Author: Dr. William Rassman

I am 21 with genetic hair loss.

I am taking propecia and minoxidil 12.5% + Azelaic Acid. If treatment works after, can I stop propecia and carry on with minoxidil 12.5% + Azelaic Acid?

As I’ve noted before, if you have any results from Propecia (finasteride 1mg) and stop taking it, you’ll see those results reverse. I’m not sure how long you’ve been using these medications, but I hope you talk to your prescribing physician before adjusting your treatments.

Even at the rather high 12.5% strength, minoxidil doesn’t maintain the benefits of Propecia (and vice versa). This is usually why I recommend starting with one medication and then adding another later, so you can get a better idea of which drug is giving you the best benefits. If you started both at the same time and decided to stop taking Propecia, you’re gambling that your visible results are just from minoxidil.

Dear dr rassman
I have currently been researching the side effects of Finasteride online, on one site it stated that your sperm while using finasteride may effect your partners health, it was not very clear on the subject, perhaps you could shed some light on this for me?

If my partner was to get pregnant while I was using finasteride is there a chance of birth defect? She is currently using birth control and we are not planing to have another child yet. And I have not started using the drug. If I were using finasteride and wanted to have a child how long would it take to get out of my system to ensure healthy baby development.. Cheers

For personal medical questions, you need to speak with YOUR doctor – don’t just search for information online that can be erroneous or confusing.

In general, as long as your partner is not taking finasteride or handling finasteride herself, there is really no risk of birth defects. You can take finasteride while trying to conceive and there should be no issue. If you are still concerned about it, the simple solution would be to stop taking finasteride.

Without wanting to go into too much detail, I believe that finasteride doesn’t actually cause watery semen because it seems to appear much more watery anyway just when the whole ejaculation process happens quicker. Could noticing this not just be a result of people hurrying up the whole process to test whether their semen is normal or not after taking the drug?

There are reports that both the ejaculate and the quantity of the semen changes with finasteride. Watery semen is one of the reports. Generally, the ejaculate is consistent in each person at any one time, but the volume could vary with frequency.

Dear Dr. Rassman,

I wondered if you could answer a couple of questions I had about Dutasteride (Adovart)?

In the past 6 months, I’ve experienced a rather significant amount of shedding and what seems to be follicle miniaturization from the crown to the hairline (though there are still hairs in this area and need to do something about it if possible.

For the past 2-3 months I’ve been using DS Laboratories Spectral F7, RS/ & DNC-N, and despite their grandiose claims of these products being the most advanced hair loss treatments available, if anything I have a lot less hair/thinner hair shafts than I did before I started with them. However, I’m not sure if this is because I haven’t used them long enough or that simply that they aren’t efficacious.

The other possibility could be hormonal changes as I’ve got symptoms of BPH (last checkup showed some enlargement but benign) and after reading something you wrote about the effect of hair dye, I started to wonder if the combination of these two factors might be the cause? I noticed in the past year or so when using Herbatint (The supposedly “safe” hair color), my scalp would feel burning/itching that would last a couple of days and I began to think it might be involved in the fallout/thinner shafts.

I’ve taken Finesteride some years ago and finding it ineffective for hair loss, I was thinking that the next step might be to try Dutasteride. So I wanted to ask, do you think it is worth a try and would the generic version be as safe/effective as the original manufacturer’s version? I’m kind of at the last defense and hope this might work.

Thanks in advance for any input you could give me on this…

Respectfully Yours

There’s a few issues that immediately stand out to me. First, I don’t know anything about your medical history or even your age. What did you find ineffective about the finasteride when you took it years ago? How long did you take it?

Second, you’re asking me about whether you should take a prescription medication (dutasteride) that isn’t approved for treating hair loss. That’s going to be something you’ll need to discuss with your doctor. The name brand and the generic should be the same medication, but I can’t say whether you should even be taking it.

Third, if you used a hair dye on your scalp that produced a burning or itching, it might be related. I don’t have experience with Herbatint, but I suppose it’s possible you had a chemical or allergic reaction.

Most importantly, if you suspect you may have BPH, I hope you’re under the care of a urologist. Your doctor may prescribe dutasteride (Avodart) for treating your BPH, which could be beneficial for your hair loss, as well.

Hello Doctor,

I’ve written to you in the past about my initial experiences with propecia. When I started, I was worried I had side effects… but I couldn’t figure out if they were real, or in my head. I soon decided that I was going to stop worrying about it, and just continue on with the medication.

Soon after, the side-effects stopped! I’ve concluded that in my case, the side-effects were most definitely in my head. I’m also happy to announce that propecia has helped me go from a NW 3/4 to a NW 2/3!

I could not be more impressed!! I hope this encourages other men who are worried about side effects to stick it out a little while longer, and to not worry about it so much!

Thank for writing and sharing this with us. I would expect that your case would be more common if some men didn’t let the side effect potential get in their heads, but in any case, I’m glad it worked out for you.

Dear Dr

I currently have a norwood 2.5 shape hairline with moderate recession at both sides. I have been using minoxidil for over a year and while there hasn’t been any regrowth, there has been a definite slowing down of recession. My hair is very thick at the forelock and all over the rest of my head so my question is:

Is it worth committing to propecia when less than ten percent see a benefit at the front hair line? From the studies i have read, minoxidil has as much chance if not more than propecia of making a difference at the hairline. I don’t want to commit to a drug with until i have to, and would prefer to wait and see whether my hair loss will extend to the crown or won’t, but would appreciate your advice.

Many thanks

Without actually seeing you and examining you, I can not tell you what to do. Your assumptions about minoxidil and where it works best, are not standard thinking… but if it works to slow down your frontal loss, that seems to be what you want.

Many Norwood class 3 balding patterns will evolve into a class 3V (which includes the crown). Finasteride is good at stopping or slowing crown loss if there is miniaturization present. You should see knowledgeable doctor who can do a bulk analysis on your scalp hair, because that measurement will determine if the process has started in the crown.

If you really care about the future of your hair, why not get a professional involved in helping you make intelligent decisions? Propecia could make a difference in at least preventing further loss, but taking that medication is going to be something a doctor will have to recommend after an examination.