Telogen Effluvium, but on Propecia: Should I Quit???

[Hamartoma]

After now some 9 mos on Propecia, I saw another dermatologist who has an extensive experience in medical, as opposed to surgical /cosmetic dermatology. He has diagnosed me with telogen effluvium. He gave me a shot of cortisone and started me on 2% Minoxodil to stimulate the hair follicles. He commented on some minor male pattern baldness associated with the diffuse thinning, so I'm at a Norowood 2A. He said to stay on the Propecia. Since seeing this dermatologist, I no longer have the trichodynia (hair pain) and I think there is a slight decrease in the extent of shedding.

The lurking question is whether to stay on the Propecia or not.....I'm still wondering if the Propecia has been the cause of the telogen effluvium or not. My dermatologist does not think that it is related to Propecia. Alternatively, the Telogen Effluvium could be due to a lot of stress at work plus the more recent anxiety over hair loss. Nonetheless, the Telogen Effluvium is most certainly the main reason for my hair loss.

Is there anybody else who predominantly has Telogen Effluvium, with minor male pattern baldness who quit Propecia and has had a good outcome?

Thanks

 

[hairschmair]

I think the questions here are:

What makes your doctor so sure you are suffering from Telogen Effluvium and not male pattern baldness?

How sure are you that he's right?

Easy answer though. Get off Propecia and see what happens a year down the line.

 

[Hamartoma]

There's no question about the diagnosis of Telogen Effluvium. The hairs are pigmented and thick and I can easily several of them out with a gentle pull. I've stopped combing or brushing my hair, as this causess a tremendious number of hairs to come out.

Regarding the male pattern baldness, I do have some recession particularly in the front and temples that was there 9 months ago, but has gotten worse.

 

[pleasegodno]

your trichodynia is definitely psychogenic (due to your stress/anxiety) and has probably contributed to your diffuse loss--i suffered from it as well and am still trying to recover from the anxiety/panic-related Telogen Effluvium that i've gone through. i'm staying on finasteride, however, because i likely have male pattern baldness as well. did you experience diffusing before any extreme stress/anxiety? if not, perhaps you experienced a shed on finasteride, which led to the anxiety, which, in turn, exacerbated your loss. regardless, good luck and keep us updated. also, was the cortisone a one time thing or will you continue with that treatment periodically?

 

[Hamartoma]

Yeah, its a chicken and egg thing. Did the anxiety /
stress last summer & fall at work trigger the Telogen Effluvium &
exacerbate very early male pattern baldness or did my starting
Finesteride in January 2005 make me more self
conscious, hence more anxiety about hair loss.
These things are impossible to sort out.

Yes, I have read that trichodynia is partly psychogenic & I do
suffer from low grade PA, as you indicate. However, the pain
largely went away last weekend after I started taking a
B-complex vitamin. While I do take a multivitamin, my diet is
largely salads and vegetarian, with just little meat. Perhaps poor
nutrition is a contributing factor...

BTW I am also noticing a little more thickening of my hair
and less shedding the past 2 weeks since seeing the Dermatologist.
Coincidence or not?

The cortisone was a one time shot to decrease inflammation.
I'm scheduled for another visit to my Dermatologist in about 2 weeks.

Good luck to you too.

 

[Weepy]

The lurking question is whether to stay on the Propecia or not.....I'm still wondering if the Propecia has been the cause of the telogen effluvium or not. My dermatologist does not think that it is related to Propecia. Alternatively, the Telogen Effluvium could be due to a lot of stress at work plus the more recent anxiety over hair loss. Nonetheless, the Telogen Effluvium is most certainly the main reason for my hair loss.

Dr. Lee's web site mentions that Propecia can trigger Telogen Effluvium.

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.

I am a noob, though, and don't know too much about him. I have to go back and check, but I remembering thinking that one of his statements in the Propecia FAQ controverted the Propecia prescription insert.