Here we go again. I just wrote Dr. Lee by email and asked basically the same questions. Dr. Clifford responded. Here's the questions (in italics) and Dr. Clifford's answers (in bold):
Hello Dr. Lee,
I'm a new patient of yours and have just received my Xandrox 5% and spironolactone 5%. I have used the spironolactone every day, at least 2x/day, sometimes 3x/day. However, I was apprehensive about the minoxidil due to the shedding, epecially in the front, at the hairline and temples.
I'm about a Norwood 2, or maybe between a 1 and 2, but definitely thinning in the front and receding just a bit at the temples. It's not really noticeable yet to anyone but me. I felt like the minoxidil was causing me to recede further.
Do these internet forum rumors about minoxidil. causing permanent shedding have any truth to them?
MINOXIDIL CAN NOT REVERSE ALL MALE PATTERN BALDNESS, BUT MINOXIDIL DOES NOT CAUSE PERMANENT SHEDDING.
You should not stop using minoxidil at any time in your treatment program. If you do stop using minoxidil, you will have a lot of shedding. You will understand why after you read further.
Minoxidil does not cause an adverse reaction. That is, minoxidil does not cause follicles to go into the telogen phase.
Only follicles that are in the telogen phase shed.
About 10% of anyone's follicles are in varying stages of the telogen phase. 1% of them are in the 1st day of the telogen phase, another 1% are in the second day of the telogen phase and so forth. The telogen phase lasts about 100 days. Those follicles that are at the end of the telogen phase shed. Those at the beginning of the telogen phase are easy to pull out but do not automatically shed.
The good thing about minoxidil: Minoxidil holds follicles in the anagen phase. When follicles are in the anagen phase, they do not shed, they do not miniaturize, and they keep growing. Minoxidil also causes follicles in the telogen phase that were scheduled to shed anyway, to shed early. That is, those follicles that are easily dislodged, will shed before the end of the 100 days with minoxidil. This is not significant, and when these same follicles grow back, they will stay in the anagen phase longer because as I have already said, minoxidil holds follicles in the anagen phase. But if you stop using minoxidil, the follicles at risk that were being held in the anagen phase will go into the telogen phase and shed. There will be lots of shedding if you stop using minoxidil.
Have you seen anyone shed frontal hair and never grow it back on minoxidil?
Yes, 17% of patients are not helped by any topical treatments. They shed with or without minoxidil and don't grow back their hair with or without minoxidil.
I'm asking because I really want to use it but am afraid I'll permanently lose my frontal hair.
Understand that drugs such as Azelaic acid, spironolactone and finasteride (Propecia) protect the follicles from DHT in the scalp but protecting from DHT in the scalp isn't the whole solution. Even men who have been castrated for treatment of prostate cancer and have no source of DHT will stop the balding process, but they do not grow back significant amounts of hair (unless they also use minoxidil as a hair growth stimulant). That's why a combination of minoxidil and an anti-androgen is important for growth outside the vertex/crown area.
Anyway, thanks for a great line of products. I love the 5% spironolactone cream.
You will think the 5% is even greater if you use it with minoxidil. I doubt you will have much success without minoxidil.
Best wishes,
Daniel Clifford, M.D
I know Dr. Clifford is not Dr. Lee, but he is his partner, so I'm assuming this position is also Dr. Lee's position. Several other docs I've read on the web also believe strongly in minoxidil. I've started using it TWICE a day, and will continue.
:freaked:
