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Woman with Androgenic Alopecia Being Treated with Avodart

I am a 42 year old female with diffuse hair loss diagnosed as androgenic alopecia from a scalp biopsy. I am currently being treated with Yazmin, continuous active pill, spironolactone 200mg and Avodart since May 2006. I have had significant progress but some reaction (dry and itchy) to the spiro. I am considering trying a different protocol because I don’t like being on 3 meds especially when I am not gettin as much improvement as I would like, and some concerns about being on 3 medications. I looked in to a hair loss clinic that uses the following combination – 1. An herbal DHT blocker that includes many supplements I have read about for hair loss, 2. A topical treatment that include minoxidil in a carrier solution to neutralize the negative effects of etoh on the scalp, 3. Regular in clinic laser therapy that has 70 lasers (as opposed to 1 used in the comb) 4 A co-enzyme to stimulate hair growth. Do you think this regime is a viable alternative to the three medications? I know any of these treatments takes months to show effect so I am trying to make as informed a decision as possible since the prospect of counting 250 hairs in the shower again is very scary to me.

You are on several treatments and are considering more. Of those treatments, some are not proven effective for women with male pattern baldness and some have exclusive and limited indications. The DHT blocker finasteride has been studied in women with androgenetic alopecia. Although effective for men, this medication was not proven to be effective for women. Dutasteride (Avodart), another DHT blocker, has never been studied for this purpose in women.

Using lasers for treatment of hair loss has been controversial and although advertised extensively, is not yet (in my opinion) proven to be effective. If it helps at all, the benefit will be new hair growth in the 10% range. Application of spironolactone for treatment of alopecia is limited to some patients with elevated levels of androgen. Topical DHT blockers have a theoretical value in men, but they have not been studied and should be no better in women than systemic DHT blockers like finasteride.

You seem to be determined to fight the baldness, an admirable trait. The best thing you can do is to find a good dermatologist for a thorough evaluation to be assured that you do not have a medical cause of hair loss which is common in women. Using anecdotal modalities for treatment of your condition may be disappointing at the end, let alone the money and time that you lose.


2007-03-19 16:02:55Woman with Androgenic Alopecia Being Treated with Avodart

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I Grew My Hair Long — Should Bangs Look Thinner Than the Rest of My Hair?

Hi Dr. Rassman,

I’m a 22 year old Caucasian male who has experienced some recession due to maturation of the hairline (I hope so anyway). As a teenager I wore my hair long, and I now have long hair again. My question is, is it normal for my bangs to look and feel thinner since there is a higher hairline, and hence, less hair to drape down? And if so, is this a commonly reported phenomenon? Thanks!

This may reflect the miniaturization at the leading edge of the hairline, the first findings for hair loss. If your hairline just got higher due to maturation, I wouldn’t expect your bangs to appear tin. It’s tough to know what you’re seeing without examining you, though.

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Wondering if bodily resistance to fin/dut is possible

Does this “tug of war” refer to the idea that your body responds to fin by increasing 5AR enzymes and therefore DHT in response to finasteride? Or does this refer to the idea that even if you inhibit 70% DHT with fin, or 90% with dut, it simply may not be enough to stop genetic balding?

The later. Also it assumes that you can stop the Apoptosis (programmed cell death) that hit hair follicles after they go through a specific number of hair cycles that are programmed in our genetics. Generally, finasteride prolongs the growth cycle and reverses the miniaturization of those hairs that are miniaturized. Given time, if the genes are strongly influencing the hair follicles, these drugs may fail over time.


2020-12-21 11:12:10Wondering if bodily resistance to fin/dut is possible

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I Had a Hair Transplant 7 Months Ago and It Still Doesn’t Grow Right

I had a hair transplant about seven months ago. It was performed April 5 2009. I had been cutting my hair all this time because I am in the military. but started to grow it out the last two weeks. but it still looks funny. What I mean by that is when it grows it doesn’t match the rest of the hair. the back hair is more full, and the front looks like stitches. Is this normal after seven months? How long do I have to let it grow to make it match the rest of my hair?

I do not know about your hair transplants or how the procedure was performed. I do not know what your expectations were or if you were given realistic expectations. So I really cannot comment on what you are experiencing. Keep in mind that not all hair transplant procedures are the same. The doctor and the team you chose can either produce great results or substandard results, depending upon their experience and skills. It is not like shopping for a car.

The best advice is to follow up with your doctor. Sometimes it can take a full year for 95% of the growth to be evident. At 7 months, I would expect 60-80% growth.


2009-10-13 11:13:32I Had a Hair Transplant 7 Months Ago and It Still Doesn’t Grow Right

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Would Constantly Shaving My Head Destroy the SMP?

My question is in regards to the SMP (scalp micropigmentation) procedure. I’ve been taking propecia about four years now-started when I was 18. My hair has halted the balding process, but I cant tell it’s slowly creeping back up, which is what I expected anyways. I’m very interested in the SMP procedure, since scarring (even minimal) and a life-time commitment to propecia just isn’t for me. My questions are:

1) As opposed to hair transplant, how old does one have to be to become a good candidate for SMP?
2) If the procedure was done, would constantly shaving the head destroy the tattooed “hair”?
3) If after SMP, one would to stop propecia and lose their hair that was retained from the drug, would the loss of natural hair be noticeable even with SMP?
4) Lastly, are there any more recent photos you could share with us other than the ones already listed?

Thanks

Any age above 18 years old will work for me if the patient understands the positive and negatives associated with the process. There’s a list of frequently asked questions at the SMP site.

Many people will shave the head every day or every other day. This is a personal preference. Shaving your head shouldn’t destroy the SMP.

If you stopped the Propecia, you would lose all benefits of the drug and the hair loss will play ‘catch up’ to what it would have been.

We only post the photos of patients that grant us permission, but we keep updating the SMP site with new photos all the time. Keep watch on it.

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I had my Gynecomastia surgically treated, Can I now take finasteride?

Taking finasteride seems to have little effect on recurrence in patients with alopecia who have undergone surgical treatment of gynecomastia. Surgeons may recommend continuous finasteride therapy in patients with alopecia who wish to take finasteride after the surgical treatment of gynecomastia.


2020-11-10 06:30:33I had my Gynecomastia surgically treated, Can I now take finasteride?

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Do celebs take finasteride or just get multiple transplants?

I’ve been wondering about this for some time. I’d be inclined to think that they take fin, but they also have the cash to just hop into a doctors office if they notice any thinning. I wish Steve Carrell would do an AMA. I wanna know if his progression is the result of fin or multiple transplants.

Many of the celebrities I have worked on (movies, CEOs, politicians) will keep working their hair with additional hair transplants until they achieve their expectations. Many use the drug finasteride as well. A good doctor sets expectations with his patient prior to the first surgery.


2019-12-11 09:18:04Do celebs take finasteride or just get multiple transplants?

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I Have A Wide Scar On The Back Of My Head, Is There Anything I Can Do?

Hi there I have scar in the back of my head very wide and I like to know if theres anything to make invisible when I shave bold I can see the big strip there, please let me know thanks!

Yes. The scar in the after picture here is still there. Can you see it? This is a typical result of our work with Scalp Micropigmentation?

SMP – Scalp MicroPigment to hair transplant scar

In addition you can check out this POST


2019-03-11 22:08:56I Have A Wide Scar On The Back Of My Head, Is There Anything I Can Do?

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Years After Hair Transplant, I Still Get Scabby Growths in Recipient Area

At least 5-10 years ago I had multiple sessions of hair transplants. All these years later, I am still getting scabby type growths at up to dozens of the implant recipient sites.They dont hurt ,but they feel annoying-as they feel like small crusty raised bumps that I have to kind of pick and tease off since hair is growing up threw the center of them.I am fair skinned Irish so I am very careful not to get a sunburn on my scalp or it makes this problem MUCH worse .Any advice/product or Rx recommended?? Thank You

I would have to see you and look at your skin to understand the problem. Flaky skin (dandruff) can be something brought on by a scalp surgery. Zinc and tar based shampoos will work to control this. You can buy this in any neighborhood drugstore.

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I have diffuse thinning

I’m a diffuse thinner, and while my hair is paper thin, I technically don’t have a completely bald spot on my whole head. Does a thin hair mean there’s a chance it can be revitalized?

No. Thinning is not an easy diagnosis to make and it requires a trichoscope and an expert doctor to understand the cause and if there is an effective treatment for which a hair transplant is often not appropriate.


2020-06-04 11:03:19I have diffuse thinning