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Any Patients Take Propecia and Still Have Shock Loss?

Just wondering as you have said a few times that being on propecia will decrease your chance shock loss after a hair transplant if you are under 30.

Have you had any patients under 30 who have had shock loss after being on propecia for a considerable period of time? And if so to what extent was the loss? Thanks

When I saw the great majority of shock loss cases, it was before the availability of Propecia (early 90s). Since that time, most of my patients take Propecia to protect themselves from shock loss, and there was far less of the fall out after the surgery… but it did still occur for some.

I don’t have statistics on the extent of loss or precise age, though.

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Any New Hair Loss Drugs Coming Up?

have you heard of any new hair loss drugs in the pipe-line;if so what sort of amount of time will they take to become available to the general public

The FDA is the place to go to look for new drugs. These drugs must go through a clinical trial and there is no assurance that a drug that starts the process will qualify to meet the safety and effective standards of the FDA. In summary, I have no way to tell you what may happen. We all have to wait out the clinical trials.


2006-08-22 06:26:32Any New Hair Loss Drugs Coming Up?

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Any NeoGraft and Artas® Robot Alternatives?

What other “automated” or similar hair restoration systems are available besides Neograft and Restoration Robotics?

The follicular unit extraction (FUE) technique is a simple and elegant technique conceptually, but it is highly variable or difficult in practice. Since I published my FUE article in 2002, hundreds of doctors have adapted their own automation and instrumentation. I encourage this, as one superior technique or machine may emerge. But as of 2011 it has not.

There are handful of doctors who have invented their own technique in some form or another. NeoGraft and the Artas® robots are just commercial adaptations. Both Dr. Cole and Dr. Harris have developed instruments which are diametrically opposed as to how they work. There is also Dr. Boudjema in France (one of the brightest and most creative people in the hair business) who first invented an FUE automation machine back in the mid-1990’s called the Calvitron (which is similar to NeoGraft). He always has a new approach and just recently talked with me about his most recent innovation (brilliant as always).

Real inventing requires ‘out-of-the-box’ thinking, but most of what is out there are just minor variations of each other. There are powered punches that vibrate, twist one way and then the other way, that are slow in RPMs, that are fast in RPMs, that claim sharper punches or duller punches as the key to best results, etc.. The Artus system uses sharp followed by dull punches and the Neograft uses very sharp punches. Each doctor will likely say ‘his’ instrument is the best.

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Any Miraculous Results from Unusual Hair Loss Cases?

Hi Dr.

What is the most unusual case you have come across during your time dealing with hair loss patients.

Has there been any miraculous results or otherwise unusual results that may give some of us extra hope?

The usual hair loss cause in men the vast majority of the time is genetics. There’s not much you can do to change what your mom and dad gave you. At times the hair loss is not uniform or symmetrical and this leads to some interesting patterns. In many patients, I have seen one side balding much faster than the other. Unusual hair loss patterns in men include a completely Norwood class 7 pattern except for the first 1/2inch of the hairline, which is completely intact. Many of these men grow out the frontal hair and use it as a strange looking comb-back hair style, and it works.

For men, we can postpone the inevitable with drugs such as Propecia (finasteride 1mg) or Rogaine (minoxidil 5% topical). I suspect in the coming years, there may be new drugs or other medical breakthroughs such as cloning, but that may take years just to get FDA clearance.

The hair transplantation methods of the past have created many interesting problems today. In the old days, plugs were put into the crown before the hair was lost, and then as the balding progressed, an island of plugs remained in the middle of a bald crown — a very weird look. Hair transplant surgery today provides awesome results. Not to toot our horn, but our patients seem to think they get miraculous results… which is a prejudice induced because of the life changing nature of the process! Look at our photo galleries to see for yourself.


2012-06-06 10:26:01Any Miraculous Results from Unusual Hair Loss Cases?

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Any Hair Growth Miracle Stories?

Doctor — I know you don’t want to raise anybody’s hopes. But here’s a question you’ve haven’t addressed before (amazingly) — I think.

Are there any miracle stories you’ve seen? Where someone came in with a lot of miniaturization, at a young age, and somehow didn’t get much worse even without treatment?

Or someone looked in terrible shape, nearly balding, and regrew much of his hair and it was hard to see he was balding?

Virgin Mary grilled cheese miracleI honestly don’t recall anything that would really qualify as a “miracle story” using your criteria of having major hair loss, yet the hair spontaneously regrows without treatment. If someone came in with a lot of miniaturization showing at a young age (late teens to 20s), I’d probably prescribe them Propecia… so there’d be a treatment in there to prevent the progression. But if hair did spontaneously regrow (here’s your hope), chances are the patient wouldn’t come back to me for a follow-up, as he’d have no need for a doctor to look at his loss anymore.

I’ve seen plenty of miracle stories from medication though, and plenty of amazing results from hair transplantation. I guess a miracle could be labeled on a case where an extremely bald man with fine hair was able to achieve amazing results from hair transplantation and a camouflaging agent. Or like the story I mentioned a month ago, where a 79 year old friend of mine was treated with Proscar for his prostate enlargement and he regrew hair as an unexpected bonus. Or when someone with a form of alopecia areata (totalis or universalis) has even the most minor hair regrowth, that can be considered a miracle. Different people will have their own way to define a “miracle”… such as a grilled cheese with a funky toast pattern.

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Any Difference Between Generic Minoxidil Brands?

Hey doc,

I want to know if there is any problem if I switch brands. Lets say i’m using brand A of generic minoxidil and switch to brand B of the same type (i.e: 5%), would there be any problems?

Thanks

As long at the minoxidil concentration is the same, there should be no difference. The FDA has rules that control the quality of the drugs and the claims in ingredients.


2008-08-11 14:11:42Any Difference Between Generic Minoxidil Brands?

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Any Data for 2mg Finasteride Benefits?

I understand that a 1mg dose of Propecia is recommended. What I want to know, however, is how much more hair grew at a 2mg dose vis-a-vis the 1mg dose — 10% more? 15% more? I know these data exist. So, what incremental improvement might there be with a 2mg dose?

While it’s quite possible that the data for 2mg finasteride hair loss treatment benefits exists, I don’t have it, I don’t recall seeing it, and I’m not sure if it was ever made available to the public.

I do know that there were studies that looked at high dose and low dose finasteride (prior to Propecia becoming available) for treating hair loss. More is not better and I am not aware of a 2mg study showing any additional benefit. The stories that I do hear are anecdotal.


2011-01-28 09:19:26Any Data for 2mg Finasteride Benefits?

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Any Bimatoprost Study Phase 2 Results Yet?

Doc

Have you heard anything or have any idea when the phase 2 bimatoprost studies will be out?

Happy new year to you and your staff.

You’re referring to the study comparing bimatoprost and minoxidil for use on the scalp, which completed the phase 2 a few months ago. The results haven’t been posted yet, as far as I can find.

Check it our at the ClinicalTrials.gov site — Safety and Efficacy Study of Bimatoprost in the Treatment of Men With Androgenic Alopecia.

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Any Adolescent Hairline Transplant Photos?

Can you post a before & after photo of someone who you’ve lowered their hairline to an “adolescent hairline”. I know you’ve said in the past you usually only do this procedure on someone who makes their living by their looks & I wanted to see how much of a difference it would make. Thanks, great blog!

These three patients had their central hairline brought down to the childhood hairline position:

Also, please take a look at the hundreds of patient before and after photos on my website in the Patient Photo Galleries.


2006-10-23 14:52:22Any Adolescent Hairline Transplant Photos?

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Anxiety, Mood Swings From Propecia?

I have been talking propecia for about two weeks and I have been experiencing wierd side effects like anxiety attacks, feeling out of it, slight mood swings, etc. However, when I asked my doctor about it, he said that he had never heard of anything like it. There are a number of people online who have complained about similar side effects and I feel that these symptoms are a direct result of propecia. I was wondering if you had ever encountered any similar cases and if so will these side effects go away. Thanks

Finasteride blocks the conversion of testosterone to DHT. As a result, there will be a temporary increase in testosterone and changes in androgens as well which might (theoretically) produce side effects like those experienced by women with PMS. One of my patients had a real complaint like this and he was a very credible physician. When he stopped the Propecia the symptoms went away. Can hormonal imbalance affect mood swings? Possibly! Some patients have repored changes in the way they feel on Propecia and I have generally discounted these report but now I will make a note of this and watch for more patient comments and blog emails that bring this up. I aleady spoke to a Merck rep about it and hopefully the verbal report will work its way back to headquarters. If I hear more of these type of complaints, I will be more vocal on sharing this with you through this blog.


2006-04-19 20:22:49Anxiety, Mood Swings From Propecia?