Category: Drugs

Thanks for the great site. I have a new one for you. I’m 26 yo male taking the standard finasteride dose for hair loss under doctor supervision for about 18 months. None of the typical complaints.

About 6 months ago the distal tip of my foreskin began tightening with a white ring of inflexible tissue. This was recently diagnosed as ‘balanitis xerotica obliterans’ or BXO. A simple analogy is thinking of your soft eyelid skin losing its elasticity. Hardly comfortable.

I’m no hypochondriac looking to blame my condition on finasteride. I’m aware any connection is unlikely. I ask your opinion based on the following tidbit I stumbled across: “…[patients] have been found to have decreased serum levels of free testosterone, androstenedione, and dihydrotestosterone compared with control subjects. The underlying defect may be a problem with the function of the enzyme 5-alpha reductase.”

Perhaps you could take a look at the medical literature on my behalf? I will be seeing my regular doctor for this matter, but I thought you might be intrigued enough to add your educated thoughts. Thanks.

Thank you for the information. It is intriguing, but I’ve not had this complaint from any of my prescribing patients. I realize not all patients might be quick to tell me about all possible issues they have, but that’s all I have to go on.

I did search PubMed, but I couldn’t find a correlation between DHT reduction and penile foreskin. The penile issues involving DHT are mainly from when you were in your mother’s womb. For example, if your mother was taking high doses of finasteride or had a genetic defect in DHT production.

Hello Dr. Rassman and contributors,

I am almost positive that tretinoin increases hair growth, at least on the face. I have never had unibrow in my life but i can grow one in a week by applying tretinoin there, and it stops growing if i stop applying. My eyebrows can also grow higher and further along the temples when applied. I have done this many many times. I was thinking since tretinoin in part possibly works by preventing hyperkeritinization that hyperkeritinization could be synergetic in balding by allowing to DHT to “stay” longer in the follicle. Also I am very certain for me that it increases eyebrow growth, however I would be very skeptical, and would not try it on my head, are their different factors that influence hair growth on eyebrows vs scalp?

Thank You

I will assume that you are not experimenting on yourself because you are trying to grow a unibrow, but if you noticed that hair grew between your eyebrows when you used the medication, it makes sense that this could be a side effect. What else can I say?

Tretinoin (also known as Retin-A) has been said to cause hair loss for some people and grow hair for others.

Wanted to write you a note regarding my response to Propecia. I have read lots of replies in regard to this subject and after two months treatment myself wanted to contribute to your very professional blog. No side effects (does increased confidence and contentment count?) and have noticed very subtle changes thus far. My hair actually does feel stronger. Somehow my hairline feels firmer and more solid. It might not look vastly different but my mind is perceiving a more dense and full head of hair. I am no longer panicking about potential hair loss and this is a magnificent relief. I would say that so far my experience of propecia has been very good and appears to be a very successful ingredient in preserving my hair. Kind Regards

It is likely that some of your miniaturization is reversing and that makes you feel that your hair is stronger (thicker hair shafts approaching normal in some of your impacted hairs).

Thanks for sharing.

My question is about the use and effectiveness of topical finasteride. Are there any recent studies as to the effectiveness or safety of such a treatment? I have read both previous posts about “Xandrox Sales Stopped by the FDA”. From what I understand about the use of topical finasteride, it appears to me that the jury is still out and it is not so easy to dismiss altogether. Granted Dr. Lee may have had no “proven” scientific basis for claims about the effectiveness of his topical finasteride treatment, Xandrox, however that does not preclude its viability as a hairgrowth alternative to the popular propecia pill just because its effectiveness is simply not known.

Topical finasteride has already been studied. For example: 1997 JOURNAL Of DERMATOLOGICAL TREATMENT 8(3):189-192
mazzarella f; Loconsole f; Cammisa A; Mastrolonardo M; Vena GA.

The use of topical finasteride is also discussed at length in the original patent application for propecia by Merck:

[0033] For the treatment of androgenic alopecia including male pattern baldness, acne vulgaris, seborrhea, and female hirsutism, the 5.alpha.-reductase 2 inhibitor compounds may be administered in a pharmaceutical composition comprising the active compound in combination with a pharmaceutically acceptable carrier adapted for topical administration. Topical pharmaceutical compositions may be, e.g., in the form of a solution, cream, ointment, gel, lotion, shampoo or aerosol formulation adapted for application to the skin. Topical pharmaceutical compositions useful in the method of treatment of the present invention may include about 0.001% to 0.1% of the active compound in admixture with a pharmaceutically acceptable carrier.

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So the topical concept does not seem like some radical idea to me but rather more of a potentially common sense alternative. Is there some known fundamental chemical problem that prevents the drug effectiveness when it is administered topically? If not, I can see no reason to discount it. Am I wrong?

I understand the medication has not been FDA approved this way, but I don’t understand what could happen from topical use that could not already happen from taking a finasteride pill orally?

Drug delivery through the skin is not as simple as making a drug topical. I’m not a pharmacologist, and to be honest, I do not know more than you summarized for the readers.

Good doctors….I’ve written before and have had a couple of posts placed on your website. This is more of a story with comments.

I’m a 41 year old white male, who started to recede in college. I had a ceaser haircut in the early 1990’s that was popular at the time. I tried Rogaine in college when it was an RX and $130.00/three months. I tried snake oils, etc.

Finally, I started buzzing my hair all through my 20’s. I got tired of shaving my head and started growing it out. My hair was still quite thick, but had a more mature frontal hairline and the crown was thinning (by my late 20’s). I still had hair, but used Toppik, to help my confidence. So too with Rogaine 5%.

Eventually, in my late 30’s I discovered this site and started to educate myself. I switched to Rogaine foam and started Propecia in 2008. After about a year, there was/is a noticeable difference. My crown filled in. Areas that were completely skin, have hair. The hair itself is thicker (diameter) and my front hairline/forelock is incredibly strong and I can wear my hair up (think Joel McHale from “Community”….after his alleged transplant). I finally have good hair again. And I love it. I get compliments, and have massive confidence.

I was at Starbucks on Monday, and an older woman turned to me and said, “You have great hair. Most men would KILL for that.” I stopped, told her that she made my day. I jokingly said I spent a lot of money on my hair to look good (Rogaine, etc.). But it’s true. Moreover, with your suggestion, I shifted to the generic Finesteride for 4 bucks a month at Target. 4 bucks!!!!! Thank you!

So, to wind this up, I have better hair than I did in my 20’s. I have an actual style and love to look good. I’m an academic, and I get checked out by coeds all the time. This NEVER happened 10 years ago. Never.

So, to all the crybabies about Propecia, all I can say is quit whining. Quit acting like a woman and worrying. To those that say that male vanity is bad/doesn’t exist, I say, you’re nuts. It’s good to feel good about yourself.

Thanks, men. Keep up the good work.

Well, there you go. I’m glad to hear you’re successfully treating your hair loss, and wish you continued happiness. Thanks for writing in!