Does 1mg of Finasteride per day have any adverse effects on muscle growth in a natural bodybuilder mid 40s :~)
Nope, there aren’t adverse effects on muscle growth with finasteride (Propecia). Some people assume blocking DHT (which is what finasteride does) will cause you to develop feminine qualities, and others believe that finasteride will increase muscle mass; both of these are also false.
Paid advertisements (not an endorsement):
I honestly think you have been somewhat indifferent towards Histogen’s potential. As researchers have recently discovered, the baldness gene affects WTN7 pathway. Histogen stimulates this pathway to produce new folicles and thicken exisiting ones. Obviously, there is a connection. The only affirmative emails you respond to involve propecia. I have been taking propecia for 2 years and I have not had any improvements with my hair. In fact, I have significantly lost more hair. Now you’ll probably say, it’s keeping what you have, but that’s BS. It isn’t effective because it isn’t addressing the real issue of hair miniturization which has been recently connected to WNT7 pathways (Dr. Christiano, Columbia)
Now I can understand why you would want to downplay this company because if it does go to market within 3-5 yrs in Asia, hair transplant surgeons will not benefit financially as much as they have in the past. In fact, nurse practitioners would be able to treat patients. At this point, I will no longer be a reader of your blog because I find your replies to be completely boring and repetative. Maybe you should invest some of the kickbacks you’ve received from Merck into a Histogen if you really wanted to see a viable hair growth treatment come to market
Good Bye and Good Luck
For those who freely read on, my position on hair loss has remained constant. There is no cure for hair loss and Propecia is certainly not a cure (though it helps treat hair loss in most men). I recently wrote about the discovery of the hair loss gene pathway you are referring to, but if you read on, it is not about male pattern baldness. As quoted by Dr. Christiano herself, “It is important to note that while these two conditions share the same physiologic process, the gene we discovered for hereditary hypotrichosis does not explain the complex process of male pattern baldness.”
In the end, I am happy that there is research being carried out to find a cure. I care about patients and if I was actively trying to steer people to my surgical practice why would I bother telling them to take a pill? Why would I spend time answering questions on this site every day that have nothing to do with directing patients to surgery? Your logic is full of flaws and you come across as an angry, desperate person. You are misdirecting your anger at me, possibly because of your impatience at these cloning companies and their moving timelines. Should I be sad that I do not receive any kickbacks by Merck or Histogen or Dr Christiano or any other companies or individuals? I’ve already stated my connections (or lack thereof) to Merck. They make a medication that works to treat hair loss. It is proven safe and effective. The rest is all conjecture.
Lastly, I am sorry that you find my comments to be repetitive, but at least they are consistent! So thanks for your insightful comments and we will miss you here!
(female) Hello.
I’ve been diagnosed with AA. Have tried several “remedies”. Most recently began using the Unda drops, 9, 40 and 243. I actually, for the first time in 3 years so a marked decrease in shedding and my hair felt better over all. Recently though, (2-3 weeks ago) I began using Rogain 5% as recommended by my dermatologist. nearly three weeks into it I’m seeing a huge amount of shedding. more than I’ve ever experienced. My fear is that the rogaine will not work and the shedding will continue at this rate.question. Can Rogaine make matters worse? If my stress factor allows, how long should I remain on the rogaine to see results and how long can I expect this increased shedding to continue? I’m so tempted to just throw in the towel and just continue the unda drops and biotin hair/skin/nail formula.
Thank you
Unda drops are homeopathic remedies and I am not a homeopathic doctor. I do not know the utility of what you are using, but if something worked for you why would you want to do something different? Many men and women report initial loss or shedding of hair after starting Rogaine (minoxidil) in the first month of its use, but the shedding should stop unless there are other underlying issues not related to the medication. Generally you need to use Rogaine for a minimum of 8 to 12 months before seeing the effects.
Rogaine may work for alopecia areata or androgenic alopecia (I’m not sure which you meant by your diagnosis of “AA”). It does grow hair, but I doubt it will grow back the hair you once had and if the problem is underlying alopecia areata, then you should be under the treatment by a good dermatologist who can often help with the process.
Dear Dr.,
Thanks always for devoting your time to the public with this forum. I notice you’ve been getting swamped with questions about a cloning cure (i.e. a class 7 bald person having a teen-age head of hair again), and people don’t seem to want to accept such a thing is so many years away. I was wondering if it’s more realistic to speculate: for those of us in our early 30’s who’ve preserved most of our hair and reversed some thinning with Propecia, is it reasonable to think a better pharmaceutical for holding on to what we’ve got will come out at some point this decade?
Thank you
There are drugs in the pipeline for hair loss, but the real question is which, if any, will make it through the investigative and FDA process. It must be proven to be safe and effective at doing what the manufacturer will claim. So I suppose it is reasonable to assume (or at least hope) something will come out eventually, but I couldn’t begin to guess at how much better it will be than what is available now. Keep your fingers crossed.
Hi…Thanks a lot for this perfect blog that answered many questions that concerns hair loss and balding. I had a HairDX test for Finasteride response and my score of CAG was 24. The dermatologist who did the test told me that I have a negative result regarding finasteride response.
1- What do you think of Hairdx test regarding F.R.?
2- Do you think I should take finasteride though I got CAG of 24 ?Thanks
I do think the HairDX for Finasteride Response test is a good idea, but it can open people up to the idea of taking medication when it is not necessary. Just because the test tells you that your response to finasteride would be good, it doesn’t mean you should automatically get on the drug if you’re not experiencing hair loss. In your case, I don’t even know if you have any degree of balding. Do you have a full head of hair and afraid of going bald or are you already seeing hair loss? If you are bald or have definite signs of balding, then what do you have to lose by taking finasteride regardless of the CAG score? Were you prepared to not take finasteride (Propecia) if the test was negative?
In any case, it is something that needs to be discussed with your doctor who knows you better than I do, as our communication has been limited to an email. If your dermatologist told you the result was negative, perhaps he/she meant you aren’t likely to have great success from the medication. It is worth noting though that you may still see some beneficial response from finasteride with a CAG score of 24. According to HairDX, “Scientists discovered that among men that had the best response to Finasteride approximately 70% had a CAG score below 22 while among men that had a subtle response to Finasteride approximately 70% had a CAG score above 22.”
Dr R
Do you have any opinion on Azelaic acid as a dht inhibitor when used topically by itself or in minoxidil tandem?
Thanks
I do not think there is real evidence that azelaic acid inhibits DHT or works for genetic balding. I am aware that there was a study which was published in 1988 (22 years ago) titled, “Inhibition of 5α-reductase activity in human skin by zinc and azelaic acid“. The testing was not carried out in humans, but in a test tube, and the information is floating around on the Internet (our everyday source of good solid medical information *note sarcasm*).
Aside from this study, I do not know of any other information with regards to azelaic acid and its “theoretical” treatment for balding, yet the legend of one decades-old study will propagate down the immortal path of the internet. For further reading and other physician opinions on this, take a look at this post from a few years back.
I am a 33 year old woman with a diagnosis of AGA. I have found out that skin atrophy is a very rare side effect of oral spironolactone, one which I am experiencing on my facial skin. This is frustrating as spiro is definately working for me. Do you think topical spiro would have the same effect? Also, it seems Cyproterone Acetate can have the same effect so that isn’t an option for me. What do you think of trying Bicalutamide, as it is a non-steroidal antiandrogen? Many thanks.
I wish I could offer some real help, but I don’t know much about the side effect risks of spironolactone beyond what I have read, as I do not prescribe it (or the other medications you mentioned). Spironolactone is a prescription medication, and as such if you’re seeing skin irritation you should immediately notify your prescribing doctor about this.
Cyproterone acetate lists hair loss as a rare side effect (as possible with many medications), but bicalutamide has hair loss listed as a common side effect, so I don’t know why you’d take that as a hair loss treatment.
Dear Dr Rassman,
In your last post you wrote the following in regards propecia.. “It does not work for frontal hair loss in most instances other than possibly slowing the process down, but is it the only real medication to address what you are going through”. However in December 2005 you wrote that “Propecia slows or stops hair loss throughout the head”.I was just wondering if in the intervening years you have become more pessimistic about the effectiveness of Propecia on frontal hair loss?
Regards
I’ve not become pessimistic about Propecia. I have seen a few cases where the drug has reversed frontal hair loss to some degree (regrew hair), but it is not common. What is common is that this drug can slow or stop frontal hair loss, and stabilization of hair loss is a real benefit for those who are actively losing hair.
Dr. Rassman,
I have several questions about hairloss. I´m 22 and have receding hairline and thining hair, less than NW2. Please tell me about preparations containing minoxidil with liposomes and topical finasteride.
- What are exactly liposomes? How do they work?
- Topical finasteride, effectiveness? Would be effective a home made lotion mixing crushed up proscar pills (i read about how to make it in a blog)and “shake” the bottle? I think that´s a
waste of money. But adding liposomes in the same or a similar lotion could make the finasteride worked topically. I´m right?- I´m currently applying minoxidil 5% twice a day and 15-20 minutes after night application y apply retin-a cream (0.05%) only at temples and hairline. I agree with you that tretinoin burns
the scalp so I prefer apply it separately from minox and only on temples at night. Do u think it´s a safe way to use tretinoin?- And finally, is nizoral 2% the best way to keep you scalp free of sebum? Does minoxidil penetrate better on this way?
I ask your advice also after being on propecia for 1 month I quit the medication because typical side effects, but fortunately they disappeared and i´m going to go back on 0.5 mg propecia EOD (every other day) within a pair of month. What do u think about this issue? Thanks Dr. Rassman, I hope your answer and it helps to other people.
If your hair loss is less than a Norwood 2, are you sure what you’re seeing is actually hair loss and not just a mature hairline?
I am sorry to hear you had side effects while taking Propecia, but I am glad your side effects are gone. As you said, you can try 1/2 dose or take it every other day and see if it helps. You might also wish to try 1/4 of a pill each day instead of 1/2 a pill every other day, as the half life of the drug is about 4-5 hours.
Hello Doctor,
I want to thank you for a great blog that I visit nearly daily. I visited your offices around 5 months ago and had a consultation with Dr. Pak, who was very informative and understanding. Since then, I’ve been on a daily regimen of Finasteride 1.25 mg/day but am going to wait until the follow up appointment before I make any judgments (superstition does that to you).
I have two questions. I already know that Finasteride does not completely stop hair loss. It just provides its patients an outlet for growing old gracefully (under my impression). Have you seen or heard of any patients who took Finasteride while also including Minoxidil in their regimen to maintain for longer than 10 years with good results?
My second question is how big a part does diet factor into the MPB process? I’m already exercising 6 days out of the week even before MPB hit me but diet (what kind of foods to eat) has always escaped me. I would like to know if there is any information a professional such as yourself can provide pertaining to what kind of diets would promote hair growth and what kind of diets work best in conjunction with Finasteride and Minoxidil to maintain hair.
I apologize for the long message and sincerely appreciate all the help you have given.
Best regards!
I believe that for some people, the use of both Propecia and minoxidil has value when used in combination, but that may depend upon a variety of factors including age, appropriate use of the medication, where the minoxidil is applied, and where on the head the balding is that you are treating. The crown generally does better with combined treatment compared to the frontal hairline. I have seen patients using both medications with good results after a decade of use.
I do not believe that any particular diet works better than another, provided that the diet is well balanced.
