Category: Drugs

I have a two part question. First, If a person is experiencing hair loss who would you advise them to go see first, a dermatologist or a hair specialist? My other question is about Proscar. I know that some dermatologists as well as other doctors prescribe Proscar to treat men with male pattern baldness even though it is only FDA approved for BPH. I am thinking about taking Proscar instead of Propecia due to the difference in cost and am just wondering if finding a dermatologist that would prescribe Proscar to someone who is 21 years old be akin to trying to find a needle in a haystack

Your first stop for hair loss is best done at a dermatologist’s office provided that he/she shows an interest in this type of problem. Your caring family doctor also works and throughout the US there are many hair transplant doctors who are skilled in diagnosis. I routinely prescribe generic Proscar (5mg finasteride) and instruct the patient to cut the pill into quarters.

I am in Los Angeles, not too far from where you indicated that you live, so I am not a needle in the haystack. I’ll point you now to my website for information, including phone number and address. Take a nice drive and pay me a visit.

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Hello Doc,
I have been on finasteride 1mg for a year and now I have switched to 1/4 Proscar. It has been working fine but I suspect little decreased libido and thinking to take half dose. I am not sure that taking finasteride 0.5 mg every day is better or taking 1 mg every other day is better or they both have the same effect?

I am asking this based on the fact that finasteride remains in the blood for only 24 hours so it means that if I am taking it alternate days then I am without finasteride for 24 hours. On the other hand, 0.5 mg finasteride is 80% as effective as 1 mg so taking 0.5 mg everyday would give me 80% cover everyday.

That is what my analysis is, but I want your view on this. Thank you very much for help sir!

I tell my patients who have sexual side effects to reduce the dose to one half a pill per day. That keeps levels of the drug in the blood stream most of the time and it should be more effective than 1 pill every other day.

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I’ve been using Propecia along with Rogaine for about 4 months now. It’s slow going, but I’m definitely seeing tiny new hairs coming in, in certain areas. I recently came across a product from Perfect Hair Solutions which is a 10% minoxidil and 5% Azelaic Acid solution and decided to order a bottle. From what I hear, result come in more quickly. I’m just trying to figure out why Rogaine hasn’t put out any thing stronger than the 5% and if it would be a side effect issue or not – also, would too high of a strength be damaging to the hair follicle? I was wondering if you can give me your thoughts on this product. Thank you.

More is not necessarily better. The higher concentration of minoxidil (10% or even 15%, for example) runs a greater risk of side effects, including systemic side effects like dangerously low blood pressure, fainting, and skin irritation.

Azelaic acid does not grow hair. It is more of a marketing hype in my opinion, as the thought process is that the acid will irritate the scalp, causing the minoxidil (Rogaine) to be absorbed better. The truth is, either of these medications can cause irritation and when used together the incidence of irritation and dermatitis goes up. The same concept holds when they mix it with Retin-A (which is also an acid).

Reading some message boards, I see a lot of disgruntled people with regards to Propecia and saying the drug destroyed their hairline, hypandrogenicity, etc. It makes you think everyone suffers from severe hyperandrogenicity because they get a zit. I know you’ve mentioned in the past that people with negative things to say usually are the most outspoken. But it is easy to get an impression reading these boards Propecia is awful because the negativity outweighs the positivity when Merck proclaims the opposite.

My question is: in your practice, have you seen people suffer from in your own practice? And with those patients on Propecia, what percentage elect to stay on it and are generally content with the performance of the drug?

Thanks Doc!

The Propecia side effects statistics from Merck are in line with what I see in my practice. It really is very minimal. I agree that the message boards bring your attention to the agenda of the posters, which may not be pure and objective like mine. I really have nothing to gain by telling people about Propecia, a drug which can regrow hair and halt hair loss (I am, after all, a hair transplant surgeon).

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Hey doc, In your experience, do you feel that lots of guys tend to over analyze their hair after starting a treatment like propecia? For instance im 5 1/2 months in, for the last week i was convinced it was starting to see some hair come back, then today i look and it looks awful. I go through these mood swings all the time, since i started propecia. I should have listened to you and got a minuturization test done but my derm just gave me the meds, so now all I have to go off of is my memory of what it looked like when i started. Secondly between what months do most your patients see improvement in their hair, or become convinced that propecia is working in some form or another?

What was the phrase — a watched pot never boils? If you’re taking a pill to treat hair loss, of course you’re likely to watch your hair with an intense focus. It’s not unusual, but you shouldn’t stress yourself out about it. It generally takes 8 to 24 months to see the benefits of Propecia (finasteride). Full benefits may take the full 24 months.

The reason I suggest mapping the scalp for miniaturization is well defined by your comment. Our memory is not objective, but scalp miniaturization mapping is objective… so you do not have to rely on your memory.

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Hi,

I’ve been going for hair transplant surgery last 2 months and after the surgery the doctor recommend me to take propecia to maintain my existing hair as i was indicated of suffering from Male pattern hairloss. Just 3 days ago i start to apply Proscar and split it into quarter 1.25 mg as financial problem and use it daily without side effect so far. Surprisingly my hair stop to fall off immediately as only used for 3 days..

My question is now i am taking 1.25 mg of proscar daily, and i plan to switch to Propecia 1 mg after 2 years from now on. Is there any case of intensive shedding happened if switching from Proscar 1.25 mg to Propecia 1 mg? As most of the cases is only mentioned switching from Propecia to Proscar for cost saving.

Thanks for your sincere advice.

Cheers.

Proscar and Propecia are both the drug finasteride just at different doses. Switching between them is no problem at all. The difference in the 1.25mg dose and the 1mg dose is relatively insignificant.

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