Reader Shares His Daily Hair Routine

Dear sir,

I first of all thank you for taking your time out to answer this question. I’m sure you’re quite busy…I’ve seen more balding heads on the streets than ever.

I’ve been losing my hair since I was 17. I just turned 21.

I went through all the usual stages. Denial, loss of confidence, etc. I still have as much left as many men RECIEVE in their procedures, but it will only get worse. I had a solution in Spring 2006, while I still had enough that no one knew – Propecia. My (completely bald) doctor recommended it for me.

But I was an idiot.

In December 2006, I stopped taking it. I felt it hadn’t made any difference. No further thickening, no regrowth. Everything seemed fine until summer 2007, when it started becoming frighteningly apparent that it HAD kept some hairs in (I washed many long, luxurious strands of Marc Bolan-style hair down the shower drain). I didn’t know why this was happening all of the sudden – I did not know that stopping Propecia not only stopped the positive effects of Finaesteride on DHT, but also allowed the MPB held back to return with a vengeance.

Within six months, my hair loss had become worse and more apparent than it had since it began. It happened quite quickly.

I went to the barber’s in October 2007 and cut my long hair off. I could tell where the hair loss was hitting hard; the hair cut from the sides and back was thick and Roman, while the hair cut from the top and front was lighter and frizzy. Not enough hair was growing to create curls or waves, so it looked like it was damaged.

Immediately I began a plan of action. This time, I wasn’t going to hit MPB with just one drug. I was going to have an armory full.

In November, I began a treatment which gathered supplements, drugs, and shampoos over the course of those following months. It has come to finally include the following daily routine:

Propecia (1X)
Rogaine Foam (2X applications)
Saw Palmetto (supplement, 400 mg each; 2X)
Nioxin 3-part System (no.2; in the shower)
Neutrogena T-Gel (1X; shower)
Nizoral (1x; shower)

The anti-MPB effects of Propecia and Rogaine are known to you. Saw Palmetto is reputed to have anti-androgen effects, as is coal tar (1% found in the T-Gel) and ketoconazole (1% in the Nizoral). Nioxin is proven only to thicken the APPEARANCE of the hair, but claims to clean away “environmental residues like DHT” on the box. Reviews and hearsay seem to back this up, so I’ve been trying it.

Why go through all the bother, you ask? Simple.

I am a musician. A player, a writer, a performer. Not just a musician, either. A damn good one, with artistic vision and a damn good shot at making it.

But this is the one thing holding me back.

1: Toupee/Wig – Will not. Don’t want to be playing a windy outdoor show or find myself in the throes of lust with someone I fancy when the proverbial “rug” falls off.

2: Shave – The aesthetics of being a performer on stage in the rock/pop medium require a youthful, attractive appearance. This I know firsthand; people who knew me when I had a large rockabilly pompadour or a healthy tangle of curls suddenly looked at me with sad shock when my receding hairline and thinning temples were revealed. I have an odd-shaped head, and that doesn’t help either. So nix the Telly Savalas look for me.

3: Hair Transplant – This is the most promising option. I have read all sorts of “breaking news” regarding WNT proteins and new solutions for this age-old bastard curse, and they may eventually pan out. But not in the next five years, and certainly not soon enough to take advantage of my youth and hit the big time. But I do not have tens of thousands of dollars to spare (especially in the midst of the economic recession), and I know that (sparing a new cure) my situation is only going to get worse.

I have read on many forums that Propecia (or finaesteride at all) loses it’s effectiveness on most men after 5 years of use. This rumor is widespread and greatly troubling; if true, the backbone of my (and many other men’s) MPB treatments will be null and void in 5 years or less, leaving us to lose all the remaining hair in a fast, depressing way (as I did much of my hair last summer).

I am at ends. While one’s self-worth should not be based on looks alone, appearance is crucial to the formation of identity. And when that tool, that weapon of good looks is taken away from a hopeful star, what is there to do?

Again, your time is most sincerely appreciated and I truly thank you for reading this.

You are incorrect with regard to Propecia (finasteride). It continues to work for years and does not simply stop at the end of the 5th year. What usually happens is that hair loss continues to progress and eventually (around the 5th year), you may go back to your baseline hair loss pattern — but if you stop the Propecia altogether, you will be far worse.

You need to get a good doctor to build a Master Plan for you. It is said that the person who treats himself may have a fool for a doctor. You’re throwing everything at your hair loss, and while it may not be a bad thing (unless you count the expense of money and time involved), it might be excessive and unnecessary. Please, discuss this with a doctor — the physician that prescribed your Propecia is probably a good place to start. Thinning hair can be devastating to one’s self esteem, and many people will do whatever it takes to not let that happen.

I wish you good luck and thank you for sharing your story with us.


2008-03-18 10:01:57Reader Shares His Daily Hair Routine

Does fin affect athletic performance negatively, positively, or at all?

The World Health Organization’s Adverse Drug Reaction Database contained 508 reports of serious muscle-related side effects suspected of being linked to the use of finasteride, mostly atrophy, weakness, myalgia and sudden, strong muscle tightening (spasms).

Results newly reported in JAMA show that the muscle mass of men is not affected by inhibition of 5 alpha-reductase, the enzyme that produces the androgen 5 alpha-dihydrotestosterone (DHT) from testosterone


2021-08-04 09:17:37Does fin affect athletic performance negatively, positively, or at all?

Does finasteride make a man more feminine?

I’m a gym bro, have healthy testosterone levels and considering fin. As I understand it. Fin increases testosterone, increases estrogen and decreased DHT, it’s the last two I’m worried about. Talks about ED and gyno, although rare, make me worry for my “manliness”. Can anyone speak to muscle building, voice tone, behavior/deamenor while on fin?

No, the dose of finasteride is far too small to overcome the impact of all of your male hormones.

Releasing Clinical Trial Results, Follow-Up

FDANote: One of my favorite contributors to this site is a reader (that wishes to remain nameless) that has provided wonderful insight into areas like LLLT (hair lasers) and the FDA. I’m admittedly not an expert in everything (no matter how much I wish I was), and he’s corrected my initial thoughts about companies publishing ongoing clinical trial results. His email is as follows:

Dr Rassman,
As someone who has worked in the drug development industry, I try to keep your readers updated with accurate info on how this process works. One of your readers asked whether “Aderans…would send out an update on their Phase 2 trial data……..and whether there are rules requiring such info to be confidential.”

There are no rules to keep trial data confidential. The sole reason why data from an ongoing Phase 2 trial is not released is because it is not available. That is, no data is available to a sponsoring company until a drug study is complete (or in rare cases, when an “interim analysis” is done). When a company begins a trial the data (and identity of the participating patients) is kept secret from the company during the conduct of the trial. This is to ensure that no data is manipulated; extraordinary safeguards are put in place. Intentional violation of such safeguards with hiding of the act is a form of scientific fraud and would result in failure of drug approval and public sanction of the company by regulatory (and other)
authorities.

The FDA (and regulatory agencies, in general) have no jurisdiction of when a company reports data to the public (and do not care). However, public reporting of inaccurate data can result in sanctions from both regulatory agencies and, if the company is public, the US Securities and Exchange Commission (SEC). The latter relates to how public release of trial data typically affects a public stock (good data raises the stock price, bad data lowers it).

Nearly all public companies release Phase 2 clinical trial data (regardless of positive or negative) on trial completion for 2 reasons: (a) to communicate results to the scientific community, and (b) to communicate the results to shareholders. Withholding such data from shareholders can be perceived as having “inside information” of results that are considered “material” (i.e. important for shareholders to make decisions on purchase or sale of the stock). In cases where a company is private (rare when a company is at the stage of Phase 2), trial data is usually released to encourage future investors (positive data) or explain why a program is not moving forward (negative data).

Bottom line: Aderans can not send out a trial update because the data will not be known until study completion and analysis (the FDA has nothing to do with this). There are no rules to keep trial data confidential when a study is completed and, in fact, there are many reasons why public companies are required by the SEC to divulge these results. In fact, the SEC has brought legal action against some companies that they feel have not released “material” clinical trial data in a prompt fashion.

Renewing My Propecia Prescription

Hi, thanks for your site, it’s been a tremendous help.

I’ve been taking finasteride for about two years now, and wanted to go about renewing my subscription. Unfortunately, my doctor is swamped seemingly, and I’ve had to make my appointment 85 days from now.

I’ve had a very positive reaction with the drug and have grown back most of the hair I’d lost (I started in its early stages) and was wondering what the best way to ration out the pills would be in order to minimize hair loss. Should I continue taking the 23 remaining pills and then tough out the next two months, or would I be able to squeeze some benefit out of taking one roughly every 4 days until my appointment?

Thanks a lot!

Why don’t you call your doctor’s office and explain that you would just like a renewal of the same medication that you have been taking at least until he/she is able to see you? I am sure the doctor would have no issues with this.

The half-life of Propecia is short, so if you HAD to ration them out, I’d think splitting each pill might be the best bet so that you get at least some finasteride each day. But first, call your doctor and see if that resolves the renewal problem.

Does Increased Shedding with Finasteride Mean Its Effective?

gday doc,

great blog.

l’ve been on 1mg finasteride for about 9 mths and have recently noticed increased shedding (about 2-3 times more hair than usual).

lve read that finasteride causes synchronization of the hair cycle and as such this can occur and might be taken as a sign that the medication is effective.

Is this correct?

No one really knows for sure. I have heard reports from patients and readers such as yourself that starting finasteride may cause shedding. Aside from the anecdotal evidence, I have not heard or read about a scientific research on this phenomenon. I would hope that the shedding is the result of the drug and the hair going into another growth cycle rather than an acceleration of the hair loss that is due to your genetics. Time will tell the answer here as the shedding should stop and reverse by the 4th month if it is caused by a change in your hair cycle.

Nevertheless, the effectiveness of finasteride (Propecia) has been well studied and documented. Thus, it would not be a good idea to stop taking the medication if you are experiencing hair loss. The hair loss may be worse if you stop the medication as your body will play “catch up” and go back to the state as if you were never on the drug.


2007-01-29 09:13:51Does Increased Shedding with Finasteride Mean Its Effective?