Category: Uncategorized

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Since You Suggested Minoxidil and Propecia Are Better Together…

I received 2 emails from 2 different readers about my recent post discussing using minoxidil and Propecia together —

EMAIL 1:

I was interested in your recent suggestion that minoxidil and propecia used together may be better than only one at a time. My question is concerning minoxidil. I tried it a while ago but got very bad itching of the scalp. Is there a form of minoxidil that won’t give me this side effect? (e.g. rogaine foam or some other variation). I would really love to use it in the hope that it will slow down the hair loss process. I know others have previously stated that they couldn’t use it due to the itching, so it would be great if there was something out there to fix that problem.

Thanks doc. I read your site almost every day and love it.

EMAIL 2:

In response to your new theory on the combination of Rogaine and Propecia. Would you then advise immediate combination of the two, or would you still prescribe a one year period of just Propecia? Could it depend on the results that one are looking for? i.e. regrowth vs. maintaining/slight regrowth. Thanks. Very helpful website.

I combined the answer of these two questions.

Although the combination of minoxidil and finasteride is reported to have a superior effect on hair growth over taking them separately, I generally do not start my patients on both of these medications at the same time. I may add minoxidil to the treatment regimen of a patient who has been on finasteride for a while and now feels that finasteride is not holding anymore. This usually happens after the first year of taking propecia when patients are done with the initial hair growth and stabilized in a new and better status. At this point patients’ rapid hair loss either stops or significantly slows down and the patient does not see hair grow as they initially saw within the first year, so they get disappointed and seek further help.

I like to leave at least 6 months to a year before starting a patient on the second medication and I also perform a miniaturization study before starting the second medication. This may give me some idea of the rate of growth with each of them. By starting one medication at a time, I know what medication is responsible for the good or bad changes. Also, if patient develops an allergy to one of these medications, it would be easier to find the culprit when you start them one at a time.

If you develop a contact allergy to minoxidil, it might be the result of the other chemicals in the solution and not the medication itself. You can switch between different versions of the same medication (i.e. minoxidil lotion vs. foam) to see whether you experience the same reaction or not with that particular product.

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I Have Been on Finasteride for 2 Years and Seem to Be Staying Thin. Should I Transplant This? (Photo)

If you are over 26, you might be a reasonable candidate for a hair transplant. Why 26? Because the patterns of balding become more evident at the age of 26, but the risk or more balding make it difficult, at times, to plan appropriately. If you use up your donor hair as many men do, then you are left deformed when the balding patterns finalize.


2019-02-20 08:58:38I Have Been on Finasteride for 2 Years and Seem to Be Staying Thin. Should I Transplant This? (Photo)

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Are the small hairs in the front of my hairline new hairs?

Hairs in the frontal part of the hairline show slightly more vellus hairs which appear small and fine and this is what you may be looking at. Miniaturization throughout the head and scalp is less than 20% of the hair population, something I have published in medical journals. See Here: https://baldingblog.com/wp-content/uploads/pdf/mp-1997-evaluation.pdf

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Finasteride and Allopregnanolone

Is it true that Finasteride in Humans would reduce important Neuroactive Steroids like for example allopregnanolone? I know there was already a post about this in the past but that was about rats. In rats, Finasteride blocks both type I and II 5α-reductase whereas in humans inhibits only type II which it seems is not present in the brain unlike type I. I would appreciate your opinion about the following two studies:

Link 1: Finasteride Treatment and Neuroactive Steroid Formation (PDF file)

Link 2: The influence of low dose finasteride, a type II 5α-reductase inhibitor, on circulating neuroactive steroids

I do not think I can add much here, as I am not a biochemist. Mood changes have been associated with finasteride and depression has been reported, but I’m unclear on specifics beyond that.

The 1st link is a study of 20 men with an average age of 69.5 years that took 5mg finasteride. The 2nd link is a study of a dozen men that took the 1mg finasteride with no listed ages that I see. Both studies are small and offer nothing definitive, using words like “probably” and “might”.

This should go without saying, but finasteride is an elective medication with some rare side effect possibilities and is available by prescription only. Hundreds of other medications also come with side effect risks, and you must talk with your doctor about these risks and benefits so you can make an informed decision.


2011-10-26 13:19:04Finasteride and Allopregnanolone

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SMP: How to pick the clinic

I am considering getting SMP for density at https://getscalpworx.com/ .What should I be looking for to ensure I have the best and safest experience? Thanks!

Ask to meet patients that had it done and look closely at the work. If you can tell its SMP, then stay away from that clinic. Many clinics put large dots on the head and place them few and far between. The SMP stands out in those patients and doesn’t look normal. Look at my SMP done with my staff: https://baldingblog.com/i-just-finished-my-smp-on-my-crown-area-today-see-before-and-after-photos/

It’s good enough for me, so it might be good enough for you.

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Finasteride and minoxidil at the same time?

I’ve been on 1mg fin a day for a couple weeks now. I read other opinions saying it’s best to wait about six months so you can more accurately assess whether fin is working. But most people on here seem to start minox and fin at the same time.

These two drugs have different mechanism of action so taking both at the same time increases your odds of getter hair growth, especially if you are younger than 25.

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So Nothing Can Be Done for Alopecia Universalis Patients?

Is Alopecia Universalis a dead end?? hair cloning and transplant isn’t beneficial at all in this stage ?

Thank you

There is no medical cure for alopecia universalis patients. Cloning isn’t available and transplantation isn’t an option, since alopecia universalis patients don’t have hair to harvest.

There is an alternative option — Scalp Micropigmentation (SMP). We have had one alopecia totalis patient treated with SMP. Look for Client 26 here (4th one down on the right).

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Finasteride effects on urination problems

I have frequent urination after taking fin that got better over time on finasteride?

Finasteride is often used for older men who have prostate problems who can’t pee because of an enlarged prostate which reduces in size on finasteride. It should not be the cause of your peeing problem


2019-12-10 10:49:17Finasteride effects on urination problems

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Soriatane and Hair Loss

Hello, I am a 49year old female and experienced hair loss on my scalp for about a year but much more noticeable in the last 6 months. I have been on Effexor for about 4 years and have been up and down in dosage as high as 225mg and as low as 75mg. I also started taking soriatane for my psoriasis about a year ago. My dermatologists thinks that it is the soriatane that is causing the hair loss, not the Effexor. Can you tell me what the more likely medication would be?

Many medications have the potential for hair loss as its side effect. Before changing any medication regimen you should consult your doctor. There is no way to tell which medication may be the cause of your hair loss, and in fact, it may not even be the medication. You may also consider if there are any medical causes of hair loss. These are the things that you should be discussing with your doctor (see the Female Hair Loss category for more).

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Finasteride dosing

Can you take 2.5mg of Finasteride (half of a 5mg pill) 3x per week as my doctor suggested, or should I attempt to split the pills further? I spent years worrying about asking for Finasteride, I finally asked using my clinic’s online messaging system, and the doctor was more than happy to give me more information and prescribe it.

This dosage is fine. Finasteride ‘fixes’ to the receptors in the hair follicles for about 7 days so the blood levels are less important as is the way you take the drug. About 1mg/day is ideal, but more will not hurt you.