Category: Drugs

Snippet from the article:

Young men could be risking their sexual health by taking a commonly used anti-baldness drug, claim some doctors. They say finasteride, sold in the UK as Propecia, can cause serious side effects and isn’t adequately labelled.

A quarter of men in their 20s show signs of male pattern baldness, with six and a half million males in the UK affected. Propecia manufacturer Merck says it continually monitors the drug’s safety and has updated the label.

Read the full story at BBC — Baldness drug Propecia ‘risking men’s sexual health’

I always worry when a single case is put forth as a typical example of a problem. I do not doubt this young man could’ve seen some side effects, but I would think that this is a very rare example if it is true. I do doubt the long term impotence reported, however. Propecia has a half life of 4-5 hours, which means it is out of the blood stream in a day. Tissue fixation of the drug may last for up to a week, but by then, all of the effects of the drug should be gone. Unfortunately, the report gives us little insights into objective evidence for the ED that doctors would explore, such as nocturnal penile tumescence studies, to substantiate if the problem is real or psychological.

I’ve received a lot of emails about this article already, so I know it’s making the rounds. The problem for all those interested in finasteride is that these stories become viral on the internet, resulting in waves of panic for those considering the decision to take it. We each have choices in our lives, and the risks vs the value of such a drug is a decision each of us should make.

For what it’s worth, the young man in the article did say that the drug reduced his hair loss. I am not suggesting that it is worth losing your sexuality to keep your hair, but there may be more to this story than the article seems to want to point out. As I’ve mentioned before, one of my sons is on Propecia and his hair loss stopped (and even reversed a little) since he started to take it.

Dr.Rassman,

I just came across Allegran starting trials with Latisse on patients with moderate MPB.. [article].

What was interesting to note was, some doctors prescribe Latisse as an off-label treatment for hairloss? What do you think of that regimen? Have you given it a try? Would it be acceptable to try that on patients who are on Finasteride and are not too bald (say NW 5)?

I am aware of Latisse (bimatoprost), which is currently FDA approved for growing eyelashes, and I’ve seen one patient who took it upon himself to try it on the scalp with no success. The dose is quite small for eyelashes and it’s quite expensive for treating the scalp, and I’m not sure what dose would even be necessary for the scalp.

I am also aware that there’s a formal trial to find out if it works for scalp hair growth, but at this time the question of how effective it is remains. I guess we’ll have some sort of idea once they release their phase 1 results next year (which is a study of 28 patients).

Hello Doc, I have a question. I just got a new packet of Proscar from a known pharmacy. However, I’m thinking I’ve gotten fake Proscar. Does Proscar taste sweet? Because I cut the tablet into quarter and when I crushed part of it (due to bad cutting) and dissolved on my tongue it tasted sweet like it just a sugar tablet.

If its fake what should I do?? Thanks doc!!

There’s no taste chart for finasteride that I know of, and I’ve never chewed it, so I couldn’t tell you if it’s fake based on taste. I would always swallow my pills with a water chaser. Any readers have finasteride taste stories?

There’s a survey I just read about regarding pill color and perceived taste that you might find interesting — How Does The Color Of A Pill Affect Its Efficacy?.

Dr. Rassman, this is in regard to body hair and propecia.
I have been taking propecia for about 1 year now, and I definitely have more body hair. I even get a little hair growing around my ears which I did not have before and I have to trim my nasal hair frequently. The Hair on my arms, legs and chest is definitely longer. I am okay with it though (even though it is rather unusual for black people).

Propecia (finasteride 1mg) is taken for the treatment of male pattern baldness on the scalp. There aren’t official statements or side effect reports that indicate that Propecia affects body hair. I do hear on occasion that Propecia decreases body hair, and some of our readers have commented that they actually lost body hair from Propecia use. Your case would be the opposite.

If I had to make a guess, I would tend to think Propecia decreases body hair since it decreases DHT (dihydrotestosterone) levels. DHT is responsible for genetic hair loss in men with the genes that predispose them for balding, but DHT is also responsible for some of secondary male sex characteristics like the growth of body hair, nose hair, ear hair, etc. Thus, it makes sense that decreasing DHT will decrease body hair… but this seems to be an uncommon effect.

In a private communication with a doctor that will remain nameless, he told me he saw a set of identical twins, one on finasteride and the other not on the drug. The twin on finasteride had distinctly less body hair than the twin who wasn’t taking it. Not that this conclusively proves anything, since obviously your situation is the opposite and you’re seeing increased body hair growth, but it is food for thought.

I’ve been using Propecia for 10 years with good results. The company I order Propecia from forgot to send my order. As a result, I’ve gone three days without Propecia and will probably have to go another week or so without it (i.e., 10 days without it). Am I going to experience noticeable hair loss before I get my shipment of Propecia? I am so ticked off!

I wouldn’t expect any noticeable problems. Missing a few days (up to a week or so) should not have any detrimental effect with respect to your hair, because there is some tissue fixation of the drug that will help keep the benefits flowing for up to 10 days. It generally takes a few months of not taking Propecia to notice “catch-up” hair loss.

I’ve tried searching for this question i’m asking now, but i felt like i wanna get more of a detailed answer to satisfy my curiosity.

how much minoxidil i should apply at a time ? i don’t feel like 1ml is enough at all especially for people like me who have diffuse thinning…

(1) is this 1ml for the entire head (crown) or for each bald-spot ?
(2) I also have some thinning on the sides can i use extra 1ml for the sides and back together ?

basically i use a dropper but i don’t count how much of the solution i pump out. i just let a drip fall over each gap to get my entire head covered with the liquid eventually. is this a sound way to apply minoxidil ? thanks much …

1. Apply 1 mL total over the entire area twice daily, not 1 mL to each individual spot.

2. You can try, but using too much minoxidil could result in a drop in blood pressure, among other possible side effects. It’s a medication with potential side effects. You should be careful and read the instructions thoroughly before using it.

If you’ve got diffuse thinning all over your scalp (including the sides), perhaps you have something else going on. Typically, male pattern baldness does not result in hair loss on the sides of the head.