bombscience
Senior Member
- Reaction score
- 7
I had some questions and I went to an MD professional in Hairloss to seek some answers. Here is what he said:
> Dear Dr. Lee,
>
> I have been using your products for just over 12 months now.
> Unfortunately I haven't had any success slowing my hair loss. Because
> of this I have some short questions. But first you should know my
> history:
>
> I have been on Propecia 1mg daily for the last 13 months.
>
> I have been using your spironolactone 2% and 5% for last 5 months.
If propylene glycol causes you irritation, then the 2% formula will also
cause irritation. The spironolactone 2% solution contains 30% propylene
glycol in the liquid base.
>
>
> I used your minoxidil and xandrox pg-free 5% solutions for 12 months
> and quit 2 months ago after not seeing regrowth. I quit also because
> i felt my scalp was more irritated when I used minoxidil as opposed to
> when i didn't, and I knew that irritation was a contributing factor to
> hair loss.
Unfortunately your are mistaken. There is no relationship between scalp
irritation and hair loss.
>
>
> I try to control any irritation that I have by using Nizoral 1%
> solution 3 times a week.
>
> Since I have quit using minoxidil, my hair loss has dramatically
> increased. I knew this might be a possibility, but it surprised me
> because I didn't show any results of slowing or reversing hair loss
> while I was applying minoxidil for 12 months.
>
> Since quitting minoxidil i have increased my spironolactone applications from 1
> to 2 times daily.
With propylene glycol? Ouch!
>
>
> I am a diffuse thinner that noticed my hair loss 1.5 years ago.
>
> Here are my questions:
>
> 1) Can minoxidil cause hair that was not thinning to become dependent
> on minoxidil resulting in further loss when treatment is discontinued?
NO, only the follicles at risk are affected by discontinuing minoxidil.
>
> Or is it a possibility that another factor has increased my hairloss
> in the last few months?
When you discontinued using minoxidil, you also discontinued the positive
effects of minoxidil for those follicles at risk.
Here's a reply I gave to a patient who asked a similar question.
Dr Lee, I was recently cautioned against using minoxidil because it
supposedly help you grow hair up to a point, say for a year and a half,
then you won't grow any more as a result of the minoxidil. They also
added that if you stop using it, you could lose even more hair than you
gained. Is there any truth to these ideas? Steve
Answer: Well, there are some kernels of truth in these cautions.
It is not completely understood how or why minoxidil works to stimulate
hair growth. When you begin using minoxidil, it can recruit hair
follicles to mature to a larger size and subsequently produce a thicker
hair shaft. However, with any given concentration of minoxidil, the hair
follicles that can be recruited to grow thicker hair will have been
stimulated to do so within the first 18 to 24 months of use. It is
unlikely that you will recruit any more hair follicles to produce a
thicker hair shaft after that period of topical minoxidil treatment.
However, the continued use of minoxidil is necessary because the minoxidil
will keep the newly grown hairs in an anagen (growing) phase and it will
help prevent the existing mature hair follicles from miniaturizing.
If you discontinue using topical minoxidil, the hair that you have
stimulated to grow again will enter into the telogen (resting) phase and
in 3 to 4 months, that hair will begin to shed. In addition, hair that
you have kept in the anagen phase with the use of topical minoxidil will
also shed. So, it will appear as if you lose even more hair than you
gained? In actuality, you will not lose any more hair than what you would
have lost had you never used topical minoxidil.
Richard Lee, M.D.
>
>
> 2) Can minoxidil slow the rate a hair is thinning in an individual
> follicle, but not help that follicle grow a thicker hair?
Minoxidil can help thicken hair. Drugs that protect the follicles from DHT
also allow the follicles to get thicker. The combination works better.
>
>
> 3) Can spironolactone act in a negative way towards hair loss, encouraging
> follicles to be affected by DHT?
No.
There are three distinct benefits of topical spironolactone in the
treatment of male pattern baldness:
(1). Spironolactone significantly reduces the amount of DHT in the scalp
by inhibiting the conversion of precursor steroids to DHT.
(2). Spironolactone reduces the DHT in the scalp by converting localized
testosterone into estrogen, which is thought to be protective of the hair
follicles.
(3). Spironolactone blocks the follicular androgen receptor sites, thereby
rendering any residual or circulating DHT harmless to the hair follicles.
Rather than reducing the levels of circulating (serum) DHT like
finasteride does, it prevents DHT from making a complex with the androgen
receptor protein.
>
>
> 4) Is there any evidence that might suggest that other hormonal
> influences might contribute to male pattern baldness? For example,
> could any excess of estrogen caused by reducing DHT lead to increased
> hair loss?
No, see (2) in your question 3 above.
>
>
> 5) I notice that the hair weight and pigment of a lost hair decreases
> significantly as the hair approaches the root. This occurs over 1-1.5
> inches of the hair strand. Is it possible for hair follicles to die
> that quickly?
Hair follicles can miniaturize in a single growth cycle.
>
>
> 6) As a medical professional, what next steps would you suggest in
> combating hair loss with me being at this crossroad? From your
> experience, would you say there is hope for me to slow things down at
> this point?
It would be a good idea to get back on minoxidil.
>
>
> I know this is a very long email, but it would be very helpful for me
> to know anything that could help me at this point. I only began
> treatment hoping to halt my hair loss, not regrow, because my thinning
> was barely noticeable when i began treatment. It's discouraging at
> this point to try to stick to a scientifically proven regimen and
> continue down a path that only seems to do more to increase my
> balding, rather that slow it. My hair loss is now visually apparent
> to everyone, and it would mean a lot to me to hear your suggestions
> that could lead to the possibility of stopping things where they are
> right now.
You would be where you are now if you had never started treatment.
Although it is often more difficult to reverse loss after you have
discontinued treatment with minoxidil, you may be able to get back on
course with continued treatment.
Try the following:
In the morning, apply 1 mL of 5% Xandrox without propylene glycol to all
affected areas. In the evening before bed time, but at least 8 hours
later, apply 1 mL of Xandrox15 to the same affected areas. Wait 10 minutes
and apply a thin film of 5% spironolactone. 5% spironolactone does not
contain propylene glycol. This aggressive approach should stop further
loss and perhaps reverse some of the loss you have experienced.
Please keep me advise of your progress.
Best wishes,
Richard Lee, M.D.
> Dear Dr. Lee,
>
> I have been using your products for just over 12 months now.
> Unfortunately I haven't had any success slowing my hair loss. Because
> of this I have some short questions. But first you should know my
> history:
>
> I have been on Propecia 1mg daily for the last 13 months.
>
> I have been using your spironolactone 2% and 5% for last 5 months.
If propylene glycol causes you irritation, then the 2% formula will also
cause irritation. The spironolactone 2% solution contains 30% propylene
glycol in the liquid base.
>
>
> I used your minoxidil and xandrox pg-free 5% solutions for 12 months
> and quit 2 months ago after not seeing regrowth. I quit also because
> i felt my scalp was more irritated when I used minoxidil as opposed to
> when i didn't, and I knew that irritation was a contributing factor to
> hair loss.
Unfortunately your are mistaken. There is no relationship between scalp
irritation and hair loss.
>
>
> I try to control any irritation that I have by using Nizoral 1%
> solution 3 times a week.
>
> Since I have quit using minoxidil, my hair loss has dramatically
> increased. I knew this might be a possibility, but it surprised me
> because I didn't show any results of slowing or reversing hair loss
> while I was applying minoxidil for 12 months.
>
> Since quitting minoxidil i have increased my spironolactone applications from 1
> to 2 times daily.
With propylene glycol? Ouch!
>
>
> I am a diffuse thinner that noticed my hair loss 1.5 years ago.
>
> Here are my questions:
>
> 1) Can minoxidil cause hair that was not thinning to become dependent
> on minoxidil resulting in further loss when treatment is discontinued?
NO, only the follicles at risk are affected by discontinuing minoxidil.
>
> Or is it a possibility that another factor has increased my hairloss
> in the last few months?
When you discontinued using minoxidil, you also discontinued the positive
effects of minoxidil for those follicles at risk.
Here's a reply I gave to a patient who asked a similar question.
Dr Lee, I was recently cautioned against using minoxidil because it
supposedly help you grow hair up to a point, say for a year and a half,
then you won't grow any more as a result of the minoxidil. They also
added that if you stop using it, you could lose even more hair than you
gained. Is there any truth to these ideas? Steve
Answer: Well, there are some kernels of truth in these cautions.
It is not completely understood how or why minoxidil works to stimulate
hair growth. When you begin using minoxidil, it can recruit hair
follicles to mature to a larger size and subsequently produce a thicker
hair shaft. However, with any given concentration of minoxidil, the hair
follicles that can be recruited to grow thicker hair will have been
stimulated to do so within the first 18 to 24 months of use. It is
unlikely that you will recruit any more hair follicles to produce a
thicker hair shaft after that period of topical minoxidil treatment.
However, the continued use of minoxidil is necessary because the minoxidil
will keep the newly grown hairs in an anagen (growing) phase and it will
help prevent the existing mature hair follicles from miniaturizing.
If you discontinue using topical minoxidil, the hair that you have
stimulated to grow again will enter into the telogen (resting) phase and
in 3 to 4 months, that hair will begin to shed. In addition, hair that
you have kept in the anagen phase with the use of topical minoxidil will
also shed. So, it will appear as if you lose even more hair than you
gained? In actuality, you will not lose any more hair than what you would
have lost had you never used topical minoxidil.
Richard Lee, M.D.
>
>
> 2) Can minoxidil slow the rate a hair is thinning in an individual
> follicle, but not help that follicle grow a thicker hair?
Minoxidil can help thicken hair. Drugs that protect the follicles from DHT
also allow the follicles to get thicker. The combination works better.
>
>
> 3) Can spironolactone act in a negative way towards hair loss, encouraging
> follicles to be affected by DHT?
No.
There are three distinct benefits of topical spironolactone in the
treatment of male pattern baldness:
(1). Spironolactone significantly reduces the amount of DHT in the scalp
by inhibiting the conversion of precursor steroids to DHT.
(2). Spironolactone reduces the DHT in the scalp by converting localized
testosterone into estrogen, which is thought to be protective of the hair
follicles.
(3). Spironolactone blocks the follicular androgen receptor sites, thereby
rendering any residual or circulating DHT harmless to the hair follicles.
Rather than reducing the levels of circulating (serum) DHT like
finasteride does, it prevents DHT from making a complex with the androgen
receptor protein.
>
>
> 4) Is there any evidence that might suggest that other hormonal
> influences might contribute to male pattern baldness? For example,
> could any excess of estrogen caused by reducing DHT lead to increased
> hair loss?
No, see (2) in your question 3 above.
>
>
> 5) I notice that the hair weight and pigment of a lost hair decreases
> significantly as the hair approaches the root. This occurs over 1-1.5
> inches of the hair strand. Is it possible for hair follicles to die
> that quickly?
Hair follicles can miniaturize in a single growth cycle.
>
>
> 6) As a medical professional, what next steps would you suggest in
> combating hair loss with me being at this crossroad? From your
> experience, would you say there is hope for me to slow things down at
> this point?
It would be a good idea to get back on minoxidil.
>
>
> I know this is a very long email, but it would be very helpful for me
> to know anything that could help me at this point. I only began
> treatment hoping to halt my hair loss, not regrow, because my thinning
> was barely noticeable when i began treatment. It's discouraging at
> this point to try to stick to a scientifically proven regimen and
> continue down a path that only seems to do more to increase my
> balding, rather that slow it. My hair loss is now visually apparent
> to everyone, and it would mean a lot to me to hear your suggestions
> that could lead to the possibility of stopping things where they are
> right now.
You would be where you are now if you had never started treatment.
Although it is often more difficult to reverse loss after you have
discontinued treatment with minoxidil, you may be able to get back on
course with continued treatment.
Try the following:
In the morning, apply 1 mL of 5% Xandrox without propylene glycol to all
affected areas. In the evening before bed time, but at least 8 hours
later, apply 1 mL of Xandrox15 to the same affected areas. Wait 10 minutes
and apply a thin film of 5% spironolactone. 5% spironolactone does not
contain propylene glycol. This aggressive approach should stop further
loss and perhaps reverse some of the loss you have experienced.
Please keep me advise of your progress.
Best wishes,
Richard Lee, M.D.
Means you don't have to hold out for a shed/regrowth cycle to see thickening.
