Balding Blog

Is Rogaine only supposed to treat hair loss at the crown or can it be used for temple and frontal balding as well? If it is not meant for frontal balding, are there any products or drugs that do help with frontal balding?

I am not sure what you are treating. Do you have male pattern balding? You could have hair loss from other causes. Rogaine (minoxidil) can be used for temples and the frontal area, but it is highly unlikely to regrow hair there. Propecia works best in the crown, but it may be more effective than monoxidil in the frontal area in some people.

I am experiencing hair loss at my temples and front hairline. I am 24 and it is at it’s very beginning stages. I Otherwise have a full head of hair and have not had problems in any other areas of my scalp. After looking into all the products out their and doing some research I have found that $transplants$, Propecia and Minoxidil are the only real effective options. The transplants are not monetarily possible right now, the Propecia is said to have no results when being used for temple areas and Minoxidil leaves me with unanswered questions. It would be of much help if you could answer all of the below questions for me.

1. Would Propecia work in my case since I am at an early stage of loss?
2. Is a 5% solution of Minoxidil better for my situation or would a 2% solution be better?
3. Will the resulting hair I grow with Propecia or Minoxidil stay permanently as long as I keep using either product.
4. Will I build up a tolerance to the product after a year or so eventually rendering it ineffective.
5. I have read of a person who experienced increased wrinkles in his forehead as well as pronounced smile lines in his face as a result of Minoxidil, can this really happen and is it common?

If you can shed some light on these areas for me it would definitely be a huge help. This is the first serious step I am taking in dealing with this hair loss problem and I want it to be the right one instead of something I end up regretting or damaging myself over. Thanks

1. You need an evaluation by a physician if Propecia is an option. You need a miniaturization study to see just what is going on and to establish a baseline for whatever treatment you elect.
2. I generally recommend 5% minoxidil over the 2%.
3. There is no guarantee that if you regrew hair with Propecia and/or minoxidil in the temples, that it would be permanent. However, they should slow down or prevent further loss. See Are Minoxidil and Propecia Worth Using? (with Photos).
4. You will not build up tolerance, but your genetic fate will eventually catch up.
5. I’ve never heard of increased wrinkles with minoxidil.

Hello Dr.

1. 27 yr old male, Norwood 2~2.5
2. use propecia regularly for 3 years. This has helped greatly in preventing mpb.
3. use minox once a day (used to do 2x a day) 1ml on hairline and 1ml on crown
4. Within the last year my temples have drastically recided (sp?) and now my hairline is starting to go.
5. I am noticing even beyond my hairline there is diffuse thinning and it’s frightening to look at.

Do you offer any advice on any other medication to add to the propecia and minox mix? It seems one would have to try a non-fda med as a last resort before surgery.

I was considering adding revivogen (non-fda approval considered) but I am unsure of how it’s anti dht properties will affect my hormonal levels (i.e. will the combo of propecia and revivogen cause a severe loss in the production of dht that would lead to make gyno?). Obviously propecia is a systemic medication, but what of topicals such as minox, revivogen, spiro, etc.? Are they systemic or only confined to the scalp.

As a Norwood Class 2, I think that you should be tested for miniaturization to see if there is balding behind the hairline. First, you need to measure just what is going on to determine if you really have the problem that you think that you have. Second, if the Propecia is working, why go to non-FDA medications and put yourself at possible risk? You need a doctor to take charge of you and give you the guidance you need.

Hi Dr.,

I have a question concerning Nizoral shampoo. I take Propecia once a day, and have been using Nizoral every few days for the past month since there seems to be a great deal of praise for it as a supplemental item when using a treatment like finasteride (no decent clinical studies to back that up, I know). My question is, have you come across any recent evidence that suggests it has negative consequences/interactions as part of being on a regimen like Propecia.

Thanks

The use of both Nizoral (ketoconazole) and Propecia (finasteride) together seems to have great popularity to many of this site’s visitors. I have not seen negative reports from using both of these products together, so that’s good. There was a small study published in Journal of Dermatology in August, 2002 about using a ketoconazole and finasteride combination. From the study:

“One hundered male patients with AGA of Hamilton grades II to IV were enrolled in an open, randomized, parallel-group study, designed to evaluate and compare the efficacy of oral finasteride (1 mg per day), topical 2% minoxidil solution and topical 2% ketoconazole shampoo alone and in combination. They were randomized into four groups.

Group I (30 patients) was administered oral finasteride, Group II (36 patients) was given a combination of finasteride and topical minoxidil, Group III (24 patients) applied minoxidil alone and Group IV (10 patients) was administered finasteride with topical ketoconazole. Treatment efficacy was assessed on the basis of patient and physician assessment scores and global photographic review during the study period of one year.

At the end of one year, hair growth was observed in all the groups with best results recorded with a combination of finasteride and minoxidil (Group II) followed by groups IV, I and III. Subjects receiving finasteride alone or in combination with minoxidil or ketoconazole showed statistically significant improvement (p<0.05) over minoxidil only recipients. No signifcant side-effects related to the drugs were observed. “

There are possibly more recent studies on using ketoconazole as a hair loss treatment (there’s one from 2007 with no abstract available), but this one from 2002 includes combining the medications and was the first such study I could find. If anyone using both treatments together has a story to share, feel free to send it or leave it in the comments section.