Category: Drugs

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Stopping Minoxidil and Sexual Side Effects of Propecia – Hair Loss Information by Dr. William Rassman

Dear Doctor,

I have two questions to ask,

My hair is good so far and safe but from three months ago I started to lose hair and I think this is due to hereditary hair loss, I think of using Minoxidil hopefully to stop the hair fall but i have two questions regarding that,

My first question:
1- is it true that if i use minoxidil for a while and then decide to stop it one day, it would cause my hair to fall out in three months, I mean is it true that it might make the way it loses faster than the normal process of hair loss or do you think that if i stop using it while my hair was good in the first place it would just start to lose as usual (the normal hair loss process)?

my second question is
Do you think Minoxidil is the best choice so far as in Propecia many people suffer from side effects?

Thank you and looking forward to your reply

Withdrawal from long term use of minoxidil only causes you to lose what you gained from the drug, nothing more. Propecia (finasteride) goes after the actual cause of the hair loss, the DHT receptor that kicks the hair out while minoxidil does not. Propecia is better for men and is only approved for use in men. Only about 1% of men suffer from libido effects with Propecia and if you are in the 1%, just stop the drug and the effect goes away in a few days.

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My Family Doctor Told Me That After 10 Years, Propecia Users Are as Bald as If Never Taking It – Hair Loss Information – Balding Blog

Dear Doc,

I am 22 years old and I am starting to lose my hair. There is history of baldness in my family, and my older brother is bald as well. I am thinking of going on Propecia, but I am weary about committing to a drug for life. Also, my family doctor said that Propecia tends to lose its potency after five years, and after ten years people who take it end up as bald as they would be without the medication. Any thoughts?

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Your doctor is wrong. For more information about this, including a good example, please see Propecia and Hair Count. Finasteride (Propecia) is a great drug to keep control of the hair loss and it is clearly protective against prostate cancer. Some doctors are just plain foolish about this drug and many patients who read the information online are far more aware than these ignorant doctors.

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Blurred Vision from Minoxidil? – Hair Loss Information by Dr. William Rassman

Hello, I’m using Rogain 5% and I’ve noticed some minor signs of blurred vision, mostly at farsighted objects.

Considering it may be a minox side effect, should I:

– Continue Rogaine 5% and wait weeks/few months because it it’s temporary (and not a really bad blurry vision) and will not damage my permanent vision.
– Change to Rogaine 2%
– Change To Rogaine Foam
– Quit using Rogaine?

Thanks for your help and amazing blog

The purpose of this site is to educate, not to become a treatment substitute for your doctor. With that said, minoxidil is known to cause blurred vision. How you react to it is either to get medical advice from your doctor or experiment as you suggested above. As a doctor, I would want to know what you are treating, whether it is the best medication for you, what your goals are, etc.

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Is Facial Hair Growth Related to DHT? – Hair Loss Information by Dr. William Rassman

I always had little facial and body hair until I was about 20. Now my facial hair grows faster and thicker. Coincidently my hairloss is much worse then before and itches a lot more. Is facial hair growth related to DHT fluctuations do you think?

I believe that DHT is one of the hormones that stimulate our male sex characteristics, like voice change, beard and chest hair, and hair loss in the unfortunate men who have the ‘genetic hair loss’ curse. I have seen in very rare cases some patients that have disappearance or decrease of body hair with Propecia use.

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Why Would Libido and Breast Side Effects Occur with Finasteride Use? – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

Is it unhealthy for a young man with a normal size prostate to take a drug (finasteride) which shrinks his prostate? It seems as though shrinking an organ that is a healthy size is a bad idea?

Also, since propecia actually causes more testosterone to be released in a man’s body, why is breast enlargement (which seems like too much estrogen), and loss of libido, etc a potential side effect? It seems more logical to me that with increased testosterone, a man would have an increase in libido, stronger erections, more ejaculate, more muscle (smaller breasts), etc.. But the reverse side-effects are listed as being caused by finasteride. Could you explain why?

There is no evidence that finasteride (Propecia) shrinks normal sized prostates, but to the best of my knowledge, the prostate size in young men has not been studied. The reason that testosterone levels rise simply reflects the brilliance of the human body, which recognizes that DHT levels are dropping on Propecia so it compensates with increasing the levels of testosterone. Men need a certain level of male hormones and the human body regulates that level by pushing the testicles to make more or less testosterone to achieve those levels. Testosterone levels rise an average of 15-18% when a person is on Propecia, which does increase the sex drive in some men (about 10% in my experience). That happened to me when I started my Propecia, so I know this from personal experience. One possible explanation for the other effects you asked about might show that finasteride might directly antagonize androgen action in breast tissue. If that was the case, it might indirectly increase the estrogen concentration in the body and cause these effects, but this is strictly a guess on my part as there is no evidence for this. I can not explain the other things you asked about. Sorry.

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Worth Taking Finasteride for Temple Hair Loss? – Hair Loss Information – Balding Blog

I’m a 23 year old male and starting to recede at the temples, and I was wondering if it would be worth it to consider taking finasteride. My hair does not appear to be thinning anywhere else.

Also, my hair loss began when I began taking wellbutrin and adderall. Can these drugs jump-start the hair loss process? Or was this merely a coincidence?

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Norwood 3Drugs like wellbutrin and adderall can jump start the hair loss process. Finasteride can address any form of hair loss in men that have miniaturization. You need to have your scalp mapped out for miniaturization to be sure that there is no genetic patterned hair loss as you are suggesting. Many people will not see their miniaturization with the naked eye, but the high powered microscopic mapping will show it if it is there. When some people talk about their temples, they mean the corner hairline and that can be seen with the Class 3 Norwood patterns. The side temple fringe extending forward from the ear can have a unique form of genetic hair loss called triangular alopecia. I would need to examine you for this condition, but it is unclear what you are referring to. You can you send me pictures here (please reference this blog posting).

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My Body Rejected Propecia – Hair Loss Information – Balding Blog

Hi Doctor, im 19 and have had frontal hairloss, some recession since i was about 15 i started early. i tried out Propecia for over a year and prognosis was it didnt work.. actually i had a weird side affect from it, my body would reject it and id have weird sensations in my throat and then my hairloss would accelerate, anyways stuff happens. im just curious since Propecia is the King of hairloss meds and it didnt work, what route should i take from here, is there any hope?
thank you very much for your time and generousity

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I would need to examine you to understand what you are telling me. I would want to map out your hair for miniaturization as well. If you can make it to one of my offices in California, I would be glad to see you. At this point though, I can not really tell you much. The body rejecting finasteride? I’m just not clear on this. Sorry.

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Pantogar and Female Hair Loss – Balding Blog

I am a 22 year old woman living in essex i have a problem with hair loss wich worries me alot i have long hair but now my hair has gone weak and unhealthy and i would like to know ways in which i can do to prevent the hair loss because i know its not normal in women of this age. im takin ‘pantogar’ which is a hair loss treatment but i dont know if its good enough. if theres another solution other than transplantation please let me know. thankyou i will be waiting for your reply

Pantogar is a homeopathic, nutritional supplement which is promoted for hair and nail problems. It is claimed to be used in the treatment of early hair loss, but there is no proven science for this supplement to show how it may work, or that it is worthwhile and valuable.

The diagnosis of female hair loss requires a close examination, something that can not be done over this distance. Unlike men, a woman’s hair loss situation is not easy to diagnose and treat. You need to see a doctor who specializes in female hair loss near your home. Try using the physician search at ISHRS.org and HairTransplantNetwork.com. Sorry, but there is not much else I can offer you over the internet.




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Hair Loss InformationI’m Single and Balding! – Hair Loss Information – Balding Blog

I am a male, 24, and experiencing thinning on the crown of my head to the point where other people are saying “are you going bald?” and poking the thin area. Real nice. I tried a 5% minoxidil safeway knockoff and began to get redness and irritation on my scalp. I discontinued use but now have no idea what to do about my hair loss. Was this reaction due to the cheaper safeway brand? Should i try finasteride/propecia? What type of doctor should i see about the persciption pills? Dermatologist? please help I’m single and balding!

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What you are describing sounds like classic male patterned genetic hair loss. You need to see a good doctor who will map out your scalp for miniaturization and then, assuming I am correct, put you on Propecia (finasteride 1mg). If the balding spot is the only sign of balding, then you have an excellent chance of reversing it with Propecia. It sounds like you had a bad reaction to minoxidil, but minoxidil is not the best medication, assuming that I am correct in the diagnosis (difficult without an examination). Some people experience irritation of the skin when using minoxidil (might be brand independent). A good dermatologist will do the right thing, but so can your family doctor. Make sure that no one even tries to suggest a hair transplant, as there are some less-than-ethical doctors that might recommend one for you.

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Hair Loss InformationHow Do I Know If I Have Telogen Effluvium? – Hair Loss Information – Balding Blog

I am a male in my early 20’s and I just came across your website. I have been on propecia for maybe 3 years and I have a feeling it is loosing it’s power. More so in the front of my scalp. What is another option? I received a book from a dermatologist and in it he lists some other medications. I don’t have the list handy but I would like to send you the list so you can let me know what you think.

I want to know about telogen effluvium. How do you know if you have it or if you are going bald? I read on the net that for telogen effluvium there is an overall thinning of the scalp but not baldness and that the hair comes back. But how long before the hair comes back? I am guessing if the hair doesn’t come back within a year then you are going bald I guess.

congrats on the site once again. Really helpfull.

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It would be hard to judge about the efficacy of Propecia. You don’t know how you would look if you were not taking it. It is true that some patients experience better results than others, but your hair loss may get even worse if you stop taking it now (by catching up to the point of loss you would have experienced if you’d never taken it at all).

As discussed here before, the effect of Propecia on the frontal area is not completely studied. Current studies on Propecia indicate good result on crown and back of scalp. Other options are minoxidil and hair transplantation. Propecia and minoxidil are the only FDA approved medications that should be used for treatment of hair loss.

Human hair is in growth or anagen phase most of the time (between 3-6 years), and following that enters to a resting or telogen phase (about 3-6 months). The hair loss that we experience on a daily basis is due to shedding of hairs that are going into telogen phase (10% of our hair population at any one time). Telogen effluvium is triggered when a physiologic stress or hormonal changes cause a large number of hairs to enter to telogen phase at one time. Telogen effluvium is characterized by diffuse hair shedding. It is usually caused by a metabolic or hormonal imbalance or medications. Typically, recovery occurs within 6 months without any treatment. If your hair didn’t come back after 6 months, you should see a dermatologist for further evaluation and to rule out the other causes of hair loss.

At your age, with frontal balding, I would expect that you have genetic hair loss. The diagnosis is made by mapping out your scalp hair for miniaturization. This will show regional miniaturization weighted to the frontal area as you are describing. If the diagnosis is telogen effluvium, it will not show that pattern and it will be more generalized beyond the frontal area into the permanent zone.