Balding Blog

So if I start a new regimen and regrowth occurs would it start out as thin hairs then gradually grow thicker and thicker? Kinda like a reverse minituarization?

When we talk about hair regrowth, we are talking about two different phenomena:

1. The growth of new hair that was not there prior to the use of the medications
2. The thickening of the miniaturized hairs that will make the hairs that are there, thicker

The studies on hair regrowth usually refer to hair counts that show more hair numbers after 9 or so months, but the reality is that much of the fullness that is created by medications like Propecia, actually reflects the thickening of hair shafts. I can see this when I compare the metric I get examining hair a year apart with the microscopic miniaturization mapping of the hair that I do in most patients.

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I know it requires DHT, genes and age for MPB to start. Propecia reduces DHT a major cause of MPB. Surely it doesn’t lower all DHT but enough to keep hair years and years for most men. You always say that genes will eventually win over Propecia. How is that possible? Propecia supresses DHT removing what’s needed for MPB genes to work! Since that’s the case shouldn’t Propecia forever? Or is it because of the remaining DHT that Propecia doesn’t supress works slowly with genetics until one day makes MPB progress despite being on Propecia? So in that case how come they haven’t found a drug for 100% DHT suppression yet? That would do the trick!

Finasteride (Propecia) blocks about 70% of serum DHT. By comparison, dutasteride (Avodart) blocks about 90% of serum DHT…. but nothing is 100%. Also, we know that it takes more than just blocking DHT to stop hair loss. Our adrenal glands do produce androgens as well as the testicles and can contribute to hair loss. This may be a hard concept to some, so here’s a simplified attempt at answering your question with an example. You can take all the anti-aging pills you want, but you will still age and die one day. Final score — Genes 1, Pills 0.

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Hi Dr.,

After much consideration, I’ve decided to stop using minoxidil. And, as expected, I am now losing hairs the minoxidil was saving. But I suspect that some of the hair I’m losing now will grow back later.

My guess is that minoxidil lengthens the anagen phase for all hairs – indiscriminately – thus delaying those hairs’ telogen phases. And so, some of the hairs I’m losing post-minoxidil are “healthy” hairs whose telogen phases were delayed. Thus, I should regrow at least some of the hairs I’m losing post-minoxidil.

Do you agree?

No, I do not agree. People who develop minoxidil dependent hair will lose their hair if the drug is withdrawn and it will not grow back. If you don’t believe me, just wait a few months and I am sure you will be converted to my thoughts on your problem.