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SHED - Please someone help!


#1

I have been on propcia for about 70 days and have had some major sheds. As I can understand it can be pretty common. However, I saw where (Dave - hairsite) stopped DUT due to the shedding.

Anyway, before I started Propecia I had pretty high hair line in front and started to be noticeable on the crown as well. NOW, after taking Propecia, it has thinned dramtically from the crown to the front…Most couldn’t notice I had hair loss but now you can definitely tell.

Do you guys recommend quitting taking the Propecia? Continue to stay on it? If so, how long as I don’t notice anything but more hairs coming out. Sometimes there’s a ton and other days very few. Any other suggestions???

Thanks so much for your help and input!!!


#2

I personally believe that a therapy which can not halt hairloss within 3 months has to be dropped. In the20 or 30 remaining days until this mark, try to accurately count every single hair you shed (fromthe shower drain and from a sheet of paper you’ll comb your hair over°. See how it evolves. I had this problem with spironolactone over 3 months. Gave it up and the shed stopped.


#3

Thanks BRM…I will do as you instructed and keep you posted. How many hairs should I lose a day on Propecia at this point? I just am worried that I know have lost so much on it and don’t have any other solutions on how to maintian or regrow. I wanted to keep what I had for another year or so before HT.


#4

Whatever some may say on this site, a daily loss of up to 150 is not alarming. I personally consider that a 250 daily hairloss can be sustained for a short period (maybe a month) but not more. This count must be calculated as an average, computing both the hair you lose on combing, washing and including vellus hair as well.
If you happen not to be a good responder to finasteride I would advise you to try this regimen: maxi hair (the multi vit recommended by Hangingisthere, 5% minoxidil and 0.3% melatonin. I have personally tested (with the hair count) that melatonin is a quite good topical antiandrogen (I reduced my hairloss by 100 hairs a day with it).
Another possibly good solution is prox-n. I would warmly advise you revivogen since this one is very very efficient for me but if you’re not a good responder to systemic finasteride, there doesn’t seem to be any reason for you to respond to topical DHT inhibitors so revivogen might be a dead end for you.


#5

Thanks for the info BRM.

Would I take these other items you suggested while staying on Propecia? I counted today and have 20 pills left on a 90 day supply. My hair is about 30% worse since starting progpecia 70 days ago but most say you won’t see the benefits until after the 3 months.

I will try that…I am going to start another post to see where to get all that stuff you said. I just want to maintain but now need some regrowth…Anything but I want to stop it as I don’t want to be shiny bald!!! Thanks!


#6

» I have been on propcia for about 70 days and have had some major sheds. As
» I can understand it can be pretty common. However, I saw where (Dave -
» hairsite) stopped DUT due to the shedding.

Any hair that sheds within 2-4 months of starting a treatment was already in the loss-phase when treatment started and scheduled to fall out anyway. Medical treatment may accelerate this process a few weeks because new hair starting to grow may serve as a stimulous for loss-phase hair to shed a little early.

Generally, this presents as a wave of shedding starting 3-6 weeks after starting treatment. The minoxidil package insert says as early as two weeks, but this is unusual. Typically, it lasts a month or so. Every treatment that brings follicles out of dormancy (which means every treatment that works) may do this in some persons. The faster the follicles get brought out of dormancy, the more likely you are to see it.

Possibly, you had excess loss-phase hair when you started treatment. The most common cause of this is stopping treatment with (say) minoxidil a few months before. Other causes include illness with a high fever, surgery, etc. — again several months before starting medical treatment.

Also, fine “vellous” hair spends the majority of its life-span in the 2-4 month loss phase. So half or more of this is generally in the loss phase and thus sheds disproportionately. “Indeterminate” hair ( a little thincker that vellous, but still not “termainal” hair) also spends a disproportionate part of its lifespan in the loss-phase and is thus more likely to shed this way than terminal hair. The hair that replaces these tends to be progressively coarser, darker and spends longer in the growth phase

In any case, the hair was about to fall out anyway. If the shed is due to treatment, it is a good sign, since it means treatment is working. Thus, as distressing as it can be, an early shed tends to be associated with a good eventual result.

BTW, medical treatment mostly works by making hair grow, not by stopping it from falling out. If you ask that a treatment significantly slow loss (at least in the short term), you are almost bound to be disappointed.

Peter H. Proctor, PhD,MD
www.doctorproctor.com


#7

Thanks Dr…I appreciate your input and expertise!

You think I should stay on Propecia? It just seems like there’s major loss or thinning all over my head and I can’t see ANYTHING coming in…Distressing for sure!!!


#8

This is all very well but you make one large assumption which is unproven and almost certainly incorrect.

you state that loss of telogen hair is triggered by a new hair coming in. There is no more evidence for this than the probability that the loss of telogen hair triggers a new anagen hair. For a number of reasons both observed and physiological the latter scenario is more likely. If this is the case then if the orchestration of new anagen hair is lost then reduction of DHT may cause hair loss but no new growth.


#9

» you state that loss of telogen hair is triggered by a new hair coming in.
» There is no more evidence for this than the probability that the loss of
» telogen hair triggers a new anagen hair.

In general, a new anagen hair starts to grow well before the telogen hair sheds. This is why about 5-10% of follicles have two hairs. Thus, in such follicles the telogen hair shedding could not serve as the stimulous for the anagen hair to start growing. However, the transition from anagen to catagen and then telogen may well act as the stimulous for a new hair to start growing and/or vice versa. Lots of feed-back loops here.

Likwise, perhaps I over-simplified my description-- More exactly, it is the complex process of growing a new hair that sometimes seems to speed up the loss of telogen hair, not the new hair per se.

For a number of reasons both
» observed and physiological the latter scenario is more likely. If this is
» the case then if the orchestration of new anagen hair is lost then
» reduction of DHT may cause hair loss but no new growth.

This is also possible. In balding, eventually a new hair does not grow as the old one sheds (or perhaps the new one is so severely miniatiurized as to not be visible.) But again, there is no net loss if treatment causes this hair to shed early, other than in the short term. This is because the telogen hair was about to shed anyway. Incidentally, it is such follicles we wake up when we “regrow” lost hair, as opposed to reversing miniaturization.

Dr Proctor


#10

» Thanks Dr…I appreciate your input and expertise!
»
» You think I should stay on Propecia? It just seems like there’s major loss
» or thinning all over my head and I can’t see ANYTHING coming
» in…Distressing for sure!!!

There are two possible answers (other than play of chance). First, like every treatment that brings follicles out of dormancy (which means everything that works), finasteride (Propecia) can also cause an early wave of loss of telogen hair. This usually only lasts a month or two. But, depending on how much loss-phase hair you have and just where things are in your hair cycle, it may last a lot longer.

Second, like all antiandrogens, finasteride also causes “reflex hyperandrogenicity”. This is the reflex increase in both circulating testosterone levels and in cellular androgen receptor numbers. E.g., IIRC, there is about a 15% or so increase in free testosterone.

Mostly, this is benign and may even minimize side-effects. However, in a few persons reflex hyperandrogenicity seems to overshoot and the patient gets paradoxical hyperandrogenic side-effects such asinc reased libido, acne flares, and increased skin oiliness. The obvious question is whether this exacerbates the balding process. I suspect it does, rarely. However, my wild guess is that this is unlikely in the absence of other hyperandrogenic symptoms because finasteride preferrentially “protects” hair follicldes. At least I hope so.

Dr Proctor


#11

» In general, a new anagen hair starts to grow well before the telogen hair
» sheds. This is why about 5-10% of follicles have two hairs. Thus, in
» such follicles the telogen hair shedding could not serve as the stimulous
» for the anagen hair to start growing. However, the transition from
» anagen to catagen and then telogen may well act as the stimulous for a new
» hair to start growing and/or vice versa. Lots of feed-back loops here.

The bottom line is that your premise that shedding is the result of a new hair growing in is not necessarily the case.

» as to not be visible.) But again, there is no net loss if treatment
» causes this hair to shed early, other than in the short term. This is
» because the telogen hair was about to shed anyway. Incidentally, it is
» such follicles we wake up when we “regrow” lost hair, as opposed to
» reversing miniaturization.
»
» Dr Proctor

When you say that there is no net loss, then on the basis that shedding is not necessarily a prelude to a new hair growing in, it is understandable that some patient see shedding causing accelerated balding. Telogen can be a very prolonged process and as such hair may be lost and not replaced if 5-AR inhibitors initiate the caspase and collagenase related pathways without being able to stimulate the processes of inducting the next cycle.


#12

Docs -

Thanks for your insight and keep up the comments.

I would like to get your input on what I should do in my case. Is 70 days enough time before quitting? I have taken pictures and there has been a definite accelerated lost amount of hair since starting propecia. Please let me know what you recommend. Again, I don’t see any new hairs but just more widespread thinning.
I thought Propecia more maintained than anything else. Your comments are more than appreciated!


#13

» Docs -
»
» Thanks for your insight and keep up the comments.
»
» I would like to get your input on what I should do in my case. Is 70 days
» enough time before quitting? I have taken pictures and there has been a
» definite accelerated lost amount of hair since starting propecia. Please
» let me know what you recommend. Again, I don’t see any new hairs but just
» more widespread thinning.
» I thought Propecia more maintained than anything else. Your comments are
» more than appreciated!

I canot make specific treatment recommendations. However, the thing to remember is that hair spends 2-4 months in the loss phase. Thus, any hair that falls out before 2-4 months was already in the loss-phase when treatmetn started. Further, it is when hair goes into the loss-pahse that sets its date of shedding.

Dr Proctor


#14

» » In general, a new anagen hair starts to grow well before the telogen
» hair
» » sheds. This is why about 5-10% of follicles have two hairs. Thus, in
» » such follicles the telogen hair shedding could not serve as the
» stimulous
» » for the anagen hair to start growing. However, the transition from
» » anagen to catagen and then telogen may well act as the stimulous for a
» new
» » hair to start growing and/or vice versa. Lots of feed-back loops here.
»
» The bottom line is that your premise that shedding is the result of a new
» hair growing in is not necessarily the case.

Again, it is the process of follicular activation that initiates shedding. It is true that a new hair starting to grow is part of this. But it is indeed possible that shedding and growth of a new anagen hair are simply cofactors. Nobody really knows.
»
»
» » as to not be visible.) But again, there is no net loss if treatment
» » causes this hair to shed early, other than in the short term. This is
» » because the telogen hair was about to shed anyway. Incidentally, it
» is
» » such follicles we wake up when we “regrow” lost hair, as opposed to
» » reversing miniaturization.
» »
» » Dr Proctor hair loss treatments

»
» When you say that there is no net loss, then on the basis that shedding is
» not necessarily a prelude to a new hair growing in, it is understandable
» that some patient see shedding causing accelerated balding. Telogen can be
» a very prolonged process and as such hair may be lost and not replaced if
» 5-AR inhibitors initiate the caspase and collagenase related pathways
» without being able to stimulate the processes of inducting the next cycle.

Quite possible, except that nobody really knows which part of the telogen phase medical treatments stimulate. Again, early shedding only affects hairs that are in the telogen phase. That is, the last 2-4 months of a hair’s 2-4 year lifespan. So the net loss is a few weeks at the end, at most. There is no evidence that medical treatment shortens the growth phase (just the opposite, in fact).

Dr Proctor


#15

Dr. Proctor what do you recommend as the best regimen for male pattern baldness?


#16

» » I have been on propcia for about 70 days and have had some major sheds.
» As
» » I can understand it can be pretty common. However, I saw where (Dave
» -
» » hairsite) stopped DUT due to the shedding.
»
» Any hair that sheds within 2-4 months of starting a treatment was already
» in the loss-phase when treatment started and scheduled to fall out anyway.
» Medical treatment may accelerate this process a few weeks because new
» hair starting to grow may serve as a stimulous for loss-phase hair to shed
» a little early.
»
» Generally, this presents as a wave of shedding starting 3-6 weeks after
» starting treatment. The minoxidil package insert says as early as two
» weeks, but this is unusual. Typically, it lasts a month or so. Every
» treatment that brings follicles out of dormancy (which means every
» treatment that works) may do this in some persons. The faster the
» follicles get brought out of dormancy, the more likely you are to see it.
»
»
» Possibly, you had excess loss-phase hair when you started treatment.
» The most common cause of this is stopping treatment with (say) minoxidil a
» few months before. Other causes include illness with a high fever,
» surgery, etc. — again several months before starting medical
» treatment.
»
» Also, fine “vellous” hair spends the majority of its life-span in the 2-4
» month loss phase. So half or more of this is generally in the loss phase
» and thus sheds disproportionately. “Indeterminate” hair ( a little
» thincker that vellous, but still not “termainal” hair) also spends a
» disproportionate part of its lifespan in the loss-phase and is thus more
» likely to shed this way than terminal hair. The hair that replaces
» these tends to be progressively coarser, darker and spends longer in the
» growth phase
»
» In any case, the hair was about to fall out anyway. If the shed is due
» to treatment, it is a good sign, since it means treatment is working.
» Thus, as distressing as it can be, an early shed tends to be associated
» with a good eventual result.
»
» BTW, medical treatment mostly works by making hair grow, not by stopping
» it from falling out. If you ask that a treatment significantly slow loss
» (at least in the short term), you are almost bound to be disappointed.
»
» Peter H. Proctor, PhD,MD
» www.doctorproctor.com

the only time i ever added a treatment that caused a shed is nizoral cream

every other time i added something, for example all the internal DHT inhibitors, saw palmetto pygeum, nettles, beta sis, I NEVER had a shed

so even though sheds might happen , I have heard stories of sheds NOT GROWING BACK

and a shed is certainly not indicative of a treatment working, in other words you dont have to see a shed for the new treatment to show its working

99 percent of the successful additions to my regimen had NO SHED


#17

Hi

I’m new to this site, and saw your post and really thought I should reply.

I have been on propecia for nearly 6 months, and when I started I had a pretty good head of hair, I only really started taking them through fear that I would start lossing my hair quite badly, as my brother did. Anyway, I asked him what I should do and he recommended propecia, so I began taking it.

After 3 months, like yourself I started getting extremely panicy as my hair was seriously shedding, and my brother told me this was a normal side effect and that things would get better. However 6 months on, my hair is still shedding at a rate which it was never doing before I started propecia and in all I’m really regretting ever touching the stuff (sometimes I’m actually noticing differences on a weekly basis). I’m using nanogen fibres everyday to cover up the bold spot on the back of my head, as for the fringe I used to have, it is pretty much non-existent anymore!

I spoke to Hairsite about this and they suggested I see it out for another 3-6 months, which I’m going to do now, as my fear is that if I stop or change to Avodart my hair will just fall out even more! I wish I had never got involved with the whole hair thing as it starts to take over your life. All I think about everyday is that there is going to be some miracle cure just round the corner, yet I didn’t even start thinking about hair loss until July last year!


#18

» Hi
»
» I’m new to this site, and saw your post and really thought I should
» reply.
»
» I have been on propecia for nearly 6 months, and when I started I had a
» pretty good head of hair, I only really started taking them through fear
» that I would start lossing my hair quite badly, as my brother did. Anyway,
» I asked him what I should do and he recommended propecia, so I began taking
» it.
»
» After 3 months, like yourself I started getting extremely panicy as my
» hair was seriously shedding, and my brother told me this was a normal side
» effect and that things would get better. However 6 months on, my hair is
» still shedding at a rate which it was never doing before I started
» propecia and in all I’m really regretting ever touching the stuff
» (sometimes I’m actually noticing differences on a weekly basis). I’m using
» nanogen fibres everyday to cover up the bold spot on the back of my head,
» as for the fringe I used to have, it is pretty much non-existent anymore!
»
»
» I spoke to Hairsite about this and they suggested I see it out for another
» 3-6 months, which I’m going to do now, as my fear is that if I stop or
» change to Avodart my hair will just fall out even more! I wish I had never
» got involved with the whole hair thing as it starts to take over your life.
» All I think about everyday is that there is going to be some miracle cure
» just round the corner, yet I didn’t even start thinking about hair loss
» until July last year!

I would get off it immediately

If you are one of those persons who get a permanent shed, lets assume thats the case, then watever you shed wont grow back, why lose even more hair for a few more months, that is nuts

I am not a believe in this …shed is good ,theory, Personally I think it is bunk


#19

» » Hi
» »
» » I’m new to this site, and saw your post and really thought I should
» » reply.
» »
» » I have been on propecia for nearly 6 months, and when I started I had a
» » pretty good head of hair, I only really started taking them through
» fear
» » that I would start lossing my hair quite badly, as my brother did.
» Anyway,
» » I asked him what I should do and he recommended propecia, so I began
» taking
» » it.
» »
» » After 3 months, like yourself I started getting extremely panicy as my
» » hair was seriously shedding, and my brother told me this was a normal
» side
» » effect and that things would get better. However 6 months on, my hair
» is
» » still shedding at a rate which it was never doing before I started
» » propecia and in all I’m really regretting ever touching the stuff
» » (sometimes I’m actually noticing differences on a weekly basis). I’m
» using
» » nanogen fibres everyday to cover up the bold spot on the back of my
» head,
» » as for the fringe I used to have, it is pretty much non-existent
» anymore!
» »
» »
» » I spoke to Hairsite about this and they suggested I see it out for
» another
» » 3-6 months, which I’m going to do now, as my fear is that if I stop or
» » change to Avodart my hair will just fall out even more! I wish I had
» never
» » got involved with the whole hair thing as it starts to take over your
» life.
» » All I think about everyday is that there is going to be some miracle
» cure
» » just round the corner, yet I didn’t even start thinking about hair loss
» » until July last year!
»
» I would get off it immediately
»
» If you are one of those persons who get a permanent shed, lets assume
» thats the case, then watever you shed wont grow back, why lose even more
» hair for a few more months, that is nuts
»
» I am not a believe in this …shed is good ,theory, Personally
» I think it is bunk

What happens if I come off it and the shed carries on anyway, or worse increases??

Do you think that the hair I’ve shed has definitely gone for good then? I know it’s not going to grow back to how it was 6 months ago, but surely some must be able to be saved.

Coming off propecia, you can’t just do it straight away though can you? Would you recommend anything as a substitute, which has worked well for you? I ordered Avodart, but hairsite told me that if I’m shedding this much from propecia then I could end up shedding even more using Avodart.

These hair products are too unpredictable; I feel a completely lost on what to do!

Thanks for your advice.


#20

Don’t touch Avo. Really how bad is the shed? 200-300 hairs a day in the shower?