Month: January 2023

First off, thanks doctor for all the help you have given. Your site is very helpful.

I actually have a one question and also a comment about propecia.

Firstly, I have been experiencing balding at my hairline for about a year and a half. It hasn’t gotten too bad yet and is moving quite slowly. I started on propecia about 6 months ago and have recently seen a slowing in the shedding of my hairline. Also I have seen a slight thickening in the hair in right at the hairline. The hairs that are growing are small and kind of thin though, so I was wondering if hair regrowth with propecia can come in cycles. Will it start as smaller miniaturized hairs, then the next cycle will they be thicker? Just wondering if this was common for the drug in your experiences.

My second comment was on the side effects of the drug. About a month after I started I noticed drastic sexual side effects. My sex drive was still there, but I could not sustain an erection. I cut back to half a pill a day and that helped at first, but once again I fell into that same situation. Recently though I’ve notice just as drastic of an improvement though. It almost seems over night the sexual side effects went away. I have even gone back to a whole pill and have no noticeable side effects. Is it normal for the side effects to go away so suddenly? Also, could such strong side effects mean that the pill is working well on me? Not that I’m complaining, just interested to know. I am glad I stuck it out though, seems it just took time for my body to adjust.

Thanks for everything in advance!

Many people who get a decreased libido can work it out the way you did. Hair loss comes in cycles, but Propecia (finasteride 1mg) does not work in that fashion. At times, you may find the hair loss will occur even when you are on the drug, and that hair loss occurs in bursts. The focus here was on libido and hopefully your libido problem has been solved. With regard to other side effects, they tend to occur and stay around while you are on the drug, like decreased volume of your ejaculate after orgasm or breast tenderness. Of course, breast pain could be brought on by other causes as well (even breast lumps, although very rarely from Propecia), so if you get them you should see your doctor.

I know Propecia won’t work to regrow a hairline but can it help regrow hair behind a hairline like 1cm behind it? Since my hairline is still intact but behind it is where the drama lies.

It can, but each person will react slightly different to medication, so regrowing hair there might be rare. It has a better chance of maintaining hair that is left, though regrowth isn’t completely out of the question. The younger you are and the shorter time since the hair is showing the impact of balding and thinning, the better the chance of reversal.

My temples receded from my highest wrinkle brow to 1.75 inches. You said a mature hairline temples are up to 1.5 inches away from that wrinkle. So I’m slightly more which is fine by me. But around those corners there is a piece of short hairs, they seem to have the same thickness as a lot of my front hairs but they look like they will fall of since I assume they are miniaturized. After that my temples will be about 2-2.2 inches receded which will be too much. I just began Propecia and am almost 22 years old, can Propecia stop those hairs from falling out and even help them grow normal again? But I’m also taking Propecia because I have frontal and mid anterior probs as well but early stage.

Propecia will slow or stop the hair loss in most men of your age. Consider sending me photos (will be kept private) and I will give you an opinion, but you should consider getting your hair mapped out for miniaturization to determine if these hairs at that exact location are really miniaturizing.

Hi Dr.

I have a quick question. I apologize in advance if you have already answered it as I tried searching. I am 30 yrs old and I have been using Propecia for almost 1.5 years. When I started it worked great, within a few months it stopped hair loss and I even noticed a bit of regrowth on the temples. Recently I got a hair cut and noticed that my hair is thinning again. And I have started to see my scalp.

My question is that is it possible for Propecia to stop working abruptly ? If yes should I consult my doctor again for options ? or is this the end of the line.

Also I might add that there has been added stress in my life recently do you think that this maybe a temporary thing where the effectiveness of propecia may bounce back ?

Thanks in advance

Hair loss can be a very subjective thing. Just to look at your hair and to judge how thick or thin it is can depend on lighting and perspective. It also depends on your hair cut. I would think that getting your hair cut short would make one’s hair look thinner (more light allowed to the scalp) anyway. Besides that… Propecia does not just stop working. Hair grows in cycles, so I would think when hair is actively in a shedding cycle, the impact of Propecia may be lessened – albeit this is somewhat of a stretch.

The best advice I can give you is to stay on the drug even if you think it is less effective. But in any case, talk to your prescribing doctor.

Doc,

You recently answered a question that perhaps I didn’t ask right about using Minoxidil for many years and the benefit on adding Propecia. I’d like to try again, because I think the answer is important. If you have used minoxidil for many years most hair subject to miniaturization would be minox dependent. Would that be a correct assumption? If so what is the benefit of adding Propecia to minoxidil dependent hair.. which after many years would be most miniaturized hair. Wouldn’t it be too late at that point since the hair Propecia might have helped are already minox dependent?

And since minoxidil is for life I assume any future miniaturized hair would become minoxidil dependent too. So what is propecia going to do at this point? I hope I was more clear this time.

Thanks again..

There is no way to answer this question appropriately without a controlled clinical study on this specific situation (those that start finasteride years after minoxidil dependence). That study doesn’t exist as far as I am aware.