Note the importance of buying legit Propecia from a real pharmacy!!
Couple years old but a UK Press Release about fake Propecia rings true today.
Thanks for sending this in. Yes, it is from late 2007, but it goes to show that counterfeit Propecia does exist and is a problem. One crackdown (no matter how large it was) in the UK doesn’t eliminate the problem altogether. Buyers need to use common sense when buying prescription drugs off the internet without a prescription.
If you knew that natural cures to hairloss existed, you wouldn’t be holding back on us just to get a few more bucks, would you?
Also, it’s been one year exactly since I stopped my 58 days on Propecia, and I still have these mental side effects of stumbling over words/lack of fluidity when speaking/lack of wit and smoothness. The only other thing in the world this could be would be the high soy diet I put myself on for hairloss measures a few weeks after I started Propecia, and right before I felt my first side effects. I’ve seen a thyroid doctor (who said everything at Whole Foods was a fraud), a neurologist, and a psychiatrist (the latter just for kicks really), and apparently I’m the foremost expert in soy isoflavones and their effect on the thyroid. Just because someone has a medical degree doesn’t mean they’re knowledgeable in every arena. I still never had any sexual or physical side effects, and my wit is still present when I type or write, so something is only affecting my speech, which lends me to believe it really has to do with the physical properties of the thyroid and perhaps the larynx. Any thoughts?
Would I hold back the cure for balding if I had it? The answer to that is… absolutely NO. I obviously spend all of this time answering questions on this site just so I can squeeze money out of you, telling you there’s no cure when secretly I’ve been hiding it in my wall safe. Did you catch the sarcasm there? If you truly think a natural cure for hair loss is out there, by all means keep rubbing onions on your head and coffee in your eyes… or whatever the “cure of the day” might be.
I can not tie the speech/voice problems you have with the drug Propecia. What you said about soy is interesting and noted. There have been some patient reports that finasteride may have caused some impact on brain function but, I suspect, that would be extremely rare and not proven in the medical literature.
Dear Dr. Rassman,
I have a question regarding Propecia side affects on the hair (!) if you stop taking it. If one stops using it after a long period (months or years), are there any chances the hair loss would increase? Meaning, if one took it for, lets say, one year and his body got used to the drug, can the hairloss get worst when he stops using it? I know of course that when one stops using propecia the shedding returns, but could it be more severe than if he had not taken the drug for the same period of time before he stopped?
Thank You
If you stop using Propecia, you may experience “catch up” hair loss. You will in effect lose all the hairs that grew from Propecia and lose all the hairs that would have been lost if you never took the medication in the first place. I have personally seen such cases and they can be pretty dramatic. The hairs that are lost will not likely come back if you re-start Propecia. I don’t know of any evidence showing that upon stopping Propecia, your hair loss even more severe than it would’ve been.
thanks so much for your work with this blog. i am 25, with what i would describe as a hairline that has receded about 1.25 inches at the corners and generally thinned in the front. i have been putting some thought into propecia’s timeframe lately, and would love to hear your thoughts on this.
merck of course has their (FDA approved!) literature, about what to expect after 3 months, 6 months, 9 months, etc…there are of course many variables that go into the whole equation, but what are your thoughts on the ratio of time an individual has taken propecia/total time the individual has experienced some degree of hairloss? i have been taking for just under 4 months now, and not really noticed anything. some people lose hair quickly, what has happened with mine has happened over 3+ years.
would you hypothesize there is a correlation between not only degree of hairloss and propecia’s effectiveness, but also between the amount of time that hairloss occured versus how long a person has been taking propecia? thanks!
There is a genetic test called HairDX Test for Finasteride Response that can check your overall sensitivity to DHT blockers like finasteride, as we are all different genetically. It scores a CAG repeat test, and when the patient scores low (less than 22, for example) they will have a better response from finasteride than when the score is high (above 22). In this way, it is possible to find out your overall sensitivity to these drugs (hence, effectiveness). Add this into the other variables you mentioned above, and you can get a more clear picture of what my happen to you over time, but the reality may not be as simple as just getting a genetic test.
The medical profession is at the doorstep of understanding genetic tests like this and fitting them into the course of patient’s balding patterns and the rate of the balding process. At 4 months, there is just not enough time to know how you will respond to the drug, but at a year or so out you may know more. Finasteride does not work as well in the frontal hair at reversing the process as it does in the crown. You can get yourself tested with this genetic test to anticipate your personal response to finasteride, but what you do with the information is not easy to ascertain. You will have to sit down with your doctor to explore the process further.
In all people, the effectiveness of Propecia over time will change because the balding process will change (it is progressive) and the degree of change varies with the individual. There are no rules other than what I discussed above, but I believe that as long as the balding person is taking Propecia, the drug is effective. To prove this, stop taking it and see that the hair loss just gets worse in a matter of months. Actually, I don’t advise you to try to prove it, because the cost in hair loss would be too great.
Paid advertisements (not an endorsement):
In the past, you have reccomended .5mg of propecia for those experiencing side effects. Why not .75mg?
As long as you have a good way to split a 1mg oval/circular pill into the correct geometry to make it 0.75mg, I don’t see a problem. Then you can take the 0.75 and save the 0.25 remaining for the next three days when you can combine three 0.25 to take the 0.75 dose. Or I guess you can just throw away the 0.25. Get the point? It makes practical sense to split a 1mg pill in half to make 0.5mg.
Paid advertisements (not an endorsement):
This is a patient who had reversal of frontal hair loss by just taking Propecia for 2 years. The miniaturization in the frontal area was 50% 2 years ago and now is 30%. This is rare to get such a good response to Propecia. The patient is 25 years old and I suggested that he wait 1-2 years to see what was going to happen on the drug. As it turns out, waiting and postponing surgery at 23 when I saw him initially was a good choice. No surgery is needed now.
Before on the left; After 2 years of Propecia (no surgery) on the right. Click to enlarge.
Hi Dr. Rassman,
I had the pleasure to meet you at your open house and I think your great and honest. I have very very major concern right now. I want to have a HT and I think you said I am not ready, however I am going to be a NW 4A. I have been taking Rogaine foam for about 2 years now and for the last month I am shedding extremely bad and I mean bad. every morning about a hundred hairs on pillow. if I sneeze in sink I see 10 hairs in sink. the shower is clogging up the drain. If I run my hand thru hair over sink about 30-40 hairs fly out with each stroke.DO I STOP THE ROGAINE FOAM? I still need A HT but don’t want to let this get completely out of control.
Thank You Very Much
You should be on finasteride. Didn’t I tell you that? If I met you and you’re a Norwood 4A, I surely would’ve suggested you get on Propecia.
Sneezing does not cause hair loss, and if you’re losing 30-40 hairs each time you run your fingers through your hair, your loss does sound pretty bad. If you stop the Rogaine Foam after 2 years, you’ll likely see more loss as the benefits from the foam will disappear. Come back and see me again.
Good afternoon Doctor! I just want to thank you for this site.
Im an 18 year old boy, and since i was around 17 my hairline changed into what it now is today. However I’m not sure where to class ito n the norwood scale. The frontal hairline is, like you say in the normal place, exactly half an inch above the furrowed brow, however my concern is asscociated with the corners of the hairline. From the highest wrinkle, if i place a tape measure to the furthest point of the corner of the hairline it measures around 2 inches.
My question is with a corner reccession like this, could i still be placed in the Norwood 2 section? Because if you look at the stage 2 of the Norwood scale, the measurements found on this site for the mature hairline don’t appear to fit with it. The front of the hairline and the corners appear to have a far greater gap than the ‘norm’ of 1 – 1.5 inches…..
And just as a last question, if i start on Propecia at this age, is there a chance i could keep this hairline for the rest of my life? I hope i’ve been clear in what i’m saying. THanks alot and i look forward to your reply.
I’d stop trying to categorize yourself into a particular Norwood class. Perhaps you are a class 2 or class 3, but I really do not know (photos might help). Are you measuring at an angle? Assuming you’re seeing 2 inches when measuring perfectly vertical from the brow to the corner, it sounds like it’s past the Norwood class 2 level. But it seems more like things are changing and evolving as you are maturing. You’re 18 years old, and a maturing hairline is definitely not uncommon at that age. The real issue is finding out if you are actually balding or not.
Before thinking about Propecia or putting yourself into a category, go see a doctor and get your scalp mapped out for miniaturization. If you are indeed thinning, Propecia may be an option to halt further loss.
Hello Dr. Rassman-
I have been taking propecia for over 4 years. I am a transplant patient and have had success with that but wanted to keep the rest of my hair also. I was never really convinced of the quality of results from propecia which had been supplied by the transplant doctor only, but kept at it. Recently, I had to get a new prescription and decided to fill it locally at my local pharmacy. It has been almost two months, and I now seem to be getting the results I was expecting. Is it possible that previous filled prescriptions could have included inferior sources of propecia? I’ve not seen or heard of anyone else with a similar experience. Have you? Thank you for your time
I’ve not heard of a situation like this. I really don’t have any reason to believe the Propecia supplied by your doctor is any different than the Propecia from your local pharmacy. If you are concerned, I would get the two different samples and contact Merck with your concerns. They have anti-counterfeiting procedures in place, which you can find out more about here. Did your local pharmacy provide you with Propecia or generic finasteride, because perhaps the dosing is different?
Hello Doctor,
I recently started taking 1mg of finasteride (approximately 3-4 months ago) and I’m seeing some noticeable hair growth.
A couple days ago I started taking some adderall and noticed that it was causing my hair to shed. Since the 1mg dosage is meant for men with normal testosterone and DHT levels (and considering the fact that adderall increases testosterone plasma levels, which translates into more DHT production), would an increased dosage of finasteride negate this increase in testosterone, and thus, DHT levels?
Also, when would be appropriate time to take the finasteride so that the drug’s effect will coincide to provide maximum efficacy against the increased DHT production from the adderall? How many hours/minutes before or after taking the adderall?
Thank you
I can understand your concerns, but you need to know the basics of hair loss. Chasing DHT levels is not the answer and this medication may have a direct impact on your hair, independent of any genetic contributions. If your hair loss is genetic (otherwise known as male pattern baldness or androgenic alopecia) there is no definite cure. Drugs such as minoxidil (Rogaine) or finasteride (Propecia) do work, but they do not STOP or CURE hair loss! Results vary among individuals. And even if you regrow hair, over the course of your lifetime you will still slowly lose hair. Taking these medications will help by minimizing the hair loss.
With respect to Adderall, it may have an effect on hair loss. Even if it did, taking more finasteride will likely not help. Studies have indicated that it does not make a huge difference between taking 1mg or 5mg of finasteride (aside from higher side effect risk). In some rare cases, I have recommended 2.5mg finasteride for patients, but I’ve yet to see any gain or slowing of hair loss as of yet (likely too soon to tell). I don’t mean to sound bleak, but DHT is not the only answer to hair loss. We have not discovered the complete mechanism for the way in which the genes work at the hair growth metabolic level… yet!
