Drugs – Page 207 – Balding Blog

June 18, 2008

Medications That Prohibit You From Getting a Hair Transplant? – Hair Loss Information – Balding Blog

i am on coumadin. is hair transplant possible?

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Coumadin (warfarin) is an anticoagulant, also known as a blood thinner. Blood thinners are on the top of the list of medications which must be addressed in a patient who is about to have a hair transplant. I have done transplants on people who are on such medications, but take many steps in the process to assure safety. Generally, one can cut back on the Coumadin and then step it up on the day of transplants. Your general health is really the issue and the reason you are on these medications may allow you to stop them for a week or so. The answer therefore is an individualized answer depending upon the patient, his/her medical condition causing the use of such a medication, and the general state of the patient’s health.

I take a thorough patient history and review all medications that a patient is taking prior to performing a hair transplant.

June 18, 2008

Could My Hair Shedding Be Due to Stopping Minoxidil? – Hair Loss Information – Balding Blog

Hi Dr Rassman.
Few questions. I am using a combination of propecia, centrum, biotin, msm and nizoral shampoo. I was using regaine for a few months but stopped just after christmas as I was still losing hair regularly. After stopping however, even more hair fell out and my hair started to shed like crazy over 3 months… this time last year I was a norwood 2, but am now a norwood 3v. I have been on the propecia for 2 and a half months now, and as I am only 21 can I expect to see good results soon? I noticed that 39 year old who went from being nearly bald to having pretty much a full head of hair (without the corners). So, my question is, do you think the reason I shed so much was because I stopped using rogaine? Would it have been better to have not used it rather than use it then stop?

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Of the combination you used, only Propecia and minoxidil (Regaine/Rogaine) are proven to regrow hair loss. At only 2 1/2 months on Propecia, I’d say another few months on the medication will begin to yield results. To what degree, I couldn’t say. Each person is different and will react differently to the medication. Some men will see good regrowth, while others will see no regrowth (but they will see the hair loss halt). At 21 years old, it is possible that it was a coincidence that your hair loss increased around the same time you took a hiatus from your treatment, or it could be that stopping the minoxidil was the catalyst for your increased hair loss. Starting the Propecia is a good step, however, and I’d suggest you stick with it. Discuss any medication changes with your prescribing doctor.

June 17, 2008

Will Skipping Some Minoxidil Applications Still Be Effective? – Hair Loss Information by Dr. William Rassman

I am a 22 year old male and use 5% minoxidil either once or twice a day. My new schedule makes it hard for me to use minoxidil everyday and am wondering if using it every other day will
still be effective.

Every other day is not the recommended dose and you probably will not get much, if any benefit from it. Twice a day is the only way to use it. At the age of 22, if this is male pattern baldness (MPB), then Propecia (finasteride 1mg) is the preferred way to go, not minoxidil. I’ve seen much better results in the younger men taking Propecia than those using minoxidil.

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June 17, 2008

Propecia — The Happy Medium for Effectiveness and Minimal Side Effects? – Hair Loss Information by Dr. William Rassman

Is Propecia a “happy medium” between the effectiveness of finasteride and the minimisation of side effects? I heard they tested up to 20mg of finasteride during clinical studies. Assuming the side effects were much greater, did those help reduce hair loss more?

Higher doses of finasteride does not seem to treat hair loss any better than the recommended 1mg. This study was done by Merck already after working with real experts in the field who had nothing to prove other than find the safest and most effective dose. The connection between dose, effectiveness, and side effects are not one-to-one.

Side effect possibilities do go up with higher doses and studies on humans have shown that. Stick to what is known and safe. The reports suggesting ideal impact on hair loss at the 1mg level are based upon observations on hair loss, not logic on what a higher or a lower dose should do. People who have the sexual side effect seem to get it on very low doses as well as those who get breast lumps. That suggests to me that we really do not understand the process clearly enough.

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June 16, 2008

After Switching to Avodart, I’m Losing More Hair – Hair Loss Information by Dr. William Rassman

I have recently begun taking avodart (.5mg) after taking propecia for ten years. I began the avodart due to research suggesting it to be more effective. I have been using avodart 7 mos. I feel I have lost more hair in my temple areas. Should I have expected more positive results by now or could I be experiencing some shedding due to the change in meds as is sometimes the case when patients usually start a new hair loss therapy.

Avodart Although it does sound unusual, I can not explain what you experienced with the switch to Avodart (dutasteride). I have no real experience with Avodart and only know what I read. There were clinical trials conducted in Korea for dutasteride to treat hair loss, but I’ve yet to see them published. At this time, Propecia (finasteride) is the best FDA-approved oral drug for slowing or stopping the hair loss process, but if you have the genes for male pattern baldness, you will still eventually bald, although at a slower rate with the medication. If/when Avodart is approved to treat hair loss, I’ll look into revising that statement.

Propecia has a poor record of slowing frontal / temporal recession, but it (in my hands and I suspect the hands of many other doctors) does slow or stop even frontal loss in many, but not all, patients — and therefore we can expect Avodart to do at least the same.

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June 16, 2008

An All-Too-Common Problem — Restarting Propecia After Realizing that Stopping It Was a Mistake – Hair Loss Information by Dr. William Rassman

I was taking propecia last year. I have read on your blogs that stopping the medication is not good if one has to achieve effective results.

However, now that i have restarted taking it, I was wondering can propecia + 5% minoxidil bring back lost hair? Or it just treats existing miniaturization? How many years of lost hair can one gain back, That is if the medication is effective?

Basically, i’m looking for hope, considering i did the mistake of discontinuing….Thx.

Propecia Unfortunately, there is no way to answer your question other than provide these points:

You need to see a doctor who can follow your hair loss and establish a good plan for your specific situation (this may involve starting Propecia or minoxidil or even nothing at all).
I doubt you will regain what you have lost and the stopping of the drug did you no service. Undoing it is something we may or may not observe, but it is worth a try.
There is always hope as long as there are reasonable expectations.

I hope that our readers really take note to what has happened here, because it seems that so many people start the drug, do not give it a chance, stop the drug for a variety of illogical reasons (not observed side effects), and then they want to undo the decision. This hair loss problem is progressive and you never make up what you lost in terms of the opportunity to stop the hair loss early.

June 13, 2008

Propecia Baseline – Hair Loss Information by Dr. William Rassman

Hello, I hear a lot about how a majority of men maintained or improved hair counts compared to the baseline measurement on Propecia. However, I can’t seem to find when this baseline measurement is taken. Since Propecia takes about 3 months to “kick in”, is the baseline measurement the hair count at that time or the hair count at the beginning of Propecia treatment?

Thanks for your help!

I suggest that you get a baseline count when you start taking Propecia and repeat it yearly, as it does take a while to see the medication’s benefits. I personally prefer miniaturization studies, because it is the miniaturized hairs that benefit from the Propecia, not as much the increased hair count. To get a very accurate hair count, you would have to tattoo a spot on the scalp, so that same spot that you first counted will be the same spot you count a year later. Most people would be unable to find that exact spot without a permanent mark of some type on it. Miniaturization studies will look at sections of the scalp, not just one spot.

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June 12, 2008

Hair Loss InformationYou’re Losing Hair – What Do You Do Next?! – Hair Loss Information – Balding Blog

Im sure these are some basic questions you’ve answered before, so feel free to direct me to a previous answer. I’m 42, and my hair is starting to both thin and recede, It bothers me quite a bit.

you say very often get examined by a professional. where do i start? is this my regular doctor, or i need to go somewhere else.

What is the difference between rogaine and propecia, and who would be best to recommend what would make the most sense for me?

thanks very much for any help you can provide.

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Doctor You should go to a good dermatologist with an interest in hair loss. Call his/her office to find out if they are the best one to treat you. Alternatively, you can see a hair transplant doctor (they have an obvious interest in hair), but don’t get yourself rushed into surgery. I see quite a number of men with problems like you describe.

There are huge differences between Rogaine (minoxidil) or Propecia (finasteride). For starters, Propecia is an oral prescription medication and Rogaine is a topical over-the-counter medication. They each have their own set of possible side effects and they both are currently the only FDA approved medications for treating hair loss. I usually recommend Propecia for early hair loss, but as it is a prescription medication, your doctor will be able to give you all the proper information about it. I wrote about this briefly before — “The two drugs work differently. Propecia is more predictable than minoxidil, but they could work together. I have seen hair come back with minoxidil, however I have seen more patients show great benefits from Propecia.”

For more, Wikipedia has good info about minoxidil and finasteride.

Please note: the above image is not an endorsement of child doctors.

June 12, 2008

Pretoxan – Hair Loss Information by Dr. William Rassman

Dear Dr.,

There is a new product called Pre Toxan, (or Pretoxan) containing L-Arginine, the website is: www.pretoxan.de

Could you please let us know your opinion, is it safe?

Thanks

I looked at their site (thanks to Google’s translatation service) and the “science” they mention just makes no sense. From what I gather, Protoxan is a shampoo that mixes the ingredients in Procapil with L-arginine. The site mentions that it, “boosts the synthesis of important components at the epidermal junction where the hair anchors to the skin.” And that Procapil, “has active compounds that help to anchor the hair follicles more firmly in the scalp, allowing hair follicles maintain their youth. By stimulating cell communication and metabolism, follicle anti-aging is promoted and anchoring molecules are rejuvenated. This helps prevent premature hair thinning, hair loss and MPB (male pattern balding).”

Excuse me if Google’s translator didn’t turn that into perfect English, but I think I see what they’re trying to say… and there is no science here. There is a poorly documented clinical trial on a limited number of men which is designed like a double blind study, but just does not cut it. The product may work, but there is no clear cut evidence that it does what is says.

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June 12, 2008

Type I and Type II DHT – Hair Loss Information by Dr. William Rassman

I don’t understand the difference between Type I and Type II DHT. Why does finasteride only block Type II? DHT is DHT right? Also, if you’re going to lower DHT levels by blocking it from forming, why not just block all of it?

In the clinical trials for Propecia, I heard they tested finasteride at 20mg and its effects on hair loss were marginally better or more or less the same. And if Propecia is great but not perfect, there must be something else causing hair loss, perhaps another enzyme acing on type II or 5AR or another enzyme acting on Type I DHT.

Is it possible for Propecia to cease hair loss where it is forever?

Cheers for your time.

DHT is DHT. It works on different receptors in the body and these are discussed on RXList.com. Essentially, “The type 2 isoenzyme is primarily active in the reproductive tissues, while the type 1 isoenzyme is also responsible for testosterone conversion in the skin and liver.”

The last question in your message is not clear. If you are asking if taking Propecia forever will keep the DHT blocked at the same level forever, then the answer is no. There is no forever anti-DHT treatment. Your body will eventually start to produce more DHT than Propecia will be capable of combating, and you may begin to see hair loss again years and years down the line. Some doctors actually increase the dose of Propecia to combat at progressive ineffectiveness, but there is no proof that a higher dose works, but it may be a logical direction to go if the drug is less effective after years.

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