Category: Drugs

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Hair Loss InformationMy Doctor Was Vague About Using Minoxidil and Propecia Together – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

My question concerns the reintroduction of minoxidil into hair loss management. I have been assessed as a norwood 3/3a by my hair restoration doctor in NYC — I’m 24, I noticed thinning at 19, and began using minoxidil 5% immediately. I used it for 4 years, maintaining most of my hairline, although losing some density, and about a year ago started taking Propecia. Unfortunately, around the time I started using Propecia, I lost some resolve, and stopped using the minoxidil. I noticed a dramatic change in my hair, with rapid receding near the temples. The Propecia seemed to be thicking the vertex, but not doing much for the hairline. 6 weeks ago, I had a 1900 graft procedure done (1300 to the frontal area, 600 between frontal and vertex area) and now I’m wondering if I should reintroduce the minoxidil along with Propecia? I’ve been using Propecia alone for 1 year, and my hairloss seems to have stabilized (i see very little hair on the pillow or in the shower). Is it worth it? What are the up/down sides? My doctor gave me a very vague response — something along the lines of “Sure, why not, it’s up to you.” I’m curious what your thoughts are on this situation?

Thanks!

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Relationship between you and your doctor should be a partnership and if you feel there is “vagueness” in his answer or you do not understand something you should approach him and ask your questions. When dealing with your doctor, be direct about not only the question of substance you are asking, but it you feel that he/she is evasive, say that and do not beat around the bush. Please remember you are the client and he/she is your hired agent and you can expect to hold your doctor to standards of communication so tell him/her that.

BaldingBlog is not meant to be a substitute for medical advice or second opinions. That being said, if topical minoxidil has worked for you in the past and you desire to start using it again I think it is your choice. I do not think it will negatively affect your hair transplants as long as it is after one week post surgery. It is my personal opinion that you should continue using Propecia. Minoxidil is not a substitute for Propecia, but it can be a good adjunct to it.

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Hair Grew Back Wavy After I Stopped Shaving My Head – Hair Loss Information – Balding Blog

Hey Dr. Rassman..My question might be a little stupid but I’m hoping you could help me out.. I’ve been on propecia for about 2 1/2 yrs now (I’m 26 yrs old).. During most of that time I shaved my head.. I grew my hair out recently and it came back very wavy. Since then I’ve noticed a large amount of hair shedding.. However the shedding is limited to only when I shower. Between washing my hair (40-50), towel drying it (10-12), and combing it (15), I see almost 80 hairs a day.. After that I put in alot of hair spray and gel and dont see a single hair fall out. Not on my pillow, not on my desk.. nothing.. Is the large number of hairs I’m seeing in the shower ones that just couldn’t come out randomly during the day? My hair is still fairly thick so I wasnt sure if they get caught in my wavy hair..

thanks for the help..

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It is normal to lose about 100 to 200 hairs a day. You may also benefit from following up with a doctor who can map your scalp hair for miniaturization to keep a quantitative record of your hair loss pattern as you continue your Propecia. With your hair short for many years, the hair loss you are now experiencing may have been happening with the short hairs such that you never noticed the fallout. The rougher you are with your longer hair, the more hair you may experience. Be gentle with the hair washing as hair that is miniaturized (impacted by genetic balding) is more far more fragile than thinning hair.

With regard to the change in hair character from straight to wavy, it is not unusual for hair character to change as we get older or as genetic balding starts to kick in. Stay on the Propecia.

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I Considered a Hair Transplant, But I Can’t Take Propecia – Hair Loss Information – Balding Blog

Hi Doc,

Thanks for such a wonderful site, it’s been very useful.

I’m 25 with thinning hair. I have taken propecia for couple of months but I have stopped it because of side effects. I have considered hair transplant but from what I read on your blog, you mentioned that it’ll be really bad to do hair transplant without taking propecia at the same time. So what are my options if I can’t take the drug, should I even consider transplant.

Thanks a lot.

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I don’t think I’ve ever stated that it was bad to have a hair transplant if you are not taking Propecia. If you can find a BaldingBlog entry where I did please let me know.

I often advise patients to take Propecia to prevent possible shock hair loss. However this is after a personal face-to-face consult on an individual basis and after I make an assessment of what the possible long term balding pattern might be. Everybody is different and there are many patients that have hair transplants without taking Propecia, but there is some risk of acceleration of the hair loss without it. The degree of miniaturization will be proportional to the risk of shock loss. There are some 25 year olds who do not have a great deal of miniaturization and they will be a lower risk for shock loss than a person with extensive miniaturization. Maybe a short term use of Propecia to protect yourself from shock loss would be worth trying. If you are considering a hair transplant you should see a good hair transplant doctor to have all your questions answered in person. Remember, there are some absolutes and if you have a hair loss pattern indicating extensive balding is probable, then you must be able to walk that line with your doctor so that you can keep you hair and understand the risks as well.

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Xanax and Female Hair Loss – Hair Loss Information – Balding Blog

(female) The last few months my hair has been thinning and my head tingles and I feel extremely stressed out… The upside of this is that I feel stubble and regrowth. My thining is all over the head but mostly in the front (bangs) I feel like it is ruining my life.. I dont feel like going out or working or doing anything! It sucks.. I used to love my hair.. I take xanax for my stress is that making it worse?? Or could it?? I got on it after my hair started falling out.. Since I feel stubble and regowth does it mean its growing back??? Thank you for your time! Have a great day!

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While many drugs are known to have a side effect of hair loss, it is relatively rare. You should always pursue if there is a treatable medical condition for hair loss. Hair loss in women have many, many causes and if it is not genetic, there is often an identifyable cause. You need to see a doctor for this who can give you a diagnostic work-up.

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Will I See a Difference Between Avodart and Propecia? – Hair Loss Information – Balding Blog

I’m 24 and for the past year I’ve noticed some light thinning near the front of my scalp. I wanted to start taking Propecia or Avodart to prevent further hair loss and hopefully regrow some hair. I’ve read Avodart is more effective than Propecia. Do you think someone my age with moderate hair loss will notice much of difference between the two?

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I realize there are many sources of information on the internet about both Avodart and Propecia. I generally do not recommend Avodart in my regular practice (although I have prescribed it on an individual basis) because of its very long half life (the time it takes for half of the drug to be out of your blood stream — which is in the order of many days). Propecia on the other hand has a half life of a few hours. Propecia (finasteride 1mg) is the only FDA approved medication for the treatment of male pattern hair loss. I would not therefore recommend Avodart over Propecia until you go through a trial on Propecia for a minimum of 12 months. The rest is up to you and your doctor.

Remember, before starting any medication you should first consult with a medical doctor to quantitatively record your current miniaturization hair loss pattern with a hair densitometer so you can follow-up up in 6 to 8 months to see the effects of the medication.

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Coversyl and Propecia – Hair Loss Information – Balding Blog

I have been on propecia for about 8 years, so far so good. Recently I am on “Coversyl 4mg” to control my blood pressure. I understand most of the high blood pressure drug will cause hair loss. If this drug does, can propecia reverse the effect? I am worried cause it takes me 8 years to maintain reasonable “amout” of hair. Hope to hear from u soon. Regards

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Many drugs have the potential side effect of hair loss and antihypertensive drugs are amongst them. If your hair loss is from the side effect of a drug, then it will not respond to Propecia. Speak to your doctor about this drug. Is there a one-to-one relationship? I mean, did the hair loss start exactly at the same time as you started to take the new medication?

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Major Hair Loss After Depo Shot – Hair Loss Information – Balding Blog

I recently got my first shot of depo and it has been going good until now. I started losing ALOT of hair. I have naturally thick hair and have never had an issue with it falling out. I fill the drain in the shower then fill a brush after the shower. It started happening about a month ago and i can feel the differance in it already. I have read that it happens with the depo but will it come back and how long will it keep falling out like this?

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If you are talking about depomedrol, it is a steroid and it is a know cause of hair loss. In men with genetic hair loss, it may precipitate permanent acceleration of the hair loss. If you stop the steroids and possibly take Propecia (assuming you are a man), then it might take a few months before you may see new hair growth once the offending agents disappear.

If you are a woman and are talking about Depo-Provera, then birth control pills are known causes for hair loss in women. If you stop the Depo-Provera, chances are that the hair loss will reverse in a number of months. Be sure that your doctor is managing the process and is checking you out for other causes of hair loss. Ask your doctor about alternative birth control to this medication.

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Hair Loss InformationShen Min, Hair Loss, and Foolishness – Hair Loss Information – Balding Blog

hi ..im 25 yrs old and have started taking an herbal hair growth supplement called Shen Min …100% all natural …ive been on it for about a week and notice my hair is falling out more..especially when i wash it i have more hair end up in my hands..i read in some posts that this is normal…but man i dont wanna lose all my hair if it’s not normal….should i stay on it ??

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First, let me say that losing hair may be normal for you. What you want to do is postpone what is happening to you as long as you can and reverse it if that is possible. Clearly what you are doing is not working, right? With that as a focus, read-on!

I’m speaking here as a physician in the United States, so my comments are based on regulations (or lack thereof) in the USA.

Herbal supplements are not regulated by the US government or health agencies, because they are not medication. And because it is not a medication, it should not make medical claims. When it comes to herbal supplements, it is a “buyer beware” market. Shen Min is making medical claims that have no basis that convinces me that it has any more value for growing hair than rubbing grass on your head.

No matter how many times I write about the many unproven products out there for hair loss, there seems to be a neverending barrage of people looking for magical cures for things that have no magic to it and is only a shortcut for disasterous hair loss. What surprises me is that men will do anything possible to avoid really solving their hair loss problem. Every day that a balding man loses in addressing his hair loss properly, is a step he’s taking to becoming balder and balder and balder and balder… until there is permanent balding. I sometimes grow frustrated with saying the same thing over and over again, but I will persist because it is important to educate people. Get a proper diagnosis by getting your hair mapped out for miniaturization , and then if there is genetic balding, finasteride is the only FDA approved oral solution for stopping or reversing it. As a hair transplant surgeon, I make my living putting hair back in the bald man, but if you think this through, why would I tell you the way to avoid my transplant option? The answer is clear to me — it is best for the patient. I even mapped out the hair on one of my sons and put him on Propecia because I knew, I absolutely knew, he had genetic balding. Much of the hair that he was losing reversed and unlike the person who asked the question about Shen Min and got sold a bill of goods, my son got what he wanted — his hair back.

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My Doctor Told Me Propecia is a Feminizing Drug – Hair Loss Information – Balding Blog

A dermatologist prescribed propecia to me, telling me it looks like I have MPB, but my GP told me that I shouldn’t take it because it’s just a “feminizing” or “demasculinating” drug. I have hesitated using it out of fear of both the reported side effects and the limited long term studies done on this hormonally-influencing drug. Can you comment on these concerns? What is your advice? Where can I go to get a thorough and proper examination? And about how much does that cost?

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I do not like using the word “ignorant”, but according to the Merriam Webster Dictionary, your GP is “lacking knowledge or comprehension of the thing specified”.

Propecia (finasteride 1mg) is a drug that inhibits testosterone from being converted to dihydrotestosterone (DHT). DHT is responsible for male pattern hair loss. Propecia will not make you into a woman or produce changes that are characteristic of women. Some of the side effects of Propecia are an increase in libido (possibly is frequently 1 in 10 people in the first few months of treatment as the testosterone rises) or decrease in libido (1 in 100). The long term (5+ year) studies done on Propecia shows benefit for male pattern hair loss, thus it is the only FDA approved drug for that purpose.

If you need further information and an evaluation of your MPB diagnosis, I would be happy to see you and answer all your questions in person at my NHI office in Los Angeles. Just reference this BaldingBlog post when you see me.

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ScalpMed and Propecia – Hair Loss Information – Balding Blog

I started Scalpmed and stopped taking Propecia. About that time I experienced hair loss. That was about 4 months ago. I thought that Scalpmed would do a better job. Do you think that it was not the right thing to do?

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I would suggest that you get back on Propecia, for its possible benefits. The result of stopping Propecia means that you played “catch-up hair loss” which means that you lost all of the benefits of the drug, something that happens over a period of about 4 months. I have seen some wonderful results and am generally enthusiastic about this drug as part of a master plan for stabilizing hair loss (at a minimum), but without the drug, you are exposed to the impact of DHT on the genetically impacted hair follicles.

ScalpMed appears to use minoxidil as an active ingredient but it does not stop the DHT from doing its job. Restart Propecia and pray. For more on ScalpMed (or Scalp Med), please see here.