Speed of Hair Loss

Once miniturization of the hair begins, how long does it take until a person notices his hair is even slightly thinner ?I go back a year ago and it was still good and today less dense. A year seems pretty fast, but doesn’t it take longer?

The hair loss process varies with the individual and his/her genetics. There are no rules here. Some people take a long time to lose the hair while others can lose it in a year or two.


2008-08-11 14:13:08Speed of Hair Loss

Does Finasteride ever lost its ‘effectiveness’ after a while?

From a practical point of view, yes it does lose effectiveness as the genetic balding process advances beyond what finasteride can help. This often takes time, but even though it may lose effectiveness, it still has value and if you should stop it, you will see that you may undergo significant loss, not only what you gained, but what you would have lost had you never taken the drug.


2018-05-20 13:40:45Does Finasteride ever lost its ‘effectiveness’ after a while?

Standard of Care Consultation for Hair Transplantation

I just had my consultation at your office last week. I want to congratulate you with a professional way of managing your practice.

This blog entry is a little lengthy, but it is important to retell this man’s tale as he told it to me. For the purposes of privacy, I’ll refer to him as Joe.

Joe had received three opinions from different doctors over the past few months. The one with me was the last of the consultations. After receiving the nice note from him, I asked him for a competitive analysis. Joe had planned to get multiple opinions over a three month period and he had already attended one of our open house events prior to seeing me privately.

He had some comments about our practice, some of which were not flattering. He criticized the quality of our video as tired and out of date (it is 14 years old) and our brochure was not nearly as fancy as the ones that he had seen elsewhere. He might not have been aggressive at pursuing us if it were not for the generally less than professional presentation of the other two practices. With the two previous groups he had met, both were front-ended with a professional salesman who went through well-scripted processes, each recommending what the salesmen thought Joe might need to address his balding problem. Both of these groups applied considerable pressure to get him to schedule a hair transplant. At one of the two clinics, the doctor came into the office, but spent very little time with him, only confirming what the salesman told Joe about his needs. When he left each of the two previous groups, he was somewhat impressed, but skeptical of their sales process. Later, he did some internet research and found considerable legal problems with one of the groups and many generally negative comments on internet chats. Both groups were eventually crossed off his list.

Our office was his third stop. He came by an open house event and met with many patients that had been through the same thing he was now facing. Three patients came in without notice and they showed results that he felt were normal looking. He was impressed with the openness of the patients attending the open house. He met two patients with the exact balding pattern that he had, both in their 40s and they had Joe’s hair and skin color as well.

Joe went into the operating room and talked to the outgoing fellow who was having the hair transplant that day. When we eventually met, he was impressed that I had committed a full hour to the interview. The night of the consultation he went to the internet and found that every claim that NHI had made on its website (reflecting their authority as a pioneer in the field) was easily validated. This was quite different than the claims made by the other groups which he felt were over-hyped in their representations. The very next day, he got an email from me with what he said “was an amazing and thorough summary” of the conversation we had on his visit the day before. I had included a full fee schedule for the quoted estimate of work. None of the other transplant office took the time to produce such a document, not even the doctor who performed surgery on his broken nose a few years ago.

I developed my hair restoration practice as I did when I practiced a more traditional ‘general surgery’. I’ve always believed that a medical practice should be classy and that means to me that the doctor should take every effort to provide what he would want to see if he or a member of his family were a patient — and that would include an honest, open communication. Unfortunately, too many medical groups who are now dominating the field of hair transplantation, have applied heavy sales tactics (which I believe is either immoral or unethical). The patient can easily become a victim if critical information is held back. As a case in point, throughout this blog, I discuss the need for assessments with mapping of the scalp hair for loss looking for miniaturization, and even with multiple articles written by me on this subject, the metrics in this field have not been incorporated into the standard of care. I would never transfuse a unit of blood without knowing the hemoglobin of a patient who was bleeding, nor would I use potentially toxic medications without understanding the working efficiency of the liver or kidneys, yet many hair transplant doctors seem to constantly offer extensive hair restoration surgery without measurements of the patients existing hair status or in giving the patient some help in predicting his future hair loss.

We need a standard of diagnosis for the consultation process and we need to exclude the salesmen who dominate the process and make recommendations that should be in the exclusive domain of the doctor. We need to incorporate such processes as mapping of the scalp for miniaturization, in order to give the patient a fighting chance in understanding what he is agreeing to when he undergoes a hair transplant. We need to provide educational material about what the patient may experience, including all of the risks (not sugar coated) associated with a transplant process. If we don’t do these things, then I will continue to speak out about our standard, hoping that the consumer will press those in this industry to discard shoddy sales tactics.

Finasteride Interactions?

Hi Dr.,

I am a big fan of your site. I get to read your new posts everyday by subscribing to your RSS feeds. My question is, given that I take 1 tablet of 1mg Propecia everyday, will it interact with other supplements or even certain food?

For example, here’s a list of supplements that I take daily (i take throughout the day, separate times):
1. vitamin b complex and biotin
2. vitamin c
3. vitamin e
4. multi vitamin
5. omega complex
6. co-q10
7. methatione (gluthatione)

Or how about foods:
1. coffee
2. green tea w/ honey
3. soy milk
4. fiber (like wheat bread, fruits)

Just wondering if trying to be health by consuming these will counteract w/ Propecia or vice-versa? Hope this is a valid inquiry.

I have been getting these sorts of questions quite frequently lately. The supplements and foods you’re consuming shouldn’t have any negative interaction with Propecia. The only interaction I can think of with food is with grapefruit, which causes problems for a variety of medications.

The following 16 drugs are listed as having a moderate interaction with finasteride (Propecia): bosentan, diltiazem, diltiazem/enalapril, efavirenz, efavirenz/emtricitabine/tenofovir, fluconazole, fluvoxamine, itraconazole, nefazodone, nelfinavir, posaconazole, rifapentine, saquinavir, sirolimus, tacrolimus, and voriconazole. And there’s 1 drug that has a mild interaction: terazosin. These are the generic names, and for a more complete list (including brand names) see Drugs.com.

Stem Cell Bank Now Open in UK

For those of us in the field of hair restoration, we have waited for the day when stems cells could be used to activate hair. In my previous post, I linked an article on Progenerator cells and their role in hair regeneration. With the opening of this Stem Cell Bank in the UK, the access to stem cell lines may accelerate the development of solutions for hair loss. Read here:

https://www.the-scientist.com/?articles.view/articleNo/49155/title/First-Clinic-Ready-Stem-Cell-Repository/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=50176304&_hsenc=p2ANqtz-8s5kMWttlyETUROd55IBcDNPnyw5I3qwuBFwEb3FIExWjK-_fnAKMRXolTwLJSwD82pJJlCOcxljKw3-wlRj_FGybjzg&_hsmi=50176304


2017-04-07 14:49:57Stem Cell Bank Now Open in UK

Stimulate Chest Hair Growth?

is there a product out there to stimulate chest hair growth?

No. If you are under age 30, you might be having delayed chest hair growth which might yet appear. Give me more details, like your age. I assuming that you are male — chest hair on women is not exactly socially acceptable in our society, of course.


2006-09-18 10:03:02Stimulate Chest Hair Growth?

Finasteride sexual side effects question

I’ve been on finasteride for a little over 6 months now and so far up until yesterday I haven’t been experiencing any sides. But yesterday I was getting frisky with my girlfriend but couldn’t get my dick to get hard. This was the only time that this has ever happened, and there’s also other factors such as me not getting enough sleep the past few days. Was wondering if anyone knows when finasteride side effects supposedly happen. Thanks!

Maybe you are reading too much into it. Most men have days that they are off and maybe this was yours. Most men don’t get sexual side effects out of the blue. Give it some time and stop thinking about it, because you can make it happen


2021-01-27 15:06:06Finasteride sexual side effects question

Stopping finasteride after 5 years

I’ve been taking generic finasteride for around 5 years (since I was 25) and I’ve maintained the hair that I had when I started taking it. I also only had a minor side effect (orgasms seem to be a bit weaker, not too much but enough to notice) but the plus of keeping my hair outweighed this negative.

I read a scientific paper yesterday about the long term effects of neurosteroids and 5a alpha reductase inhibitors and it got me a little worried. Then I went down the rabbit hole of posts on places like Medium and Vice about how the drug ruined their lives and it was difficult for me to get some sleep last night and I was seriously considering just going cold turkey but even there you get people saying that stopping finasteride could give you PFS symptoms as well.

Not really sure what to do now, as much as I like having my hair I don’t want to screw up my brain and body over the long term.

Currently, I’m thinking of dropping down from 1mg to 0.25mg a day as I saw a graph showing that DHT inhibition only goes from 68% to 62% but what do you think?

Almost all of my patients who were on finasteride for years and who have stopped the drug for man y reasons, have often seen significant hair loss and regretted stopping the drug.


2019-06-22 09:30:44Stopping finasteride after 5 years

Finasteride then dutasteride and my hairline is still receding

I’ve seen a lot of your messages on reddit being very helpful for people combating baldness. If you have a moment I hope you could help me with a small question. In my mid 20’s I noticed my hairline begin to recede and went on Finastride. It seemed to work great. My hair recession slowed down significantly. However, when I turned 34. I began to notice my hair line was receding again. I’m aware that drugs like Finasride, more or less, just slow the process down. But I was alarmed at how quickly my hair seemed to be receding all of a sudden. It was like the drug simply stopped working. I panicked and with some research I found that Dutasteride was an alternative that’s been shown to be slightly more affective. So I switched, from 5MG of Fin(quartered) to 0.5 of Dutasteride. That was approximately 10 months ago and my hair continues to recede and thin, at what feels like an alarming pace.

So here is my question. Have I made a huge mistake in switching? Will I lose all the hair that I kept on Finastride even though I’ve switched to Dutasteride? I thought that if Dutasteride worked it would keep the hair that Fin was holding back. Or perhaps there was no slowing these effects any longer, whether it was Dut or Fin? I don’t know what to do.

Dutasteride and finasteride can be interchanged without negative effects. What you are describing is the inevitable changes in progressive hair loss and I doubt with the history you gave, that any medication will help you at this stage. If your hairline bothers you, a hair transplants is the only option.


2021-01-04 14:50:35Finasteride then dutasteride and my hairline is still receding