Category: Drugs

Hello doctor,
I am a 19 year old student suffering from hair loss since I was around 17. As you would know this is normally a very young age to begin losing hair. My mothers side of the family unfortunately seem to have the baldness gene, with all of her brothers being bald.

I recently saw a doctor whilst abroad who confirmed for me that I was indeed losing my hair and that I was beginning to thin around the sides. He recommended and prescribed Tricovivax to me. I wanted to know whether it would be safe for me to use especially at my age and whether or not I should begin to try it.

I have been using Alpecin caffeine shampoo but that doesnt seem to be doing anything at all to be honest, My hair gets greasy very very quickly and I normally have to wash it once a day, I also tend to find I have a dry skin on my scalp after I wash it. I am considering starting propecia but am worried of the side effects. Please advise, any information would be highly appreciated. Thank you

Tricovivax is just a brand name of minoxidil sold in some international markets. Minoxidil is also known as Rogaine or Regaine, depending on where you live. At 19 years old, I don’t see a problem with you using minoxidil. It works best in the crown, but I don’t know where your hair loss is.

I wouldn’t expect caffeine shampoo to do anything to treat hair loss.

Hey doctors,
I know there’s all this debate about Propecia and ED……and whether or not there’s a placebo effect or the power of suggestion at play. Have you seen this study from 2008?

Link: The effect of 5 alpha-reductase inhibitors on erectile function

This was published in the Journal of Andrology in late 2008, but I don’t remember if we wrote about it before. Thanks for sending in the link.

Based on this study, finasteride was associated with a significantly higher proportion of erectile dysfunction (ED) in patients that were informed of possible erectile side effects as compared with patients for whom the same information was withheld. For patients taking the 5mg finasteride to treat BPH, the incidence of ED was 9.6% for the group without counseling and 30.9% for the group with counseling (source: Mondaini et al, 2007).

The abstract concludes: “We conclude that 5 a-reductase inhibitors do not lead to erectile dysfunction to a significant degree, and we support the position that dihydrotestosterone is less relevant than testosterone in erectile function.”

Hello
I have been on Finasteride 1mg for a year and had controlled the hair loss totally. Also had seen some thinning areas getting thicker and almost no side effects,but some months back i visited a skin doctor for some skin rash. Later while leaving I just mentioned that I used finasteride and he then told me i should try Dutasteride 0.5mg, which he claimed to be safer and greater results. But now i have been on it for four months have been losing lots and lots of hair everyday, front hair line which was earlier thicker is thinning rapidly.

i just don’t know what to do? should I go back on finasteride 1mg and again wait for months for it to kick in or wait and complete 6 months of dutasteride?? is dutasteride not suiting me cause of my life style of heavy workout and hi protein diet? I had read somewhere that dutasteride releases high scalp testosterone ….plz advise

This is an unusual complaint, as dutasteride is at least as effective as finasteride. It is possible that if you have genetic hair loss, it is accelerating. I don’t know why your doctor would say dutasteride is safer than finasteride, but I didn’t prescribe either medication to you and I can’t give you dosing advice or a treatment plan. Get to see a specialist to address your issues.

Hello,
I am a 19 year old male, I noticed my hair started thinning 1.5 years ago after starting college. I do a lot of aerobic sport and I think that I have a balanced and healthy diet.

Since 5 months I’ve been on Propecia prescribed to me by my dermatologist. Since then I haven’t seen any difference in the amount of hair I lose everyday, although during exam periods with a lot of stress, I seem to lose more hair than usual (this over a period of 4 weeks).
Since starting, the top of my head has thinned quite a bit to the point that you can see parts of my scalp under light.

A lot of the hair I lose (other than thick hair) seems to be new hair (thin hairs, with “pointy” ends). I notice small bulbs on many hairs too. I also have a tiny bit of dandruff in my hair since starting propecia. Ever since I started losing my hair, each time I run my hand through my hair I get 3-4 strands… This is on any part of my head (sides, back, top).

I wanted to know if Propecia is working for me or if there a way to check if I am responding to the medication? Thank you

In general, Propecia takes about 6 to 12 months for one to see the effect. You can also continue to lose your existing hair while on Propecia, and one must remember that the medication is not a cure and it does work better in some patients (each patient is different).

If you want to know if Propecia is working for you, follow up with your doctor. Hopefully, there were some good pictures taken before you started and maybe even miniaturization and bulk measurements were documented, which are scientific ways to determine if the drug is working. Otherwise, it is just a guess and your own subjective opinions.

Results of dutasteride trials have been nothing less than impressive, particulary the study conducted by Olsen et al (2006) indicating that dutasteride at both 0.5mg and 2.5 mg/day generated a superior hair count to finasteride 5mg at 12 and 24 weeks. Anecdotal evidence has also suggested that dutasteride is an optimal hair loss treatment; www.twinhairloss.com is exemplary of its efficacy, in addition, the many thousands that are using it for hair loss purposes. I have also been in correspondence with one of the twins in this study. He has been on a daily dutasteride dose of 0.5mg since day one and the results are astounding.

Additionally, dutasteride has now been approved in Australia as a hair loss treatment since mid 2011. Despite not being FDA approved, is the current literature and anecdotal evidence still not enough to substantiate that dutasteride is a superior treatment to finasteride?

Thank you.

I haven’t heard of such dutasteride approval in Australia as a hair loss treatment. I can only find a public assessment report from Australia’s drug regulatory agency (Therapeutic Goods Administration) dating to January 2011 about the drug being approved for treating BPH, which is what the US FDA also has approved it for. Do you have a link handy so I can read more about the approval since mid 2011?

There is evidence that dutasteride is superior to finasteride for treating hair loss, but there are probably more complications, such as loss of libido, with dutasteride. And more importantly, the subject of sterility is still an open issue as far as I am concerned.

I generally prefer my patients to try finasteride first, and if it fails to achieve the desired goals and the patient is aware of the risks discussed above, then I have written prescriptions for dutasteride after I’ve developed a relationship with my patient. It is on a case by case basis, though.

Doctor there was a topic about pro hockey player ryan getzlaf.

this is my question:

if ryan getzlaf had taken propecia at the first sign of hairloss, do you think he would still be to where he is today? or is there a good chance he could of of maintained what he had or freezed the hair loss clock by a decade or so?

my other question is: how come alot of people who show the first sign of hairloss dont go on propecia? I mean its proven to work, why not take it? how come they just let the thinning continue? I see alot of celebrities young males and pro athletes who are losing hair, and why not just take propecia? I mean they can afford it.

Propecia is an elective medication and it is only available after consultation with a physician after a good examination and understanding of its limitations, risks, and benefits. It may not always happen this way, but it should be. Propecia does not necessarily stop hair loss or reverse hair loss completely, but it does work to buy time for most. In the end, your genetic predisposition will eventually catch up and you may lose hair despite being on Propecia. This does not mean the medication is not worth taking or that the medication has stopped working.

Finally, it is not as simple as taking Propecia at the first sign of hair loss. You need to be followed by a doctor who can give you a Master Plan for the hair loss.

Doc

Have you heard anything or have any idea when the phase 2 bimatoprost studies will be out?

Happy new year to you and your staff.

You’re referring to the study comparing bimatoprost and minoxidil for use on the scalp, which completed the phase 2 a few months ago. The results haven’t been posted yet, as far as I can find.

Check it our at the ClinicalTrials.gov site — Safety and Efficacy Study of Bimatoprost in the Treatment of Men With Androgenic Alopecia.