Finasteride lowers type II DHT while Avodart lowers both type I and II. Does the amount of type I DHT have any effect on hair or it is only type II that may cause hair loss?
Thanks.
We answered this years back here. Short answer — it’s been proven that type II is linked to MPB, but type I hasn’t been linked.
Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.
This is part 8… and final part. Thanks for sticking with me on this!
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Minoxidil as a systemic medication?
These systemic medications are not FDA approved in the United States for the treatment of hair loss, as well as many other countries. Minoxidil was originally used in the 1960s as a treatment drug for high blood pressure, but its impact was not consistent with lowering blood pressure. Many of these earlier patients developed a reversal of their hair loss and many women treated with it developed facial and chest hair.
Aspirin and hair transplantation?
Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.
This is part 6. More to come…
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Does finasteride induce mood and other psychiatric changes?
I believe that these case reports are the exception to what we commonly see and that finasteride is generally safe, but if a patient feels that they have changes in their personality or mood since the drug was started or if a family member sees changes in their mental state, they should meet with their doctor to discuss the appropriateness of their continued use of the drug.
Note: The annual meeting of hair surgeons was in held in Alaska this past week. The following review is very selective and is biased by the things that were interesting to me and what I (Dr. Rassman) thought could be interesting to the readers.
This is part 5. More to come…
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Does finasteride (Propecia) impact the body’s inflammation response in hair loss?
Are finasteride’s sexual side effects overstated?
One joke on the floor I overheard was that based upon the internet reports, the average 50 year old had a better than 40% risk of sexual side effects, but that reduced to only 2% for those reporting side effects from Propecia, making Propecia less risky for those side effects.
Dr Rassman,
minoxidil is the worst product ever in the world. I started using it 1 and half month ago and then my hair loss reached a shocking amount .I quit minoxidil 15 days ago. My hair loss reduced but still there is some shedding. Now I am look like really bald. I am really worried about it. My social life also is affected. I dont wanna go outside or do something with people. I am really depressed. At the same time I am using propecia but as I said I am bald right now.My questions are, will my lost hairs be replaced? If it will,how long it will take? I am 20 years old and my hair is really important to me. please help me.
Hair is really important to a lot of men, so you’re not alone. I am sorry you are experiencing hair loss. Unfortunately, hair loss is mainly due to genetic causes and many men in their late teens or 20s will go through what you are going through.
There have been cases of initial shedding from minoxidil use, but this is usually temporary. I can’t say for sure how long it’ll persist or if those shed hairs will regrow. I do not know anything about you (e.g. age and family history). Please follow up with the doctor who prescribed you Propecia and discuss further options.
I have been taking minoxil for roughly 8 months and have had decent results in the hairline area, especially the corners. I’m going to start finasteride soon however I have a question about shedding. As I understand it, the shedding that can happen on finasteride is due to the follicles that are DHT damaged shedding the hair to grow back stronger.
My question is: is hair grown back solely with minoxidil more likely to be shed when starting finasteride?
The initial shedding is noted with the use of Rogaine (minoxidil) way more often than Propecia (finasteride). I’ve only rarely seen this problem in patients after starting finasteride, but I am seeing growing concerns from readers about it. It’s interesting how various claims can be given so much acceptance when it’s not something widely noted in large scale studies or amongst doctors with patients on the drug.
So unfortunately I don’t have an answer to your question, since I don’t have enough of a patient history that have experienced it.
Hello Dr. Rassman,
When a person’s genetics finally wins the tug of war against finasteride or/and minoxidil, will the hairloss then reassume in the form of a slow, steady process, or will the hair maintained by the drugs come off in large amounts within a short period of time?
Thank you for your time.
The genetic progression of hair loss while on these medications (the “tug of war”) would likely be slow, in the order of months or years. It does not happen over a few days or weeks.
Hey, I am a 16 years old and I have started to notice that I am losing my hair. My doctor has prescribed me propecia and I have been on it for almost 2 months now. I have noticed that a lot of hair has been falling out recently but I have heard this is common with propecia. Is this true?
I was also wondering if you have heard of anyone of my age who has been successful with propecia, since it is meant for people who are 18 and older. I’m not really looking to grow more hair, I just want to keep the amount of hair i have now and hope that I wont lose anymore.
Propecia will slow the process down and sometimes provide some regrowth, but it won’t cure the loss completely. You will continue to lose hair at some rate, over time. I do not believe increased hair loss is common when you start Propecia use, but I have heard others mention it.
I would expect that a 16 year old will get a better response than a 21 year old with very early loss. We rarely see boys of your age go on the drug or have enough hair loss to warrant taking the drug, so I don’t have a wealth of past experience with teens on Propecia. Please follow up with your doctor.
I am a medical intern working 80+ hour week. My hair loss is probably due to a combination of stress and Androgenetic alopecia. Would taking finasteride impair my cognition? Are there any studies that test congition and finasteride use? Should I take HairDX Genetic Test before starting on finasteride?
Thanks
If you are medical intern you should know to look up these types of questions on PubMed. I have yet to come across any studies or valid reports that taking finasteride will impair cognition. There is a study that suggests finasteride can inhibit hippocampal neurogenesis in mice, but there’s another study that say sleep deprivation can cause the same thing. Plus, we don’t know how this translates to humans.
I’ve heard cognition mentioned by patients who find abstract information on the Internet, but I really do not know what to make of it. I don’t recall having patients tell me about any personal experiences with memory or concentration issues after starting finasteride, though.
With respect to the HairDX genetic test, I do not have a strong opinion. Genetic balding is diagnosed by a physical exam and the treatment is based on an individual case by case basis. The best test for the presence of hair loss is mapping the scalp for miniaturization and measuring hair bulk.
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I’m aware that fin isn’t as effective on thickening hairs at the hairline, but is it effective at halting further recession, as it is at stopping general thinning?
Finasteride (Propecia) may halt further hairline recession, but hairline recession is usually not reversed with this drug. It’s also usually not a permanent phenomenon, so over time you can expect more hairline recession even if it stops the recession initially.
In other words, even if you take Propecia every day without missing a step and have good results, you could eventually start seeing the loss start again. It’s not a hair loss cure, though some patients have been on the medication for over a decade while still seeing good results.
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