Category: Drugs

Hi Dr.Rassman
I am a 20 years old guy. I have a bad family history with hair loss. The same thing happend to me 1 year ago. I decided to take propecia 2 weeks ago. The problem is that in the first 5 days i had testicular pain.Than it was better and better and now i dont have it anymore. I asked my doctor,but he didn’t tell me why it was happening.Can you tell me why did it happen to me?
Thank you for your time.

I am not familiar with testicular pain from Propecia. It is not a known side effect and I have had no patients report such a problem to me, despite the many patients who I have prescribed this drug to.

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I’m am a 22 year old male and have been balding since i was 17. I have been taking Proscar, saw palmetto and applying minoxidol for about one year now and there is definite improvement in the crown of my head but not alot in the front. I have just ordered dutasteride over the net but i still have some proscar left. I was wondering could i take them at the same time, not take the proscar and just take the dutasteride, or maybe take the dutasteride and not take the proscar?

When you play doctor, you sometimes undo what you are trying to do. I know it’s been mentioned on this blog many times before, but for the readers that aren’t familiar with the various hair loss drugs, Proscar (5mg) is the same medication as Propecia (1mg). Propecia is FDA approved for treating hair loss, and Proscar is a prostate drug. Many people will cut Proscar into quarters to achieve the benefits of Propecia, but for a reduced price.

Dutasteride and Propecia are both very good DHT blockers, with Dutasteride probably stronger. There is no point to take Propecia if you are taking Dutasteride, but I have warned the young men out there that there is no FDA clearance for Dutasteride in young men for hair loss use.

Saw Palmetto may be a competitive inhibitor to Propecia and/or Dutasteride. That means that when Saw Palmetto hooks on to the DHT receptor instead of Dutasteride or Propecia, it will compete with these drugs. Saw Palmetto is a weak DHT competitor, making the stronger drugs less effective. You may be undoing what you want to do.

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They are suppose to come out with new meds ..beyond avodart that are suppose to work well do you know about this???

I am unable to answer this question. I do not follow the FDA applications for new drugs nor the clinical trials that are in the early stages of development. What I do follow are those drugs that reach the ‘end of that pipeline’ and at this time I am not familiar with drugs at this stage of development from which to calculate a time-line.

There is an alternative therapy to propecia. Try this: Strong Green Tea Extract, Soy Isoflavones, and Evening Primrose oil. I also, would like to challenge any doctor that believe that is quackery. This combination will work much better than Propecia and there are no sexual side effects. Don’t believe me try it and you will begin to feel your hair stems getting stronger and you will slowly start re-growing hair.

There are many herbal suggestions for alternative treatment for male pattern genetic balding. I have no experience with this, but clearly you have. I have stayed with traditional, known treatments for hair loss like Propecia and Minoxidil as they have predictive results that are scientifically well documented. I stay away from experimenting on my patients with unproven herbs or poorly defined drugs with benefits. I am also not aggressive when it comes to the unapproved FDA drugs for hair loss like Avodart. If the herbal approach works for you, then that it good for you. If it does not work, a person experimenting with these herbs run the risk of losing hair that may never come back. As hair loss is a progressive process, the pattern for hair loss in each man with the genetic predisposition for it, they may lose valuable time and valuable hair moving them further down the balding pattern scale.

I would like to know what you found out in regards to Avodart at the hairloss convention. Please get back to me when you get a chance.

There is a strong suggestion that Avodart will work better than Propecia from what I heard at the meeting. There are, however, many questions not answered such as:

1. What is the appropriate dose considering that there is a half life of 6 weeks for the medication in your body? Nobody seems to have a good answer to this question.
2. Some think that Avodart may stay in the tissues for over 6 months, so what effect could this have on your system?
3. What is the long term safety of Avodart taken by young man? All of the documented studies are on men over 50 (old-‘farts’ like me)

These are the reasons that most doctors do not want to prescribe Avodart ‘off label’ (not FDA approved for hair loss treatment). From a medical-legal point of view, as well as a licensing issue, I can not really prescribe it. Also, my expertise is in surgery, not medications (although I try to use medications I command and know forward and backward). There are some dermatologists, internists, urologists and family doctors that would prescribe this medication, and if you want to go that route, you should try to find one of them to prescribe it for you. With an off-label use, the issues of safety are risks that you must take.

The preliminary studies that were presented indicate that it works to grow hair when Propecia fails to do so. Still, Propecia should be the first line for the medical treatment of hair loss. What does concern many doctors, however, is that there may be a Vioxx type of hidden side effect in the young man that is not known. Will it produce cancers or heart disease or some other problem that is not yet identified? This is the reason we look to the FDA, to define safety and effectiveness for us. So far, the safety is not clear and the effectiveness appears to be coming into view through unofficial channels.

Hello Dr., I have been using minoxidil lotion for two months now. I do not suffer from any systemic side effect as yet. BUT, every time I apply it I have noticed that I ,almost immediately, with in minutes experience a little bit of strain on the skin under my eyes. When I look in the mirror it appears that I have developed dark circles. With continuous use I notice fine lines and dryness on my face. Now to avoid this I have started applying the lotion in supine position while rubbing the tip of the dropper on my scalp. I stay in that position at least for next 20-30 minutes. This is to make sure not even a trace of medicine flows down on my face. But still I have the same sensation on my face. All these effect however disappear even if I discontinue the medicine even for two days. This has been a repeated experience. Any comments?!! Do other patients also complain about the same problem?

This is the first time I have heard anyone report this. I can not understand it unless the medication is actually landing on the skin of your face or around the eyes. There are reports of local skin reactions to minoxidil that ‘irritate’ the skin. Some of the medication can be absorbed through the skin and drop the blood pressure a little and this is a transient effect that does not last long. Maybe this medication is not worth the trouble it is causing you. Clearly if you stop it, it goes away. Is there are real benefit worth the problems you are experiencing?