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First of all thank you for what you do with this site it is a tremendous resource. I am twenty and began to recede at the hairline about a year ago. I started taking one fourth of a proscar daily in April without a prescription and got a prescription for it in June after seeing a dermatologist. I have since been taking the generic version daily. The medication does not seem to be working as I have continued to lose much hair from my crown to the point where my scalp is visible in harsh lighting.

I have long hair but i have noticed in the last week that I am losing the very short (terminal?) hairs again after not noticing them for the past few months. Could this be due to the switch to the generic version? The proscar pills were individually sealed while the generic are together in a pill bottle could this air contact affect their potency? As it has been seven months and I have lost noticeably more hair should I discontinue the medication?

Thank you, my dermatologist is pretty clueless when it comes to hair loss, so I appreciate your knowledge.

Generic finasteride 5mg is the same drug as Propecia, which is just finasteride in 1mg strength, so there should be no difference in efficacy. I don’t think bottle vs individually sealed has any bearing on the potency.

Finasteride does not work that well for frontal hairline, so what you may be experiencing is just your normal course of hair loss that the drug cannot address, particular in a man of your age who might have an aggressive pattern of hair loss in the family line. Many men like you report that their father or fathers father or mothers father had an extreme balding pattern at an early age. These men will not see the same effects as men who are not heading to an advanced hair loss pattern. I would ask if any of those balding men in your family had advanced balding and at what age did they lose their hair? That may shed light on your problem. Lighting will make the hair appear thinner. Do you have comparison photos to look at from before you started? You’ll need to discuss changes to your medication with your prescribing doctor but if you have your father’s pattern (of advanced balding) nothing may help. The best way to know this is to see a doctor who offers hair bulk assessment with the HAIRCHECK system. If you are heading for advanced balding, then this test will tell you that. If it were me, I would want to know!

I started using Minoxidil 5% twice a day. I didn’t experience any side effects, so a year later, I substituted the 5% Minoxidil with 12.5% at night. I still didn’t feel any side effects. I switched to Xandrox 5% (minoxidil with azaelic acid) last December since I have PCOS and it was recommended to help stop the miniaturization of my hair. Within a couple of weeks (maybe even a week), I experienced heart palpitations. Is it possible that people can become hypersensitive to Minoxidil after a period of time (for me, 2 years)? Or could it be coincidental and related to something else?

Thanks

I have never recommend 12.5% topical minoxidil, as it can have serious systemic side effects (just as you described). More importantly, heart palpitations can be a harbinger to a serious and life threatening condition. I strongly recommend that you follow up with a physician for an examination. Minoxidil can cause a drop in blood pressure in a limited number of people.

Dr. Rassman,

I have been a patient of yours for over three years now and I recently visited your office back in August. After seeing you again it was established that my hair loss had not progressed from last year and had possibly even improved. Unfortunately, over the past month, I have been experiencing non characteristic loss. When I am in the shower, I have never ending clumps of hair coming of my head and clogging the drain. Also, when brushing my hair there is even more loss. Dr. Rassman, this has never happened before and I have no idea what to do. Is it possible that the Propecia that I have been taking since November of 2005 has stopped working for me and my genes are taking over?

All of the loss has been occurring since I have been out of town on a job. I seem to even have some kind of infection on the corners of my lips. I am sure the two things are not related, but I figured I would tell you.

Anyway, is this a normal experience for someone on the drug as long as I have been? Should I take more of it? Is it possible for a person to lose all of his hair immediately? Could this be a possible hair cycle or allergy? Again, I have no idea what to do and what to expect. I appreciate you taking the time to read this and your advice/help would be greatly appreciated.

Thank you and looking forward to hearing from you soon!

Hair loss can increase from stress amongst many other things, such as the normal progression of hair loss that occurs in some men (even those on Propecia). As one of my patients, please come see me and let me see if your miniaturization has increased. We can get a baseline on the HAIRCHECK instrument by measuring your hair bulk now and then repeat it in a year to see, for future purposes, if you are continuing to lose your hair.

Includes snippets from Wall Street Journal Article: Crucial to the hair-growth and balding process, scientists have found, vitamin D and the microscopic receptors that bind to it in skin as essential to good hair growth. These elements have become the focus for several research teams. (Supplements might offer health benefits for people lacking enough vitamin D, but they won’t bring back lost hair, researchers say.)

Some researchers, including those from the San Francisco Veterans Affairs Medical Center and Harvard Medical School, have identified molecules besides vitamin D that appear to activate the receptor and hold potential for future hair loss treatments. Japanese researchers demonstrated in animals that adding vitamin D helped the process of using stem cells to generate new follicles. Found in the Wall Street Journal — The Search for a Baldness Cure

My friend Dr. Richard Shiell commented:

“Plenty of sunlight and Vit D here in Australia (world’s highest rate of skin cancer). From my observation, our baldness rate and pattern-type is pretty much the same as elsewhere.

We are seeing Vit D deficiency in some Muslim women and children who cover-op and do not take advantage of our sunlight. I have not heard of any increase in hair loss. Kids at the beach these days are covered from head to knee as in the Victorian era so, if the author is correct, we should see more baldness in the future. I don’t believe it.”

It’s important to highlight the sentence from the article that states: “Supplements might offer health benefits for people lacking enough vitamin D, but they won’t bring back lost hair“.

In response to this news, some hair restoration doctors stated that they often recommend vitamin D as part of the treatment for women with balding or thinning hair. There does not seem to be a downside to this use, but I wouldn’t get too excited just yet about calling this a “cure”.

Tags: vitamin d, hairloss, hair loss, wsj

The neck hair is not permanent hair so as this man gets older, he may see his neck hair disappear and so will these grafts in the recipient area that came from the neck because these hairs ‘don’t know’ that they are not in his neck.

These photos are great. They show that you don’t need to have surgery to get great results, if you have the type of balding that responds to these medications.

I Got My Hair Back, Got Lazy And Now Back To Square One from tressless

Hi Dr. Rassman,

First off, I would like to say you have an excellent site here and it has been the source of many of my answers while I suffered with my paranoia of hairloss.

I wanted to ask about a type of hairloss I noticed while talking to a person. The man exhibited diffuse baldness and was almost completely bald on top however all over the top of his head he had a few thick hairs that were buzzed down. All the hairs that I could see were all thick. Also, his hairline was completely unharmed. It was covered in thick hairs from left to right. I was wondering if this is normal MPB or not since from my understanding in the diffuse form of MPB, all the hairs slowly thin out on top of the head. I know it is normal to see some thick hairs among thin hairs in someone who’s going bald, but this guy had only thick hairs on top of his head.

Thank you for taking the time to read this.

Some men who bald can have a persistent frontal hairline. Some never go bald in the front. These are a few exceptions to the classic Norwood patterns. You can also have thick (non miniaturized) hairs on balding areas. It is just that the proportion of thick to thin are different.