Day: January 1, 2023

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Propecia Shedding vs Regular Hair Loss

I read alot of posts from medical experts and bloggers about shedding on Propecia and how it is a good sign that the drug is working. My question really is what is the difference between shedding on a drug like propecia and actual hairloss? How can you tell which one is occuring and at what point in your treatment do you accept your shedding as hairloss. Hope this is clear. I just don’t understand the difference. If 17% of males that use Propecia get no benefit did they experience hairloss that they believed was just shedding?

There is no way to distinguish shedding from Propecia (rare) vs normal shedding from continuation of male genetic hair loss. Hair loss shedding will be continuing at the same rate that you saw it prior to starting the drug if the drug is not working. Any shedding caused by Propecia should pass within 3-4 months so that by the 8th month, the benefits should be clear one way or the other.


2006-05-16 08:24:06Propecia Shedding vs Regular Hair Loss

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Propecia Raised My Testosterone, So I Switched to Avodart

since taking propecia for 6 months my testosterone had been raised quite high, so i decided to switch over to avodart as i heard it is better. my testosterone is still high. my question is, is it worth me taking these medications for my hair loss as its raising my testosterone in turn producing higher amounts of DHT and higher amounts of DHT will cause more hair loss. in a sense im taking a drug to stop DHT but at the same time the drugs making higher amounts of DHT so im in a confusing paradox. should i continue with either one of these medications if all there doing is creating more DHT, even though there getting rid of it. please help Dr. Rassman and NHI team. thanks

It sounds like you are buying these drugs on your own without being followed by a doctor. There is a reason why these medications require a prescription from a doctor. In general, Propecia should not raise your testosterone levels to a significant amount over the long term, but testosterone levels have been found to be higher in those men on Propecia. There may be other issues special to your particular case. If Propecia raises your testosterone levels, Avodart will also increase the levels (certainly not decrease). If you’re indeed under the care of a physician, you need to ask these questions to him/her.

Without going into the biochemical aspects, there is no paradox that you are referring to. The real paradox is taking Avodart (dutasteride), because Propecia (finasteride) raised your testosterone level.

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Propecia and the Prostate, a Comment from One of Our Readers.

It isn’t just an issue of the prostate shrinking. The attached article points out that there is atrophy (tissue wasting) and apoptosis (cell death) in the prostate as well. You can do a quick Google search to see that there are hundreds of thousands of guys who have used Propecia and despite stopping the drug, still report having watery semen with reduced volumes.

Yes, I don’t doubt that for a moment. I know of one family member that stopped Finasteride after 15 years and had a full return of his semen to its normal level and consistency, so that means that the results vary with people.

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Propecia Peaks at 2 Years?

hi dr,
just had a few questions about propecia and why its peek results are reached at 2 years. is it possible that it could continue the de-miniaturization process beyond that point for a young man such as myself at 21? i began taking it at an early 20. thank you for this informative blog and your response in advance.

We don’t know why results from Propecia (finasteride 1mg) peaks at the first 1 to 2 years, but it is an observation many doctors and patients have made. With that said, it does not mean the medication stops working or is less effective after that time frame.

For the few who see more balding after years on Propecia, I have been advising that they consider increasing the dose to 2mg daily provided that there are no sexual side effects. Of those whom I’ve given this recommendation, none have reported sexual side effects. Please remember, I’m not your doctor and I’m not recommending this to anyone here.


2009-09-10 09:25:36Propecia Peaks at 2 Years?

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Propecia Patient Results (with Photos)

Dr. Rassman, I saw one of your comments on Propecia on the balding blog. You are welcome to use my pictures to show your bloggers what the drug can do. As you remember, I am 39 years old and I got these results in just 8 months on the drug. Contrary to what some say about the sex drive, the drug did nothing to suppress it. Sometimes I wish it did. I saw a couple of other doctors before I started Propecia and one had a salesman who tried to sell me 1500 grafts. He said Propecia would not work. Glad I did not have the surgery and listened to you guys.

Thanks for coming forward on this very important issue. The young man can get an outstanding response from Propecia, especially the ones under 30. You are an exception to the rule and a lucky one at that. Although sometimes I feel like a Merck salesman, because I suggest this medication for many of my patients, it is because of people like you that I have become an enthusiast for Propecia. Although the corners did not return, the fullness you wanted was achieved and you are happy. That is what this is all about. You were wise to seek out other opinions and I applaud you for such persistence. There is no “A” given in school for such decisions, and in the real world, the hairy guy you look at in the mirror every day is better than that “A” on a report card.

The below photo on the left is before Propecia use (scanned from a Polaroid, so please forgive the quality); below photo on the right was taken about 21 months after continued Propecia use. He’s had no hair transplant surgery. Click the photos below to enlarge.

 

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I have been on Propecia for a month and I noticed pain in my nipples

Breast pain and nipple pain has been reported with people using Propecia (finasteide). If this continues, you should see a doctor if that is why you are asking this question. Some people develop small painful breast lumps so an examination of a doctor is a good idea. When this happens (it is rare), the drug often needs to be stopped.

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Propecia Maintenance Phase?

I have been using Propecia for about 8 years. Though no measureable regrowth, I feel it slowed or haulted the hair fallout and have been able to keep what I have. I do not believe I have sufferred from any of the “male concerning” side effects. My question is, is there a thing such as a maintenance phase? Meaning, instead of taking the 1mg tablet daily, can I take one every other day and still be alright?

Thanks

The need to take the same dose over and over again for life should continue. If you drop the dose, you run the risk of losing hair. If you do go for every other day, that’s your call to make… but I wouldn’t recommend it. Unlike your case, some patients have reported that after 5 years or so some hair loss picks up again, and in those patients I have been recommending an increase in the dose to 2.5mg each day, provided that there are no side effects. Discuss any prescription medication changes with your prescribing doctor.


2009-05-14 10:28:22Propecia Maintenance Phase?

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Propecia, Liver Deposits, and the Harshness of Winter

Thank you Dr. Rassman for maintaining a wonderful blog and for being a generally nice guy. My history is a bit checkered:

Seven Years ago I was told by Dr. Bernstein (another really nice guy by the way) that based on family history I might have diffuse pattern alopecia although only the vertex was thinning. He put me on Propecia and refused to operate till some time passed. The Propecia worked well but I had elevated liver enzymes from fatty liver deposits and stopped it after a year. After six years I have lost a lot of hair on the crown but the rest of my hairline did not vanish as I expected. In fact the crown is noticeable precisely because the rest of my hair is present. So basically from a thinning vertex I now have a bald vertex but the rest is intact. I don’t know about miniaturization though.

  1. Question 1. My liver readings are the same. What are my options?
  2. Unrelated question 1. I have always wondered whether i have mild trichitillomania. I ask because I never pull my hair hard but I used to (and still sometimes do) very very gently test my vertex hairs and they always slip out readily. The test is so mild that on my permanent zone I can barely feel the tug and yet on the vertex two out of three hairs slip out. Have I harmed myself with this “strength test or were these weaklings doomed anyway?” Incidentally the hairs would not come out when I took Propecia.
  3. Unrelated question 2. My biggest discomfort from my bald spot is the dampness from sweating on the bald crown. In New York my scalp sweats profusely from the heating indoors and once outdoors it feels colder than the rest of my head even with a hat. In fact the hat in contact with the bald spot feels awful.

Napoleon

  1. People with liver disease just need to take a smaller dose of Propecia and they can be on that medication. Without seeing you I can not make judgments. I’d see Dr. Bernstein again.
  2. I don’t know if you have a mild case of trichotillomania, but if you’re just gently pulling on the hair to see if it comes out, it may just produce traction alopecia. Trichotillomania is an obsessive compulsive disorder, and it doesn’t seem like that’s what you’ve got going on… but I really couldn’t diagnose trichotillomania over the internet like this.
  3. Bald heads do sweat in hot weather and lose body heat in cold weather. Hair allows air to move through it in hot weather acting like a radiator effect. In the winter it acts like a blanket as it insulates the scalp where the blood supply is quite high (in the winter) so the body does not lose heat. When Napoleon’s French troops invaded Russia in the early part of the 19th century, the first soldiers to die from the harsh cold temperatures were those who had balding.
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Propecia Linked to Male Breast Cancer?

There was some reference in the 7-year Proscar study to a statistically significant increase in male breast cancer among the participants taking 5mg of Proscar daily.

Any thoughts or perhaps you have seen further research?

By the way, your visit from Jimmy and Adam on the “Man Show” was hysterical. You handled those guys with style. Well done!

Thanks for your comments on the Man Show. I fully enjoyed doing this as well as many other similar programs.

According to the New England Journal of Medicine (Volume 349:1569-1572 October 16, 2003 Number 16, Prevention of Prostate Cancer with Finasteride) there was only one case of male breast cancer in this study group of almost 19,000 men (see CNN article: Baldness drug may reduce prostate cancer risk).

Gynecomastia (breast nodules in men) is more common and is often painful when it occurs, but this is not cancer. There is no evidence that cancer is a risk, but if there is a history of breast cancer in your family, I might consider finding out if the gene for breast cancer susceptibility (BRCA1 on chromosome 17 and BRCA2 on chromosome 13) is carried in you (see Do We Know What Causes Breast Cancer in Men?). If you carry the gene, then you might avoid Propecia. The good news is that you can test for BRCA1.

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Propecia Is Working Well in My Hairline, But Not So Much in the Crown

I’m 20 years old, have naturally fine hair, and my hair started miniaturizing/thinning when I was 17. I have recently started Propecia and have been taking it for approx. 4 months. The shedding stage of Propecia has pretty much stabilized and I have noticed a significant improvement in my hairline as well as improvement in thickness of hair. My crown, however, seems to not be improving other than stopping hair loss (I could be wrong it’s hard for me to see that area on my head). Am I likely to grow new thicker hair in hair in the crown, given that I already have in the temporal area? I know you’ve said that Propecia is generally more effective in the crown, so if I’m already growing new hair at the hairline it would seem logical to conclude that I should expect improvement in the crown. Is this assumption valid? Is improvement likely in another 6 months?

Thank you

I generally tell men to take the drug for at least a year to see the benefits. At 4 months, you have not been waiting long enough. As the impact of Propecia on the crown is reported to be more frequent than the impact on the frontal hairline, I would expect that if you had a good response in the frontal area, that you will have a good response in the crown if you wait long enough.


2008-07-15 08:54:05Propecia Is Working Well in My Hairline, But Not So Much in the Crown