Category: Drugs

hey doc,

im 22 yrs old, experiencing receding hair line, and thinning of hair. i have been using propecia for the past few wks, and will continue using it for a while. should i also use rogaine? i wanted to know if it would benefit to use both or not. also, if i use rogaine, can i use a monoxydil subsititute, found at local grocery stores instead? will the cheaper generic product give the same intended effect as rogaine? please let me know.

thanks for your help.

Minoxidil is the generic form of Rogaine. Both are over the counter medications, sold at many places, you do not need a doctor’s prescription, like you do for Propecia.

I generally tell my patients to just take Propecia alone for at least 8 months to a year to be able to gauge its effectiveness. When you combine both Propecia and Rogaine from the beginning, you will not be able to tell if any effect is due to just one of the drugs or the combination, and you will be incurring the cost of both drugs for as long as you want the hair loss stopped or slowed down. If you find that Propecia by itself is effective and you are happy with the results, you have saved the cost of Rogaine for that period. If you are one of the few patients who do not get the desired results with Propecia, then you can stop taking the drug.

The two medications work differently. Minoxidil must be applied twice a day and it is messy. Propecia is a pill that should be taken every morning. Propecia attacks the hormone DHT that causes hair loss. Minoxidil was developed as an oral medication to treat high blood pressure and was found to have a side effect, which is the ability to grow hair in a small percentage of the population who took the drug. Minoxidil was then approved as a hair loss treatment in a topical solution called Rogaine. The topical Minoxidil can cause blood pressure drops and skin reactions, so you need to be careful taking it, and it does not work very well in the front of your head. Although Propecia does not impact regrowth in the frontal area most of the time, it will slow down or stop the loss in the front, particularly in young men.

I know MPB can cause itching and scalp discomfort in some….have you ever seen the same problem occur with taking Finasteride long term —perhaps via hormonal upregulation? Thank you

I am not familiar with itching as a common complaint with Propecia/Finasteride, however, any medication can cause skin complications. If you suspect that Propecia/Finasteride is causing itching or scalp discomfort, you can go off of the medications for one or two weeks. Any skin complication due to the drug will go away because Propecia is out of your system in a day or two and the skin turn-over in your body is usually under two weeks.

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I have been using propecia almost 4 months and I didnt see any response yet .My hair got thinner I am 28 years old who has very thick hair and i have type 2 male pattern .My goal is to keep my hair , not to regrow . I have seen my hair receving from the frontal hair line little bit last couple weeks. Avadort has 50% better growth response than Propecia according to some research.Is it better for keeping the hair. And would you say i should keep using propecia and i started earlier than average patient , would it help me to keep my hair.when would htere be a drug that will stop the hair loss 99%.It doesn’t have to bring it back.And my family hair loss history is 3 A .

If you have been using Propecia for only 4 months, you should wait out a period of from 8-12 months before judging if it is effective at stopping the hair loss. Usually, people will see less fall out in the first 4 months. If after 12 months, there is still no cessation of the loss, then a visit with your doctor to talk about other options like Rogaine, Avodart, etc… may be appropriate. There is much new information out there that suggests, as you stated, that Avodart is more effective than Propecia. Avodart is not promoted as a hair loss prevention drug by the drug manufacturer, and the FDA has not ruled on its safety and effectiveness when used for hair loss. Safety is an issue and the FDA guidelines are generally worth following. The half life of Propecia is 4 hours which means that it will essentially be out of your system within a day or two, but Avodart may last for months, so if side effects occur, they will be with you for a long time. Get a good, open-minded doctor and establish rapport with him/her.

I am one month after having a hair transplant. I have been using minoxidil 5% as recommended by my doctor since the surgery. My head itches and is pealing. Can this be caused by the Minoxidil?

Minoxidil can be an irritant and has been known to produce these side effects. I would suggest that you stop it and see if it goes away. If it is caused by the Minoxidil, it should go away in a week or two and the time off of it should not have any negative effect. I recommend that my patients who are already using Minoxidil wait for at least one to two weeks after a hair transplant, before they resume its use.

Do DHT blockers reduce body hair?

It has been reported that both Dutasteride (Avodart) and Finasteride (Propecia) can reduce chest hair. One doctor did report that he counted body hairs and found the count dropped by half on one patient he followed. The patient, of interest, did not notice the reduction.

Based upon this, one might expect that it will also reduce nose hair and ear hair, or at least the build up of these unwanted hairs. If I knew for certain that there was a solution that was as simple as a pill, I might offer it to all of my patients and I would even take it myself. The story, however, is still out.

My doctor started me on Propecia without examining me. I have been on it for 3 months. Should I continue to take it? My hair is farily full, but my corner areas have moved up about 1/4 inch. I am 24 years old.

If you are taking Propecia without an examination, then maybe you do not have genetic hair loss. You should see a doctor who can examine you, take measurements with the appropriate instruments, and can make the proper diagnosis. If you do not have genetic hair loss, then you should not be on Propecia.

Corner hair loss can be just a ‘maturing hairline’ and most men have a change in the frontal hairline as they move into their 20s. Most of these changes occur between 17-29 and these changes are not genetic hair loss.

I currently have used propecia for 8 years and have seen no hair loss since that point of initiation and some regrowth. I am very interested in dutasteride since it’s efficacy seems greater than finasteride. Though it isn’t currently FDA approved for male pattern baldness, do you think it safe for this use? And at what dose? Going through many blogs and websites, it seems the use of this drug for baldness is common.

Thanks

You are correct to state that the FDA has not approved Avodart (Dutasteride) for hair use. The half life of this medication is measured in weeks, not hours like Propecia, so the question is “what is the effective dose to prescribe?”. Intellectually, you can justify monthly doses, but there are no studies on safety or effectiveness which is the hallmark of the FDA. Side effects are reported more with Avodart than Propecia but then again the dose will dictate the frequency of the side effects. There is a gamble going outside the FDA approved drug route. The benefits of a theoretically more effective drug must be balanced against the safety and proven effectiveness issues.

Hi doc… do you agree a lot of people do not lose anymore hair while on Propecia??? One doctor I have been writing to says Propecia stops the hair loss in most patients.

I do not believe that Propecia can be reliably expected to stop all hair loss. Propecia studies done by Merck show that hair loss continues over time, but by taking Propecia the balding starts at a new level and possibly falls out at a slower rate. Their studies on patients go out now 7 years.