Category: Drugs

I have been fighting the effects of MPB for 10 years now and am 36 years old with good results and a lot of dedication. Ten years ago I started using Propecia when it first came out. It worked very well for me. Five years ago I noticed that it did not have the same effeciveness. I started to use Minoxidil along with Proscar split in to two. This worked well for three years but a year and a half ago we started to try for a baby and I did not want to have Proscar broken up around the house. I stopped using Proscar and just used Minoxidil which worked untill about two months ago when I started to see thining at the front. This is the same thinning I saw 5 years ago. Do you think this is a 5 year pattern that my hair goes through and not to worry? Have you seen somebody use Propecia for 8 years get off it and get back on it a year or so later with good results? What would you recommend?

It isn’t too late to restart the drug, although what hair you lost may not come back. It will likely slow down or stop what you are losing now. Some people think that Propecia works only in a 5 year cycle, but that is not true. The official Merck study was limited to 5 years and that is what people seem to remember.

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Hello,

What do you think of Revivogen and this recent study, comparing it to Finasteride and Dutasteride: study (PDF File)

The science looks interesting, but it is not clear from this study that there will be actual hair growth. If you want a known DHT blocker, finasteride is safe and proven to work. Nonetheless, I appreciate the link and thanks for sending.

Dear Dr. Rassman,
Thank you very much for maintaining this very informative and detailed website. I would sincerely appreciate your advice regarding my propecia therapy. I am 21 years old and have been taking propecia since July 2007. After the first 6 weeks on the drug, I noticed a complete cessation of hair loss. I subsequently discontinued the drug on the very poor advice of my father, an internist with little experience with finasteride treatments for MPB. I then restarted the drug about 2 months later, and again noticed complete cessation of hair loss within several weeks. I stopped taking propecia a second time, again on the advice of my father. Once again the hair loss returned within a few weeks.

I went back on propecia in late December, and have been taking it for the past 8 weeks. Unfortunately I have not noticed any change in the amount of hair I am losing. I am wondering if you would kindly explain the mechanism of this phenomenon. Have I induced resistance or tolerance to propecia in my hair follicles? Have I upregulated the expression of DHT receptors on the follicles? Is it possible that my estrogen levels or testoterone levels are relatively higher than they were when I started treatment several months ago?

I realize that I have committed a very grave error in discontinuing my propecia on two separate occasions. Have I irrevocably lost my responsiveness to the drug, or will it likely prevent further hair loss? Fortunately my hair loss is still not noticeable, and I would be happy simply to retain what I have.

With best wishes,
A stressed-out medical student.

It is often surprising how little doctors tend to understand about hair loss and its treatment. If you are playing with this drug, you allow the hair loss to continue its downhill course each time you stop taking it. The hair that you lose when you stop taking it may be lost forever, so stopping the Propecia intermittently may just set you up to a progressive lower hair count over time. Perhaps you were just in a rapid state of hair loss. Whatever is the cause of your situation, from a mechanistic point of view, you MUST continue on this drug for life. Stopping it allows you to play catch-up hair loss and eventually you will just progress further down the balding road.

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I received the following from a patient:

Guess what I’ve discovered? Indirectly, of course Turns out that THIS stuff had an odd side effect (it’s a glaucoma medication) it grown hair and has become RevitaLash. There’s more to the story (possible lawsuit, etc) about the product… how interesting! Anyway, I would like to buy the Xatalan (if you can/will write a prescription) and test it on my hairline. Does that sound interesting to you?

Xalatan is the brand name that Pfizer uses to market the generic drug latanoprost.

This is interesting, but upon looking up the drug for risks and potential side effects, I am not sure about safety. My one and only real caution is the safety issues. For example, if you accidentally got this into your eye, then there are pressure changes in the eye that might damage your vision — and there are verbal reports from doctors experienced with this drug that have told me it can change eye color. The medication is normally used to drop high eye pressure under the direction of a physician, but if your eye pressure is normal, it can drop to below normal levels and possibly cause injury.

As far as hair growth, it would be interesting to see if anyone has tried it, but the cost is high on a per drop basis so you would have to be quite wealthy to put drops of this stuff on your scalp.

• MedLine Plus – Latanoprost
• Wikipedia – Latanoprost

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Hi Doctor,

I came across a doctors site which supposedly has a procedure for balding in which they actually inject a small amount of fines. and minox. along with vitamins and trace elements via computerized mesogun into the mesoderm of bald areas. The site is www.msi-medspa.com, under hair restoration tab, in the “Is there any other solution for hair loss other then surgery”.

Does this technique seem feasible? I have been on propecia for a month now. My question is, would using the above technique assist in preserving the current stage of my hair until the propecia begins working (assumingly in 3 months now)? Could it be used in conjunction, and would injecting fines. directly in bald areas prevent side effect?

Thanks for your help.

Oral Propecia (finasteride 1mg) starts working immediately, but it takes months to see the effects of it (a good 8 months to see the impact on hair growth). I can not imagine injecting either minoxidil (which will drop your blood pressure, as that what it was designed to do) or finasteride (not shown to be effective here).

The site you referenced says: “Tiny amount of active ingredients of minoxidil, finesteride together with all vitamins and trace elements are injected via computerized mesogun into the mesoderm of bald areas It gives an excellent results in both Androgenic and pseudo androgenic alopecia.”

I would like to see the proof that this procedure provides “excellent results”, for it sounds like you’d be experimenting with yourself as the guinea pig.

Hi Dr. Rassman,

Check out this article on the Wall Street Journal: FDA Chief Is in Budget Bind.

With all due respect, why do you put so much stock in the FDA? It is clearly a horribly mismanaged government agency. President Bush and Congress have declined the FDA’s request for a budget increase due to the system being “badly broken” and even though it is still considered the “gold standard” (as the article states), it is obvious that there is much corruption. So why can you so easily disregard every product that hasn’t made FDA approvals and even some that the FDA have cleared (like the hair lasers)? I get that you’re hesitant to recommend anything beyond the FDA approved drugs because you are a physician and you do not wish to do any harm, but I’m open to new ideas and you seem to be coming from this old school mentality of just believing what the government tells you and disregarding everything else.

I love your site and I know you’re writing by far the most honest hair loss site on the web, but this is just something I have a problem with and I hope I can shake your tree a little bit to find out your thoughts on the FDA as a regulatory agency and their actual ability to act in the best interest of the public or in the best interest of the drug companies.

If I had to judge safety and effectiveness, I am afraid that I would be doing only one thing with my life and that thing would be to become an expert in possibly only one drug. It would take years and a massive effort to perform the same types of studies that the FDA requires. Every civilized country has their own FDA or equivalent with the same mission — to judge safety and effectiveness of various products before they come to market.

Governments build bureaucracies and much like the Katrina disaster in Louisiana, our government did not do a competent job. I am not a fan of bureaucracy or incompetence, and upon reading your referenced Wall Street Journal article, I know it speaks clearly about the problem. I am afraid, however, that I must use whatever sources are available to determine safety and effectiveness and other than the FDA, there are not any other substitutes.

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I understand that using a sauna can remove drug residues from the body. In view of this, my question is can you use a sauna while on propecia? or will it limit the effectiveness of propecia itself?

thanks

No, a sauna will not cause you to expel or remove Propecia from your body or limit its effectiveness.

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