Post Hair Loss Questions and Get Answers

This question comes from a member of our hair loss social community and discussion forums: 

Recently, I scheduled hair transplant surgery, and I was surprised to hear the doctor recommend that I start finasteride (Propecia) and minoxidil (Rogaine) as well. If I’m fixing my current baldness with surgery, why would I take preventive hair loss medications as well?

This question brings up several very important points about hair loss, hair transplant surgery, and the comprehensive treatment of thinning hair.

Hair loss (specifically androgenic alopecia or genetic patterned hair loss) is a progressive condition. This means that an effective treatment for hair loss involves two important steps: halting the progressive thinning of hair and regrowing/restoring the hair that is already lost. Hair transplantation is an excellent treatment for restoration the hair that is already lost, but it does not treat progressive hair loss. If hair is transplanted to one region of the scalp, but no preventive treatments are started, the rest of the hair around the transplanted region is likely to recede. If the rest of the hair around the transplanted hair is lost, the remaining implanted hair will be surrounded by bald scalp, and this creates an unnatural appearance.

In order to avoid this phenomenon, hair restoration physicians usually recommend preventive hair loss medications like minoxidil (Rogaine) and finasteride (Propecia). If these medications are taken in conjunction with hair transplant surgery, the transplanted hair will fill in the gaps where the hair is already lost and the medications will prevent the surrounding hair from falling out. What’s more, the preventive medications may also thicken the remaining hair and cause some potential regrowth of hair that was previously lost.

Hi, I’ve been using minoxidil for approximately two years and was quite happy with the results until I went two weeks without using it. After that I noticed a lot of hair loss! I’m still continuing to use it but now wondering if I’ve completely wasted my time and money for the past two years as I’ve heard you don’t regrow hair when you’ve had a break in the routine. Is that true?

I would not say that you’ve completely wasted your time. However, it is likely that some of the hair that shed will not regrow. Even so, I would venture to guess that restarting Rogaine (minoxidil) has continued to preserve hairs that would have been lost otherwise. It’s always the best option to continue use.

Unfortunately, there is really no way to know for sure. Only time will tell how much hair growth will return.

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

Get Proven Treatments at the Best Prices by visiting our new online hair loss treatment shop.

Technorati Tags: minoxidil, hair loss, regrow hair, Rogaine, hair growth

This common question comes from a member of our hair loss social community and discussion forums: 

My father has an advanced balding pattern (likely a Norwood Class VI), and I’m wondering if this is how my hair loss will eventually progress? Will my balding pattern match my father’s? Is it possible to predict hair loss based upon balding patterns in other family members?

Hair loss sufferers (or individuals concerned about hair loss) often assume they will inherit their father’s, brother’s, or grandfather’s balding pattern. However, this is belief is not completely accurate.

Patterned hair loss (androgenic alopecia) is a complicated genetic and biochemical condition. However, most experts agree that the physical expression of the hair loss trait is “polygenetic with variable penetrance.” In laymen’s terms, this means that the genetic component of hair loss comes from a variety of genes and can technically be inherited from either your mother or father. Additionally, the term “variable penetrance” means that the hair loss gene is expressed differently in each individual. This means that one individual with the hair loss genes may exhibit a Norwood Class VI balding pattern, while another person with the same genes will only become a Norwood Class II or III.

Along with finasteride (Propecia), minoxidil (Rogaine) is one of the only medications approved by the U.S. Food and Drug Administration for the treatment of genetic hair loss (androgenic alopecia). Although both drugs are proven alopecia treatments, many hair loss sufferers worry about the potential side effects; specifically, the reported sexual side effects associated with finasteride.

Most studies believe sexual side effects occur in approximately 0.3-3% of Propecia users, and agree that most dysfunction subsides after stopping the medication. However, unlike Propecia, the potential for sexual side effects with minoxidil usage has not been extensively studied. So, this leaves many individuals wondering: can Rogaine (minoxidil) cause sexual side effects?

To answer this important question, Coalition hair transplant surgeon Dr. Paul Rose researched the issue, and published an article about minoxidil and sexual side effects at our Hair Restoration Discussion Forums:

Dr Rose:

In the fall of 2012, researchers at Johns Hopkins University made a startling discovery: finasteride, known most commonly by the brand name Propecia, appeared to cause long term sexual side effects for a number of males who were using the prescription medication to treat hair loss.

Prior to the study, it was well-documented that finasteride could cause a number of sexual side effects during use. After the study, however, a small body of research indicated that males who take the popular hair loss medication could suffer with sexual side effects long after use was discontinued. The study analyzed only a small number of patients, and many hair loss professionals believe rigorous follow-up studies are needed to better understand the long term side effects of finasteride. Nevertheless, the study sparked concern among men and women who suffer with hair loss, particularly those who currently use a non-surgical method of restoration.

Just wondering; if balding is a progressive condition, why would patients opt for surgery (be it strip/extraction)? Won’t we have to deal with it once the hair falls out?

You are correct. Androgenic alopecia is a progressive condition and there is no hair loss cure. This is the very reason why hair transplants are not recommended for very young balding men and also why most hair restoration surgeons highly recommend medically stabilizing hair loss with Propecia (finasteride) and Rogaine (minoxidil).

The older we become, the easier it is to more accurately judge just how far on the Norwood Scale our hair loss will progress. This helps doctors and patients agree on a long-term plan that will make the best use of grafts in order provide for adequate donor hair to address future balding. Medical treatments can prolong the life of existing hair and, in some cases, even regrow hair. The right patient with the right plan can achieve a natural and aesthetically pleasing result that will last a lifetime.

It’s important to remember that not everyone is a candidate for surgical hair restoration. Patients have to find a skilled and ethical hair transplant surgeon that they trust to give them the best advice.

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

I’m a 31 year old man and have been experiencing frontal hair thinning for the past year or so.  My hair is continuing to thin and seems to be getting worse at a quicker rate. I have also recently been experiencing a dry scalp. I have not lost any hair in the back (vertex) area or on the top of my head.  It’s only limited to the front, like a receding hairline. I have been researching hair loss treatments and have read that some treatments, like Rogaine, are only for the vertex or top-back part of the head.  Is there a recommended product for the frontal part of the head?  Thanks for your help.

Unfortunately, there is no non-surgical hair loss treatment proven to regrow a receding hairline. The clinically proven and FDA approved hair loss drugs Propecia (finasteride) and Rogaine (minoxidil) are very good at maintaining and sometimes regrowing hair in the crown but not particularly effective for frontal balding.

The best option to restore a receding hairline is hair transplant surgery. I highly recommend researching hair loss on our hair restoration forum where you can benefit from the combined knowledge of our patient members as well as many of the world’s leading hair restoration physicians.

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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

I am a 23 year old female who has been suffering from chronic Telogen Effluvium for 18 months. I have had all blood and thyroid tests that all came back normal. I believe the initial trigger was weight loss and being underweight for a few months, but I have been in a healthy weight range for over 12 months now and the hair fall has not stopped. My dermatologist recommended I use Rogaine for several months; however I have read that in most cases after stopping Rogaine all the hair it helps grow will fall out again. I am afraid to start using it at all if it will only give me a temporary hair loss solution. Can you advise what I should do?

Unlike you, most men and women using Rogaine (minoxidil) to treat hair loss are suffering from androgenic alopecia (genetic balding). Because there is no hair loss cure, treatments like minoxidil must be used indefinitely in order to maintain hair growth. However, hair follicles in the zones of permanent growth at the rear and sides of the head will not become dependent on minoxidil. Thus, should these patients eventually discontinue the drug; they will not end up balder for having used it. Instead, their thinning hair will resume and will eventually take on the same pattern they would have had if they’d never used the drug at all.

This question, from a member of our hair loss social community and discussion forums, was answered by Coalition hair transplant surgeon Dr. James DeYarman:

Can topical Rogaine be absorbed into the body causing negative side effects?

Rogaine was created from a drug called Loniten. It was a high blood pressure medication and the side effect was people would start to grow body hair. The strength of the pill was 100 mg. and started out at one pill per day. The active ingredient in Loniten is minoxidil and that is what was put into solution to create the first minoxidil hair loss treatment.

The side effects from Rogaine can be skin rash, hair growth on the face and, in some cases, headache. Because of the amount being used it would be hard to get any lowering of the blood pressure using the medication topically. For minoxidil to be effective on the hair follicle it has to be massaged into the scalp and because of the small amount of minoxidil in Rogaine, it is unlikely to have any effect on blood pressure. I hope this answers your question.

Dr. James DeYarman
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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

Get Proven Treatments at the Best Prices by visiting our new online hair loss treatment shop.

This question comes from a member of our hair loss social community and discussion forums:

I currently use liquid Rogaine (minoxidil) to treat my hair loss, but I’m now also considering temporary Scalp Micropigmentation (SMP). However, I read online that topical minoxidil can cause temporary SMP ink to prematurely fade. Is this true?

According to SMP experts, using both the liquid and foam versions of topical minoxidil can cause temporary Scalp Micropigmentation ink to fade prematurely. Minoxidil solutions contain alcohol, and excessive, continual exposure to alcohol is what causes the temporary SMP ink to fade. Normally, temporary SMP ink fades completely between 6 to 24 months after the procedure, and early ink dissipation may result in excessive SMP “touch up” procedures and an uneven appearance.

However, because minoxidil is a proven hair loss medication, individuals may still want to utilize both temporary SMP and a minoxidil-based solution. Since minoxidil foam contains less alcohol than the liquid solution, it is likely a better option for hair loss sufferers who want to use both treatments.

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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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Technorati Tags: hair loss, Rogaine, minoxidil, hair loss, Scalp Micropigmentation, SMP, temporary SMP, temporary Scalp Micropigmentation, hair loss medication, hair loss sufferers

I am only 17 years old and I am losing 50 hairs a day since the age of 14 after I had typhoid. My father began to go bald at the age of 35. Now, for the past week I am massaging my hair daily with olive oil but there are no visible results! My hair is not thinning out but every time I brush my finger through them I find my hairs coming out with a white bud at their root. So what should I do now?

It is perfectly normal to lose up to 100 hairs per day. If you are not experiencing thinning hair then you may have nothing to worry about. However, it never hurts to consult with a dermatologist or experienced hair restoration physician for an evaluation.

Rubbing oils in your scalp will likely do nothing to combat genetic balding and regrow hair. At your age, you are too young for Propecia (finasteride) but you can use Rogaine (minoxidil) if your doctor thinks it’s necessary.  These are the only two hair loss drugs that are clinically proven and FDA approved for the treatment of male pattern baldness (androgenic alopecia).

David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
To share ideas with other hair loss sufferers visit the hair loss forum and social community

Get Proven Treatments at the Best Prices by visiting our new online hair loss treatment shop.