Dear Dr. Rassman,
Thank you for this informative website. I visit everyday, and my wife just gave me your book for the holidays. Unfortunately, I am one of the few who have experienced side effects with Propecia. I was orginally on 1mg per day, and then I tried 1mg every other day, and .5 every day. But everytime I had to stop. Luckily, all three times the side effects disappeared after I stopped taking it (the last time I was on propecia, was about a year ago). I would like to try to get back on the medication again, but I was wondering if you had any advice on how I should approach this. I am only 25 years ago, and plan on getting a transplant in the near future, but would like to stabilize my hair as much as possible before hand. Thank you for your help.

I hope you enjoy the book, and I’m glad you find this site useful… but I am afraid that I have no good news for you. Those few patients who have sexual side effects or breast pain and/or enlargement that persist after numerous attempts to restart their drug program, will continue with the same outcome.
Be sure that your hair transplant surgeon maps out your worse case hair loss with miniaturization studies before you start the transplant process. A good Master Plan is critical to looking good for the long term.

A valid and interesting point. I honestly don’t know how plausible it is, but it is certainly a refreshing perspective from a sea of anti-Propecia campaigns and the paranoia of its side effects that I’ve been receiving via email lately.
Rogaine (minoxidil) is an irritant and if you use it around the eye and accidentally get it into the eye, you could be in for problems. I would think that the use of minoxidil in any form would not be a good thing to do for eyelashes. The new eyelash growth medication is Latisse (bimatoprost).
I think you’re confused. It is true that Propecia and Rogaine do not work in completely bald areas, but drug impact and surgical results are independent of each other. In a person with a slick bald area, the difference will come from the hair transplant and not the medication. If the hair grafts were transplanted successfully and from the donor area, those grafts will not require medication to grow. Remember, the donor area is the back horseshoe-shaped area as seen in the diagram at right. This area is permanent in most men (unless disease is present) and that is why it is used in transplantation.