Month: January 2023

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My Doctor Won’t Prescribe 5mg Generic Finasteride and Propecia Is Too Expensive!

Hello how are you? I am patient under dialysis treatments because my kidneys do not work anymore, and I wonder if some of your doctors could prescribe me generic 5 mg. My doctor did not want to prescribe generic finasteride 5 mg, the doctor just prescribe me Propecia, but is very expensive. It cost more than 80 dollars for thirty pills, I can not afford to pay that, I’ll be waiting for your reply. thank you!!

You can make an appointment with any dermatologist or a hair transplant doctor if your doctor won’t prescribe the 5mg. Did he give you a specific reason for not prescribing it (even if you are instructed to cut the pill)?

You would first need to have a good medical diagnosis for androgenic alopecia before you receive a prescription for Propecia or its generic finasteride. In general, there is a consultation fee for patients, but most hair transplant doctors waive the first visit fee.

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My Doctor Was Vague About Using Minoxidil and Propecia Together

Hello Dr. Rassman,

My question concerns the reintroduction of minoxidil into hair loss management. I have been assessed as a norwood 3/3a by my hair restoration doctor in NYC — I’m 24, I noticed thinning at 19, and began using minoxidil 5% immediately. I used it for 4 years, maintaining most of my hairline, although losing some density, and about a year ago started taking Propecia. Unfortunately, around the time I started using Propecia, I lost some resolve, and stopped using the minoxidil. I noticed a dramatic change in my hair, with rapid receding near the temples. The Propecia seemed to be thicking the vertex, but not doing much for the hairline. 6 weeks ago, I had a 1900 graft procedure done (1300 to the frontal area, 600 between frontal and vertex area) and now I’m wondering if I should reintroduce the minoxidil along with Propecia? I’ve been using Propecia alone for 1 year, and my hairloss seems to have stabilized (i see very little hair on the pillow or in the shower). Is it worth it? What are the up/down sides? My doctor gave me a very vague response — something along the lines of “Sure, why not, it’s up to you.” I’m curious what your thoughts are on this situation?

Thanks!

Relationship between you and your doctor should be a partnership and if you feel there is “vagueness” in his answer or you do not understand something you should approach him and ask your questions. When dealing with your doctor, be direct about not only the question of substance you are asking, but it you feel that he/she is evasive, say that and do not beat around the bush. Please remember you are the client and he/she is your hired agent and you can expect to hold your doctor to standards of communication so tell him/her that.

BaldingBlog is not meant to be a substitute for medical advice or second opinions. That being said, if topical minoxidil has worked for you in the past and you desire to start using it again I think it is your choice. I do not think it will negatively affect your hair transplants as long as it is after one week post surgery. It is my personal opinion that you should continue using Propecia. Minoxidil is not a substitute for Propecia, but it can be a good adjunct to it.

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My Doctor Took the Strip Out of the Wrong Place!

I got my hair transplant done in Dec of 2008. During the consultation the Doctor showed me the area that he was going to cut. After the hair transplant was done I found out that he has cut the wrong place , he has cut right under my crown area. He has cut the wrong spot and I have gone to 4 different Doctors and all of them have told me that the cut is to high and the doctor that has done the transplant didnot know what he was doing. He has taken hair from part of my head that he has told me that I will be going bald and placed it in the front. So What can I do about this. Can anyone help me with this . Oh. by the way I paid for 2500 Grafts and he told me he only did 2100. I do not think he is telling the truth about the 2100 also. Everyone of the doctors that I have seen after the Hair transplant have told me that my hair transplant is not 2100 . They all said it looks like may be from 800 to 1000 grafs. Please if anyone knows what should I do please help me out. Thank you.

LegalAs you indicated you are in the area, a visit to my Los Angeles office will allow me to really understand the damage you have. The hair that was transplanted is not permanent hair if it was taken from too high on the back of the scalp. I would want to examine that area today and measure the degree of miniaturization, which will tell me how long that hair may last. Donor strips taken from the crown tend to scar badly — is that the case with you also? If it is, it will need to be transplanted as well. You have legal recourse against the doctor for not only the costs of the surgery, but the damage that he did which may have a long term consequence to you. These options also should be explored. I look forward to meeting with you.

Doctor selection is doing your research, knowing the experience of the doctor, his patient results, his skill and artistry, and his overall integrity. Hair transplantation is a lifetime process and often can not be reversed.

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My Doctor Told Me To Use Minoxidil After Transplant

Dear Dr.Rassman, I recently had a hair transplant the beginning of December of 2005′. I only needed a small area above my bangs,(I’m a female with blond, baby fine hair),and was given a mega’ session to my surprise!) It will be three months the start of March. My question is that post-op, I was told to start using minoxidil for 3 to 6 months. I was told that this would help in blood flow to the follicles. Will the transplants grow without minoxidil? I haven’t been using it every day like I should. Shouldn’t a transplant grow without using minoxidil? I lost alot of my hair that I already had when they were putting it the grafts. I don’t see any of the original hair coming back very fast…something about the hairs being “shocked”? Were they destroyed when the new hairs were translanted, or will they come back? I have less hair now, than when I went in for the procedure! Not to mention the “ear to ear” donor site, that is slowly coming back! Thank You.

Minoxidil may help improve the rate of hair regrowth, however, transplanted hair does not need minoxidil for growth. It sounds to me like you may have some shock loss from the surgical procedure. More than likely, the shock hair loss will reverse (it usually does in women) and your hair would then grow back somewhere between 3-5 months following the surgery.

I am frankly surprised and dismayed by your comment that the megasession was a surprise. There should be no surprises in this process so I would think that your doctor failed you in this regard as good communication is the key to the entire hair restoration process. Your concerns are real, but I wonder if you lost faith in your doctor by my observation that you came to the internet for advice that should be part of the standard of care that one should expect from their doctor.

For the information of the readers reviewing this blog, hair transplantation in women is usually restricted to a sub-set of balding and thinning problems because female genetic hair loss does not occur in patterns like it does in men. In the fringe area around the sides and back of the head (donor area for the transplant), men usually have healthy hair (99%) while women often do not (20% have a good supply of healthy hair). That means that if a women does not have healthy hair and is transplanted, the unhealthy hair is moved along with the healthy hair (not a good use of a surgical procedure). Women with female genetic hair loss can have 4:1 unhealthy hairs:healthy hair ratios. What that means is that for every good hair transplanted, four unhealthy hairs get moved. This is the reason we do not transplant many women as the value may not be there. I have met some doctors who claim that women make up a sizeable part of their practice and generally I have the view that the value proposition here is totally favoring the unscrupulous doctors that do this and give this industry a bad name. What makes women easy victims for the unscrupulous doctor is the general hopelessness that they feel as they move from doctor to doctor looking for the magic cure for their balding so when a doctor brings the promise of a cure, they will easily spend thousands of dollars to go that route. I do transplants on women, but very few of them as women make up less than 5% of my transplant practice and of those women, half of them are treated for non-genetic balding problems such as complications of facial surgery. The old axiom remains, ‘Let the Buyer Beware’.

Good luck to you.

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My Doctor Told Me To Sleep A Certain Way for 6 Months After Transplant

i had a hair transplant 2 month ago. the doctor advised me to sleep in a certain way for 6 month, to wash my hair only with baby shampoo. unfortunately, after a month and half after the transplant i started doing foolish things, sleeping the way i always sleep, washing my hair with neutrogena and nizoral shampoo, sometimes even putting pressure on my head. do you think that i could have affected the transplanted grafts . i already see new hair coming out;however, it is not even. also i have noticed that a lot of my hair in the front is falling. headaches are also present.

I like to joke with my patients and tell them, “No sex for 6 months after your hair transplant surgery”. Back in 1992, I had a patient come from Asia and I told him this joke with a laugh in my voice (I am now convinced that the laugh was not translated by the translator as the patient only spoke Korean). At about 3 months, I got a call from Korea by a different translator telling me that my patient passed a message to me: No hair transplant is worth giving up his sex life. Then, I realized that my humor does not work for non-Americans so I now always qualify my jokes being sure that what I say is understood clearly. I may joke with my patients about their sex life and every one of them confirm that they would rather just go bald, so the laugh is mutual.

Joking aside, you can sleep normally a few days after surgery. You can use normal shampoos. You can resume normal activity (yes, even sex). You can even (gently) scratch your head if it itches, run a marathon at the 5th day and do whatever aerobic exercises you want at the 5th day as well.

I suggest that you educate your hair transplant surgeon.

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My Doctor Told Me It Would Be Fishy to Prescribe Proscar to Someone So Young

I am only 25 but I am starting to see signs of Male pattern baldness and I wanted to be proactive. I asked my doctor about Proscar, because I read that it could be cut into fourths, and he told me that it would look fishy if he prescribed this medication to someone so young. He told me he could only prescribe Propecia for me. However, I’m not sure that the cost of Propecia fits into my budget. Any advice on what I could do would be great.

Thanks

Really, the only thing I can suggest is to find another doctor who will prescribe what you want. If you came to see me, I would first insist on an examination to determine if you are really balding (miniaturization study).


2007-08-31 09:33:21My Doctor Told Me It Would Be Fishy to Prescribe Proscar to Someone So Young

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My Doctor Told Me I Have Keloids On My Scalp

my derm told me that i had keloids in the back of my scalp. is it normal for a women to get them in there scalp? i have 7 of them in the lower back of the scalp and the and maybe 3 in the middle. they injected them with steroids 1 and they didnt get any better. just got a lil smaller, not to much though. i thought in the back of the scalp was more for men to have.

I would assume that your doctor is right if he diagnosed you with keloids. If you want a second opinion, you can try seeing another dermatologist. Keloids don’t discriminate.

Here is an excerpt from eMedicine: “The prevalence [of Keloids] has been reported to be higher in young females than in young males, probably reflecting the greater frequency of earlobe piercing among females. Keloids and hypertrophic scars affect both sexes equally in other age groups.”

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My Doctor Told Me Dutasteride Was Safer Than Finasteride, But I’m Losing More Hair Now!

Hello
I have been on Finasteride 1mg for a year and had controlled the hair loss totally. Also had seen some thinning areas getting thicker and almost no side effects,but some months back i visited a skin doctor for some skin rash. Later while leaving I just mentioned that I used finasteride and he then told me i should try Dutasteride 0.5mg, which he claimed to be safer and greater results. But now i have been on it for four months have been losing lots and lots of hair everyday, front hair line which was earlier thicker is thinning rapidly.

i just don’t know what to do? should I go back on finasteride 1mg and again wait for months for it to kick in or wait and complete 6 months of dutasteride?? is dutasteride not suiting me cause of my life style of heavy workout and hi protein diet? I had read somewhere that dutasteride releases high scalp testosterone ….plz advise

This is an unusual complaint, as dutasteride is at least as effective as finasteride. It is possible that if you have genetic hair loss, it is accelerating. I don’t know why your doctor would say dutasteride is safer than finasteride, but I didn’t prescribe either medication to you and I can’t give you dosing advice or a treatment plan. Get to see a specialist to address your issues.


2013-02-04 10:29:33My Doctor Told Me Dutasteride Was Safer Than Finasteride, But I’m Losing More Hair Now!

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My Doctor Suggested I Use Minoxidil for 1 Year, Then Gradually Stop Using It

Dear Dr. Rassman.

I wrote you before about my hair condition. I am male, 22, caucasian. I went to the trichologist last week and was prescribed to apply topical Minoxidil 5% +mpg 0.0125% together with some vitamin-enriched solution called “Biostim” (ingredients include: Aqua, Sabal Serrulata extract (biogen), mono propylene glycol, ceramide, panthenol, calcium pantothenate (vitamin b3), vitamin E, vitamin A, Vitamin H (biotin), vitamin H (P.A.B.A.), Inositol (vitamin B8).

The doctor I went to also told me the weirdest thing about the long-term treatment plan. he suggested that I follow the usual minoxidil regime for 12 to 14 months, then switch to less concentrated solution with less frequency of application until I’m in my late 30s. What he added to that,that it is possible to take me out the medication at that age, because (quote) my “hormone levels will settle up”… I don’t know what to think of it? It sounds like some sci-fi scenario for me…

another thing I want to ask you is that I’m currently quite happy with my hair – I have slight recessions at the temple area and that is my only problem. I always had quite high hairline, so recessions are quite visible (if I for some reason will go for shorter haircut). I have no history of baldness in my family (my father is 60 and he is on NW3, so are/were most of my family). So as far as I understand the idea of the treatment is not to let my hair loss progress…

I’m very confused abouth this whole situation. Should I trust my trichologist, or does he sound ridiculous? Should I consider undergoing Minoxidil treatment at this stage or not?

I look forward to your reply.

kindest regards

Hair loss is a progressive process and if you think about it, you can logically figure out if the Master Plan made by your trichologist makes common sense. Certainly, I approach the problem with a solution (Propecia and/or minoxidil) and continue treatments that are successful. The idea of starting minoxidil and withdrawing it if it is working, guarantees hair loss from that withdrawal. Propecia always works at least by slowing down the hair loss (to what degree though, is different per person), possibly stopping it altogether, or maybe reversing it.

As for the Biostim product, the only place I can find that references this is one trichologist in London, leading me to believe he is the exclusive marketer of this product. Perhaps it is a private label item and he is just looking to make some money? I don’t know. The ingredients you listed do not look like they’ll do much for your hair. It is your call, of course.

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My Doctor Suggested I Take Generic Propecia

Hi Dr, many thanks for the excellent blog. I just had a question regarding generic propecia. My doctor in the UK approved me as a good candidate for propecia and advised me I could now buy generic 1mg propecia online to save money. I’m currently on merck’s product and haven’t experienced any serious side effects.

The generic manufacturers on the site he suggested are Sunrise and Cipla. I can’t find much info on these companies and was wondering if you were familiar with them and if they are reputable, or furthermore if you think buying generic 1mg is a good idea in the first place, even if I have been examined by a Dr?

Any advise would be much appreciated. best

The generic should be the same as the name brand. The 1mg generic finasteride isn’t legally available due to patent restrictions in the US, but the 5mg generic is off patent and available. Things could be different in the UK. I suppose that if you get the generic from a reputable source it would be fine, but many online pharmacies are suspect since they don’t require a prescription in the first place. I’m not a fan of that.

As for the companies you asked about, I think Sunrise is US based, but I’m not too familiar with them. All I could really find was their website and an FDA warning letter from last year about the use of excessive active ingredients in some medications they made. I am more familiar with Cipla since I’ve been asked about them a few times before. Cipla is a very large pharmaceutical maker out of India and their biggest claim to fame is that they’re the world’s largest producer of HIV/AIDS fighting medications.

For more info on Cipla:

For more info on Sunrise:


2011-08-04 09:46:17My Doctor Suggested I Take Generic Propecia