Category: Drugs

I am in my early twenties and am in Type II of my hair loss. I started losing here about 2-3 years ago and in the past year it is becoming quite noticeable, i am losing hair at a faster rate then ever and am concerned that I will end up like my father (type 6). I have been staying away from Propecia and Rogaine due to their irreversible side effects concerning sexual dysfunction. Is there no viable alternative other than hair transplant for me?

Nope.

Side effects are not proven irreversible from Rogaine and Propecia, but if you don’t want to try either of the two FDA approved hair loss medications, that is your choice. Unfortunately, hair transplantation is the only permanent solution at this point if you do not want to manage your balding problem with medication.

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What is the best way to stop finasteride ? all of a sudden or gradually ? , can sudden withdrawal cause rebound effect and more worsening (speaking of side effects not hairloss) ? and if gradual withdrawal is the best then how can i do so ?

thanks

The half-life of the drug in your body is somewhere between 4-6 hours. That means essentially that most of the drug that you take today will be gone tomorrow. Once the drug levels drop below a certain level, you will lose the effectiveness of the drug and it may take 1-3 months for the impact of the loss to be seen in your hair falling out. Tissue levels may maintain the effect of the drug for a couple of weeks or so.

The answer to your question — there’s no “best” way to stop the medication.

Does finasteride thicken up hair shafts DURING the growth phase, or (with good results of course) does it thicken up only when a new cycle begins?

I do not have a definite answer to your question, but I can venture a guess. As the usual hair cycle is over 2 years in most men and we see benefits from Propecia in 8-12 months, I would guess that as the hair shaft emerges from its source, the shaft thickens. Of course, as the hair growth above the skin grows at about 1/2 inch per month, I would expect that the thickening of the hair shaft starts quickly and increases over time.

All miniaturized hairs are not equal. Let’s say that the shafts that have lost 90% of their bulk will be slower to benefit (if they benefit at all) than those miniaturized hairs which have lost 20% of their bulk. The impact on new hair should be better if these new hairs are healthy ‘terminal’ hairs that have considerable life left in them. When I see patients for follow-up examinations and comparison studies, I see that there are less miniaturized hairs and more of thicker shaft hairs, and as we use the bulk analysis instrument on more patients, the answer to your questions will be much more clear.

I think you have a great question from a scientific perspective. I wish there was a time lapse photo of a hair shaft under the influence of Propecia (or even Rogaine).

hey, doc. I have asked you guys a question about testosterone and hair loss, and you mentioned how testosterone does not cause hairloss by itself, and it only DHT.

I went to see an endocrinologist today and he said “everyone experiences temple recession(different from mpb), and that temple recession is caused by high testosterone, not DHT.” He also said that propecia is a good drug for hairloss but its basically a 50/50 risk when taking it. either it will work and stop hairloss, or destroy the hairline, but keep the crown. he was pretty confident with his statement. I asked if there is scientific proof, he said its common sense. not sure whether to take his theory with a grain of salt or its true.

what do you think doctor rassman? do you agree with him or disagree? your opinion on this is very important to me, and probably to others

This is not a place to get a second opinion and I do not like to second guess other doctors when I have not even examined the patient (you) myself.

That being said, Propecia does not “destroy” hairlines, and the percentage is better than 50/50 that you will see benefits. I cannot find a source that states temple hair loss is caused by high testosterone, so I’m not sure where your endocrinologist got that information.

I am a 51 y/o male. I have been taking Finasteride for the past 4 yrs. I also take Lovastatin for my cholesterol. My latest blood test showed elevated levels of Bilirubin. My doctor stated that it might be from the Finastride and that it is a possible side effect of the drug. I can’t find any info on this claim and I find it hard to believe that it all of a sudden is causing this.

Can you help me? I don’t want to stop taking the Finasteride and lose the results. I also must add that Dr. Pak did a procedure on me just about 2 yrs. ago and I love the results. Thank You.

I’m glad you are enjoying the results of your hair transplant!

I would ask your doctor to look for another cause of liver dysfunction. I have not heard or read about finasteride causing this type of problem. Lovastatin and similar medications do report elevated bilirubin levels as a possible side effect, however.

hi, doctor in one of the topics you said propecia is like testosterone. here is the link

I thought finasteride wasn’t a steroid hormone.

Thank you for pointing that out. It was an error in our part, and I guess it went unnoticed for nearly 6 years. It should have stated DHT (not Propecia) is like testosterone in that it is one of the male hormones.

We have corrected it. Sorry for the confusion.

I keep reading everywhere how many men were able to maintain their hair on Propecia for years and even a decade but they always state that once the drug can’t maintain their hair anymore they start to lose it rapidly! Why is it so? Why can’t it just gradually thin? This really is bad because once it appears the drug wears off before you know it you’re like half bald!

Where are you reading these things? I do not recall seeing any of my patients losing hair “rapidly” after taking Propecia for years… nor do I recall a case where the medication simply “wears off”.

Genetics play a large part in how men lose their hair. Propecia slows it down for all ages of adult men. It sometimes grows hair back and even seems to halt it for some time, but in the long run it is a slow process.