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I’m worried because the doctor missed half of my scalp (photo)

What was the plan you had with the surgeon? Did you and he discuss leaving the middle free of grafts? Did you have hair in the middle that is not showing here because of the shave? If you were uniformly bald, I would agree that this is not a good plan. You have a finite amount of donor hair so first I want to know what is your total donor supply estimate and how much of it was use for this surgery? That would allow me to determine what could be done in the future in another hair transplant session. Do you have a Personalized Master Plan with your doctor to address now and future issues of balding? This is critical, of course.


2020-03-10 06:42:52I’m worried because the doctor missed half of my scalp (photo)

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I’m Worried About This Shedding I’m Seeing After Starting Minoxidil

Dear Doctor,

I am 28 yr old male. I have been losing a few strands of hair here and there for the past couple of years. However, it aggrevated in the past six months or so, with visible thinning of hair on the crown and receding of temples. I consulted a physician and a dermatologist. My reports about anaemia, thyroid function and blood sugar levels are normal. I was informed that I am suffering from genetic male pattern baldness.

I have been prescribed Minoxidil 5%, twice daily, Propecia once daily with Nizoral 1% twice a week. I have been on the above regime for a month. However, I have observed dramatic hair loss in the past month. I am loosing about 300 hair everyday. The most worrying part is that there are times when I loose a bunch of two to three hairs with a single white bulb at the bottom.

I am told that the use of Minoxidil can cause such increased hair loss. From your vast experience, can you confirm if such increased hair loss is common in the first month of treatment?

Also, assuming that this increased hair loss is pursuant to initial reaction to Minoxidil – will the hair lost in the past month grow back to their original length and thickness or is the best case scenario that only small thin miniature hair will replace them?

Thanks

I’ve had some emails over the years of reporting on this site from people asking about minoxidil shedding. I’ve written about it here.

I can’t say for sure how long it’ll persist or if those shed hairs will regrow, but it seems to be a temporary thing that lasts about a month in those that see this initial shedding and the hairs usually do return.

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I’m Very Sensitive to Products with Alcohol, Like Rogaine Foam

Dr Rassman, is it possible for a person who is very sensitive to products containing alcohol even have problems with the Rogaine Foam. I stopped the foam because it was drying out my hair alot and I noticed my hair thinning more and falling out more. Even if I go a few days without using it my hair looks better. I never had itching or redness from it but my hair texture changed to a more haylike feeling. I used good conditioners too but my hair still was still too dry and the hair diameter was thinner. I have my hair professionally colored and it even strips the color of my hair near the roots. So basically is it possible for someone to have a negative result due to even a small amount of alcohol in the product. I also notice my face retains more fluid and my skin gets more acne when I use the foam or any type of minoxidil. Would that also be considered a negative reaction to minoxidil?

Rogaine Foam has alcohol in it, so if you do have a sensitivity it could be an issue. While the 2% minoxidil is alcohol based, the 5% minoxidil liquid is propylene glycol based (though check the ingredients on the packaging since it may still have some alchohol). You may consider trying the 5% as an alternative to the Foam. Alcohol does dry the hair out. If you’re retaining fluid in your face, that is a known negative side effect. I’d meet with a dermatologist about the acne.


2008-09-24 08:43:00I’m Very Sensitive to Products with Alcohol, Like Rogaine Foam

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I’m Using Olive Oil in My Hair

My hair is still thick, but it’s slightly receding on the left side, and a little from the front. I’ve using olive oil once a week, it seems like it’s ok, do u think I should keep doing that???

Do you use extra virgin?

I would add a bit of balsamic with a pinch of onion powder to make a great vinaigrette. All jokes aside, olive oil has been used as a wetting agent for the scalp. It has no value for hair loss, but if you like it, you can continue to use is relatively safely.


2006-12-12 16:29:39I’m Using Olive Oil in My Hair

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I’m Using 3 Hair Treatments and I Want to Wean Off Them

I have been using minoxidil and proscar as well as laser treatment for hair lose for the past 8 months and have had amazing results. I am 21 and don’t want to keep taking all these products for the rest of my life. Is it possible to slowly reduce the use of these products tell i no longer need them or at least be less dependent on them?

Of the three treatment options, you can stop using the laser treatment since it is very unlikely that it has contributed anything to your results. For finasteride, the 1mg dose has been judged scientifically as the ideal overall dose. There is no reason to change it. Since you have seen good results to date, stay on the minoxidil. Some people do develop minoxidil dependence, which means that when you wean off of it, the hair that were dependent on it may very well fall out. A very important take home message here is that once you are on the finasteride, then you are always going to be on it. If it is stopped, you will lose hair in the amount that you would have lost if you were never of the medication. You can’t lower the dosage until it isn’t needed — you will lose hair if you do this.


2008-08-11 11:14:14I’m Using 3 Hair Treatments and I Want to Wean Off Them

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I’m transgender (18 years old)

I have developed a mature hairline already and am concerned that I may get more hair loss. What should I do?

With a mature hairline at your age you will not know if you are losing hair (look to your family history) or if you are going to lose more hair. As long as you have testosterone produced by your testicles, you will lose hair if you have genetic balding. To find out, get a HAIRCHECK test to see if there is hair loss behind the hairline. Then you may have more decisions to make if the test is positive for hair loss.

 

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I’m thinking of stopping Minoxidil

I have been using Fin for 4 years with pretty good results, added Min to regime but now wanting to stop after 16 months as I’m getting a hair transplant later this year.

Hair transplants certainly help with balding, but the medication is what stops hair loss progression of your native hair that is still left on your head. I have performed hair transplants on thousands of men and those who stayed on finasteride were likely to be finished with their balding, as this man shows well: https://baldingblog.com/20-years-ago-2-hair-transplant-procedure-photo/

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I’m Terrified to Use My Prescription for Finasteride

Ive been sitting with my prescription to fin all week and not taken it because Im terrified of the side effects. Ive been doing a ton of reading on it and it seems any side effect is rare. Im also legitimately seeing regrowth in my buddy who told me to go for it. How often have you seen side effects with this over the years? What are some things I should look for should I give in and start?

Im not sure why I am so worried.

If you talk yourself into side effect, the side effects will be 100% nocebo type effect. But if you did as my son did (he just took it and never gave it a thought), he did notice in a week that his sex drive increased significantly and he then called me about it. Normally, negative side effects, when you subtract the placebo group, is under 2% of men taking the drug.


2020-05-04 12:43:45I’m Terrified to Use My Prescription for Finasteride

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I’m Taking Propecia, But I Want to Try Out Rogaine Foam

For time and financial reasons, how effective is it to start and stop minoxidil within propecia treatment? In other words, can I retain whatever I gain from Minoxidil as long as I’m still taking propecia.

I’m on propecia right now and would like to try the Rogaine foam, but don’t necessarily want to be committed to taking it for life without it being a waste.

Thanks for your help.

Stay on the Propecia and add minoxidil foam, but use the minoxidil foam for at least 8 months prior to concluding if it works. If there is benefit beyond what you got from Propecia, then you should stay on both, probably for life. The two drugs work differently and they can have added value to each other.

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I’m Taking Propecia and Avodart Together Daily — Is This Unsafe?

Hi Dr,
I’m currently taking both Propecia (1 mg) and Avodart (0.5 mg) daily and am noticing good results. However, I’m wondering if this combination has the potential to be unsafe – can it mess with hormonal levels? Does taking more of these enzyme inhibitors leave more testosterone in the body?

I am not sure if what you are doing is safe or unsafe, but I would never recommend it to any of my patients. I would follow up with your doctor who is treating you and ask for his/her opinion. Did the same doctor prescribe both medications? Do you have prostate issues or are you strictly trying to treat hair loss?

The sexual side effects are more common with Avodart (dutasteride), but when you add Propecia (finasteride) to your routine, I wonder if you have any sex life left.


2011-03-03 10:44:11I’m Taking Propecia and Avodart Together Daily — Is This Unsafe?