Category: Drugs

From your medical point of view, if someone had side effects from a year’s worth of Propecia, could fasting help speed up the side effects going away? I’ve read that water fasting or juice fasting accelerates recovery because energy usually spent on digestion is now used for healing and returning the body back to a baseline level.

I don’t advocate fasting and I really don’t know that water or juice fasting would speed up recovery or increase the speed of side effect disappearance. It’s an interesting idea, but to be completely honest, what you are saying makes no sense to me.

Hi Dr. Rassman,

Is it always best to start Finasteride sooner than later? I’ve read some information suggesting that finasteride only works for a certain period before losing its effectiveness. Should it be started at the first sign of balding, or should one wait a bit until it is absolutely necessary?

I am 26 male and have started to thin in the front. Dermatologist confirms male pattern baldness by inspection only, no mapping. He is hesitant to prescribe me finasteride for life, considering that we don’t know its long term effects and he’s considering that it might cause more aggressive forms of prostate cancer (though it lowers prostate cancer risk overall). But reading your archives it seems that you think finasteride is the best treatment option for young men who are starting to bald.

Do you have any concerns about its long term safety? Say usage for 10 years plus?

Thanks!

I think that your dermatologist is off base. The medical facts do not support him and the earlier you start Propecia, the less hair you will lose. Propecia should be started at the early onset of hair loss. Hair loss is a one way street, progressing only to more balding when it is caused by genetics in the male. I haven’t seen you, so if your dermatologist says you are experiencing early genetic loss, you may consider getting a second opinion for the Propecia.

Propecia has been available on the market since early 1998 (FDA approved in 1997), but I’m unaware of any recent studies on patients that have been taking it for that long. I do have my own patients that have been taking it for over a dozen years with great success. Some have experienced a perceived reduction in benefits after 5-10 years, but the medication is still working to some degree. If the medication were to be discontinued at that time, more hair loss will be seen (catch-up hair loss). It’s the tug-of-war between the medication and your genetics.

Hi Dr.
I have a question for you. Why does Rogaine sell a Women’s version, and a Men’s version, Why couldn’t I use the womens version if they have both have minoxodil in them?????

Thank you

Yes, you could use the “for women” version if you wanted to.

• Rogaine for Men contains 5% minoxidil, less alcohol and more propylene glycol than the Women’s Rogaine.
• Rogaine for Women contains 2% minoxidil, more alcohol and less propylene glycol than the Rogaine for Men.

Propylene glycol is found in many products, and you can learn more about that here.

Doctor Rassam,

I have recently started taking anti-anxiety drug escitalopram clonazepam after consultation with a doctor.

Please let me know can I also take finasteride along with it.

This is a question for your prescribing doctor who knows your medical history. Generally speaking, finasteride does not seem to produce problems with most other medications.

Hello Dr. Rassman,

This is without a doubt the best hair loss site on the web. I have learnt a lot over the last year or so. I really hope you can find the time to answer my questions.

I am 28 and have noticed that my hairline has receded on either side of the widows peak and even the widows peak looks thinner and see through now than it did 3-4 years ago (when I believe the changes started). I can feel my hair has thinned in a norwood 3a pattern although this is not noticable to others yet.

My question is regarding propecia. I have tried to take it but no matter how little a dose I tried I had the same side effects (low libido and erectile dysfunction). I tried 1mg daily, 0.5mg daily, 0.5mg every other day and 0.25mg daily but just could not adjust to it. What would be your suggestion for me and others in my situation as I would really like to try and combat the hair loss? I have been using minoxidil but is there anything else I can do as I really can’t handle propecia?

Also with regard to balding patterns you have said that the final balding patterns become evident for young men that start losing their hair early but as mine started at 24-25 when would you expect my final pattern to be evident as it is not obvious yet but I can only guess at a Norwood 3a as the hair still feels very thick past this point?

I would really appreciate if you could take the time to answer my questions. Thanks

Compliments will get you a long way with me, but not long enough to solve your Propecia (finasteride) problem. While I don’t know how long you were on the medication before each of your dosing changes, you could just be one of the men who just can’t tolerate even a small dose. Minoxidil is likely your only other option, aside from perhaps a hair transplant. You indicated that you’re in the UK, so I’d get yourself followed by a good doctor like Dr. Bessam Farjo, who is located in your area.

It’s really difficult to say when your final pattern would be evident without any real history to look back on. Unfortunately, I can’t give you any kind of realistic estimate on when your hair loss will stop.