Category: Drugs

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Hair Loss InformationI Was Diagnosed with Mild Alopecia Areata After I Was Prescribed Propecia – Hair Loss Information – Balding Blog

Im 24 and I noticed my hair thinning approximately two years ago. However it was hardly noticable. My dermatologist said it was due to hereditary and put me on Propecia. About three months later my hair began to fall out rapidly (about 200 plus hairs in the shower alone) from all over my head. It later slowed down to around 80 plus in the shower and has been consistently falling out at this rate for around a year. It seems to be affecting the top of my head more that the sides but it is hard to tell since it is diffuse loss. I saw a hair specialist who diagnosed me with mild diffuse Alopecia Areata. He prescribed a topical to apply once at night which in a few weeks stopped my hair loss completely. My question is will the hair I’ve lost ever grow back?

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The diagnosis of diffuse alopecia areata is best made with a skin biopsy. Have you had that done? You have two diagnosis of genetic balding and alopecia areata…. both are not good from a hair loss perspective, but both can be treated. You need a confirmed diagnosis first and foremost. The treatment of alopecia areata is highly specialized. Some doctors use steroids to suppress the reaction in hope that the autoimmune process can be reversed. I wrote about a special treatment for this disease before — see Alopecia Areata in a Patient with a Miracle Cure (with Photos).

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Is Propecia Taking Months to Work, and How Realistic Is It to Expect Regrowth? – Balding Blog

Hi Dr. Rassman, let me first apologize as this message is quite long. I’ve got some questions about Propecia. First, I am twenty-six and I first noticed some slight bi-temporal recession about 1-2 years ago. It seemed to progress very slowly and even halt at times, but around nine months ago, the recession picked up speed considerably. I first went to Hair Club and got on the EXT regimen, which I stopped because it seemed to do more harm than good. I’m currently on my fourst month(bottle) of Propecia and for a while it seemed that it had stopped further loss. Recently, however, the middle-front part is receding inward at terribly; I’ve gone from long, thick hair with a barely noticable widow’s peak to noticable recession in just a few months. The odd thing is, I’m not seeing more than 5-10 lost hairs-sometimes none-in the shower drain and almost none on my pillows (the classic places we notice shedding/loss).

My question is: Is this the drug taking a few months to kick in and possibly an initial shed that will yield positive results later on and how would I know if I was experiencing hyperandrogenicity in the absense of any sexual side effects or increased acne?

Second, if I ultimately stop or significantly slow my loss and/or turn back the clock a little, would it be realistic to expect, say, to regrow hair that has been lost within 6 months to a year and, if so, how long do you think it might be effective in my case.

Last, I wear my hair in a ponytail at work and use a non-alcoholic smoothing product called citre shine. I notice what looks like a bunch of broken off hairs around the receding area that both my doctor and a dermatologist say looks like new growth, but I’m not sure. How can I tell breakage due to weakened hair from regrowth?

Again, I apologize for the incredible length of this message; I just wish to be as detailed as possible so as to provide you with good info. I regret that I don’t currently have photos available but I could probably get some together for you in the future.

Finasteride takes time to see if it is working. Most people notice that the amount of hair that falls out in the shower drain reduces within a month of starting the medication, so we could assume that it does stop the actual loss in many young men. You are right, more recent hair loss has a higher likelihood of regrowth, but everyone is different. The degree of hair loss that one sees over time varies with individuals and there are no rules. With regard to your questions of hair breakage, alcohol based products dry the hair and make it fragile. Breakage is usually not the cause of the balding process itself, but thinner miniaturized hair are generally more fragile to what you are doing to your hair (smoothing products, for example).

With regard to your stubs of hair at the hairline, without examining you under magnified video observation, I can not comment on your observations. Breakage usually reflects drying or direct damage to the hair shafts due to causes like the application of topicals, nutritional deficiencies, heat applications, dyes, and other such treatments.




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Hair Loss InformationWhat Kind of Doctor Can Make a Master Plan? – Hair Loss Information – Balding Blog

Hi dr. rassman, i just would like to get some feedback from you on my situation. i had been noticing some recession/loss in front and went to see the dermatologist. he said it was early signs of MPB and told me to get on propecia/minoxidil. at that point (which was less than a month ago), i didn’t really notice any appearance of scalp. however, now after being on the treatments, it seems like it’s getting worse with thinning and areas of scalp becoming apparent in the front. is this normal in such a short period? eg getting worse before getting better? it’s kind of scary, considering i’m supposed to be on medications to make it better. should i be worried?

also you speak alot about finding a doctor to work with and form a plan, etc. what type of doctor are you referring to? a dermatologist? a hair transplant specialist?

i appreciate any advice/information. thank you.

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It is just your comments that are critical to understanding the need for a Master Plan to deal with questions about your hair loss, how it is progressing, and what the treatment is actually doing to modify your loss. A doctor with a great deal of experience in following hair loss is often the experienced hair transplant surgeon or a good dermatologist with an interest in such problems. The doctor must have incorporated miniaturization studies to establish a metric baseline for seeing the impact of time and drugs on the hair loss between each visit. Most important, you must like the doctor and he/she must be caring and understanding of your concerns. My expertise is in seeing thousands of patients over the past 16 years that have had hair loss from aging over time, and the impact of various treatments such as drugs and hair transplants. I think that if you review this blog you will see the importance of experience.

With regard to your experience with the early treatment of your hair loss, you must be patient and wait out at least 8 months to see the effects of the drugs you are using. Everyone responds differently, so ask your doctor if you have questions on your response.

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Cyclosporine A and Regrowing Hair? – Hair Loss Information by Dr. William Rassman

Good day,
First, I’d like to say that I appreciate this site for it’s complete and very honest answers. I regularly come to this sight for information. So, thank you!

Second, I just read an interesting paper concerning hair stem cells, the protein NFATc1, its inhibition by cyclosporine A, etc. This paper is authored by Elaine Fuchs from Rockefeller University. This paper is to be published in the journal, “Cell.”

Here is the link: NFATc1 Balances Quiescence and Proliferation of Skin Stem Cells

My question: Since it is already an approved drug, would topical application of cyclosporine A help in slowing or possibly even regrowing hair?

Since this drug is not approved by the FDA for use in treating hair loss, I would strongly discourage you from using it for that purpose. We know that cyclosporine, as it is used now, has many side effects which would make it not worth taking, as it could negatively impact you. This is a dangerous drug used for treating difficult medical conditions. On the positive side, this study will only help further our understanding of hair stem cells and potential new treatments for hair loss.


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More Effective — Avodart or Proscar? – Hair Loss Information by Dr. William Rassman

Do you think Avodart 0.5mg or Propecia 5mg is more effective for hair loss?

First, Avodart (dutasteride) is not FDA approved for the treatment of male pattern baldness (MPB), although because of its mechanism it should work in the same manner. Perhaps one day it will be approved, but it currently is not. Tests are presently underway in an approved FDA contractor to determine the safety and effectiveness of dutasteride. Early studies show it is more effective at much higher dosages which may cause sterility in young men.

There is no Propecia 5mg — you’re confusing it with Proscar, which is 5mg finasteride (for prostate treatment). Propecia is 1mg of finasteride and is FDA approved for the treatment of MPB. Propecia and Proscar are the same drug in different dosages.

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Finasteride and Semen Quantity Reduction – Hair Loss Information by Dr. William Rassman

Hello Doc..
What is the exact mechanism of finasteride to reduce the semen quantity? Does everyone who is taking finasteride face the problem of reduction in semen quantity to some extent or are there people who do not have any reduction in semen quantity??

People react differently to certain medications. There is a small percentage (1-2%) that sees a decrease in libido, however, there are others that see an increase. Along the same lines, some may have a decrease in semen volume (not uncommon), however, according to an article from October 1999 in the Journal of Urology titled “Chronic treatment with finasteride daily does not affect spermatogenesis or semen production in young men“, the authors concluded that, “Treatment with 1 mg. finasteride daily for 48 weeks did not affect spermatogenesis (sperm production) or semen production in young men.”

A more recent study does report two patients with decreased sperm counts.

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My Dermatologist and My Hair Doctor Disagreed About Propecia – Hair Loss Information by Dr. William Rassman

I’m 33. About 6 months ago I went to see a ht doc, and my doctor and dermatologist. The ht transplant doc prescribed propecia and told me to come back in a year, but my doc and the derm would not. My doc said you could see a little of my scalp on top but nothing out of the ordinary. The derm said, along with my family history, that “there are no signs of mpb and your hairline is strong.” But I had bad imflammation, he prescribed Luxiq, a topical steroid, but I have been feeling like I was losing more than normal/thinner than normal. About a month ago, I started the propecia, just to see how it went, because I was nervous about losing anymore.

The inflammation has only gotten worse, and now in the last few days, I am shedding like crazy! My head does not itch, it is just a dull pain/feeling on the vertex. The last few days I lose up at least 50 hairs so easily when styling my hair for just a minute – much, much more than ever before. I’m afraid to even touch it.

So – can you shed on propecia if you arent actually actively losing hair? Does the shedding hint that I actually am losing hair? Also, if I decide now to stop the treatments and follow up again with my derm, will the hair that I’ve shed come back, even after stopping the treatments?

Thanks

I would assume that the hair transplant physician did a miniaturization study to come to the conclusion that you have male pattern balding and that you need Propecia. Eyeballing someone’s scalp is not the equivalent of this. I would make make an appointment with your dermatologist and have him/her recheck you since you are having more problems. I can not tell you what is going on without knowing what your dermatologist is treating with the steroids. Having said that, I would doubt that Propecia is causing your hair loss.

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Hair Loss InformationIs Avodart Making Me Angry? – Hair Loss Information – Balding Blog

Since taking propecia for three months then switching over to avodart for a further six months, i seemed to be very agrivated all the time and angry to the point were i was arguing and getting into fights. Is there any connection with this and taking avodart.

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Why the switch to Avodart (dutasteride) from Propecia (finasteride)? Propecia is the only FDA approved oral medication for the treatment of hair loss. Avodart is not. If the Propecia was working well for you and had an acceptable side effect profile for you, you should go back to using it. Avodart has not been shown to help with male pattern baldness better than Propecia unless the dose is three to four times higher than recommended dosages and even this information is suspect. Since it may be causing you severe emotional issues, you should strongly consider stopping this medication. We do on rare occasions see personality changes with these drugs. You may also consider talking to your doctor or therapist about your anger issues if in switching, your anger has not subsided.

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Hair Loss InformationNexium, Prilosec, and Hair Loss – Hair Loss Information – Balding Blog

I am 52 years old (male) and have pretty good hair and after taking Prilosec for 2 months and then changed to Nexium for another 3 months, my hair has become quite thin. I have three questions.

  1. if I stop the Nexium, will my hair recover back to what it was?
  2. what alternatives are there to Nexium or Prilosec?
  3. are H2 blockers better to your hair that the PPIs?

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  1. Your hair will probably not come back, but please know that your hair loss may not even be associated with these medications.
  2. Sorry, you’ll need to ask your doctor about any alternative drugs. I am not your doctor and do not know your medical history.
  3. Again, you’ll need to pose these questions to your doctor. I am not a GI doctor or an internist.

If these medications are the cause of your hair loss, stopping them may help to stop further loss, but these are rare side effects. Please do not discontinue or change your medication without consulting your prescribing physician.