Sam
asked: "Doctor, I was just wondering if you could give me
some insight into probability of shedding due to stress. I am 25
and have had the worst year of my life. (Laid off, nasty break up
with GF) This all occurred in the beginning of the year, and for a
time I was very depressed, had very very bad eating habits (eating
maybe once a day) and abusing alcohol. Around March or April I
noticed a lot more hair being shed on my pillow and in the shower,
and noticed that my hair, including my hair line is considerably
thinner. I never noticed a problem before all this happened so I
shrugged it off and told myself it was stress. However, I still
have not seen any regrowth, and despite changing to a more healthy
lifestyle, my hair remains thin. I know you cannot confidently
diagnose me over the internet, but my question to you is: What are
the chances that this is stress related shedding? and because I am
still somewhat depressed (because of the state of my hair mostly)
will that affect/delay the recovery of my hair? The reason this is
bothering me is because it was unexpected, and with all the
factors involved I cannot distinguish MPB from what I've read
about telogen effluvium. Your insight is greatly appreciated.
"

Dr Peter H. Proctor, PhD MD answered: Some
characteristics of stress loss: It is caused when a stressor
causes an extra amount of hair to go into the loss-phase. So, it
typically takes 2-4 months after the stressor to show up. The
stressor can be physical (e.g., severe illness or surgery) or
psychological, such as severe depression. Unlike pattern loss,
stress loss tends to be associated with an increased rate of hair
shedding, sometimes as much as 3-400 hair per day. Stress loss
also tends to burn itself out after a few weeks to months.
Finally, it tends to regrow starting within a year or so after the
shedding slows. In fact, if it doesn't regrow, it probably wasn't
entirely stress loss. Medical treatment may help it grow back
faster.

Janice asked: "Dr. Proctor, Thank you for taking the time to
answer questions. With Rogaine, there is usually a period (several
weeks to months after starting with Rogaine) where a lot of hair
falls out called the "dread shed". For this reason, I've
been afraid to even start Rogaine for fear that the shed would
happen, but regrowth wouldn't. Does the same type of shedding
occur with your products? "

Dr Peter H. Proctor, PhD MD answered: Everything that brings follicles out of dormancy ( which means everything
that works ) can cause loss-phase hair to fall out early. Our
formulations are no exception. Somehow you have gotten the
impression that this is common. It is not, happening only 10-15%
of the time, at most. In any case, it is caused by follicles
coming out of dormancy, is often the first sign that treatment is
working and the hair was about to fall out anyway.

Richard
asked: "my hair started to drop since few weeks ago, and
traces of boldness can be found. is there something wrong with the
shampoo i'm using? "

Dr Peter H. Proctor, PhD MD answered:

No specific way I can say, but shampoos generally do not cause hair
loss. See www.drproctor.com/baldfaq.htm
for more on hair loss and its causes.

Janice
asked: "Dr. Proctor, Thank you for taking the time to
answer questions. With Rogaine, there is usually a period (several
weeks to months after starting with Rogaine) where a lot of hair
falls out called the "dread shed". For this reason, I've
been afraid to even start Rogaine for fear that the shed would
happen, but regrowth wouldn't. Does the same type of shedding
occur with your products? "

Dr Peter H. Proctor, PhD MD answered:

Everything that brings follicles out of dormancy ( which means everything
that works ) can cause loss-phase hair to fall out early. Our
formulations are no exception. Somehow you have gotten the
impression that this is common. It is not, happening only 10-15%
of the time, at most. In any case, it is caused by follicles
coming out of dormancy, is often the first sign that treatment is
working and the hair was about to fall out anyway.

Sam L asked:

" I started taking methyphenidate(ritalin)
about 3-4 months ago for ADD. Recently I've noticed a massive
amount of shedding all around my scalp, in addition I've been
experiencing a large amount of pain in the vertex area of my scalp
whenever I take it. I've since discontinued the medication, but
I'm wondering if it's possible that is just telogen effluvium and
that the shedding is just because of a large number of new hairs
coming in. If it is, what can I expect, when will it stop, and is
there anything that I can do to speed this process up? (I have a
wedding coming up in May, and I'd rather not be half bald.) Also,
do you think it would be ok to switch to a different stimulant and
not have this happen again? Thanks, S "

Dr Peter H. Proctor, PhD MD answered:

I have not heard of Ritalin causing hair loss. So I cannot answer
your questions precisely. However, an increased rate of diffuse
hair shedding is more often caused by stress-loss than by pattern
balding.

Miriam DeJesus asked: "Recently, i have bought
an at home relaxer. while applying the formula, to the roots
first, i began to feel my scalp burning. it was an intense burn
but i insisted on finishing the product on my hair. after about 10
minutes of this burning, i finally washed off the product from my
hair. i expierenced a mass amount of hair loss while rinsing. but
the worst part is, is that after drying my hair, the roots seemed
to be very badly burnt. The hair is very stiff and feels as if i
have added extensions. Just when i was combing my hair, a clump of
hair had detached itself from the end of my hair when the burned
part began. i am afraid that everywhere my hair is burned, the
hair will break off eventually leaving me with nothing. What can i
do or apply to my hair to prevent any further hair loss. "

Dr Peter H. Proctor, PhD MD answered: "Most likely, it
will eventually grow back. But you need to see a local physician
about this.

steve asked:

Steve asked: "Good morning Dr. Proctor. I have a question about the effectiveness of
Finasteride. I've read (and experienced myself) that Finasteride
will stop the hair loss in many users. However, for many, this
effect will last for only some time (a few years) and then the
effectiveness of Finasteride will begin to decrease, and the hair
loss will slowly resume. Why would you think this happens? Do our
bodies eventually adjust and adapt to the medication? Thank you
very much. " Dr Peter H. Proctor, PhD MD answered: "Yes,
many persons no longer respond to finasteride after a few years.
We don't know why exactly why. The exact reasons are likely
complicated. I am sorry for pressing the point. It's just that I
have a brother whose results with Finasteride has only gotten
better and better over the years; where as for me, the response
has decreased to the point where Finasteride seems completely
ineffective. Just for speculation sake, would you think that it
has something to do with the immune system somehow
adjusting/adapting to the medication? Thank you for your response.
"

Dr Peter H. Proctor, PhD MD answered:

Most likely, it is for several different reasons. E.g., antiandrogens
stop working in prostate cancer for a complex number of reasons.
One of these is that the tissue become more sensitive to
androgens. Other reasons are that the follicular damage, fibrosis,
etc, may progress to the point that the follicles no longer
respond to stimulation.

rehan asked: "dear dr, im suffering from mild hairloss in the
frontal part of my head at the young age 19.(i dont have any bald
spot as such just a little scantier hair in the frontal region,ON
THE WHOLE I GOT THICK GROWTH). i wanted to know that is there any
way i can know for sure whether im suffering from mpb or
not..>??(my dad started balding at the age 40) ive been to my
GP recently and (previously 5 months back been to a dermatologist
) but to no good avail. DR MY HAIRLOSS IS VERY MILD AND JUST TO
EXPLAIN YOU THE PATTERN IT IS OF TYPE 4A.(MOST OF MPB CASES I VE
NOTICED OF MPB IS OF TYPE 2)(HAMILTON SCALE). GETTING MPB AT SUCH
A YOUNG AGE SHOCKS ME..THATS WHY I TURN TO YOU TO HELP ME DIAGNOSE
MY CASE.(I KNOW FROM SUCH A DISTANCE YOU CANNOT COMMENT BUT CAN
YOU TELL ME SOMETHING SO I CAN HELP ME DIAGNISE MY CASE.).like
could this be hairloss due to stress,dandruff,or longstanding
intestinal tract infection. i have high regards for you dr.thank
yoou in advance."

Dr Peter H. Proctor, PhD MD answered:

Most likely, you have pattern loss. This is because it is by far the
most common cause. But obviously there is no sure way for me to
tell. I also caution people in their late teens to early 20's not
to mistake the normal transition from a teen-age/female hair line
(straight across) to the adult hair line ( with temporal
indentions). This may progress and then just stop. In my opinion,
it does not need to be treated.

Steve asked: "I am 20 years old and I want to become a TV news
personality. I am one year from graduating, and I am experiencing
hair loss badly. I talked with my doctor and I began taking Rogain
about 6 months ago and I have seen great resutls in the vertex and
mid-scalp area. However, I continue to have a receeding hairline.
Not having a full head of hair could really hurt my chances of
full-filling my dream of being a news anchor. I am very
self-conscious of this issue. I can handle losing my hair....as I
get older....but not as this point in my life. Im only 20 years
old and I feel so lost. Please help me with any tips/treatments
you can recommend. "

Dr Peter H. Proctor, PhD MD answered:

See www.drproctor.com/baldfaq.htm
for a discussion of possible treatments for balding and how they
work. Even minoxidil alone will often stop progression, at least
for a while.

Tom asked: " Dear Doctor: What is the benefit to a 5AR type I
inhinitor as it pertains to hair growth/cessation of loss? Thank
you!! -Tom. "

Dr Peter H. Proctor, PhD MD answered: "We don't know.
There is very little type-1 5 Ar in the hair follicle. So if these
agents help, it is likely indirectly, say, by supressing oil-gland
activity. Dr Proctor"

kcee asked: "Dr. Proctor, Would using NANO shampoo yield the
same results as using Rogaine? I would rather use it if it would,
as I seem to get scalp irritation now from using Rogaine. I have
used your NANO shampoo before and like it, but discontinued
because of the cost of my various efforts to retain my hair
(propecia, Rogaine, etc). However, if NANO would work on the
nitric oxide area of the hairloss battle as well as Rogaine, I
would begin using it again to avoid the scalp irritation. Thanks
for your time."

Dr Peter H. Proctor, PhD MD answered: NANO
shampoo can act as a substitute for Rogaine. It also compliments
it, as it does other treatments.

Stephany asked: " My boyfriend has a very small bald spot on the
back of his scalp that has just become evident in the last couple
of months or so. No hair appears to be growing. Can you tell me if
this is serious and what it could possibly be. "

Dr Peter H. Proctor, PhD MD answered: "Might be alopecia
areata, but you wold need to see a local dermatologist for this.

Charles Paulson asked: " What is the theory of using Clomid
for MPB? Aromatase inhibitor? I presume you do not recommend
it."

Dr Peter H. Proctor, PhD MD answered: "No I do not.”

Jeremy asked: "Dr....I was just curious if you have heard about a
very high end shampoo, conditioner, follicle booster called
Alterna Restore? It supposed to wash away DHT from scalp. A friend
of mine's mother was losing her hair and tried everything with no
results. Then she tried the Alterna restore and supposdley it all
grew back. My assumption is that these type products work better
with stress related hairloss. What are your thoughts "

Dr Peter H. Proctor, PhD MD answered: "Never heard of
it, Sorry. BTW, "washing away DHT" makes no scientfic
sense. Not that the stuff might not work some, lots of things do
at least a little. Just that this is not how it works.

Peter H Proctor, PhD, MD
www.drproctor.com

CC
asked: "About 7 yrs ago I started to notice eyebrow loss
accompanied with tiny "water blisters" in the eyebrow
area. The blisters eventualy went away...but so did ALL OF my
eyebrows (both sides). What in the world happened? I was never an
"eyebrow plucker" ...so why did this happen? After
searching online under eyebrow loss, I have never seen another
situation such as mine. Is this something that you have heard of
before? If so...what is this condition?"

Dr
Peter H. Proctor, PhD MD answered: "There is no way
for me to tell. Alopecia areata and seborrheic dermatitis are two
possibilities. Dr Proctor

pickens
asked: "Dr. Proctor, thanks for your time. I am about to
start propecia, normal regime and after reading some posts on the
site, I have a few questions. Everything that seems to be a
negative about propecia is related to reflex hyperandrogenicity,
along with a users most recent post, about a small cancer risk.
What is exactly relex hyper.? I tried to look it up, but had
trouble understanding some of the medical terms. Do you think you
could dumb down a definition for me? Am I right in assuming that
would hear more about the cancer risk if it was not rare, and most
importanttly are there any ways to avoid the reflex hyper. side
effect. I can not tell you how much this forum helps me out.
Thanks again. "

Dr
Peter H. Proctor, PhD MD answered: "

Clinically
significant reflex hyperandrogenicity is rare with 5-AR
inhibitors. A more likly side effect is the opposite-- decreased
sexual function and libido, etc.

But
to answer your question, "reflex hyperandrogenicity" is
the reflex increase in testosterone levels and tissue sensitivity
to androgens that occurs with antiandrogenic treatment in general.
In prostate cancer treatment, it limits the effctiveness of the
powerful antiandrogens used to treat this disease. So patients are
generally castrated.

Some
increase in testosterone levels does occur with finasteride. It
may even help minimize the sexual side-effects. But it generally
does not result in hyperandrogenic side-effects. Further, the hair
follicles are specifically "protected" against the extra
androgenic activity. As for dutaseteride, it is a stronger
antiandrogen and thus produces more relex hyperndrogenicity than
does finasteride. Nbldy knows whether this is
clinically-significant.

steve
asked: " Dear Dr Proctor, my question is if in the future
can someone have a hair transplant using someone elses hair as a
donor and when?"

Dr
Peter H. Proctor, PhD MD answered: "Can't say. Sorry.

Question
ID:6964 | Sebum
and hair loss. | Asked
on 10/14/03

Sanka
Liyanage asked: "My scalp is really oily and I think
it is leading to my hair loss. Will takking propecia work for me?
If not what can I take. Can you get back to me at your immediate
conveniece. Thank you. "

Dr
Peter H. Proctor, PhD MD answered: "No way to
specifially say what treatment will work other than just trying
it.

Peter H Proctor, PhD, MD
www.drproctor.com

Elior te asked:
"greetings during the past year my hair stopped growing,
it grew for a year before it stopped. the reason im asking you
this is because every time i touch my hair 10 hairs fall off of it
and i didn't know who else to turn to. can this be explained?
"

Dr
Peter H. Proctor, PhD MD answered: "This is far too
complex an issue for me to say much here. You need to see a local
physician. Also, understand that the normal rate of hair loss is
50-100 hair per day. This can sometimes seem like an awful lot.

Lee
asked: "Hi doctor in your reply to post 3861, you noted
that it is advisable to skip propecia every forth day. I just
wanna know whether this regima is to prevent our body system to
build up the resistance against the substances of propecia
rapidly. Thanks Lee"

Dr
Peter H. Proctor, PhD MD answered: "Na. It is just
because it gives the same integrated does that you get from
propecia. Pyurely arbitrary, almost certainly does not really make
any difference.

jason
asked: " Hi dr Proctor Im wondering can daily use of minox
5% in the frontal hairline area temps etc..result in halting
hairloss there?..as long as u continue to use..or will u still
rcede..and what are the statitics on this..thank you"

Dr
Peter H. Proctor, PhD MD answered: "

At
least for the near term, minoxidil is about 80% effective in
preventing progression of hair
loss. Perhaps even a bit more...

tom
asked: "is there any dr who performs an FUE session which
leaves the patient with no scarring and no loss of donor hair ? if
so, which one ? "

Dr
Peter H. Proctor, PhD MD answered: "No.... If there
were such, everybody else would soon be using his techniques. Dr
Proctor

T-Mizzle-Clizzle
asked: "Hi, i have some confusion over the issue of the
use of SOD treatments and anti-oxidants in conjunction with
Minoxidil. Would Nitric Oxide created through the use of Minoxidil
or NANO or Proxiphen not be recognised by any anti-oxidant or SOD
as a free-radical and therefore scavenged as it were, thereby not
able to exert its effect upon hair growth? Is it therefore
counter-productive to use something like folligen or GSE or
Proxiphen, or basically ANY anti-oxidant / SOD in conjunction with
minoxidil, or even at all full stop? Thanks in advance for any
advice. T."

Dr
Peter H. Proctor, PhD MD answered: "

Minoxidil,
NANO, etc. do not "create" nitric oxide. Rather they
contain the nitric oxide chemical group, which fakes out the
various nitric oxide receptors becaus it looks sterically like
nitric oxide.

This
NO chemical group is not released and acts chemically rather
different from nitric oxide itself. Also, low levels of nitric
oxide prevent the production of potentially high levels of nitric
oxide involved in the immune response. These low levels are what
act as messengers for stuff like hair growth.

Superoxide
both destroys nitric oxide and converts it to
chemically-destructive compounds. SOD's, etc. prevent this

jason
asked: " Hi Dr Proctor. I asked u whats the chances of
going from a norwood 2 to 2.5 with minox..u said less than 10% but
what if i use an anti-androgen like 17a or spiro as well daily..do
my chances increase by alot?"

Dr
Peter H. Proctor, PhD MD answered: "

It
may help some, raising your chances from less than 10% to (say)
10-15%. But it is still very difficult to bring a hair line
foreward. If I knew anything that consistently did this, I would
sure be using it on my patients. True, a small chance is better
than no chance. But it is best to treat growth in front of a hair
line as a bonus and no a primary goal of treatment.

frank asked: " hi doctor proctor. i have had no
sucess with 5 % MINOXIDOL do you think 15% minoxidol will help,
also any more topicals on the horizon. thank you"

Dr
Peter H. Proctor, PhD MD answered: "....

See
www.drproctor.com/baldfaq.htm
for more possibilities in hair loss treatment.

jason
asked: " Hi Dr Proctor Im considering starting minoxidil
for my frontal recession..what are my chances of getting back to a
norwood 2 being im a norwood 2.5 with the use of minox 5%
daily...statically speaking"

Dr
Peter H. Proctor, PhD MD answered: "..

....The
general rule of thumb is that medical treatment only rarely moves
hairlines foreward. With minoxidil alone, the chances are less
than 10% or so.

nadia
asked: "Helo, my 13 years old girl had started to lose
hair around one area in her scalp (at the back top of the head )
and this is worried me alot . to give u history information about
her ; *Her Grandmother " had little hair in her scalp and her
grandfather is bold as well as her father so we can say its
genetic from her father side " i have a good healthy hair
thou.". *she had a dandruf broblem 2 years ago starting from
one area in the scalp " the back of the head close to the
neck which is not close to the are where she is having the hair
loss now".She has been treated for this and the dundruf is
getting less now. *she used to wash her hair daily " still"
and dry her hair with the dryer , and using an antifrezz products
. Please help coz this makes me worried alot. thank you Nadia
"

Dr
Peter H. Proctor, PhD MD answered: "

...She
needs to see a local dermatologist. For one thing, 13 years old is
far to young for pattern loss, particulalry in a female. She may
well have alopecia areata.

Tom
asked: "Dear Doctor: I am using a regimen consisting of
many different products to reduce my hair minituriation. .5 mg
Avodart, 2-3000mg Lysine, Revivogen 1x per day with the shampoo,
and I alternate between Nizoral 1% Keto and T-Gel shampoo. Now, I
understand that if you stop taking the Avodart, just like
Propecia, the effects will be lost after a period of time. If I go
a week without the Revivogen, or without any DHT reducer, is that
enough time to have the levels of DHT go back up, or will the
avodart be powerfull enough to keep them down? THANK YOU! -Tom.
"

Dr
Peter H. Proctor, PhD MD answered: "

Unfotunately,
I do not know what Revivogen is. So I cannot comment. As for
avodart, like everything
else, if you stop hair
loss treatment, you will lose what you have gained. If there
were any exceptions, I would certainly be using them in our
formulations.