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I’ve been on Finasteride for 3-4months now and I’ve been going through and immense shed. I’m losing hair on my crown , on my middle area , temples have receded 1 inch and my front sides are thinning. I’m 19 years old and understand that my hair loss is quite aggressive. One thing that I cannot understand is why my inflammation has not declined since I have introduced Finasteride.

Since Finasteride inhibits DHT , and DHT is the cause of inflammation (immune response to DHT attacking follicles) Shouldn’t a reduction in DHT cause a reduction in inflammation?

I know Ketoconazole in products such as Nizoral and Revtia will help with inflammation , but I was curious to see if there would be a drop in inflammation.

If you truly have inflammation, I would strongly suggest you see your doctor for a physical exam. Normal male pattern baldness (MPB), otherwise known as androgenic alopecia (AGA), is genetic and DHT is responsible for it, but it does not cause inflammation that you can see. DHT does not cause an immune response or attack hair follicles. The source of the information you have is not reliable.

Hi Doctor. My hairline has been the same for about 20yrs and about a year ago noticed a slight change on one side. I haven’t seen much of a change in a year and a half. To me, it looks like my hairline never finished maturing. I’m now 37 years old and recently made my debut on national television. My hair is black and curly with good density. I did see a doctor who said that at this point, if I got a HT, it would look like I had hair on my forehead. She said the measurments were normal etc. I am also starting to get gray hair and will probably start dying it soon. Is it possible when you go gray your hairline might change slightly? If I wanted, would you lower my hairline if it continues to recede? People tell me that at age 37 if you aren’t showing signs of baldness, or have mild recession you probably wont lose your hair; is this true. Just concerned about my new career on tv, where your appearance is everything. Thanks.

Firstly, grey hair and balding are not related. Look at the beautiful head of hair on George Clooney for an example.

At one time I had transplanted a number of men who were in their early 20s and had soap opera stardom, with hair loss starting as you described. The entertainment field demands that many of its male soap opera actors look almost like boy toys, apparently that being the look most women like. So getting hair transplants to maintain a career look is not an unusual request and I would be happy to render you my opinion upon examining you. I’d argue that for many people, appearance is everything — so that isn’t limited to just entertainment-based careers.

If you are receding slightly and want to do something proactive (due to TV careers, personal preference, etc), a choice to have a hair transplant surgery is an option, but it is one that you must fully be educated on with respect to its limitations and expectations. At your age (37), if you don’t have significant balding, your chances of further balding may be slim. You may continue to recede in the front corners, but I really cannot tell. You should have your hair examined under a microscope for miniaturization. If appearance in front of a camera is important to you and you are conscious of your frontal hairline, you can also consider using makeup products (like DermMatch or Toppik) that make your hair look fuller.

Hello!
I m 18 years old and i m suffering hair loss since the age of 13. I used to have much hair so when i was younger my family said that it was ok, and it was going to stop. Now i am 18 and there are clearly bald spots on the front. This is getting me very depress i do not know what to do. Yes my father is kinda bald , i dont live with him but i saw him once a year ago ( he was 55 years old). i’ve seen pictures of him, when he was 30-40 and he had normal hair not bald spots or anything. If this is genetic then it comes from him, because no male in my family is bald.

Is there anything i can do? any doctor you can recomend? please help me stop it. I touch my forehead and everytime i feel less hair. Please doctor if you need any other imformation let me know. Help me stop it PLEASE

If you have bald spots appearing on your scalp (as you described), that doesn’t sound like genetic hair loss / male pattern baldness. MPB does not cause bald spots and I would look to other diagnosis such as alopecia areata, ringworm, etc. If you’re saying your hairline is thinning (and not actually forming spots), then that could very well be MPB. I don’t know though, as I haven’t seen you.

Before going on Propecia you need to secure a firm working diagnosis with your doctor (a dermatologist should be fine for that). A good psychiatrist may be beneficial to help you through this stressful period. If you’re feeling depressed, you should seek help. Good luck.

I shaved my head bald about two months ago, just so all my hair could grow back evenly. About a week later, I noticed acne starting to appear all around the back of my head. Even when my hair reached its usual length about a month later, acne was still appearing. And i know it wasn’t wise, but I would pop the pimples, then when they grew scabs, i’d pick them off. Now I cut my hair down again about two weeks ago and i noticed about twenty or so small bald spots on the back and top of my head. Is this permanant? Is there something I can do??? My hair is my life!!!

Sometimes shavers are not so sanitary and cause pimples or folliculitis. Your skin and scalp naturally contain (normal) bacteria and even the worrisome Staph, which can be a major infection problem that spreads easily. Irritating the skin/scalp with blades or shavers can also introduce the normal bacteria to the skin/scalp, causing local infection and irritation (pimples). So ask yourself is this acne or folliculitis (infection)? You’ll need to see a good dermatologist for the answer to that.

Hello William

My question is regarding a drug which should be the same as Proscar/Propecia (It has the same ATC-Code and the same level of finasterid, 5mg). It comes from the apparently wellknown company Actavis: http://www.medicalnewstoday.com/articles/71641.php

Now if it is possible to use a fifth proscar instead of a propecia pill, it should be okay to use one/fifth Actavis instead right? The reason I ask is because the price here in Denmark for Actavis is ten times lower than Proscar. There are also many other companies which produces products that are similar but alot cheaper than Proscar.

I am 25, male and I have Norwood 2 with a beginning vertex. Thanks for your help and keep up the good work (I have learned alot from your site).

Kind regards

Yes, 1/5th of a Actavis brand 5mg finasteride pill should be the same as 1/5th of a Proscar pill. There are many makers of generic medications, and it does vary by country. As long as you can be sure the medication is what it claims to be, it should be the same regardless of the maker. I say “should”, but I have no way to tell if it is that case for every pharmaceutical company. From Wikipedia, other makers of generic finasteride include:

• Ajanta Pharma (trade name Appecia)
• Aleppo Pharmaceutical (trade name Prosteride)
• Cipla (trade names Fincar and Finpecia)
• Dr. Reddy’s (trade names Finax and Finast)
• Intas Pharmaceuticals (trade name Finalo)
• Ranbaxy (trade name Finara)

Interestingly, a few months back Actavis recalled every generic drug they manufactured in their New Jersey plant, thanks to an FDA inspection that showed the standards were not kept up. Read more about that at the FDA site. Finasteride was not one of the drugs listed, as it was apparently not made at that facility. Just food for thought, though…

Hello Dr. Rassman,

First and foremost, thank you for taking the time to keep up this blog; it keeps my neuroticism in check.

I am a 21 year old male with mild MPB in my family on both sides, and I have been experiencing some thinning of my temples recently. Three months ago I started taking a multivitamin, and I want to make sure this is not be contributing to this new problem. If you could please take a look at the ingredients and let me know if anything is questionable, I would appreciate it
greatly. Thank you very much, Dr. Rassman.

Ingredients are here

When I initially looked at the link you sent, I made some notes with the intention to go back and review the list of ingredients more in-depth before posting. Unfortunately, the link doesn’t work anymore and I don’t have a name for the vitamin you’re taking.

At any rate, here are some general notes: a standard multivitamin is usually fine, but I always question when there are ingredients that supply over 1000% of the daily needs. Some vitamins in excess can cause hair loss, but I have been unable to go through the list.

Hi,
Great site. I take proscar and it works great. My question is regarding Vitamin D. I am low in serum D and am adding a supplement. I have read that Vitamin D can help with hair loss. My question is does it raise Testosterone levels or DHT levels which would work against what Proscar is doing.I does show Vitamin D as a PRE-hormone which I don’t quite understand. Could the VitD make things worse especially on someone with diffuse hair loss over all of head. My doctor thinks this diffuse loss could be a result of my low D. What is your opinion. By the way I’m a male.

Thanks

Vitamin D is safe if taken in reasonable (recommended) doses and if your Vitamin D level is low, this supplement may help your hair situation. Super dosing it may cause hair loss.

Dear Dr.,

Upon graduating college at the age of 22, I began noticing hair shedding. At first I thought that it may have been hereditary, but then it got to the point where I could actually pull out the hair without much effort.

After a very exhausting effort, the first diagnosis from my dermatologist was Telogen Effluvium enduced by stress. Months later a biopsy was taken, and the diagnosis was changed to folliculitis. I am currently on Minocycline 2x per day, a two corticosteroid topicals (a shampoo in the morning, and a foam at night). My scalp has cleared up dramatically, and there is no visible scaring, though I am still noticing some hairline pimples. When my scalp itches, I do a light “hair pull” and usually one hair comes out- and the end of the hair has a bulb like shape.

I’m still VERY FRUSTRATED from the hair loss. My question is this: Since I have had Folliculitis for about two years now, is there a chance that the hair will grow back, now that the inflamation has been reduced? Are there any questions I should ask my dermatologist?

Thanks

I do not understand how you can have folliculitis for two years. Why do you have folliculitis? Did it ever go away? You need to take charge of your health and educate yourself on what is going on. Sit down with your doctor and ask him/her to explain to you what is going on with your condition. If you are not satisfied, go to another doctor for a second opinion. Generally hair loss in men is genetic. Does your hair loss fit a Norwood pattern?

I have been losing my hair around the crown and in the front for past three to four years. However, now I am starting to lose hair in the back of my head I have never seen this happen before and I do not know why?? I have a very stressful job but am only 25. Please help!!!

I don’t know what you would like me to do to help you. Losing hair in the back of the head (below the crown) is unusual, and my advice is that if you are concerned about your hair loss and want to be proactive about it, go see your primary care doctor or a hair transplant surgeon (who will not necessarily do a hair transplant) for a good diagnosis of what is going on. There may be treatments (not only surgery, but medications) that may help with your situation.

Hello doctor

Could food poisoning or food allergy cause hair loss , and if so permanent or temporary ?

Thank you

I would doubt that there is a connection, but some do believe that food allergy can lead to alopecia areata. I haven’t read anything about food poisoning causing hair loss, but I’d expect that if you had a bout of food poisoning followed by hair loss, it was stress induced (in which case it should be temporary).