Efficacy of Hair Loss Medications on the Front of the Scalp

[Tracy C]

I'm willing to stick it out with finasteride until the two-year mark, but I really am starting to feel like my results have hit a wall.

What does your doctor think?

Have you been using Rogaine or generic Minoxidil as well? Where are you on the norwood scale and how long have you been there? What are your goals? Do you just want to maintain what you have or do you want to try to grow some hair back?

You are much more likely to experience sexual side effects with Dutasteride than Finasteride. If you are currently taking 1/4 of a 5mg pill of Finasteride once per day, maybe you could give Mr. Spex's idea of taking it twice per day a try. He posted a thread about that a short while back.

[Parasol]

There is some misinformation being passed around suggesting that hair loss medications (finasteride and minoxidil) are not effective in growing hair in the front part of the scalp. With our patients’ permission, we have posted the results of treatment with Propecia and Rogaine to show that medications do work well in many cases. It is important to note that most patients have used the medications consistently for at least a year to achieved the desired results.

Below are some examples of Bernstein Medical patients who have treated their hair loss with medication alone. Visit the Bernstein Medical website to see additional before and after photos of medical treatment.

Click for larger versions:

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Patient OVQ

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Patient KMJ

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Patient QTC

rbernstein,

These results are incredibly impressive. Question:

Were all three patients on Minoxidil AND Finasteride? Could you breakdown their regiments?

[Tracy C]

Their regimens are in the photo descriptions. They are taking 1/4 of a generic 5mg pill of Finasteride daily. Some are using 5% Minoxidil twice per day, some are using 5% Minoxidil once per day. Some are not using Minoxidil at all.

Patient OVQ is taking 1.25mg of Finasteride per day and using 5% Minoxidil once per day in the PM.

Patient KMJ is taking 1.25mg of Finasteride per day and not using Minoxidil.

Patient GTC is taking 1.25mg of Finasteride per day and using 5% Minoxidil twice per day.

[Parasol]

Their regimens are in the photo descriptions. They are taking 1/4 of a generic 5mg pill of Finasteride daily. Some are using 5% Minoxidil twice per day, some are using 5% Minoxidil once per day. Some are not using Minoxidil at all.

Patient OVQ is taking 1.25mg of Finasteride per day and using 5% Minoxidil once per day in the PM.

Patient KMJ is taking 1.25mg of Finasteride per day and not using Minoxidil.

Patient GTC is taking 1.25mg of Finasteride per day and using 5% Minoxidil twice per day.

Thank you, Tracy.

I'm on a mobile device and do not see any medication descriptions when I click to enlarge the photos.

I appreciate you breaking it down for me.

*EDIT*

I now see them on the Bernstein website! Got it. Wow. I'm an idiot.

Thanks again.

[25 going on 65]

What does your doctor think?

Have you been using Rogaine or generic Minoxidil as well? Where are you on the norwood scale and how long have you been there? What are your goals? Do you just want to maintain what you have or do you want to try to grow some hair back?

You are much more likely to experience sexual side effects with Dutasteride than Finasteride. If you are currently taking 1/4 of a 5mg pill of Finasteride once per day, maybe you could give Mr. Spex's idea of taking it twice per day a try. He posted a thread about that a short while back.

My regular doctor knows nothing about MPB so I don't consult him about it. I've corresponded with an IAHRS doctor about Avodart and he said he does prescribe it, but not until after the patient has used finasteride for at least six months (to check for side effects I suppose). I've used it for over a year.

I don't use minoxidil. Did for a brief time but there were some odd side effects so I ditched it. I do use ketoconazole shampoo 2% formula.
I'd say I'm a NW2 with mild thinning around the crown and a couple other areas that are too thin.
My goal is to grow as much of my hair as possible without a surgical transplant.
I haven't heard of the morning+night approach to finasteride but it may be worth a try. It would still probably be cheaper than an Avodart rx.

[Tracy C]

I don't use minoxidil. Did for a brief time but there were some odd side effects so I ditched it. I do use ketoconazole shampoo 2% formula.

I'd say I'm a NW2 with mild thinning around the crown and a couple other areas that are too thin.

My goal is to grow as much of my hair as possible without a surgical transplant.

That is possible for some people. It might be possible for you. It hasn't been long enough for you to know if Finasteride is going to allow any hair to grow back though. It takes about a year to tell is Finasteride is slowing down or arresting your hair loss. It takes longer before you will know if it is allowing hair that can grow back to grow back.

It's too bad you couldn't use Minoxidil. Even only once a day could benefit some people. However if you are only a NW2, you probably would not see appreciable benefit from using it anyways. Low level laser therapy might be able to help you though. LLLT increase the caliber, increases the strength and improves the quality of the hair that you have. This effect makes your hair look fuller and more youthful.

[25 going on 65]

That is possible for some people. It might be possible for you. It hasn't been long enough for you to know if Finasteride is going to allow any hair to grow back though. It takes about a year to tell is Finasteride is slowing down or arresting your hair loss. It takes longer before you will know if it is allowing hair that can grow back to grow back.

It's too bad you couldn't use Minoxidil. Even only once a day could benefit some people. However if you are only a NW2, you probably would not see appreciable benefit from using it anyways. Low level laser therapy might be able to help you though. LLLT increase the caliber, increases the strength and improves the quality of the hair that you have. This effect makes your hair look fuller and more youthful.

To me it seemed like my hair loss stopped after 6-8 months on finasteride but it might have been my imagination if it truly takes 12 months. I've seen thickening in areas behind the hair line but there are 2-3 thin areas that still bother me. I will say that the general "diffuse thinning" has improved noticeably all over the top of my head.
Odd side note: my hairline seems to be pretty much "frozen in place" but it receded a bit more on the right side than the left. My left temple is like a NW1.5 while the right temple is more like a NW2. Kind of annoying but at least I can cover it with styling.

I'm reluctant to try laser therapy because the evidence for it seems sketchy, but it seems to have worked for you so I'm not ruling it out.

Final note: I want to thank you for your contributions to this forum. You're one of the posters who always calls out the snake oils, and your advice generally sticks to what works (proven DHT blockers, minoxidil, keto). It's nice to see someone else keeping things sane and I wish you the best of luck in treating your hair loss (which you seem to be doing successfully).

[Winston]

Actually, you can see results on finasteride in a little as three months. Most people notice some sort of response within 3-6 months, but for those who do not, they are told to give the drug at least twelve months to see if it's having any effect.

[WarLord]

13+ years on finasteride and your hairline is solid?? Have you noticed any loss n front and at the temples since you started? Also, are you using any other treatments?
Your story gets me excited because I've been worrying a lot lately about finasteride losing its effectiveness after 3-5 years, especially in front. If this drug could maintain my hairline for more than a decade that would be a dream come true for me.
Also, have you noticed any side effects?

Guys, in what a space are you living?! I have kept my NW1.5 hairline for 15,5 years on minoxidil alone, and it would never occur to me that it should stop working. The available treatments are very effective especially as a sort of prevention. If they can regrow hair, it is just logical that they can keep existing hair. The bullsh*t that is posted on internet forums is sickening. Can you understand that people, who are successful with their treatments don't need to go here?

[WarLord]

Minoxidil has a different effect than finasteride and won't stop your hair loss. It stimulates growth where your follicles can still grow hair, but the number of follicles capable of growing hair will continue to decrease if you have male-pattern hair loss and are not using finasteride or dutasteride.

Blah blah blah... And the old bullsh*t again! So you are surprised that some people can maintain hair on finasteride for 10+ years? But why do you yourself contribute to spreading misinformation in the internet? What a wise head told you this? Can I guess?

[25 going on 65]

Guys, in what a space are you living?! I have kept my NW1.5 hairline for 15,5 years on minoxidil alone,

Then you do not have hereditary hair loss. Minoxidil doesn't stop MPB.
You are also responding to posts from January.

[Tracy C]

Then you do not have hereditary hair loss.

His comments do indicate that he does not actually have MPB but instead just the natural and normal adult mature male hair line. Some males can prevent the adult male hair line from developing - but most males can not prevent it.

However, his argument concerning the fictitious time limit on the effectiveness of treatments is still a valid one. I know males who actually do have MPB but maintained their hair for over 15+ years. Females with FPB can be expected to maintain for even longer.

Minoxidil doesn't stop MPB.

That is correct. Minoxidil does not stop MPB or FPB. It just fights against the effects of androgenetic alopecia. Finasteride (for males) and Spironolactone (for females) actually stops androgenetic alopecia.

[25 going on 65]

However, his argument concerning the fictitious time limit on the effectiveness of treatments is still a valid one. I know males who actually do have MPB but maintained their hair for over 15+ years. Females with FPB can be expected to maintain for even longer.

I agree there is no time limit for how long the medications work. But from what I have seen, 100% maintenance for males (in the hairline particularly) is the exception after 10-15 years and not the norm
WarLord has referred to the 10 year Rossi study showing most men retaining their hair, but the study assessed the patients by having 3 experts evaluate color photographs. Had they taken hair counts in the hairline/temples, I suspect most of the men would have lost at least minor ground there, which is the typical anecdote from long term users (maintenance in most areas of the scalp, with slow loss in the hairline).
The full study only shows a handful of the photographs, and I have not seen another 10+ year study to compare it to, so I guess it is hard to know. I would be very interested to see the full set of photos but I doubt they will ever be made public?

[Tracy C]

But from what I have seen, 100% maintenance for males (in the hairline particularly) is the exception after 10-15 years and not the norm.

For males, maintaining a youthful hair line at all is the exception and not the norm. Most males cannot prevent the natural and normal adult mature male hair line from developing. Unless he gets his nuggets removed. That will arrest nearly all normal male development from that point on - including the natural and normal adult mature male hair line.

[WarLord]

Then you do not have hereditary hair loss. Minoxidil doesn't stop MPB.
You are also responding to posts from January.

MINOXIDIL STOPS MPB!!! Are you crazy?! If it regrows hair, it means that it has the capacity to preserve existing hair. You are completely brainwashed by posts of some internet morons, who theirselves haven't used this stuff.

The long-term studies from late 80's that are at disposal quite clearly show that a large proportion of patients was regrowing hair on 3% (!) minoxidil even after 4-5 years. And even if you extrapolated the declining curves of average hair counts to the future, it would take about 15 years, until the people reached baseline. And I repeat that this was 3% minoxidil!