Category: Drugs

Hello,

I was wondering how decreasing DHT levels causes the side effects that it does. Can increased testosterone make up for low DHT levels?

Thank you for your time.

The effects from decreasing DHT’s impact on the hair follicles is achieved by taking medications such as finasteride (Propecia/Proscar) or dutasteride (Avodart). There is recent evidence that DHT may be actually made in the skin and glands of the hair follicle itself. That would explain the need to get some tissue binding for such drugs as finasteride. More testosterone in theory might produce more DHT, but with finasteride on board, it will be blocked at the placed it is produced and in the hair follicle itself with appropriate tissue binding from a systemic dose, so more testosterone may not make much of a difference.

An unwanted side effect of taking Propecia is a reduction in your sex drive/erection by 1 to 2 percent and breast enlargement (gynecomastia) 1-in-300 to 1-in-500 people. The drug also impacts the prostate with less semen volume with ejaculation in many men. There may be other rare side effects that you can read about on Drugs.com. My personal feelings is that there are many false and exaggerated bits of misinformation on the web about the frequency of these side effects. The Internet is a valuable resource, but of course, not all the information you find on it is true.

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I have taken propecia for almost a year with good results and now I would like to consider switching to Proscar. Is the use of Proscar commonly understood by dermatologists to be effective for treating MPB, or should I assume that my doctor is unaware about this use of Proscar?

thanks.

Simply looking at the generic name (finasteride) will tell them that the drug is the same, but in different dosages. If you’re worried that he/she doesn’t know the differing marketing names of Proscar and Propecia, you can bring it up when you have your next appointment. I would expect it is commonly known though, as the medication has been on the market for years.

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First of all, I’d like to say this is the best hair loss website. Thank you for all the insights.

My question is this. I’ve switched from 1mg propecia to the generic 5mg finasteride.I am a patient of Dr.Pak. The staff member at your office recommend I go to Cotsco to buy the generic finasteride to save money. I did. However, I’m concerned. My concern is that the blue 5mg pill is EXACTLY the same size as the 1mg propecia. It is difficult to cut, but ive managed. Is this the right product? Surely it says 5mg finasteride, a blue pill, but how can a 5mg pill be the same size as the 1mg pill? And even if it is, when you evenly cut it into 4 pieces (1.25mg a piece), how do you know which side has more mg while the other has less? Your honest answer would be appreciated. Thanks.

The 1mg Propecia pill contains more fillers so that the pill can be at a size that is easy to swallow, but not so easy to have it disappear if you accidentally drop it. The medication is evenly distributed in the pills, so that when you cut the 5mg pill you should have the same amount of finasteride in each piece.

It sounds like you got the right product, so long as it is actually 5mg finasteride. Some pills might be bigger with score marks (intended to be cut), but each generic manufacturer is different.

I meant to post this a little while ago, but it slipped through the digital cracks…

ABC News posted a list of drugs that have dual uses (some being for off-label use). While not all of the mentions are hair loss related, among those medications that are relevant to this site are:

1. Dutasteride — used for hair loss (off-label) and prostate
2. Finasteride — used for hair loss and prostate

Regular readers of this site will note that both medications are approved by the FDA to treat prostate issues, and finasteride is also approved in a smaller dosage for treating hair loss (Propecia). Dutasteride (Avodart) is still not FDA approved as a hair loss treatment, but some doctors in the article believe it was stalled because of side effect concerns.

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Hello there

I have read many studies about the effect of ECGC (commonly found in green tea) on hair growth. While I realize this is not an FDA approved hair loss treatment, I neither reside in the USA nor care for what the FDA approves. So in short I would like to create a topical forumula containing ECGC to apply to my scalp. I have some high quality ecgc extract (Teavigo 98%) but of course it contains some bulking agent. I would love to hear any ideas about what would be an effective way to create a topical solution from this and will happily report back my results.

Thank you

You can do whatever you want in making medication for your own use, even in the United States. The FDA only protects the public from people or companies which:

1. makes claims about a product’s safety or effectiveness that can not be validated through proper scientific studies
2. produce a product without Good Manufacturing Practices (GMP) in place

As I’ve mentioned before, I follow the FDA because I am a US-based physician. So while you may not care what they approve, I do. That being said, I do not know anything about creating medications that can be absorbed through the skin, so I can not help you. I’m just the wrong person to ask. If any readers have experience with this, feel free to comment with suggestions. Good luck and please keep me in the loop if you figure out a solution to the hair loss puzzle.

Hello Dr. Rassman,

So I have several questions. Firstly, I read somewhere that if the scalp is wet upon application of Minoxidil, that the Minoxidil would be absorbed better achieving better/faster results. I’m a little skeptical of this. Is this true?

Secondly, if I apply the Minoxidil before I blow dry my hair, how long should I wait to blow dry it to achieve maximum effectiveness? I’m kind of in a rush in the morning and so waiting more than a half an hour would kind of be impossible. If this were the case, I might abandon application of Minoxidil in the morning. How less effective would only one application of Minoxidil per day be?

This is perhaps a stupid question that I should have asked my physician a long, long time ago, but, how is 1 mL of Minoxidil supposed to cover my entire scalp!?!? A lot of it tends to run down my forehead as it is, thereby wasting it, but even if it were all put to good use, 1 mL only seems to cover several square inches before I no longer feel any left on my fingertips during the massaging. Is it there even though I don’t feel it or something? What am I doing wrong?

I don’t know if this is relevant or not, but after 4 months of using 5% Minoxidil and noticing no results, I decided to switch to 15% Minoxidil w/ 5% Azelaic acid.

Azelaic acid is an irritant and in using it is supposed to increase the blood supply to the scalp and therefore increase the absorption of minoxidil. Your point about coverage is well taken. It takes a lot of minoxidil to cover the entire scalp, so I generally advise patients to apply it only to the areas that are thinning. Minoxidil is best applied after a hot shower, as the circulation of the scalp is higher at that time. Waiting 5-10 minutes should suffice, but using the Rogaine Foam rather than the liquid could solve your styling timing issues and it may be more effective.

Many of your additional minoxidil questions have already been answered at Rogaine.com.