MY EMAIL CONVERSATION WITH DR.RICHARD LEE

[melchiangmai]

Hi guys,
I talked to Dr.Lee about some issues and thought it might be interesting to share. I put *** in front of his reply.



I have general diffuse thinning all over and hairline has receded about 1.5
cm. So lets say I'm a NW 1.5 Someone having a quick look would not notice I have MPB

My current regimen is as follows:

Propecia (doesn't seem to work for me although used it over a year before the minox)
Nizoral shampoo
Regular Minoxidil 2%

*** You could improve your chances of reversing hair loss, if you increased the strength of minoxidil to 5% or higher.

I would like to add Spironolactone only to the hairline. Do you suggest the
2% or 5% formula?

*** 5% formula after you have applied 5% minoxidil or higher to the same affected areas.

In regards to the medication, I have heard that a minimal approach is good, meaning slowly add products to the MPB fight as its a life long fight. Do you agree with this?

*** Not really. Each patient has to be treated as best suit his needs. If a patient has advanced loss, it may take very aggressive measures to reverse the loss.

So basicly, here are 2 questions:

1) Do you think I should apply the Spiro just on the hairline and save it
later for the other parts or should I start applying all over the front,
temples, and crown too? As I mentioned, I thought slowly adding products
would be a good approach but its better to ask you.

*** Apply it to the affected areas.

2) Do you think starting low with a 2% minoxidil is a safer strategy rather
than jumping right away into the 5%?

*** Success with minoxidil is dose dependent.

I've heard from many that the drug loses its effectiveness after a while so it might be better to start low and work my way up.

*** There is plenty of bad advice on the internet forums, and there are a lot of misconceptions about minoxidil and 'tolerance'. Minoxidil will help to recruit atrophic follicles to grow thicker hair again for about two years (sometimes as long as three years). Beyond that time, it continues to help keep the hair in the anagen phase, so the new hair has a longer anagen phase.

***But, because most patients do not see any significant 'improvement' after a few years, they are assuming that the minoxidil has caused a tolerance and is no longer 'working'. If they are unfortunately convinced to stop minoxidil treatment, the hair that they have regrown will shed again in 3-4 months.

I thank you so much in advance for checking on my questions for me.

*** You are welcome,
Richard Lee, M.D.

[HairLossFight.com]

This is very informative. Thanks melchangmail.