Hair Loss From Steroids.com
The #1 resource on the Internet to learn about and prevent androgen-related hair loss.
Information based on academic, professional and nearly a decade of personal experience.
I am not a doctor and this is not medical advice. Neither is this an acceptable alternative for the opinion of a physician. The is merely my 10+ years of experience combating androgen-related hair loss and the clinical research I have gathered..
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My Youtube Channel -------------------------->
Lots and lots of videos about hair loss, my experience,
how to stop it and encouraging potential regrowth.
Low Level Laser Therapy (LLLT)
Low level laser therapy was approved by the FDA for treating hair loss in January
2007. People undergoing treatment can use laser helmet and laser hoods at doctor's
offices. Smaller hand-held commercial are devices sold as well.
How it works
Low powered lasers stimulate hair and scalp tissue by activating ATP, protein
synthesis, and androgensis. The hair cycle remains the same but the added
stimulation encourages hair growth and in some cases, hair regrowth.
An increasing body of peer-reviewed clinical trials have allowed certain laser devices
to earn FDA-approval.
One of my hair restoration doctors, Dr. Glenn Charles, is one
of the biggest advocates of low level laser therapy and presents the findings on
a 2003 study that examined a specific device that what was later commercially
released as the "Hair Max Laser Comb".
Results of the 5 subject examined are found on the table (appendix 3, table 4)
to the right. All subjects increased their previous hair count over a 6 month period.
As noted in the product recommendations, I was initially very skeptical of low
level laser therapy, or frankly any "devices" that promise to promote hair growth
or prevent hair loss. After my latest hair restoration surgery in April 2010, I had
the opportunity to try low level laser therapy to encourage healing and new hair
growth. Found the $250,000 laser device quite effective.
I was recommended the X5 Hair Laser by Spencer Forest and believe it is very
effective to stimulate hair growth in follicles that might have shed or would
otherwise remain dormant after exposure to high levels of androgens.
Like many cutting-edge products, quality matters - don't buy a cheap laser if you get one.
There was a product that was once available on eBay called "The Amazing Hair Laser Brush" that followed the FDA-approved blueprint and had legitimately strong and safe lasers. That product was discontinued however after some copyright issues.
Ketoconazole was [and still is] an ingredient that is included in powerful anti-dandruff shampoos to combat dermatitis. The ingredient also has anti-androgen potential and can topically inhibit DHT. It is available in Nizoral and Revita shampoo, in 1% and 2% strengths.
How it works
Ketoconazole, if allowed to sit, will absorb into your scalp and help block the formation of DHT.
Ketoconazole is also clinically proven to stimulate hair growth according to a 2005 study in the "Journal of Dermatology" conducted by the Division of Biomedical Imaging Research at Graduate School of Medicine at Juntendo University in Tokyo, Japan.
I believe that ketoconazole shampoo is a good choice to include as part of a stack to prevent hair loss.
I lose less hair in the shower when I use ketoconazole shampoo on a semi-regular basis.
For a lot guys, ketoconazole is a God-send and nearly totally prevents hair loss.
Although I did not have those "amazing" results, I still recommend that you try it and definitely use it if you are using steroids and want to prevent alopecia.
Nizoral is the ketoconazole shampoo that most people use.
Nizoral is a very powerful anti-dandruff formula and gives a lot of guys dry scalp.
It has ingredients that help the ketoconazole absorb better and you can use it everyday since it won't dry your scalp out.
Hair Loss Prevention: What is Currently Available to Treat Androgenic Alopecia
...and the science behind it.
Minoxidil, the generic name for "Rogaine", was the first FDA-approved treatment for androgenic alopecia.
It is a topical formula that you apply to thinning areas or any areas that may be prone to hair loss.
How it works
Although minoxidil has been approved for the treatment of male and female pattern baldness since the early 1990s, how it works is still debated by researchers and scientists. Most doctors believe that minoxidil acts as a 'vasodilator' and widens blood vessels and opens potassium channels which allows a greater amount of blood flow, oxygen, and nutrients to reach the hair follicle and the hair shaft that is being "suffocated" by DHT.
I must have tried 20 different minoxidil formulas, from high-quality 15% minoxidil to Rogaine form to inexpensive 5% minoxidil from Costco. I believe that minoxidil is effective for slowing down hair loss and hair loss from steroids.
I lose significantly less hair when shampooing if I have been regularly using minoxidil.
men who used 5% minoxidil over the course of one year reduced the amount of hair loss they experienced while
washing from [a mean of] 69.7 hairs to 33.8 hairs. Over a 100% reduction in hair loss, if you are into "numbers".
This mirrors my experience too, I lose nearly twice as much hair if I am not regularly using minoxidil.
I also strongly believe that the quality and strength of the minoxidil solution is significant.
If you are using steroids you should definitely use 15% minoxidil unless it irritates your scalp too much.
You can return to the 5% minoxidil when you discontinue steroids.
This is the product that I use, I consider it the "single best product" to prevent hair loss from steroids:
Finasteride (Propecia or Proscar) - By Rx Only
Finasteride, the generic name for "Propecia", was the second of two FDA-approved treatments for androgenic alopecia.
It is a pill that is available by prescription only for men.
How it works
Finasteride helps prevent hair loss by reducing the amount of DHT that is in your body. As of July 2011, DHT is thought to be the primary catalyst to genetic pattern hair loss in those predisposed to androgenic alopecia. When you reduce your DHT levels, hair follicles, that would otherwise be attacked by DHT will get the chance to survive. Additionally, if you lower your DHT levels, hair follicles that were previously under attack may be able to return to their prior size and thickness, provided the hair follicle is not too thin. The International Society of Hair Restoration Surgery further details the role of finasteride in combating androgenic alopecia.
The American Hair Loss Association reports that according to a Merck study, the manufacturer of Propecia: 1mg of finasteride can lower your DHT up to 60% which stops the progression of hair loss in 86% of men. Although this Merck study, highlighted here, has been debated, the pharmaceutical company won FDA approval of Propecia with their clinical study. The American Hair Loss Association considers finasteride to be the single best option for prevent androgenic alopecia from the natural conversion of testosterone to DHT.
If you are prone to male pattern baldness, taking finasteride is a must if you want to prevent hair loss from steroids. Please be aware that finasteride will only prevent hair loss from testosterone-based steroids and will not reduce DHT or prevent hair loss from androgens, such as Dianabol or Trenbolone that convert to DHT by other means than the 5AR reductase.
For every 250mg of testosterone that I would take, I would take an additional 1.25mg of finasteride.*
* This was my personal experience, clinical research suggests that just 1mg should reduce your DHT by ~60% regardless of the amount of testosterone you are taking.
I highly encourage you to get a prescription for finasteride from your doctor and get it from an American pharmacy.
Products from international pharmacies and "research" chemical vendors were simply not as effective for me.
Finasteride is a lifetime commitment, but a worthwhile one.
Azelaic acid is an extremely weak acid which can be applied to sensitive skin (or the scalp) for the purpose of inhibiting both type-1 and type-2 DHT. It is often included in many prescription and commercial acne medications and treatments (DHT plays a significant role in acne). It is also considered a viable treatment for rosacea and cases of hyperpigmentation. Azelaic acid is sometimes included in higher-quality commercial minoxidil solutions.
How it works
Azelaic acid is topically applied to your skin or scalp and transdermally penetrates below the surface where it can inhibit unwanted DHT. It is different than finasteride which systematically inhibits DHT throughout your entire body. In theory, azelaic acid will only inhibit DHT below the skin surface to which it is applied.
In a study published in the 1998 "British Journal Dermatology," British and French scientists concluded that azelaic acid was capable of inhibiting up to 100% of type-1 and type-2 DHT when topically applied to human skin. This study, detailed on Hairsite, drew quite a bit of attention. Their azelaic acid also included zinc sulfate [sulphate]. As of July 2011, however, no peer-reviewed clinical studies have confirmed the effectiveness of Azelaic Acid in treating androgenic alopecia.
I believe that azelaic acid is the very best anti-androgen for topically inhibiting DHT. It can inhibit both type-1 and type-2 DHT, making it useful for combating hair loss from steroids such as Dianabol, Trenbolone, and other steroids that convert to DHT via other means than the 5AR reductase. It is no surprise that azelaic acid is included in acne preventing solutions.
It is the best topical compound to prevent hair loss from steroids.
Oddly azelaic acid does not receive a significant amount of attention for its potential as an effective topical anti-androgen.
Especially considering that it is clinically proven to inhibit up to 100% of DHT below the skin's surface.
I believe azelaic acid is not often discussed because only recently has it been included in high-quality formulas that include a carrier that allows azelaic acid to penetrate to the receptor sites of scalp DHT.
It does work. Big time.
I encourage anyone seeking to prevent androgen-related hair loss to use a high-quality azelaic acid formula.
Spironilactone or "spiro" was originally prescribed as an oral 'potassium sparing diuretic' used to treat hypertension, also known as high blood pressure. Recently has received a good deal of attention for its potential as a topical anti-androgen that can inhibit DHT when it is applied to the scalp. Commercial formulas include 5% spirolactone in a cream or lotion. Cheaper formulas offer spirolactone dissolved in a liquid solution that can be applied to areas of thinning area.
How it works
There remains some debate on how topical spirolactone functions as an anti-androgen. Topical spironolactone is applied to your scalp and transdermally penetrates below the surface of your skin where it can block DHT receptors and prevent circulating DHT from attaching to scalp hairs. Spiro, unlike azelaic acid, does not inhibit DHT but rather blocks the receptors that may absorb it.
You may be surprised to learn that topical spironolactone has been used since the late 1980's to inhibit DHT. In a 1988 clinical study published in the "International Journal of Tissue Reactions" by the Department of Dermatology at the University of Pavia in Italy, Italian researchers found that spironolactone, when applied topically, was significantly effective at blocking DHT receptors. Unfortunately, I cannot confirm the ~80% reduction active-free [not just circulating] DHT figure that many people claim. Hairsite details the 1988 Italian study.
Unfortunately, topical spironolactone did not work for me.
I tried numerous formulas including Dr. Lee's high-quality 5% spironolactone lotion and 2% liquid topical that were formerly available.
For years, I would apply it to my hairline and it did absolutely nothing.
Eventually I got my hair line restored, and that is what you see in the videos.
So I cannot recommend spiro to prevent hair loss.
A lot of guys report success with spiro, so maybe it's worth a try. But I can't honestly recommend it to you.
I believe azelaic acid is a far better choice because it directly inhibits DHT, instead of blocking the receptors.
Theoretically you would have to block your DHT scalp receptors and keep them blocked.
Maybe that is possible with spironolactone's reasonably long half-life.
Maybe some better quality topical spirolactone formulas, with better transdermal carriers, will become available in the future.
For now, stick with azelaic acid to inhibit scalp DHT.