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(female)
I have lost my natural curl and half the amount of hair that I had as a side effect of Keppra. I would like to know since I have taken myself off it, will my hair grow back with the natural curl that I lost?

Hair loss is a known rare side effect of Keppra (levetiracetam), but I can’t say for sure if your hair will regrow now that you’ve taken yourself off of it. You’d have to wait out about a year to see if it regrows.

You were taking Keppra for an important medical reason (like seizures), and you should not be taking yourself off of medications without speaking to your doctor. I can’t even say for sure if Keppra was the cause of your hair loss.

Hi Doctor Rassman, I have a question, I know med advice is not given on the internet, but all I need is just an expert opinion from someone like yourself who is an expert in hairloss industry.

I am 28 years old male in perfect health. No drinking or smoking at all. I have been on brand propecia 1mg for 2 years exactly as prescribed by my dermatologist. in the 2 years I have not got the best results, hair looks almost the same as pre treatment with propecia, but doctor said looks like I am slightly below baseline. so he said for me to keep taking propecia 1mg daily because it has slowed the rate down, I have not experienced any side affects at all on propecia.

Since I have not experienced any side affects from finasteride, my dermatologist also wrote me a prescription for avodart 0.5 mg. he told me avodart is a stronger dht blocker and told me to use it ever other day at the 0.5 mg level. He suggested I still take the 1mg finasteride daily, but just use avodart 0.5mg every other day, basically 4 times a week. He told me not to drop finasteride as maybe I might experience a loss of hair that finasteride was hanging on to. I asked if this was safe and he said yes, and not to worry. Basically in your opinion do you have any positive results from patients that use avodart? do you think its better for hairloss?

I really do not know the details about you. I generally think that if Propecia (finasteride) is working, then just keep to it. If your hair looks the same today as when you started Propecia 2 years ago, that sounds like it’s working just fine. Not everyone will see substantial regrowth, and just keeping the hair loss at bay would mean the medication is successful.

Avodart (dutasteride) added to the Propecia routine makes no sense to me, as both medications work in similar ways. I’ve prescribed dutasteride in rare cases for patients that saw results from Propecia dissipate over the years… but in your case, it sounds like the Propecia is working just fine. I have no idea why your doctor would prescribe both drugs to you.

I am 22 years old and it appears that I have been losing more and more hair every day. If I go on the drug Propecia, how long will it take for the drug to stop the hair loss.

Responses from finasteride vary with the individual. I have seen some people stop their hair loss in a week from starting the medication, and other take a couple of months. You need to make the decision to continue using it from the time you start taking it. The full benefits could take up to a year.

Results Abstract:

Reported AEs with 5ARIs include sexual dysfunction, infertility, mood disorders, gynecomastia, high-grade prostate cancer, breast cancer, and cardiovascular morbidity/risk factors, although their true association, prevalence, causality, and clinical significance remain unclear. A pooled summary of all randomized, placebo-controlled trials evaluating 5ARIs (N = 62,827) revealed slightly increased rates over placebo for decreased libido (1.5%), erectile dysfunction (ED) (1.6%), ejaculatory dysfunction (EjD) (3.4%), and gynecomastia (1.3%). The limited data available on the impact of 5ARIs on mood disorders demonstrate statistically significant (although clinically minimal) differences in rates of depression and/or anxiety. Similarly, there are limited reports of reversible, diminished fertility among susceptible individuals. Post-marketing surveillance reports have questioned the actual prevalence of AEs associated with 5ARI use and suggest the possibility of persistent symptoms after drug discontinuation. Well-designed studies evaluating these reports are needed.

This is from a new review of the available data, published in Sexual Medical Reviews, titled “Side Effects of 5-Alpha Reductase Inhibitors: A Comprehensive Review“.

The report concluded: “5ARIs are associated with slightly increased rates of decreased libido, ED, EjD, gynecomastia, depression, and/or anxiety. Further studies directed at identifying prevalence rates and persistence of symptoms beyond drug discontinuation are required to assess causality.”

Indeed, I look forward to reading more controlled studies that are necessary to determine the relationship between the cause and effect.

I am a 25 year old male who recently quit taking quartered Proscar pills after only 1 month on them. I began experiencing dull, persistent stomach pain and what I believe to be erectile dysfunction.

In the past 7 days, I have achieved only one full-on erection. I have achieved a couple relatively weak erections in the morning, but none strong enough for vaginal penetration. My girlfriend and I have attempted sex about 4 or 5 times, and only been successful the once.

Is it possible that I have ED after only a month on finasteride? Further, is it possible that now, 6 days after stopping, I am still experiencing sexual side effects? I am open to the possibility that the ED issues are psychological, but I am extremely worried about how to regain my sexual ability.

Thanks for your help.

You should be asking the doctor who prescribed the medication. I would need a more detailed history that would be obtained if I saw you. Erectile dysfunction can occur in as short a time as a week and stomach problems have been reported in the form of nausea, bloating, and excess intestinal gas.

The medication is ‘fixed’ in the tissues for up to 1-2 weeks although it is essentially our of your blood stream in 24 hours. I would expect that if your ED is caused by the medication, it should go away when you stop the medication, along with any other side effects you might experience. It could also be psychological.

After about 4 months on propecia and minoxidil I am experience a very slight start of regrowth in my temples! nothing major at all, but it would seem as if i will be able to sustain my current hair. In my temple region I have to types of hairs sprouting. One is thick and dark(like the rest of my hair)sprouting along the edges of my existing hair line. and the other is light and fine scattered through out where my hairline used to be. I was just wondering what I should expect, long term from these new hairs.

It takes a full 8 months or more to see real results from these medications. At 4 months, I would expect some small hairs from the minoxidil and minimal impact from Propecia. Be patient and wait at least 8 months, if not a year.

Snippet from the article:

Scientists at cosmetic company L’Oreal claim to have invented the first product which can actually “reawaken” dormant hair cells and allow them to grow back. It could offer hope to millions affected by male pattern baldness or just the thinning of hair through old age or for medical reasons.

Already demand for the new treatment has seen salons taking thousands of pre-orders even though the recommended three month treatment costs nearly £300.

After 90 days researchers claim that the liquid “Kérastase Densifique”, when applied to the roots, can promote the growth of more than 1500 new hairs.

Read the rest — Breakthrough hair loss product works on stem cells

The real question is whether I should buy stock in L’Oreal. The study they cite saw 101 people over 3 months with some regrowth, but I have no idea how many people were actually in the study or why it lasted only 3 months. As more news becomes available we’ll look into it further.

First, I can’t thank you enough for maintaining this resource–it’s alleviated a lot of my anxiety about hair loss simply by giving my a place to find answers to my questions.

I recently had a consultation with a surgeon about reshaping my temples. I’m 29, and probably a NW2-3. (I’ve had relatively high temples since high school, though the spaces have expanded slowly since though then.) He ultimately recommended 1100 grafts to fill in my temples and create a relatively straight hairline.

I have two questions:

1. He told me that diet has a significant impact on hair loss, second to genetics. He advised a vitamin regimen of L-Lysine, Vitamin E, Saw Palmetto, MSM, Glucosamine, Chondroitin Sulfate, and Ester-C. In addition, he recommended that I stop consuming creatine, and eat a sulphite/nitrite-free diet that’s rich in antioxidants and low in refined sugar and bleached flour. I realize that much of this might be good health advice generally, but does it have any non-negligible connection to hair loss? I appreciate interest in my general welfare, but this had me a tad skeptical.

2. After examining the entirety of my hair, he told me that I’m “programmed” for hair loss not beyond a NW3. He did not conduct a miniaturization study; this was a “naked eyeball” examination. Because he didn’t think I’m “programmed” for any crown-area loss, he said Propecia wouldn’t be necessary. Should I take this pronouncement with a grain of salt, or could he accurately reach that conclusion via the type of examination he made?

Many thanks, and all the best. If it’s at all relevant, he did not recommend any type of hairline lowering, but simply filling in the temples and leaving the forelock as is.

While it is possible that you won’t advance beyond a Norwood class 3 hairline, I don’t trust doctors who give eyeball opinions for predicting hair loss. There are some good tests (miniaturization mapping and better yet, bulk analysis) that will tell you with some certainty if you are balding.

The decision to take drugs like finasteride should be based upon clinical evidence of balding. You might want to consider getting a second opinion, hopefully from a doctor that can give you a more thorough analysis of your hair. If you aren’t balding, Propecia isn’t necessary (though you should consider it to prevent shock loss from any hair transplant you may have). If you do have early balding, now would be the best time to start the medication.

As for the recommended vitamins, I am not a nutritionist, so your doctor’s suggestions may be good ones for your overall health. I wouldn’t expect to see lush hair growth upon taking them, though. None of those have satisfactory evidence linking them to treating genetic hair loss.

Hello Doctor. I took minoxidil and finasteride for about a year then switched to minoxidil and avodart. i have no side effects but i can’t understand tell if finasteride or dutasteride is working on me, because i still am shedding. Some hair is growing, some hair is minimizing, and i think the medications haven’t stopped miniaturising progress. Is the only way to understand that finasteride or dutasteride works on me is to do the Hair DX test?

Thank you

The HairDX Test for Finasteride Response should be able to tell you if you are a good responder to the medication, but the best test to find out if finasteride or dutasteride is working is to get a bulk measurement of the scalp hair in 4 different locations. It should’ve be done before the drug is taken and then at about a year after. This test (HairCheck) is the most sensitive test available today. Good documentation should include progressive photographs with the hair length the same.

With all the medication switching, what has your prescribing doctor had to say?

Snippet from the article:

A mid-stage trial of Allergan’s hair loss treatment Bimatoprost Scalp also failed to provide sufficient efficacy to proceed to a late-stage study, and the company said it will be extending the mid-stage development program.

Link: Allergan delays eye drug, shares fall

I found the above tidbit buried within an article about Allergan’s delay of their eye drug to treat age-related macular degeneration. Many folks were hoping bimatoprost (the eyelash treatment also known as Latisse) used on the scalp would be the next FDA approved hair loss treatment, but it seems that will be delayed for some time.