In My Late 40s and Propecia Gave Me a Decreased Libido – Hair Loss Information – Balding Blog

I am in my late 40s and have receding hair and a slight thin spot at the crown. I’ve been taking Propecia for about 2 years now and while I haven’t noticed any hair growth, my hair seems to stay consistent. I am, however, unhappy with the decreased libido side effect. I would like to stop taking Propecia and try Rogaine or saw palmetto.

Would you advise this and if you would, should I stop the Propecia cold turkey or gradually stop it?

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PropeciaI can’t advise someone that isn’t my patient to start or stop a prescription medication, which is what Propecia is. I can just give general advice. There’s no weaning process when stopping the medication, but please talk to your prescribing physician about the best way to change your dosing. There’s a couple points you might be aware of, but I feel I should highlight for you just in case:

1. Any benefits you’ve seen from Propecia will start to disappear within months of stopping it, so if you want to try to maintain the consistency you’ve seen you might wish to ask your doctor about taking a lower dosage (some Propecia is better than none) to see if that helps with the side effects.

2. It’s also possible that the drug itself isn’t the cause of your lower libido and there’s another issue coincidentally going on. Stress, anxiety, and age can also be reasons for a lower libido. People seem quick to point the finger at medication first, but in reality people that don’t take medications still have these same issues every day.

Propecia is entirely elective medication for a cosmetic issue (you’re not going to suffer health risks by stopping it), so ultimately it’s up to you whether you want to take it or not.

Is FUE or Strip Better for Asians? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I’m considering getting a hair transplant and I need your opinion. I am asian and was wondering which suits better for asians FUE or the strip harvesting method? I am hearing mixed comments. FUE less scaring for asians. strip harvesting higher chance. from your experience which is better for asians?

Thanks!

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Both the FUE technique and the strip technique have their own pros and cons, and there is no correlation with Asian hair. The type of surgery is based on each and every individual. FUE is best to use with smaller areas and when the density of the hair is good. The strip can be used almost on any good transplant candidate. FUE is not the latest and greatest that some clinics claim it to be and for those individuals with extensive hair loss, it is clearly not the procedure of choice. That is why patients like you are confused about these choices.

As an example, many Asian patients have surgery with Dr. Pak and most of them have the traditional strip surgery with great results. One of the more public examples of such a patient was Jon Gosselin (he had the strip surgery).

I Wonder If I Should Even Be Taking Finasteride – Hair Loss Information – Balding Blog

Hi Dr.
I have enjoyed reading your blog. Throughout my life I have had thin hair but it has never bothered me. If I could keep it at the density that it has been I would be happy. Male Pattern Baldness does run in my family (especially my moms side) and a lot of my cousins have already decided to shave their heads. I have been lucky so far and am at an older age than they were when they started to thin. I thought I had dodged the bullet but I received a shorter than usual haircut this summer and noticed my hair looked a little thinner than usual.

I was into a dermatologist within a week and onto finasteride which helped me mentally more than anything. I still have a full head of hair and the only person to notice it looking thinner so far is me. As time goes on I wonder if it is really appropriate for me to be taking finasteride. Do you have an opinion on this? I have an appointment with a reputable hair restoration surgeon in a month. I made this appointment mostly to have someone tell me if I am really thinning and to make some kind of a “master plan” if I am. Surgery is nowhere in the plans for now.

My main concern is that I could possibly damage my hair by taking finasteride if infact it isn’t necessary. Any information you have on this would be greatly appreciated. Thanks again for your very informative blog.

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Taking finasteride will not damage your hair, but you should not be taking finasteride if you do not have androgenic alopecia. There’s no reason to take unnecessary medication, and your doctor will be able to tell you if Propecia is helping. Perhaps your haircut didn’t reveal anything new, but it’d been so long since you’ve had it cut that short that you forgot what your short hair was like? I don’t know…

Really what you need is a good diagnosis, and after you have that, then you can discuss the treatment options and your ‘realistic’ ultimate goal with your doctor to see if Propecia will help.

Renokin – Hair Loss Information – Balding Blog

Hi,

Dr Rassman, you are really doing such an amazing and praiseful work.

I just wanted to know your thoughts about Renokin, it claims to create new hair follices and arrest hairloss. here is the link to their website

Thanks!! looking forward to your response.

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RenokinI’m not sure what to think of Renokin. It’s a new product that consists of three steps (shampoo, conditioner, spray) and claims to regrow hair. I’ve seen so many that follow this same structure of outlandish claims, little evidence, and nobody taking these to task. Whether it works or not, I couldn’t say. I’ve got no experience with it and it is apparently quite new to market. The product is being sold as a cosmetic, not a medication, so there are less legal boundaries that the company needs to deal with when selling it. In other words, they aren’t under the strict guidelines that a drug company must fall under to prove the product does what it says.

I do talk about Propecia, Rogaine, and their generics (finasteride and minoxidil), because they are the only proven medications that work for treating hair loss. Even these medications do not cure or stop hair loss completely, though. To many hopeful readers I probably sound like a sour-puss, because I do not believe in most of the products that are sold with claims of halting hair loss or regrowing hair. Fair enough. If I see satisfactory evidence to the contrary, I’m fully willing to change my tune… but this is my blog and my opinions from years of being in the business of hair loss.

If you wish to try Renokin or products like it that offer more marketing than substance, please do so at your own risk… the risk being your bank account most of the time.

Generic Propecia in Canada? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I just wanted to say how much I enjoy your site. I have been following it for years.

I had a quick question. I recently went to my pharmacy in Canada to refill my Propecia prescription, and they informed me that a generic 1 mg form has become available. I was under the impression that the patent was scheduled to expire in 2013 (similar to the US). Sure enough, I picked up my prescription, and it was 1 mg of finasteride. I am sort of surprised by this, and I was wondering if it’s possible to make sure my pharmacy didn’t make an error, giving me a 5 mg tablet by accident? Is there any way to find out when the Propecia patent expires in Canada?

Thanks for all your help over the years!

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CanadaI honestly don’t understand the prescription drug patent process in Canada. I assumed it was similar to the US law, but a quick Google search shows that the generic Propecia (1mg finasteride) is being sold online in Canada. Buying these medications in the US from an online Canadian pharmacy isn’t legal, but that hasn’t seemed to stop these pharmacies for quite some time. I don’t condone it, in case anyone was going to ask.

So either the patent already expired in Canada or there’s some other reason that the various online pharmacies are selling the 1mg dose in a generic form. That is good news for everyone except Merck in the United States. If anyone has further info about this, please let me know.

Did Spectral DNC-L Cause More Hair Loss and Would Stopping It Regrow that Hair? – Hair Loss Information – Balding Blog

I’ve been using “Spectral DNC L” for almost 4 months now on my hairline and temples as I had noticed them very slowly receding over the years. The main ingredient is DHT inhibitors and Minoxidil along other ingredients that they say will grow hair all over the scalp including hairline and temples.

After the first month I experienced shedding at the temples and hairline. The hair shedded looked thick and healthy and after 5 weeks people were noticing I was thinning at the hairline and temples which they had never noticed before. I’ve continued applying it as I was told it’s natural for shedding to occur before new hair would grow. It’s now week 15 and all I have managed to achieve is to shed strong healthy hair to be replaced by very thin lifeless hair that is small and hard to detect giving a general appearance of a fast receding hairline.

I have persisted with Spectral DNC L in the hope that something will grow back and the hair will get thicker but at the moment I think that prognosis is poor. My question to you is that if I discontinue with Spectral DNC L, assuming that it was the minoxidil component that caused the shedding, would my hairloss revert back to the stage it was at 15 weeks ago before I started topical treatment.

In essence would the few fine lifeless hairs that have been grown due to the treatment drop out and would the stronger more numerous healthy hairs grow back that I had before the Spectral DNC L application 15 weeks ago. I ask this as many people say that if you cease a minoxidil treatment, within several months your hairloss would revert back to it’s original stages. In my case an increased volume of hair to the point that no one would have noticed my receding hairline. Perhaps I have just accelerated my MPB with Spectral DNC L and lost healthy hair through shedding in weeks that may have remained with me for another year or more.

In effect if my hairline doesn’t grow back to the condition it was before I took the Spectral DNC L then in my case it would be reasonable to suggest that, assuming minoxidil is the active component; “Spectral DNC L not only has no affect on improving temple and hairline baldness but actually accelerates hairloss replacing healthy hair that was shed with at best, semi visible thin lifeless hair”. Should I continue in hope for another few months or give up.

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Spectral DNC-LI can not really advise you. The impact of minoxidil is as you describe, but the Spectral DNC product has other ingredients that may change the impact when combined with it. You might switch to just minoxidil and see what happens over the next couple of months.

Experimenting with what you are doing is about the only way you will know… and experimenting means that there is risk. Do you have a good doctor? You might want to see him/her!

Clumps of Hair Clog the Drain – Has Propecia Become Less Effective? – Hair Loss Information – Balding Blog

Dr. Rassman,

I have been a patient of yours for over three years now and I recently visited your office back in August. After seeing you again it was established that my hair loss had not progressed from last year and had possibly even improved. Unfortunately, over the past month, I have been experiencing non characteristic loss. When I am in the shower, I have never ending clumps of hair coming of my head and clogging the drain. Also, when brushing my hair there is even more loss. Dr. Rassman, this has never happened before and I have no idea what to do. Is it possible that the Propecia that I have been taking since November of 2005 has stopped working for me and my genes are taking over?

All of the loss has been occurring since I have been out of town on a job. I seem to even have some kind of infection on the corners of my lips. I am sure the two things are not related, but I figured I would tell you.

Anyway, is this a normal experience for someone on the drug as long as I have been? Should I take more of it? Is it possible for a person to lose all of his hair immediately? Could this be a possible hair cycle or allergy? Again, I have no idea what to do and what to expect. I appreciate you taking the time to read this and your advice/help would be greatly appreciated.

Thank you and looking forward to hearing from you soon!

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Hair loss can increase from stress amongst many other things, such as the normal acceleration of hair loss that occurs in some men (even those on Propecia). As one of my patients, please come see me and let me see if your miniaturization has increased.

Cutasil – Hair Loss Information – Balding Blog

Dear Dr. Rassman,

I was wondering if you were aware of this product, Cutasil.

The website says it’s set to be marketed in a year, and that it heals scar wounds and restores the follicles. Could this have application to improving transplant procedures?

Thanks for your input

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CutasilThere are hundreds if not thousands of new products for treating hair loss all with the promise of growing follicles. Some include wound healing claims as well. I really do not know anything about this Cutasil product as it hasn’t been made available for testing or review and the link you sent has the only info I can find about it.

I appreciate you bringing it to my attention, but there are so many product announcements that ultimately go nowhere or can’t perform nearly as well as what is claimed. This one remains to be seen, but as skeptic I’m not going to hold my breath.

At this time there is no product that reverses or grows back hair that was lost from genetic causes or helps with the transplant process. Even if there was such a product, the most important part of a hair transplant surgery is the doctor, the staff, and the highly specialized techniques involved.

Propecia Caused Side Effects – Should I Take Less? – Hair Loss Information – Balding Blog

Dear Doctor,

I am a 22 year old male who has been on Propecia for about 3 1/2 months. I have experienced a series of side effects that I believe are related to Propecia use. I list them here in order of appearance: thin/somewhat watery ejaculations (the first side effect I noticed, about a week into the treatment), loss of spontaneous erections, difficulty obtaining and maintaining erections, (the erections themselves are also weaker), and a loss of sensation in the genital area. I also believe I may have had slight penile shrinkage/penile tissue atrophy, and an increase in body hair growth.

I have become concerned about these side effects, and am pretty certain that they are not psychological, since I started Propecia being very certain that I would not suffer the side effects. I can attest that my sexual mechanism was optimal before starting Propecia, as expected for a man my age.

My question is, can I safely go off the drug? Can I expect that these side effects will clear up with time? Also, I have read about the effectiveness of reducing the dosage; what can you say about taking .5 or even .25 mg of Propecia daily? Should I switch to such a dosage now, or should I go off Propecia entirely, see if side effects subside, and start again with a reduced dosage?

I would greatly appreciate your help, as I am concerned.

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Generally when you stop Propecia, the side effects disappear in a matter of days/weeks. Along with stopping the side effects, the value of the drug and all of its benefits will produce “catch up” hair loss, which means that your hair loss status will go back to what you had before you started the drug and you’ll lose any hair you would’ve lost had you not taken the drug at all.

I’ve advised some of my patients to try a lower dosage (0.5mg is better than none) and they’ve had some success with treating the hair loss and seeing a reduction in side effects, but it’s not an across-the-board finding that I can guarantee. Keep in mind that I’m not your doctor, and any dosing changes should be discussed with your prescribing physician.