Drugs – Page 256 – Balding Blog

August 6, 2007

Using Rogaine and the LaserComb – Hair Loss Information by Dr. William Rassman

Hello Dr. Rassman, I’m a 24 year old male who started losing hair at about age 16. My case is not critical but I am starting to get a little worried since hairloss has increased significantly over the last year.

I recently started using Rogaine, but I found an article involving the Lasercomb which I read and therefore studied a bit on the subject. Now, my question is: Is it safe to use Rogaine and the Lasercomb at the same time? What damages or interactions could occur?

I have read some of your articles regarding both subjects but was unable to find one that combined the use of both. I would greatly appreciate your advice on this matter.

I see no problem with Rogaine and using the LaserComb, but I doubt that the laser will bring much value. Minoxidil might help and may add value if used with Propecia (if you do have male pattern baldness). With regard to the LaserComb, I really don’t believe the results that are claimed.

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August 3, 2007

Late 50s, Noticing Acceleration in Hair Loss – Hair Loss Information by Dr. William Rassman

I am 57 years old and have maintained a good head of hair (albeit grey these days) throughout my adult life. I did notice in my late teens and early 20’s some recession at the temples, but overall I have what is considered to be good “coverage” when compared to others in my age group.

I have been on Flomax for a urinary flow issue (high bladder neck) and Androgel for hormone replacement for 5 years now. Recently, I added Plavix, Enalapril, 81mg aspirin and Vytorin to the regimen because of an angioplasty and to lower my lipids.

In addition, I take Fish Oil, Folic Acid (5mg) Saw Palmetto and CoQ10 (200mg) although these are not prescribed, only suggested.

Recently, I have noticed some acceleration in hair loss at the crown and frontal area, although it’s progressing slowly and mildly.

I am wondering if the new combination of drugs might be the reason, or if this is simply the natural progression of MBP. I imagine at this point a minaturization study would be a good idea instead of speculating on the impact of my drug cocktail.

Please advise, and thanks for your excellent site as well as your candid, well-researched and scientific approach to this problem.

Yes, I believe a miniaturization study may be of benefit. Genetic male pattern balding (MPB) may be a cause of your hair loss, but is rare (although not unheard of) to occur so late in life. Of note, taking Androgel may contribute to the MPB due to its androgenic properties. However, you should always consult with your physician before starting or stopping any medication. It is unusual that hair loss starts in a person of your age, so I would look to the medications that you use as a possible cause.

If your hair loss is related to MPB, there are medications (such a Propecia) that MAY offset it.

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August 1, 2007

Xalatan (Latanoprost) for Regrowing Hair? – Hair Loss Information – Balding Blog

Hi doctor,
I just wanted to know your opinion on xalatan (Latanoprost) on its effectiveness to regrow hair?
I ask because I have sparse eyebrows from overpluckig and was wondering if theirs anything I can do to regrow them.

Thank you

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Xalatan is a prescription drug used to lower eye pressure in people with high inner eye pressure or open-angle glaucoma. The stimulating effect of this medication on the growth of eyebrows and eyelashes and pigmentation of hair was accidentally found in a group of patients who were using topical Xalantan for treatment of glaucoma. This finding was published in the American Journal of Ophthalmology in 1997. Since then, many other studies have been conducted to evaluate the effect of Xalantan on hair growth in human and animals. Here’s one — Prostaglandin analogs for hair growth: Great expectations

Despite the above mentioned reports, Xalantan is currently not one of the recommended medications for prevention and treatment of hair loss and probably more studies are needed for its efficacy and side effects in comparison to other available hair loss medications.

As for the second part of your message — sparse eyebrows from over-plucking will likely result in permanent hair loss over time. Aside from using eyebrow makeup, hair transplantation is a possible option.

August 1, 2007

I’ve Been on Finasteride for a Decade – Is It Time for Me To Try Avodart? – Hair Loss Information – Balding Blog

I have been using Finasteride successfully for the last 10 years. In addition I recived progesterone scalp injections every 3-4 months in the same time frame. Lately ( the last 4 months)my front is thinning and something aint working anymore. I think the scalp injections may be novel and maybe never worked? However I split a 5mg finasteride, and take a 1/2 every other day.

Is it time to try the avodart? It looks like the dosage might be suspect.Can you take it at 0.5 mg everyday, as I realize the 1/2 life is longer than proscar? I am a 56yr old male,good health. please help!

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You need to discuss these issues with your doctor! I do not prescribe or inject progesterone in my practice since I see no medical or clinical benefit from doing it. I also do not recommend 2.5mg of finasteride since 1mg works just as well for the treatment of MPB. In other words, there is no benefit that I can see and the reports on the 1mg do seem reasonable. Furthermore, I generally recommend taking finasteride as directed once a day, since the medication is cleared from your bloodstream within 24 hrs. Before considering dutasteride (Avodart), I would try taking finasteride in the correct dosage and correct regimen. You suggested that the finasteride may fizzle out and become less effective. That may be, but are you willing to deal with more side effects with dutasteride? Before changing any medications, please consult with your doctor that prescribed you these medications.

August 1, 2007

I Have So Many DUPA Questions… – Hair Loss Information – Balding Blog

Hello,
I am a 23 year old male and am fairly certain I have DUPA. The hair on the sides and back is still pretty thick I think. However the hair on the top is thin from the normal hairline to the crown. It still isn’t that bad, I don’t think anyone would ever think I was going bald when it is dry, however whenever I exercise or go swimming it gets wet and almost looks as if I am malnourished or something; seriously. And God forbid it rain (I get extremely concerned when it rains and I’ve forgotten an umbrella) cause when it hits my head you can see straight to the scalp. My hair has always been very thin/fine ever since I was a child, but now I feel that it is getting worse. What I would like to know is if DUPA is not always caused by DHT, then what is it caused by? And it seems as though there aren’t many solutions to this type of baldness, except possibly Propecia, is there anything else? Also I have begun using Rogaine, is it worthless for DUPA? I know that’s quite a few questions, but to be honest that’s just the tip of the iceberg for me, I’m sure I’ll ask for more, Thank You so much.

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You should see a physician to get a firm diagnosis of DUPA (diffuse unpatterned alopecia). You may not have DUPA if you have thick hair as you describe in the back of your scalp. Propecia (finasteride 1mg) in particular works by blocking the DHT hormone which causes AGA (androgenic alopecia) or MPB (male pattern balding). Since DHT may not cause DUPA, Propecia may not be of any benefit. BUT… I generally recommend male patients try a course of it, as some patients with DUPA do get a response from the drug. Keep in mind, nobody really knows what causes DUPA and drugs such as Propecia and Rogaine have not been studied for the treatment of DUPA.

Thank you for all the questions, but please keep in mind this site is NOT meant for the diagnosis or treatment of any medical conditions.

July 31, 2007

Keeping Up with Hair Transplants Once Finasteride Loses Effectiveness – Balding Blog

Doc,

It appears that most of the hair transplant examples I’ve seen have tended to be transplants around the hairline (and hair combed back in most cases too) versus crown transplants. If one suffering from MPB were to undergo a hairline transplant and be on Propecia (for the crown) indefinitely, there will inevitably come a time (5+ years) when even the finasteride will wear out in terms of its effectiveness in keeping the crown hair. Does that mean that a series of hair transplants are required to “keep up” with the rate of hair loss overtime?

To give this question the respect it deserves, one needs to understand the natural progression of genetic male patterned balding. This is a progressive process that will eventually lead to a final pattern consistent with your genetically predetermined pattern. Look at the Norwood classification chart for hair loss and you will see a series of patterns. These can be the ‘end stage’ of the hair loss or they may be intermediate stages leading to a more advanced stage along the progression indicated in the Norwood scale. The problem is that you really do not know (for sure) where you will end up, but there are many ways to estimate where you might be by looking at:

Your miniaturization map of your scalp. The final pattern may very well show some degree of miniaturization, even if you are not frankly balding yet.
Your family pattern and see if you can identify (a) the worst case in the family or (b) the person whose pattern you believe you are following. Then you might be able to ascertain your final pattern (an educated guess).

If your final pattern is not the more advanced patterns (demand for hair) and if your hair density is adequate (supply), then you might be able to keep up with the progression of your balding as it is happening. If, however, the final pattern will be a Class 5, 6 or 7 pattern, you might not be able to keep up with the balding process with additional transplants because you may run out of donor hair (supply). The one clear point I wish to make is that you need to have a Master Plan to take in your worst case scenario and you must have a doctor who you can trust to work with you on that plan. The Master Plan has one objective and that is that no matter what happens, your hair restoration surgeries should always leave you with a natural appearance. Too many patients and doctors think in the short term, and think that the hair transplant will solve the problems of balding. That may not be realistic, so the relationship between the patient and the doctor is all important.

If you are having your first surgery when you are 24 years old and you are supposed to become a class 6 or 7 in the future, even though you are only a class 3 now, it is likely to assume that you need more than one surgery. On the other hand, if you are 35 and have almost reached the end of your hair loss process, you may be done with just one procedure and may never need another surgery. You have to understand that Propecia is not a permanent solution, but it does slow down the loss process in most men. Sooner or later, your hair loss will catch up until that final hair loss pattern is reached. Taking Propecia (Finasteride) may prolong the outcome, but the final pattern is probably inevitable.

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July 31, 2007

My Doctor Said I Shouldn’t Cut Proscar… – Hair Loss Information by Dr. William Rassman

the doctor that did my hair transplant told me that i “should not” use proscar because when the droplet of finasteride drips into the 5mg proscar pill, all the finasteride could be on one side. so when you cut the pill into 5th or 4th you might not get anything in a couple of 1/4 pills. is this true??

I highly doubt this is true. If this information is true, wouldn’t there be a chance that a “droplet” of the active medication (finasteride) can also miss the pill, making it a dud? This just goes to show you that have to be very careful about what to believe and what not the believe. Or hope that there is someone out there who is very careful about where they put the “droplet”.

The only concern I have heard about cutting Proscar in to 1/4 pieces is that the dosing may not be exactly accurate and that if you cut more than one in advance, the cut pills may be able to hydrate from the humidity in the air and then become less effective. I do not think this is of clinical importance. If you elect to cut the pill, but sure to store only one cut pill in a sealed small air tight container.

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July 31, 2007

Propecia and the Liver – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,

In an earlier post you said that it is safe to take accutane and propecia concurrently because they do not interact. However, is it possible taking both at the same time will lead to some kind of liver damage? Another, related question is: how taxing on the liver is propecia?

Thanks in advance for your reply!

The combination of these two medications is not reported to be causing any liver problems. Propecia (finasteride), like many other medications, is metabolized in the liver. Metabolism of this medication in the liver does not affect the function of the liver in normal individuals. If you have severe liver insufficiency, doctors may need to adjust the dose of Propecia, as well as any drug that gets metabolized in the liver.

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July 31, 2007

Why Doesn’t Propecia Work For Some People? – Balding Blog

Is propecia less likely to work if one is required to start it as a younger age (such a I, who is 18) as their is a higher level of testosterone present? Also when propecia proves not affective in a person why is this?

Thank you

It is not a perfect world! Some people respond to a medicine differently than others. I believe that all men with genetic balding will have some benefit of Propecia, but will the degree of benefit meet the needs of the patient? That is the question…

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July 30, 2007

Hair Loss InformationWoman Taking Propecia Is Experiencing Accelerated Hair Loss – Hair Loss Information – Balding Blog

I am a 42-yr old African American woman. I had hair restoration surgery in March 2006 for androgenic alopecia in the crown. For the last year and a half, I’ve been taking Propecia in pill form 2.5mg/day as well as topically. I’ve noticed since taking the meds, I’m experiencing diffuse thinning all over my head now. Have you heard of Propecia causing accelerated hair loss? Is this a temporary side effect? If I stop now, will my density return?

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Propecia (finasteride 1mg) is an oral medication for the treatment of androgenic hair loss approved only for use in men. It blocks a hormone known as dihydrotestosterone (DHT) which is responsible for hair loss in men. Propecia is not approved for women, because female hair loss is not necessarily caused by DHT and it may cause birth defects when women take the medication. Finally, only 1mg of finasteride is recommended for the treatment of androgenic hair loss. Taking 2 mg or 2.5 mg is not necessarily twice as better or effective. It will however increase the potential for more unwanted side effects. I would recommend that you see your doctor and address these concerns to him/her and or see another physician for a second opinion. This website is NOT a second opinion.

The question should be: Will taking Propecia harm me if I am not going to get pregnant? We really don’t know the answer to that, as the appropriate clinical studies were not done on women so safety and effectiveness are still up in the air. I couldn’t possible know the cause of your hair loss without an examination and a detailed medical history.

Also worth noting, Propecia is not available in a topical form or available in 2.5 mg strength.