Category: Drugs

Hi Dr. Rassman,
Assuming that Rogaine does work the same throughout your scalp, do you think Rogaine will be able to bring forward a maturing hairline? In other words, does a maturing hairline work in the same way MPB does through DHT? Or is a maturing hairline just programmed follicular apoptosis that wouldn’t respond to minoxidil in the same way that miniaturizing hairs would? Thanks.

Rogaine (minoxidil) is not a DHT blocker and only works as a side effect to grow hair. I am virtually 100% positive that Rogaine will not restore your juvenile hairline.

I am 28 years old and have noticed that my hairline has changed over the last year (at the temples). This has caused a great deal of alarm that I might go bald. I went to Dr. Bernstein for a free evaluation & he said that he saw some minaturization in the front but as to future predictions, it’s hard to say as i’m adopted.

I have wrestled with whether or not I should take propecia as I don’t like medications/side effects. It is possible that my hairline might “mature” & then stop… but i don’t want to wait until it’s too late.

IF i start propecia & then decide to stop – will my hair be worse than if I had never started in the first place? If in-fact fate/genetics have it that I am not meant to go bald – will taking propecia interfer with the “nature of things?” and leave me dependent upon a medication whereas I wouldn’t have needed it before?

Thank you.

Think of a timeline that you are progressing on (your timeline), then look a couple years down that line — assuming you took Propecia (finasteride 1mg) for the first year and then stopped it, you will be in exactly in the same place as if you never took it. I always tell patients that when you stop taking Propecia, you undergo what appears to be rapid hair loss, but it is just ‘catch-up’ hair loss to bring you back to the degree of hair loss you would’ve had anyway. Propecia will not reverse the mature hairline back to your juvenile hairline.

My process for following patients is simple: the full value of Propecia takes a full year or so. We use general rules about balding and although most men slow down their balding process in their 30s (28 is almost 30), some don’t follow the doctor’s rules. Hair loss is a progressive process in most men, but fortunately it slows down to a “crawl” by the time most men reach their 40s. You should be followed by a good doctor with yearly miniaturization studies and Dr. Bernstein in NY is a good doctor to do this for you. At the least, it will give you a good metric as to how you are doing. Good photography will also help define what is happening to you. You need to have a good dialog with a doctor who can work you through the process.

Dr. Rassman,

I am considering asking my doctor to prescribe avodart, I began balding around 19-20 years old. I shaved my head for past 10 years and now would like to explore my options. I am most likely Type VII but can see many blond immature hairs so makes me believe follicles aren’t dead. Do you think its even worth trying? And if so, what do you recommend? I am 31 if that makes any difference.

Let your hair grow out for about 2 weeks and then get an examination. You should get your hair mapped out for miniaturization to see where your balding pattern is now, since you don’t seem sure of your pattern and I’d guess that you haven’t had a doctor actually look at your scalp in quite a long time. Avodart (dutasteride) is yet to be FDA approved to treat hair loss, so if you have a doctor that is willing to prescribe it to you, it could be worth trying — but I couldn’t say without seeing you.

Hi Doc

About 3 weeks ago i started taking propecia(1mg) and roaccutane(20mg). I am 21 years old and yesterday i started noticing hair growing on my nose and lots of new hair on my head, its quite visible from close and it looks quite thick. I haven’t had hair on my nose before this… Should i continue taking the medication?

Propecia does not grow hair on your nose but it may stop hair from growing in your nose and in your ears if it has not started doing that yet. Minoxidil might produce hair loss in other parts of the body, but you are not taking it — and although Roaccutane (accutane / isotretinoin) can cause hair loss, some abnormal hair growth has been reported on that drug.

I ave now been on Propecia 1mg a day as prescribed by my Dermatologist. My hairline is not receeding, but the entire scalp except the sides and back is thinning to the point where you can see scalp at all angles. I have been on propecia since April, 22 2008. My question to you is is there a phase where the hair becomes thinner before propecia begins to work? I have felt tingling in my scalp since i have started it and was wondering if that’s a good sign that propecia might be working.

Thank You

You’ve only been on Propecia for about a month, so it is too early to see results from the medication. Wait out a full 8-12 months to determine what is happening to your hair and your response to Propecia. Tingling has nothing to do with hair loss or hair growth

Can a person still experience regrowth even after 2 years on Propecia and Minoxidil. And how long does it take for an intermediate hair to turn into a terminal hair with Propecia and Minoxidil?

It sometimes takes more than a year to get detectable results. Getting a ‘terminal’ hair where a previous miniaturized hair was before, has never been proven 1:1. We are guessing on what we see.

I know you’ve treated many men with thinning hair. For men in their early thirties like me, what can you estimate are:

1) The success rate for stopping hairloss with Propecia alone
2) Cosmetic regrowth with Propecia alone
3) Reports of sexual side effects or discontinued use from Propecia alone?

How many patients do you have taking Propecia for more than 5 years?

I tried 1/4 Proscar daily but had awful side effects, and I believe Merck’s side effect percentages are low. My hair loss is in the “early” phase and only really noticeable to me when I obsess, but I’d really like to not have a noticeable bald spot any time soon!

You take Propecia, right? How long? What else do you do for your hair?

Thanks!

I have been taking Propecia (and no other medication to treat my hair loss) for over 5 years.

The success rates of Propecia depend on what you consider success. You will still continue to lose hair if you are genetically prone to losing all your hair but it may slow to a crawl. Propecia can reverse hair loss, stop hair loss, or slow it down. A small percentage of men (I really cannot give you a number, but it is probably greater than 10%) have good growth and some reversal on the top/crown area. A larger percentage of men (about 90%) have slowing of hair loss. Many of my patients have been taking Propecia for over 5 years without side effects. I routinely look at my patients’ hair under a microscope for a miniaturization study to document the progression.

You are asking a question that is tailored specifically to you and this is impossible because everybody has different results. Try to understand the “big picture”. Propecia is not a magic pill that cures hair loss. NOTHING does! Propecia is the best medication we currently have to treat male pattern baldness, though. You need to sit down with a physician and talk about all the risks and benefits and come up with a Master Plan for doing something (or nothing) about your hair loss. I know you are looking for specific suggestions by me, but you are not my patient and I can not examine you over the Internet.