Category: Drugs

If one were to up their daily dosage of proscar could side effects like loss of libido, morning erections, and loss of sex drive happen right away and then quickly go back to normal a few days later. In other words, can the body adjust to the increased dosage of the drug in a matter of days and all the things I mentioned above return to normal?

In general, higher doses of medication can cause an increase in side effects. I usually do not endorse higher than the recommended dose of finasteride for treating hair loss, which is 1mg a day. A higher dose does not equate to better results.

If you’re taking Proscar, that is already a 5mg tablet, so I am hoping you’re taking a split pill, otherwise you’re already getting way more medication daily than necessary. Propecia is 1mg finasteride (for hair loss), Proscar is 5mg finasteride (for prostate). In any case, talk to your prescribing doctor about any changes in dosing.

With respect to your body adjusting for changes in dosage, it is not so specific and everyone’s response is different. I have no way to know how your body will respond to a medication increase.

Hello,
are there any side effects on Propecia that affects the heart? I know that right now it’s not part of the official listing on Propecia’s side effects, but as an expert, I believe you hear a lot from people who’s taking it and might have any information regarding it.

I started taking propecia about 2-3 weeks ago. Since yesterday I started to feel a strong pump in my heart every now and then, specially at night, and it seems to intensify when I lay down. The strong pump is a bit odd, it feels like an uncomfortable tension in my chest, and it’s also slightly respiratory.

Ps: I’m 25 years old, weight 175 pounds. Don’t have any heart issues, and never felt this before. I also take another medicine, an anti-depressant: Zoloft.

Congratulations for the blog! Thank you.

I have not had any patients in the years I’ve been prescribing Propecia that developed heart related side effects. If you have heart related issues, you need to speak with your doctor ASAP. It probably is unrelated to Propecia and can be a very serious medical condition.

Dear Dr. Rassman,

For 2 years I’ve take minoxidil 5% and experienced chest pain and difficulty in breathing twice previously. Both times it happened when I mixed minoxidil with retinoic or azelaic acid and used a little bit too much acid. The first time it lasted like 3-4 days. I had chest pain, difficulty breathing, rapid heart etc.

And today, when I came home I was a little bit tired, I hesitated applying minoxidil (I use rogaine foam in the morning, kirkland in the evening). Firstly I applied azelaic acid (drug name Azelderm, %20 azelaic acid) and then the daily dosage of minoxidil to the crown area. After 20 minutes I had side effects. This is rare, only the 3rd time in 2 years. I urgently washed my hair in order to send away the minoxidil and dried it and then I went to the hospital. My blood pressure was 12/7. It was ok and the heartbeats were ok. 4 hours after applying it I feel better, but still some heart pain.

Why does this drug causes chest pain and difficulties in breathing even though my blood pressure is ok? If you have an opinion I’ll appreciate it, thank you for everything.

Minoxidil applied topically shouldn’t cause chest pain in most cases, though if you are experiencing it, I suspect your body is absorbing too much of the medication. Your chest pain sounds more like a heart attack / unstable angina type of pain. I would take this seriously and go see your doctor or go to your local ER to get your heart checked out.

Even if you still believe your chest pain is related to your minoxidil use, you cannot afford to not rule out that your chest pain can be an underlying serious condition.

Hello Doctor,

I have a question that I don’t think you’ve gotten before, it has to do with when I should expect to see results with Propecia.

I understand it takes about 6+ Months to start to see results, I assume time line is meant for people with average length hair. However; I have very very short hair, I crop it pretty close. Since my hair is short enough that mere buds would be noticeable…when do you think I should start to see new hairs?

How long would it take for the budding hair to just start to show itself on an almost bald head?

First, hair length won’t make the hair regrow faster or slower.

Propecia doesn’t always grow new hair, though it can thicken existing miniaturized hair. If your hair is short, I suppose you will be able to see new hairs (if there are new hairs that grow)… but I doubt you are that observant to see a few hairs out of thousands of existing ones. It’s like trying to see new grass grow from an existing field of grass. Long or short, it would be pretty hard.

If Propecia is really working, you will see it overall in your appearance, not at the individual hair level.

What do you know about the spiro cream being touted all over the Internet as a DHT inhibitor for men and women?

I have stated in past posts that topical spironolactone probably does not work for treating hair loss. Spironolactone in (real world) practice does not solve the hair loss problem from its touted anti-androgen property, which is more theoretical in my opinion. There’s no conclusive evidence that I’m aware of.

I realize some doctors and commercial websites will market this as an anti-hair loss medication, but I personally have not used it in my practice.

I understand that finasteride can stop hair loss or slow it down. When you mean slow it down, does that mean instead of permanently losing 10 hairs a year you only lose 5 for example. How slow does the hair loss really become on finasteride in terms of numbers and actual hairs lost? Thank you.

There is no absolute cure for genetic balding. Taking a medication like finasteride (Propecia) slows down the hair loss. Perhaps it is best explained with the graph where you see a group of men who never took Propecia (the placebo group) to another group who did take the medication. The group that took Propecia collectively have less hair loss.

Unfortunately, I don’t have the actual data, but the visual graph should be helpful. Click to see the larger size:

Hello Dr Rassman, thank you for this amazing blog of stable information.

I am a 23 year old male, thinning in a NW 3V pattern with diffuse hair loss on top of scalp with a NW 6 final pattern (had my miniaturization check). However, I look like I have dense NW 2 hair with proper styling (caught it very early). I have been using minoxidil and propecia for 7 and 9 months respectively, and had fantastic results since then. My shedding had almost completely stopped and I had a significant increase in density and regrowth.

However, since the beginning of last month, I have been experiencing a horrific process of shedding, almost more than 300 hairs everyday. Obviously this upset me after seeing such good results during the previous months, but I did notice the hairs I shed are very small (both in length and width) and miniaturized, and the general appearance of my hair has not altered so much during this intense period of shedding (have photographed my hair during the process, derived this result from comparisons; unfortunately bulk measurement is not available in where I reside).

So my question is as follows; does medicine like propecia and minoxidil (medicine with the potential of regrowing hair) operate in cycles? Are my small hairs shedding in order to make way to healthier, thicker hairs? Can some of the miniaturized hairs be effected after 8-9 months into the treatment? Or the first shedding period effects all the miniaturized hairs at the same time and the process of regrowing hair is a smooth transition which does not include a secondary shedding phase? This is the second shed that I am experiencing since beginning the medication, and I have been unable to find any other credible information similar to the matter.

I have been to my dermatologist (who specializes in hair loss), but he has only told me that shedding waves with types of medicines occur sometimes and I should not worry about it. Don’t get me wrong, I do understand that medical solutions are almost always temporary, and I accept the fact that I will go bald eventually. I am only curious about what I am experiencing, as these drugs are supposedly most effective after the 1 year mark. I wonder whether you have seen something similar in your practice throughout the years?

Thank you very much in advance.

I’ll break your questions out to make it easier to answer —

1- Does medicine like propecia and minoxidil (medicine with the potential of regrowing hair) operate in cycles?

ANSWER: Probably not

2- Are my small hairs shedding in order to make way to healthier, thicker hairs?

ANSWER: I doubt that is the case

3- Can some of the miniaturized hairs be effected after 8-9 months into the treatment? Or the first shedding period effects all the miniaturized hairs at the same time and the process of regrowing hair is a smooth transition which does not include a secondary shedding phase? This is the second shed that I am experiencing since beginning the medication, and I have been unable to find any other credible information similar to the matter.

ANSWER: I rarely see shedding with either minoxidil or Propecia. Shedding this far into treatment might mean that your hair loss is now into a more aggressive phase, or you are developing a refractory state when it comes to one of these medications.

You will have to wait it out. Sorry, I can not help you.

Has there been any new studies published on the use of dutasteride for hair loss? I thought a study in Korea was being done.

I’ve mentioned the Korean study before (here, here, and here), but the ClinicalTrials.gov site just says that it was last updated this past September, though no results were posted. So that doesn’t appear to be much help.

The only dutasteride studies I can find relating to the drug as a hair loss treatment are:

• Bioequivalence Study of Dutasteride Five 0.1 mg and One 0.5 mg Soft Gelatin Capsules in Healthy Male Volunteers (currently recruiting participants)
• Sexual Function in Men Receiving Dutasteride for Androgenetic Alopecia (not yet open for participant recruitment)

I don’t know more beyond what you can find in those links, though.

Hi Dr.Rassman,

I was wondering what is the transitional zone for propecia/rogaine on a scalp for its effectiveness? Since propecia/rogaine works better/only on the back not the front of the scalp? I need to know so I can figure out a masterplan.

Thanks

Propecia (finasteride) and Rogaine (minoxidil) generally work best on the top crown area. The medications do not work as well (or much of the time at all), on the front of the scalp.

Your doctor should be able to help you create a Master Plan, but I am not sure what you mean by a “transitional zone” on the scalp.