Hair Restoration Blog

Hello, Dr. Mohebi.

I used the Propecia prescription you gave me.  It cost me over 80$ to get 30 1mg pills, since it’s not covered under my insurance.  I looked online to see if I could find it cheaper and found a number of sites selling it for much less.

Do you think it’s not a good idea to buy Propecia online?  The site I found doesn’t require a prescription or anything and I can actually get 270 pills for almost the same price I just got the 30 pill refill for at the pharmacy.

Could you check out this link out and tell me if it’s not a good idea to buy it? It seems to me that the pharmacies can charge whatever they want for it, but 80 dollars for 30 pills just seems outrageous to me…  I wonder if $90 for 270 1mg pills is for generic finasteride, and not actual propecia.

I just want to know what your opinion on buying propecia online is.  Sincere thanks.
See you soon.

A:
I have heard bizarre stories about online medications that are sold to patients. There are many stories about affordable hair loss treatments as there are for affordable hair transplants.  I generally don’t approve buying Propecia or any other medications online.

Think about it, the current medical system closely supervises all stages of production, distribution and sales of the medications. Everything is highly regulated and controlled to minimize the chance of mistakes.

Online medications for hair loss or any other conditions, do not have this regulations and if something goes wrong or you get a product that does not contain the medication at all, you have no control on it and no one will be responsive. The fact that prescription medication is sold online without the doctor’s script is risky too.
You can shop around to find the best price for Propecia or finasteride, but I cannot support online shopping for medication from non-supervised resources.

Q:

I had gastric bypass about 10 years ago. Not only have I lost a lot of my hair but i have never regained it. Especially after taking a shower i notice that i loose a lot more hair then i should. I have brought this concern up with my doctor but all he tells me is to increase my vitamin intake. I have also been taking Biotin for about three months and vitamin B12 along with a multi-vitamin but have not seen a difference. In addition my eyelashes are thinner and I have lost the thickness of them. I am thinking about rogain for women but if you can please give me any advice I would really appreciate it I am only 38 and fear i will be bald byt the time i turn 40.
Thank You,

A:

As we discussed in the article “Gastric Bypass Surgery and Hair Loss”, it is common to see hair loss or changes in the quality and color of hair after a gastric bypass surgery. The changes are generally seen in the first few months after the gastric bypass surgery. Similar hair loss conditions could also be seen in a variety of other medical conditions, major surgeries or trauma.

The immediate few months following a gastric bypass surgery mimics sever starvation conditions in which body may have difficulty obtaining many essential elements or nutrients through regular diet and supplement of nutrients and vitamins may become necessary.

Hair loss after a gastric bypass may be seen in the patients who don’t have any obvious vitamin or mineral deficiency. Patients need to be evaluated on a regular basis by their surgeon and with regular lab tests. The initial hair loss should return to normal if there is no other underlying condition exists.

In case patient has any other medical condition that can accelerate hair loss or in the case of genetic male patterned or female patterned baldness, patient may never gain their hair back. In those conditions the stress of the surgery acts as a stimulator forcing patient scalp hair to fall on a faster than normal pace.

My recommendation is to see a good hair transplant surgeon and undergo a miniaturization study to rule out any other treatable causes of hair loss.

Q:

I am a 35 year old woman with history of scalp dermatitis. My doctor gave me steroid solutions for my dermatitis that helped the condition, but I have been suffering from hair loss now. Could steroid solution be the cause of my hair loss or could the scalp dermatitis be the cause of my hair loss?

Although hair loss is reported as a rate side effect of many medications, losing hair is not a common condition that could be seen after topical steroid use. Dermatitis or inflammation of skin could be seen as part of many other skin conditions. I think you have to see a good dermatologist and get an accurate diagnosis for your hair loss condition. Microscopic evaluation of the scalp or miniaturization study is a great tool to diagnose the condition of your hair loss and to see whether your hair loss is still active or not. I perform a miniaturization study on almost all my patients to determine the activity of their hair loss condition and also to predict their future hair loss. The type of your hair loss and its association with other medical conditions could be assessed by a hair specialist after taking a history and examination of your hair and scalp including performing a miniaturization study. We do perform

miniaturization study on all patients while evaluating them for hair transplant. If you are diagnosed with a treatable condition that has caused or accelerated your hair loss, proper treatment may cure your balding and give you your full head of hair back.

Q:

Do you recommend Finepecia for treatment of hair loss?

A:

Finepecia is another name for finasteride or Proscar. Finepecia, Propecia or finasteride is a medication that blocks the production of Dihydroxytestosterone (DHT) and can stop or slow down the process of baldness. The medication is also prescribed for treatment of enlargement of prostate by physicians. You need to be evaluated by your hair doctor preferably with a miniaturization study before starting on Finepecia. For more on Finepecia or generally medical treatment of hair loss you can visit the website of US Hair Restoration.

Q:

Hi Dr. Mohebi,

I had asked you some question about Finasteride 1 mg. I am still hesitating to re-take it. I came across a product named Procerin. Do you suggest it? Does it work in a different way compared to Finasteride 1 mg. What are the side effects and efficiency with respect to Finasteride?

Regards,
Patient’s name

A:

Procerin is a mix of several elements such as some herbal, vitamin and minerals. To be more precise the ingredient formula of Procerin tablets includes:

• Saw Palmetto Berries (which is an herbal DHT blocker)
• Gotu Kola
• Nettles
• Magnesium
• Zinc Sulfate
• Eleuthero Root
• Vitamin B-6
• Pumpkin Seed Meal
• Muira Puma Root

Procerin XT Topical Serum ingredients include:

• Gamma Linolenic Acid
• Grape Seed Extract
• Azelaic Acid
• Saw Palmetto Extract
• Avocado Oil
• Nettle Extract

We know that pattern hair loss is not due to lack of vitamins or minerals so you really should not take those components on a regular basis. Out of the herbal components of Procerin the only ingredient that is known to help the stop hair loss is the Saw Palmetto extract that has DHT blocking activities. The effect of Saw Palmetto (topical or systemic) in comparison with finasteride is not studied extensively. I should say the same thing about its side effects that are not evaluated as in depth as finasteride so I do not recommend it regularly for my patients. However if you cannot take finasteride for any reason Saw Palmetto might be an alternative.

Q:

Hey doc!

How’s it going? I hope all is well. I have two things on my mind. One is a question: the Murad shampoo directs users to use the shampoo daily.. do you think i is okay to use that shampoo daily? The reason why I am asking is because of the chemical content in shampoo, it is usually recommended to shampoo every other day or so.

A:

I answered another question about Murad shampoo “Murad Shampoo for hair loss” before. I don’t believe that DHT blockers especially in the form of shampoo can be absorbed from the skin to affect the hair growth compared with systemic DHT blockers i.e. finasteride pill. I don’t think that daily use of the shampoo can hurt your hair either, unless it is specifically prohibited by the manufacturer.

Q:

You have mentioned shock loss in some of your articles that may happen after hair transplant surgeries in young men. Does it happen to everyone and if happened, is it reversible.

A:

Shock loss used to be a big problem for many hair transplant patients. Shock loss generally happens in the first 1 to 3 months following the hair transplant procedure and can be reversible in some patients and to some degrees. Remember that shock loss happens mostly to the hair follicles that have some degree of miniaturization are already in the process of falling out and the stress of surgery just accelerates the rate of hair loss. Strong terminal hairs are usually resistant to the shock loss.

There are several ways to minimize shock loss after hair transplant surgeries. Topical medications like minoxidil could prevent shock loss to some degrees. Finasteride (Propecia) would perhaps be the most helpful medication for reducing the shock loss after hair restoration surgeries, if patient starts taking Propecia right before his hair transplant surgery.

My recommendation to most patients is to start finasteride even a few days before the surgery so it is locked in the system by the time of surgery and can protect hair from shock loss phenomenon. The rate of shock loss has significantly dropped in our hair transplant patients in the last few years, and it has to do with us strongly recommending finasteride use before hair transplant surgery to all our male patients.

Q:

hi, why do men with thinning hair seem to have a reddish color to their scalp and men with thick a thick head of hair seem to have a whiteish color to their scalps……i find it a condition that exists in alot of cases several of the men i observed wear caps when they are outside so i’m quite sure the sun had nothing to do with it. one of my sons has a very thick head of hair……..”whiteish” scalp..my other son has thin hair and a reddish skin colored scalp.

again thanks for your help

A:

Thin (Miniaturized) hair is generally seen lighter and in people with dark but thinning hair, hair could be seen as light brown or reddish color, not because it has less concentration of the pigment (melanin), but due to its smaller size and less number of pigments overall. One of the first signs of hair loss could be lightening hair color in the thinning areas. Scalp tone is also a reflection of hair color especially in people with fair skin that you can see through the skin and hair shaft may alter skin tone.

Q:

Hi Doctor,

My mother is obsessed with my hair loss and gives me a whole bunch of vitamins and mineral tablets everyday to help regrow my hair.
Do you think they work? Or should I stop them.

A:

Although lack of certain vitamins and minerals could cause hair loss in their sever form, living in north America and having a normal and balanced diet; it is unlikely that you are suffering from vitamin or mineral deficiency. On the contrary, if you look at your family pattern of hair loss, you probably can find other male members of the family who has similar male pattern hair loss. As I always say, you need to have the triangle of baldness, which is “Gene, Male gender, and time” to become bald. Vitamins deficiency is not to blame as part of triangle of male patterned hair loss. You can continue taking vitamins to please your mom, but don’t overdo it since vitamins are not going to bring your hair back. Instead you need to see a good hair specialist or dermatologist and undergo a good hair loss evaluation with miniaturization study and start taking one of the effective medications to prevent further hair loss or to use hair transplant to restore your lost hair.

Q:

I have heard high estrogen in males can contribute to hair loss. Is that true? I am a 40 year old man with low sex drive and female patterned hair loss.

A:

High levels of estrogen in men could be seen in many other conditions such as estrogen-producing tumors, congenital adrenal hyperplasia, chronic alcoholism and advanced liver disorders. Elevation of estrogen in men can cause sexual dysfunction, change in body fat distribution in a female pattern and breast enlargement and secretion.

Balding is not a typical sign of excess estrogen. In fact one of the signs of estrogen deficiency could be hair loss in female patients. A common type of this kind of hair loss is seen in telogen effluvium that women lose hair due to sudden drop of estrogen and progesterone levels. Although excess estrogen is generally not the trigger for hair loss, it can affect the balance of other hormones and indirectly cause hair loss. The latter is not a common cause of hair loss in men or women though.