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Hair Loss/Fin and hairline

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QUESTION: Hi Dr.

I'm 34 and I've been on finasteride 1mg generic for 7 months after noticing some thinning on one side of my hairline (I have a distinct widows peak like Andy Garcia). Since February, however, the peak of the my hairline has gotten very thin, gray, and wispy--hairs throughout my hairline are just disappearing and the hairline is getting very thin--the actual peak is virtually gone now after only 7 months.

Can finasteride cause this hairline reaction?  Such as a spike in testosterone or hormones killing the hairline. It wasn't this bad until starting the fin. Some people say it's just the progression of mpb, but it's way too coincidental that my hairline disappears like this after starting finasteride. What do I do now??  Any doctor I speak with says no way to Avodart as a hair medication. And I see side effects can be strong. It feels hopeless.  

I've heard about using Minox with it, but I see it only aids in some people and for only a temporary amount of time if it does (crutch until it stops working if it is even working).  I look forward to your advice.

ANSWER: My guess is your hereditary pattern and timing is such that you were destined to lose those hairs this year and even taking 1mg Finasteride was not enough to offset your inherited pattern and timing of the loss. I would suggest applying 5% Romaine Foam twice a day to those hairs hoping to keep them in their active growth phase and I'd add Avodart twice a week while continuing the Finasteride daily. After two months I'd increase the Avodart to every other day and eventually daily. In doing so you will have gone from 66% suppression of DHT with just 1mg Finasteride to 90% suppression with Avodart. The studies show a much better result taking Avodart and I'd use the crutch to keep those hairs alive until you get the 90% suppression in three months.

---------- FOLLOW-UP ----------

QUESTION: Thanks Dr. P. Is Rogaine foam or liquid even worth it? I heard if it works it only grows very sparse tiny white hairs, if that.  Also, can finasteride cause more miniaturization? The hairline that i have left has very wispy white hairs throughout.   As for Avodart, my derm and GP both said its not approved for hairloss, so I don't know what to do. Should I find a pharmacy online overseas?  They certainly have it.  Does it cause more shedding?  Thanks!

Answer
Is Rogaine foam or liquid even worth it? ---  YES
I heard if it works it only grows very sparse tiny white hairs, if that.---  Do you want to keep your hair? IF so use Romaine Foam twice a day.
Also, can finasteride cause more miniaturization?  ---NO
The hairline that i have left has very wispy white hairs throughout. --- The combination of both Romaine and Finasteride is your best bet.
As for Avodart, my derm and GP both said its not approved for hairloss, so I don't know what to do. -- Maybe phone around to find one who will
Should I find a pharmacy online overseas?  ----That is your choice
They certainly have it.  Does it cause more shedding?---- NO

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Peter J. Panagotacos, <B>M.D.</B>

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.

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I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website www.hairdoc.com

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