Hair Loss InformationI Can’t Take Propecia Because I Have Hepatitis B? – Hair Loss Information – Balding Blog

Hi Doc,
I am very concerned about my hair loss, and so far my frontal area is balding apparently. I thought about having hair transplant, but one doctor told me that I need to take propecia to stop losing the existing hair after the surgery.

However, I have Hepatitis B so my personal doctor suggested me not to take propecia since propecia can increase the chance of me getting liver cancer.

This is truly a delimma to me, do you have any suggestion or solution to that? Thanks

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I do not understand why your doctor suggested that you can not use finasteride (Propecia). Finasteride get metabolized in the liver like many other medications. If you are in liver failure, then that may be a different story. Its use needs to be controlled and it probably needs dose adjustments in the patients who have liver disease or cirrhosis (not just hepatitis). I am not aware of any evidence that indicates an increased risk of liver cancer with finasteride if you have hepatitis.

Generic Minoxidil vs Rogaine? – Hair Loss Information – Balding Blog

Hi, I had a question about the effectiveness of generic rogaine. My hair has recently been thinning (I assume as a result of genetics since my doctors can’t find any other reason). I noticed that the Wallgreen’s brand of rogaine is a lot cheaper so I’ve been using that. So far after 3 months I haven’t seen any difference. Do you think generic rogaine is as effective as the name brand (they appear to have the same ingredients)? Thank you very much doctor! I really appreciate it.

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The generic minoxidil and Rogaine do have the exact same ingredients. I do not see any difference between the two and their effectiveness should be the same provided that the concentration is the same, and they are using the same inert ingredients. The foam form seems to be better, because of distribution and penetration of the skin.

Switching from ScalpMed to Generic Minoxidil – Hair Loss Information by Dr. William Rassman

I was unable to access your link that campares Rogaine to ScalpMed. The link is broken. Therefore, my question to you is this: Is the only ingredient in Scalp Med, (when mixed with “Vitadel” which is simply minoxidil) that actually effects hair growth Minoxidil? I suspect that all these similar products are merely inactive ad-ons since the only common ingredient ALL the products have is that they must be mixed with minox.

Is that so? In other words, if the product works for me-and it does so remarkably, would I see the same results by simply using the $20 a bottle minox and not spend the extra $100+ on the Scalp Med or Follicare, etc.?

I’d be very grateful if you could clear this up for me as I love the results but simply cannot afford their prices anymore. And stopping using will cause the new hair to fall out. Also, do
you think that a DHT blocker is important and/or effective in combo with minox? I look forward to your kind reply. Thanks much.

ScalpMed, as we stated before, does not have any scientifically proven ingredients besides minoxidil and I do not see any reason why minoxidil should not be as effective, possibly even better.

There has been some research done on topical DHT blockers (mostly by Japanese researchers), which shows effectiveness of these products. I guess I would like to see more research on larger groups of patients before recommending them to my patients on a regular basis.

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Is DHT Essential For Genital Function? – Hair Loss Information – Balding Blog

Is DHT essential for proper genital tissue structure/function?

(more detailed: could lack of DHT lead to decreased AR expression in penile tissues & nitric oxide production… leading to tissue changes, ie fibrosis/collagen deposition which cause such shortening/lack of bloodflow?)

I know there is relevant posts to this issue where you dismissed finasteride in relation to a change in penis + testicle size but i thought it was important to bring forward my case to show that there is definately some relation with finasteride and penis size *in a flacid state*, aswell as testicle size. I am a 20 and a half yr old male who has been on propecia since about 19.

id like to point out im not saying that my penis has actually reduced in physical size due to finasteride, but in its flacid state it now resides alot different to how it use to – doesnt hang as much, looks like ive come out of a cold shower – which in turn gives the apperance of a smaller penis.

what ive experienced:
– testicle/scrotum shrinkage. they are no longer hanging as low as they use to, they are now tight and pulled very close to the body. scrotum could almost be described as empty and wrinkly
– reduction of how penis resides in flacid state. In the flacid state my penis is ALOT smaller then usual. penis doesnt “hang” nice and soft and move around loosely as it once did when to flacid. penis is now retreated /retracted as if in cold water, its almost withdrawn and seems it is lacking circulation/blood flow. penis once hung lower than the bottom of my testicles but is now actually pushed up and forward by how tight the testicles now are, and how reduced the size of flacid state is.

i found another person who experienced similar side effects to me. he stated he experienced:
– penile/scrotum shrinkage, loss of length/girth
– loss of morning/spontaneous/nocturnal erections
– empty/wrinkly scrotum
– penis constantly retreating as if in a cold pool
– loss of sensation/numbness to both penis shaft and scrotum, both feel lifeless/not pleasureable
– penile tissue changes: narrowing, curvature, darkening, emergence of numerous varicose veins along shaft

now i have not experienced the severity of his symptons, or his loss of size during erections, but it is quite alarming there are others out there who have experienced this issue and there isnt any warnings out there regarding this alarming side effect

after reading through several links below, one must question – is it possible that lack of DHT leads to decreased AR expression in penile tissues & nitric oxide production… leading to tissue changes, ie fibrosis/collagen deposition which cause such shortening/lack of bloodflow???

the links:
http://finasteride.jconserv.net/viewtopic.php?t=146
http://www.asiaandro.com/1008-682X/5/33.htm
http://finasteride.jconserv.net/viewtopic.php?t=346

thanks for any input you can share on this topic!

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DHT is very important in the first trimester of pregnancy when the testicles and penis form. If DHT is not present (mother on finasteride or born with a defect where the fetus does not make DHT), then a hermaphrodite will probably develop. For more on hermaphrodites, see:

It is true that being exposed to DHT blockers before puberty can negatively affect the development of the male external genital system and other secondary male sex characteristics (beard and body hair even after puberty). DHT is essential for development and growth of the male genital system before they are completely mature and reach their final size. Our current understanding is that the use of finasteride after puberty when the amount of testosterone is very high with corresponding high DHT levels, should not impact these secondary sex characteristics and will still allow the penis and testicles to reach their maximum size. There is not much information on the use of this drug in young teenagers and I suspect that prior to the age of 16 when balding may start in a select number of boys, the decision to use finasteride is easier the further into the teens the person is.

You have referred to a study done on 3 groups of young rats. This study has shown that a lack of either testosterone or DHT can affect the growth and development of the external genital system negatively.

In the studies done on humans, there was no report of similar or any other negative changes on the external genitalia in adult men or boys in their late teens. I have been recommending and prescribing Propecia to a good portion of my patients, and as of yet have not heard any such complaints with regard to impact on penis size once the penis has grown to its final adult size. You have to remember that this medication has passed all clinical phases and was proven effective and safe for treatment of male pattern baldness (in adult males). If you are still concerned with the changes in your genitalia, you can see a urologist to make sure you don’t have any other medical problems that have been causing this issue.

Hair Loss InformationSwollen Testicles from Propecia? – Hair Loss Information – Balding Blog

hi doc,
i read lots of your posts regarding testicular pain when on propecia, but could not find the one on swollen testicles.I have been taking the pill for a week now and both of my testicles are
swollen.Though there is no pain.I am very much scared and even considering to stop the drug.Kindly advise. is it normal and will go away over time as i continue using the drug or should i
stop taking the pill.did you come across these type of cases in your patients.

your comments would be of immense help to me.I will talk to my doctor also.

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Every now and then we do see patients with complaints of testicular pain or swelling. According to the results of the research on this topic, the rate of these side effects in patients who are taking Propecia (finasteride 1mg) is exactly the same as those on the placebo. If you are experiencing these side effects, you have to see your doctor to rule out other conditions that can cause those kinds of symptoms. Some of these medical conditions may be serious and need urgent evaluations such as incarcerated hernia or torsion of testicles. You can restart the medication if everything is OK and obviously missing a few days of finasteride is not life threatening.

Hair Loss InformationGefitinib Grows Hair? – Hair Loss Information – Balding Blog

Dr. Rassman,

Have you ever heard of a drug called Gefitinib? P.A. Burt observed a few years ago that a patient treated with the drug who had been bald for many years experienced sudden robust hair growth. I know of one other anecdotal report in which a patient experienced terminal hair growth at the tip of his nose. Aside from this, I’m not able to find any other infromation on the drug. I wonder what its safety profile and mechanism of action would be, especially when administered concomitantly with finasteride. Cool, huh?

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Gefitinib is a drug for the treatment of certain cancers. I am surprised that a cancer drug would grow hair, mainly because cancer drugs usually “kills” cells (especially cancer cells). If it actually grows hair, I am sure we will hear more about this drug. I would take caution in the fact that cancer drugs have many unpleasant side effects.

Hair Loss InformationIsn’t New Hair Grown from Rogaine Still Effected by DHT? – Hair Loss Information – Balding Blog

Hello Doctor,

I do not understand this dependability of my new hair grown on rogaine, isn´t this new hair also affected by DHT? what a I mean is: will my new hair fall even if I take propecia? why is this new hair different from the ones being saved by propecia?

thank you doctor

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BikeRiding a bike or driving a car may get you to where you want to go, yet they work very differently… just as Propecia (finasteride) and Rogaine (minoxidil) work differently to treat hair loss. Propecia blocks DHT production and by creating this block, the genetic element for hair loss is ‘subdued’. Minoxidil may work by extending hair cycles and/or moving hair into the anagen cycle. DHT can still do its dirty work.

Hair Loss InformationDoctor Just Put 65 Year Old Woman on Propecia – Hair Loss Information – Balding Blog

What can be done to stop or reverse miniaturization. I am a 65 year old female. Just in the past year, my hairs are so thin, you can barely see them in the sink. I’m on 5% minox with propecia added (my Dr.just started this 3 wks ago).

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Female genetic balding is a process that does impact women of your age. It starts with miniaturization of the hair. Minoxidil does slow it down, but there is no evidence that Propecia (finasteride) will have any effect. I have reviewed a number of studies on Propecia in women and the general conclusions by respected researchers and clinicians is that there is no benefit for women except those with known Polycystic Ovarian Syndrome (PCOS), which is not the case here.

Hair Loss InformationIs Finasteride Making My Eyes Sensitive to Light? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,
I saw my Dermatologist recently and after a quick scan of my hair, he prescribed me Proscar for early stages of MPB. I’m 28 now. I started taking 1/4ths and after 3 months decided to cut
it into 1/8ths to stay below 1mg per day.

About a month in, I noticed a few things with my vision. I noticed a couple of floaters, I was more sensitive to light especially at night with headlights and street lights and my eyes
were more dry. A trip to the eye doctor revealed no issues, but the effects still persist periodically.

In your experiences, have you had any patients report any changes to their eyes/vision? I’ve read some posts on message boards with the same issues but don’t find them reliable.

Many thanks! and this is a great board!

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LightFirst, I commend you in having the skill to break such a small pill into 8 equal pieces.

Second, I doubt finasteride is the cause of your eye problem. I’ve not had any reports of this from any patient I’ve prescribed finasteride to and I haven’t seen anything in the medical literature about vision issues from finasteride. It is unclear if you were seen by a optometrist or an ophthalmologist (the latter is a physician who specializes in eye problems). Seeing “floaters” may be benign, but it may also herald other medical issues.

Developed Facial Swelling from Propecia? – Hair Loss Information – Balding Blog

hiya i was taking propecia last year for about 6 months and it was great. i started again very recently and i’ve deleloped swelling in the face of my skin, i have stopped now. i’m just wondering if there is anything i can take that can counteract that and be able to still take propecia because it worked so perfect a such a long time before?
thankyou

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I have never heard of Propecia causing facial swelling, but drug allergies sometimes present that way. It can happen with any medication. Facial swelling can sometimes be related to tongue and throat swelling, which may be life threatening if the allergy presents in its worse form. While life threatening issues from the use of Propecia (to my knowledge) have never been reported, it is still a remote possibility. And with only the information you provided without a physical exam and complete medical history, it is impossible to give you any advice other than to see your doctor and share these concerns with him/her.