Category: Drugs

I want to know everything that you know about the connection between Hyaluronic Acid and hair loss. Why are there no products on the market combining this powerful connective tissue component with Minoxodil? Why can’t they just make a line of products that target hair loss from all ends, like tartar control, whitening toothpaste that fights gingevitis? By combining hyaluronic acid with collagen and minoxidil and DHT blockers wouldn’t hair be at its safest and sturdiest? Also, how come some people will have plenty of DHT and still not go bald? What is the specific chemical quality that constitutes vulnerability of a specific hair folicle to DHT? Instead of inhibiting DHT and affecting muscle mass, secondary sexual characteristics and sex drive, can’t the individual hair folicles be made immune to DHT’s causing hair growth to be inhibited. After all, isn’t DHT what made hair grow out of that folicle in the first place? I know I’m a bit of a hurricane, but I’m in love with a balding man and find myself as invested in his plights as he is, and I can see he is suffering from this.

I found an article on the FDA website which addresses hyaluronic acid. See Science Meets Beauty: Using Medicine to Improve Appearances and do a “find in page” (usually CTRL+F) to search for hyaluronic acid.

DHT is only bad when you are talking about hair loss in genetically prone individuals. Maybe one of our ancestors understood the benefit of balding, but we have not figured it out. There are many solutions for hair loss in men. Propecia is a great drug if the hair loss is caught early enough. Also, hair transplantation works well for many people (see Before and After photos).

Dear Dr. Rassman,
From all the information out there, I still can’t seem to find a clear and definite answer as to which products actually work in regrowing hair. I’m in my early 50’s and only have a bit of thinning going on around the crown area on top. Which product would be best for my situation? I would like to see it get thicker again in this area. Also, I’ve heard that using minoxidil may work for some, but ceasing use can actually cause more severe hair loss than before starting to use this product. Is this true?

Minoxidil works great in about 15% of people, but it must be applied twice daily. In about half of men there will be a mild effect. The older you get, the less effective Propecia is at regrowing hair, but when it works, it works well in the crown. Both of these medications must be maintained to hold their benefit and when they are stopped, the body loses all of the benefits in months and brings you back to the base line of hair loss, which is where your hair would be had you never taken the medications. For this reason, if it works, you must stay on it for life. There are dozens of other products sold with promises galore, provided you want to part with your money. Most products that are sold over the counter, if they work at all, have minoxidil in it, so I generally recommend buying minoxidil at the supermarket or Costco for far less money than when it is sold inside some other potion or lotion and not clearly marked.

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I have been on propecia for 3 years, now I am 24 and the effects seem to be wearing off. It has worked well to stop loss up until now. What would cause it to stop working and how can I combat this? Is there something else I can take? What about avodart?

Thanks a million!

Unfortunately, Propecia (and probably Avodart) will eventually stop working in men with an aggressive genetic hair loss predisposition. In these men, you need to have a Master Plan to determine what you might do when the drugs stop working. In many young men taking Propecia, the effects over time will decrease, but when it does, you should not stop taking it because then you will experience what I call ‘catch-up hair loss’, which means that you will lose all of the benefits of the drug over the previous years within months upon stopping it.

Some doctors who prescribe Avodart are reporting better results in men like you, but this is still no miracle cure. Even if the Avodart works where Propecia fails, the Avodart will eventually fail as well.

I am a 33yr old male. I first experienced hair loss at age 23. At age 25, Propecia was available on the market so I tried it. I got good results but decided after going back and forth a few times that I did not want to have to get a prescription and take a pill every day. Is there any other proven remedy? I notice celebrities such as Tiger Woods, Matthew McConaughey, Eric Lindros, and Bruce Springsteen to name a few, reverse their balding trend. Help me make the most informed decision please.

Propecia will help reverse some of your hair loss at a young age. Stopping it is not a wise decision. Although Propecia is a wonderful drug, I believe that this drug has its limits and will not reverse balding that is stable like a hair transplant will. There are many celebrities that I know of personally who have had multiple hair transplants and continue to take Propecia to prevent further hair loss. I only wish they would let me use their names, however I respect their wishes and take patient confidentiality very seriously.

I have used the 5% Minoxidil solution for nearly two years as directed, ie., twice a day. While it seems to have worked with my hair loss, it seems that my sex drive has waned. Also, when I do, it seems erections aren’t what they were before. I am 46 and in otherwise good health.

Are there any indications that long term use of Minoxidil (like I have used it) has any effect on either a male’s sex drive or erectial function? Thanks in advance.

There are no known sexual side effects from topical minoxidil (also known as Rogaine). This is a drug that has been around since the 1970s (it was originally a medication for high blood pressure) so its safety and side effect profile are pretty well known – even for patients who have been on it for decades. It does work to strengthen hair growth.

There are several other possible causes for loss of libido not least of which is the pervasive rumor that “hair loss medications” cause decreased sex drive. While decreased libido/erectile dysfuntion is a rare (+/- one percent) and temporary (1-3 days usually) side effect of Propecia, it does not occur with minoxidil use to our knowledge.

Finally, (for the rest of you readers out there) it bears repeating that human beings are highly suggestable – if you tell someone, man OR woman, that they might possibly have a side effect or if they even just THINK that they will have it, they will often manifest it for you. (It is often joked that this goes double for guys when it comes to their manly functions but both sexes will have this effect.)

Back to the original writer of this blog entry – this is not to say your symptoms are not real – I believe they are. If you persist in having significant symptoms of decreased sex drive or erectile dysfunction, I’d HIGHLY recommend you talk about it with your doctor. In the meantime, I can reassure you that you may continue to use the minoxidil without fear that it is causing your symptoms.

Dr. Rassman, Are there any alternatives for someone who has developed side effects from propecia. I began to develop gynocomastia from it after three months and I am no win the process of looking for something else to slow down hair loss.

Also, thanks for having this blog!! You rock!

Gynecomastia (painful nodules that appear in the male breast) is a rare complication/side effect from Propecia. I believe that even Avodart has the same side effect. My heart goes out to you. Get a good Master Plan, which may be critical to defining what your future hair loss has in store for you. Minoxidil may help as well, but it usually does not stop the hair loss in the young man.

Hello Folks,
I have been using finasteride 2MG daily and found no issues related to Sex drive. However what I find interesting is that the hair shedding has increased to a very high extent i.e more before using drug. Is this normal? i found that this is due to movement of hairs from telogen to anagen phase. Should I stop the drug? Increase the dose?
Thanks

I have no patients that have complained of shedding from Propecia, yet I have been asked about it in emails via this blog a few times. I probably have more patients on Propecia than any doctor in California, so I find it interesting to hear about the shedding problem that is reported to me here. My best advice is to continue to take the drug. What you might be seeing is some accelerated hair loss in its normal cycle, which hopefully will be addressed as the drug kicks in.