Author: Dr. William Rassman

I know you’ve treated many men with thinning hair. For men in their early thirties like me, what can you estimate are:

1) The success rate for stopping hairloss with Propecia alone
2) Cosmetic regrowth with Propecia alone
3) Reports of sexual side effects or discontinued use from Propecia alone?

How many patients do you have taking Propecia for more than 5 years?

I tried 1/4 Proscar daily but had awful side effects, and I believe Merck’s side effect percentages are low. My hair loss is in the “early” phase and only really noticeable to me when I obsess, but I’d really like to not have a noticeable bald spot any time soon!

You take Propecia, right? How long? What else do you do for your hair?

Thanks!

I have been taking Propecia (and no other medication to treat my hair loss) for over 5 years.

The success rates of Propecia depend on what you consider success. You will still continue to lose hair if you are genetically prone to losing all your hair but it may slow to a crawl. Propecia can reverse hair loss, stop hair loss, or slow it down. A small percentage of men (I really cannot give you a number, but it is probably greater than 10%) have good growth and some reversal on the top/crown area. A larger percentage of men (about 90%) have slowing of hair loss. Many of my patients have been taking Propecia for over 5 years without side effects. I routinely look at my patients’ hair under a microscope for a miniaturization study to document the progression.

You are asking a question that is tailored specifically to you and this is impossible because everybody has different results. Try to understand the “big picture”. Propecia is not a magic pill that cures hair loss. NOTHING does! Propecia is the best medication we currently have to treat male pattern baldness, though. You need to sit down with a physician and talk about all the risks and benefits and come up with a Master Plan for doing something (or nothing) about your hair loss. I know you are looking for specific suggestions by me, but you are not my patient and I can not examine you over the Internet.

Does being on propecia inhibit someone from donating an organ, or for that matter, blood to another person? Will being on propecia affect matching tests?

If it does, what is the time period that i need to stop the medication before i can donate or go through tests to see if I am a match?

Taking Propecia will not affect the tests for matching blood or organs. I’m not aware of any problem with donating organs while taking Propecia, but I’m sure the doctors will pre-screen you.

Donating blood is a different story, however, as your blood can wind up in a woman who then becomes pregnant, then leading to complications with the baby (for example). The time period is 1 month off Propecia (finasteride) before donating blood, 6 months for Avodart (dutasteride). There are a handful of drugs that make you ineligible for blood donation, and you can find the list at the Red Cross site.

Please i need your help.
One month ago, i started using minoxidil and finasteride after consulting a dermatologist. Now i have developed otitis externa, according to the doctor it’s a allergic reaction of minoxidil and advised on stop using the above two drugs. Can minoxidil cause otitis externa? As before prescribing the above drugs, i was asked to go under some blood and sugar test-which came normal.

Yes, there is an association reported between otitis externa and minoxidil. It is on the official side effects list for minoxidil, along with other infrequent adverse reactions.

The list states: “allergic reactions (sensitivity, hives, generalized erythema and facial swelling); dizziness; tingling sensation; headache; weakness; neuritis; edema; eye irritation; altered taste; ear infection (otitis externa); and visual disturbances”.

Hi you can just send me an email back if you want but ive noticed sum hairloss since i was 18 ive been takin propecia for a year now and im 20…i really cannot tell if its working any recommendations?

For starters, you should discuss this with your prescribing doctor. Miniaturization measurements should’ve been taken before starting the medication and followed up with more measurements every few months to see in real numbers if the Propecia is helping you. I’m not sure what you’re looking for the drug to do — it might not regrow hair, but can halt existing hair from falling out.

Dr.Rassman,
I’m confused as to the extent of shedding I may have to deal with while using finasteride. I have read in at least one of your replies that it is a rare side effect of the treatment but I have also read on other websites i.e. hairlosstalk.com discussion forum “what is shedding,” that shedding can be quite extensive and very noticeable. Could you clear up this confusion for me? Thanks for your time.

I see patients almost every day who have been taking Propecia (finasteride 1mg) for many years, and also patients who just recently started on Propecia. I have seen and treated patients on this medication for over 10 years (since it became available) and I rarely have had any patients report shedding to me. According to Merck, I prescribe more Propecia than many doctors and if my history on the drug is an indication of what other doctors see, then the Internet reports may be either overblown or just a response from the few that get it. Most of the time it is a progression of their natural genetic balding that they became more aware of since taking the medication.

I suspect if there are people who experience shedding they would be proactive in searching for the cause and discussing their experiences on the Internet and trying to find more information (such as yourself). The same idea is true for people who are experiencing sexual side effects. As such, there may be a disproportionate perception of how often this occurs. (Because people who have no side effects will never post their stories on the Internet.)

The most common cause of hair loss or shedding is from genetic causes of male pattern baldness. Propecia is not a magic pill and it has limitations. Without knowing your state of hair loss (without a miniaturization study or an examination of your hair before you started taking Propecia) it is impossible to say what you are really experiencing. Assuming in the rare case that you are shedding from Propecia, some have theorized that your hair is going through a “reset” mode where your miniaturized hairs (hairs in resting cycle) fall out before the growth cycle of hair starts. Mind you, this is a theory. In the end, remember that you are taking a medication to grow or slow down the hair loss and it will take up to 6 months to a year to notice some change. If you are still concerned you need to speak with your prescribing doctor.