Category: Drugs

Hi doc. I jut want to ask you a question. I have been taking Propecia for almost 4 weeks now. During the 4 weeks I noticed an increase in my acne (face, scalp, and back), and my scalp acne flared up like crazy, to the point it hurt to put my head on the pillow. I never had pimple on my chest and I broke out there as well. I haven’t changed anything in my diet, or routine, so I can almost be certain that Propecia is the culprit. I guess it works differently in everyone.

I have decided to stop taking it. Will 4 weeks of usage have any negative impact on my hair? Before taking Propecia my hair was thinning but not noticeable to others. Can 4 weeks of Propecia usage then stopping it kick start hair loss like crazy? During the 4 weeks of usage my hair loss was at the same rate as before even taking the drug.

Stopping Propecia after only 4 weeks will have no impact on your hair loss. Over the many years of doing this site, I’ve only had a few reports emailed to us about an increase of acne from Propecia, but I haven’t seen that in my own patients.

Hi Dr Rassman,

I would like to ask a question that has been on my mind for years, but haven’t seen an answer to this question. I’m 30 year old male.

How would I ever know if propecia is having an effect on my libido, sex drive etc? After all, these effects are not practically measurable. For instance, my libido is constantly changing from month to month, and even a day to day basis. How would I ever know it’s having an effect? I don’t currently take propecia, but am considering it. This has been my biggest factor in deciding to take the drug. Appreciate any recommendations that you can make to help measure these effects.

Thanks for a great blog.

One does not measure libido, as this is a subjective call for everyone. You are right — our libidos do vary with mood, age, time of the day, stress in our lives, relationships, etc…

The decision about taking a drug like Propecia should relate to a Master Plan for your hair loss problem.

I am 29 years old, and I started noticing hair loss when I was 20. I have been using Regaine 5% since almost 4 years and Propecia since almost 3 years.

I have seen very good results with Regaine 5%, but these results are mixed. When my hair is extremely short (trimmed by the machine to level 1 or 2), Regaine is very effective. When I let it grow, it remains effective until a period of 4-5 months, where I start experiencing hair loss again. Then I shave my head, and it starts working again, and the cycle continues. This is not due to the fact that I cannot see hair loss when the hair is short; I am testing my hair loss even at very short length.

When minoxidil (Rogaine/Regaine) works, it usually works as long as you use it. When you stop using it, you lose the benefits quickly.

Shaving your head has nothing to do with the hair loss or hair growth, and what you are reporting is likely more illusion than reality. Shaving your head was commonly thought to increase hair growth, but contrary to this myth that has been around for centuries, it does not impact new hair growth at all. I can’t comment on what you’re seeing, because it doesn’t make sense to me.

From the news release:

The U.S. Food and Drug Administration today approved Gilotrif (afatinib) for patients with late stage (metastatic) non-small cell lung cancer (NSCLC) whose tumors express specific types of epidermal growth factor receptor (EGFR) gene mutations, as detected by an FDA-approved test.

Lung cancer is the leading cause of cancer-related death among men and women. According to the National Cancer Institute, an estimated 228,190 Americans will be diagnosed with lung cancer, and 159,480 will die from the disease this year. About 85 percent of lung cancers are NSCLC, making it the most common type of lung cancer. EGFR gene mutations are present in about 10 percent of NSCLC, with the majority of these gene mutations expressing EGFR exon 19 deletions or exon 21 L858R substitution.

Gilotrif is a tyrosine kinase inhibitor that blocks proteins that promote the development of cancerous cells. It is intended for patients whose tumors express the EGFR exon 19 deletions or exon 21 L858R substitution gene mutations. Gilotrif is being approved concurrently with the therascreen EGFR RGQ PCR Kit, a companion diagnostic that helps determine if a patient’s lung cancer cells express the EGFR mutations.

Read the rest — FDA approves new treatment for a type of late-stage lung cancer

Participants receiving this drug had a delay in tumor growth that was over 4 months later than those receiving chemotherapy. The press release notes that there was “no statistically significant difference in overall survival” though.

Dr. Rassman, I have been on propecia for nearly a year and half. I started to take the drug at age 27 when I noticed that my hairline receded to a norwood 2.5 pattern. I have noticed that on the right side on my hairline near the temples in addition to the frontal region above the forehead there has been significant regrowth in terms of length and also thickness. However the left side has remained stagnant for the most part. In your practice have you seen this often in young men and what may I expect in the coming months or year?

I as well thought I have suffered from from side effects due to the drug. I had some erection issues and also some gynocomastia develop. A blood test reveal that I had lower testosterone levels and started a strength training and weight loss program and both of the side effects went away while staying on the drug. Many of the users who suspect side effects need to check other health issues.

Thank you so much for taking the time to answer my question.

We see hair loss that is not symmetrical, so I would not be surprised that one side reacted differently to Propecia than the other side; however, you are the first person to have reported this to me. I would go back to your prescribing doctor to have measurements done (assuming you had measurements taken before starting the drug, you can have comparisons made).

With the side effects that you reported, most people would just assume it was Propecia and not even consider any other possibility. It just goes to show that there are other possible reasons for effects that people see, and deciding on your own about the causes of the issues without a medical exam may not be in your best interest.

Hi Doctors, Im a big fan of the site.

I am afraid of what I read online about Propecia. Is there anything natural without harmful side effects that I can do to increase circulation in my scalp, slow down thinning? Do you recommend anything?

The problem with hair loss is not circulatory dependent. The body reduces the blood supply to the scalp as the thinner, sickly hair does not need all of that circulation. Scalp circulation is not the cause of genetic hair loss.

Too many people overreact to the rare sexual side effects of Propecia, but before you draw any conclusions, talk to your doctor and make an informed decision. The odds are in your favor that the side effects won’t occur, but if you’re certain you’re going to have side effects, the power of suggestion is something you should be wary of. There are no all-natural supplements that are proven to regrow or stop genetic hair loss.

Amazing website. I have been on finasteride for the past 12 yrs or so. It has held on to my hair quite well but I have noticed my temple areas and front part of my hairline thinning out recently. The crown is still slightly thick.

I want to know when is a good time to switch to avodart since I have noticed the front part of my scalp thinning out. Should I switch ASAP? I know its not approved for MPB and the risk could be slightly higher etc etc but I know a few of the people who comment on here have switched and are having excellent success even in the temple and hairline which is not very common.

Avodart must be prescribed off label (unless you have prostate issues), so it’s up to your doctor if he is willing to prescribe it to you.

The decision to switch from finasteride to dutasteride (Avodart) is one that you must reach with your prescribing doctor. Some people report better response with Avodart, but you must realize that the risks may be greater for sexual side effects and the possibility of sterility. Unfortunately, the information on this is not clinically available in younger men for treating hair loss, so it is a gamble.

Doc

If one has been on minoxidil for years wouldn’t all hairs at risk of loss be minox dependent? I know they work differently but what does adding Propecia do for those hairs at that point? Since stopping minoxidil will cause you to lose those hairs regardless of Propecia. So lowering DHT appears to not help hair that is minoxidil dependent. And if one has been on Minox for years that could be a lot of hairs, right?

If you add Propecia do the same hairs then become dependent on both?

Thanks

I really don’t know. The minoxidil dependent hairs are not the permanent hairs, just those vulnerable to miniaturization. The same is true about finasteride (Propecia), but I do not know what happens as the two drugs overlap with regard to dependence.