Propecia, Shedding, and Telogen Effluvium

[Weepy]

Like some other Propecia users, I have experienced increased shedding. I came across this article from Dr. Lee, and was interested in this board's collective wisdom. Based on what I have experienced, read and heard, this seems to be relatively true.

I started with minoxidil. and noticed shedding, which eventually slowed. About 2 weeks into minoxidil., I thought I should be more agressive and try Propecia. About 1.5 weeks after Propecia, start, I have noticed hair coming out by the handful when I comb my hair.

I am starting to think that a simple test of whether or not Propecia will work is whether or not you shed at start of therapy. This is only a guess, based on limited reading and recent experience, though. I am a noob.

I.3 Myth: Shedding is an indication that Propecia is working

It is not normal for Propecia to cause shedding at any time during its use. Binding the type 2 5-alpha reductase does not cause a shift from anagen to telogen, so no shedding would be expected to occur. If shedding does occur, it is not a sign that finasteride is working. There have been rare cases in which patients have reported a telogen effluvium months after initiating treatment with finasteride. Apparently, a drop in the systemic levels of DHT had been the inciting event in causing these cases of telogen effluvium. Although a telogen effluvium usually begins somewhere between 11 and 16 weeks after the inciting event, it can start as soon as 4 weeks thereafter.

There are no specific numbers that we can put on the amount or percentages of hair shed in a telogen effluvium. The amount and degree of hair loss is dependent on the severity of the telogen effluvium. Rarely, will the amount of hair loss exceed 50%. The shedding is generally diffuse (global) and can affect areas of the scalp not usually affected by male pattern baldness. So, it would be common to note shedding from the sides and back of the head in addition to the crown, vertex and frontal areas. The shedding tends to be fairly symmetrical, but will be more noticeable in the areas affected by male pattern baldness, because there is a higher ratio of hairs in the telogen phase than in the other areas of the scalp not involved with male pattern baldness. The shedding lasts about 6 weeks. It usually takes 4 months to a year for the hair to grow back.