Category: Drugs

Hello Dr. Rassman. First, a huge thank you for this great site. It is an island of real medical information amidst the sea of misinformation of hais loss.

I have a question I believe has not been asked before. Can the switch from finasteride to dutasteride cause catch up loss?

After 4 years on 1.25mg of finasteride, 3 months ago I added 2.5g of avodart daily for two months, lowering the dosage to 0,5g daily after that. I mantained finasteride for the first month of avodart and stopped taking it since about two months ago.

As of now I am experiencing massive shedding all over the scalp (including the sides and donor area), with the characteristic white bulb of a telogen effluvium. Could this shedding be catch up loss from not taking finasteride, causing permanent damage, or does avodart “picks up” that protection and is just normal shedding from switching medication? Is it reasonable to expect my hair to grow back? I discussed this with my doctor, but he simply does not have your knowledge. I returned with my daily 1,25 of finasteride a few days ago, just in case, and will maintain a low dose of avodart for extra dht suppression.

Thanks for your time!

Changing many factors makes an analysis extremely difficult. I haven’t heard of a switch between medications causing catch-up loss, but I’m not sure why you were taking both medications and changing doses so much. Did your doctor prescribe this method?

Since you’re going back to your finasteride routine that worked for you before, I’d give it some time to see what happens. I’m not sure why you experienced a massive shed, and it’s particularly troubling that it occurred in the back and sides of your scalp. If your doctor isn’t knowledgeable about treating hair loss, you should try to find one that does. You should have your scalp examined and baselines measured so that you can know for sure what any treatment is doing (good or bad).

I said this many times, and it may not be something you want to hear, but in the end your genetic predisposition will win out. It is really not about total DHT suppression.

Im a male of 20yrs but i hardly have any facial hair. i’ve always wanted a thick Goatie beard but i dont have any hair there. is it good to use Rogaine or Propecia?? plz help.

Thanks for the help 🙂

Rogaine has been known to grow hair in the skin and it might help facial hair, but the hair will probably not be strong like a real beard. You’re 20 years old, so your best bet would be to just wait a little longer to see if the facial hair starts to come in on its own. Some men just have very little facial hair in general, though.

Propecia won’t grow a goatee.

I just wanted to see what your thoughts were about my “theories” in regards to Minoxidil 5%.

Firstly, I have read online about how it has caused erectile dysfunction, anxiety, heart palpitations, etc.

Are there any studies that show that these are legitimate side effects, or are they just symptoms listed by individuals? I think it is highly possible that these individuals could be effected by the listed side effects due to psychological issues due to their hair loss, and assuming the minoxidil is causing these physiological symptoms.. What do you think?

Secondly, do you think that the failure rates of minoxidil are due to people who stop using the solution too early on, rather than the minoxidil not “working”?

What you read on the web isn’t always true.

The official reported side effects are listed on the minoxidil insert and the drug profile (see here). Minoxidil taken orally in pill form is a blood pressure lowering mediation, so it is conceivable you can get lightheartedness and heart palpitations if your body absorbs too much of the topical. Chest pain and fainting are also possible if you’re sensitive to the medication. Erectile dysfunction is more likely to be due to a psychological issue or an underlying medical issue, rather than minoxidil.

With respect to the failure rates of minoxidil, I believe it is partly because of compliance issues. Many men and women have a hard time adhering to a twice a day schedule, and therefore do not get the full benefit of the treatment.

When applying rogaine, does it matter where you apply it on the scalp for it to work? Doesnt it get absorbed in the blood vessels and spreads out throught out your scalp?

For example if you apply it on the top wouldnt it work for the front as well, or does it have to be applied on the exact area of hairloss? Thanks

I would follow the instructions including in the packaging. The basic idea is that you apply Rogaine (minoxidil) where you want hair to grow, twice daily. If you apply it on the top, it wouldn’t really do much for the front.

Hi there doctor rassman
here is a study on minoxidil injected to the scalp vs topical treatment – Egyptian Dermatology Online Journal

The injected minoxidil was done 2 times and then one time a week and yielded greater results than topical treatment.

This is clearly not an approved study; however, I would not doubt the results reported by the Egyptian doctor. Minoxidil was originally an oral medication for the treatment of high blood pressure, and it worked, though not well.

At an ISHRS meeting a couple of years ago, it was reported that minoxidil by mouth or intramuscularly could reverse hair loss and was a common practice in India. We know from the old studies on the oral minoxidl that systemic administration produced excess hair production in different parts of the body.

I will not be offering it in my practice until the FDA comes out in favor of it, but it is interesting research.

Is it safe to take my prescribed thyroid medication (desiccated) and carbamazapine (seizures) at the same time I take propecia?

Would two hormone affecting drugs (thyroid & propecia) taken together interact. Or carbamazapine interact?

Thanks for the website.

I don’t know of any interactions between desiccated thyroid, carbamazepine, and finasteride. You can probably take them at the same time, but you should discuss it with the doctors that prescribed the medications to play it safe.

Can you tell me if this could prevent minoxidil from working? Liquify the foam so you can apply it with a dropper. Fill the cap with foam. Hold the cap in a glass that’s filled with hot water. The foam will melt. Then apply with a dropper.

I do this because I get irritated by liquid Rogaine and I find that the foam doesn’t reach properly the scalp.

I haven’t heard of this being done before, but I’d think that this is a reasonable solution to your problem.