Category: Drugs

Dr. Rassman

I have recently read an article stating that the combination of steriod use and propecia can enhance hair loss rther than protect it and that they should not be used together. Is this true?

Many steroid users want to protect their hair from loss and steroids are known to increase the hormones and byproduct DHT that promote hair loss. There are more body builders using steroids with hair loss than those who work out but do not use steroids. Many body builders ask me if Propecia will help them keep their hair. The best thing to do is stop taking steroids, but using Propecia can not hurt. There is logic that any DHT block will help and Propecia (finasteride) can accomplish this in theory. The key question to ask is: Will the negative impact of steroids on my hair be offset by the positive impact of a good DHT blocker like finasteride? The answer here is a theoretical, “probably”.

Dr. this question has been asked before but there never seems to be a clear cut answer from anyone I have asked.If I am a good responder to propecia if and when the benefits do decrease will my hair get worse than at my starting point or go back to my starting point and maintain. This is all if I keep taking it. Thanks Dr.

The 5 year data from Merck shows that after 5 years, the average patient comes close to his starting point. There is a suggestion that after 5 years he will be worse off than his starting point. This is a bell curve statistic which relates to the average person in the study. You are not average, nor am I. Some people will do better (good responders) and some worse (bad responders).

I hope that answers the question for you.

Dear Dr Rassman
Two questions please: first, it is recomended to apply Minoxidil twice a day, in the morning and evening. Does it matter if I apply it later, around midday?

Second: what do you think about Pantovigar?

Many thanks.

Many doctors feel that if minoxidil is not used twice a day it has substantially less value. Generally, twice a day means as close to 12 hours apart as is socially reasonable.

Everything I researched on Pantovigar seems to be in German — I do not speak or read German. No further comment can therefore be made by me at this point in time.

I am 41 year old with a history of succesful treatment of MPB with Propecia. Over the past 6 months I was taking a supplement (tribulus) to help with working out and muscle gains. It is a herb which is reputed to increase testosterone. It seems to me that my hair is losing some weight and thickness during the past 3 months or so. I am wondering if you think that such a supplement could negatively impact on hair?

It is difficult for me, as a physician who understands the classic drugs, to comment upon such substances which are not reflected or reported in standard PDRs (Physician Desk References are used for full disclosures of all FDA approved drugs). Based upon what I read in BodybuildingForYou.com, there is a clear suggestion that this botanical is stimulating hormone modification, some of it steroid like. That would mean that this supplement could caused hair loss.

I did not feel good after looking at USDA – Tribulus terrestris. Maybe I am just old fashioned. I try not to take anything that has such varied and powerful effects. I always point out that arsenic (another herbal) is very toxic. A single bubble of arsine (the hydride gas) can be fatal and it is this herbal that was promoted as the cure of syphilis by doctors some 100+ years ago (may have also killed some of the patients). It was a classic poison in many classic writings, and at the least, entertained thousands of readers of great literature.

Has there been any studies that have shown any increased hair growth taking proscar 5mg daily vs propecia 1 mg daily.

The 1mg dose is just as good as the 5mg dose for treating hair loss. This was determined when the drug company (Merck) did effectiveness testing. I am sure you can get it from the FDA. For urological problems, the 5mg dose is more effective. The question is really about how much finasteride binds to the hair follicles themselves. We know for prostate problems, that there is different binding dynamics than with hair follicles. I am not familiar with any study that directly compares the 5mg dose to the 1mg dose, but I would suspect that like any bell curve, the 1mg recommendation applies to those individuals in the center of the bell curve and that some people most certainly would be better with a higher dose, possibly worth trying if the 1mg dose is not adequate to meet the needs of the patient’s problem. See Pattern-Baldness.com for more.

Is Avodart pretty much the same (in terms of ingredients) as Propecia except that it has a longer half-life? Or are they fundamentally different products that just happen to share one of the same ingredients and effects (preventing hair loss)?

They are related drugs, but they are different and do not share the same ingredients.