Category: Drugs

If I only have moderate thinning at the crown, is it worth the risk using rogaine if I may lose hair and make a somewhat bad situation worse? In other words, if it only works 50% of the time, why should I take a chance that the Rogaine causes intial hair loss and then hope I get it back with it working for me? Is this initial hair loss rare or common? If it only happens 5% of the time I will risk it but if it happens 20% of the time, it isn’t worth the risk to me. Can you help me out? Thanks.

It seems you have already made up your mind, but you may consider seeing a doctor to have your hair in the crown area measured for the degree of miniaturization (for an objective documentation) and explore other medical options, such as Propecia (finasteride 1mg). To blindly start a journey (medical treatment) without a map (miniaturization study) would not be very smart.

Minoxidil does not cause hair loss that lasts if shedding does occur, and whatever is lost from the initial shed should regrow back. I don’t have statistics to show what percentage of users the shedding occurs with.

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Dr. Rassman, if you could, please answer this question. It’s very important, I’ve seen a ton of people online that really need this clarified for them by an expert in this field. Can Propecia cause Reflex Hyperandrogenicity, thus actually accelerating your MPB and, if so, what are the symptoms? I can’t tell if this is happening to me or not. Also, if I have lost hair due to Reflex Hyperandrogenicity is that hair gone forever or is there a chance I can get it back?

HairLossHelp.com has a good explanation of reflex hyperandrogenicity –

“When the effects of androgens in the body are lessened, e.g. through lowering DHT or by systemic hormone receptor blockade, the body seeks equilibrium through a process called upregulation. This can take the form of increased hormone production and/or increased tissue sensitivity to the remaining hormones. The reason side effects usually gradually disappear with finasteride is probably due to such upregulation. In a small percentage of individuals, it may be that this process overshoots the mark, resulting in significant hyperandrogenicity. This is marked by such signs as greatly increased facial oil, increased pimples, and greatly elevated libido. It’s possible that in certain cases such hyperandrogenicity overcomes the hair-protective effect of, say, finasteride, though this does not appear to be the case for the vast majority of people.”

The term “reflex hyperandrogenicity” is a new one to me, and while I unfortunately do not have the answers to your questions directly, hair loss from genetic causes in men is usually not reversible.

More about reflex hyperandrogenicity at PropeciaHelp.com and Google Answers.

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Dear Dr.Rassman,
Has consuming whey protein have anything to do with increasing DHT or accelerating the hair loss process/MPB?? I am a 26 year old guy from India and have hair lost only at the frontal temple areas while whenever I wet my hair i can see it thinning at the front. I am currently taking finax 1mg for the past 1 month. Do you suggest I take minoxidil along with it.

Thank you

I doubt whey protein is causing your hair loss. Finax is a generic version of Propecia (finasteride 1mg) sold in India by Dr. Reddy’s Labs. If you’re taking this, I’d hope that means it was prescribed to you. Nevertheless, you need to see a doctor to get the correct diagnosis. Don’t forget, the most common cause of frontal temple hair loss in young men is genetic balding. I wouldn’t look to whey protein as the problem, as it is more than likely your genes. You’re doing the right thing by taking the finasteride. I’d say that you should just be patient and the finasteride will at least stop the hair loss if not regrow some of the hair, especially in someone as young as you (about 30% chance of regrowth and 95% chance of slowing or stopping the hair loss). I would stick to the finasteride (per your doctor’s advice) and hold off on minoxidil for the first year to see what happens from the Finax.

I’m a hairy 22yr old guy. I over-plucked my eyebrows and wanted them to grow back quickly so I applied Rogaine to them just once. In 1 hour, I felt extreme dizziness and heart palpitations, so I washed off the Rogaine. 2 days later, my eyebrows started falling out. 2 weeks after that, I started losing substantial amounts of hair from my scalp, arms, legs and even pubic area. This enormous amount of hair shedding has been going on for 3 months now. My eyebrows and scalp are starting to look like total crap because the hair isn’t really growing back anymore. All my blood tests have come back normal. I’m positive that the Rogaine set off some kind of systemic reaction in my body. You once answered a question entitled “Rogaine Destroyed My Hair!” I got in contact with the individual who posted that question. He also used Rogaine just once. After speaking with him, I learned that the progression/symptoms of our hair-loss have been almost identical.

Doctor, is it possible that we have some rare genetic vulnerability to Rogaine? And why has it continued to affect our bodies for so long? Shouldn’t any effect be temporary? The other guy is still losing hair and eyebrows, even though he applied the Rogaine 2 years ago. Both he and I notice that when new hair does grow in, it quickly falls out within a week or 2. Thanks doc. I hope you can offer a glimmer of hope.

I have noted your history, but I have no experience with this. As you may know, minoxidil is a drug that was originally made for use in high blood pressure and it produces a drop in blood pressure, which would explain your initial symptoms. With regard to the longer term side effect, I really don’t know, but would strongly suggest that you get your hair examined by an expert with (at the least) mapping and miniaturization studies done.

I have been taking Propecia for 2 years. Recently my girlfriend got pregnant.. Should I be worried? Will everything be O.K.? Thanks!

Congratulations! I don’t think you have anything to worry about with respect to Propecia use and conceiving. There is no evidence that I’m aware of to suggest that it would affect your fertility or have an impact in conceiving a child.

Hello doctors.

I’m 34 and started using Propecia at the first sign of hair loss six years ago. The results have been fantastic and I have experienced no side effects. My wife and I are planning on starting a family soon and even though I’ve read on your site and others that it’s safe to keep taking propecia, I do have my concerns. I am also concerned on the lack of long term propecia studies. If I just want to maintain my current hair, or at least slow down the loss of it, do you think switching from Propecia to Rogaine foam would do the trick? Or would all the hair I’ve kept because of being on Propecia still fall out in less than a year?

Thank you very much.

Propecia has a very short half life of 4 to 6 hours, which is the time it takes half of the drug to be cleared from your blood stream. Therefore, it should be out of your system in one day. There is no evidence to suggest that it would affect your fertility or have an impact in conceiving a child. The results of studies on the drug crossing from your semen to your wife are (according to what I read in the research papers done by the drug company) almost nill. For those patients who are still wary of whatever side effects it may possibly have on their unborn child, I generally recommend that you do not take Propecia for one week prior to the act of conceiving, during your wife/girlfriend’s very fertile period, which is about a week long. This should not have any deleterious effects with your hair loss.

i have been taking proscar for probably 7 or 8 years. a few years ago i had a pretty bad shed. freaked me out. however the hair did come back. again, i am having another shed and i\’m pretty stressed about it. is it normal to have sheds periodically even while on proscar?

It is important to realize the the genetic hair loss has its own course, independent of the effects of the drug. What you think is shedding from finasteride, is probably more genetic hair loss. Hair loss goes in waves and cycles of loss (shedding) most likely be due to your genetics, not the finasteride. You should discuss this with your prescribing doctor.