Efficacy of Hair Loss Medications on the Front of the Scalp

[WarLord]

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?

From what you have seen? Where? Here in the internet forum? This forum is full of hypochondriac defeatists, who spread unsubstantied claims and assure each other that all medications will work for only a handful of years. In the meantime, the medications keep working in the vast majority of men, who have no reason to go here and whine about the alleged loss of efficiacy. If you believe that you will lose your hair soon despite anti-hairloss treatments, then you really deserve this fate! I wish it to you wholeheartedly!

Besides that, you are a typical visitor of this forum by all parameters: Waiting idly until NW4, and then looking for help. That's too late, lad, and that's your own fault.

[WarLord]

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.

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.

I DO have MPB. It started, when I was 22 years old (1996). My doctor told me that I would be losing hair despite anti-hairloss treatments. I didn't. Actually, I have preserved my hair exactly in the state, when I started. The only exception was a short experiment with herbal extracts in 1998 - and you should see, how quickly my hair started to disappear!

It really doesn't seem anyhow exceptional to me. The point is that you must treat it early and be disciplined.

Now I am paradoxically in the worst state ever, due to an unhappy experiment with 15% minoxidil - and that's the reason, why I am here. If I hadn't done this experiment and if I hadn't lost a lot of hair in my left temple, I wouldn't have gone here and you wouldn't have known my story. You still would have assured each other that minoxidil can't stop hair loss for a long time and holding off MPB for 15+ years is impossible, because other visitors of this forum say it is so.

[WarLord]

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?

And as for the other parts of your personal propaganda: The table 6 in Rossi et al. clearly shows that 71 patients (63%) persisted in their improvements achieved during the 1st year, or improved even further. How could they get worse, if they visibly kept their improvements? Or do you want to make a study based on anecdotal posts on this forum? Well, then you would find out that 50% minoxidil users get swollen eyes and bloated face and 50% finasteride users lose more hair than they gain. Good luck!

[Tracy C]

It really doesn't seem anyhow exceptional to me. The point is that you must treat it early and be disciplined.

Agreed.

Many forum members will continue to believe current treatments will only work for a few years now matter what you try to tell them.

[WarLord]

Agreed.

Many forum members will continue to believe current treatments will only work for a few years now matter what you try to tell them.

"Many forum members" idly waited until they were NW4. Now they expect miracles and if they don't happen, they lurk about internet forums, whining that stopping MPB is impossible.

[JJacobs152]

"Many forum members" idly waited until they were NW4. Now they expect miracles and if they don't happen, they lurk about internet forums, whining that stopping MPB is impossible.

Tracy and Warlord, could you look at my album that I made. I just wanted to get your thoughts on what NW you think I am. I know, it can be irrelevant at times, but just want to know for my own personal reasons.

[25 going on 65]

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!

Minoxidil forces hair to grow from follicles it otherwise would not, and also causes hair to grow thicker than it normally would. The reason these hairs do not grow, or do not grow as thickly, without minoxidil is due to follicular miniaturization from DHT exposure. DHT exposure causes MPB and minoxidil does not stop this process. You can maintain a higher hair count than you would have otherwise, but you cannot maintain the same absolute hair count for 15 years on minoxidil alone IF you have MPB.

Besides that, you are a typical visitor of this forum by all parameters: Waiting idly until NW4, and then looking for help. That's too late, lad, and that's your own fault.

I am NW2.

And as for the other parts of your personal propaganda: The table 6 in Rossi et al. clearly shows that 71 patients (63%) persisted in their improvements achieved during the 1st year, or improved even further.

The methodology was 3 individuals assessing color photographs of the patients, and the study does not display the photos (except a select few). I am confident finasteride can maintain hair counts on the crown and anterior mid scalp for 10 years. I am not confident that it can maintain temple and hairline hair counts for 10 years "in most men" because the only evidence for this is in the Rossi study, which did not obtain hair counts at all (instead we have 3 people saying it "looked maintained" based on photographs), has never had its results reproduced elsewhere, did not show its photos for anyone else to assess, and is not backed up by any anecdote (if you know of one I look forward to seeing it....we have many showing the opposite, including by people who have a very positive view of fin)
Studies showing eg maintained crown hair are numerous, used large samples with control groups, took actual hair counts, and are backed by countless anecdotes.
Is it possible that most men can maintain hair in all scalp regions for 10+ years on fin? Maybe. but I am not convinced at this time. I hope you now understand why and do not feel angered by that.

[konfusion]

"Many forum members" idly waited until they were NW4. Now they expect miracles and if they don't happen, they lurk about internet forums, whining that stopping MPB is impossible.

well I started when I was NW1, more than 5 years after my dermatologist thinks I am still NW1 but in my opinion it is more like a NW1,5 going into NW2. He also said that there is minor miniaturization on top of my scalp where Fin should work the most but it may not be something to worry. I accept the fact that treatments work very well, who knows what NW I would be now without them? but I just want them to be a little more effective. I maintained a good amount but I wish I could have maintained it all.

[WarLord]

Minoxidil forces hair to grow from follicles it otherwise would not, and also causes hair to grow thicker than it normally would. The reason these hairs do not grow, or do not grow as thickly, without minoxidil is due to follicular miniaturization from DHT exposure. DHT exposure causes MPB and minoxidil does not stop this process. You can maintain a higher hair count than you would have otherwise, but you cannot maintain the same absolute hair count for 15 years on minoxidil alone IF you have MPB.

LOL Really? "You cannot maintain"? I did. And there are plenty of people, who are still above baseline after the same amount of time. And who actually said this? Bryan the Baldy? The man, who is picking up graphs from some studies, without even reading them?

These claims are completely fabricated. You have nothing to support this. An anti-hairloss treatment doesn't have to address DHT to be effective. And if you don't believe in the power of anti-hairloss treatments, what is actually your business here? What the hell do you pursue by spreading such a misinformation? This forum is supposed to help people suffering from hairloss, not to infect them by garbage coming from some individuals, who haven't had enough experience with the treatments yet and rely on some silly internet legends.

[WarLord]

well I started when I was NW1, more than 5 years after my dermatologist thinks I am still NW1 but in my opinion it is more like a NW1,5 going into NW2. He also said that there is minor miniaturization on top of my scalp where Fin should work the most but it may not be something to worry. I accept the fact that treatments work very well, who knows what NW I would be now without them? but I just want them to be a little more effective. I maintained a good amount but I wish I could have maintained it all.

If you feel that it is not as effective as it should be, then you should add something to your regimen.

[WarLord]

The methodology was 3 individuals assessing color photographs of the patients, and the study does not display the photos (except a select few). I am confident finasteride can maintain hair counts on the crown and anterior mid scalp for 10 years. I am not confident that it can maintain temple and hairline hair counts for 10 years "in most men" because the only evidence for this is in the Rossi study, which did not obtain hair counts at all (instead we have 3 people saying it "looked maintained" based on photographs), has never had its results reproduced elsewhere, did not show its photos for anyone else to assess, and is not backed up by any anecdote (if you know of one I look forward to seeing it....we have many showing the opposite, including by people who have a very positive view of fin)
Studies showing eg maintained crown hair are numerous, used large samples with control groups, took actual hair counts, and are backed by countless anecdotes.
Is it possible that most men can maintain hair in all scalp regions for 10+ years on fin? Maybe. but I am not convinced at this time. I hope you now understand why and do not feel angered by that.

Those "many showing the opposite" actually report very minor, unnoticeable recession of their temples after a very long time on finasteride. Furthermore, it is logical that people, who are visibly above baseline, can't lose the hair that they had at the beginning.

[25 going on 65]

LOL Really? "You cannot maintain"? I did.

If you are being honest about your experience on minoxidil, then you do not have hereditary hair loss.

These claims are completely fabricated. You have nothing to support this. An anti-hairloss treatment doesn't have to address DHT to be effective.

At this point your argument is not with me, but with hair loss specialists with medical degrees.
Minoxidil does not prevent MPB.

Those "many showing the opposite" actually report very minor, unnoticeable recession of their temples after a very long time on finasteride.

If they notice it, it is noticeable.

people, who are visibly above baseline, can't lose the hair that they had at the beginning.

I am not convinced that the majority of participants were visibly above baseline re: hairline and temples. The three individuals assessing the photos report they were. I would like to see the pictures myself, and of course obtaining hair counts would be better
If the results of this study are ever reproduced elsewhere I will be more confident in the claims

You obviously have very strong feelings about this and will not agree with me. That is OK. Good luck in the future.

[WarLord]

If you are being honest about your experience on minoxidil, then you do not have hereditary hair loss.


At this point your argument is not with me, but with hair loss specialists with medical degrees.
Minoxidil does not prevent MPB.

You are continuously inventing things that disagree with both anecdotal evidence and available long-term surveys. This is a fallacy that is not based on any evidence. Can you think logically at all? How can minoxidil regrow hair lost due to MPB, if it doesn't do anything against MPB???

By the way, what about the stuff suppressing PGD2 in the scalp? Why do these fools investigate prostaglandins and not androgens?

I am not convinced that the majority of participants were visibly above baseline re: hairline and temples. The three individuals assessing the photos report they were. I would like to see the pictures myself, and of course obtaining hair counts would be better
If the results of this study are ever reproduced elsewhere I will be more confident in the claims

You obviously have very strong feelings about this and will not agree with me. That is OK. Good luck in the future.

And I don't know, what is your business here. Are you the director of the League of Balding Men? Do you need new members, who would give up available treatments?

[25 going on 65]

You are continuously inventing things that disagree with both anecdotal evidence and available long-term surveys. This is a fallacy that is not based on any evidence. Can you think logically at all? How can minoxidil regrow hair lost due to MPB, if it doesn't do anything against MPB???

I did not say minoxidil does nothing. Minoxidil forces hair to grow where it otherwise would not, or grow thicker than it otherwise would. Your follicles continue to miniaturize and MPB continues to progress, however your hair count will be higher than it otherwise would be at each (for example) 6 month interval. In other words it provides a cosmetic result in spite of your genetic condition, rather than preventing the condition from progressing.
I am not unique by making these statements. This is the standard description of minoxidil's effects on this forum and also by hair loss specialists. If you feel we are in error, consider posting relevant studies in a new thread to possibly change the public perception

By the way, what about the stuff suppressing PGD2 in the scalp? Why do these fools investigate prostaglandins and not androgens?

Not familiar enough with PGD2 to comment.

And I don't know, what is your business here. Are you the director of the League of Balding Men? Do you need new members, who would give up available treatments?

I use finasteride and ketoconazole shampoo.

[WarLord]

I did not say minoxidil does nothing. Minoxidil forces hair to grow where it otherwise would not, or grow thicker than it otherwise would. Your follicles continue to miniaturize and MPB continues to progress, however your hair count will be higher than it otherwise would be at each (for example) 6 month interval. In other words it provides a cosmetic result in spite of your genetic condition, rather than preventing the condition from progressing.
I am not unique by making these statements. This is the standard description of minoxidil's effects on this forum and also by hair loss specialists. If you feel we are in error, consider posting relevant studies in a new thread to possibly change the public perception.

Yes, minoxidil doesn't prevent the attack of hair follicles by DHT. If you quit minoxidil, you will be very quickly in the state, where you would have been without minoxidil (which means that you could go from NW1.5 to NW5 within several months). So, hair preserved by minoxidil is a "zombie hair". But the most important thing is that minoxidil keeps the hair in the growing phase, possibly by increasing the levels of PGE2 (which counterbalances the negative effect of PGD2).

In short, the attack of hair follicles by DHT leads to a chain of chemical reactions, whose result is a "dead" follicle. But it doesn't matter, what a part of this chain you block by an anti-hairloss treatment. You can start at the beginning (by blocking DHT), in the middle (by decreasing PGD2), or at the end (by increasing PGE2).