Telogen effluvium from Finasteride?!?

[shawn12345]

Hi guys, I just had my consultation with Dr. Lee at minoxidil.com and he told me to do the "Pull test" that he probably does with everyone.

On the sides and back of my head, almost no hair came comes out. On the front of my hair (bangs-area), I can pull out a 1-2 hairs. Moving backwards towards the crown area, the number that I can pull out increases. In the middle-top of my head, I can pull out ~4-5. and when I reach all the way to the crown area, it increases to ~6-8 (my estimate). They all have the whitish "bulb" at the ends.

Dr. Lee says that I am "apparently experiencing telogen effluvium, and it would be best to discontinue the use of finasteride".



Is this really possible? Instead of causing hair growth, the Finpecia has caused ADDITIONAL hair loss?? I've been on it for ~4-5 months. What percentage of men experience this?

From what I have read about telogen effluvium, it is usually only temporary, but does this mean that the finasteride is keeping my hair in a perpetual state of telogen effluvium?

Anyone else experience this? Thanks!

Shawn

 

[Timi]

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[shawn12345]

I've been taking finasteride for ~4-5 months. It has not changed my hair color.

Has anyone else ever experienced telogen effluvium from finasteride? I didn't think this was even possible.

Also on minoxidil.com, it also says that there is no such thing as Propecia shedding, but a lot of people here have experienced it. I am not sure who to believe.

 

[Axl_Rose]

I to would like an answer to your question, perhaps Bryan would be kind enough to provide some insight or someone else with some knowledge on the subject.

 

[shawn12345]

I just emailed Dr. Lee again asking him some additional questions, and here were his responses:

1. What makes you sure that I am experiencing telogen effluvium from the finasteride (what are the usual symptoms)?

You are taking finasteride, and your shedding is abnormal. It is normal for 10% of your follicles to be in the telogen phase. Unfortunately, up to 25% of your follicles are in the telogen phase. This is 2 1/2 times normal.

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 numbers 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.

Is it possible that Rogaine is causing the telogen effluvium?

No, minoxidil in Rogaine, contrary to common belief, does not cause shedding. Minoxidil will allow hair that was going to shed anyway to shed early, but it doesn't cause hair to go into the shedding (telogen) phase.

2. From what I have read on the internet, telogen effluvium is temporary and usually clears up after a matter of months.

This is true if the inciting cause is removed.

If I continue finasteride, will the telogen effluvium go away eventually?

Yes, and then it will reoccur because you have not removed the inciting cause.

Or will it keep my hair in telogen effluvium permanently? How often do you see this problem happening in patients?

Because a telogen effluvium from finasteride occurs rarely, most doctors never see a case of telogen effluvium. I have contact with thousands of patients and hear complaints of telogen effluvium once or twice a month.

Dr. Lee is saying that Propecia shedding is not normal, but I see this happening all the time on this forum. I have only been on finasteride for ~4-5 months and the guidelines say I should try it for a year before deciding to quit it, but Dr. Lee says that I should quit immediately. I am also not really shedding from the sides and back of my head, just the top/front. So now I am not sure who to believe. Does anyone know anything about this?

Would it be useful for me to get a scalp biopsy? What will this tell me?

Any information would be helpful, thanks!
Shawn

 

[Nicky]

I’ve searched the forums and the web and I wasn’t able to find any questions regarding this issue(telogen effluvium due to propecia or finasteride) that I have too.

The only answer I found is Dr Rassman's opinion who is a very good and well respected doctor. He simply doesn't believe that propecia can cause telogen effluvium. Maybe Dr Lee thinks so..

Here are two links that can help you


Dr Rassman's opinion:

http://www.baldingblog.com/2009/03/11/c ... effluvium/

A situation like yours:

http://www.baldingblog.com/2005/09/02/t ... -propecia/

 

[shawn12345]

Yea I just really don't know if I should "ride it out" or just stop completely. There are reasons for both. I just wish that I could definitively say that "yes, finasteride caused telogen effluvium" and then the obvious action is to stop.

But Dr. Lee also thinks that shedding from Propecia is a myth, which I do not agree with. He says this here: http://minoxidil.com/subpages/hairloss_ ... i.html#i03

Why does he claim this when so many people on this board have experienced shedding from Propecia, then their hair grew back?

Just confusing to me...

I also don't think I am having "massive shedding". I don't see it coming out in the hundreds or anything. And my shedding didn't start that abruptly. It was kind of always there, but I guess there have been ups and downs in the amount of shedding.

 

[icdalite]

I believe your Telogen Effluvium if that's what you want to call it was due to minoxidil.

Dr/ lee will not accept it for obvious reasons.

Think about it, why would u loose hair only in front and crown and not sides.........because you apply minoxidil only to those areas and not sides.

 

[Tyler_Durden]

I don't use Minoxidil, only propecia and I am seeing the same thing.

I've been on finasteride for about 6 months, I never really monitored my shedding before hand but it has been consistent since starting propecia... It certainly never slowed down.

The thing the worries me is that if I pull on any of the hairs on the top of my head, they simply come out, this was never the case before starting the meds. Nothing on the sides though, and yeah, it does seem weird to me that Telogen Effluvium would only effect the top of your head yeah?

The other thing is the increase in oil/sebum I am getting around my forehead, this was one thing I never had a problem with. But I thought this might be attributed to Nizoral instead of propecia, but now I dunno because I heard it can be a effect of Telogen Effluvium.

I was starting to thin before I took the meds though and I know if I don't try to use them I will continue along this path, this is the thing keeping me on them.
Hopefully it picks up, I dunno though...

 

[Kaze]

Hey I have been experiencing Telogen Effluvium since starting propecia. I immediately got itchy scalp a day into propecia. I noticed my a hair thinning two weeks in and it has been diffusing evenly thoughout my hair including my donor area and the sides of my head. I had only temporal recessions before starting propecia. I have had trouble finding other people with this reaction to propecia. Please respond back. I dont really know where to turn to at this point. I have been on propecia for 7 months at this point and it continues to grow thinner.

 

[Kaze]

If you google Telogen Effluvium, it says it is diffuse thinning thoughout the whole head equally like mine is. If you are only having it at the top that is angrogenic alopecia.

Ive been trying to find someone with the same symptoms as me but it looks like you guys dont quite match up with me.

 

[icdalite]

Kaze, I had exactly the same overall hair loss as month after I started minoxidil (generic). Six months later when I started finasteride,, the problem became a lot more worse and was consistently loosing hair behind and sides as well.

I have been off minoxidil for 6 months now but continued with finasteride, no improvement as I'm hitting the one year mark. Some pics below.

[attachment=1:1sxcjgy2]3.jpg[/attachment:1sxcjgy2]

[attachment=0:1sxcjgy2]5.jpg[/attachment:1sxcjgy2]

 

[icdalite]

Hey seaback, is that reply for me or Kaze. I have already been on finasteride for a year now.

Also, when I buzz my hair (lev 2) and then do a tug test a lot of hair comes out..is it the same for you?

 

[Kaze]

Idcalite,
Ill take it your the back of your head donor area looks just as thin?

The only difference between you and me is your thinning started on minoxidil and mine was when i started finasteride. First, what was your hairloss before treatment? I can say I could see no scalp between hairs before I started propecia.

2. How long were you on minoxidil. From what ive heard it is suppose to cause shedding. WHere did you apply the minoxidil and was the loss only where you placed it.

3. Is your thinning on finasteride just no improvement or is it getting worse and worse daily?

I am seven months now and my hair is thinning to where it almost looks like yours. Ive grown my hair out though to cover the thinning.

Seaback- what was your hairloss before propecia? Are you saying you started thinning like me Idcalite on propecia going from no scalp to what idca pictures look like?

 

[FFS]

Hi had the same afte using 8 month finasteride it didn't stop yet, It's horrible and still hasn't stopped....

 

[icdalite]

Well I was shedding at a slow rate (male pattern baldness) only in the scalp area. Was on miox for 11.5 months and would apply it all over scalp and hairline. Not on sides.

After I started minoxidil and later finasteride I started shedding all over inclucding the sides and donor area. Initially keeping it a bit longer helped as it would cover my scalp albeit a little thin.

However, after dumping minoxidil (on finasteride and nizoral for 6 months now), it grows at a snails pace and does not cover my scalp entirely. What makes it worse is that since its diffused in the scalp region, my scalp is visible even without the light on it. Somone on this board ( i think finfighter) advised me that after dropping minoxidil, it might take 3-4 months for the new hair cycle to kick in and I starting to see new hairs. Well it never happened...

I am only on finasteride at the moment and am considering lowering the dose to 0.5 mg to see if it makes any difference.


On another note I'm going to get my blood test done for T, DHT, thyroid etc.

I have mentioned this in earlier post but when I do the tug test I always oull put hairs from top,sides and donor region effortlessly. It could well be thyroid or some other problem I'm having because finasteride and minoxidil does not seem to work on me.

 

[Kaze]

Okay. I just wanna check here icdalite. Does accutance come into the equation here for you? My hairloss started when I got on accutane on the temples and i was thinking that might have something to do with my bad reaction to propecia.

Okay so we are pretty much having the same problem. You had diffusing hair in an male pattern baldness pattern and i had a receding hairline in a male pattern baldness pattern. When we started taking finasteride our hair all over scalp has thinning evenly everywhere. We are different from most people because everyone else isnt showing scalp on their side and donor area. If you reduce you medication you should pay attention to see more if your non male pattern baldness areas are thickening up. This is the only area you can be sure to thicken up cause these areas arnt affected by dht.

Yeah I want to see a doctor and have some tests done too before I start reducing my meds. You can make the leap first and see what happens. It sucks cause we are 2/thousands of people who take propecia and we are the only ones who got Telogen Effluvium. What luck! We should keep in contact since we are having the same problem.


My guess is that if I quit my hair will thicken up in the non male pattern baldness areas due to the Telogen Effluvium stopping but my male pattern baldness pattern will get a little worse. Im not sure if my temples loss hasnt even stopped that much from propecia.

My guess is that the same thing will happen to you too.

 

[Kaze]

I read your story.

Okay Im having the same shedding you had only i had receding hairline before the propecia and you had the diffuse kind.

Okay im past 7 months and it is still thinning. IM in the same pickel as you.

So was the propecia affecting your thyroid wich gave you Telogen Effluvium?

I dont wanna quit cause the propecia is halting my sort of slowing my recession but im thinning everywhere including the back of my head. Im gonna call my practioner and get my blood tested. I had the test before and there was nothing accept male pattern baldness. Ill give you the heads up what they say.

So what is you plan now to stop the male pattern baldness thinning. Are you gonna try laser?

Im gonna take great picture to show how much my hair will improve once i get off propecia.

 

[mannyFJ]

Any update of your conditions, guys? I'm in the same boat and going on 8 months

 

[Maave]

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