Category: Drugs

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Maturing Hairline at 18 Years Old – Hair Loss Information – Balding Blog

Hey doc, I’m 18 years old and I have long wavy hair. I’ve noticed that my hairline is receding in the front…more so on the right side and a few small bald circular spots in the front. My dad is in late 50’s and he has a head full of thick hair while my mom is in her 40’s and is showing signs of baldness. However, she is constantly stressed out about various issues so I’m not too sure if its heridetary. My grand-dad passed away in his 50’s and he was balding. I tried shaving my head before and i look absolutely horrible! Is there anything I can do to promote the regrowth of my hairline? I am not exactly the Brad Pitt look-alike and my hair was the only thing I had! Are there any new treatments under development and on the market that can do something about this dire issue? Thanks for your help.

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What you are reporting is the maturation of your hair line, which occurs between the ages of 17-29 in most caucasian men. The corners rise about 1 to 1 1/2 inches and the center rises about 1/2 inch to 3/4 inch. To see if this rise is normal, look into the mirror and lift your eyebrows up. There is a high crease, which reflects the top of the Frontalis Muscle, the place that hairline transition zone usually starts in boys and most women. As caucasian men go through an aging process (I like the term maturing process) where the hairline rises as discussed above, but for many non-caucasian men, the hairline is flatter and does not rise as far in the corners or not at all. If you have sisters, have them lift their eyebrows and look at that crease and you will see hair just touching that crease. This is a normal male process and nothing to be concerned about, provided that it does not rise higher than the measurements I just referenced. If it does, or if a doctor examines you and determines that you have miniaturization (too many fine hairs behind the mature, adult hairline location), then you may have early male patternedgenetic balding and the best drug to slow or prevent hair loss is Propecia. I have seen many wonderful, miraculous results from this drug in young men. Propecia has been on the market for about 7 years and it is safe. My son, many members of my family, and I take this drug and none of us has defined any negative side effect, sexual or otherwise.

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Hair Loss InformationHow Long Until Hair Regrowth with Medications – Hair Loss Information – Balding Blog

Hi DR,
i have been through all the entires in the blog and find it quiet useful… here is my problem/question…

I am almost 26 yr old male and experiencing considerable thining. This probably started 7 months ago although it was not that noticeable and there was considerable self denial on my part. My frontal hair are thinning althogh my hairline is maintanied and now even the crown area is thinning considerably. It a very emotional rollercoaster for me and i’m feeling depressed. today I started on propecia and saw palmetto and maybe i ll use nizoral shampoo too. I want to know how long will it take to see a complete stoppage of hairloss and regrowth of new hair ? I may be a BIT late in starting but the thinning started occuring 6 months back and considering that I had a head of full thick hair until october last year… I was in total self denial that my hair was thinnnig. My dermatologist confirned its a case of MPB since my dad started losing his hair in his very late 20s. I am not even married and its very emotionally distressing :(. What are my hopes ?? Also will a sinus surgery(with local IV sedation) cause any further hairloss on me or contibute ?

Please write back. Thanks

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With a 7 month history of hair loss, there is sill a possibility of controlled loss or reversal of some or all of the hair loss within the first two years you are on this medication. You must wait this out. I would recommend against taking Saw Palmetto with it, as there may be competition for the DHT enzyme sites between the two medications making the Propecia less effective. Any added stress can impact the rate of hair loss, and sinus surgery is no exception. Still, if you need the sinus surgery, do it and continue to take the Propecia regularly.

Good luck.

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Hair Loss InformationSignificant Hair Loss on Propecia – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

About two years ago, I started taking Propecia for my hair loss and stopped after three months because at that point i noticed a drastically increased rate of hair loss, and assumed that I was reacting negatively to the drug(one hair loss specialist suggested that it is possible that my tissue became hyper sensitive to DHT because of the drug, but I did not experience any increased acne or libido, which he said would also be indicative of that rare kind of reaction to Propecia). Eventually I decided to try Propecia again, and now I have once again reached the three month mark, and once again, like clockwork, I am seeing significantly more hair on my pillows, in the shower, etc, than what I had when I was off the drug, but no acne or increased libido. I am wondering if you think this means the drug wont work for me or if it is just a temporary phenomenon that I should wait out, and that I will probabely still benefit from Propecia. I understand that some people experience sheds while on Propecia that are a sign the drug is working, but have heard that this should happen within the first two weeks of using the drug, not so long as three months into it. Thanks very much for your time.

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I believe you must stay on Propecia for 8-12 months. Stopping and starting your taking of the drug is not a good idea. There have been some reports that hair cycling changes in a small number of people with Propecia, such that more of the effluvium (loss) side occurs at the beginning but the anogen (building stage for hair loss) will follow in 6+ months. It does not sound like you have given it enough time. This is a most unusual complaint, one that I have personally not seen in my practice but one that has been reported by some of my colleagues.

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Non-Hair Benefits of Propecia – Hair Loss Information – Balding Blog

I read something that suggests that Propecia has other benefits besides hair loss. Is this true and if so, you you expand upon it?

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Finasteride has many suspected benefits. Those that I’ve observed include better urination for elderly men with a poor urinary stream, less nightly urination (for people who may have early prostate enlargement) and an increased sex drive in about 1 in 10 men of all ages. Other potential benefits might include a slowing of the buildup of new hair in the nose and ears, a slowing of the building of new hair in the chest, and based upon a new article in the literature (J Dermatolog Treat. 2005 Apr;16(2):75-8) a new treatment to control symptoms for people who have a sweating disorder (Hidradenitis Suppurativa).

The greatest benefit may be the reduction of risks of prostate cancer, something that all men, if they live long enough, will develop. This has been well documented in the literature.

The dose for all of these potential benefits were obtained when finasteride was given in 5mg doses, but some people feel that similar benefits may be obtained with the lower dose of finasteride in Propecia.

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Higher Scalp T Levels with Avodart? – Hair Loss Information by Dr. William Rassman

Dr Rassman
Have you heard any speculation concerning the significantly higher scalp T levels with Avodart vs Propecia and long term hair implications?

Thank you

Testosterone increased 4.4% for Finasteride, 6.4% for 0.05mg Dutasteride, 16% for 0.1mg Dutasteride, and 27% for 0.5mg and 2.5mg Dutasteride. Although the rise in Testosterone may seem high, the Testosterone levels were almost always within normal range according to Roger S. Rittmaster, MD.

Scalp DHT measurements were also assessed for both DHT and Testosterone. Scalp DHT was decreased 27% for 0.05mg Dutasteride, similarly for Finasteride (38%) and Dutasteride 0.1mg (37%), 54% for 0.5mg, and 82% for 2.5mg Dutasteride. Rittmaster concluded that these results show that most of the DHT in the scalp comes from type 1 5-alpha reductase.

Scalp Testosterone rose 24% for Finasteride, 46% for 0.05mg Dutasteride, 44% for 0.1mg Dutasteride, 104% for 0.5mg Dutasteride, and 154% for 2.5mg Dutasteride.

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Side Effects by Taking More Propecia Each Day? – Hair Loss Information – Balding Blog

Hello Dr. Rassman,

I am a 26 year old male, and have been losing my for about 4-5 years now. I’m currently a Norwood class 3.

I am using 2milligram of Propecia daily as it seems to work much better for me than 1 milligram. This might be because of my size (I’m 6’3″ and 205 pounds). I had tried one milligram daily, and still noticed substantial fallout. This fallout was hampered once I started on the two milligrams daily.

My question is weather or not the 2 milligrams of Propecia I am taking can come with any side effects, and weather or not it is completely safe to keep up with the 2 milligrams daily.

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If you are not having a side effect at the 2mg dose, then I suspect that you will not see any side effects over time. I do not see a down side to taking the larger dose. The official dose response studies that I am familiar with show that 1mg is as effective as all higher doses and I believe that the studies take it to 5, 10 and even 20 mgs in one doctor’s case. I am not recommending higher doses but it it works for you, I do not see a problem with the 2mg dose.

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Why Is Avodart Not Approved Yet? – Hair Loss Information – Balding Blog

I keep reading and seeing all these photos of people using Avodart and the results are amazing.Why is this drug not FDA approved.I really want to start a new game plan with my hairloss.I can not afford anymore hairloss.

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This drug is approved by the FDA for the treatment of prostate enlargement. So while Avodart has been deemed safe for treating the prostate, it is not approved for hair loss. The drug is currently targeted towards older men, but any drug for hair loss would probably be targeted at a younger market. I am not an expert on the toxicology of drugs, so I can not comment on the effects of Avodart use by the young man, however, I do believe that there may be indications for use in young men, such as those who are failing to get their hair loss under control with Propecia, for example. I am not the manufacturer or the FDA, and without clinical trials and proven scientific results about the use of Avodart in hair loss, I can’t have complete confidence of its efficacy. A doctor can elect to prescribe this drug ‘off label’ if the doctor is comfortable with the medication use.

I’ve answered quite a lot of Avodart questions on this blog. Here’s a quick roundup of some of the past Avodart posts:

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Hair Loss InformationHair Loss at Age 16 – Hair Loss Information – Balding Blog

Hello Doctor. I’m a 16 year old boy with a family history of MPB. My father (who is almost completely bald now) told me how he started balding in High School and was almost completely bald when he got out of college. I recently noticed my hair line receding. My hair is somewhat long so it’s easy to cover up, but I was wondering if any treatments can help stop, or delay my fate. I’ve been to my doctor to ask about Propecia, but she recommended against it, saying I’m too young, and opted for Rogaine or it’s generic counter-parts instead. Is there anything I can do?

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In young men your age, it is unclear if an aggressive hair loss pattern will respond to Propecia as well as if the hair loss started later in your life. The data is not in. With that said, I do not believe that you are too young for Propecia. I feel strongly that Propecia is the only drug that can help you slow or stop the hair loss. If your doctor does not have a better solution, get another opinion. Minoxidil just will not stop the hair loss that you will have, assuming of course that you follow your father’s pattern (a likely scenario based on what you’ve told me here).

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Taking Propecia While Trying to Have a Baby – Hair Loss Information – Balding Blog

I have been taking Propecia for about 8 years. My wife and I are anxious to have another child. I completely stopped taking Propecia for about 5 months when my wife and I started trying to have our first child two years ago as I was afraid of side affects. He is perfectly healthy. Was that necessary or advisable? Should I stop taking it while we try to conceive again? Thank you.

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There are many answers to this question depending upon the doctor and his interest in practicing and giving advice on what could be sensitive medical legal issues which are at time at odds with what is in your best interests. Very little, if any, Propecia comes from the sperm into the woman’s womb. Merck (the manufacturer of Propecia) does not warn men wishing to have children to stop taking the medications for your situation. That, in itself, tells much of the answer to your question. Some doctors, however, tell their patients if they are worried to do the following:

  1. stop taking the Propecia during the one week that fertility is present or stop it through the entire period from conception to the delivery of the baby
  2. use a condom when your wife is pregnant
  3. stop the drug completely during the entire pregnancy

I feel that the first part of #1 may be wise if you do not trust the drug company disclosures and to adopt #2 if you are really worried. These two steps are extreme, while #3 is almost crazy because you will abandon all of the benefits of the drug and get progressive hair loss during the 9 month pregnancy period, based upon no evidence that this is a problem. See my previous answer to this question here: Taking Propecia While Starting A Family.

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Avodart for Androgenic Alopecia? – Hair Loss Information – Balding Blog

Dr Rassman

Do you know for certain if GSK has dropped the idea of continuing Avodart studies for androgenic alopecia?

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I can not speak for Glaxo Smith Kline, a pharmacuetical company, as to their official or unofficial plans for the drug Avodart. They manufacture Avodart for prostate disease as the most powerful and most effective DHT blocker. In theory, it should work better than Propecia, but without a committment by this drug company to bring it to market as a hair loss drug, the FDA will not allow it to be sold for hair loss.