Rapid Hairloss - Post 6 years Propecia

[hairbrigade]

Hi, I'm a 34 year old healthy male, and I've been on 1mg/day Propecia for well over 6 years, and it's done wonders. I went from heavy thinning to almost a full head of hair (albeit rather fine) up until the 5th year, but during the last 6 months I've had a MASSIVE hair fall out, and my scalp is now very tender/sore, noticeably bare on top and with many more hairs in the sink than usual.

What has happened??!!

I have been rather stressed/anxious over last year, and had to stop Propecia for 7 days last June and again in early November due to doctor checks (all fine!) so I'm not sure if this 'broke the Propecia hold on my hair' but I've been back on the tablets every day since, and will continue to do so.

I've recently spent a lot of money of some HLCC scripts DHT inhibiting and Multi Vitamin conditioner thinking that maybe the Propecia isn't blocking enough DHT on scalp and that key hair vitamins are missing due possibly reduced blood flow to scalp (hence my scalp pains). But I'm lost to understand why Propecia is failing to stop this now!!

I am massaging my scalp every morning with the shampoo which alleviates the scalp pain and am now considering going on Regaine/Minoxidil foam as my last hope.

Any thoughts why Propecia would suddenly stop working so fast? My diet is the same (very healthy).

 

[frenchy]

i think finasteride tends to loose it efficacity somtimes after a few years, you may consider jumping on dutasteride ?

 

[hairbrigade]

Thanks for response, I agree with finasteride potentially losing it's efficacy, I think some say its after 5 years, but such a rapid loss in hair perplexes me. I hear some have used it over 10 years successfully, but I guess everybody is different. Thanks for the dutasteride tip - I will consider that. Also considered increasing the Propecia dose to 1.5mg a day, or giving these DHT inhibiting shampoos I recently bought chance to work albeit I'm rather sceptical of their benefits.

 

[frenchy]

yeah i think shampoo won't do much, and in theory increasing finasteride dose won't neither .

 

[Quantum Cat]

some people here have been on it for 15-20 years and say it still works, so it doesn't necessaily lose it's effect. It all depends on genetics in the end.

out of interest why did you stop taking it for doctor checks?

 

[hairbrigade]

My blood potassium levels were rather high and my Doctor wanted to see if it was the finasteride causing it. Never quite got to the bottom of that but last 3 tests have been perfectly normal and he's now fine with me to continue with yearly checks!

It's just strange as the finasteride really did miracles for my hair for a long period of time. The loss has just been massive over the last 6 months.

I'm just hoping now I'm back on them every day since stopping for a week in early November, combined with a thorough daily hair wash/massage routine and a recent reduction in stress/anxiety levels will yield less loss and new growth.

I notice lots of small stubbly hairs underneath my quite long hair on the scalp which I hope is new hair growth, as opposed to minaturisation of existing hair follicles!

I hear Minoxidil Foam twice a day is very good - I've resisted so far for cost, effort and potential side effect reasons and had no need with the Finasteride working so well for so many years, but maybe its worth a try!

Otherwise I think it will be a FUE hair transplant for my scalp sometime in the near future!

 

[maxou]

you don't necessarily need to switch to dutasteride but you could consider adding a low dose dutasteride to your current regimen

such as 0.5mg/week while staying on 1mg finasteride a day

The below thread is exactly your case: regrowth/mainting for 5 years, then slight decrease
http://www.hairlosstalk.com/interac...e-Dutasteride-Treatment-Androgenetic-Alopecia

 

[hairbrigade]

Great, thanks for the link

 

[Wolf Pack]

Hi, I'm a 34 year old healthy male, and I've been on 1mg/day Propecia for well over 6 years, and it's done wonders. I went from heavy thinning to almost a full head of hair (albeit rather fine) up until the 5th year, but during the last 6 months I've had a MASSIVE hair fall out, and my scalp is now very tender/sore, noticeably bare on top and with many more hairs in the sink than usual.

What has happened??!!

I have been rather stressed/anxious over last year, and had to stop Propecia for 7 days last June and again in early November due to doctor checks (all fine!) so I'm not sure if this 'broke the Propecia hold on my hair' but I've been back on the tablets every day since, and will continue to do so.

I've recently spent a lot of money of some HLCC scripts DHT inhibiting and Multi Vitamin conditioner thinking that maybe the Propecia isn't blocking enough DHT on scalp and that key hair vitamins are missing due possibly reduced blood flow to scalp (hence my scalp pains). But I'm lost to understand why Propecia is failing to stop this now!!

I am massaging my scalp every morning with the shampoo which alleviates the scalp pain and am now considering going on Regaine/Minoxidil foam as my last hope.

Any thoughts why Propecia would suddenly stop working so fast? My diet is the same (very healthy).

May I ask did you have scalp issues before taking finasteride? I have been thinking about it, that finasteride inhibits 90% of type 2 DHT but in those with lots of inflammation and fibrosis in the scalp, maybe that 10% of type 2 DHT left is still damaging slowly but surely? DHT is the initial trigger but there is a lot more that leads to hair loss.

Switch to dutasteride.

 

[Quantum Cat]

May I ask did you have scalp issues before taking finasteride? I have been thinking about it, that finasteride inhibits 90% of type 2 DHT but in those with lots of inflammation and fibrosis in the scalp, maybe that 10% of type 2 DHT left is still damaging slowly but surely? DHT is the initial trigger but there is a lot more that leads to hair loss.

not even close

 

[maxou]

1 mg finasteride / a day inhibits around 50% of dht

this is why aggressive hairlosses can't be fought w/o dutasteride

 

[Wolf Pack]

not even close

I am not talking about serum DHT, you are probably getting confused with that 68% of serum DHT inhibition at 1 mg.

No one cares about serum DHT, it's the type 2 DHT, more specifically located at the hair follicles that is the key.

Here finasteride takes out 85-90%, dutasteride takes it all out more or less but also collateral damage as takes out type 1 which is located in your brain for example AND has sfa to do with hair loss.

 

[hairbrigade]

Appreciate all the responses.

Had a sore/tender scalp and lots of hair loss in sink before starting finasteride late 2007 but assumed soreness was male pattern baldness related.

There is a definite connection between sore scalp and hair loss, so assume that's all DHT connected.

Whilst on finasteride over the last 6-7 years I've rarely had a sore scalp, hair loss stopped completely followed by much sustained regrowth (my friends were amazed by results!) until the last 6 months when the tenderness returned and that has coincided with rapid hair loss.

Sounds like I need to consider either totally swapping or complementing the finasteride with dutasteride then.

I will look into the health/benefits trade-off between that and the other common hair loss drug (albeit topical) Minoxidil which I understand is popular to use alongside finasteride.

 

[Wolf Pack]

Appreciate all the responses.

Had a sore/tender scalp and lots of hair loss in sink before starting finasteride late 2007 but assumed soreness was male pattern baldness related.

There is a definite connection between sore scalp and hair loss, so assume that's all DHT connected.

Whilst on finasteride over the last 6-7 years I've rarely had a sore scalp, hair loss stopped completely followed by much sustained regrowth (my friends were amazed by results!) until the last 6 months when the tenderness returned and that has coincided with rapid hair loss.

Sounds like I need to consider either totally swapping or complementing the finasteride with dutasteride then.

I will look into the health/benefits trade-off between that and the other common hair loss drug (albeit topical) Minoxidil which I understand is popular to use alongside finasteride.

Good options for you then. dutasteride is not approved for long term safety so something to consider, you will have to buy it online. No Doctor here will give it to you. Ideally they needed a drug between finasteride and dutasteride, that takes out all of type 2 DHT without touching type 1. I guess they feel finasteride is good enough for most people.

Yes I suspect you have an aggressive form of hair loss with what you describe with the scalp situation. It is strange though finasteride suddenly lost it's effectiveness. Should have been a gradual decline in hair loss in those 10% of individuals who don't respond as well. Do see your Doctor again and have a full check up consisting of various bloods to rule out organic causes of your hair loss.

 

[hairbrigade]

Very constructive advice - thanks.

I'm siding more towards trying minoxidil alongside the finasteride as albeit there are reported side effects, it is deemed safe enough to sell in chemists across the UK. Maybe that's the 'boost' my hair needs, assuming the finasteride alone has finally ran out of steam!

I will certainly ask my Doctor to check my scalp as suggested, albeit I'm pretty sure it's male pattern baldness related. There's no redness as such, it can get quite shiny despite daily washing and it's quite tender to the touch compared to the back and sides.

As you say, possibly the male pattern baldness has now reached new levels of aggressiveness through age, and thus the finasteride can no longer keep at bay alone, albeit the sudden accelerated loss is quite strange. I guess it's difficult to say if it's due to increased scalp DHT itself, increased follicle dislike to DHT, or lack of blood flow/nutrients to scalp.

 

[zzzzz]

OP, switching to dutasteride might be a good option, BUT

shedding does not equal miniaturization. It is certainly possible that your hair is miniaturizing and finasteride is no longer strong enough, but as long as the hair isn't miniaturizing it won't be a problem

 

[abcdefg]

I would be curious to someday see some answer as to why finasteride loses its effectiveness like this over the years. Does hair adapt to lower androgen levels or is it really male pattern baldness speeding up as you get older?

 

[Ventures]

I would be curious to someday see some answer as to why finasteride loses its effectiveness like this over the years. Does hair adapt to lower androgen levels or is it really male pattern baldness speeding up as you get older?

I don't know is it myth or true, But if this is true, that AR become more and more sensitive, than even castrated man would loose hair in the end since his AR would become so senstiive to remaining 15-30% of DHT.

 

[zzzzz]

I would be curious to someday see some answer as to why finasteride loses its effectiveness like this over the years. Does hair adapt to lower androgen levels or is it really male pattern baldness speeding up as you get older?

it doesn't lose effectiveness, either DHT levels increase naturally (some guys DHT levels go up as they age from young men into middle age), as well as one or two other possible explanations. But it is not the drug itself that becomes weaker, the body does not "adapt" to it either

 

[hairbrigade]

it doesn't lose effectiveness, either DHT levels increase naturally (some guys DHT levels go up as they age from young men into middle age), as well as one or two other possible explanations. But it is not the drug itself that becomes weaker, the body does not "adapt" to it either

I assume then that my DHT levels have naturally increased over the last few years (I'm 34 now) and that Propecia alone can no longer hold back the resulting damage to the hair follicles. This would also make sense as to why the scalp burning has returned over the last 6 months, combined with the heavy shed (& I mean HEAVY!!).

I've attached some pics. First is prior to taking Propecia in 2007, three whilst on it (years 3-6) and finally a very recent one. It almost appears that I am heading back to my pre-propecia hair state and 'throwing away' all the good work so to speak! I cannot believe I had such thick hair only 7 months ago (picture of me in suit). Seems as though the DHT has either 'gone through the roof' in last 6 months, or the finasteride has struggled to 'regain ground' after I stopped in twice due to other checks.

I'm worried that by stopping Propecia twice for an 8 day period over the last 6 months has damaged its efficiacy permanently. I havent missed a day in 2 months now and recently added 2% Nizoral to my routine (2-3 times a week) to try and calm the scalp and recover recently lost hair (fingers crossed there). I am not keen on complementing with 0.5mg dutasteride, even once a week until it is proven 'safe'. My last options are increasing the finasteride dose from 1 to 1.25mg/day (tricky as my UK chemist only sells 1mg Propecia), minoxidil Foam and of course...a FUE transplant which I've already done some research into!