I Can’t Handle Propecia!

Hello Dr. Rassman,

This is without a doubt the best hair loss site on the web. I have learnt a lot over the last year or so. I really hope you can find the time to answer my questions.

I am 28 and have noticed that my hairline has receded on either side of the widows peak and even the widows peak looks thinner and see through now than it did 3-4 years ago (when I believe the changes started). I can feel my hair has thinned in a norwood 3a pattern although this is not noticable to others yet.

My question is regarding propecia. I have tried to take it but no matter how little a dose I tried I had the same side effects (low libido and erectile dysfunction). I tried 1mg daily, 0.5mg daily, 0.5mg every other day and 0.25mg daily but just could not adjust to it. What would be your suggestion for me and others in my situation as I would really like to try and combat the hair loss? I have been using minoxidil but is there anything else I can do as I really can’t handle propecia?

Also with regard to balding patterns you have said that the final balding patterns become evident for young men that start losing their hair early but as mine started at 24-25 when would you expect my final pattern to be evident as it is not obvious yet but I can only guess at a Norwood 3a as the hair still feels very thick past this point?

I would really appreciate if you could take the time to answer my questions. Thanks

Compliments will get you a long way with me, but not long enough to solve your Propecia (finasteride) problem. While I don’t know how long you were on the medication before each of your dosing changes, you could just be one of the men who just can’t tolerate even a small dose. Minoxidil is likely your only other option, aside from perhaps a hair transplant. You indicated that you’re in the UK, so I’d get yourself followed by a good doctor like Dr. Bessam Farjo, who is located in your area.

It’s really difficult to say when your final pattern would be evident without any real history to look back on. Unfortunately, I can’t give you any kind of realistic estimate on when your hair loss will stop.

Will Shaving My Head Bald Lead to Eventual Hair Loss?

Is it true that women that shave their legs all the time eventually will have less and less hair growing on their legs? What I’m getting at is, as a 23 year old man that shaves his head daily, if I decide in a few years to grow my hair out again am I going to run the risk of going bald from all the shaving? I’ve been shaving my head completely bald since I was a teenager and have no hair loss in my immediate family that I know of. And before I started shaving my head, I had no visible loss. I just want to know if I’m hurting my hair by shaving it off every morning.

Thanks!!!

These are old wives tales and have no truth to them. A similar myth is also shaving the head will make the hairs grow out thicker or fuller. False!


2011-12-16 15:17:55Will Shaving My Head Bald Lead to Eventual Hair Loss?

With dutasteride half life of 5 weeks, why take it daily?

What about dutasteride? Going by that logic and considering its half life, shouldn’t we gap duasteridet dosage to like once a week or once every 4 days or something? Thanks.

I agree that with a 5 week half life for dutasteride, a once a week dose should work.


2020-12-16 11:04:10With dutasteride half life of 5 weeks, why take it daily?

I Don’t Want to Take Propecia Until After I’m Married

i am a 24 yr old sikh male living in the uk. up until the age of 18 i had long uncut hair but then in 2003 i cut my hair. my hair has always been thin in texture from a young age. at first when i cut my hair it seemed to be quite thick on top and didnt seem to concern me too much. however after a few months of getting it cut i began to realise that a lot more of my scalp was visible, particularly in well lit areas.

so in following summer of 2004 i shaved my hair off completely in hope that it would grow back thicker which was really a waste of time. by summer 2005 i had realised that my scalp was a bit more visible than before so then i made the decision to start using rogaine. this seemed to work at good effect and by jan 2006 i had grown my hair a bit longer and had a new style cut. my hair appeared to be a lot better than before and a lot of people did notice. this however may have been due to the new style as well. but by summer 2007 i began to realise that my hair was appearing to be thinner again and i also noticed that at my crown the balding area had increased. the fact i have got a double crown does not help appearance either. so in late december 2007 i decided to switch rogaine for a private minoxidil 5% containing MPG. this too at first appeared to have made a slight improvement, and is a lot easier to apply than the rogaine. however by now in may 2008, i am still not to happy with the density of my hair. i went to a trichologist late last year, he advised me that i should not consider a hair transplant until i am least 25 and that i still have a bit too much hair for a HT. he advised me to take propecia, however i am scared of using the drug due to all the reported side effects. i would be willing to use the propecia, preferbly in a few years and after marriage! both my mother and fathers family have cases of hair loss, my father is bald apart from the hair on his back and sides. both my sisters have fine hair aswel, but they have a full head of hair.

i have seen pictures of hair transplants on patients who have diffused thinning and this would be my preferred method of sorting my hair out, however i am aware that i need to consider the long term instead of the short term. can you please give me some advice on what to do? thanks.

I don’t know what I can say that hasn’t already been said on this site —

I’m not sure I quite follow the logic about waiting until after marriage to start Propecia (finasteride 1mg). The side effects from Propecia occur in less than 2% of men and most claims you read about on the Internet are unsubstantiated. Without seeing your hair, I couldn’t tell you if you’re a transplant candidate, but if you’ve already seen a doctor and were told that surgery was not recommended, I’d listen to him. You could’ve very easily gone to someone that would’ve taken your money and performed a surgery on you just to appease you. I don’t know which doctor you went to, but by not doing surgery on you, he likely did you a favor. You are, of course, entitled to go to another doctor and I’m sure eventually you will find a surgeon that is more than willing to take your money.

See the following for more:

Woman Took Dutasteride and Got Acne

(female)

Hi Dr. Rassman! I have a quick question for you. While I found a combination of Rogaine, Diane 35 birth control, and 200 mg spironolactone just about completely reversed my AGA hair loss, I was stupid enough to begin taking Dutasteride (Avodart) which I ordered from the internet at a dose of 0.5mg/ every other day. The predictable shed started recently as is common, but what really got me was my skin started getting filled with pimples (I take pride in having good skin) and I decided it wasn’t worth it, since my hair had already become pretty good before I started it, and who knows if the acne would be temporary, or even get worse. I stopped it about 5 days ago.

Now I am wondering if you have any idea, even a vague one, as to when my hair will return to how it would have been pre-Dutasteride use, since I stopped using it during a hair shedding phase which was induced by the drug. (weeks/months/ever?)

Any ideas would be so helpful in helping me feel reassured. Thanks so much for your time.

I hate to use you as an example, but this is exactly why you should not treat yourself with prescription drugs bought via the Internet. I can’t say this enough — you should not be self-treating your medical issues and you certainly should not be purchasing prescription medication without a physician’s prescription.

Unfortunately, I do not know anything about you to even begin assessing your medical issues. Sorry. You really need to see a doctor for an in-person examination. I realize the Internet is an easy way to try to diagnose and treat yourself, but you could be doing more harm than good.

Dutasteride (Avodart) is not recommended for women and it may have unforeseen long term side effects. I was able to find a forum where a woman took dutasteride and had a similar side effect that you had (acne breakout)… but beyond that, I really don’t know what it would do for treating female hair loss.


2012-03-20 21:12:45Woman Took Dutasteride and Got Acne

I Got a Year of Finasteride for 16 Bucks at Costco!

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).

Women vs men wearing wigs

Why are women wigs way more accepted by society and look way better and real than men wigs ?? It’s also much more expensive for a guy to wear a wig rather than a girl . And 90% of men systems look fake

Wigs are very common in African American women because if they have kinky hair, they can’t style it like the fashion models do. The same is for other women who can more easily through on wig for a night out rather than go to the salon to have their hair fixed up.

Men don’t have that luxury to change their hair on the ‘drop of a hat’ and when they wear a hair system, most men have their head shaved, with the wigs fixed on by glues so that they can’t just come off and switch a style.

I Had a Bottle Busted On My Head and Want the Scar Removed!

Hello. I had busted my head from a starbucks cappuccino bottle(Please don’t ask how It’s a personal issue..) And I was bleeding harshly from my head so my parents wrapped my head with some bandage really tight and put some healing glue over the scar. In like a week in a half it healed and the glue came off like a scab and I was left with a very smooth scar on the back of my head near the root of my head about the size of a quarter, the top part of your pointer finger(the first line part and up cant explain it good). I know hair isn’t growing back because its been three years.

I want to have the scar removed from my head, the surgery is they cut it out then sew your scalp back together and your left with a lined scar that is barely visible when hair is grown a little. I do NOT want hair transplant please don’t give me information about it. Please explain as much as you can about the “scar removal” surgery I have in mind and also a cost for this.

What I would like to have is have a surgeon cut out the scar since its a little smaller than a quarter and stitch the scalp back together leaving me with just a tiny thin line scar that would be. No wider that the original sizer of the sizer or length. Also since I am african american, I want to cut my hair down low to about a 2 but I can’t cause of this baldspot, my dad is willing to try surgery but not until its reasonable. Remember it is about the size of a quarter which is very small compared to others.

Thank you please help me with my problem. Also the color of the scar is about my skin color maybe even a bit darker, I have black indian hair so a big brown baldspot sticks out. Please fill me in with everything you possibly can.

Scar removal from the scalp sometimes works well… and sometime doesn’t work well. That depends upon:

  1. Your healing abilities
  2. The location of the scar
  3. The direction of the excision scar
  4. The surgical technique used

I would have to see your scars to determine what I would do. From what you described here, I am at a loss. You need to see a cosmetic surgeon with experience in scar revision.

Would 0.25mg Finasteride Be More Effective than Saw Palmetto?

Hi Doc,

I’m a 26 year old male with a fairly aggresive NW4 developing, and need to do something to stabilize this before going for a HT next year.

I’ve grown pretty scared of finasteride side effects through the experience of a good friend who unfortunately suffered some of the psychological sides we’ve all been reading about online.

Question is, would a 1/4 dose (0.25mg) finasteride still be more effective for someone in my position than the full (320mg) recommended dose of saw palmetto? I’ve tried the latter before with no side effects, but didn’t stay on it long enough to evaluate the results.

Thanks doc and keep up the excellent work!

Propecia is finasteride in 1mg strength that you take daily for genetic male pattern (androgenic) hair loss. It’s been indicated that 0.5 mg finasteride daily is about 70 to 80% as effective as the full 1mg dose. I suppose you can infer how a 0.25mg dose may help. But in general if you are going to take a drug, you should take it as directed and speak with your doctor about all these issues. With saw palmetto, you really do not know the dose of the effective ingredients as they vary per manufacturer. Add to that the knowledge that saw palmetto has never been proven to work on hair reliably with a good scientific study.

My final point is that if you are going to read the issues of Propecia on the Internet and scare yourself with unsubstantiated reports without even seeing a doctor, the chances are you will likely have a side effect from the sheer psychological impact.