Dr Lam's Hair Restoration Forum

Hi Dr. Lam,

Very nice forum - contains numerous informative postings that have really helped me to become educated on the topic of MPB and potential courses of medical treatment. My question concerns propecia and the impact of lowering DHT in the follicle...By taking propecia - one reduces the amount of DHT being generated by the body but what of the levels in the follicle? The conversion of testosterone to DHT occcurs in the prostate gland, liver and skin but how does propecia reduce the existing DHT molecules in the follicle? By halting the conversion - would the DHT levels in the follicles reduce on their own (over time) and result in either hair re-growth or increased fiber size?

I have been reading various articles and forum postings and it would seem that a person utilizing propecia might experience increased "shedding" of hairs (outside of the normal hair cycle) around the 12 week mark and lasting around 2-4 weeks. The forum postings suggest that one will see not only the miniaturized hairs being lost but also normal terminal hair in larger than expected levels. Does an explanation exist to explain this increase in shedding hairs? Thanks in advance,

William Holst

hi,
1. yes, DHT is reduced in the follicle.
2. yes, the hairs can be reconverted back into terminal hairs but it does not stop the process of ongoing hair loss. it just temporarily reverses and slows things down. when the medicine is stopped DHT levels return unfortunately.
3. the shedding is due to hairs being converted from telogen to anagen phase. similar shedding can occur about a month after starting minoxidil.

Dr. Lam,

Does Propecia only impact the minaturized hairs (i.e., hair affected by DHT) and that is what one should see being shed (majority) if they are having a successful response to the medication? Thanks,

William

yes, and also it slows down the progression from terminal to vellus hairs as well.

Hi Dr. Lam,

I remember reading somewhere that a clinic in Dallas may have conducted a trial to determine Propecia's efficacy as it applies to older men i.e., age > 41 years old. Are you familiar with this trial or have any knowledge of a similar study? I have been reading through the various posts to this forum along with the very informative youtube videos submitted by your clinic regarding the effectiveness of Propecia and Minoxidil on areas other than the vertex/crown. I was wondering if you could point me in the direction where one might find some of the newer studies for Propecia/Minoxidil as it relates to the hairline and frontal areas. Thanks in advance,

the best place to look is on medline. and do a search. google "pubmed" to find it.
s.