Are the Propecia Site Photos Altered? – Hair Loss Information by Dr. William Rassman

dr. Rassman,

I read one of your articles about laser light therapy and the results of the pictures from the LLT could be altered or they could have been touched up to make it look as if more hair growth occurred. Saying that, how do we know that the people on the propecia.com website didn’t alter their images or the images you see from propecia or avodart results are altered?

Yeah, propecia could work, but to what degree and I personally thing propecia just maintains what you have unless you use minoxidil. What do you think?

The studies that show the benefits of Propecia used in Merck’s material are the results of well controlled and audited scientific studies, some of them done under FDA guidance. I would trust official Propecia photographs from Merck, but I would not trust many of the commercial photographs that are produced just to ‘prove’ that the changes are real. If you look carefully on many photographs used for the various potions, lotions, and herbal solutions for hair loss, the lighting, the hair length, the view — they are all different. On some photographs I have even seen scalp coloring agents used in advertisements, particularly for the crown shots on many commercial products.

So, always check the authority of photograph sourcing. For hair transplantation, I offer open house events at both of my offices just because even from the photographs on our website, the average person may have difficulty in determining just what the change really is. When you meet a patient face to face, what you see is reality and not the best view or an illusion created by the person taking the pictures. Of interest, at each of our open house events, we often have a person present who had created all of the benefits on Propecia alone (no transplants) and they have their before shots to prove where they came from. I still believe and preach: Let the Buyer Beware.

Propecia and Follicular Neogenesis – Hair Loss Information – Balding Blog

Hello Doctor and thank you for this your answers on this forum. I was curious about two things. First, is it true that taking Propecia will SOMETIMES help maintain the other areas of hair you are not taking the medication for? In this, I mean if I were to take Propecia for very minimal vertex thinning, but my hairline and frontal hair are perfectly fine the way they are right now, will propecia help keep those hairs in perpetuity? (in general of course, I know there are no guarentees in all of this). Second, do you keep up on the latest information regarding the process currently being worked on called follicular neogenesis (the elusive “cure all” for baldness? I’ve heard from many sources (including Bosley reps) that within 8-10 years, all the kinks MIGHT finally be worked out of this, thus hopefully ending and curing baldness. I know the key word is “might,” but I was just curious how much you’ve heard about it and your thoughts. Thank you so much.

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Divide the term follicular neogenesis into three words and you get:

  • Neo: New
  • Follicular: Refers to hair unit of growth
  • Genesis: A biblical term suggesting source, creation, derivation of something, birth, the beginning or origin

Put them all together and you get a new technology — or at least the name of one. Sounds like a good name to me. There are many people working on technologies that will create new hair follicles from the source (possibly the stem cells that generate hair follicles) once we learn to control the stem cells. The success of forcing stem cells to create hair follicles is about 10% now with a great deal of randomness to the process. I have heard the same estimates of time (10 years) for the resolution of things related to cloning, etc…

Your first question has a problem with it. If the hair is thinning in the back, then there is genetic balding possibly in other areas as well. Thinning either means miniaturization of the hairs or loss of density. Propecia works better in decreasing the miniaturization (increasing the thickness of the hair shafts) than it does with restoring the density (growing new hair). I do not believe that Propecia (finasteride) will prevent the loss of either hair shaft thickness or loss of density, but I do believe that it will prolong the period of loss for years.

Ibuprofen and Hair Loss? – Hair Loss Information by Dr. William Rassman

In November 2004 I took Ibuprofen for a knee injury and by the end of the week my pain was unbearable; the Ibuprofen did not help with the pain at all, but all of my hair fell out. Well, I used Nioxin and have been taking one Biotin and 3 Hair, Body, and Nail pills a day.

My hair on my head is growing back (finally) It’s very short and I can see differing lengths…. But I have also noticed very fine hairs growing on my face and not just where my eyebrows used to be. Is this the normal fuzz that was probably there before that I didn’t notice or are my vitamins trying to make me look like a man.

I’m 37 years old. Please help me.

While many drugs may cause hair loss, I suspect your hair loss may have been coincidental or from the physical stress caused by your knee injury. With respect to the fuzz you notice on your face, it is most likely that was there before and you had not noticed. You can see this in everybody. We’re all fuzzy!

Increased Scalp Testosterone with Dutasteride – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,
I have seen the results of the study that has shown significant increases in scalp testosterone with dutasteride (104% for 0.5 mg). Could this major increase in scalp testosterone contribute to further male pattern balding, since testosterone can also bind to the androgen receptors in hair follicles? Basically, is there any possibility that the decrease you get in DHT from dutasteride could be overwhelmed by this increase in testosterone? thanks very much.

What you are talking about is as much science as speculation. From what I have learned from doctors who use dutasteride in those patients who do not respond to finasteride (Propecia), the report is that it is stronger and more effective. I have addressed the scalp testosterone levels with dutasteride before here. More insights may be obtained by looking at pubmed.gov.

I only have a limited understanding of the pharmacology here, so I would rather just refer the readers to better authorities.

Sexual Side Effects Months After Propecia Use – Hair Loss Information by Dr. William Rassman

Dear Dr. Rassman,

Last year I had a hair transplant done at the New Age Hair Clinic and along with that the recommendation of taking propecia to help prolongue losing more hair, which makes sense obviously. Propecia really worked for me and I was pleased with its results combined with the transplant, however, after six months I noticed those sexual side-effects I had been told about. I never worried about it because it had such a small percentage tagged to it so I figured I wouldn’t have to. But now I have no sex drive and difficulty achieving and maintaining erection…but others as well. There is no orgasm for me anymore and most of the time a loss of ejaculate and when something does come out, it’s almost like a gel… My penis has lost feeling and almost in a way “detached” shall we say from the body because i really can’t feel it that much anymore. This worries me because I have been off the drug for six weeks now. My real question is have you ever seen these adverse effects permanent in a patient? It’s really starting to scare and depress me… I figured it would take a few days to get out of my system and once I saw it was only temporary go back on it because I don’t want to lose what I worked at with the transplant, as is what my doctor recommended, but the effects seem worse now than when I was on it… Can you help me at all? Should I go back to using it or keep waiting till I see improvement and then perhaps use it? I would really appreciate any information you can give me… The dilemma of choosing between hair and sex drive is a hard one being I am only 23… I want both. My doctor can’t help me at all so maybe you can, I’m hoping. Also, have you ever heard of a hair-loss product called scalp-med? I saw it on tv and checked out their website at scalpmed.com and it looked good because they say no sexual side-effects because it’s applied directly to the scalp, but it all seems too good to be true so I was wondering if you knew if it was legitimate or not. Thanks for taking the time to read and respond to this. I appreciate it.

Propecia, hair loss, penis detachment, orgasm, ejaculation… OH MY! From the tone of your writing, I can see that you are very concerned about hair loss and sex. Worry not, for I would say you are like most men. If you obsess over something like your hair loss and image, you can produce impotence. Your sexual problems might be related to the Propecia use, but the problem should go away soon after discontinuing Propecia. Propecia certainly does not stay in your system for 6 weeks after stopping its use. Your sexual problems may be psychological or you may have an underlying medical condition that you have not been diagnosed with. If it continues to be a problem you should see a medical doctor for a formal evaluation. With respect to Scalpmed, there are numerous posts on the product here.

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What DHT Level Am I? – Balding Blog

I read this on one of your posts: “…but what about the young man with a stronger Type I and Type II DHT blocker”

Is there any such test to find out what type of DHT type / level / category I am? Cheers!

I think that you misunderstood what I was talking about (see Regrowth – Phase II FDA Hair Loss Study Results for Dutasteride). Each of us is the same with regard to the way these drugs work on us, so you don’t need to check yourself out to categorize yourself (as you asked). Dutasteride is more effective at blocking both type one and type two receptors, making it superior to finasteride, at least in theory. As what studies there are have incomplete clinical trials, we can not be sure what this all means and certainly we do not know enough about safety in the young man taking this drug for his lifetime.


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Taking Rogaine for 9 Years and Want to Switch to Propecia Now – Hair Loss Information by Dr. William Rassman

I’m 30 and have been taking rogaine for the past 8 or 9 years. I recently got a prescription for propecia. Should I gradually get off of the rogaine?

Assuming that you have benefits from the Rogaine, you should assume that your hair is minoxidil dependent. That means that if you stop the minoxidil, the hair may fall out. Propecia will not prevent this phenemonon. I would suggest that you stay on the Rogaine and get your hair mapped out for miniaturization before starting the Propecia so you know what you are doing.

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Should I Try Medications Before Considering a Transplant? – Hair Loss Information by Dr. William Rassman

Just turned 40 and starting to bald on top back “crown” of head, was using minoxidil 5% (~1yr), just started on Propecia (day 2) (from what I read here, I guess OK to use both). Should I try all these remedies first before considering a Hair Transplant, do hair transplant results look more natural and successful if started early? Where are you located (offices), would I have to travel from Houston to there for a consultation?

If you just starting to lose the hair in the crown (meaning that it is now noticeable), there is a good chance that Propecia will reverse some or all of it. Recent hair loss (2 years or less) is most susceptible to reversal. I would suggest not stopping the Minoxidil, as your hair is almost certainly dependent upon it. Wait 8 months and if there is not enough reversal, then a hair transplant may have great value.

Our offices are both in San Jose and Los Angeles, California. If you come from out of town and have a procedure, we will subsidize your costs of travel and put you up in a hotel for the night of surgery.

Body Resists Propecia – Hair Loss Information – Balding Blog

The body will eventually build a resistance to almost every drug right? Why is it that the same won’t happen to Propecia?

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Finasteride blocks DHT from acting upon the receptors to about the 80% level. Eventually, the hair loss will continue to progress, but from a better, hairier level, and even with the progression of the hair loss, some impact of finasteride will persist because many of the DHT receptors still remain blocked. Nothing in this world is forever, except death. Drugs that block the DHT receptors make your hair grow, but they are not the final answer today for hair loss.

Proscar Has Gone Generic in the US – Hair Loss Information by Dr. William Rassman

Dr. Rassman,

It says here that Proscar has gone generic. Do you believe it, and what does it mean to american customers of Finasteride? I am particularly confused about the 180 days bit? Does it mean that generics of proscar will only be available for a 180 day window.

Thanks Doc

See Dr. Reddy’s launches generic Proscar in U.S..

Yes, Proscar (brand name of 5mg finasteride) has gone generic. Propecia (brand name of 1mg finasteride) is still not available in the generic form in the US. Some patients take Proscar and break the pill in 1/5 or 1/4 in place of Propecia because it costs less. This does not mean Proscar is available without a prescription in the US, but it now that it is to be available in the generic form, it should cost even less to take finasteride in 1mg doses (as long as you break the pill).

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