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Hi Doc,
I’ve been on Propecia for 5 1/2 months now for a receding hairline. I’m currently a NW2 and I am moving slowly to a NW3. However, the propecia does not seem to be slowing or stopping the recession at all since I started, so I’m assuming it won’t work past this point anyway. However, the interesting thing is that the propecia has made my hair much coarser than it was before. Prior to taking it, my hair was fine, now it is coarse and curly. If I stop the propecia since it’s not working for the recession, will my hair go back to fine again? Thank You

Propecia does not generally reverse recession or frontal hair loss. At best, it slows it down. At 5 months, you should not expect much change. It does thicken the hair as you are noticing, because it strengthens miniaturized (thinner) hairs. I would assume if you stop Propecia it would make your hair fine again and probably even cause shedding as those “fine” hairs were likely the ones that were going to fall out eventually. This is called “catch up” hair loss. Is it reasonable to say that the coarser hair you are talking about matched the hair on the back of your head? Check that out.

hi dr.,
i have a question about dr. richard strick. i went to see him because of your very positive comments about him on this site regarding his treatments of alopecia areata using his dncb treatment.

1. He claims its successful 90% of the time, if it is that successful, i would imagine the fda would approve it & other doctors would use it to treat patients because that would be a huge deal for those who have alopecia areata.

2. After speaking with him and his staff, I have heard about 2-3 contradictions (or at least apparent). For example one of his staff said “it does not work on body hair” & he said no it definitely does work on body hair. (different conversations at different times)

Basically my question to you is, do you think or would you put it past dr. strick to outright lie or maybe exaggerate about the effectiveness of this treatment for whatever reasons he may have? Im not sure what to make of this, i want to have confidence in this treatment but my confidence is shaken.

Are you sure you heard him right? What you experienced sounds like confusing signals and you should go back to him to get clarification. To my knowledge, he does not use this dinitrochlorobenzene (DNCB) treatment for body hair alopecia areata.

I provided photos of a patient that I met with who had a great result from the treatment, so the effectiveness was clear to me. I can’t vouch for success rates, but I’d be honest with him and ask Dr. Strick to clarify some of the issues you had from your previous visit.

My daughter started losing hair across the back of her head as an infant (like many do, from turning their head in their crib). It was breaking as much as it was falling out. It continued to break and be brittle. I was told by her pediatricians that she would grow out of it, and that nothing could be done. 4 years ago a dermatologist could not diagnose her either. She is 13 years old now and her hair has never been 100% haelthy, although she has had times when it was better than others. A week and a half ago she tried using Head and Shoulders shampoo, thinking it might help. As of last night, on the top and across the back of her head there is nearly no hair. She is not “bald” back there per se, but the hair there is less that 1/8 of an inch long. Another trip to a different dermatologist this morning revealed nothing. He had no idea, other than that it was “extreme, and apparently rare” and he did not know what the cause was. He suggested a peanut oil treatment and biotin. I’m considering asking her pediatrician to run some blood tests, but am not sure what to request. Hormones, vitamin deficiency, thyroid? Any insight you can give me would be much appreciated. Obviously at the age of 13 this is devastating for her. Thank you.

I can appreciate that it is very devastating to your child. Unfortunately, I really have no input here aside from the fact that you seem to be taking the right steps and seeing specialists. You may benefit from still another opinion with another dermatologist or a hair transplant doctor who might give you a different perspective after an examination. I would like to help, but I am not her doctor and the blog is not an appropriate medium for such.

Hello mr. rassman

My question is can someone go bald if they share stuff with a bald person. sharing a soaps, shampoos, combs, and such or sharing a pillow.

Hair loss does not reflect a contagious disease. If it was contagious, then there would be as many balding women who share such soaps and shampoos with their husbands or boyfriends.

I have been using thymuskin a topical shampoo and dropper solution made in Germany by Klett-Loch gmb. The company claims it reduces or inhibits DHT in the scalp, acting as a coating/membrane around the follicules. It is also a synthetic thymus extract/peptide originally from a baby calf, cow but is now synthetic due to cattle health, the German company claims. They say it also acts by boosting the level of thymosin and or boosting the thymus gland which normally shrinks in size. They say it was originally developed for chemotherapy patients that lost their hair after chemo, but soon they say the German doctors who were bald themselves started using the thymus product with success. It is extremely expensive to me @270.00 for a 2 month supply. Does thymosin and or the thymus gland play a role in hair follicule stimulation and or growth? Why did the chemo patients not lose hair when using it while under chemo? I ordered it because I thought with all the products out there, that surely a German company would not lie! It dosen’t suit them based on their history. haha funny. thanks Dr. Rassman

To my knowledge, nothing topical inhibits DHT production on the scalp, though there are some shampoos that claim to reduce scalp DHT. In my humble opinion, it is probably just marketing hype, but if it works as promised, the company can make a fortune selling it at any price worthy of putting in the effort. The Thymuskin North American distributor claims the product was sold for 20 years in Europe, but the amount of years a product is available in the European marketplace really doesn’t have any bearing on its effectiveness. The user reports online vary wildly, and with so many Thymuskin resellers and affiliate links out there looking to cash in, it really makes it hard to distinguish what is a real review and what is a disguised advertisement.

The thymus gland does not play a part in hair growth. There is an association between hair loss and the thymus gland in a special type of inherited disease, but that would not point to the use of any thymus extract in the treatment of the normal genetic hair loss that is common in the general population. I’m not sure what T-cells have to do with hair growth or hair loss, but these cells are in the critical path for autoimmune diseases. Again, in my humble opinion it is just marketing hype, but I will be glad to be proven wrong.

I’ve been using Propecia along with Rogaine for about 4 months now. It’s slow going, but I’m definitely seeing tiny new hairs coming in, in certain areas. I recently came across a product from Perfect Hair Solutions which is a 10% minoxidil and 5% Azelaic Acid solution and decided to order a bottle. From what I hear, result come in more quickly. I’m just trying to figure out why Rogaine hasn’t put out any thing stronger than the 5% and if it would be a side effect issue or not - also, would too high of a strength be damaging to the hair follicle? I was wondering if you can give me your thoughts on this product. Thank you.

More is not necessarily better. The higher concentration of minoxidil (10% or even 15%, for example) runs a greater risk of side effects, including systemic side effects like dangerously low blood pressure, fainting, and skin irritation.

Azelaic acid does not grow hair. It is more of a marketing hype in my opinion, as the thought process is that the acid will irritate the scalp, causing the minoxidil (Rogaine) to be absorbed better. The truth is, either of these medications can cause irritation and when used together the incidence of irritation and dermatitis goes up. The same concept holds when they mix it with Retin-A (which is also an acid).

I have a two part question. First, If a person is experiencing hair loss who would you advise them to go see first, a dermatologist or a hair specialist? My other question is about Proscar. I know that some dermatologists as well as other doctors prescribe Proscar to treat men with male pattern baldness even though it is only FDA approved for BPH. I am thinking about taking Proscar instead of Propecia due to the difference in cost and am just wondering if finding a dermatologist that would prescribe Proscar to someone who is 21 years old be akin to trying to find a needle in a haystack

Your first stop for hair loss is best done at a dermatologist’s office provided that he/she shows an interest in this type of problem. Your caring family doctor also works and throughout the US there are many hair transplant doctors who are skilled in diagnosis. I routinely prescribe generic Proscar (5mg finasteride) and instruct the patient to cut the pill into quarters.

I am in Los Angeles, not too far from where you indicated that you live, so I am not a needle in the haystack. I’ll point you now to my website for information, including phone number and address. Take a nice drive and pay me a visit.

I have total head miniaturization and half my sideburns seem to have miniaturized. I was diagnosed with DUPA but I want to be sure that my miniaturization is not being caused by hormonal imbalances or malnutrition. I am going to get the yurine analysis 2 rule out malnutrition as a cause and I’ve already checked my iron and thyroid. Can you give me a list of hormones you think I should check and also could you recommend any doctors that are knowledgeable in this area in the new york area?

I haven’t seen your hair loss, but it is always good to get a second opinion. Some common blood tests for female hair loss:

• Sex Hormone tests
• SHBG (Sex Hormone Binding Globulin) used to test status of male hormones
• Estradiol is a sex hormone
• FSH (Follicle Stimulating Hormone) *not hair follicle but follicle in the ovary*
• LH (Luteinizing Hormone) is a sex hormone
• Free Testosterone
• Total Testosterone
• ANA (Anti Nuclear Antibody) used to test for Lupus or other autoimmune diseases
• TSH (Thyroid Stimulating Hormone) used to test for hyper or hypo-thyroid disease
• Test Iron status
• TIBC (Total Iron Binding Capacity)
• Ferritin
• Iron

In the NY area, I would see Dr. Robert Bernstein. Tell him I said hello!

I don’t think my question about chemical relaxers causing baldness was answered, or perhaps I didn’t ask it right. If the professional never messes up the chemical relaxer on hair, can that cause baldness? I’m not talking about the occassions when they might mess up and burn our scalp, I’m referring to the chemical being applied perfectly to the hair.

I have heard many accounts that chemical hair relaxers have caused hair loss from the chemical stress/burn. Most of what is lost usually grows back, but it can take over a year. There is no such thing as PERFECT in real life and everyone has a different impact from chemicals, even a different impact over time (what worked in the past could damage your hair in the future).

Hello Doc,
I have been on finasteride 1mg for a year and now I have switched to 1/4 Proscar. It has been working fine but I suspect little decreased libido and thinking to take half dose. I am not sure that taking finasteride 0.5 mg every day is better or taking 1 mg every other day is better or they both have the same effect?

I am asking this based on the fact that finasteride remains in the blood for only 24 hours so it means that if I am taking it alternate days then I am without finasteride for 24 hours. On the other hand, 0.5 mg finasteride is 80% as effective as 1 mg so taking 0.5 mg everyday would give me 80% cover everyday.

That is what my analysis is, but I want your view on this. Thank you very much for help sir!

I tell my patients who have sexual side effects to reduce the dose to one half a pill per day. That keeps levels of the drug in the blood stream most of the time and it should be more effective than 1 pill every other day.