Category: Drugs

Hi,

I’m 23 years old and a male. I was on propecia, when I was uncomfortable about my hair situation, though my doctor suggested it wasn’t a necessity. I have more thinning in the temple region (perhaps maturing hairline but I have a large forehead). After awhile, I decided it was not worth it to be on this pill forever and I hadn’t noticed a significant change in my hair. So, I decided to stop taking it roughly 7 months after I started. I have noticed lately some shedding (not of miniaturized hairs, but regular kind). I normally shed during the winter anyway, but I’m wondering whether I should be concerned that Propecia has screwed with my hormones, or I should expect hair growth to resume?

It seems like you are describing a phenomenon called “catch-up” hair loss after stopping Propecia.

Patients sometimes do not understand that having no change is good, as it indicates stability. You may not notice new hair growing with Propecia, but you are also not losing more hair. Once you stop the medication after a few months, all the positive (silent) benefits of Propecia will reveal themselves, as the hairs the drug protected from falling out will be lost.

I do not believe Propecia “screwed” with your hormones. Instead, you likely have genetic hair loss and Propecia (while you were taking it) was keeping your hormones (DHT) from causing hair loss.

Paid advertisements (not an endorsement):

Hello Doctor,

I’m male, 37, 6,1, 180lbs, don’t take any medication and my hair is about 1.5 – 2 inches long and sometime 3. I have male balding on the top and receding hairline. In the past I have had thick and lots of hair, now the top is thinning to a point were I get sun burns and makes me cold in the winder. This is the part that I really don’t like as I hate wearing something on my head.

My question is, when looking at Rogaine, which product is best for me? Here’s my thinking, some with questions:

1. It is important that the solution gets in contact with the scalp, so with “longer” hair will the foam product be as effective?
2. Is volume and length of hair need to be considered when choosing product?
3. With the foam product how do you know one is using the right amount?
4. There has been remarks about the smell of the foam, are there scent free versions [coming]?
5. How can one test the product without buying a full size?
6. Is there a difference between the different brands, besides price?
7. Is there a generic foam vs. Rogaine?

Thanks.

1. Yes, the Rogaine (minoxidil) needs to be in contact with the scalp in order to be effective. Hair length doesn’t matter, but volume of hair could play a role in getting the medication to reach your scalp. Just be diligent and move your hair around to get the minoxidil onto the scalp.
2. See answer above.
3. I would think there is some instructions on the packaging. The Rogaine Foam site says “the total amount of foam applied should not exceed half a capful.” For the liquid, the recommended dose of the Rogaine 5% topical applied twice daily.
4. I have no idea if they’re making a scent-free version.
5. I don’t know if Johnson & Johnson (makers of Rogaine) offer a free sample of the foam. Drugstore.com sells it at $22.79 for 1 month or $42.49 for 3 month supplies. The best price depends on your own research.
6. The foam is reported to have better absorption than the liquid formulation, but I do not believe it is a significant advantage to achieve a drastic difference. Generally speaking, a generic minoxidil 5% solution would be the least expensive (most bang for your buck).
7. To my knowledge, there is no generic version of Rogaine Foam.

More information can be found on the Rogaine Foam site. Remember, before starting any medication you should see a doctor (a hair transplant doctor is fine) for a good initial evaluation. You may also be a candidate for finasteride (Propecia).

I have taken finasteride for about 18 months. after noticing a decrease in semen quantity (by about 40%) i stopped taking it for about 6 months. After stopping it. i have lost much more hair than what i had before starting the medecine. I can now almost see a big bald patch on the crown. I am thinking of restarting the medication. I would like to know if i will get any more side effects if i restart taking finasteride, i.e will my semen quantity reduce even further than what it has reduced earlier? or could i get any other side effects now considering that i had tolerated finasteride quite well earlier??

Your experience with finasteride and your semen quantity are probably the most cost common side effects reported. If you restart the finasteride, it will probably happen again. Despite the reduced quantity, you should be alright with fertility.

The really bad news is that you experienced “catch up” hair loss when you stopped taking the drug and that will not likely reverse, retaining much of the balding that you developed over the past 6 months. Your doctor should have told you about this, as I stress with my patients that stopping the drug will have the hair loss problems you experienced.

Paid advertisements (not an endorsement):

I don’t think topical finasteride is regularly available at a pharmacy, but there’s a doctor that I’ve seen offering it. Why doesn’t Merck offer this and is it as good as the pill?

According to the website of one doctor that sells it, “Topically applied finasteride is reserved for use by those who wish to block only 5-10% of the DHT activity in the scalp, which is a lower level than typically achieved from ingesting tablets.” So why would you want to use a messy cream on your scalp and not block as much DHT as a single daily pill can?

If it doesn’t work as well as the 1mg finasteride pill in treating hair loss (if it works at all), this is probably why Merck doesn’t offer it. I really don’t know what Merck’s reasons are, but I doubt that there is real data to support the doctor’s declaration and I would insist on seeing where the “block only 5-10% of the DHT activity in the scalp” comes from. I am skeptical and I wouldn’t have a way to validate such claims.

Note: Bottle is for illustration purposes.

Doc,

I’m confused! We all know that finasteride reduces the amount of DHT in a man. This hormone is known to be the cause of secondary male characteristics, like hair growth and muscle development. So with reduced DHT levels, it should be HARDER to gain muscle, right.

Then how come in many of your previous posts you mention that taking finasteride makes it easier to build muscle since it increases testosterone levels by almost 20%? Granted testosterone levels increase since more of it doesn’t convert to DHT, but DHT, which is more responsible for muscle growth than testosterone, decreases!

How do you explain this?

I’m not seeing the connection here.

To clear any confusion, DHT blockage with Propecia may give you a small transient increase (not permanent or persistent) in testosterone levels, reported as high as 15%. These minor changes in hormones will not likely affect muscle mass (gain/loss) and are not long term.

Paid advertisements (not an endorsement):