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Do I Skip Every 5th Day of a Quartered Proscar Tablet?

Hi,

I recently decided to see a doctor for my hair loss. I’m a 29 year old man and my doctor said the best thing was to start on finasteride and suggested that a prescription for generic proscar and splitting the tablets was the better way to go due to cost. I’m comfortable doing this but wanted to know the best way. Should I quarter the pills and then skip every 5th day or take 1.25 mg everyday?

Your prescribing doctor should have given dosage instructions. For my patients that cut the generic 5mg pill, I recommend they quarter the pill and take one piece daily. If you can cut it into 5 even pieces that would be ideal, but not likely done with ease. Skipping a day is not recommended.


2012-07-10 09:06:11Do I Skip Every 5th Day of a Quartered Proscar Tablet?

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Prostate Pain Same Day I Took My First Propecia Pill

Hi Doc,

I’ve been reading your blog on a fairly regular basis and have found it very informative. I’m almost 19 and my hairline has been creeping back since around my seventeenth birthday. At the moment I’m probably an nw2. My brother who is 21 would be considered nw4 if it wasn’t for a very fine scruff of hair in front.

Concerned that I was following suit with him, I decided to fill a prescription of propecia. The possible side effect were pretty unnerving but I figured it was my only real chance at keeping my hair.

I’ve read on your blog that the 1 mg dose does not affect the prostate but it definitely did in my case. The day I took the first pill, my prostate had sudden pains throughout the day. My semen also became water-like. I know this isn’t supposed to be a big issue, but it concerns me that it started happening right away and seems to me like another sign that it was affecting my prostate.

My question is where do I go from here? Have any of your patients had a similar experience? I recently started using a minox product but am unsure what to do as far as meds. Should I try a lower dosage of propecia? Would saw palmetto be worth trying?

Also, have any of your patients experienced results in the hairline from minoxidil alone?

Thanks for your work

First, how do you know what prostate pain feels like? I don’t imagine most men would be able to pinpoint which internal organ is hurting so quickly… particularly the prostate. Prostate pain generally ranges anywhere from lower back problems to urinary issues. Is that what you felt? Second, you had sudden pains after one dose? That strikes me as extremely odd. It’s worth noting that there are some rare reports of testicle issues after taking finasteride, but I haven’t heard of any case where this occurred on the same day that you took your first dose ever. I’d think it’s more likely that you psyched yourself up for side effects, as you said you were pretty unnerved about the medication before you even took it. You were expecting some negative reaction and you got it — this would also be known as the power of suggestion.

You need to get a good, solid diagnosis with the tests I have suggested (miniaturization mapping, hair bulk measurement) before you make the decision on taking finasteride for life. I hope your prescribing doctor gave your scalp a thorough examination before suggesting you take this medication. Now that you’re noting problems though, you should talk to your doctor about this. I’d get off the medication to see if the pain goes away. Remember, a good Master Plan is needed for every young man facing an uncertain future for hair loss.

As for minoxidil, that is an over the counter treatment and so long as you don’t become worried over potential side effects from that drug, it might be worth a try. It would be rare to see regrowth in the hairline from minoxidil or finasteride.


2011-02-18 14:11:01Prostate Pain Same Day I Took My First Propecia Pill

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Do you change to dutasteride if finasteride is not working well?

So im almost 11 months on fin,And my hair changed sooooo much , thining all over and actually getting quite big bald spot in the crown. I did buzzcut , and thank god my gf dosent hate it. Few days ago i went to one of the top dermatologist in my country to advice me what to do next. I explained to him that fin failed , and i keep losing alot . I suggest moving to dut and he warn me about it.

As I develop a relationship with my patients and if after my relationship shows that finasteride is not working, I may add dutasteride; however, as I develop a Personalized Master Plan with my patients, I fit the results of the drug into that plan and then work with the patient addressing each successive step.


2020-03-22 08:40:26Do you change to dutasteride if finasteride is not working well?

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Psoriasis Treatments to Keep It Under Control?

Dear Dr Rassman,

Firstly i would just like to thank you for providing such a constructive and educational forum for unbiased, informative hair loss advice. I work in a hair transplant clinic and never hesitate to refer patients to this site for additional information.

My question however is regarding a friend of mine who suffers from psoriasis, her scalp being the worst affected area. I felt compelled to seek your advice after seeing her in tears yesterday, fed up with the constant irritation and discomfort. She is nearly always scratching her scalp and is now experiencing noticeable thinning and loss in some areas.

Can you recommend any particular treatments to control the condition or at least alleviate the itching? She has seen numerous doctors and dermatologists but is yet to find anything that works.

Any advice would be greatly appreciated.

This is a standard dermatologic condition which any good dermatologist should be able to address. The best person to treat your friend’s psoriasis is her dermatologist, but as she’s having difficulty finding a treatment that works, I found a good list you can both review at the National Psoriasis Foundation site.


2008-10-21 15:27:34Psoriasis Treatments to Keep It Under Control?

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Quality of Shedding Hair

Doctor,

I’ve been searching this blog for some time and can’t find the answer to this everlasting question: Can the “quality” of the shedding hair tell anything about what’s happening with the hair loss? Does losing shorter, miniaturized hairs say that one is balding more rapidly than one who sheds healthy terminal hairs? I’m saying this because you diagnosed me with an early Norwood 3A pattern last year, and I have been on Propecia ever since. But it seems that the hair that I shed from the front is thick on the end, and thinner near the root. Does this indicate miniaturization or just the hair cycle?

I don’t think I’ve miniaturized further since you last saw me on October of 2007, but only a re-exam from you would tell.

Thank you for your time.

Clearly you should see me at about a year for your annual re-examination. The thick hairs you are shedding are most likely part of the normal cycling that we go through. We generally lose about 100 hairs/day and that it probably what you are seeing. It does not make sense to me that the hair thickness on the scalp side of the shed hair should be finer than the distal end. If you bring the hair into the office, I can measure it for you with a micrometer.


2008-08-04 14:34:44Quality of Shedding Hair

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Doctor recommended 10 sessions of PRP and I’m 22 years old.

The doctor recommended 10 sessions of PRP at $500/session. I would guess you might purchase a good used car for that $$ amount. So if you were shopping for a car, you would research it, right? Doubt that you will stop your hair loss with PRP and reversing it is another story! Some doctors are just not honorable. I can tell you that I would doubt that you would get much value from this PRP package.


2020-07-14 06:53:41Doctor recommended 10 sessions of PRP and I’m 22 years old.

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Questions about Finasteride

Thanks so much I really appreciate this.
So the questions are…
1. How common/rare is propecia in causing (a) prostate cancer, (b) breast cancer, (c) Gynecomastia, (d) infertility? Finasteride does not cause prostate cancer. There is a risk of Gynecomastia which is rare and infertility which is very rare.
2. By taking the propecia it is the a actual drug that is causing a cancer / tumor to appear? Or does it just mask a cancer / potential cancer? Finasteride may mask the PSA test by making it lower than it normally is, but it does not cause cancer, in fact, people who take finasteride have a lower risk of cancer by 25%.
3. How common are sexual side effects? Sexual side effects range between 2-4% depending upon which study you read.
4. Would my grandad having prostate cancer affect me taking propecia? Even if I’m 25. It will reduce your risk of prostate cancer by 25% over time. Cancer of the prostate is very very rare for any man under 50.
5. In your years of experience with the drug how many people have reported serious side effects? In my experience, all side effects, if they occur, are reversible and the frequency is about 2%.
6. Would you say the drug was safe? Yes
7. Can you drink alcohol on the drug? Yes
8. Can you lose muscle / gain fat due to the drug? And how likely? Unikely
It’s only because online there are so many stories which scary stories. I feel speaking with an experienced and knowledgeable doctor on the matter will put my mind at ease as you know what you are talking about with years of practice.


2019-07-01 11:48:02Questions about Finasteride

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Doctors Discouraged 19 Year Old From Using Propecia

Im a 19 year old male,and for the past year and especially the past 3 months my hair has thinned and receded almost an inch. Ive always been told i just have a large forhead so i shrugged it off, now im scared because i am afraid to go out without my hat on and i dont like this. Ive started rogaine but i feel like its gonna be pointless cause of how much ive already lost, im not ready to suck it up and shave my head yet. Both my docter and dermotoligist told me its just bad genes and i got male pattern baldness and discouraged propecia and vitamins. Ive died it 5 times in the last year, and i plan on dieing it again, because the darker color makes it seem as though i hav e more hair, both docters told me this doesnt affect it. Ive always had long hair and im not ready to lose it, am i to young for a hair transplant.

If you have genetic hair loss, you should be on Propecia, so I disagree with your doctors. Without a doctor / patient relationship, I can not make a diagnosis, but 19 is not too young for Propecia treatment in genetic male patterned balding. You need to have your hair mapped out for miniaturization to determine the diagnosis. You are clearly too young to think about hair transplants, particular without getting some doctor first to take care of your hair loss with appropriate medications.


2006-11-17 10:26:46Doctors Discouraged 19 Year Old From Using Propecia

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Rapunzel! Let Down Your Long, Golden Hair

How long can the human hair grow?

RapunzelI was once told a story about a beautiful princess (Rapunzel with golden hair, of course) who was imprisoned in a high tower for many, many, many years. Maybe someone will remember the fairy tale better than I, but to the best of my memory (I am now 64 years old) I seem to recall that she was saved by a prince who climbed up on her long hair to save her. There were missing pieces in the fairy tale that my age now brings into focus, like how she got food up there, possible toilet facilities, showering or general cleaning for many years (any prince who climbed up her long hair must have lost his ability to smell, for there were no perfumes in the story to hide what must have been a smelly lady). Sorry, I’ll focus on the original question…

The human hair growth cycle is believed to be between 2-7 years. As I have mentioned in the past, there are three phases to hair growth cycles, telogen (falling out), catagen (about to fall out) and anagen (the growth phase). Each individuals hair cycle is impacted by genetics, hormones, stress and any medications the person takes. You can imagine the difficulties of plotting the growth of individuals hair in different parts of the hair cycle and documenting the factors that address growth rates (impossible) so much of the research is either conjectural or taken from animal models that are not really compatible.

Now I remember my great grandmother (age 114) when I was a young man. On occasional Sundays, the granddaughters would take her hair out of a bun and wash it. I remember it went to the floor and beyond. There was great care in managing the hair wash. Now as a hair surgeon and expert in the hair field, I have to reconcile my memory of her hair with what I know about hair cycles. Could her hair be greater than 5 feet long. The answer I believe to this conundrum is that the hairs that fell out, weaved themselves into the remaining hairs (like dreadlocks) and that although the hair appeared to be greater than 5 feet long, had the granddaughters really brushed the hair when they washed it, most of that long hair would have come out simply because it was not attached at the root.

To really answer the Rapunzel story tale with academic precision, one would have to find a woman (men’s hair usually does not grow the length of women’s hair) who actually washed and brushed her hair so that all of the broken and loose hairs were brushed out. This would have to be on a few hundred women to make the data statistically significant. That would tell us how long a female hair can actually grow. The average hair grows at about ½ inch per month and for 7 years which means that the longest hairs should be no more than 42 inches (a bit over 1 meter) long. Can any of my readership tell me a ‘reality based’ Rapunzel type of story where the actual hair length exceeded 42 inches?

Now that was a bit long winded, but I guess I do get carried away with a form of ‘love’ for this growing baldingblog readership. Thanks for feeding this ‘young’ blog with your questions.