Category: Drugs

I saw on TV a Rogaine foam commercial and they claimed it helped 85% of men in a clinical test regrow hair. Seems like a high percentage there. Also, how the hell is someone supposed to
put foam on their scalp if their hair is only thinning and not yet bald?? Seems like spray would work 40x better.

Yes, it seems like a very high percentage for success. In my opinion both should work and it is specific to individual preference. You can put the minoxidil that is store purchased into a spray bottle and spray it, but just be careful to avoid misting it into your eyes.

The reasoning for the foam’s existence (aside from a way to market the drug in a new way) is that it stays on your scalp longer and does not run off making an oily mess, as it is alcohol based. The primary thing that would make minoxidil (Rogaine) work better (foam or spray) is to follow the directions and apply it twice a day everyday, but compliance is not so easy for most men.

I recently tried rogaine and it fried my head. After about 4-5 days of it… it caused my head to itch like crazy and a rash broke out. I heard that the foam is less irritating however the foam was worse for me. After I let the initial rogaine rash heal I tried the foam and that time it almost seemed like an allergic reaction because after only one application my scalp and even parts of my face developed an even worse rash that began only an hour after application! Is there any brand that I should give one more shot at? Have you heard this before??

I think your experience may suggest that you are allergic to Rogaine (minoxidil). Practically all medications can cause allergic reactions and it seems you have found what you are allergic to. I would consult with your doctor for other treatment options for balding, such as Propecia (finasteride) — if you are male.

Hi Dr. Rassman,

I had a question for you regarding the cessation of Propecia, which I don’t believe has ever been answered on your blog. You’ve made it quite clear that stopping Propecia will lead to the state a patient’s hair would have been had they not taken Propecia at all; they would lose all hair gained or maintained while on Propecia within 12 months of stopping the medication. Suppose one wants to stop Propecia for any given reason. Is there a way to wean oneself off of it over an extended period of time (even years?) to avoid this sudden loss?

Thanks

I do not have a specific recommendation. I suppose you can slowly decrease your dose over the course of a few months. but you will still lose all the hairs that Propecia was sustaining. It may not be quite as “sudden”, but it will still be a loss.

Before starting or stopping or changing any medications, you need to discuss these issues with your prescribing doctor.

Hello Doctor,

I had surgery to remove gynecomastia caused by Finasteride use for hair loss. I was taking 1.25 mg daily. I have seen great results from medication as regards to my hair loss. I would like your opinion on stopping the medication now because of recurrence or is recurrence not a possibility after surgery. Also can 1.25mg of finasteride be taken once every three days with the same results and less side effects..

thanks for your time

I have very little experience with those few patients who developed gynecomastia (breast enlargement in men) from Propecia other than having them stop the medication and see if the gynecomastia goes away. It usually does. On one patient I remember, I had him stop the medication and then after the gynecomastia went away, put him on a 1/2 dose (1/2 mg) of propecia and the gynecomastia returned. You are caught in a delicate predicament with clear choices. What I can tell you is that it was reported that half the standard dose (0.5mg) of Propecia has 80% of the impact on preventing hair loss and it may work for you, but then again in one of my patients it did not seem to help even at 1/2 the dose.

Your situation is different in that you had surgery once to remove swollen glands that are present in some men (most don’t take Propecia) and maybe it was there prior to taking the drug? If I were you, I might try (speaking as a layman, not a doctor) the drug one more time. It may not cause recurrence, but if it did, then you should be able to stop it and reverse the effects (as most men who stop the drug do). I would speak to my doctor before making that decision and get his sage advice on the matter.

My dermatologist did not feel comfortable prescribing Proscar for my MPB so I have been stuck taking and paying for Propecia.

I know that no generic form is legally available in the U.S. and “Propecia” is strictly used for cosmetic purposes. However, one would think that since most insurance companies don’t cover the drug it would be more reasonable priced for the average Joe to pay for it out of pocket. So I have a two part question:

1. Why is it so expensive when most people have to pay for it out of pocket?
2. Lastly (and seriously), I don’t know how closely you have been following the 2008 Presidential election but are you aware of any of the two major candidates healthcare or perception drug policies that would lead to lower cost of Propecia (even though it is cosmetic drug).

Love the blog!

Propecia ’08!

I don’t have decent answers to either of your questions, unfortunately… because these aren’t things I have access to. To answer why Propecia is so expensive, you’d have to defer to the company that manufactures it and owns the patents on the drug, Merck. You could speculate all day why drug prices are what they are, but I don’t know of any reason they’ve ever given for a specific price of a specific drug. As far as your second question, who knows if Propecia would be covered by any national health insurance. We have considerable time to wait this one out.

Although you did not ask me about the presidential race, those that play the odds will know that we have not had a hair-challenged president elected to the highest office in the U.S. since the 1950s (Dwight “Ike” Eisenhower), so Obama may be the favorite for those who play “Hairy Politics”.

hello dr,
my question may sound a little funny but it kind of sits on my mind so i would really like to hear your comments. i started using propecia 4 months ago, my baldness still isnt visible and i started propecia because i had hair loss all over the scalp and had seborrhea and pain on my scalp as well. my scalp was checked for miniaturization and was found with 44% of it.

so i started to take propecia but i still dont see any change in the hair loss, sometimes i think i do but overall i cant really notice any change aside from that my seborrhea and scalp pain i had subtled almost completely. the thing is, i did not have any side effects at all (and i hope i wont have any too), quite the opposite actually, i think my libido increased and my sex life has improved since! and that is why i have this weird feeling that the medicine just didnt effect me at all (excepts for the things i mention which i dont know if propecia got something to do with it), do you think that there might be a link between no side effects what so ever and the drug not effecting me?

i would really appreciate your comments regarding the issue dr. thanks a lot and please keep up the great work you’re doing!

Although not widely publicized (or criticized), an increase in libido is a more common side effect of Propecia (finasteride) than a decrease in libido. It should eventually return to normal. If the increase in libido bothers you or your partner, you can try taking just a half pill of Propecia daily.

These side effects will not interfere with positive impact of Propecia on hair growth or stabilization of the hair loss.

Hello I’m 37 years old and I have been using Propecia (1mg every day) for a year. First 6 months I had perfect results and I significantly increased my number of hairs. Since 1 to 2 months I have been losing hair massively. I must say that the very little side effects also disappeared this period.

Can it be the case that the Propecia is suddenly not working anymore? I have read about a shedding but this seams always to happen within the first 6 months. Can this also after 10-12 months?

Thanks you very much

The loss of hair while you are on Propecia (finasteride 1mg) is a sign of progression of the hair loss process that Propecia is not stopping. If you stop the drug and the hair loss is caused by the genetic process, then the hair loss will accelerate even faster. We go through phases of acceleration of hair loss and sometimes even the Propecia won’t stop it. Speak with your doctor about what is happening and make sure it is not another cause of hair loss like telogen effluvium.