Category: Drugs

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Hair Loss Information16 Year Old with Frontal Hair Loss – Should He Take Rogaine or Propecia? – Hair Loss Information – Balding Blog

Hey Doc,

I am experiencing thinning at the middle-front of my hairline, and my doctor has prescribed me Nizoral 2% and Rogaine.

However, after reading your post at Why Do Hair Loss Treatments Not Work in the Frontal Hairline?, I realize that you say “finasteride does work to slow down or stop hair loss in the frontal area, particularly if caught early enough.”

I have caught it early (I am only 16), and am taking every measure I can to control my hairloss. Does Rogaine not help with the hairline? Only Finasteride? I need to gather all the information I can so I can talk to my doctor about prescribing the proper medication for my situation. Thank you so much.

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Minoxidil (Rogaine) does not stop the genetic balding process like finasteride (Propecia), so the use of minoxidil may not be the right move for you in the long term. Either medication may help with the hairline, but results have been more consistent in the top of the scalp.

First, I would want to do a mapping of your scalp for miniaturization to be sure that you are actually in the genetic balding process. If I confirmed that and I was your doctor (which I am not), then after understanding much about you, your medical history, your growth history, and doing a physical examination, I might prescribe this drug. I can’t make a blanket statement about prescribing medications to men I haven’t communicated with beyond a single email and prescribing a medication that is generally not recommended for a 16 year would require special circumstances to be considered like where you growth is at this time (height, bone growth, etc..)

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How Deep Do You Make the Holes When Placing Hairs? – Hair Loss Information – Balding Blog

Thanks for the great site and the time you put into it. I have a couple questions. First of all, I watched the episode of John and Kate plus Eight and thought it was very informative.

I would like to ask that when you make the sites for the grafts, how deep do you go into the scalp? Second question, I receive finasteride from a doctor here in Canada. The pills are a capsule not a tablet. Do you have any knowledge of finasteride being sold in capsules? I’m just curious if i’m getting the real thing.

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PropeciaI do not know about the capsule form of finasteride. There are many phony drugs on the market. Only Propecia, which has a distinct look (see photo at right), is guaranteed to contain 1mg of finasteride, because the drug company Merck controls the patent on it and no one else can legally manufacture and sell it in North America. The only way is to send it off to a laboratory for analysis.

With respect to how deep I make the incision (or holes) — they are about 5mm-6mm deep, which is about the length of the hair follicle. Some people (like Asians) have longer follicles than Caucasians. One of the most important jobs of the surgeon is to make sure that the incisions are uniform and deep enough to take the full follicular unit, as well as control the direction and the angle of the incisions. The hairs will grow in the direction that the incision was made. Sometimes when doctors do not make the correct angle, your hair may grow out in an improper direction making it difficult to manage and may be unnatural looking.

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My Dermatologist Just Told Me to Use Minoxidil and Didn’t Run Any Tests for My Female Hair Loss – Hair Loss Information – Balding Blog

Hello – I hope I’m not being redundant with this question but I didn’t see a similar question on your site or on the many others I’ve searched (have also read lots of books). I’m 54, female and am not yet in menopause. About 4 years ago, I noticed that a relatively thick layer of my bangs would no longer grow past my eyebrows. In general, this layer of shorter hair extends to both temples and stops at the front of the ears (although it is obviously most noticeable right in front and makes styling a hassle). I have become much more careful with heat styling and have been taking supplements (Black Currant Oil, Bio Available Silica , EFA’s, Multi-Vitamins, Special Hair Formula Vitamins, Calcium, and have recently adjusted my diet to include salmon, nuts, good fats, etc — and I’ve seen some overall thickening and lengthening.

I recently went to a local dermatologist who is a specialist in hair and he diagnosed me with androgenic alopecia and prescribed rogaine for the small area at the hairline. If I recall correctly, he said I had a brief anagen phase. I show no signs of shedding or thinning and I have a very thick head of fine hairs (I know I’d be an excellent candidate for transplants should I need them!). I asked him about whether I could take birth control pills (low androgen ones) or spirodactone instead of or in addition to the Rogaine (which seems like a mess and hassle — for the rest of my life). He said no no no and wouldn’t run any tests for ferritin, hormonal issues, etc. I would think that the fact that I’m 54 and still menstruating (and have a very large uterine fibroid that’s still being fed by estrogen; I’m being watched by my ob/gyn) would suggest some hormonal atypicality for my age, but what do I know?. Although he was very nice and kind, I’m not 100% confident in his diagnosis because the hair has improved significantly since this problem began. Is it possible that I have a different problem? Could I first try to treat this issue with anti-androgen medications before I sign on for life with Rogaine?

Thank you for time and best wishes.

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Your dermatologist is probably correct with his assessment. Many people will have a shorter anagen phase as they age. This means that as hair grows at about 1/2 inch per month, if your anagen phase is shorter (let’s say to the tip of your nose in the front), then you can calculate backwards the length of the anagen cycle by dividing that distance by 1/2 inch.

You should have the battery of tests run, which will rule out other causes of changes in the anagen cycle other than genetic causes. These blood tests include:

  • Sex Hormone tests
  • SHBG (Sex Hormone Binding Globulin) used to test status of male hormones
  • Estradiol is a sex hormone
  • FSH (Follicle Stimulating Hormone) *not hair follicle but follicle in the ovary*
  • LH (Luteinizing Hormone) is a sex hormone
  • Free Testosterone
  • Total Testosterone
  • ANA (Anti Nuclear Antibody) used to test for Lupus or other autoimmune diseases
  • TSH (Thyroid Stimulating Hormone) used to test for hyper or hypo-thyroid disease
  • Test Iron status
  • TIBC (Total Iron Binding Capacity)
  • Ferritin
  • Iron

As you are using a variety of other substances, I can not tell you what has worked, but clearly it sounds like something is working to increase that cycle time. Go back to your dermatologist and be more forceful with getting him/her involved in the diagnosis. For more information, please see Female Genetic Hair Loss Is Different From Male Genetic Hair Loss.

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Took Propecia for Years, Stopped for 6 Months, Saw a Ton of Hair Loss, Restarted It Again to No Avail – Hair Loss Information – Balding Blog

Hi,

I’ve been reading your blogs for a while now but have finally got the nerve to send you an email to ask a question. I’m 28 yr old male. I have been taking Propecia since I was 24 yrs old. Actually I first started taking Propecia, I was told by my dermatologist to take it just three times a week because he felt that my hair loss was very minor. I did that for about 3 months or so then I went on one pill a day from the time I turned 25 and took a pill a day for about 1 year and a half. By the time I was 26 and half, I was reading that Propecia could affect my ability to have children so I stopped taking the pill. I started to see heavy amounts of shedding of my hair but I thought it might be due to the amount of stress I go through. However, after a six month stint off Propecia, I met with a doctor and decided to go back on it until now. Since the time I started back on it last February (2007) I’ve noticed my hair is substanitally thinner than it was last year even though I’ve been taking Propoecia. Its thin to the point where I can see my scalp in most angles of light. Does this mean that Propecia is not working for me? I’m actually going through a stressful time in my life right now, does that have anything to do with it or cause Propecia not to work? I lose about 30 hairs everytime I shampoo my hair and there is basically hair everywhere over my pillow case. Are there any suggestions you may have for me?

Thanks

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On again and off again Propecia (finasteride 1mg) does not get you all of the hair back that you lost when you stopped the drug. You need to stick with a knowledgeable doctor and maintain taking the drug daily. Taking Propecia should be a lifetime commitment. Anything less will eventually push you into what I have discussed many times on this blog — “catch-up hair loss”. There is also no comparable “catch up hair growth” that equals the value when you first started to take the drug and during the first full year of treatment.

Regarding whether Propecia is working for you, you should be able to ask your prescribing physician, who I hope has measurements of your hair loss at the time you restarted the drug over a year ago to be able to compare them to now.

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I Stopped Propecia and Now I See Sperm in My Urine!!! – Hair Loss Information – Balding Blog

Sex: Male
Age : 25

I have been using Finasteride for the past 7 months. I have seen some improvement in hair regrowth during the coarse of the treatment. I stopped it suddenly 2 months back. As soon as i stopped sperm got released in my urine and with out my control it was leaking so many times. but after some 20 days this problem goes off. now no issues. Since i stopped the treatment hair started falling again. Is it advisable to go for the treatment again?

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This is the first such observation in my advanced medical history. Perhaps stopping Propecia made your eyesight so fine-tuned that you’re now able to see sperm with the naked eye? I’m kidding — that isn’t possible. If you’re seeing a weird discharge in your urine, you should see a urologist. I couldn’t advise you whether to stop or start the medication, particularly since it sounds like you have other medical conditions that need to be looked at first and foremost.

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Should I Stop Propecia After 6 Years? I Never Saw Any Regrowth – Hair Loss Information – Balding Blog

I have been taking Propecia for 6.5 years. I was wondering should I continue. Will the effects fade after 6 years? Will my body get ammune to it. It basically stopped my hair loss, I got no gains.I don’t know if it actually works on me or my hair just reached a point and stopped or slowed loss. I am 46.

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If you stop taking the medication, you will lose any benefits you’ve had. If you haven’t seen gains in hair, that doesn’t mean the drug hasn’t worked — it could’ve retained hair or slowed the process down for you (as you noticed). Stopping the Propecia will result in “catch-up” hair loss, where your hair will fall out at an accelerated pace to get to the point that you would’ve been at had you never taken the drug at all.

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Can Propecia Keep Miniaturizing Hairs at the Temples from Falling Out? – Balding Blog

My temples receded from my highest wrinkle brow to 1.75 inches. You said a mature hairline temples are up to 1.5 inches away from that wrinkle. So I’m slightly more which is fine by me. But around those corners there is a piece of short hairs, they seem to have the same thickness as a lot of my front hairs but they look like they will fall of since I assume they are miniaturized. After that my temples will be about 2-2.2 inches receded which will be too much. I just began Propecia and am almost 22 years old, can Propecia stop those hairs from falling out and even help them grow normal again? But I’m also taking Propecia because I have frontal and mid anterior probs as well but early stage.

Propecia will slow or stop the hair loss in most men of your age. Consider sending me photos (will be kept private) and I will give you an opinion, but you should consider getting your hair mapped out for miniaturization to determine if these hairs at that exact location are really miniaturizing.




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Balding Forum - Hair Loss Discussion

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Is Minoxidil Shedding Age-Dependent? – Hair Loss Information – Balding Blog

Dear Doctor,

I am 19 years old and my hairline has receded a bit at the front and a bit more at the temples starting about a year ago. I am considering using rogaine to halt the loss but I read on the website that it could cause a significant increase in hair loss during the first stage of use. my questions are:

  1. is it safe to assume that because I am relatively young, my hair wont fall out as much during this stage?
  2. I read that rogaine does not work for everyone. If I experience the initial excessive hair loss, then stop using rogaine, will most of that hair grow back?

In addition, I would be more than happy to have your opinion on what path of treatment I should take

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Shedding from minoxidil use does not occur for everyone and should be temporary, and there is no connection between this shedding and your age. See Hair Loss Worse After Rogaine for more.

You’re focused on Rogaine (minoxidil) and at 19 years old, your hair loss most certainly will be genetic. Propecia (finasteride) is the best choice for genetic hair loss in a 19 year old, without a doubt. Get your hair mapped out for miniaturization, have your doctor make a diagnosis, and then get him/her to think through a Master Plan with finasteride (Propecia) in it.

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Propecia and Tinnitus – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

i am following up on a previous message i sent. I am wondering if you know of anyone who after taking propecia(finasteride) found the following symtoms- tinnitus with an overall feeling of pressure in the head. I only took the drug for two weeks and then stopped after these symtoms appeared. I am still suffering with this six months later. I had these same symtoms five years ago, (but was not taking propecia at the time) which lasted for one year and am wondering if the propecia could have triggered this again as it is used as a blocker, or might it just be a coincidence.

Hope you can answer this for me, thanks!

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I do not know what may be the cause of your problem. While many drugs can cause tinnitus, it is relatively rare. More importantly, tinnitus can potentially be a sign of serious medical problems and suggests to me that you have some medical issue which needs to be addressed by an expert in middle ear problems. I personally have not seen any patients in the last 10 years with tinnitus as a side effect of Propecia. I’ve been asked about this once before, a couple of years ago — Propecia Causing Tinnitus?