I have FUT surgery scheduled in late late July. I started taking propecia early July..so would have started about 3 weeks before surgery. Is this long enough before to help reduce chances of shock loss?
The longer the better, but 3-4 weeks should cover you. Stay on the medications until all of the results are achieved and then consider staying on the drug for life. Talk with your doctor about this.
Dear Dr. Rassman,
I’m 24 and I’ve been using Propecia since Dec 2006. It worked very well to slow down my hairloss but in the last 30 days I’ve been seeing more shedding. I work at my computer and I’m seeing more and more hairs on my keyboard and desk. I’ve been using Propecia for 2 years (almost) – is this the normal timeline for the hair cycle? Dormant for 2 years and then shedding for a couple of months? Is my shedding a sign of more balding to come?
Thanks!
If you had been my patient from the beginning, I would have a reference map of your hair and scalp for miniaturization and I would be able to look at the change over time. By starting from point zero and looking at the measurements two years into it, it will help show what occurs over the next two years, but will not help you now. This could be caused by a normal acceleration of the genetic process, or you can be misinterpreting what you are seeing. You should go back to the doctor who put you on the Propecia and ask him to examine you and give you an opinion.
Hi Dr. Rassman, can you explain why people with hypothyroidism and hyperthyroidism often suffer from hair loss? I was diagnosed with hypothyroidism last summer(TSH of a little over 8.8), and since then my endocrinologist has changed my dosage of thyroid medication twice, most recently in April. I have been experiencing a lot of hair loss since I have started the medication. Could propecia possibly be beneficial to my situation? Thanks for the great website.
Unfortunately, I do not know the exact mechanism of why people with low thyroid can experience hair loss from it. As the saying goes, it is the “practice” of medicine and not the “science” of medicine, and as such, medicine can be a descriptive and observational discipline.
Propecia will not be beneficial for hair loss associated with thyroid conditions unless there is an active genetic component to it. Propecia is a medication for androgenic alopecia.
I know Propecia won’t work to regrow a hairline but can it help regrow hair behind a hairline like 1cm behind it? Since my hairline is still intact but behind it is where the drama lies.
It can, but each person will react slightly different to medication, so regrowing hair there might be rare. It has a better chance of maintaining hair that is left, though regrowth isn’t completely out of the question. The younger you are and the shorter time since the hair is showing the impact of balding and thinning, the better the chance of reversal.
Dr. Rassman, if more Finasteride blocks more conversion of testosterone to DHT in the 5-alpha-reductase Type II, then why would it not be better for preventing more hairloss? I heard of people who up their dosage if it starts to lose effectiveness and it works for a period of time. Also, what would happen if 100% of DHT is blocked and you had no side effects, in theory could you never have hairloss? Lastly, why cannot Saw Palmetto be used in conjunction with Propecia to block more DHT?
Regards
To make DHT, your body must have the enzyme 5-alpha-reductase. We know this because some people are born with this enzyme missing and when that happens:
That suggests that DHT is the cause of hair loss when interacting with a person’s genetics. I can not be sure that DHT and 5-alpha-reductase type I or II are totally responsible for genetic male pattern balding, but it is highly suggestive. It may not be as simple as blocking one hormone, so we may not really be sure of the science.
Lastly, I do not believe there is good scientific evidence of saw palmetto blocking DHT the same way Propecia does. I reviewed this subject fairly completely and could find conflicting discussions from good scientific sources that show evidence that saw palmetto may work on blocking DHT… or it may not. Saw palmetto is a herbal medicine that has been traditionally used for prostate (not balding) problems in men, so studies on balding are not very complete or scientifically studied with good double blind clinical research projects. Finasteride is a medication that has been used in high doses (5mg) to treat prostate enlargement in men with a unexpected side effect of growing scalp hair in balding men. The value of both Propecia and saw palmetto will probably give more side effects, particularly the negative impact on libido.
I been reading about the shedding that may happen with Propecia in the beginning of treatment in the blogs and on the Propecia site. If it’s gonna happen, will the shedding be noticeable or I’ll just lose a little more hair a day then I should? Also is it a rare or common thing to shed with Propecia? Right now my thinning ain’t visible to people but I know it’s there I would really be upset if Propecia will make my hair thinner in the beginning.
In the many years in practice and being one of the largest Propecia prescribers (according to Merck) in California, I do not remember one case of shedding reported by my patients. I do believe it does happen because of the large number of people who report it to me on this blog, but I suspect it is far less common than the reports you can find on the Internet seems to suggest it is. As I have not seen it in my patients, I really do not know the answer to your question, but I suspect it may vary all over the place from minimal to substantial.
hello Dr…
I used Minoxidil for a while and stopped as i feel it created some problem in my erection.i need to know how long it will take for me to get rid of the side effects.
I could guess that maybe you have ED and that a small drop in your blood pressure, which is a side effect of minoxidil, is helping it along (meant to be negative). Honestly though, I couldn’t tell you based on the info you’ve supplied (none).
As I do not know your age and have not examined you, I generally think that some doctor might be able to help. If I knew more about you, maybe I could help. With that said, minoxidil is not known to produce erectile dysfunction (ED) or a libido drop like finasteride does. See a doctor for a complete examination.
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If shedding occurs after starting minoxidil and then hair in that area regrows, are those regrown hairs now minoxidil dependent? If minoxidil regrows hair that wasn’t there to start with, i can understand the dependency, but if it sheds hair that was there to start with and then makes those hairs require minoxidil to survive, I have to wonder if its even worth using this stuff.
If there is shedding from minoxidil, it should be complete in 1-2 months and that should not be enough time to build dependencies. This is an educated guess and I am not aware of any study that would back up my opinion here.
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Hi Doc!
I have been losing my hair for about 4 years now. I have used a number of products already including Avacore, Rogaine and most recently Kevis. I have been using Kevis now for about 6 months with no results. I have been losing more hair then I have ever lost on the other products though the people at Kevis had told me that I would not lose any hair and that the success rate is over 90%. They also said that I will see results within 2-3 months and when I told them that I dont see anything they said that I will have to wait 6-9 months before seeing any results and that I will have to double the dose. I am now completely bald at the sides- in the front and the middle is thinning terribly. I really want to stop using Kevis but I’d like to know if there is anything you recommend doing as an alternative hair loss program.
Thank you so much for your help.
What you are telling me is that you believed what you were told by salesmen who profited by giving you advice. Bad advice that ended up putting more money in their pockets. That is a shame. The ingredient in Kevis that the company promotes as HUCP is hyaluronan (hyaluronic acid), which is a supplement commonly used to treat joint pain — not hair loss. That is just one of a handful of ingredients listed, including water, alcohol, sorbic acid (a food preservative), and biotin (which is also known as vitamin B7). Although the product packaging and website certainly look slick, there is no science here. I can’t even find any before / after photos on their website, which should tell you something about the product right off the bat. All I see there are stock photos of happy people with full heads of hair.
Although I don’t know your age, I’m going to assume you are in your early to mid 20s. You should have seen a doctor and instead of wasting your money and the precious hair that you may have lost forever because of the delays, you should have been put on Propecia (finasteride 1mg). Propecia is the only oral FDA approved treatment for hair loss and it would’ve almost certainly halted the loss a 20 year old (again, just guessing on your age). It’s still not too late to do it right, so see a good doctor (dermatologist or hair transplant surgeon who is ethical) and get on the track to the correct treatment. The other treatments you mentioned (Avacor and Rogaine) are minoxidil, which apparently does not work on you.
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I have been on generic finasteride 1.25mg daily for the last 3 and a 1/2 months, prescribed by a hair transplant consultant.
I am worried that I may be starting to develop gynecomastia, my chest area around my nipples feels softer than usual. There also appears to be a slight protrusion of the nipples, whether this is a reality I am not so sure. I am by no means overweight but I have a good “pinch” of belly fat at the moment. However I have been the same weight to the best of my knowledge since commencing with finasteride.
I have searched your archive but there seems to be no example/instruction of how to assess whether you have “gyno” or not? I know self diagnosis is not to be advocated but is there any way the layman can make an objective judgement?
I really enjoy your blog and it is great to have a professional opinion on hair loss available online.
This diagnosis is best made by a doctor. There’s no real instructions on assessment, but this article may prove valuable to you — Evaluation and treatment of gynecomastia. If you are really experiencing more breast tenderness, it may be caused by Propecia (finasteride 1mg), but for enlargement of the breasts from gynecomastia, this is a diagnosis that requires an examination. Although breast cancer is rare and usually not tender, any mass in the male chest should be examined by a professional familiar with the difference between breast cancer and gynecomastia.
Was the consultant who prescribed you Propecia a physician? If not, then he broke the law by prescribing a prescription item and this should bother you. I would hope that if you had a doctor prescribe the medication, that doctor should be responsible enough to see you again and examine you accordingly.
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