How long does it take to work?
There is no standard answer. I have seen men that showed great results in 6 weeks, and others with no results in a year when they had a poor surgeon or surgical team.
Taking 1/3rd Proscar Tablet?
Hi Dr. Rassman,
Many thanks for the detailed and trustworthy information you offer your readers. It is a true resource amidst the unreliable heresay elsewhere.
I am a 29 y.o. male — I started Propecia 1mg 4 years ago and it worked great until this summer when my hair started falling out quickly. My doctor increased my dosage to 1.67mg, which I filled with generic finasteride at Target(thank you again for pointing out the great deal there). It has only been a month, but I am hopeful it will work again.
Recently, my regular dermatologist (not the prescriber) asked whether the pill I am taking is scored and evenly distributed. I inquired with the pharmacist who said it was not scored and likely not evenly distributed. He knew of no generic finasteride that is.
What are your thoughts on the effectiveness of taking 1/3 of a tablet that I am not sure is evenly distributed. I looked in the archives and was able to dig this up, but it seems like the answer was inconclusive at the time and I am wondering if anything changed. It also dealt with Proscar, not generic finastertide.
Thanks so much
I am not an expert on drug mixing, but I believe that the various ingredients are homogenized, so as it is made into a pill there’s no irregularities in the mix. If the ingredients were irregularly mixed at a pill level, then in theory it could be irregular from pill to pill… and I’m not sure if the FDA would allow that. I’m not well versed in pharmaceutical manufacturing policies, though.
As for taking the 1.67mg finasteride, if that is what your physician prescribed you, I’m not going to argue with that. There have been times where I’ve increased the dosage recommendation for individual patients if they notice hair loss accelerating after being on Propecia for years.
FUE over-harvested with scars and depleted donor area (photos)
More and more patients are experiencing over zealous surgeons who take out too many grafts from their donor area in doing FUE. I know that many patients want a lot a grafts so that they can get their hair back as quickly as possible, but pushing the envelope is a real problem as many men, who have donor densities that are not high, get this type of result and eventually may become bald in the back of their heads. If some of the hair does not recover (some of what we see is the result of shock loss), then the only option to treat this is scalp micropigmentation (https://scalpmicropigmentation.com/scar-covering/). I have discussed the limitations of FUE in previous posts here: https://baldingblog.com/2017/07/21/many-fue-grafts-many-fues-grafts-one-know-safe-limits/
2020-09-04 03:28:102020-09-01 09:46:56FUE over-harvested with scars and depleted donor area (photos)
Taking Finasteride for a Year With Good Results — Is It Time for a Hair Transplant?
Hello Dr. Bill,
First, thank you again for your continued dedication to providing the most up to date information on the issues regarding MPB.
My question is this: I’m a 25 y.o male experiencing early stages of a balding pattern in the form of NW 3-4. I have been on finasteride for almost a year and am satisfied with the results thus far (no further loss, and from an initial glance, some reversal). However, I want to achieve a more aesthetic look. I’m wondering if its advisable to undergo a HT to fill in the thin areas even though theres no bald spot. Would i probably have some shock loss? Is it too early to begin the rearrangement process that is to come with HT?
Thank you for your advice!
If you have a good response to Propecia and are still wanting more hair, considering a hair transplant is appropriate, but you want to make sure that your selection of a doctor is an informed one. You may consider reviewing the links on this page — Hair Transplant Doctor Credentials — to get a better idea of what to look for in a hair transplant surgeon.
I couldn’t say if you’ll probably have shock loss. If you’re sticking with the Propecia, I’d say your chances are quite slim that you’d experience shock loss of any great significance. I also couldn’t tell you if you’re even a candidate for transplantation without seeing you, but based on what you’ve described (mid 20s, Norwood 3-4, finasteride for a year), you’re not automatically disqualified. In other words, if you were 19 years old with a Norwood 2 and have never taken finasteride, it’d be pretty easy for me to tell you to not consider a transplant for at least a few years.
FUE video from Dr. in Pakistan
This is a remarkable video of Dr. H Mohmand performing FUE at a rate of over 3000 grafts per hour at his clinic in Islamabad, Pakistan. Very commendable skills.
Taking Propecia Provides False Negative on PSA Test?
Hi – I have heard that taking propecia may provide a false negative in some cases on a PSA test since DHT is lowered. Is it possible to have prostate cancer and not know it from a PSA test because propecia hid the true results?
Prostate Specific Antigen (PSA) test is a screebubg test for prostate cancer. It is a nonspecific screening tool for doctors to consider when evaluating a patient. PSA can be affected by many non-cancerous causes such as infection, benign elargement of the prostate (BPH), or even digital manipulation (during a rectal exam, for example). Finasteride is thought to reduce elevated PSA levels so we generally take a PSA baseline test for all men over 50 prior to starting the drug.
For further reading, the Dec 2005 Journal of Urology published a 7 year follow-up study of patients taking 5mg finasteride (5x dose of Propecia) and found no significant increase in Prostate cancer risk (Dr. G. Andriole was the lead author, Ref: J Urol. 2005 Dec;174(6):2098-2104)
That article was prompted by the New England Journal of Medicine article published in July 2003, which alluded to an agressive form of prostate cancer with finasteride use (which was not correct from the follow-up study).
2006-04-27 13:33:112006-04-27 08:48:06Taking Propecia Provides False Negative on PSA Test?
Funny Patient (with Photos)
The photos below are of a patient who came to my office yesterday, now 11 months after his transplant of 2403 grafts. When he saw his before pictures, he asked me to cremate them because that man no longer existed. We had a great laugh together as he shared his own amazement of the transformation which he had not fully appreciated until he viewed those old photographs. The humor took another step as he put on the Groucho Marx mask that we bought to give to his grandson. It was one of those joyous experiences that I see day after day. For me, it’s the impact on peoples’ lives that really makes my day.
This patient is a Norwood Class 6 with salt & pepper, medium fine hair. “Before” on the left; “After” in the middle and on the right.
Taxotere Can Cause Hair Loss
Taxotere is a drug for treating cancer. Cancers and hair have something in common – they are both fast growing organs. Cancer drugs attack fast-growing organs. In the body, hair is the fastest growing organ, followed by the intestine. Therefore, hair loss, nausea, vomiting, and diarrhea are often side effects. Once the medications stop, the hair will probably come back, and nausea, vomiting, and diarrhea along with it will subside.
2018-06-25 05:55:292018-06-26 10:12:01Taxotere Can Cause Hair Loss
Generic Minoxidil Says Only Intended for Vertex
I purchased 5% Minoxidil from Costco and on the side of the box it explains that Minoxidil is only intended for the top of the scalp ( vertex only ) and will not work for receding hairlines or on the front of the forehead – is this true ?
I don’t have a problem with the top of my forehead or the back. I have receding hair line. If it is true, can you recommend what I could use to regrow hair for receding hair lines ?? I appreciate your help, thanks
The claims for minoxidil reflect the approved study that was submitted to get the product to market through the FDA. I am certain that minoxidil works on skin (best in the crown), but it even works on the face of women, putting hair where there was none before. Minoxidil is not my #1 choice for men with genetic balding. My preference is to treat the cause of the balding with a DHT blocker (finasteride).
Is thinning hair always miniaturized?
Does miniaturized hair gradually grow shorter with each cycle or can a miniaturized hair be long, say 5-6 inches then fall and stop growing?
At the start of the year my hair was thick but after a stressful couple of months, all my hair turned super thin with bald patches. The hair turned so thin it has very wide partings. Also all my body hair thinned too. Beard, arms, legs and pubic area. It’s like every hair on my body miniaturized. I can see my scalp now with wet hair. It all happened quickly, this wasn’t a gradual thing. The hair texture feels weird. My beard hair has thinned the same. I had thick hair on arms and legs now it’s all very fine. My pubes are now thin and wispy. I started taking fin a few months ago. I was prescribed it for prostate. Will this help? I can’t find anything about this when searching the net, only TE but does hair thin during that? At the start of the year I was very stressed, hardly eating or sleeping for a couple of months which I”m sure caused this.
Let’s imagine a hair that grows out for two years and is 12 inches long. If miniaturized started into the second year, the hair closest to the scalp would be thinning then the hair at the end which was made 2 years earlier. So a miniaturized hair can be seen simply by pulling out a long hair and looking at both ends. Another aspect of these miniaturized hairs is that they will grow slower and slower over time, eventually they stop growing and just stay there, falling out with washing, brushing and just the wind.
There is another condition that I just recently defined in the literature called Age Related Thinning. In this situation, all of the scalp hairs become thinner all at once and it is uniform thinning throughout the scalp. Although this is more common in men and women over 50, it does appear in younger men and women. I have seen it in men in their 20s and they make the mistake to think that this is balding because they can see through the hair to the scalp. There is no known treatment for this and neither minoxidil nor finasteride can reverse this as I know it. This is my article about it: https://newhair.com/pdf/Kumaresan-Muthuvel-Bernstein-Rassman-Commentary.pdf
2020-07-22 02:49:112020-07-21 11:29:01Is thinning hair always miniaturized?