Balding Blog

Dr Rassman
I have read about avodart injected into the scalp with good results. Can you tell me how it would work without getting into the blood stream first. Here is the link:

Mesotherapy using Dutasteride-Containing Solution in Male Pattern Hair Loss
(PDF file)

The results are interesting, but the sample size was very small and the length of the study was only a few months. This might be worth exploring with further research, though. The paper is almost 2 years old, so if there’s a follow-up study I’d love to see it.

This paper says there were 28 patients that completed the study, with 14 having received an injection of “0.05% dutasteride containing solution” and 14 receiving a saline placebo. Hair growth was noted in most of the 14 dutasteride-treated patients, and all of the placebo patients did lose hair. This is promising, but since the study only went on for 12 weeks (I realize it was just a pilot study), a longer study should be established in the future to address safety concerns. Growing hair is great, but if you end up risking your health it negates the cosmetic benefit of your hair. Also important to note — this doesn’t appear to have been published in a peer-reviewed medical journal, which means it wasn’t subjected to any scrutiny by those experienced with this medication and method of application.

I appreciate you bringing this to my attention as it is quite interesting, but I wouldn’t suggest anyone rushing to have this done though. Besides, taking a pill sounds a whole lot easier and less painful than injections in the scalp — not to mention that dutasteride still isn’t even FDA approved for use in treating hair loss and anything injected into the scalp (which is very vascular) will see fast absorption into the body 100% of the time. The paper itself concludes, “As is often the case with previously untested new techniques, this study raises more questions than it answers.” Indeed.

In a recent post (Propecia and Coffee) you mentioned that some people believe that the increase in urination from drinking coffee and/or alcohol might diminish the impact of Propecia.

I currently drink about 1 gallon of water a day and because of this I urinate a lot. Could this prevent me from seeing maximum results from Propecia? Should I drink less water?

With respect to the post you are referring to, I never stated I believe in the theory that urination will make Propecia less effective. People write about these things on the Internet and the speculations get propagated (as I have probably contributed). So no — I do not think drinking and increased urination contributes to less efficacy of Propecia. I wouldn’t worry about it.

But, isn’t drinking a gallon of water a day considered excessive? I’d be concerned with possible water intoxication or hyponatremia.

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Hey Doc,

In the thirteen months I’ve been taking propecia I’ve noticed that the hair on the rest of by body has been growing at a much faster rate. I’ve also noticed that in the the four months I’ve been using rogaine, small hairs have been growing on my forehead and my eyebrows are definitely getting much thicker. Is there a correlation between them or am I just paranoid? This seems odd to me since nobody in my family is as hairy as I am at the moment Also, how long does rogaine usually last for before its effects begin to die out? I’m a 21 year old male with middle-eastern background.

Thank You.

Propecia (finasteride) blocks DHT. DHT is known to be responsible for secondary male characteristics, such as body hair. At least in theory, if you block DHT you would have less body hair. I have heard and seen on several occasions patients stating they got less body hair after a year of taking Propecia, but you would be the first one to say you have more body hair as a direct result of it. This can also be coincidence as well.

If anything, I would suspect that Rogaine (minoxidil) is causing body hair growth and is responsible for the growth of forehead hair. You must be either applying it to your forehead or absorbing some of it into your body, causing a systemic effect. Another thought is that you are only 21 years old and some men continue to mature in their secondary sex characteristics (body hair, for example) into their mid 20’s. I realize you are trying to make sense of all this even by comparing yourself to your family members, but sometimes it just is the way it is.

I’m planning to travel out to LA for a consultation [from overseas]. How far in advance do you recommend booking an appointment.

One final question. A few folks have mentioned nasty sheds that are associated with rogaine, and in particular with rogaine foam. If you read the blogosphere, it’s enough to scare one stiff. In your experience, how frequent are the sheds and do they often result in a negative cosmetic change in the short term?

Thanks

The more notice you can give for an appointment, the better… but if you’re in from out of town with a fixed schedule, we’ll do our absolute best to fit you in whenever you can stop by. I look forward to meeting with you.

As for minoxidil shedding, I think its pretty rare but I honestly haven’t kept much referential data on it. Since it is an over-the-counter medication (meaning a doctor’s prescription is not needed), I don’t have much follow-up with patients regarding it. If the shedding does happen, it should stop within a few months… but it doesn’t happen for most people.

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