minimising shedding

[guyfromsydney]

Do you know if its possible to reduce the inititial shedding associated with propecia/rogaine - by starting on a smaller amount? and slowly building up to a higher dosage?

 

Over a few months?

[hairbank]

No, there's nothing I know of. Don't sweat the shed, though. That's just the hair going into it's normal resting phase which lasts anywhere from 6 weeks to 2 months.

 

Up to 15% of your hair is resting at any given time............Fin/Min occasionally causes a more-than-normal amount to rest at any given time, say maybe 25% or so...............but it grows back after done resting.

 

So, I wouldn't worry about a shed! You'll cycle through it.

[MrJobi]

Regarding shedding.

It is actually a good thing as it indicated the hairs are going through the growth phase. the best defense is to be prepared with concealer.

[MarylandGuy]

Not to mention, that not everyone will shed when starting propecia.

[Dr Proctor]

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. I estimate that about 10-15% of pateints see it.

 

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.

 

Peter H Proctor, PhD,MD

(promotional link removed)

[HTinthefuture]

I am confused. If 10-15% of patients see shedding, and shedding is a sign of it working, does that not point towards the fact that this drug is only working well with 10-15% of people using it (on average). asking because I was on propecia and went off due to shedding that did not seem to want to stop and other side effects that I kept hoping would go away. Now I am contemplating going on it again, but worry the side effects are more common than not. I am not putting down the drug, because I feel it truely does work for some/many....but with any drugs often the side effects are somewhat downplayed.

[Dr Proctor]

Originally posted by HTinthefuture:

I am confused. If 10-15% of patients see shedding, and shedding is a sign of it working, does that not point towards the fact that this drug is only working well with 10-15% of people using it (on average)....

 

No. This is because visible early shedding is caused by a combination of several factors. First, Waking up follicles inducing loss-phase hair to shed early. This does not appear to be the case in the majority of persons. Second, enough follicles being turned on at any one time that the increased shedding becomes perceptible.

 

That is, if the follicles are turned on more slowly, over a period of time, you are less-likely to observe visible shedding. The convers is also true-- the more follicles that get turned on and the earlier they get turned on, the more likely shedding will be significant enough to be perceptible. This is why an early wave of shedding tends to be associated with a good eventual result.

 

This is only a rule of thumb and naturally with the qualification "all else being equal". E.g., if for some reason you have an abnormal amount of loss-phase on board when you start treatment, this can also cause an apparent shed. The most common cause of this we see is stopping medical treatment several months before.

 

Again, the hair was about to fall out anyway.

 

Dr Proctor

[HTinthefuture]

thanks, that is good news as I had early shedding and lots of it. so hopefully i will have similar results this time around. I know I should have stayed on it, but I was lucky my hairloss wasn't drastic over the past 5 years or so.

 

another question. many people are getting proscar and dividing into 4 for much less cost. This gives you 1.25 mg, which is more than the 1 mg in propecia. Would this cause more shedding as well due to the larger amount? when I did this I had a hard time getting equal 1/4 amounts so I think one day it could have been 1mg, the next 1.5, next 1.25...and so on. in this case, would it be best to just discard the ones that aren't equal? as you are varying the dose up and down if they are not as close in size as possible, or do 1/4 every other day as that would translate to roughly .75mg everyday? thanks!

[Dr Proctor]

Originally posted by HTinthefuture:

another question. many people are getting proscar and dividing into 4 for much less cost. This gives you 1.25 mg, which is more than the 1 mg in propecia. Would this cause more shedding as well due to the larger amount? when I did this I had a hard time getting equal 1/4 amounts so I think one day it could have been 1mg, the next 1.5, next 1.25...and so on. in this case, would it be best to just discard the ones that aren't equal? as you are varying the dose up and down if they are not as close in size as possible, or do 1/4 every other day as that would translate to roughly .75mg everyday? thanks!

 

Over a broad range (IIRC, from .4 mg/day to 5 mg/day) the dose response curve for finasteride is essentially flat. That is, every dose works about the same. This pretty much moots any differences in the size of the quartered Proscar tablets.

 

Peter H. Proctor, PhD,MD

wwww.doctorproctor.com

[HTinthefuture]

thanks, that is good to know.