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Microdosing Finasteride, from Reddit

The following is from a Reddit post. The graph is very interesting. I asked for the references from the poster for scientific clarity:

BACKGROUND: Many of you will be familiar with this old graph showing DHT inhibition from various microdoses of finasteride. You may even be using that data to help you choose which microdose of finasteride to take in an attempt at minimizing the chance of side effects. Turns out it was derived from the study: “Clinical dose ranging studies with finasteride, a type 2 5cz-reductase inhibitor, in men with male pattern hair loss”. However, as far as I can see, the graph isn’t actually displayed in the original study. Someone created the graph from just the numbers that the study reported.

Anyway, the home-brew graph contains a number of limitations, so I’ve improved upon it in the following ways:

    • Instead of using just one study, mine uses three, one of which is topical. That’s all of the range dosing studies as far as I know! They are colour coded everywhere in the image for clarity. The old graph is represented in my new graph as the red solid (not dotted) curve.

    • The graph display range has been adjusted from 0-5mg to 0-1mg. This helps make it a lot easier to see the much smaller microdoses, even around 0.05mg.

    • I give the ORIGINAL data points (as shown by the diamond/circle/X points and x/y labels). Needless to say, everything else is derived and only an approximation, so should be treated with caution!

    • Accuracy is better in the new one. The old one has a figure of 25% DHT inhibition for 1/16th mg dosage. I think the true figure is more like 37% as shown in the new graph.

    • I also give (where applicable) the DHT percentage reduced not just in the serum, but also the scalp, and also show a curve reporting the number of hairs grown back (or lost) – see the dashed red curve.

    • Finally, the studies I used are listed, and I stated the number of days / months before a DHT measurement is taken.

As more microdosing studies come in (topical or oral), I look forward to updating the graph further. Here’s the new graph again: https://archive.is/OGDk3

 

 

Click to enlarge


2020-12-04 08:42:43Microdosing Finasteride, from Reddit

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Avodart and Mixing Shampoos

Hello Dr. Rassman.
Thank you for taking the time to respond. I also wanted to ask you about going on Avodart (Dutasteride) or it’s Generic Dutagen. I have been on Propecia since 1999, and I think it is no longer working. I read Merck’s official report on Propecia’s 5 year efficacy, and it looks like after 5 years Propecia stops growing any hair at all, and it’s ability to keep hair is weakened. Dutasteride appears to block 93% of DHT production, where Propecia can only block 38-45% DHT. Can I get a prescription form you or Dr. McClellan? I am noticing that my “own” non-transplanted hair is thinning, and hopefully the Dutasteride or it’s generic version can stop any more loss.

Also, I am using Nizoral shampoo (Ketoconazole) 2 times a week, and Head and Shoulders shampoo (Pyrithione Zinc) on the other days. Is it safe to mix the Ketoconazole and P. Zinc? A friend told me that the P. Zinc can cause miniaturization of the hair follicle, and mixing the 2 shampoos can have disastrous results. Then on the the other hand, many people on online hair loss forums are saying it is fine to mix the two shampoos. Only using Nizoral 2x a week does not stop my newly acquired incessant itching. It would be great if I knew it was safe to use Ketoconazole and P.Zinc.

Thank you so much for you time, I’m sure you hear all these worries all of the time. Now that I see my new hair sprouting, I want to keep it growing, and keep or grow more of my own.

Here is a link to some of my other posts with my comments on Avodart. I will make a decision with regards to prescribing Avodart in early September, after I return from the International Society of Hair Restoration Surgery meetings in Sydney, Australia.

With regard to the various questions you had concerning the shampoos you mentioned, I really do not know the answer, as many people respond differently to each. Experiment with each and when you find something working, then stick to it. Mixing shampoos should not be a problem.

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Bad Surgical Planning (Photos)

They say a picture is worth 1000 words, clearly that is the case here. The surgeon’s plan was faulty from the start, transplanting only the first 2 inches of the hairline from an FUE harvest and leaving the area behind it bald. After 8 months, the plan nevertheless failed, because the grafts failed to grow. If the surgery would have succeeded, this poor man would have a bald patch between the transplants and the hair behind it. What the surgeon should have done was either spread out the recipient grafts to cover the entire frontal area that was devoid of hair producing a thinner look, or he should have increased the number of FUE grafts transplanted into the front and top. No person should be left looking like a half finished hair transplant job as this man would have looked like had the surgery succeeded. His doctor was clearly more oblivious to the realities of the transplant technique than this patient believed. Now he has lost about 2000 of his donor follicular units forever (possibly 1/3rd of his supply), and has a failed transplant in the front that he has to live with.


2018-12-18 10:09:22Bad Surgical Planning (Photos)

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Bald Spot After Accident With Hair Clippers

About 4 months ago my fiance had bought a pair of clippers at our local walmart so he could cut his own hair. (which he had done for many years) Well somehow in the middle if shaving the back of his head, the clippers pulled his hair and took a nice big chunk out of the back of his head. Ever since then there has been a bald spot a little bigger than a half dollar on the back of his head. The spot just won’t grow back! What can he do? Thanks..

ClippersOuch! I assume by “chunk”, you mean a bit of scalp. If that’s the case and hair and skin came out, that is certainly not good. I have no way of knowing either way if it’ll grow back though, as I haven’t seen the wound (depth, size, etc). If it does not grow back, he may want to transplant hair it if it is large enough to be noticeable.

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Miniaturized Hair — Does it Mean the Hairs are Thinner or The Entire Head of Hair is Less Full?

You really spend a lot of time working on this site. So I’ll be brief.

On March 22nd 2007 you had a post of a man that was trying to keeping his hair full (Trying to Keep Looking Full). You stated that he had 50% miniaturization of his hair. Does 50% miniaturization mean that 50% of the hair on the crown of his head has miniaturized and 50% is normal? Or does that mean the hair strands themselves are 50% thinner then when he was younger?

Also, I just started 1/4 tablet of Finasteride two weeks ago. I’m almost 25 and my crown has started to miniaturize. I know it’s too early to see positive results. But is it too early to see shedding? I ask because I’ve noticed a few shorter hairs in my hand after I run gel through my hair. The hairs are about an inch or so shorter then the rest on my head.

Thanks!

Hair that is miniaturized comes in all sizes and the thinner it gets, the more advanced the miniaturization is. When hair miniaturizes, it often is less long as the hair growth slows down. More advanced miniaturization will stunt the hair growth almost completely, a stage before it falls out. This is why I near-constantly write about getting a good baseline on your miniaturization with a series of measurements so you know where you are starting from. This way you can see numbers and the visual effects of the hair loss process. I hope this clears up any possible confusion.

I’m assuming that when you say you’re taking 1/4 tablet of finasteride, you mean 1/4 of the 5mg finasteride (which is Proscar or generic Proscar). Otherwise, I do not understand why you are taking 1/4 pill of the 1mg finasteride Propecia pill. There is no reason to reduce your dose from the recommended 1mg hair loss treatment, unless you’re one of the unlucky few that are experiencing side effects.

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Balding at 14 Years Old

I work in a school and recently met an 8th grade student, so 13 or 14 years old, who had very advanced male pattern baldness. It had clearly progressed in the male pattern, and he was somewhere around a Norwood 5 or 5A. There was a large bald circle on the crown, and what remained of the forelock was very thin. My question is: Is it possible for MPB to occur that early without the presence of a disorder, or does balding at such a young age reflect some underlying problem beyond the simple genetic predisposition for male pattern baldness?

Androgenic alopecia (AGA) or Male Pattern Balding (MPB) starts with puberty when the hormones change in the young man. In general most MPB starts around late high school/ early college years. I suppose a 14 year old going through puberty can have signs of MPB. I have seen 16 to 18 year old boys with complete Norwood 5/6 balding.


2015-09-24 13:50:41Balding at 14 Years Old

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Minoxidil and body hair

hey dr, your patient that take oral minoxidil do they develop unwanted hair on back- shoulder or upper cheek? thanks

Every person responds differently. Some get more body hair, and some don’t.

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Balding Time-Lapse Video

Hi Dr. Rassman

I just watched a timelapse video of a man age for 17 years, which shows the balding process really nicely. I noticed that his hairline recedes very slowly and gradually. But his crown thins all of the sudden at age 44. Can you explain why this happened?

Thanks

This is a great video illustration! This man took multiple photos daily for nearly two decades. As to why he lost his hair in this way… it’s all in the genetics.

See the video below: