re looking to have their tests available on the east coast.

May 21, 2009

Both Times I Started Propecia I Saw Accelerated Hair Loss! – Hair Loss Information – Balding Blog

I noticed someone else asking if propecia could accelerate hair loss and wasnt sure if it was possible or not. Both times I started taking propecia I did notice unusual hair loss within a couple of weeks. I understand it could take 6 months to get results but is there a possibility that in the first severall weeks it actually causes loss?

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There are some reports of accelerated hair loss from Propecia, but this is probably just accelerated hair cycling and after it takes its course, the growth (anagen) part of the hair cycle will pick up and grow more hair.