Female treated with finasteride and minoxidil (photo)

This is a young woman who was started on finasteride one year ago and minoxidil 3 months ago. The change is dramatic. Of great concern is the possibility of pregnancy while on finasteride which she must avoid or develop a child with possibly sexual identification problems.


2021-05-12 08:34:12Female treated with finasteride and minoxidil (photo)

Since I’m Terrified About What I Read Online, I’m Going to Take 0.25mg Propecia Twice a Week

I am a 22 year old male who has had thinning hair for almost 5 years and have got to a point where my quality of life has deteriorated, due to this I decided to take the plunge with propecia.I took my first dose of propecia yesterday at 0.25 mg and plan to take this twice a week, every Tuesday and Saturday, having read about success with this regime.

I know propecia only has a half life of 8-12 hours but it takes the body around a week to start creating the enzyme that creates DHT in the body and studies show that 0.25-0.5 mg has up to 80% success of 1.0 – 5.0mg. This is because I’m terrified of sides on propecia and also I would not be comfortable taking any medication every day of my life. I just wondered what you think of this regime?

When the Propecia (finasteride) studies were performed that eventually led to the medication’s FDA approval, various doses were tried. The 1mg dose gave the most consistent results for treating hair loss. Above the 1mg daily dose, the results were no better than the 1mg daily dose; however, below the 1mg dose, it was found to be less effective. In your case with taking a 1/4 dose only twice a week, the medication will be out of your system for days at a time, so the benefits might be fairly limited.

The side effects you are concerned about may happen, but statistically it is a small risk; however, I have found that the risk of sexual side effects increases in those young men who obsess over the possibility of having side effects, somewhat talking themselves into it. It is your call, of course.

Sleeping with Products in Hair

Does it hurt to sleep with Toppik and hair spray on your hair or should they be washed out each night?

I do not believe that sleeping with Toppik and hair spray would cause further hair loss. The Toppik will probably get on your pillows and make a mess if it comes off.


2006-02-03 08:46:50Sleeping with Products in Hair

Finasteride after transplants?

For the post-op users that did the fue transplant and were prescribed finasteride, is the prescription supposed to be taken forever or just for a few month? I am 90% on board and about to book but I’m hesitant bc I don’t want to take a pill forever and I was reading about the side effects and I that pushes me away from it. I know the answer is probably on here but I want to hear from actual, firsthand users.

Thanks for your replies in advance.

If you don’t get sexual or other side effects, then since genetic hair loss is progressive, I generally advise patients to stay on it for life. It has the advantage when you are older, of reducing the risk of prostate cancer by 25% in addition to slowing down the hair loss that is almost always progressive.


2020-12-07 11:03:10Finasteride after transplants?

SMP for High Contrast Scalp and Hair

Dr. Rassman,

For patients who have high contrast scalp and hair (ie. dark hair and fair skin). Wouldn’t a combination of SMP and surgery help minimize some of that contrast and maybe achieve a more fuller look?

Yes! It would be advantageous to complement the scalp micro-pigmentation (SMP) with a hair transplant for a full and realistic (3-dimensional) look. No one treatment is perfect. Hair transplantation can never give you the complete fullness you once had, since it is just rearranging what you currently have. But hair transplants can give you a good hairline, adequate coverage, and even almost normal densities if the area covered is small.

SMP can give you the look of fullness but it will not be real hair, since it is like using concealers (think DermMatch or Toppik) but without the daily applications because it is permanent.

Finasteride and minoxidil 3 months (Photo)

Finasteride and minoxidil have been used for 3 months with good results; however, this man has not shown comparable photos so it makes the case less compelling


2020-11-02 10:26:38Finasteride and minoxidil 3 months (Photo)

So, if I replace my receding hairline, what happens in another 5-10 years when I continue to recede? Answer: A Master Plan with a good doctor who measures your Hair Bank!

I have been doing hair transplants for 29 years and started off doing Follicular Unit Transplants (which I pioneered) with large sessions of follicular units rather than the old type of plugs as well as FUE which I started doing in the mid-1990s. I first published the idea that a Master Plan is critical for every person and it must take into account the limited hair in the donor area. I discussed looking at the donor area as a bank account, but rather than money, it is hair in that account. The unique thing about a donor area bank account is that there are never deposits, only withdrawals. So the doctor MUST ALWAYS document how much hair is in the ‘donor bank’ and with each withdrawal, he must plan to leave enough to satisfy the patients initial needs and his long term needs as more hair is ALWAYS lost over time. I have transplanted patients over the 29 years, keeping up with the progressive balding process to keep them hairy. I have always been honest if compromises are necessary. Today, too many doctors think short-term because it is better for them financially if they move a lot of ‘bank hair’ out earlier. Also, the patient frequently thinks short term, and doesn’t appreciate the problems he may run into in the future. But the doctors who want to get your money now are not the doctors you want. Always be sure that your doctor talks about your donor supply (bank) as he depletes it with FUE or FUT because you know what is going to happen WHEN you lose more hair in the future (a guarantee so read this: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/). Here is an example of one of many of my patients who have stayed ‘hairy’ despite continued hair loss: https://baldingblog.com/norwood-class-7-pattern-patient-received-11000-grafts-plus-smp/

Finasteride and the Swedish Medical Products Agency

This is continued from my response an hour ago about finasteride and the Swedish Medical Products Agency (MPA). The question was:

What is your opinion about the Swedish Medical Products Agency 2008 study that supports permanent side effects from the use of finasteride?

As I said in my earlier response, “If you believe in the study, do not use Propecia. Many of the reports that I read are on bulletin boards which are suspicious.

What that boils down to is that I’m not going to try to convince people to use a medication if they’re already so convinced it’ll do them harm. I’m not a sales rep and it isn’t my job to make guarantees about medications or provide incentives for you to take it. It’s an elective medication. You don’t have to take it if you don’t want to. If you’d rather believe message boards than published reports in medical journals, then by all means that is your choice to make.

But I’ll elaborate more with some interesting tidbits from the Swedish Medical Products Agency (sources: here and here). Some key points I found:

  1. In clinical studies, single doses of finasteride up to 400 mg and multiple doses of finasteride up to 80 mg/day for three months (n=71) did not result in dose-related undesirable effects.
  2. Drug-related sexual undesirable effects were more common in the finasteride-treated men than the placebo-treated men, with frequencies during the first 12 months of 3.8% vs 2.1%, respectively. This means 3.8% of men taking Propecia had undesirable sexual effects and 2.1% men taking a fake sugar pill had undesirable sexual effects. The incidence of these effects decreased to 0.6% in finasteride-treated men over the following four years. Approximately 1% of men in each treatment group discontinued due to drug related sexual adverse experiences in the first 12 months, and the incidence declined thereafter.
  3. People that are up in arms about the Agency listing “persistent difficulty having an erection after discontinuation of treatment” as a possible side effect should also realize this is listed under the “frequency unknown” section. In other words, they received complaints about it (how many hasn’t been established), but it is not a proven effect.

“Something I hate about the hair market” from Reddit

Every once in a while, once a month, I simply search “hairloss treatments” to see if anything new happened, or maybe a new treatment, but all I get is recent articles like “does ___ cause hairloss?” “can vitamins help with hairloss?” “can saw palmetto halt hairloss?” Bull**** articles like these make me pissed off, not because of the articles themselves, but because they are repetitive articles that i see every month when I search this shit. What happened to Breezula? WAY-1001? Guess we’ll never have a good safe, non-fearing treatment. Guess everything comes with a price.

Back in the 1980s, there was a ‘product’ called the Helsinki Hair Growth Forumlae that may have been the first modern product claimed for the hair growth pitch to hit the US market for magic hair growth cures. As the first, it sold like ‘hotcakes’ and it took more than 10 years for it to lose its unique market position because the FDA dinged them for claims that could not be proven. I look them up, and they are still selling hair products, just no magic claims.
If you look at newspaper in the late 1800s and early 1900s, you will see a lot of products selling cures for hair loss like magnetic hats that you wear at home. People never liked the idea of being bald so they easily reached out to anything that was offered. Today, with the internet, we have the ability to discern the difference between fact and fiction, but many people have realities that they want to believe and will often buy into anything that sounds ‘reasonable’ with low risk and possibly low cost solutions for hair loss.
There are now many doctors who have become the salesmen for sometimes shady cures, but because they wear a white coat, or have the MD after their name, they become believable. I have to be careful how much I say about the doctors who are making promises that they can’t deliver on but I can tell you, the readership, ‘Let the Buyer Beware’ as there is no fast, cheap fix for hair loss that I know of.


2019-12-16 09:08:35“Something I hate about the hair market” from Reddit