Sides And Back Thinning On Dutasteride (pics)

[1knox1]

It’s probably not the main culprit but do you need to use nizoral 3 times a week? It’s pretty harsh stuff. I know you’re only using the 1% but still.

There’s a few stories (with pics) on here about nizoral affecting hair texture.

 

[MKP05]

I believe it's a very bad idea to with back to less potent finasteride. Impressive shedding is a good sign that you're likely to experience regrowth. Maybe you want to consider a stronger minoxidil solution (10-15%) to accelerate regrowth.
In my case the first months on therapy were difficult, I lost a lot of dead hair. My scalp looked ridiculous and was incompatible with my social status and lifestyle. When some regrowth on my temples occurred I started to slick back my hair. Now regrowth is sufficient to fully cover my scalp, the rate of regrowth is different different areas (temples regrow at a slower rate).

I’m not going back on minoxidil. It did nothing for me and I used it for over one year. I understand the logic that everyone uses when they say you have shed to get regrowth. But finasteride crushed my hair and now dutasteride is crushing my donor zone. My f*****g donor zone. It’s really hard for me to accept that I just need to plow through. I did that already with finasteride and it just got worse and worse. If I’d known that I could lose hair in the back and sides on duta I would’ve never switched over. I think I’m doomed to go bald in the most freakish way possible. It’s honestly starting to look like I’m seriously ill. Hair is just fried everywhere. I’ll probably push through for another month and then re-evaluate but I think this is f*****g bullshit. And what’s worse is that I did most of the damage to myself by getting on and staying on anti androgens. I’m likely in some extremely small percentage of people who just have an adverse reaction to this stuff. Maybe I’m overreacting but it’s been almost two years now and just when I think things can’t get any worse they do.

 

[MKP05]

It’s probably not the main culprit but do you need to use nizoral 3 times a week? It’s pretty harsh stuff. I know you’re only using the 1% but still.

There’s a few stories (with pics) on here about nizoral affecting hair texture.

I don’t think it’s nizoral. My hair started falling out on the sides and back just a week after starting dutasteride. This was after 17 months of finasteride and not changing anything else. Hopefully it will grow back but my response so far to these drugs has been horrific and i have very little expectation that things will reverse course. In a million years I didn’t think my donor area would take a hit like this. I would’ve rather kept losing ground on finasteride than losing my sides and back. I can’t even wear a hat to hide my hair loss. f*****g miserable experience so far.

 

[Anatoly]

My understanding is that the more factors one controls, the better the result. In the latest photo you provided your scalp does not look healthy enough. My skin looked similarly inflamed, now it's quality has changed. Dutasteride/finsateride may be insufficient for some to see regrowth.
I understand your experience with minoxidil, well, being off it will save your nerves. In my case I have to use it exactly every single day: once I missed it for 5-6 days, my regrowth was in place when I resumed it. But about 20-30% (judging my temples) were already dead, therefore I experienced a shed for 2-3 weeks. Moreover, Rogaine 5% does not make substantial visible difference, when I used it without a 15% solution. Now I use it only in the morning. Being on a 15% solution is an entirely different experience. I have compared and payed with a lot of stress for these comparisons of different regimens and missed doses)
In your case I would first think about what is lacking in your therapy given that finasteride and 5% minoxidil have been insufficient. Maybe I have to meet some other requirements - e.g. 1) get rid of reddish skin (intensive Nizoral, roaccutane, you may discuss it with your doctor why your skin is reddish), this is hardly about getting on/off finasteride/dutasteride; 2) some deficiencies- e.g. I have to take iron and D vitamins - I have severe vitamin D deficiency, although before my hair story I did not notice this); 3) any other sources of inflammation in your body besides DHT-caused inflammation- e.g. when my tooth crushed and I suffered pain (=infection, inflammation) for a week that was enough for me to see increased shedding again. It stopped when I eradicated this source of inflammation and my hsC-RP level became normal again.

I'm a social scientist and comfortable with controlling as many variables as possible, I believe this is the right way. It took e some time and a lot of nerves to identify a regimen that will produce regrowth in my particular case- e.g. I take zinc, this reduces the activity of my oil glands, I completed the course and stopped; my scalp became oily again despite keeping Nizoral, minoxidil etc - then it became more reddish and then I noticed my hairline started to fall out again ( I closely monitor 2-3 square cm on my temple), I resumed zinc - my scalp returned to a healthy state. The same happened when I missed Nizoral despite being on zinc)).

I see that you have spent two years. It's upsetting that you still haven't got what you want. I spent 6 months with all this stuff, different regiments, short experiments, comparisons. I decided that I will start with an intensive regimen; the thought that I' using most powerful drugs controlling for as any factors as possible allowed me to better overcome stress related to severe shedding etc. I knew that statistically I had very good chances of getting what I wanted - this helped to overcome difficult early treatment phases.

I have learned that my current hair regrowth is difficult to maintain: any alterations or other intervening factors are likely to ruin it. Now my hairline has returned to the times I was 18 and I can enjoy an American Psycho hairline/style, but this is unstable and dependent on quite a number of variables. I do not consider hair transplant because it will not produce a natural hairline (with thinner hairs of different diameter and growth rate + baby hairs that are important to fill in the hairline), none of the best London clinics hair transplant satisfied me.

 

[Anatoly]

My hair started falling out on the sides and back just a week after starting dutasteride.


You may consider intensifying Avodart regimen. In my first month I actually took two-three capsules + a capsule topically (temples and crown) every day. I knew that I had to get rid of all dead ( or soon-to-die) hairs, I wanted to make it quicker. Every day l pulled my hair to check the intensity of shedding in different areas. Only after 4+ months on Avodart (plus 6 weeks finasteride 5-10 mg) when I pull my hair I have no hairs in my hand.
The statistics I have suggest that age is correlated with the time one needs to see regrowth. I'm 27. If I were 37 it would have taken me longer, I believe.

 

[MKP05]

I just want my hair in the back and sides to stop falling out and to grow back. I’d do anything to go back to the state I was in two months ago. This really could not have been a worse outcome. I’ve killed my hair by doubling down with dutasteride. My doctor thinks I should drop the dutasteride and revert back to finasteride but at 1.25 mg rather than 1mg. I don’t know what to do but I agree about the inflammation. But I honestly believe the inflammation is being triggered by the dutasteride - either an allergic or immune response. I’m glad that you found a regimen that works for you and that you have it under control. But this is not working for me and despite everyone saying to just push through I know in my gut that I’m never going to recover from this just like I never recovered from the initial hit when I started finasteride. I would never have touched these drugs had I known I’d be this damaged in 20 months. About the only positive I can say is that I don’t suffer from any of the more commonly reported side effects. But I’m more convinced than ever that these drugs can and do cause irreversible hair loss in some cases like mine. It may be rare but some people simply do not react well to these medications.

 

[StevenGerrard]

How long have you been on Duta? Total? I had multiple nasty sheds during the first ~80 days... like absolute hell... You need to be patient and stick with the medication.

 

[Derelict]

sh*t, that looks brutal,, never had a shed that bad when i started duta, then again i started it roughly the same time as oral min and had a real bad shed so maybe it was a combination of both. Hands completely covered in hairs when washing my hair. Ride it out and hope for the best.

 

[MKP05]

How long have you been on Duta? Total? I had multiple nasty sheds during the first ~80 days... like absolute hell... You need to be patient and stick with the medication.

Exactly two months. What’s interesting is that I’m not shedding anywhere else except the sides and donor area. It literally attacked the one place which was good. I’m freaked out for sure but I know I can’t stop. It’s like my finasteride experience all over again except this happened in 2 months rather than 4. Crazy.

 

[MKP05]

sh*t, that looks brutal,, never had a shed that bad when i started duta, then again i started it roughly the same time as oral min and had a real bad shed so maybe it was a combination of both. Hands completely covered in hairs when washing my hair. Ride it out and hope for the best.

That’s the other thing. I’m not seeing clumps of hair in my hands ever. Even when I shower. Nothing. But sure as day is long the entire back of my head is diffused and the hair above the nape got obliterated. I guess I’m just lucky. Lol

Thankfully my hair loss everywhere else including the temples has slowed down dramatically, to the point where it doesn’t look much different than 2 months ago when prior to starting treatment 2 months would definitely have been enough time to see a visible deterioration of the temples and hairline.
So it seems to be maintaining my Norwood area while destroying my donor area.
f*** it. I guess i have no choice but to keep going. This blows.

 

[Derelict]

That’s the other thing. I’m not seeing clumps of hair in my hands ever. Even when I shower. Nothing. But sure as day is long the entire back of my head is diffused and the hair above the nape got obliterated. I guess I’m just lucky. Lol

Thankfully my hair loss everywhere else including the temples has slowed down dramatically, to the point where it doesn’t look much different than 2 months ago when prior to starting treatment 2 months would definitely be enough time to see a visible deterioration of the temples and hairline.
So it seems to be maintaining my Norwood area while destroying my donor area.
f*** it. I guess i have no choice but to keep going. This blows.

Does a lot of hair in your donor area come out in a pull test?

 

[MKP05]

Getting a haircut tomorrow. Hoping buzzing it on the back and sides makes the diffuse less noticeable. But it will probably look like sh*t and I’ll want to drive my car into a ditch on the way home. .

Does a lot of hair in your donor area come out in a pull test?

No. none. In fact I just used two hands to pull both sides of the back of my head. I did this seven times and I pulled hard. I didn’t get one single hair to come out. I’m assuming this is not a good sign??

just like when I was on finasteride this doesn’t feel like a normal shed. My hair was just zapped. Sudden loss of density is the only way I can describe it.

 

[MKP05]

Getting a haircut tomorrow. Hoping buzzing it on the back and sides makes the diffuse less noticeable. But it will probably look like sh*t and I’ll want to drive my car into a ditch on the way home. .

No. none. In fact I just used two hands to pull both sides of the back of my head. I did this seven times and I pulled hard. I didn’t get one hair to come out. I’m assuming this is not a good sign??

just like when I was on finasteride this doesn’t feel like a normal shed. My hair was just zapped. Sudden loss of density is the only way I can describe it.

Oh and I never recovered the density after my finasteride “shed”. So based on past experience you can imagine that I’m skeptical about recovering the density in the back. This doesn’t feel normal or align with other shed experiences I read about

 

[Anatoly]

But this is not working for me and despite everyone saying to just push through I know in my gut that I’m never going to recover from this just like I never recovered from the initial hit when I started finasteride. I would never have touched these drugs had I known I’d be this damaged in 20 months. About the only positive I can say is that I don’t suffer from any of the more commonly reported side effects. But I’m more convinced than ever that these drugs can and do cause irreversible hair loss in some cases like mine. It may be rare but some people simply do not react well to these medications.[/QUOTE]


I also had thoughts like this. These are not helpful thoughts. To my knowledge from academic journals, this logic is scientifically implausible. One may seek a simpler explanation: finasteride you used was simply not enough to provide regrowth, but it had certainly made your hair loss slower.
I want to see photos of your regrowth in 3-6 months. Keep calm and go on) to make other people here be happy for your upcoming success story. Do scalp massage to accelerate shedding phase. Intensify your regimen. If finasteride was insufficient to reverse your hair loss, hardly likely it improves your current state.

 

[MKP05]

But this is not working for me and despite everyone saying to just push through I know in my gut that I’m never going to recover from this just like I never recovered from the initial hit when I started finasteride. I would never have touched these drugs had I known I’d be this damaged in 20 months. About the only positive I can say is that I don’t suffer from any of the more commonly reported side effects. But I’m more convinced than ever that these drugs can and do cause irreversible hair loss in some cases like mine. It may be rare but some people simply do not react well to these medications.

My point was that finasteride was not maintaining my Norwood region sufficiently but at least it wasn’t causing my donor region to lose all of its density. When I had the same reaction on finasteride at 4 months I got the same advice. It’s normal. Keep going. But the density never returned in 17 months even though it didn’t drastically worsen either (although the temples and hairline did continue to recede).

I’m frustrated and I do appreciate the feedback and encouragement. The truth is that I don’t definitively know exactly what’s causing my donor region to drastically thin. It could be a combination of factors. The switch to dutasteride certainly seems to be the catalyst but was it the sudden shift in hormonal balance? An autoimmune response (I have alopecia areata as well)? Stress induced Telogen Effluvium? I have to hope that - whatever the cause - it is temporary and will eventually get better. I’m willing to give it more time and if it does turn around I’ll definitely report the results. At this point if I could maintain the Norwood region and regrow the donor region I’d consider that a success. Anticipating a bad end result is merely the byproduct of my recent experience with finasteride. but I do realize that this mindset neither helps me maintain my resolve to keep going nor is it good for my health or hair. Thanks for reminding me.

 

[MKP05]

Sides and back of hair continue to thin drastically. Now I’m also losing lots of hair at my left temple, forelock and mid scalp. When I run my hands through my head I get 0-2 hairs coming out. But each week the loss in density is more and more noticeable. I just looked at pictures of my hair at the end of November when I started dutasteride and although I was losing ground at thar point I still had thick hair in the donor area. That’s all gone now and replaced with fine, flat hair which no longer adequately hides the scalp on the entire back of my head. This is brutal.

 

[Anatoly]

I appreciate your concerns. If I were you, I would do the following:
1) do not stop dutasteride so early, otherwise you will never learn what is happening to you; e.g. in my particular case severe shedding subsided only when I was in my 4th month of dutasteride;, initially instead of the thick hairs I lost I saw a regrowth of thin fine hairs (I was scared as well), but gradually they grew thicker, darker and healthier - now they are thick and normal, but their ends are thin and almost transparent; moreover, I use high-strength minoxidil - which, I believe, facilitated a faster regrowth in my case, otherwise it would have probably taken me much longer to see a regrowth of normal hair
2) check your cortisol level etc - apparently you're stressed, this is an important variable
3) I believe your assessment, but it is still imprecise: do a trichoscopy now and in a few months to get a definite answer to whether you have more or less hairs per cm2
4) have a general health check - there may be some underlying condition that diminishes the benefits of your finasteride and more recent dutasteride use *(e.g. high-sensitive CRP to get an impression about overall inflammation in your body etc, see a gastroenterologist to make it sure that nutrients you get from food etc actually reach your hair to allow it to regrow properly)

 

[MKP05]

I appreciate your concerns. If I were you, I would do the following:
1) do not stop dutasteride so early, otherwise you will never learn what is happening to you; e.g. in my particular case severe shedding subsided only when I was in my 4th month of dutasteride;, initially instead of the thick hairs I lost I saw a regrowth of thin fine hairs (I was scared as well), but gradually they grew thicker, darker and healthier - now they are thick and normal, but their ends are thin and almost transparent; moreover, I use high-strength minoxidil - which, I believe, facilitated a faster regrowth in my case, otherwise it would have probably taken me much longer to see a regrowth of normal hair
2) check your cortisol level etc - apparently you're stressed, this is an important variable
3) I believe your assessment, but it is still imprecise: do a trichoscopy now and in a few months to get a definite answer to whether you have more or less hairs per cm2
4) have a general health check - there may be some underlying condition that diminishes the benefits of your finasteride and more recent dutasteride use *(e.g. high-sensitive CRP to get an impression about overall inflammation in your body etc, see a gastroenterologist to make it sure that nutrients you get from food etc actually reach your hair to allow it to regrow properly)

The flip side of that coin is that if I don’t quit medication there’s no telling how much additional damage it’s doing to me. Since I’ve started dutasteride the following things have happened
1) hair loss on the sides and back of head where there’s previously been no hair loss. This is the exact same thing which happened to me when I started finasteride. I lost hair everywhere in the Norwood region and it never recovered. I received the same advice to keep going and that eventually I would be fine.
2) my left testicle swelled up so badly that I had to see a doctor who sent me for imaging tests which revealed multiple cysts (luckily nothing more serious)
3) most recently my facial hair has stopped growing. Not completely. But at a growth rate a fraction of what it once was. Cosmetically this is no big deal as I’m clean shaven but it is another marker that my hormones are completely out of whack.

As for the inflammation I think it’s very possible that the inflammatory response is being caused by the medication itself. There are tons of accounts on this forum and others similar to mine where hair loss was reported to accelerate after starting treatment and never recover even after several months of use. Many have reported that the hair loss only slowed down after discontinuing treatment and some have reported partial recovery of their hair.

I think the points you are making a very good ones. Unfortunately this is all guesswork and I’m left grasping at straws. I’ve had my blood checked for related causes now 3 times in the past 20 months - most recently this past January. The only strange result I had this time was to my SGPT (ALT) which was 2 times the normal level. There are scientific studies (you can look them up) which show that dutasteride can cause harmful side effects which impact blood sugar and cause non alcoholic fatty liver disease. Higher than normal levels of ALT are a marker for NAFLD. I’m not ready to draw the conclusion that dutasteride was responsible for my ALT increase as I was also just getting over a sinus infection which may have impacted the result. But it’s highly suspicious.

Anyway I do appreciate your feedback and know you’re trying to help. Everything you suggested is reasonable but unfortunately I don’t have unlimited time and resources to keep getting things checked which MIGHT be contributing to my hair loss. I’ve taken so much time off from my family and work to see doctors about this that the thought of going to more doctors has really lost its appeal. Especially since none of them have any clue why this is happening to me. I haven’t taken my dutasteride today but I probably will because I’m in a catch 22 where I’m fucked if I do and fucked if I don’t.

 

[Anatoly]

ince I’ve started dutasteride the following things have happened:

Your story is important for me, as I need to know what may happen to me as I age while being on dutasteride. Thanks for coming back.

1) I lost hair everywhere in the Norwood region and it never recovered. I received the same advice to keep going:

Of course, I assume that your case may be a rare one. But I've to admit in my case there're things that are somewhat in line with what you say.
I've recently had another trichoscopy: I learnt that in my donor area there are more hairs per cm2 than used to be before treatment. This is in line with what I see: my hairline on my neck has lowered (around +2 cm) - to the extent it was about 10 years ago. HOWEVER, this recent trichoscopy revealed another thing: although I have more hairs per cm2, they have become really thinner. And this is also seen: thinking about your story, I compared my profile photos more thoroughly. My back has visibly flattened. Initially I thought it was my subjective perception, but a microscope has confirmed that it is not.

How should I evaluate this - progress/regress? Honestly, don't know. On the one hand, I have more hairs on my back, my hairline has lowered and my scalp is far better covered, on the other hand my hairs there are thinner, which has made my back visibly flatter. Moreover, I have cut 10+ hairs at their root in three spots in my donor area (this is invisible for my hairstyle))) ) and compare them to the regrowth on my temples. Without any microscope I clearly see that current hairs from my back are thinner than the therapy-produced hairs in the area where hardly were any hairs (just a bald scalp with a few transparent fine hairs) before treatment. Is this thinning on my back caused by my intensive Nizoral use? I doubt - as the regrowth on my temples is substantially thicker. What would have been to my donor area without high-strength minoxidil - I don't know and do not want to experiment. Is this caused by dutasteride? - you're story pushes me to read further and re-evaluate my experience. Although it runs against common knowledge, I have to assume that it may have smth to do with dutasteride.

Next, you note:
3) most recently my facial hair has stopped growing.
This is an absolute truth in my case. As my hair loss became more severe, my beard became better and better). Avodart was clearly ruining my beard - and this was despite my usage of high-strength minoxidil (I used it on my scalp, we know that it get into one's blood and affects one systemically - my body hair were growing impressively). I managed to restore my beard only by applying 15% minoxidil + 5% azelaic acid (0.5ml twice daily) directly on my beard area. And I know if I stop, I'll lose my great beard.
Moreover, an interesting thing has happened to my eyebrows: as my hair loss progressed, my eyebrows hair loss progressed as well. When I was 18 my eyebrows were thicker, larger and darker. Before my hair loss treatment they looked like sh*t. Now they look so good as if they are painted my face. Is it thanks to minoxidil? I do not think it's the only factor - because they gradually receded along with my temples and crown.

What are all these observations for? We know that in a male some hair grow thanks to DHT, a beard in particular, and some hairs die because of DHT, a crown area in particular. Genetics is a wonderful thing, unique to a human. One might assume that besides a beard, there may be other areas on one's scalp, determined by one's unique genetic pattern, that benefit from DHT. This runs against a widespread knowledge that hair follicles in your donor area are not sensitive to DHT and therefore suitable for a hair transplant. I assume that in some people these things may more more complex than that. There are many examples when existing medical truths are constantly challenged - e.g. with respect to MACE prevention - at one point in time guidelines suggested one thing, time went by, new research accumulated ... and with respect to some aspects of MACE prevention newer guidelines suggest quite the opposite. It's normal.

This is how I would approach your predicament, assuming your hypothesis is correct. I think you need to discuss this with a trichologist who at least holds a PhD and works at a top university and/or top RESEARCH clinic.



2) my left testicle swelled up
Come on), This happens to men whether they are on or off finasteride/dutasteride. This happened to me as well long before my hairless treatment. Usually one shouldn't worry about it and it subsides without any intervention. I do not care about this condition in myself and therefore haven's done proper reading (whether dutasteride substantially raises these odds). I only know that erection + ejaculation at least 2-3 time per week lowers these odds.


'As for the inflammation I think it’s very possible that the inflammatory response is being caused by the medication itself'.
------ From my literature review, I cannot say it is a right direction to dig. It should be a different mechanism.

'my SGPT (ALT) which was 2 times the normal level. There are scientific studies (you can look them up) which show that dutasteride can cause harmful side effects which impact blood sugar and cause non alcoholic fatty liver disease'.
------ come on), these side are not statistically significant from placebo. There is an endless list of more plausible explanations. ALT 2 times the upper level of the normal range is OK, nothing to worry about. If you're not on lipid lowering drugs now, you'll have to take these in the future. Now medical science suggests it's completely ok if your ALT & AST do not exceed 3 times the upper level of the normal range, although there are still a lot of people who prefer to die of a heart attack or stroke but with a pleasing thought hair their liver enzymes are within the normal (as it is written on some piece of paper) range)))

'I haven’t taken my dutasteride today but I probably will because I’m in a catch 22 where I’m fucked if I do and fucked if I don’t.

You may consider:
1) lowering your dose to 1-3 capsules per week
2) using topical dutasteride and or dutasteride mesotherapy ONLY on your crown and temples
3) have a good holidays + stress-relieving techniques (maybe your doctor will prescribe you a course of some antidepressant)
4) wait until Breezula (Clascoterone) comes out

 

[bluecyclone]

This is brutal. I mean there’s already risk in these meds and for them to do harm is criminal.

The ‘shed is a good sign’ bullshit has failed me with minoxidil, Finasteride, and now out of desperation I’m going to try Dutasteride as well.