Category: Drugs

Snippet from the abstract:

Finasteride 1 mg is indicated for the treatment of men with androgenetic alopecia (AGA). However, more than 5 years efficacy and safety has not been previously reported. To assess the efficacy over 10 years in different age groups of men with AGA. 118 men, between 20 and 61 years, with AGA receiving finasteride (1 mg/day), were enrolled in this uncontrolled study.

Read the rest from the July/August 2011 issue of Dermatologic Therapy

I don’t remember if we posted about this before (it was first published last summer), but this is the longest study on the effectiveness of finasteride over a 10 year period of time. Side effects included reduced libido in 5.1%, reduced ejaculate of semen volume in 1.7%, and erection problems in 3.4%. Gynecomastia and depression were not among the reported side effects.

Of those individuals who had a good initial result and long term use, the overall results were better. This may be a predictor of long term benefits. Better hair growth in the long term was reported in men over 30 and in men over 40, as the drug remained effective (unlike what had been reported — that men who took the drug for long periods of time experienced reduced effectiveness). What was most impressive was that in 110 men who took the drug for 10 years, there was only significant degree of hair loss in 14% of the men studied.

My fiance and I are planning on trying to start a family in a few months (after the wedding). I’ve read in some places that Rogaine can lower sperm quality or affect an unborn fetus somehow, but I can’t find it anywhere that looks official. Is there any truth to this? If I do stop using it, will a large portion of my hair fall out within weeks? I’ve never gone more than a day without using it.

I’ve been on Rogaine for about three years now and it appears to have slowed my hair loss. If the choice is between keeping my hair and the health of my unborn child, obviously I’ll pick the latter. But I’d rather not have to choose. Thank you!

Rogaine (minoxidil) should have no effect on your sperm, nor have I have read anything supporting what you read about it affecting the fetus. Of course, if you’re concerned you should talk to your doctor.

Perhaps you’re confusing it with Propecia (finasteride), which has rare side effects related to ejaculate and fertility (but not change sperm count).

Hello Doctor

I’m a 27yo male with a full head of hair yet. I comb my hair a couple of times a day after my minoxidil application with a wide tooth comb. As I have medium length hair sometimes knots are formed and even if I’m gentle sometimes I feel little painful pulls.

Should I be worried about those? I doubt any hairs are being pulled out by the root because I try to be gentle, but if some hair does, will it grow back?

Thank you very much.

If you’re being gentle, I don’t know what to tell you. You could try switching to the foam instead of the liquid solution and see if it helps.

Hello Dr Rassman.

Want to start by thanking you and all the others who helped and contributed to this awesome forum!

I have been depressed for a while now. But then I’m very critical of antidepressants. So i have decided to test ST. John’s wort, who according to studies can be just as effective as antidepressants while it has much less side effects than conventional antidepressants.

But St. John’s wort has a tendency to affect the metabolism of other drugs.

My question is, do you know if St. John´s wort will affect propecia

I am not much of a herbal expert, but I do know that some herbs can interact with medications. In particular, St. John’s Wort is listed as having interactions with Propecia (finasteride 1mg), though I do not know if this will have a clinically significant affect on the efficacy of Propecia. You may run the risk of increase side effects, however.

I would consult with your doctor.

Hi Dr. Rassman and Dr. Pak
I recently had an FUE procedure done at your Los Angeles office and I want to thank Dr. Pak and his stuff which are very knowledgeable and really smart! And most of all very carring and are willing to go the extra mile to make the surgery the most pleasant one, I even had I conversation with Dr. Rassman while waiting for the elevator to arrive, he’s so down to earth and very polite.

I just wanted to let you guys know that at Costco warehouse store I recently got my finasteride medication for the whole year for only $16 dollars, before I used to pay $63 dollars per month for propecia, big savings, Once again thanks to Dr. Pak, Dr. Rassman and all of your staff (nicest people that i’ve been around so caring!) and sorry that on the day of the procedure I didn’t shave my head off and for being a little late to the appointment.

Thanks for everything you guys do for us and keep up the great work.

Thanks for your kind words!

And thank you for sharing your Costco information. It seems they lowered their pricing. That’s great news! For anyone looking to save some money, I should note that you do NOT need to be a member at Costco to use their pharmacy (or buy liquor, for that matter)… but you do need a prescription for the 5mg finasteride (and cut the pills for treating hair loss).

I have been taking finasteride 5mg for 6 years and it has done a good job. I started cutting the pill in half and over the course of 5 months since I did so, I lost an incredible amount of hair. Do you think this is because I cut the dosage?

I think if you were taking finasteride at 5mg strength daily for genetic hair loss, you were likely wasting your money and over medicating yourself. Did your doctor prescribe this to you for treating hair loss or do you have prostate issues? The recommended dose is 1mg daily for treating hair loss. Taking more just gives a higher chance of side effects. As far as I’m aware, more finasteride doesn’t mean more hair… so cutting the drug dose from 5mg to 2.5mg daily shouldn’t mean less hair.

I do not know why you are losing more hair. It may be that your genetic predisposition is taking its normal progressive course. You should follow up with your doctor for their assessment and recommendation.

Just understand the big picture here: There is no drug (no matter how high of a dose) that will stop hair loss completely and forever. Finasteride slows it down or even temporarily reverses hair loss to some degree, but over the course of years (and your lifetime) your genetic fate will win. If you are destined to lose your hair, it will happen. It is not related to the drug dosage. It is more related to time.

How will finasteride impact muscle gains? I have heard so many things. some say it will improve because of the increase in testorone, i have also heard it can decrease because of higher estrogen levels. And have also read because of the higher estrogen you can store fat in the glutens and thigh areas, is this all true?

Propecia was once banned by in the Olympics and some professional sports by the World Anti-Doping Agency, because it supposedly masked the use of steroids and due to similar theories that you point out, but I would doubt that finasteride will produce significant performance or muscle mass gains. Nowadays, Propecia is not banned in the Olympics or any professional sports to my knowledge.

The various info you’ve read online are prime examples of how there is so much disinformation on the Internet.

I am from India. I am experiencing hair fall since 8 months. With doctors advice i started using finpecia and minoxidil 5% solution from the month of october. Initially there is a substantial reduction in hairfall. But minoxidil solution is creating itching and irritating sensation on my crown area. so i stopped using it in the month of january but continuing finpecia regularly. Since hairfall again started i started using minoxidil solution too.

I read in finpecia reviews that there will be a shedding phase after 3 or 4 months. now its the 5th month and it started shedding, Is it the so called ‘shedding phase’ while using finpecia? When it will stop. Please tell me. I am 22 years old and i am tensed about loosing may hair before 30’s.

Generally, you do not have a shedding phase with finasteride 1mg (Propecia) use. Finpecia is a generic Propecia sold in India and manufactured by Cipla. I have been asked about finasteride shedding on occasion from readers, but I believe this is misinformation. The initial shedding is from topical minoxidil (Rogaine) and it is a well known phenomenon. The scalp irritation is also a well known issue for some who use minoxidil.

I cannot tell you when or if your hair loss will stop. I am not your doctor nor have I examined you to determine what your diagnosis or prognosis may be. You need to find a doctor who can examine you and recommend possible treatments. The drugs may give you few more years with hair or slow down the hair loss, but it never completely stops it (there is no cure).

Dear Doctor.
I am a 34 year old male with slightly receding temples and full hair on the rest of my head who has been taking 1mg Propecia daily for almost exactly 4 years with good results (no regrowth but no extra balding). Over the last year I had 2 blood tests that have shown an increased level of creatinine (not creatine). I mentioned to my GP this could be from propecia use. He suggested I quit the drug for 2 weeks and have another blood test to see if there are any changes. So I have two questions for you:

1: are you aware of any increase in creatinine in the blood from propecia use?

2: will quitting for 2 weeks affect my hair loss/growth

Many thanks in advance.

Stopping Propecia for 2 weeks should not impact your hair loss/growth significantly, if at all.

In general, elevated levels of creatinine is a non-specific measurement of the state of your kidney function. It is VERY important that you follow up with your doctor for this. You may have other serious medical issues unrelated to Propecia, since Propecia is a drug that is metabolized primarily by your liver (not kidney). I would not expect Propecia to affect your kidney function or creatinine levels.