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Hi Dr, Rassman im 21 years old and have been using follicare for about 8 monthes or so and i think there has been some progress. There’s like peachfuzz growing but its been like this for awhile. How long would something like this take to start to grow thicker and with more color? and should i use a different product?

One of the ingredients in Follicare is minoxidil 5%, and this peach fuzz-like growth is what many will see get from minoxidil. You can stay on it or switch to the less expensive generic minoxidil (5% “extra strength”), available over the counter at any drug store.

Hey doctor Rassman,
I’m 21 years old and I’m losing hair rapidly. I started taking propecia and rogaine six days ago,I haven’t experienced any shedding at all, I have two questions that I hope you would answer:

1. how long does it take for the side effects of propecia to show? from the second day I took propecia I started feeling that my sexual drive is getting very low, and for the last two days I can’t get full erection and I’m really worried, can the propecia do that in just one weak?
2. when I use rogaine liquid it stays on my head as a very thin layer that peels when I scratch it or when I shower, sometimes I take rogaine in the morning after I shower and then again at night without showering untill the morning, my question is, is the rogaine getting through to my scalp or does it stay above that oily layer?

thank you

1. It is possible that reduced libido could occur in a week or so of daily Propecia use, but I wonder if you have anticipated it such that the psychological effects of expectations may make it happen.
2. Rogaine is best used after a shampoo. The use of something like the Rogaine Foam will disappear quickly as the alcohol evaporates, while the oily minoxidil will not. If you decide to shower after applying the minoxidil, wait an hour or so to let it absorb. The oily layer should not be there.

Dr Rassman

First of all i like many of your readers would like to thank you for the time you take in responding to many peoples worries concerning hairloss.

I am 23 years old and have been using propecia for 1 year now (Thanks to the advice i have recieved for this site), i have noticed that since using propecia that my hairloss has started to slow significantly almost to the point of no further notice of hairloss. I have considered looking into the possibility of a hair transplant possible the FUE procedure, however before taking this step i would be interested to hear your opinions about taking both Propecia and Regaine to tackle hairloss. Is it a worth-while option in taking Regaine along with propecia to furher enhance hair growth before a FUE or stip procedure is considered?

Thank you for you time.

I can’t hurt to add minoxidil to your daily Propecia. Many men do use both medications at the same time with good results. The downside is that hair impacted on the front of your head by the minoxidil may become dependent upon that drug. I generally do not recommend minoxidil prior to a hair transplant for frontal hair, but often in the crown.

I am male age 27, I am a amateur football player too, I have no hair loss in head and no diseases at all and i am perfectly alright , But since years i could see that i have less hair in my legs (only tiny pores) and arms and not at all growing. How to increase the leg hair and arms too, Shall i use Rogaine on my legs and arms will it give any results. would you recommend this. please reply me. thanks lot

Rogaine (minoxidil) is reasonably worth trying on your legs and arms. Give it at least 6 months of twice daily use.

Dear Doctor,

I want to start using minoxidil to help with hairloss. I was reading as much as I could about it, including every entry on your site.

While reading about minoxidil on the web, I came across companies utilizing a different form of minoxidil in their formulas called “minoxidil sulfate” which is supposed to be much better than regular minoxidil.

A search for minoxidil sulfate pulled up the following study on PubMed apparently from research done by UpJohn:

“An important step in understanding minoxidil’s mechanism of action on hair follicles was to determine the drug’s active form. We used organ-cultured vibrissa follicles to test whether it is minoxidil or its sulfated metabolite, minoxidil sulfate, that stimulates hair growth. Follicles from neonatal mice were cultured with or without drugs and effects were assessed by measuring incorporation of radiolabeled cysteine in hair shafts of the treated follicles. Assays of minoxidil sulfotransferase activity indicated that vibrissae follicles metabolize minoxidil to minoxidil sulfate. Dose-response studies showed that minoxidil sulfate is 14 times more potent than minoxidil in stimulating cysteine incorporation in cultured follicles. Three drugs that block production of intrafollicular minoxidil sulfate were tested for their effects on drug-induced hair growth. Diethylcarbamazine proved to be a noncompetitive inhibitor of sulfotransferase and prevented hair growth stimulation by minoxidil but not by minoxidil sulfate. Inhibiting the formation of intracellular PAPS with chlorate also blocked the action of minoxidil but not of minoxidil sulfate. Acetaminophen, a potent sulfate scavenger blocked cysteine incorporation by minoxidil. It also blocked follicular stimulation by minoxidil sulfate apparently by directly removing the sulfate from the drug. Experiments with U-51,607, a potent minoxidil analog that also forms a sulfated metabolite, showed that its activity was inhibited by both chlorate and diethylcarbamazine. These studies show that sulfation is a critical step for hair-growth effects of minoxidil and that it is the sulfated metabolite that directly affects hair follicles.”

I found a few companies such as Sinere that use this form in their Nanominox and DS Labs which uses it in their Spectral DNC.

My question is….if this form of minoxidil is “14 times more effective” than regular, according to UpJohn’s own studies, do you have any idea why they don’t use it in their own Rogaine products? Also, do you think I would be better off using this form myself?

I cannot find anything impartial written about this compound, so anything from you, hopefully detailed, would be greatly appreciated.

I do not have a good answer to your question, but the study (which is nearly 2 decades old) that you are referring to was done on neonatal mice, not humans. I would think there are some differences between mice hair and human hair. Being that the studies are from the late 80s/early 90s, I’d make the leap and assume that if the minoxidil sulfate were to be that much better than regular minoxidil (and with no greater side effect potential), that there would be a new product out by now using it. The FDA has approved standard minoxidil in 2% and 5% concentration, and both are available for over the counter sales (no prescription required).

If you know of a product that uses minoxidil sulfate, I suppose you can give it a shot — I’m not by any means recommending it (I like to stick with the medications proven safe and effective), but if you don’t mind being a guinea pig, I’m sure visitors to this site would love to hear about the results.

Hi Dr. Rassman,

Is there a minimum amount of time I need to be on Propecia before I can get hair transplant surgery?

Thanks!

There is no set rule. Obviously, the longer you take it the better off you’ll be, but it also depends on individual basis. For example, if you are completely bald, it does not really matter. Or if you are young in your mid twenties and you are rapidly losing hair, I would say you should take it as long as possible to slow the hair loss. Or if you are in your mid to late forties and your hair loss is stable, the risk of shock loss is less and the importance of being on Propecia for dealing with shock loss is not as great. Generally a few days or weeks is minimal. The drug works fairly fast on the hair follicle.

Ok this is really upsetting me. I’m 27, male, in great physical shape. There was a period during march of 2007 where i was under alot of emotional stress. (girlfriend cheated on me, work was really stressful (Sales job), and I noticed my hair wasn’t the same. Then November 2007, I decided to take rogaine foam. Shedding ocured initally and it looked like something was growing back. Fast forward to October 2008. My hair is falling out alot. not at the temples or front part, nor the crown area. Its literraly on top of my head. Rub my hair and like 25 strands of about 2.5 inches come out. I called Pfizer about the situation and they never heard anything like it. So my question is? Any idea what’s happening? and also if it is the rogaine that tirggered this, is it permanent? Any suggestions?

You have a progressive process of hair loss as 50% of men do. It sounds like you are heavily stressed and we know that stress accelerates the genetic hair loss problem. Assuming that you are genetically balding, the better drug would have been Propecia (finasteride), but with aggressive hair loss even that may not have worked. Do the right thing by getting a diagnosis from a competent doctor and use the appropriate medication to try to hold what you have left.

Just wondering if you could comment on the effectiveness of Propecia. The official website for the drug states that 99% of men who took it did not lose any hair after 2 years. If this is true, then why have I read in other places that propecia doesn’t work for 10-15% of men?

I verified the 99% on the Propecia site — 5 out of 535 lost hair, which is 1% of the study. I would tend to believe Merck, who is under scrutiny from shareholders and the FDA, before I’d believe the various sensationalist writers on various forums that state “facts” as they see it, not like it is. I don’t know where you got the 10-15% figure from.

DR.,

I am a 22 year old caucasian male. I have had thick dark-brown hair my entire life until recently. Only in this past year I have been noticing thinning and receding in my temples and shedding, thinning of all the hair on my head. I still have a full head of hair, but people have noticed that my hair has changed from thick, wavy and dark to thin, straight and brown. 5 months ago I visited a doctor because of Hairloss/constipation/and not feeling that great. i got a physical and blood test. Nothing was wrong.

shedding continued so.. I recently visited a dermatologist who walked in the room, prescribed me PROPECIA and ROGAINE and walked out. Didn’t look at my head or ask questions. I also have obtained a habit of gently combing my fingers through my hair and seeing how many hairs that fall out and then collect them. I have a ziplock full of hair. They fall out from all over and ive noticed that they have gotten thinner and lighter.

I am only 22 and I am not sure what is causing the shedding/thinning, whether its Male Pattern Baldness or not.

My QUESTIONS and CONCERNS are…

1. I am kinda scared and not sure whether I should take the Propecia or not. And if i take it then stop will it make things worse.?
2. I started the rogaine for 2 weeks, I think it gave me a flaky scalp, and maybe lightened my hair strands? And Is it bad to stop and start rogaine.

random question
3. I get really thick and strong red or light pigmented hairs in my dark beard and dark hair. They are much harder to pluck/pull out. WHAT ARE THESE HAIRS?

With regard to the dermatologist who did not examine you, to me that says he did not care. Go see another doctor who will look at your hair, examine it, and perform a mapping of your hair and scalp for miniaturization so that you can not only have a diagnosis, but get a baseline study to see value (or lack thereof) after a year of taking Propecia.

Some people get drying and flaking of the scalp with minoxidil. I would suggest that you use the oil based minoxidil and see if this addresses the flaking.

I don’t quite understand what you are asking about with regard to the red hair mixed in with the dark hair other than you may have some red genetic factors that induces it. Were you are red-head when you were a child?

Hi,

I have been taking propecia for about 7 years. Am now 36 years old and I have a full head of hair. But now, I have stopped due to high SGOT reading of my liver. During the course of the 7 years, I have tolerated the drug very well but now, I just want to know whether I am genetically predisposed to balding or not before I take up the drug again.

I had a check with a dermatologist, she had checked my hair and told me to stop taking the drug as my hair was ok. Are there tell tale signs for me to watch out for me to decide to take up propecia again or not?

You can take the genetic test to find out if you have the gene for hair loss, which if negative will tell you that you do not have the hair loss potential problem. If you are positive for the gene, it means that you might get hair loss. Then you and your doctor can decide. I am not familiar with an association between Propecia and liver disease as a cause and effect (see Did Propecia Effect My Liver?).