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In an article just published in the Journal of the American Medical Association, Internal Medicine edition by Dr. Blayne Well et.al. , the impact of finasteride on patients with known depression were studied. Of that population, 272 patients out of 100,000 have a tendency for depression. Could it be that these men, once identified should not be prescribed the drug finasteride? Their concern was to determine if there was a suicide risk that increased because of the use of 5 alpha-reductase inhibitors which included finasteride and dutasteride.

The answer, in my opinion, to this is probably Yes, it is a good idea not to give this drug to people with known depression. Note excerpts below:

Hi Doc,

Nice blog.

My question is kinda odd, but please humor me. I can tell there’s some sort of relationship of importance between cause-driven itchy scalp and hair loss.

I really think someone in the hair loss research field, such as yourself, should look further into what I’m saying. I am a statistician by background; I have a PhD in my field, and I am by no means bringing up a crazy idea here. It’s a theory. We all want a cure for baldness, and the best bet is to hear out every conceptual idea or theory. If you could learn the connection here, I believe you would not only make a lot of money, but you’d also help a lot of people.

So, here goes… I noticed about a year or two ago – when I eat something spicy, my head itches. Ok, big deal. Sometimes when I workout, my head also itched. However, the spice aspect, is more noticeable, regular and I can even predict it. When I eat something spicy, I know I’ll have an itch shortly “only in the area of my head that’s thinning or balding”. It’s really strange, and my statistics background tells me there’s got to be a connection there.

The questions I think need answering are:

-Why do humans feel itching?
-What in a spice could cause itching at distant location?
-Could it be something from the spice goes into the bloodstream right away and effects DHT?

I seriously think a dermatologist should be able to answer this. I know I’m not the only one to bring this up.

I am not a dermatologist, so I will try to answer to the best of my capacity. I do know from personal experience that one of the consequence of eating spicy foods is sweating on the scalp, which can make your scalp itch. It also makes my nose run and sometimes my eyes water depending on the heat level. This may be due to a histamine reaction from the capsaicin, the chemical which makes it spicy. But I do not see how this is related to hair loss.

Most male hair loss is due to genetic causes, which is known as androgenic alopecia (AGA) or male pattern baldness (MPB). It is really not a DHT issue in and of itself. In other words, if you do NOT have the genes for hair loss, you will not go bald no matter how much DHT you have.

As far as why humans have to feel the sensation of itching, that is like asking why humans have to feel the sensation of pain. I think that is a bit beyond the scope of BaldingBlog. Sorry.

Finasteride for 3 months with good early results showing nicely. I would expect more filling in over the months ahead

After 5 days, a few patients have reported sexual side effects. When that happens, I often tell my patients to stop the medication for a few weeks until everything becomes normal again, and then retry it at one pill every 4 days for 3 weeks, and if that works, increase it to one pill every 3 days for 3 weeks. If that works, try one pill every two days, and stay on this dose, which is 80% as effective as the full dose.

I’m a 19 year old male who started Finasteride in January 1 because I had a receding hairline. In the past four months or so, my hairline has significantly receded and is becoming really noticeable, particularly around my temples. I thought I’d be able to maintain and hopefully regrow a little given that I’m young, but it seems to have had the opposite effect. Is this a shed? Is there a chance Finasteride is making my balding faster? How long should I wait to see the full effects of finasteride? Reading on websites is hard because most articles are written by companies that either sell Fin or say fin doesn’t work because they offer hair transplants.

You should stick to the finasteride and any shedding phase will pass. Finasteride may not slow down the recessions as sometimes, especially in a maturing hairline, finasteride will not work. Transplants are out of the question at your age. See a an expert like me who will tell you want is going on. See here: https://baldingblog.com/haircheck-test-how-it-is-done-video/

I have seen thinning and hair loss in the nape of the neck with Finasteride. I have also seen reports of loss of body hair while on the drug.

Does DHT affect hair on the nape of the neck? from tressless

Hey Doc- I had a quick question. Have you seen any patients have hair loss worsened by Fin? I took fin from roman for maybe a week and had such extreme shedding immediately that I stopped. Shedding continued for 8 weeks or so and stopped but I went from a NW2 to a NW4 in that time. Do you think this will grow back? I tried Min, but the sides were bad for me and made it extremely uncomfortable. Thanks!

I have heard about shedding, but I haven’t seen it myself in my patient population so it must be rare. I gather that those who have it should stay on the medication as their is a delayed response but the response usually does happen in a couple of months.

I have been on finasteride for more than 10 years, then I decided just recently to stop it. I lost basically everything in 3 months when I stopped min/fin. I started back 30 days ago is it possible to regain everything?

It is possible that some or all of the hair is still there. Good luck with a potential reversal. Let me know in 3 months so I know. I always want to be educated by the men who are balding and dealing with such problems.