Category: Drugs

if my son takes propecia at age 18 and there is a history of hair loss in my family, will this ensure he will never lose his hair? if so then why wouldn’t all people take it at age 18? why would prince william allow his hair to fall out if all he had to do was take a pill a day to save all the embarrassment he has had to endure now. thanks

Taking a drug on the possibility of hair loss does not make sense to me. Your son can be checked out for hair loss with some simple office tests (miniaturization and/or bulk analysis). Even if he will eventually lose hair, by taking Propecia now, it doesn’t guarantee that he will not lose hair eventually, as the drug is not 100% effective at stopping hair loss. I get that people want to be proactive, but if there is no genetic hair loss seen, there is no reason to take medication to treat it.

As far as Prince William, he can address his hair loss if it bothers him. I haven’t spoken to the Prince lately (or ever), but it’s possible that he doesn’t care.

Can finasteride interfere with a young man’s development of secondary sex characteristics, such as facial and body hair?

I ask because I have been taking finasteride for early onset MPB for about two years now, starting when I was 21 (and still in puberty), and have noticed that I still lag far behind my peers in terms of facial and body hair. Also, temperamentally, I am prone to anxiety and depression, and my personality is marked by many “feminine” qualities. I assume that all these things are largely genetic, but I wonder if the lack of DHT in my body could have anything to do with it. By taking this drug, have I prolonged my adolescence?

I hardly doubt finasteride would interfere with the development of facial or body hair, or the prolonging of your adolescence. You should’ve been done with puberty years ago. Your secondary sex characteristics are most likely genetic, like the hair loss.

Hi i have a question. I just started taking propecia and I have started using rogaine for a week. My question is can I quit rogaine and just take propecia before i become committed to taking rogaine every day?

Sure. If you just started using Rogaine (minoxidil) a week ago, you haven’t seen any benefits from it yet. Stopping it now shouldn’t be a problem.

Hello,
I’m in my mid 20s and considering using finasteride. Out on the internet, there are of course plenty of people reporting side effects. One I’m worried about is weight gain-as an athlete a gain in fat would directly impact my performance. Is weight-gain a side that occurs in a relatively small number of users, such as the other sides? Or are a large percentage of people seeing this weight gain? Is it possible as a young, athletic person I have little to worry about here, or could I actually have more to worry about with regards to weight gain? I’m ready to start finasteride immediately but this is the last worry on my mind.

If you are ready to start finasteride, then you must be in contact with a medical doctor since it is a prescription medication, so please address these concerns with your doctor.

Of all the potential side effects associated with finasteride, I do not think weight gain is even on the top ten list. In the grand scheme of things, ALL drugs have side effects. Before starting any medications you and your doctors should consider all the risks and the beneits, and lay out a clear Master Plan.

Doctor Rassman, I am sure you get this questioned asked alot, but in your opinion as a hair restoration expert, do you think by adding 0.5 mg avodart once a week to a every 1 mg propecia regimen can make a difference in loss of hair or even gain?

There was a study of a an individual who took one avodart pill once a week to a propecia everyday regimen and he saw substantial growth. The study was only on one person, but its not a conicidence that it happened when he added the low dose of avodart once a week? or do you think avodart and finasteride at the end of the day still produce the same outcome? I know at the 2.5mg it produces the best results, put more of a high side affect profile, and very expensive.

Both Avodart (dutasteride) and Propecia (finasteride) work in a similar mechanism by blocking the formation of DHT, but I have often stated that treating androgenic alopecia is not only about blocking DHT. I do not believe if you block DHT 100% you will stop or reverse the balding process.

I’m not sure which study you’re referring to, but if it was an anecdotal report on ONE patient, it isn’t something I would put a lot of stock into. Please note that just because there is study results available, it doesn’t necessarily make it the golden truth. Now with that said, many doctors believe Avodart is a better medication for stopping hair loss than Propecia, but I am concerned about sexual side effects and the few reports of sterility that came from Avodart.

A few patients that I treated with Avodart did get a response after Propecia stopped working as well for them. That is as much as I know. I couldn’t tell you if adding a single Avodart dose per week will make a difference, though.

Sometimes I take Propecia right when I wake up, other times I take it at the end of my morning routine (shower, shave, etc). There have been times where I might’ve taken two tablets in the same morning, since I had forgotten whether I took it already. That has made me wonder, is taking two tablets of Propecia in one day dangerous? I try not to do it on purpose, but I figured it was better to have two tablets than no tablet.

Taking two Propecia (finasteride 1mg) tablets by mistake is not dangerous. Some men take five times the Propecia dose for prostate conditions (5mg finasteride is Proscar).

You should NOT be taking more on purpose, because it will not do much with respect to hair loss/growth. One Propecia taken daily is the recommended dose for the treatment of male pattern baldness. If you happen to take two by mistake, you’re not likely to see problems… but it should be noted that the more drug you take over the recommended does, the higher incidence of sexual and other side effects.

Hello Dr. Rassman,

Had yet another question about finasteride. I have been using it for a year now, and am quite sure have not progressed (with hairloss) any further, so it has worked quite well in that regard.

Question is this. In your practice have you heard or seen reports from patients who complained of severe tiredness, lethargy due to the use of this medication. Strange thing is that the horror stories they talk about in regards to libido etc. I have not experienced any of those in these 12 months (fingers crosses), in fact I feel I have a higher libido…its strange

The one side effect I feel I am noticing, is this nagging feeling of tiredness lethargy, and a blue sort of mood. I wouldnt say its depression its just an alteration of mood. Its quite annoying, and then you see these reports about suicidal ideation with finasterdie usage … worries me. Just dont know what to do, the pill is doing really good for my hair, but these side effects are quite annoying. Nothing sexual, thats all great, but just a strange nagging feeling of tiredness, lethargy and depressive moods. Comes and goes. And this doesnt seem to be in my head, since I am not going through something too major in my life, or a very stressful time.

Anyways I will definetely discuss this with my doctor, but just wanted to know what your opinion on the above matter is, and if in fact you hear such reports from your own patients…thanks in advance

You have the right idea about discussing this with your doctor. There have been reports where patients (mostly from websites) refer to “fogginess” and symptoms like depression in people on finasteride. In my private practice over the last 10 years with thousands of patients on Propecia (finasteride), including myself and my son, the complaints of mood alteration is probably around 10 people. The complaints of sexual issues in my experience has been around 1 to 2 percent, which correlate with the reported incidence.

It is also interesting to note from my experience, that for those who have been very worried (scared) to take Propecia due to all the materials they have found on the Internet, and eventually did go on to take Propecia, almost all of them ended up with the negative side effect. I do not mean to discount any real and physical conditions, but there is also something to be said about the power of the mind.

Finally, I have seen many patients who were very depressed with other psychological issues, but those patients were not on Propecia / finasteride. I am not sure if there is a clear link, but it is something you need to speak to your doctor about.

Dr Rassman,

I’m 30 and although I have been losing hair since my early 20s, it’s only after I got my hair cut very short recently that it hit me how much I am balding (I am somewhere between Norwood 2 and 3).

Like many men, I find it very difficult to accept and it is causing me a great deal of stress. However I have decided to act on it before it’s too late, and so I am taking Propecia as of today. I am also using Rogaine foam 5% and although it seems to reduce the hairloss, I wonder if I should stop now that I’m taking Propecia.

In several of your posts, you suggest that Propecia works best for men in their 20s, and also that the number of years between the start of the hairloss and taking Propecia affects the results.

Does this mean that I should not expect great results from Propecia, being in my early 30s and having waited nearly 10 years?

Thank you for your excellent blog!

The results will depend upon how much miniaturization you have in the remaining hair. Propecia works well for early miniaturization, which is what men in their 20s have. It still works in men of your age, providing that you have not lost the hair and are presently bald. Propecia does not work well for areas of complete balding, but on occasion, minoxidil may bring out hair were minimal hair is present. I can not advise you without seeing your photos and establishing at least a telephone consultation with me.