HOW MANY?
- Thread starter cateyes81
- Start date
G
Guest
Guest
anything from 0 to 10 years.
Most responders can maintain for 4 - 5 years.
Remeber that even when it 'stops working' is hasn't stopped working at all. It will still be slowing down the process considerably, stay on it until your NW6-7 or until you dont give a f***.
Most responders can maintain for 4 - 5 years.
Remeber that even when it 'stops working' is hasn't stopped working at all. It will still be slowing down the process considerably, stay on it until your NW6-7 or until you dont give a f***.
ShedMaster
Senior Member
- Reaction score
- 5
Everyone is different. Noone knows for sure. 4-5 years is the average time that propecia will slowly start to loose its effectiveness. When combined with minoxidil and nizoral, these time periods should be lengthend considerably, IMO. Also, perhaps in 5..6..7 years from now we will have a new weapon in the fight against male pattern baldness. I wouldn't consider that to be discouraging. Now if you are a nonresponder to the treatments listed above, then I would be discouraged that the underlying cause of the male pattern baldness is too strong even for those treatments to be effective.
Cornholio
Established Member
- Reaction score
- 1
The problem is that nobody studies combinations of medications... And that is what most of us are using... It makes sense that a DHT blocker combined with a growth stimulant might have additive effect, but that hasnt been studied.
This is the link for the 5 year minoxidil followup... while effects were tapering subjects were STILL BETTER OFF THAN AT THE BEGINNING OF THE 5 YEAR MARK. This was without DHT supression, the root cause of male hair loss, with twice a day minoxidil use. http://www.hairlosstalk.com/download/mi ... esults.pdf
This is the link for the 5 year Propecia study, with investigators rating 90% of patients as having no further visable hair loss at 5 years on propecia... Most retained the same amount of hair they had at the start of the study.
http://www.hairlosstalk.com/newsletter/article111.htm
The results available for most people with combination therapy (these and other topicals) are unknown and will probably never be studied, as studies are only done at great cost by companies to get their drug approved (and to be in the studies you cant be on other treatments), but it should be as good or better than that reported by any single drug study.
To read these boards most are not satisfied with their treatment results, but individual posts dont have the weight of actual 5 year studies which are more objective. Also, poster expectations and hopes play into their dissatisfaction... I think in 1 year I will be dissatisfied if my hair is not much much thicker after all the effort and expense, but in reality if there is no objective further loss (which I may be unable to report) that is a "success". Regrowth is an entire separate issue, but with combined treatments and these 5 year studies I think it is reasonable to say that most people can maintain for at least 5 years with a single agent, and that with multiple agents the outlook is unknown (but could/should be a little better). The 10 year studies should be out in a few more years to give some foresight.
This is the link for the 5 year minoxidil followup... while effects were tapering subjects were STILL BETTER OFF THAN AT THE BEGINNING OF THE 5 YEAR MARK. This was without DHT supression, the root cause of male hair loss, with twice a day minoxidil use. http://www.hairlosstalk.com/download/mi ... esults.pdf
This is the link for the 5 year Propecia study, with investigators rating 90% of patients as having no further visable hair loss at 5 years on propecia... Most retained the same amount of hair they had at the start of the study.
http://www.hairlosstalk.com/newsletter/article111.htm
The results available for most people with combination therapy (these and other topicals) are unknown and will probably never be studied, as studies are only done at great cost by companies to get their drug approved (and to be in the studies you cant be on other treatments), but it should be as good or better than that reported by any single drug study.
To read these boards most are not satisfied with their treatment results, but individual posts dont have the weight of actual 5 year studies which are more objective. Also, poster expectations and hopes play into their dissatisfaction... I think in 1 year I will be dissatisfied if my hair is not much much thicker after all the effort and expense, but in reality if there is no objective further loss (which I may be unable to report) that is a "success". Regrowth is an entire separate issue, but with combined treatments and these 5 year studies I think it is reasonable to say that most people can maintain for at least 5 years with a single agent, and that with multiple agents the outlook is unknown (but could/should be a little better). The 10 year studies should be out in a few more years to give some foresight.
wow this news should be great news for everyone! I wonder why most treatments will just keep the hair you already have and not grow much hair? i mean if the DHT was reduced shouldnt we grow more hair? what is it that makes us keep the hair that we have?
The reason is that there is damage done to the follicle once it has started to minaturize. Once a follicle is basically dead, or no longer able to produce a terminal hair, its tough to bring it back to life. Inhibiting DHT will sometimes reverse the miniaturization process a bit, but it can't bring back hair that's been gone for years. Growth stimulants are pretty much the same story- you can only get back some of the hair you've lost relatively recently.
DHT inhibition works to keep hair because DHT is one of the essential components in the miniaturization process. Without as much DHT, the process slows way down or stops.
DHT inhibition works to keep hair because DHT is one of the essential components in the miniaturization process. Without as much DHT, the process slows way down or stops.
Cornholio
Established Member
- Reaction score
- 1
How many years...
Now, why dont people on these boards seem happy with available treatments? A few ideas...
1) Non-responders or poor responders seek out these boards... The studies do show some people get less hair regrowth and maintenence. If the first treatment you try works you may very well not seek out sites like this. (For me, I started proscar 4-5 years ago, and didnt seek out a hair loss site until I noticed thinning again years later. I sure wouldnt be here if things had continued to go smoothly as it does for some... Now I have adjusted my approach and hope to happily "disappear" again once im sure its working : )
2) Not everyone is using the "big 3" or the most proven regimine... Laser combs and topical anti-androgens and inflamil MAY help, but you would be hard pressed to find studies showing objective regrowth... If you arent on the proven treatments (finasteride, rogaine, nizoral) you are a "study of one," and it is hard to know what to make of your success or failure...
3) Hairlines are tough (F'ing temples), and available treatments may or may not tackle the hairline as well as crown and vertex... It is harder to apply topicals to the hairline, and they seem predisposed to go fast and early. Rogaine and Finasteride dont have indications for the hairline, probably for the reason that benifits are more marginal there and harder to demonstrate. Even with maintenence in other areas progression in "problem areas" produces complaints on the board. (my plan is to try retin-a or other creams at the hairline to help out other treatments).
4) Regrowth is tough... Sadly I am NOT happy with my current hairline (though I bet in 10 years I would take it back happily) and unless some major improbable frontal regrowth occurres I will remain a little discontent. This despite the fact that I knows maintenence for 10 years would be a major victory... Even succeeding (regarding maintenence) with a well designed program I will probably gripe and be dissatisfied.
So, I think that there are treatments that work for a lot of people... Choose the proven treatments as early as possible and you will probably enjoy a significant delay in progression... and certainly do better than you would have with no treatment. Notable regrowth can be hoped for, but not expected (sigh). If progressing despite multiple treatments used faithfully you may have a stronger predisposition than most, and may need a little extra effort/innovation in treatments.
Whether hairloss can be delayed indefinitely is an unanswered question (not studied)... Posts on these boards suggest not everybody can maintain forever, but the above studies (limited to single drugs) suggest that MOST people can maintain for years. If you find yourself not falling into that group there are less conventional treatments to turn to (dutasteride, RU) before throwing in the towel.
Now, why dont people on these boards seem happy with available treatments? A few ideas...
1) Non-responders or poor responders seek out these boards... The studies do show some people get less hair regrowth and maintenence. If the first treatment you try works you may very well not seek out sites like this. (For me, I started proscar 4-5 years ago, and didnt seek out a hair loss site until I noticed thinning again years later. I sure wouldnt be here if things had continued to go smoothly as it does for some... Now I have adjusted my approach and hope to happily "disappear" again once im sure its working : )
2) Not everyone is using the "big 3" or the most proven regimine... Laser combs and topical anti-androgens and inflamil MAY help, but you would be hard pressed to find studies showing objective regrowth... If you arent on the proven treatments (finasteride, rogaine, nizoral) you are a "study of one," and it is hard to know what to make of your success or failure...
3) Hairlines are tough (F'ing temples), and available treatments may or may not tackle the hairline as well as crown and vertex... It is harder to apply topicals to the hairline, and they seem predisposed to go fast and early. Rogaine and Finasteride dont have indications for the hairline, probably for the reason that benifits are more marginal there and harder to demonstrate. Even with maintenence in other areas progression in "problem areas" produces complaints on the board. (my plan is to try retin-a or other creams at the hairline to help out other treatments).
4) Regrowth is tough... Sadly I am NOT happy with my current hairline (though I bet in 10 years I would take it back happily) and unless some major improbable frontal regrowth occurres I will remain a little discontent. This despite the fact that I knows maintenence for 10 years would be a major victory... Even succeeding (regarding maintenence) with a well designed program I will probably gripe and be dissatisfied.
So, I think that there are treatments that work for a lot of people... Choose the proven treatments as early as possible and you will probably enjoy a significant delay in progression... and certainly do better than you would have with no treatment. Notable regrowth can be hoped for, but not expected (sigh). If progressing despite multiple treatments used faithfully you may have a stronger predisposition than most, and may need a little extra effort/innovation in treatments.
Whether hairloss can be delayed indefinitely is an unanswered question (not studied)... Posts on these boards suggest not everybody can maintain forever, but the above studies (limited to single drugs) suggest that MOST people can maintain for years. If you find yourself not falling into that group there are less conventional treatments to turn to (dutasteride, RU) before throwing in the towel.
The Gardener
Senior Member
- Reaction score
- 25
If you are on the Big 3 and are a responder, which statistics say most people will be, you will ALWAYS have more hair on your head than you would if you never started a regimen. It's not like you go through five years of improvement and BOOM, hello horeshoe!
Our goal is not David Schwimmer hair, but instead it is to gain and maintain an age-appropriate hairline. I honestly think this is the most healthy level of expectation that I would instill in anyone here seeking advice, and I think the fact that there are medications out there to help us attain this is a wonderful thing. Don't take it for granted.
I am making a generalization here, but, lets say that we started our hairloss 5, 7, or 10 years before our peers did, which made us self conscious about it. These treatments close that gap, get us back onto par, or hopefully better if we respond well!
Our goal is not David Schwimmer hair, but instead it is to gain and maintain an age-appropriate hairline. I honestly think this is the most healthy level of expectation that I would instill in anyone here seeking advice, and I think the fact that there are medications out there to help us attain this is a wonderful thing. Don't take it for granted.
I am making a generalization here, but, lets say that we started our hairloss 5, 7, or 10 years before our peers did, which made us self conscious about it. These treatments close that gap, get us back onto par, or hopefully better if we respond well!
Cornholio
Established Member
- Reaction score
- 1
Propecia
Well, I was blissfully unaware of my hair for 4 years on propecia (not thrilled with it, just not worried). As I was happier with my hair (not paranoid enough to look closely and count hairs its hard to say if there was regrowth) there was probably only thickening. I was only using proscar at that time, no shampoos or topicals.
After 4-5 years I looked closely and noticed a scar that had been about a centimeter within the hairline was now exposed, and frontal hair was thinner... and, I was having trouble maintaining thick bangs (some recession and thinning). Not an emergency but a "wake up call".
My goal is maintenence for decades : ) as I dont think Ill accept a recession any better in my 50's than I will in my 30's... So, Ive added rogaine and tricomin and switched orals. Now I have to wait and see.
I dont call this a failure of finasteride as im very glad i took it (for the time and slight thickening it brought), but for me I am suspecting I may need a little "bump" up in treatment. Not everyone will, and starting slowly with treatment makes sense, if youre not in a crisis.
Well, I was blissfully unaware of my hair for 4 years on propecia (not thrilled with it, just not worried). As I was happier with my hair (not paranoid enough to look closely and count hairs its hard to say if there was regrowth) there was probably only thickening. I was only using proscar at that time, no shampoos or topicals.
After 4-5 years I looked closely and noticed a scar that had been about a centimeter within the hairline was now exposed, and frontal hair was thinner... and, I was having trouble maintaining thick bangs (some recession and thinning). Not an emergency but a "wake up call".
My goal is maintenence for decades : ) as I dont think Ill accept a recession any better in my 50's than I will in my 30's... So, Ive added rogaine and tricomin and switched orals. Now I have to wait and see.
I dont call this a failure of finasteride as im very glad i took it (for the time and slight thickening it brought), but for me I am suspecting I may need a little "bump" up in treatment. Not everyone will, and starting slowly with treatment makes sense, if youre not in a crisis.
this was an e mail sent to me by dr lee himself
Well you have male pattern baldness whether you have treated it or not. We can't change the genetic code. We are trying to alter the genetic expression with these treatments. Sometimes we are quite successful, other times we are not. By definition, if male pattern baldness doesn't respond to proper therapy, it is because of the genetic expression of an accelerated progression of male pattern baldness. The 'second shedding' may also be due to the propitious timing of male pattern baldness. If treatments for male pattern baldness have any success, those gains usually occur primarily within the first year or first few years of therapy. And then, only if the genetic expression of male pattern baldness is relatively quiescent. There are times, genetically determined, when male pattern baldness will suddenly accelerate. At these times, none of the therapies we currently have available will prevent the progress of male pattern baldness, although the rate of progress can be slowed. You have experienced both these periods sequentially. It would be wonderful to be able to predict the times of accelerated male pattern baldness and/or to have medications that could prevent those episodes. But we can't. And we don't. So, I share your frustration. There may be some reassurance in knowing that the period(s) of accelerated male pattern baldness are self limited, after which you may again have success with minoxidil and and medicines to protect the follicles from DHT.
I dont get what he means by accelrated male pattern baldness and that NO treatments at that time will be able to help it? and that AFTER the periods of accelerated loss can we continue using the products again?
Well you have male pattern baldness whether you have treated it or not. We can't change the genetic code. We are trying to alter the genetic expression with these treatments. Sometimes we are quite successful, other times we are not. By definition, if male pattern baldness doesn't respond to proper therapy, it is because of the genetic expression of an accelerated progression of male pattern baldness. The 'second shedding' may also be due to the propitious timing of male pattern baldness. If treatments for male pattern baldness have any success, those gains usually occur primarily within the first year or first few years of therapy. And then, only if the genetic expression of male pattern baldness is relatively quiescent. There are times, genetically determined, when male pattern baldness will suddenly accelerate. At these times, none of the therapies we currently have available will prevent the progress of male pattern baldness, although the rate of progress can be slowed. You have experienced both these periods sequentially. It would be wonderful to be able to predict the times of accelerated male pattern baldness and/or to have medications that could prevent those episodes. But we can't. And we don't. So, I share your frustration. There may be some reassurance in knowing that the period(s) of accelerated male pattern baldness are self limited, after which you may again have success with minoxidil and and medicines to protect the follicles from DHT.
I dont get what he means by accelrated male pattern baldness and that NO treatments at that time will be able to help it? and that AFTER the periods of accelerated loss can we continue using the products again?
He means that male pattern baldness is not a linear progression from hairy to bald. There are times when you lose hair fast, and times when things slow down and may stay stable for years. Lot of guys jump to NW3 in their 20s, and stay there until their 40s.
During the "storms" of male pattern baldness, it is very hard to stop or reverse hairloss. When things quiet down again, you might be able to get regrowth or maintenance for a long time. I think treatments always help somewhat, but when things are going really fast, the best you can do is slow it down a bit. Think of it as trying to stop a train.
Basically, he's saying we are fighting against powerful genetic forces and usually the best you can do is delay the inevitable for some period of time.
During the "storms" of male pattern baldness, it is very hard to stop or reverse hairloss. When things quiet down again, you might be able to get regrowth or maintenance for a long time. I think treatments always help somewhat, but when things are going really fast, the best you can do is slow it down a bit. Think of it as trying to stop a train.
Basically, he's saying we are fighting against powerful genetic forces and usually the best you can do is delay the inevitable for some period of time.
Cornholio
Established Member
- Reaction score
- 1
cateyes81 said:
I dont think he's saying stop products when things get worse (of course), or that youre not better off with treatments during these periods... just that even with the best available treatments (I think he recommends propecia and his topicals to patients) there may still be times when things get worse (more thinning and recession) despite maximal treatment, if it is in your genes for that to occurre... and that after these self limited spells you might see some benefit from treatment after things cool down again.
Thanks for sharing that... i was wondering what the experts thought about how effective available treatments were...
rapidfrontal
Established Member
- Reaction score
- 0
I have accelerated loss in my temples, especially right and I just emailed Dr. Lee about this yesterday, below is his reply to my email in case you are interested:
From your brief description, there are three possible explanations for your hair that is thinning and falling. (1) telogen effluvium (2) acute accelerated onset of male pattern baldness or (3) a telogen effluvium that sometimes heralds the onset of male pattern baldness.
A telogen effluvium would be explained by a shedding of the hair "all over" the scalp, including the back and sides, which are areas not usually affected by male pattern baldness. The inciting event for a telogen effluvium, such as your period of severe stress or systemic drugs, usually predates the shedding by approximately 100 days. If your hair loss were due simply to a telogen effluvium, all of the hair will grow back.
male pattern baldness can have a sudden and explosive onset, such as you have described. Although not common, there have been reports of physical sensations (e.g. itching, burning, redness, etc.) in the affected areas of the scalp accompanying an accelerated phase of male pattern baldness. In this case, the hair will grow back, but the thickness of the hair may be dramatically decreased.
Then, there are cases of telogen effluvium that begins a period of accelerated male pattern baldness. This would be the worse case scenario, because there is sudden excessive shedding and the hair follicles, which shed their hair shafts, will miniaturize and replace the hair shaft with hair that may be vellus-like.
For any hair loss treatment the work requires a norm of 4 to 6 months. The reason is simple. What we are trying to do is to replace thin or fine hair shafts by thicker ones. In order for that to happen, the follicle producing the fine hair shaft has to shift into the telogen phase, which lasts ~100 days, shed the fine shaft, and start growing an observable thicker shaft. That requires 4 to 6 months, regardless of the treatment. That is one reason you have not seen a response to finasteride.
From your brief description, there are three possible explanations for your hair that is thinning and falling. (1) telogen effluvium (2) acute accelerated onset of male pattern baldness or (3) a telogen effluvium that sometimes heralds the onset of male pattern baldness.
A telogen effluvium would be explained by a shedding of the hair "all over" the scalp, including the back and sides, which are areas not usually affected by male pattern baldness. The inciting event for a telogen effluvium, such as your period of severe stress or systemic drugs, usually predates the shedding by approximately 100 days. If your hair loss were due simply to a telogen effluvium, all of the hair will grow back.
male pattern baldness can have a sudden and explosive onset, such as you have described. Although not common, there have been reports of physical sensations (e.g. itching, burning, redness, etc.) in the affected areas of the scalp accompanying an accelerated phase of male pattern baldness. In this case, the hair will grow back, but the thickness of the hair may be dramatically decreased.
Then, there are cases of telogen effluvium that begins a period of accelerated male pattern baldness. This would be the worse case scenario, because there is sudden excessive shedding and the hair follicles, which shed their hair shafts, will miniaturize and replace the hair shaft with hair that may be vellus-like.
For any hair loss treatment the work requires a norm of 4 to 6 months. The reason is simple. What we are trying to do is to replace thin or fine hair shafts by thicker ones. In order for that to happen, the follicle producing the fine hair shaft has to shift into the telogen phase, which lasts ~100 days, shed the fine shaft, and start growing an observable thicker shaft. That requires 4 to 6 months, regardless of the treatment. That is one reason you have not seen a response to finasteride.
ok just curious though when we get these accelerated outbursts of hair loss when the products dont really work after the chaos is over will our hair go back to its original state? (because of the products of course) i just hit the year mark for the big three and i have not seen improvement in the past 6 months its just stayed the same. I keep assuming that if my hair is not improvijng it is just getting worse and that there is no middle ground where my hair will just "stay the same" anyone get what im trying to say
rapidfrontal
Established Member
- Reaction score
- 0
cateyes, in the email of Dr. Lee's he mentions the 'second shedding' and then later he says, 'you experienced both of these sequentially' What is this all about? Experienced what sequentially?
And yes after the accelerated period you can continue using the treatments and in his opinion with success.
And yes after the accelerated period you can continue using the treatments and in his opinion with success.
rapidfrontal
Established Member
- Reaction score
- 0
cateyes81 said:
In that email to me Dr. Lee seems to be saying that after the shedding stops (meaning after the accelerated period of loss ends) the hair will come back, but probably with a finer and less robust hair as those follicles are on their way to dying out.
Many consider no change an improvement, as do I. An improvement over loss. I do not agree that if you don't see improvement in you hair it is getting worse, but I do know what you are saying.