Author: Dr. William Rassman

I have been on Propecia for 2 years; I am 45 years old and have seen no improvement in my hair. I am somewhere between a NW 2 and a NW 3. The fontal forlock has thinned significantly while on Propecia. In your practice have you seen any patients quit Propecia and not get any worse or do most people experience increased hair loss once they go off the medication?

Also, I would do a hair transplant immediately if I was confident that I could go back to work undetected after 2 weeks. It would be a big help to get your thoughts on this as I think this is probably the biggest reason people do not get transplants. Perhaps post some pictures of patients at 14 days. Your blog is great and NHI would be my choice once I decide to take the plunge

Assuming that you have the balding gene and a HairDX finasteride response test indicates that you have an average sensitivity to Propecia, then I would expect that you, like many other men, had their hair loss stabilized on the drug. If that is the case, then you can assume that you may very well lose hair by stopping the Propecia. The series of steps and events are important in the building of a good Master Plan so that whatever happens, it will be planned for. I am sure you can see a series of potential scenarios here, so a good working relationship with your doctor is all important.

Here are some previously posted examples of patients just days after surgery:

• Female Hair Transplant (2 Weeks Post)
• Norwood 6 Patient (10 Days Post)
• Scabs After a Hair Transplant (11 Days Post)
• Norwood 3v Patient (10 Days Post)
• Norwood 5 Patient (12 Days Post)
• 2 Different Patients (1 Day and 10 Days Post)
• Hair Transplant (10 Days Post)
• Hair Transplant (2 Weeks and 5 Months Post)

I have been kind of thinking that propecia has quit working for me, as I’ve just recently notice a considerable loss. I have been using it for around 8 years and it’s worked amazing. I also added rogaine to the roster a few years back and it got even better. But, as I’m sure most readers would agree one becomes more and more complacent and less regimental after continued periods of success. For instance if my girlfriend stays the night I sometimes find it hard to run to the bathroom and apply. I also have been missing some days taking propecia. I actually looked back at when I purchased the prescription, the date today and of course divided by 4 (I break proscar pills) When I extrapolated, I noticed I’ve been missing at least a day or 2 a week. Could that maybe be why I’m now noticing more loss, or do you think it might just be as you’ve said in the past my mpb fighting back harder?

Thanks for you time, I appreciate you and your site lots

You seem to appreciate the subtle nuances, so I am not sure what I can add. “Stay to the plan” is the only advice I can give you. If you stop the minoxidil or the Propecia completely, the hair loss will really accelerate. Missing a day here or there will not likely cause any great problem, but I’d stick to the recommended dosage as closely as you can.

How do you determine benefit from a treatment if there has never been regrowth and further loss? I’ve used 2% minoxidil once a day for many years with out regrowth and continued loss. I continued on the assumption the loss might have been worse without treatment. But that’s just a guess. How do I know if I’m just wasting time and money? Do you assume that after many years the hair is going to become minox dependent regardless what the seen results are and quiting is a bad idea?

This is the problem that many people have. If you stop the medication and nothing happens, then the medication was having no impact… but if you stop the medication and the existing miniaturized hairs were dependent upon the medication, then reactive hair loss from withdrawal will be the problem. Most of the time restarting the medication does not return you to same status as before you stopped the medication. It’s kind of a guess that you have to make.

I took Proscar (1/4 of pill per day) for 2.5 years for my hair loss problem .I haven’t seen a clearly any side effects in the past 2 years but lately I read that Proscar causes erection dysfunction so I stopped using it three days ago and I tried to masturbate but I ejaculate quickly and before that my penis get rigid enough(I ejaculate before get hard) but just last week my sexual life was normal but now I have difficulty to achieve a correct erection . I still have nocturne erection while sleeping and in the morning so do you think this problem is caused by Proscar or just due to stressful situation after knowing that Proscar could causing irreversible sexual disabilities .

are the sides effects of Proscar irreversible? do I have to consult a Doctor? how much time I need to take a ride of the side effects(testicles pain,libido,ED.. ? can I take other medicines to heal theses sides effect are they effective ?

This seems more like a psychological problem rather than an effect of the finasteride. You took the medication for quite a while without issues, then after reading about possible side effects you suddenly developed them. Ever hear of the power of suggestion? That’s what is sounds like to me.

At any rate, this is a prescription drug… so definitely see your prescribing doctor if you feel you’re having issues with libido or any pain and let him know of your recent issues.

Hi, first of all, I’d like to thank you for taking some of your time to answer our questions. Losing hair is not something easy to deal with and having a knowledgeable voice is really helpful.

My question is about the efficacy of Propecia if you restart it after a long break. To make a long story short, I went to a dermatologue about 7 years ago for my slight hair loss and he didn’t want to prescribe me Propecia as he felt I wasn’t receding enough. But as I didn’t want to take any chances, I went to a generalist whom I persuaded to give me the stuff (incredibly, he didn’t even knew what it was). But after about a year, noticing that my twin brother wasn’t losing hair either, I kind of believed I simply had a mature hairline and stopped using it. But now, I’m pretty sure I have MPB, nothing to dramatic but enough to make me want to be proactive and start Propecia again.

My question is, will it be as helpful to me as to someone who never took it or will my body had developed some kind of resistance to it ? Thanks a lot.

You do not develop a resistance to Propecia. It is always better to take it earlier on in the hair loss process, but it is never too late. I can’t say for sure how helpful Propecia will be, but hopefully you’ll see some benefits if you stick with the medication this time.

As you are aware, Propecia is available by doctor’s prescription… so talk with your doctor about whether it is right for you.

I’m 20 years old and considering quitting finasteride after 15 months as I’ve seen no effect at all, but I’ve read finasteride can make you more sensitive to dht. Is this true? By quitting will I be more susceptible to dht than I was before taking it, or will it down regulate aftertime. Many thanks.

You will not be more sensitive to DHT, but you will lose all of the benefits of the drug if you stop it. Even though you say you’ve had no positive effects, it is possible that the medication at least slowed the rate of your loss. After you stop taking finasteride you may see hair loss which would have reflected the hair you would have lost 15 months ago had you not taken the drug in the first place (which I refer to as “catch-up” hair loss).