Kaze's Story- diffuse equal shedding on all scalp even donor

[Kaze]

Has anyone experienced diffuse shedding this bad after starting propecia 1 mg a day, and did it ever stop shedding or come back? THese are only after photos. I dont have before shots because i never saw scalp before taking propecia, I only had temporal recession. Its been getting worse over the 7 months. I never recorded my density before because i had no loss. Take my word for it.

You can tell how apparent my scalp is now. The shedding is evenly diffuse throughout my entire scalp including the donor area. Ive been pulling sesame seed looking things out of my hair where hairs used to be. Ive been losing normal look hairs some with bulbs attached, some with none. Ive been losing short hairs and long hairs.


I started propecia 7 months ago after i was experiencing rapid temporal recession over a period of 8 months. About 4 days in I started experiencing itching all over the scalp and after my haircut two weeks in i could start seeing my scalp. I started taking nizoral 1 once every 3 days after 2 weeks on propecia.

Thanks for the expertise and the help you can provide.

 

[Kaze]

By the way, the pictures suck cause its iphone and i dont wanna show my face. It is as diffuse on the sides as well. I have red bumbs at base of follicles and it itches when i go for runs and work out.

Thanks.

 

[MrAnon]

Have you had blood work to rule out thyroid issues and such? Is there miniaturization in the donor area? I'm not sure even the reflex hyperandrogenicity conspiracy guys claim finasteride gives you DUPA (diffuse unpatterned alopecia).

 

[Kaze]

same reason your on it even though its making your hair worse. i can blame it on propecia if i stay on the pill but if i quit the only thing i can blame is my cruddy genes. just imagine the pictures above only much worse. thats my hair now.

 

[icdalite]

So does one have to continue with propecia/finasteride for the recovery which takes 4 months to a year.

Or does one have to come off it and then the recovery process starts???

 

[Kaze]

Hey icda,
The basic and most import fact missing from irish's post is that you have to remove the cause of the Telogen Effluvium in order for it to recover. Does it make sense that you body would get shocked into Telogen Effluvium and then slowly adapt to it. Nope.

Too bad quitting propecia isnt an option for me due to thinning at temple caused by dht. Im stuck in a pickle between thinning on propecia or temple loss off propecia.Im about about to blow some money on fluridil though.

Yo irish. Hows your third go at propecia going?

 

[icdalite]

I am a bit confused too. Its been more than a year and my hair has graduallu thinned all over while on finasteride. Upto March of this year I could have attributed it to minoxidil usage (which I stooped in Nov-dec), but I've continued with finasteride religioulsy.

The hairline has gone back a bit soon after I quit minoxidil (liquid 5% generic) , but it was receding while on minoxidil too. After a fw months its just stopped in its tracks and no further recession. The shedding too has reduced a lot.

But its ridiculously thin all over and thats my problem. I don't get it, even if one is diffused you still have to take finasteride right? I mean just because you are diffused it does not mean DHT is not causing your hair to fall. I am a bit apprehensive to start someting more potent like fluridil or dutasteride...

Its been 6-7 months now, not sure if I need to give it more time to recover from permanently stopping minoxidil usage. I usd to apply it all over because I was diffused....

 

[irishpride86]

A letter from Dr. Lee



****,
I agree from viewing your pictures that you are suffering from hair loss in a pattern (male pattern baldness). The troubling part of your previous letter was the description of shedding from your eyebrows, which is not associated with male pattern baldness. Please explain that shedding in more detail.
In answer to your question in this email, there have been reported cases of telogen effluvium with the use of Propecia/finasteride. You should consider stopping finasteride to prevent a chronic telogen effluvium. Minoxidil will aid in dislodging the follicles that are in the telogen phase so they shed sooner, but minoxidil will help the follicles as they grow back in again stay in the anagen phase and not shed as frequently. See further comments regarding treatment in bold print below.

STATEMENT:
The important thing to understand is that male pattern baldness is not a matter of losing hair, i.e., shedding. Shedding 50-100 hairs/day is normal. male pattern baldness is a matter of atrophy of the hair follicle, which you are reversing when treating your hair with these medications.

Normal scalp hair grows for 3 to 6 years (anagen phase) before shedding and going into a resting phase (telogen phase), which is always in the range of 100 days. The smaller the hair shaft is, the shorter the growth phase (for severely miniaturized follicles, the growth phase can be less than three months). At any one time, about 10% of the hairs on your scalp will be in the telogen phase.

We have been receiving a number of reports of excessive shedding of both miniaturized hair as well as normal hair. This may be related to taking the medication finasteride (Propecia). Usually, the patients are initially happy with the results, but then begin a period of severe shedding (telogen effluvium) typically 3-4 months after initiating therapy. The hair can be dislodged easily soon after treatment with finasteride, but most of the follicles affected fall out after 3-4 months.

The hair shed in the telogen effluvium may again become noticeable as it grows back about 3-4 months later, but it may require up to a year to replace the hair that was shed in the effluvium.

A telogen effluvium can be triggered by stress, trauma, fever, other physiological changes, and many drugs. A sudden hormonal shift, e.g. a sudden decrease of systemic dihydrotestosterone (DHT), can also be a cause of effluvium. This is what is apparently happening to some patients complaining of massive shedding. If the shedding is a telogen effluvium due to a hormonal shift due to Propecia, the latest consensus among dermatologist is to stop using the drug causing the rapid shedding. However, it is recommended that you continue to use the minoxidil and use another anti-androgen that does not cause a hormonal shift of DHT. Our prescription minoxidil formulation Xandrox contains anti-androgens that block DHT from affecting the follicle receptor site rather than lowering the DHT level in the blood. It is best to use the prescription minoxidil with these anti-androgens and forego treatment with Propecia when you experience telogen effluvium.
Fortunately, telogen effluvium does not cause a scarring alopecia, so the hair will grow back in again. Furthermore, finasteride will still keep follicles at risk from miniaturizing.

DR. LEE M.D