Category: Drugs

What if I dont see hair loss, but I have seen a ton of hair on my pillow and in the shower. I know I am losing hair but I cant prove it.

I met with a 22 year old man that came to my office over his fear of losing hair. His father and grandfather had significant loss at an early age and he saw hair coming out in the drain, but couldn’t really see loss on his scalp. So this sounds almost exactly like what you’re dealing with.

His HairCheck bulk measurement showed that his crown loss was measured at 45% of his donor area. His hair is curly, coarse, and almost black. I did not see any signs of hair loss just based on a visual inspection, but the measurement did not lie. He told me that even his own mother questioned his visit to my office.

He recently came back to my office one year after his first hair bulk measurement, and we ran the numbers again. This time, his bulk measurement showed that he reversed the hair loss in his crown. How did he do it? I had prescribed Propecia and he stayed with it. It worked wonders for his crown.

Have any of your patients come back to you to report on children they had who were born with or who later presented with health issues that your patients thought might be linked to their use of finasteride? I know there’d be no way to show causality, I’m just wondering if it’s happened.

Personally I don’t care as much about infertility as I do about having a child who has health issues as a result of my finasteride usage. I’m having conscience-pangs just thinking about it. Could finasteride exert some kind of deleterious effect on the genetic content inside sperm whereby the sperm _does_ manage to fertilize the egg but where genetic abnormalities are passed on to the child? As usual, I suppose the answer is that nobody knows for sure.

No. At least, no one ever came to me who was on the medication asking about it. Propecia / finasteride taken by men as directed is not a pregnancy / health risk. When taken by women, it can potentially cause birth abnormalities possibly due to hormonal changes it causes during fetal development.

I know there are plenty of men that have had kids after taking the medication, so perhaps our readers will leave comments about their experiences.

Dear sir,

I went to see a dermatologist yesterday about hair loss, and he prescribed Finasteride 1mg, Minoxidil, Nizoral shampoo and a vitamin called Betavite for six months, and asked to see him after 2 months for a review. When i asked about finasteride, he said that i will have to use it ONLY for 6 to 9 months and not longer than that. I was confused with all what i find in the internet that i have to use if forever. I asked him whether i have to use if forever, and he said NO.

I will go to him again to clarify, but in the mean time, appreciate if you could please give an opinion on this. Thanks.

When you get advice that you either don’t like or think is incorrect, then you should probe your doctor for more information. I don’t know where your doctor got the idea that finasteride shouldn’t be taken for more than 9 months.

Men that take finasteride shouldn’t stop taking it after X amount of months for any reason that I can imagine. Catch-up hair loss will occur sometime after stopping the medication — your hair loss will resume and catch up to the point where you would’ve been had you not taken the medication at all. In other words, finasteride should be a lifetime medication, or you’ll lose any benefits you saw (hair regrowth, hair loss halting). A member of my own family has been taking it now for 10 years without problems.

I have been using Minoxidil 5% for few months now, I noticed a lot of flakes on my scalp.The color of the scalp is whitish when compared to the rest of it. Also some time its very itchy. Please recommend me any medication or precaution or steps needed to avoid the flakes or remove them as it does get annoying. Thanks

I have seen this often as a side effect of minoxidil. Speak with your family doctor for treatment or a decision to possibly stop taking the medication.

Snippet from the abstract:

OBJECTIVE: To determine the degree of improvement in semen parameters after finasteride discontinuation.

DESIGN: A prospective database of men presenting for a fertility evaluation was analyzed for semen and hormone parameters before and after discontinuation of finasteride.

SETTING: A male infertility specialty clinic.

PATIENT(S): Men presenting for fertility evaluation from 2008-2012 on finasteride.

Read the rest — Finasteride use in the male infertility population: effects on semen and hormone parameters.

In a study of 4400 men over a 57.4 month time span, sperm counts were performed after finasteride was discontinued. There was an 11.6-fold increase in sperm count on the discontinued use of finasteride (Propecia at the 1mg dose), suggesting that the drug brought down the sperm count in most men.

In men with severe oligospermia (low sperm count), the counts went up when the drug was stopped. No men had decreases in sperm count in the study. This suggests that individuals on finasteride who are interested in having children, should be aware that there is a risk of reduced sperm counts on the drug.

First of all, I just wanted to say you are doing a great job with this website. I come here almost daily and it has helped me a lot dealing with my hair loss. I am in my mid 30’s and have been on proscar for a few years. This is the first time I am posting anything, and I have four questions if you could answer, it would be really helpful to me.

1. If a person does not have BHP and still takes proscar, would they still have the urge to urinate more frequently? Does the frequency of urination mean the medication is still working even after prolonged use?

2. I noticed when I first started taking the drug my morning erections were virtually non existent. But now, I am getting them more frequently, does this mean the medication is not working as well and my body is immune to the drug or am I just one of the lucky 2% not to have any noticeable problems?

3. I have read on here that you have asked some users to increase their dosage of proscar. At the same time, I have also read on here you have said that 1 mg does the same job as 5 mg. So why do you tell certain people to increase their dosage if the results won’t be any better? (don’t mean to be rude or anything)

4. When is the ideal time to switch to avodart? Should I try first increasing my proscar dosage and if that doesn’t work switch right away or slowly introduce avodart into my routine and then after a few weeks quit proscar?

Cheers.

First, I hope the Proscar you’re taking is cut into pieces, rather than taking the full 5mg pill daily to treat hair loss. Finasteride 1mg (Propecia) is a hair loss treatment, Finasteride 5mg (Proscar) is for treating the prostate.

1. Proscar / Propecia (finasteride) should not cause changes in urination frequency in those men without enlarged prostates. So how frequently you urinate has no link to whether the medication is working.

2. If you do have erection problems in general it may be a 1 (or 2) in 100 side effect. The fact you’re having more morning erections now than before probably has nothing to do with the drug, but rather other extraneous causes (such as a healthier lifestyle, diet, mental health, etc.).

3. I generally do NOT encourage patients to take more than the recommended dose of finasteride. If I have been inconsistent or not clear over the years on this site, then please point me to the specific post. I realize there are plenty of newsgroups and forums that may have a different opinion, but in my professional experience of treating thousands patients, they do not see a difference when they increase the dose. More importantly, changing the dose of drugs or changing to another drug is something you must discuss with your prescribing doctor. Trying to self treat by researching medications on the Internet may lead to confusion and misinformation.

4. I do not endorse anyone taking Avodart (dutasteride) for treating hair loss. I’ve prescribed it off-label on a limited basis and once in a rare while I do meet patients who have been on it, but I do not personally see a large enough difference to weigh it against the higher side effect risk.

Hi
Is there any evidence that shows that Minoxidil solutions greater than 5% are anymore effective than the 5% solution?

Many doctors think that the higher the percentage, the greater the benefit… but along with a potentially greater benefit comes more and more problems with side effects such as postural hypotension, dizziness, tinnitus, scalp irritation, etc. As well, anything over 5% topical minoxidil (from my understanding) requires a physician’s prescription, probably due to the aforementioned side effects that may require monitoring.

I am not aware of any double blind randomized study / scientific evidence that higher minoxidil concentration works better at growing hair. In my opinion, a higher dose minoxidil for treating hair loss is marketing inspired (“more is better” concept) and anecdotal accounts.

My understanding is that the propecia patent ran out in January of this year, and that Dr Reddy’s no longer has the monoply on the generic form. However I live in the UK and have heard nothing about the release of generic finasteride in the UK. Propecia prices have not moved an inch and there has been no information on the release of generic finasteride over here.

I was wondering if you had any idea when we might start seeing the release of generic Finasteride here in the UK in 1mg tablet form?

I’m not sure about the release of a 1mg Propecia generic in the UK, but I’m pretty sure the 5mg Proscar generic is available there (they’re the same drug, just different dosages). I would make a call to your local pharmacy, as they would likely have availability info about generic Propecia.

In the interest of cost savings, many patients request a prescription for the 5mg finasteride generic pill and cut it into four pieces, making it almost equivalent to the Propecia (finasteride 1mg). In the US, the 5mg generic pill runs about $3-$6/month at discount pharmacies, but I do not know the cost breakdown in other countries.

I’m currently taking one 0.5 mg capsule of Avodart for hair loss daily. Visiting a hair transplant doctor the other day he said I could take it once a week and have the same results, as avodart stays in ones system for several weeks. What is your advice? I’m a 58 year old male. Thanks

My advice is speak to your doctor. If you were prescribed the medication, discuss any questions you may have with the doctor that prescribed it to you.

I do not advocate the use or usually recommend Avodart (dutasteride) for treating hair loss. I have prescribed it in select cases, but Avodart does have a long half life and many doctors have many different opinions on how to take the medication. There isn’t any defined dosage for it as a hair loss treatment.