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I have been on propecia for about 6 months and it seems to have stopped my shedding. I read somewhere that Lexapro can cause hair loss. If i start taking Lexapro 10mg can it still cause hair loss even if i’m taking propecia?

The drugs that cause hair loss are not protected by taking Propecia. Keep in mind that Lexapro doesn’t cause hair loss for everyone taking it, but it is a possibility.

This is a comment I received in response to this past Friday’s post, Hair Transplant 10 Months After One Procedure:

The results look great.

I do have a question though. I’ve often read that it’s frowned upon to transplant to the crown at a younger age because you might not have the hair to cover the front as you get balder (and who wants to be bald in the front and have hair in the crown?)

Was the crown covered because he has hair density similar to his father, or maybe he’s older than I think and not on pace for a Norwood VII?

The patient is in his early 40s and is a very special case. His density is very, very high (like his father and his brother), which means that he easily has a total of 10,000-14,000 graft capability. I could’ve easily taken out 5,000 grafts had the grafts been needed. He is in a good situation to stop doing hair transplants now and with the Propecia that he takes religiously he probably will not lose much more anytime soon. I don’t expect him to follow his father’s Norwood 7 pattern.

If the patient was to lose more hair between the frontal area and the crown (which was transplanted in this first procedure), he would have lots of reserve still left. It is important to note that very high hair density was critical in this decision process.

I realize there are a lot of products claiming to “regrow” and “promote” hair growth. I also understand people that notice the loss and want to “nip” it in the but before it gets worse. You offer a lot of “No” that won’t work, “Buyer bewares”. People with hair loss, that don’t want to just accept it, need something that works. Even if it only helps some, it feels good to be trying and not giving up. I do not want to go bald. I have a feeling from watching my dad and brother go bald that it has something to do with skin build-up and regeneration blocking the follicles. Whether from hormones like DHT or Skin composition or both.

What do you think about Dr. Lewenberg’s formula? With both my dad and brother having the oiliest heads and dandruff on and off. How would the proven Minoxidil help if it can’t even get through the oil and build-up to improve the circulation?

There’s got to be something that helps, even if only a little. Like I said, some is better than none.

“Hope springs eternal,” says poet Alexander Pope. That is my view of the various hair loss remedies. There’s no cure for hair loss, and that’s what it sounds like you’re asking for. Medication isn’t guaranteed to work the same for everyone that takes it. As I’ve said over and over, the only medications I recommend are those that are FDA approved for treating hair loss — finasteride (Propecia) and minoxidil (Rogaine).

I’ve written about Dr. Lewenberg’s Formula before. Your focus on getting minoxidil through the scalp oil is not a problem if you wash your hair regularly. I don’t know where you got the idea that balding is caused by skin build-up, but that isn’t likely to be the case.

Is it possible to lose hair in the crown even with a juvenile hairline or am I most likely seeing a cowlick or nothing at all?

I, Dr. Rassman, am an example of a person who has no hair loss in front, but had established a mature hairline before I lost crown hair with a wide 4 inch circle of hair loss. My transplants were only done in the crown (1600 grafts). I am a happy camper.

The frontal area and the crown area have independent tracks on the hair loss timeline. Each hair follicle is genetically coded for the number of cycles in its lifetime and usually the frontal area gets impacted faster and possibly earlier than the crown in some men. I am afraid that there are no general rules for your hair follicles to follow. So to answer your question, yes, it is possible to lose the crown while retaining a juvenile hairline.

Hi Dr. Rassman:

A number of years ago, I had some hairloss related to having my hair tied back too tight. At first I thought I was losing my hair, by over the years it’s become increasingly apparent that I’m suffering from damage from traction alopecia. The hair is back, but grows only an inch or two.

Is there anything short of a transplant I can do to treat it?

With traction alopecia in some cases there are elements of damage that still leave hair there, but the hair is not healthy anymore. Yes, hair transplants can increase the density there and the hair transplants will grow to full length. There’s really nothing else you can do to treat it, unfortunately.

Hi doctor,
Am using finasteride (finpecia) for 7 months. So far i don’t have any side effect that usually tie with finasteride .So i want to know how long does it take to show side effect from finasteride normally.

I would expect that if you were to get side effects, you would have by now. Usually, the sexual side effects are noted within the first few weeks of use, but they only occur in 1-2% of people. For those curious, Finpecia is the name of the generic 1mg finasteride from India (it can’t be legally sold in the US due to patent laws).