Q: What are the most common causes of hair loss in women other than genes?
A: For localized hair loss the most common causes are traction (due to tight braiding) and alopecia areata (an autoimmune disease that produces smooth round patches of hair loss).
Other than genetic (hereditary) thinning; generalized hair loss is most commonly caused by medications, anemia, and thyroid disease.
Q: I am interested in a hair transplant, but am turned off by the apparent side effects of follow up Propecia. Could herbs serve the purpose of Propecia? Regarding laser treatments, do they work on their own, or do you need drugs to supplement? Can laser damage in some cases, rather than benefit? It seems odd that laser therapy has been undertaken in Europe for 10 years, yet there are no published studies on the results. Might this be because it doesn’t work in the longer term?
A: Finasteride is the best medication. Herbs are not particularly effective for hair loss. You should consider trying finasteride.
If you are in the 2% group that has side effects with Propecia, just stop taking the medication. If you do not experience side effects, then there is no problem taking the medication long-term. Hair transplant surgery doesn’t prevent the progression of hair loss. That is why it is used in conjunction with medication.
Laser therapy can cause shedding initially (as can Propecia and Rogaine), but this means it is working. It does not cause actual hair loss. Your skepticism of the value of Laser therapy long term is one we have as well. Keep in mind, however, that while long-term studies are extremely important, they are very hard and costly to run and there is little incentive for companies to do this.
It is interesting that the FDA does not require longer term data on medications or devices that need to be used on a continued basis.
Q: I’ve now been taking finasteride for just over 5 months. I have noticed that my semen quality has changed just in the last 3 months, and it seems now much less in quantity and is quite watery and clear in color. I think the current problems are due to the finasteride, what do you think?
A: Finasteride, the active drug in Propecia, can change the quality of the semen, since it is decreasing the component of seminal fluid that is secreted by the prostate.
You may want to consider having your sperm counts checked, although a decreased sperm count is rare with finasteride. If the symptoms are not bothering you and the sperm counts are normal, it should be OK to continue the medication.
Q: Is it necessary to take medications before, during, or after the hair transplant? Will these medications affect pregnancy?
A: It is not necessary to take any medication for a hair transplant other than the local anesthesia used during the procedure.
Although I would not have a hair transplant during pregnancy, the procedure will have no effect on future ones.
Q: I heard that there is a new drug on the market called Avodart for prostate enlargement which might help with hair loss as it blocks the conversion of testosterone to DHT better than Finasteride and is more effective than Propecia. Do you recommend taking it and if so what is the dose?
A: I am currently not recommending that patients take Dutasteride for hair loss, although it is more effective than Propecia, finasteride 1mg. (Dutasteride 0.5, the dose generally used for hair loss, seems to be slightly more effective than finasteride 5m in reversing miniaturization.)
The reasons that I am hesitant to prescribe it at present are outlined in the Hair Transplant Blog question Is Avodart Safe?
In addition to the reasons that I listed in that response, I would also consider that: Dutasteride, unlike finasteride, decreases sperm counts, it can result in persistent decreased sex drive and the incidence is greater than with finasteride. Finally there are a significant number of alpha-type 1 receptors in brain, those affected by dutasteride, but not finasteride.
However, since Dutasteride is approved for older men with prostatic disease, using it for hair loss in this age group (usually in a lower dose) is reasonable.
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Disclaimer: The purpose of the Hair Transplant Blog is to provide the public with general information on hair restoration. Information provided on this site should not be used for medical diagnosis and/or treatment.
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