Month: July 2012

I’m 22 have some heridatory hair loss in my family.

I can noticeably see miniaturization on my hairline and the corners receding. my front hair is thin, but the rest of my hair is thick. most like norwood level 3.

I have spent hours trying to find the right product to thicken my frontal hair and too stop any further receding. but theres so many products out there I cant decide. for a young person in the first signs of frontal balding what would your advice be on a product to prevent it.

thank you

There are no products that are guaranteed to thicken the hairline, but Propecia has worked to regrow hair on rare occasions in that area. I wouldn’t count on it regrowing the hairline, though. I would expect it would at least slow the loss down (particularly in young men with early hair loss, such as yourself). It is a prescription medication and you’ll need to talk to your doctor about it.

There are a lot of products out there that claim to do things they just can’t do. After all… if they worked as claimed, you probably wouldn’t see so many men out there with receding hairlines.

I was just wondering about the doctor saying that going off the medication does not reverse breast enlargement. That is, frankly, a bit scary. Websites like Livestrong.org (not exactly Encyclopedia Brittanica but I’m tempted to trust it) say that all the side effects of propecia are reversible. Can you clarify?

Link: Livestrong.com

In my experience, the few patients who had breast enlargement did not always reverse. I find that this one complication is the most persistent of all side effects and some of the patients ended up treating the breast lumps with surgery.

I’ve been asked what it would mean if 2% of the millions of men taking Propecia had suffered sexual side effects, and some lesser percentage of these men’s side effects are permanent. This has been a hot topic that has been discussed at length, but it’s a topic that I wanted to touch on again.

I must have written prescriptions for this drug to thousands of patients and although I have seen reports of decreases in libido and ED in about 2% of patients (as expected), I have not seen one case where these side effects did not go away upon stopping the drug. A larger audience of others like myself were unofficially polled and their experiences echo mine. It is not that I doubt that these problems can persist after stopping the drug, but it seems very rare indeed.

As I’ve mentioned before on this site, one of my son’s is taking Propecia. When he compared the risks to the reward, he concluded that the benefits far outweighed the limited risk. He tells me that he’s experienced no side effects and has been on Propecia for almost 8 years or so.

Clearly, each patient must make his own decision on this matter and my position is to inform my patients of the general risk… but this risk is very, very small. Before I’m asked again, I own no stock in Merck, I am not a paid consultant for Merck, and if I was rapidly losing hair, I’d take this drug to thwart the problem.

Dr R
Perhaps a rhetorical question but…..
amid all the blog postings, magazine articles, support groups, “chest pounding”, editorials etc – why has there not been a well-controlled, scientific study that has prospectively followed a group (perhaps 200-300) of men who begin Propecia for a period of several years? This type of study can then quantify the incidence of persistent sexual dysfunction (that is said to be common), use nocturnal penile tumescence to document further; understand any baseline factors that can possible predict who is more likely to have such an effect, and explore/evaluate all the differential diagnoses that predispose to erectile dysfunction or libido problems (psychological including social issues and life stresses; concomitant medications; coexisting medical conditions such as diabetes, hypertension, lipid disorders; endocrine abnormalities including testosterone/prolactin levels; cigarette smoking; chronic alcohol use; vascular problems, etc) as well as influence of different therapeutic options.

Such a study, which could be done outside of the influence of a pharmaceutical company, seems to be able to be done by any leading urology academic center that sees large number of men placed on Propecia, and would be relatively inexpensive and noninvasive. At present, the field seems to be highly dependent upon retrospective questionnaires in men who have these effects, and an absence of extensive data.

I completely agree. We need to have a statistically valid audience for a good prospective summary. Unfortunately, that type of study will take years to obtain and someone has to pay for it.

Hi Dr. Rassman and Dr. Pak.
I had a question I recently read a question on your forum about a guy that was taking propecia/finasteride everyday and also dutasteride/avodart once a week with great results. So I was thinking of trying this regimen of propecia and avodart for a least a year to see if I works for me? Any thoughts would be greatly appreciated.

Oh and thanks for all your hard work as doctors and also for keeping this forum going strong. And also to thank you (Dr. Rassman) and Dr. Pak who has done my two procedures the most recent one being around February 2012.

And finally to all your staff which are some of the nicest people you’ll ever meet!!

First, thanks for your kind words! They really mean a lot to us.

The combination of finasteride and dutasteride statistically will produce more sexual side effects. That is the reason we generally do not prescribe it. We can discuss this face to face on your next visit.

I ordered generic propecia online and got a product called proscalpin… ever hear of it or know if people have achieved good results?

I’ve never heard of Proscalpin, but there are a variety of names the generic 1mg finasteride is sold under, mostly by pharmaceutical companies based out of India. I’m not familiar with all of the brand names, but I’ve heard of or have been asked about many (Appecia, Finpecia, Finax, Finara). The drug patent hasn’t expired yet and these generic 1mg pills aren’t legally available for sale in the US.

Based on what I found online, Proscalpin is made by an Indian company called Dadha Pharma that sells generic medications primarily for the online market. There doesn’t appear to be too much info on Dadha available online that I can find, and I’m at a loss to even find a website for the company.

So long story short, I’ve never heard of this particular brand and I have no way to know if what you’re getting is really 1mg finasteride. I don’t recommend buying prescription drugs from online pharmacies that aren’t legally allowed to sell them in the US.

Is it best for nonresponders to simply quit taking fin/propecia to have thicker hair? I’ve been taking it for about two years and continued to loose ground, but only severe thinning at the temples.

Since it is known that fin/propecia hurts the hairline, would it at least shed less after quitting the drug?

It is known that Propecia hurts the hairline? Some people have asked (through this blog) about shedding upon starting the drug, but this isn’t a typical occurrence and doesn’t seem to be limited to just the hairline.

You are asking me to give you advice on whether or not to take a prescription drug — something that I do not do. There may be answers to your situation (such as taking dutasteride), but I would insist on a bulk metric measurement before you were put on other medications to get some objectivity in analyzing the results. You might also consider having a HairDX Genetic Test for Finasteride Response done. Talk to your prescribing doctor.